Research Critiques and PICOT Statement Final Draft Essay Paper

Research Critiques and PICOT Statement Final Draft Essay Paper

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor. The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study). Research Critiques In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions. The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question. Refer to "Research Critiques and PICOT Guidelines - Final Draft." Questions under each heading should be addressed as a narrative in the structure of a formal paper. Proposed Evidence-Based Practice Change Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes. General Requirements Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Cardiopulmonary resuscitation (CPR) is required for all nurses and is an essential aspect of nursing education since nurses are typically the ones who find the victims of cardiac arrests in hospitals. It has been extensively established that medical and nursing staff members have insufficient skills and knowledge recall after receiving cardiopulmonary resuscitation training. A further recommendation from the International Liaison Committee on Resuscitation (ILCOR) was to transition from instructor-driven task-focused training to high-fidelity simulations that included team leadership abilities. As a technique of training that includes adult learning theory, real-time clinical scenarios, and debriefing of the scenario, a high-fidelity simulation is receiving greater prominence in the healthcare industry. It provides healthcare professionals with a chance to exercise their expertise and assess their achievements Research Critiques and PICOT Statement Final Draft Essay Paper.

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Background

When patients are in the intensive or acute care settings of health facilities, they may face life-threatening incidents. In order to rescue patients, resuscitation measures must be made by healthcare providers. Resuscitation efforts can fail owing to a range of factors, such as lack of skills, confidence, knowledge, and expertise on the part of the personnel. Communication breakdowns during cardiac arrests and codes are a big issue of concern in our healthcare organization. This study explores a nursing practice issue that occurs during cardiac arrests or as a result of inadequate and inefficient communication amongst clinicians.

Patients' safety is jeopardized due to poor communication among resuscitation staff, Since the staff could be lacking crucial information, misunderstand information, follow confusing directives, and disregard changes in the client's condition, a client is at risk for adverse outcomes. Communication breakdown also raises the risk of medical mistakes. Patients are susceptible to traumas and sudden fatalities as a result of medical mistakes that may have been avoided if the personnel had communicated more efficiently. The role of nurses in resuscitation efforts varies depending on the care setting. Since nurses are more involved with patients, high-fidelity CPR simulation techniques have a greater impact on patient outcomes (Aqel & Ahmad, 2017). Frequent high-fidelity clinical simulations will be used in this study to examine their impact on the ability of nurses to manage cardiac arrests.

As such, the PICOT question is: In adults in intensive care environment (P), does a frequent high fidelity clinical simulation (I), compared to once or no clinical simulation in a year (C), help nurses manage cardiac arrest effectively (O), in one month (T)Research Critiques and PICOT Statement Final Draft Essay Paper.

The study in question used two qualitative and two quantitative research articles to answer the PICOT question. The first article “Integrating the Electronic Health Record into high-fidelity interprofessional intensive care unit simulations” by Gold et al. (2015) proposes the integration of electronic health records into high-fidelity interprofessional intensive care unit simulations in order to minimize patient safety risks. The second article “Implementing an in Situ Mock Code Quality Improvement Program” by Herbers & Heaser (2016), endorses in situ mock codes as a highly efficient manner to offer hands-on exercise and enable personnel to work collaboratively. The authors of the article also highlight the need for improved communication and training among medical practitioners. The evolving healthcare system necessitates retraining and refresher courses for all healthcare workers in order for them to remain productive in the fields in which they work, regardless of their level of experience Research Critiques and PICOT Statement Final Draft Essay Paper.

It is necessary to examine whether or not training can be used to increase the value of the outcome delivered by healthcare providers. This is due to the fact that when a practice gap or shortcoming is identified in the way healthcare practitioners provide help in situations like CPR, the utilization of training and simulations may enhance the responsiveness and efficiency of the staff in subsequent circumstances. In two quantitative research articles, "Effect of a Pediatric Mock Code Simulation Program on Resuscitation Skills and Team Performance" by Hazwani et al. (2020), and "Timely Recognition of Ventricular Fibrillation and Initiation of Cardiopulmonary Resuscitation by Intensive Care Unit Nurses" by Vincelette et al. (2019), it is demonstrated that this is true (2018). In the article by Hazwani et al. (2020), in situ code simulation is proposed as a useful tool to improve team performance and the quality of cardiac resuscitation. On the other hand, Vincelette et al. (2018) propose that proper training of nurses through simulations be provided so that they can recognize ventricular fibrillation and the need for immediate defibrillation.

The interventions described in the publications are consistent with the one I proposed in the PICOT question. As a means of narrowing the practice gap, they unanimously advised that simulation be used. In this simulation, medical personnel would be put into mock settings in which they would have to deal with a patient that required immediate healthcare (Fauquet-Alekhine & Pehuet, 2015). Trainers would identify areas of weakness and progress in this kind of simulation, and the professionals may use the knowledge gained from these simulations to enhance their performance in future simulations.

Applicability of the Articles in Solving the PICOT Question

The articles emphasize the importance of training and effective communication, which have been identified as a concern for healthcare personnel, particularly in the case of cardiac arrests. Patients' health may worsen as a result of a lack of good communication between members of the medical team. This is because the members of the team are not clear on the various tasks they each have to perform in order to manage the patients under consideration (Herbers & Heaser, 2016). As a result, increased training of team members in hospital environments is required in order for them to acquire good communication abilities, which will benefit them in their pursuit of delivering quality healthcare. Improvements in communication will guarantee that the practitioners will work together more effectively, allowing them to perform their various tasks and provide the desired results in the long term (Herbers & Heaser, 2016)Research Critiques and PICOT Statement Final Draft Essay Paper.

The articles also acknowledge the value of healthcare technology in improving the outcomes of healthcare-related operations that are carried out. Healthcare providers will be able to better serve their patients with the help of modern technology (Gold et al., 2015). Specifically, this will be accomplished via the swift communications that will take place between healthcare providers and patients, as well as the better communication that will take place among practitioners both inside and outside the healthcare facility (Gold et al., 2015). Training is required for practitioners in order for them to effectively utilize the technology that will enhance their communication. This will help them to be adequately prepared to deal with the many problems that may arise and to get the best possible results from the undertakings that they are involved in.

As an additional point of emphasis, the articles advocate for training to increase the overall quality of the performance of medical personnel. It was suggested in the publications that training and simulations be used to enhance the responsiveness and productivity of teams in emergency cases like CPR (Eyikara & Baykara, 2017). Considering the increase in efficiency seen throughout the simulation training, it is clear that the utilization of training will enhance the teams' efficiency in the long term (Eyikara & Baykara, 2017). Additionally, the articles advocate for the use of collaboration as a solution for the adverse outcomes that have been encountered, stating that allocating diverse responsibilities in such circumstances would result in better results.

Methods of Study

Simulations were employed in the two qualitative studies. The first research included the deployment of an ICU simulation that was primarily centered on sepsis resuscitation, in which a group of clinical personnel would be needed to care for a 60-year-old client who had been moved into their ICU by emergency services (Gold et al., 2015). Professionals were compelled to utilize electronic health record systems to assess patients, make prescription orders, order diagnostics, and seek testing results, all while using the same electronic health record system. The ability to identify their areas of strengths and weaknesses when utilizing EHR and propose recommendations that would improve their situation was made possible in this manner. The other simulation was created in order to enable nurses who are engaged in clinical emergencies to have more confidence in their abilities (Herbers & Heaser, 2016). A two-year response time was used as a benchmark for assessing the degree of confidence. Improvements in confidence levels were projected to lead to a reduction in response times, which would enhance the overall efficiency of emergency services provided to their clients Research Critiques and PICOT Statement Final Draft Essay Paper.

For the two quantitative articles, the collection and analysis of relevant figures and facts pertaining to the simulations was the main focus. Examples include the time it took for clinicians to commence emergency operations like defibrillation and the length of time it took them to seek medical assistance. In order to establish whether or not there was a performance improvement after the interventions were implemented, the prior and subsequent performance of the people were compared.

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Results of the Study

The studies revealed that nurses need training in order to enhance the efficiency of services provided to their patients. As a result of the training, it will be simpler for them to recognize their weak points and make improvements in those areas, therefore increasing the overall quality of care that clients get (Gold et al., 2015). Also emphasized is the critical role that communication plays in society, both physically and via the use of technological tools that are readily accessible nowadays. Improvements in team performance in the delivery of healthcare are made possible by technological advancements because coordination and collaboration are greatly enhanced (Herbers & Heaser, 2016).

Healthcare practitioners' performance can only be improved if they are well trained, according to the research articles. Because the professionals who participated in these simulations performed better, the results of the studies demonstrate the value of training. Training also has a direct impact on the confidence of professionals, who become more collected and capable of carrying out their tasks despite the high-pressure levels they are subjected to as a result of their training (Hazwani et al., 2020).

Outcomes and comparisons

I projected that frequent simulation training for medical practitioners would lead to a greater likelihood of them being more knowledgeable in managing various emergency situations that they would encounter, particularly the care of cardiac arrests. Using simulation training as a response to the adverse health impacts that have been seen in the past while dealing with patients undergoing emergency situations like cardiac arrest, the PICOT question proposes a new approach to the problem. Because of this, it is anticipated that properly training the individuals who will be engaged in dealing with these types of situations would lead to favorable results in the future.

Ethical Considerations

Prior to performing research, researchers must guarantee that their research complies with the ethical considerations established by the board responsible for undertaking research. When conducting research, the most important ethical aspects to keep in mind are informed consent, beneficence, and non-maleficence, as well as maintaining the confidentiality and anonymity of participants. Researchers ensured that their studies were beneficent to the impacted community in the course of performing their research. They did this by ensuring that their investigations resulted in positive outcomes for the participants. When it came to publishing the results of the research, it was important to maintain confidentiality and privacy so that the name of the subjects could not be exposed. Also noteworthy is the fact that participants in the research were not coerced into participating; rather, they were told about the study and gave their participation voluntarily. The ethical clearance for the research was given by the appropriate authorities in each of the areas where the studies were conducted. Accordingly, it can be stated that the researches were conducted in an ethical manner Research Critiques and PICOT Statement Final Draft Essay Paper.

References

Aqel, A. A., & Ahmad, M. M. (2017). High-fidelity simulation effects on CPR knowledge, skills, acquisition, and retention in nursing students. Worldviews on Evidence-Based Nursing, 11(6), 394-400. https://doi.org/10.1111/wvn.12063

Gold, J. A., Tutsch, A. S., Gorsuch, A., & Mohan, V. (2015). Integrating the electronic health record into high-fidelity interprofessional intensive care unit simulations. Journal of Interprofessional Care, 29(6), 562-563. https://doi.org/10.3109/13561820.2015.1063482

Herbers, M. D., & Heaser, J. A. (2016). Implementing an in situ Mock code quality improvement program. American Journal of Critical Care, 25(5), 393-399. https://doi.org/10.4037/ajcc2016583

Eyikara, E., & Baykara, Z. G. (2017). The importance of simulation in nursing education. World Journal on Educational Technology: Current Issues, 9(1), 02-07. https://un-pub.eu/ojs/index.php/wjet/article/view/543

Fauquet-Alekhine, P., & Pehuet, N. (2015). Conclusion. Simulation Training: Fundamentals and Applications, 137-139. https://doi.org/10.1007/978-3-319-19914-6_7

Hazwani, T. R., Harder, N., Shaheen, N. A., Al Hassan, Z., Antar, M., Alshehri, A., Alali, H., & Kazzaz, Y. M. (2020). Effect of a pediatric Mock code simulation program on resuscitation skills and team performance. Clinical Simulation in Nursing, 44, 42-49. https://doi.org/10.1016/j.ecns.2020.01.004

Vincelette, C., Quiroz-Martinez, H., Fortin, O., & Lavoie, S. (2018). Timely recognition of ventricular fibrillation and initiation of cardiopulmonary resuscitation by intensive care unit nurses: A high-fidelity simulation observational study. Clinical Simulation in Nursing, 23, 1-9. https://doi.org/10.1016/j.ecns.2018.07.005

Research Critique – Part II

Background

The first article by Vincelette et al. (2018) discusses the effects that timely recognition and initiation of cardiopulmonary resuscitation by ICU nurses have on the possibility of saving patients’ lives. Studies have shown the positive impact of cardiopulmonary resuscitation in the increased chances of survival of the patients that experience any form of heart or breathing issues in the ICU (Vincelette et al., 2018). However, the nurses' lack of the knowledge and skills to initiate defibrillation has led to a reduction of the rate of success in the patients’ chances of survival. A simulated scenario was undertaken to improve the patients’ chances of survival, whereby a scenario of a cardiac arrest after the use of ventricular fibrillation was shown (Vincelette et al., 2018). From the simulation, the nurses took at most 12 seconds to call for assistance and 28.8 seconds to start doing chest compressions. By the end of the simulation, 91% of the nurses could recognize instances that require immediate manual defibrillation Research Critiques and PICOT Statement Final Draft Essay Paper.

The second article by Hazwani et al. (2020) investigates the effects of team performance on the resuscitation skills employed by healthcare professionals. The effectiveness of the CPR offered to a patient determines the patient’s safety and health. When CPR is required, coordination of a team leads to increased chances of saving the patient’s life (Hazwani et al., 2020). These being the case, records from pediatric wards were checked to see the role of team leaders in the teamwork undertaken to save a patient’s life and how long it took for the levels of success to be achieved (Hazwani et al., 2020). Furthermore, simulation sessions were undertaken to help improve the practitioners’ levels of success, leading to an improvement curve as the number of simulations increased.

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How the Two Articles Support the Chosen Nursing Issue

The two articles support the use of training to improve the quality of output provided by healthcare professionals. When a practice gap or weakness was noticed in how the teams offered support in emergencies such as CPR, the two articles proposed the use of training and simulations to improve the response and performance of the team in future situations (Eyikara & Baykara, 2017). Given the improvement in performance during the simulation training, it is evident that the use of training would improve the teams' performance in future situations (Eyikara & Baykara, 2017). Furthermore, the two articles support teamwork as a remedy for the negative outcomes experienced, whereby assigning different duties in such situations will lead to improved outcomes.

The interventions suggested in the two articles match with the one that I made on my PICOT question. We both suggested the use of simulation as a way of closing the practice gap, whereby the professionals would be placed in mock situations that would require them to handle a patient requiring emergency medical attention (Fauquet-Alekhine, 2019). Through such simulations, the trainers would point the areas of weakness and improvement for the practitioners to improve their practice in subsequent simulations (Fauquet-Alekhine, 2019). By continuing such simulations severally, the competence levels in the practitioners will increase, resulting in significantly improved outcomes in future situations (Fauquet-Alekhine, 2019). The comparison of the previous and future performance should be undertaken regularly to ensure that the practitioners do not lose their skills and experience over time Research Critiques and PICOT Statement Final Draft Essay Paper.

Methods of Study

The two articles used both qualitative and qualitative methods of study to achieve the expected outcomes. The qualitative data collection method used in the two articles was the use of observation, whereby supervisors observed the practitioners in mock situations where they would try to save a patient with an emergency medical situation and their actions and decisions during this period would be recorded to see how effective they were. Afterward, qualitative data collection and analysis were undertaken, whereby the important facts and figures concerning the simulations would be collected. For example, the data on how long the practitioners took to initiate the emergency activities such as defibrillation and how long it took them to call for medical help would be recorded. The performance before and after the training were compared to determine if there were improvements in the performance of the personnel after the interventions were introduced.

Qualitative research is beneficial to any research due to the ability to understand the subjects' attitudes, thought processes, and beliefs through the qualitative data collection methods involved (Ryser, 2021). However, qualitative research methods may be resource-consuming since it requires much time for the data to be collected. It also needs more resources for the simulations to be undertaken (Ryser, 2021). On the other hand, quantitative research is beneficial since the findings can be tested and checked for validity (Ryser, 2021). However, quantitative research could be disadvantageous since, in concentrating on the mathematical and statistical data, important facts such as relationships could be overlooked, leading to negative outcomes in the pursuit of facts in the research being undertaken (Ryser, 2021).

Results of the Study

The two articles were insistent on the need for training to improve the performance of healthcare practitioners. The simulations undertaken in the two studies prove that training is important since they resulted in improved performance of the professionals who undertook them. Furthermore, training has a direct role in improving the confidence levels of the practitioners, whereby they tend to be more composed and able to perform their duties despite the amount of pressure they operate under. Secondly, the two articles have proven that for success to be achieved in emergencies in healthcare, the level of teamwork among the members determines their competence and ability to perform excellently. When team members work seamlessly, they are more likely to be more effective in handling difficult situations. Therefore, training them as a team will make them more competent and ensure that they produce the expected outcomes in different situations.

From the two studies, it is evident that healthcare facilities should invest in more regular training for their employees to improve their competence levels. Given the significant improvements in the incompetence of the practitioners involved in the study, facilities should invest in training to deal with the practice gaps that they experience. Furthermore, the leadership should look for ways to gel their teams together so that their positive relationships could lead to better outcomes in all of the situations that they experience in the future Research Critiques and PICOT Statement Final Draft Essay Paper.

Comparison of Outcomes

The expectations from my PICOT question were that regular simulation training of healthcare workers would result in better chances of healthcare workers being more competent and in a position to handle the different medical emergencies that they face, especially the management of cardiac arrests. The PICOT question suggests the use of training through simulation as a solution to the negative outcomes that have been experienced in the past when handling patients experiencing medical emergencies such as cardiac arrests. Therefore it is expected that effectively training the personnel involved in handling such cases will lead to positive outcomes in future cases.

From the articles critiqued, it is evident that simulation will significantly improve the performance of the professionals handling difficult medical situations. Findings from the articles show a significant improvement in how they handle the situation, how quickly they realize the medical issue at hand, and how quickly they realize that they require additional help to handle the situations.

References

Eyikara, E., & Baykara, Z. G. (2017). The importance of simulation in nursing education. World Journal on Educational Technology: Current Issues, 9(1), 02-07. https://un-pub.eu/ojs/index.php/wjet/article/view/543

Fauquet-Alekhine, P. (2019, October). Importance of simulation training needs: Illustration with collective decision making. In International Conference for Multi-Area Simulation ICMASim (p. 267). https://www.researchgate.net/profile/Philippe-Fauquet-Alekhine/publication/338885091_Importance_of_simulation_training_needs_Illustration_with_collective_decision_making/links/5e313dc7299bf1cdb9f95c10/Importance-of-simulation-training-needs-Illustration-with-collective-decision-making.pdf

Hazwani, T. R., Harder, N., Shaheen, N. A., Al Hassan, Z., Antar, M., Alshehri, A., & Kazzaz, Y. M. (2020). Effect of a pediatric mock code simulation program on resuscitation skills and team performance. Clinical Simulation in Nursing, 44, 42-49.

Ryser, G. R. (2021). Qualitative and quantitative approaches to assessment. In Identifying Gifted Students (pp. 33-57). Routledge. https://www.taylorfrancis.com/chapters/edit/10.4324/9781003235682-2/qualitative-quantitative-approaches-assessment-gail-ryser

Vincelette, C., Quiroz-Martinez, H., Fortin, O., & Lavoie, S. (2018). Timely recognition of ventricular fibrillation and initiation of cardiopulmonary resuscitation by intensive care unit nurses: A high-fidelity simulation observational study. Clinical Simulation in Nursing, 23, 1-9 Research Critiques and PICOT Statement Final Draft Essay Paper

Research Critiques and PICOT Question Guidelines –

Final Draft

Quantitative and Quantitative Studies

Nursing Practice Problem and PICOT Question

  1. What is your identified nursing practice problem?
  2. List your PICOT question, following one of the templated formats reviewed in the course.

Background

  1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question.

How do these four articles support the nurse practice issue you chose?

  1. Discuss how these articles will be used to answer your PICOT question.
  2. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question.

Method of Study:

  1. State the methods of the articles you are comparing and describe how they are different.
  2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method.

Results of Study

  1. Summarize the key findings of each of the studies into a comprehensive summary.
  2. What are the implications of the four studies you chose in nursing practice?

Ethical Considerations

  1. Discuss two ethical consideration in conducting research.
  2. Describe how the researchers in the four articles you choose took these ethical considerations into account while performing their research.

Outcomes Comparison

  1. What are the anticipated outcomes for your PICOT question?
  2. How do the outcomes of the four articles you chose compare to your anticipated outcomes?

Proposed Evidence-Based Practice Change

  1. What is the link between the PICOT question, the research articles, and the nursing practice problem you identified?
  2. Based on this information, propose an evidence-based practice change for your identified setting Research Critiques and PICOT Statement Final Draft Essay Paper