Clinical recommendations: Given the synthesis of the literature, what clinical recommendations emerge for your clinical setting / population?
My PICOT question is : In ventilated patients in the ICU (P), how does chlorhexidine oral rinse (I), compared to standard oral care (C), reduce ventilator-associated pneumonia (O) during the hospital stay (T)? University of South Florida College of Nursing NUR 4169c: Evidence Based Practice Assignment Directions: Synthesis Paper The purpose of this assignment is to develop the skills to synthesize the literature that will answer your PICOT question. The results of this assignment will be incorporated into your evidence-based practice project. So you may be well prepared, review the lectures up to and including Measuring Outcomes, read the assigned chapters, and review the suggested checklists. Also, review the “Appraisal Checklist for the RCT”. This assignment requires submission of a draft for formative feedback, after which you will submit your final paper with all suggested revisions. Below you will find the required elements of this assignment. All submissions must be in APA format. Please note there is a minimum of 1200 words, or 4 full pages for this assignment. Points will be deducted for not adhering to the word count. 1. Abstract: on one page (less than 200 words), and includes the clinical problem, the objective or purpose of the paper, search engines & key words used, specific results, and conclusion. Hint: Review the abstract in one of the studies you located. The information in your paper should be similar in terms of content and format. 2. Introduction: Succinctly identify the clinical problem that requires an evidence-based solution. You may use systematic reviews, meta-analyses, or Cochrane reviews to document the significance of the topic in the introduction only. End the introduction with your PICOT question. You may refer to the Literature Table in this section. 3. Body/Content: (Use the bolded words below as headings) a. Literature Search: Identify the databases that were used to search for the relevant literature (CINAHL, PubMed, etc.) and the key terms used. Be sure to include at least 3 sentences in all paragraphs. b. Literature Review: Use a minimum of 3 peer reviewed, primary RCTs and one clinical guideline that informs the question. If there is no clinical guideline, find a 4th RCT. • You must use randomized controlled trials ONLY (systematic reviews or meta-analyses are not allowed in the literature review) [were the participants randomly placed into a control or intervention group? If not, then it is NOT an RCT]. • If not already completed, create a literature table to summarize these key points, which will help you write this section. The table should be appended to the end of the paper. • Concisely summarize each RCT, writing a succinct paragraph stating the purpose, method/procedure, sample, measures, and specific results as they relate to the PICOT. • At the end of each paragraph that discusses the respective RCT, after discussing all aspects of the study (see previous bullet point), use the ‘RCT Appraisal Checklist’ to appraise the strengths and weaknesses of the study. All nine components of the ‘RCT Appraisal Checklist’ must be included in the strengths and weaknesses discussion. Do NOT include the authors’ review of literature. • Summarize the recommendations of the clinical guideline as it relates to the proposed practice change/PICOT. c. Synthesis: synthesize the research findings from all studies and the guideline, always relating them back to your PICOT question. The first paragraph should be a concise restatement of each study’s results, including statistics and a citation. Summarize the guideline recommendation. The second paragraph should be the “meat” of the synthesis where you describe similarities and differences among the study results, how the results impact the proposed practice change/EBP project, as well as what is known and not known (gaps) in the field for future research. Be concise. d. Clinical recommendations: Given the synthesis of the literature, what clinical recommendations emerge for your clinical setting / population? Describe how practice must change to become evidence-based. 4. Reference list (does not count towards word count). 5. Table: see template on next page. Label the table, and refer to it in the body of the paper using APA formatting for table usage (does not count towards word count). While the paper should appear in portrait/vertical position, the lit table should appear in the landscape/horizontal position.
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