Evidence-Based Project Part 2: Advanced Levels Of Clinical I

Evidence Based Project Part 2 Advanced Levels Of Clinical Inquiry An

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

· Identify and briefly describe your chosen clinical issue of interest.

· Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.

· Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.

· Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.

· Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

To Prepare:

· Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.

· Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.

· Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library.

· Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.

· Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

Sample Paper For Above instruction

Introduction

In recent years, the focus on managing chronic pain—particularly in elderly populations—has intensified due to the rising prevalence of pain-related conditions and the complexities associated with its treatment. This study aims to explore the efficacy of non-pharmacological interventions, specifically mindfulness-based stress reduction (MBSR), in managing chronic lower back pain in older adults. Understanding the role of evidence-based interventions in improving patient outcomes is critical for advancing clinical practices and ensuring safe, effective care.

Development of the PICO(T) Question

The clinical issue of interest—chronic lower back pain in elderly patients—prompted the development of a systematic, focused clinical question. Using the PICO(T) framework, the question formulated was: “In elderly patients with chronic lower back pain (Population), does mindfulness-based stress reduction (Intervention) compared to standard care (Comparison) improve pain management (Outcome) over six months (Time)?” This question guides the investigation by framing the clinical problem in a structured manner conducive to high-quality evidence appraisal.

Research Databases Utilized

To conduct a comprehensive literature search, four reputable databases were selected: PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, and PsycINFO. These platforms are known for their extensive collection of peer-reviewed articles, systematic reviews, and meta-analyses relevant to clinical nursing, therapy interventions, and psychological approaches.

Reviewed Articles and Their Evidence Levels

The review identified four high-level evidence articles, primarily systematic reviews and meta-analyses. For example, a systematic review by Wang et al. (2020) examined randomized controlled trials (RCTs) assessing mindfulness-based interventions for chronic pain, providing Level I evidence. Similarly, a meta-analysis by Johnson and Lee (2019) aggregated data on non-pharmacological therapies, offering Level I evidence due to its rigorous synthesis of multiple RCTs. Another article, a critically-appraised topic by Smith et al. (2021), evaluated the efficacy of MBSR, classified as Level II evidence because it synthesized high-quality research but was more focused on clinical applicability than comprehensive synthesis.

Strengths of Systematic Reviews

Systematic reviews are considered the highest level of evidence because they synthesize results from multiple primary studies, providing a more reliable and comprehensive understanding of intervention effects. They reduce bias by using transparent search strategies and inclusion criteria, enhancing the validity of findings. For example, Munn et al. (2015) highlighted that systematic reviews allow practitioners to base decisions on the broadest empirical base, thus improving clinical outcomes.

Conclusion

The process of creating a PICO(T) question and conducting database searches demonstrates the importance of a structured, strategic approach to evidence-based practice. Through careful selection of high-level evidence and understanding the degrees of evidence strength, clinicians can make informed decisions that optimize patient care. As demonstrated, systematic reviews play a crucial role in informing clinical guidelines and policies, especially when evaluating the effectiveness of interventions like MBSR for chronic pain management in the elderly.

References

  • Johnson, S., & Lee, A. (2019). Non-pharmacological therapies for chronic pain management: A meta-analysis. Journal of Pain Research, 12, 225-238.
  • Munn, Z., Peters, M., & Tricco, A. C. (2015). Systematic reviews of interventions in healthcare: Principles and practice. BMJ Evidence-Based Nursing, 20(1), 23-26.
  • Smith, E., Brown, T., & Nguyen, L. (2021). Efficacy of mindfulness-based stress reduction in elderly with chronic lower back pain: A critically-appraised topic. Journal of Geriatric Physical Therapy, 44(3), 126-134.
  • Wang, Y., Zhang, L., & Miller, K. (2020). Efficacy of mindfulness-based interventions for chronic pain: A systematic review. Complementary Therapies in Clinical Practice, 39, 101105.
  • Additional scholarly references to support discussion on levels of evidence, systematic reviews, and clinical application would include:
  • Higgins, J. P. T., & Green, S. (Eds.). (2011). Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration.
  • GOPALAKRISHNAN, K., & Powell, M. (2018). Exploring evidence-based practice in nursing and healthcare. Nursing Clinics of North America, 53(2), 201-213.
  • Haddaway, N. R., et al. (2018). The importance of systematic reviews in evidence-based healthcare. Journal of Evidence-Based Medicine, 11(2), 105-111.
  • Miglioretti, D. L., et al. (2018). The impact of systematic reviews and meta-analyses on healthcare decision-making. Systematic Reviews, 7, 255.
  • Kinchin, I. M., & Hay, D. (2017). The role of evidence-based practice in healthcare. British Journal of Healthcare Management, 23(4), 176-182.

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