Nursing interventions to prevent pressure ulcers in long term care settings

Critical Review
Details of task: This assignment has four parts.

Part 1: Background
Explain a clinical or workplace issue that describes a nursing or midwifery issue of concern for an individual or group of patients/clients that you wish to explore (approximately 200 words). This information should be supported by readings and accurately referenced.
Part 2: Population Information
Describe the population identified in your scenario (approximately 500 words). This will include information on:
? the incidence of the health or other issue in the local population compared with national and international data
? how the issue is diagnosed/recognised
?the current management for this health or other issue ?the outcomes used to measure success of the management ? prognostic details ? any costing information available
This information must be accurately referenced.
Part 3: Search Strategy and Annotated Bibliography
From the scenario, develop a question you need to answer in order to provide the best practice. Use the PICO (or PICo) framework.
P = population I = intervention C = comparator O = outcome Information and resources relating to PICO and PICo are available through the Moodle site and through the Nursing & Midwifery section of the Library�s website. For some questions there might not be a comparison group. To optimize learning from this assignment, you might need to adapt your PICO or PICo if limited information is available.

P = population I = phenomenon of interest Co = context
6Determine a search strategy, with search terms, inclusion and exclusion criteria and databases used, that will yield relevant literature for finding evidence to decide best practice. Provide a summary of your search strategy (approximately 300 words). For this exercise, your search strategy will need a final yield of 8 � 20 articles.
Evidence Based Practice (EBP) is the process of making clinical decisions based upon evidence, combined with clinical experience and patient expectations.
EBP is used in a variety of fields, including medicine, nursing, psychology and allied health.
The process involves an assessment of evidence using a hierarchy of evidence types, with Cochrane systematic reviews commonly considered the ‘gold standard’ for evidence. For example, see the EBP evidence pyramid, or the Joanna Briggs evidence hierarchy.
To find evidence to base your decision upon, start by phrasing your scenario as a specific, answerable question. You can use ‘PICO’ for this.
[P] Who or what is your patient or population group?
[I] What is your intervention or indicator?
[C] What is your comparison or control?
[O] What outcome are you looking for?
For example:?A 47 year old woman comes to see you. She is overweight, concerned about her overall health, and would like to lose weight quickly. She has heard a report on the radio suggesting that resistant corn or potato starch can reduce obesity. You begin to investigate any evidence to support this.
Rephrased as a specific, answerable question, using PICO:
In [P] overweight, how does [I] resistant starch compared with [C] ordinary starch effect the [O] weight loss?
Next, translate PICO into a search strategy which you can apply to a database to find evidence.
� treat each component as a separate concept.
� brainstorm for synonyms and alternative spellings and terminology for each concept, linking these with OR – this will broaden your search.
� combine your concepts with AND – this will focus your search.
[P] overweight OR obese?AND
[I] resistant starch OR R.S.?AND
[C] ordinary starch?AND
[O] weight loss
Choose the most relevant components to combine – you don’t need to combine all four in a single search. For example, you could conduct a search on ([P] AND [I] AND [C]), or on ([I]AND [C]), or ([P] and [I
Choose an appropriate EBP resource to search, such as the Cochrane Library, CINAHL, Joanna Briggs, Ovid Medline, or TRIP, and conduct your search.

Undertake a literature search using your search strategy.
Provide an annotated bibliography of the literature you have located, using the two table formats below.
Table 1: Annotated Bibliography 1
Table format � landscape layout, 5 columns (using headings provided), no more than one page per article. Single spacing and 11-point font are acceptable.
? Authors & Title � provide authors and title of paper, and comment on the authors (first, second and last authors if there are more than 3 authors), their standing in this area of research or practice, and the extent they are cited by others (their H index determined from the Scopus data base).
? Year � provide year of publication and comment on whether the date has any relevance for practice.
? Journal � provide name of journal and comment on what standing the journal has in the international and national health community (impact factor and Q rank determined from the Web of Science database; journal citation reports)
? Country � provide country where research conducted and comment on similarities and differences in the research setting compared with your location. For example, consider the type of health care system, funding of health care system, type of clinical setting.
? Population � describe the population studied and comment on the similarities and differences compared with the population described in the background to your issue.
Comments may be brief and written in note form.
Table 2: Annotated Bibliography 2
Table format � landscape layout, 4 columns (using headings provided), no more than one page per article. Single spacing and 11-point font are acceptable.
? Authors, year & design � provide authors and year of publication; name the study design (for example, randomized controlled trial, case control study, survey, interpretive study using in-depth interviews).
? Research question � report the main objective of the study.
? Sample size and profile � report how many people were in the study, how they were selected and whether a power calculation was done (if appropriate).
? Include/Exclude � report if the article meets or does not meet your inclusion criteria and why.
? Outcomes � report the main findings (including numbers, if quantitative) and comment on whether these are to be considered clinically meaningful.
Part 4: Search Outcomes
Provide a description of how you went about your search, identifying how many articles met your initial search criteria, how many were eliminated and finally how many articles are included. You may present this information discursively in a paragraph of no more than 200 words or in a Prisma chart.
Part 5: Reference List
Provide a reference list using APA 6th edition format, for all literature cited in the assignment. Information on this referencing style is available on Moodle.
Approximate word limit: 3000-4000 words



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