Systematic review for asthma for study. additional with PICOT that is specific for the study.

This week’s graded discussion topic relates to the following Course Outcome (CO).
•CO4 Develops and outlines a scientific, systematic decision-making process to integrate critical thinking with clinical judgment to assure safe and effective outcomes. (PO 4)

Your capstone change project begins this week when you identify a practice issue that you believe needs to change. The practice issue must pertain to a systematic review that you must choose from a List of Approved Systematic Reviews for the capstone project, whose link may be found in the guidelines for the Week 3 Capstone Project: Milestone 1 assignment page.
•Choose a systematic review from the list of approved reviews based on your interests or your practice situation.
•Formulate a significant clinical question related to the topic of the systematic review that will be the basis for your capstone change project.
•Relate how you developed the question.
•Describe the importance of this question to your clinical practice previously, currently, or in the future.
•Describe what a research-practice gap is.

Pediatric Nurse…. I need this by tomorrow but I was not allowed to choice you as a writer if I put 24hrs. Please assist. Thank you in advance

Sample another classmate submitted:

I am choosing the following systematic review: Policies for replacing long-term indwelling urinary catheters in adults. I chose this topic because of my current job. I work in long-term care and skilled nursing. I am currently the rehab unit manager, but prior to that, I was the Infection Control Preventionist. This topic is a very important in my type of clinical setting. Cooper, Alexander, Sinha, & Omar said, “the effect of health-care policies related to the replacement of long-term urinary catheters on patient outcomes is unclear” (2016). This is very true. Some urologist say don’t change catheters monthly and some say it is extremely important. There is really no clear-cut guidelines with long-term indwelling catheter use. Just like this review article, patient outcomes remain unclear and no trail data to sufficiently say one policy is better than the other (Cooper, Alexander, Sinha, & Omar, 2016).

My Clinical Question:

When re-catheterizing patients with long-term indwelling catheters, is there clinical effectiveness in providing a prophylactic, single-dose antibiotic in reducing symptomatic urinary tract infections in patients with a history of urinary tract infections and catheter changes?

P= Patients with long-term indwelling catheters

I= Prophylactic, single-dose antibiotic with catheter changes

C= No Prophylactic, single-dose antibiotic with catheter changes

O= Decrease of symptomatic UTI’s in patients with indwelling catheter changes

I developed this question based on certain patients in my facility. There is a total of 10 indwelling catheters in my facility, currently. 1 out of those 10 patients has an order to administer one dose of Bactrim DS with every catheter change. Compared to a few others with catheters, her UTI rate is much lower than those without that order. Could it be proper technique when changing, her body, or is there a clinical difference in providing that antibiotic. As an ICP, using antibiotics prophylactically is a big no-no and hard to really explain. However, if this is effective, treatment cost of UTI’s in relation to catheter changes could decrease. Currently and clinically, I am curious if one dose of antibiotic is truly that potent and enough to prevent symptomatic UTI’s with changes.

The research practice gap was something I have never heard of until now. According to Leach & Tucker, the research practice gap in nursing is when there is disconnect between best practice and actual practice (2017). This gap can lead to poor patient-care and poor outcomes. I feel this means research or EBP is based on something that is not clinically important. Why would one want to implement research and best practice into a clinical setting that would not benefit from it? From our EBP course, it was important that research must be clinically significant. I take it that would help bridge this gap. “Bringing research and nursing practice closer together can help narrow that gap” (Leach & Tucker, 2017). It would be clinically insignificant to implement a process/procedure that would not improve patient care. Bridging the researchers developing the interventions and the practitioners implementing them help avoid this gap (Neal, et.al, 2015). Throughout my transition to my BSN, I now understand the importance of research and the benefit of us actually doing it, reading it, and understanding it.

Cooper FPM, Alexander CE, Sinha S, Omar MI. Policies for replacing long-term indwelling urinary catheters in adults. Cochrane Database of Systematic Reviews 2016, Issue 7, Art. No.: CD011115. doi:10.1002/14651858.CD011115.pub2.

Leach, M. J., & Tucker, B. (2017). Original research article: Current understandings of the research-practice gap in nursing: A mixed methods study. Collegian. doi:10.1016/j.colegn.2017.04.008

Neal, Z. P., Neal, J. W., Lawlor, J. A., & Mills, K. J. (2015). Small worlds or worlds apart? Using network theory to understand the research-practice gap. Psychosocial Intervention, 24, 177-184. doi:10.1016/j.psi.2015.07.006