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elderly patients with COPD
Research Critique Table, Framework & Model
Please see attached instructions
A Criteria for Content
- Research Critique Table
- The PICOT/PICo question is presented after the title of the table
EBP PICOT QUESTION:
The PICOT question for this EBP project is: In elderly patients with COPD (P), do pharmacological interventions combined with pulmonary rehabilitation (I) as compared to pharmacological interventions alone (C) result in a reduction of COPD exacerbations (O) after six months (T)?
- Students will select four (4) research-based studies and complete the Research Critique Table following the format noted in the sample.
- Only research-based studies are to be included in this table. The research-based article may use either a quantitative or qualitative approach as appropriate to the identified PICOT/PICo question. For this assignment, the selected references should avoid systematic research review (SRR), meta-analysis, clinical practice guidelines, or any other secondary analysis articles.
- All selected research-based articles must be consistent the selected PICOT/PICo question.
- Complete citation of selected research study is required in the column labeled as Citation
- Permalink for each research article is required and located in the column labeled as Citation
- Reference list is required located Research Critique Table
- The required column headings are:
- Citation
- Purpose of the research
- Research design and sample
- Data collection methods
- Results
- Strengths and limitations (both must be identified for each research study)
- Theoretical Framework
- Explain the theoretical framework that will be used in this project consistent the PICOT/PICo submitted
-
Describe how the theoretical framework is useful to the selected PICOT/PICo question
- Change Model
- Explain the change model that will be used in this project
- Describe the steps within selected
- Describe how the change model is useful to the selected PICOT/PICo question
Research Critique Table (sample)
State the PICOT/PICo Question:
| Citation | Purpose of the research | Research Design and Sample | Data Collection Methods | Results | Strengths (S)Limitations (L) |
| Cavanaugh & Huse. (2014). Surviving the nursing Shortage: Developing a nursing orientation program to prepare and retain intensive care unit nurses. Journal of Nurse Executives, 16(2), 34-56.
Permalink |
To create an orientation program that would produce competent nurses to work in the NICU who had no previous NICU experience. The orientation program would also be streamlined to ensure all new hired nurses were provided the same information and patient types | Quantitative StudyN=27 nurse orientees over a two-year period | Formal preceptor program developed for identified preceptorsOrientation program developed to foster critical thinking, interpersonal relationships, and technical skills in new orientees
Caffarella’s program model used to create a program due to fluidness of the teaching model |
Final orientation evaluation revealed 100% of orientees felt the program prepared them to competently work independentlyThe clinical educator identified key components of a successful program: well-prepared preceptors and biweekly conferences with the preceptor, orientee, and clinical educator
Retention rate after two years was 93% |
S-program design/concepts transferrable to other nursing departmentsL-small sample size |
| Hardy, J. & Smith, J. (2016)Enhancing staff development with a structured preceptor program. Journal of Nursing Education, 54(1), 101-110.
Permalink |
To redesign an orientation program on an ICU unit due to high staff turn-over, low staff satisfaction rates, and a 14-bed expansion.Orientation model based off Connelly and Hoffart and including the Myers-Biggs cognitive personality style assessment | Qualitative Study: PhenomenologicalExamination of previous orientation program with new design based on structure, identifying qualified preceptors, developing a preceptor course, and orientation packets for the new nurse
Current program lacked structure |
Identification of staff nurses who would make effective preceptors, development of a preceptor educational course, management commitment, development of an orientation manual | Greater satisfaction with preceptor role N=5 total staff who had gone through the preceptor classNew staff members feel orientation process is designed to meet learning needs
Increased overall staff satisfaction Many employment applications due to referrals from current staff |
S-study can be transferred to other types of nursing departmentsL- no exact measurements regarding number of participants, possible bias of researcher |
| Loft, W. (2015). Moving forward: Creating a new nursing services orientation program. Journal of Nurse Executives, 76(2), 56-61.Permalink
|
To redesign a hospital orientation which would create a more meaningful experience for new employees. | Quantitative: Descriptive Study: PredictiveN=74 surveys returned/reviewed from May to December 2004
May to June results were from the current orientation process New orientation process began July 12 |
Redesign orientation based on Scope and Standards of Practice for Nursing Professional DevelopmentOrientation checklist replaced self-study tests
Modular orientation classes set up to allow employees who did not need to specific classes the opportunity to spend time on assigned units |
May and June results reflected what administrators already knew to be issues with current systemJuly through December results showed an overall improvement in satisfaction rates of the new orientation program | S- sample size of 74; able to critique results from the two programs; survey comprehensive using Likert-scale as well as open-ended questions
L-Unknown number of total orientation participants versus number of surveys returned; a 3 month follow-up survey resulted in poor response, so no significant data was able to be reported |
| Meyer, G. & Meyer, S. (2017). Utilization-focused evaluation: Evaluating the effectiveness of a hospital orientation program. Nursing Leadership in Healthcare, 78(9), 90-98.
Permalink |
To evaluate the effectiveness of current orientation practices and which aspects of the program were viewed as positive and which were viewed as negative | Quantitative:Descriptive study: Survey
N=59; total number of surveys distributed = 90 |
Improve areas of orientation program based on survey results | Top three survey questions noted to be:The need to provide quality time and opportunity to practice new clinical skills
Having a designated preceptor was important Offering preceptor classes to potential preceptors was vital to successful orientation programs |
S- The survey was pilot tested before distribution.Surveys were distributed to all shifts in multiple departments
L-Small sample size (rate of return was 60%) |
| Modic, C. & Harris, Y.T. (2015). Masterful precepting: Using the BECOME method to enhance clinical teaching, Journal of Nursing Education, 67(12), 134-145.Permalink
|
To provide staff unit educators a tool for educating and mentoring preceptors | Descriptive Study: SurveyTo examine commonly experienced orientee behavior
N= 342 from 13 states in the U.S. and Ontario, Canada |
The classification and recognition of common orientee behaviors allows preceptor programs to include effective teaching strategies for preparing the preceptor when these behaviors are encountered | The most frequently encountered orientee behavior was slowness and disorganizationMost strategies used by preceptors to deal with different orientee behavior fell into one of 6 categories: Behavioral, Emotive, Cognitive, Organizational, Modeling, and Elicit help | S-large sample sizeL-fixed questions regarding preceptor education, results were unclear as to whether strategies provided by the preceptor in dealing with a difficult orientee was successful or not |
| Morris, C., Pfeifer, K., Catalano, R, Fortney, G., Nelson, L., Rabito, B., & Harap, H. (2013). Outcome evaluation of a new model of critical care orientation. Critical Care Clinics of North America, 64(4), 573-582.
Permalink |
To determine if a new orientation program had an effect on satisfaction, retention, turnover, staff vacancy, staff preparedness, and cost effectiveness | Quasi-ExperimentalN=173
A total of 197 nurses had participated in the new program, with only 173 giving consent to answer questions Questionnaires were handed out to educators, managers, preceptors, and orientees. Questionnaires were given at set intervals throughout the program and after the program for direct feedback. |
Key components recognized by participants allowed the program develops to improve the current orientation program | Two successful teaching strategies identified: pocket guides and time spent in the simulation lab (p=0.023)The created Critical Care Institute program, which helped prepare new hire nurses for patient care was rated high among the different groups.
One year after the program was instituted: -Retention rates increased by 2% -Turnover rates decreased by 1.5% -ICU vacancy rates decreased by 10% Cost for the new program increased by $24,810 Length of orientation remained the same |
S-Large sample sizeL-No clear conclusions drawn regarding why certain values are so far below the national level (ICU vacancy rates and turnover rates) |
| Prouix, R. & Bourcier, C. (2017). Graduate nurses in the intensive care unit: An orientation model. Journal for Nursing Leadership, 33(10), 194-201. | To find a more efficient way to develop skills during a new graduate nurse’s orientation and improve the orientation program | Qualitative StudyPhenomenolog-ical
Examination of previous orientation program with new design based on themes found in recent literature regarding challenges and stresses of a new graduate nurse |
Unit preceptor teamProgram redesign based on the stages of skill acquisition of a new graduate nurse | Year 1: original goals of the program were metInformal interviews at the conclusion of orientation yielded positive feedback
Preceptors found the redesign rewarding New design saved the unit money |
S-study can be transferred to other departments based on themes testedL-No exact number of orientees mentioned; unsure of level of ICU patients; subjects were new graduate nurses only |
| Thomason, T.J. (2014). ICU nursing orientation and post orientation practices: A national survey.Nursing Leadership, 22(2), 67-75.
Permalink |
To determine the national practices regarding current instruction methods, preceptor training, and post-orientation programs for ICUs. | Descriptive study: SurveyA geographic map of the U.S. was divided into 7 regions. Inclusion criteria for hospitals included JC accredited and have one or more ICUs, not including pediatric ICU or progressive care units
N=24 hospitals participated; results obtained from either a telephone survey or electronic survey Survey tool included 35 questions |
Information gathered regarding national practices for ICU orientation programs including instruction methods and post-orientation support | Orientation times based on previous experience and RN level87% of hospitals used didactic, classroom education with average 73 hours spent
All hospitals surveyed reported the same three key elements to measure success of an orientation program |
S-a beginning attempt to gather information regarding national orientation programsL-small sample size
Electronic surveys sent to CNSs who had affiliation with organizations |
| Ward, G. H. (2013). Enhancing orientation and retention: One unit’s success story. Applied Nursing Leadership, 4(1), 22-29.
Permalink here |
To design an orientation program that supplies quality preceptors to new nurse hires which will arm them with skills to be successful in their positions and retain them within the organization | Qualitative Study:Phenomenolo-gical
N=22 orientees over a 2 year period (2011 to 2013) Evaluation questionnaires were completed at the end of the orientation class |
A department specific class was developed to help new department hires become familiar with the unit’s patient population and frequently performed procedures | Participants felt overall the class was a valuable addition to their orientationRetention rates on the unit increased from 44% in 2004 to 88% in 2006 | S- Study examined orientees over a 2 year periodL-Interviews limited to one department |
Note to students:
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