2023 Respond using one or more of the following approaches Share an insight from having read your colleagues

 

Respond  using one or more of the following approaches:

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from readings, or after synthesizing multiple postings.

 

                                                  INITIAL POST 

             Using evidence-based practice (EBP) is an essential tenant of nursing  practice. Therefore it is imperative to develop the skills necessary to  gather, interpret, and evaluate scientifically based data. To begin my  research for this week’s assignment, I first did a Google search of  nursing research topics to help myself generate ideas and narrow down a  problem that interested me. After considering several topics, I decided  to write about delirium in acutely ill patients.  Acute Delirium is  something that I have a lot of experience with, both personally and  professionally. The aim of my research will be to find out how  non-pharmacological interventions compare to pharmacological treatment  of acute delirium.

Search Results Analysis

             Once my topic was selected, I went to the Walden library to search for  evidence-based literature on delirium management. According to Walden  University (2018), the levels of evidence pyramid determines the quality  and amount of evidence available. The top three sections of the pyramid  are referred to as filtered results. Filtered results are comprised of  systematic reviews at the pinnacle of the pyramid, followed by  critically appraised topics, and critically appraised individual  articles. The next three sections of the pyramid are referred to as  unfiltered results and include randomized controlled trials, cohort  studies, and case-controlled studies. Background information and expert  opinions make up the base of the pyramid (Walden University, 2018). 

           I began searching for resources from the top of the evidentiary  pyramid, systematic reviews. I used the Joanna Briggs Institute EBP  Database, and then limited my search results to systematic reviews, and  set a date range of 2014 to current. I used the keywords “delirium” and  “interventions” this search yielded four systematic reviews. When I  search the term “acute confusion” I found three results. I also utilized  the Cochrane Database of Systematic Reviews, and found two systematic  reviews by searching for “delirium” in the first text box, and “nursing  interventions” in the second text box, again searches were limited to  full text with a date range of 2014 to current. I also used the Joanna  Briggs Institute EBP Database to search for critically appraised topics.  My search for “delirium interventions” yielded just one result.  However, when I searched for “delirium” I found ten results. I also  searched those same terms on Guideline Central and found four critically  appraised topics results. Finally, I searched for critically appraised  individual articles using the Evidence Alerts database, and the terms  “delirium and acute confusion” this search yielded 23 critically  appraised individual articles.

Next,  I searched for nonfiltered resources utilizing the CINAHL Plus  database. I first looked for randomized controlled trials by searching  for the terms “delirium” and “nursing interventions” in the first and  second text boxes respectively; this search query yielded four  randomized controlled trials. To find cohort studies, I typed “delirium”  in the first text box, “interventions” in the second text box, and  “cohort studies” in the third text box, this search resulted in 27  articles. I searched for case studies using the same search terms in the  first and second text boxes and limited the publications to case  studies, this search yielded 56 results.  However, when I adjusted the  filters to include case studies published within the past five years,  the number of results reduced to 14 case studies.  

Comparative Value

             I found congruency between the evidentiary pyramid and my  search results; the further down the pyramid, the more resources I  found; but, the quality of the information decreased concurrently. While  the systematic reviews were not as numerous, they are superior in terms  of scientific rigor and evidentiary support. Moreover, the information I  found within the systematic reviews were very consistent with my chosen  topic compared to information further down the period like cohort and  case studies. When search terms were altered, for example, searching for  “delirium” versus “acute confusion,” the results remained more  consistent when searching for the higher level filtered results whereas  alteration of search terms would create a wide variation in results  further down the pyramid, in the unfiltered resources. 

Polit  and Beck (2017), contend that systematic reviews are the best resources  for EBP because they contained synthesized information about a topic  from numerous evidenced-based studies. However, it is important to  recognize that the quality of evidence can vary significantly regardless  of its position within the evidentiary hierarchy (Pilot & Beck,  2017). Overall, I found greater quality and consistency of information  within the systematic reviews and critically appraised topics and  articles. Nonetheless, I found several high quality randomized  controlled trials and cohort studies that provide high-quality  information for making a comparison between pharmacological and  non-pharmacological interventions for managing delirium. 

Helpful Tips for Literature Reviews

             I found the course guide for this discussion post extremely helpful. I  followed the guide to conduct my searches, find my articles, and  evaluate the information. I also like to use Google Scholar because the  search algorithm pulls a lot of information, it does have some  drawbacks, the main one being that the articles are not always available  in full text. But, it is very user-friendly, and because it casts a  wide net, I can easily find pertinent information. If I see an article  that peaks my interest that is not available in full text, I copy the  title or other vital information and then plug that information into the  Walden University Library. I have always been able to find the article I  want using this method. I also find it helpful to organize my search  results within folders, and to tag my articles with the types of  studies. I also find that the National Center for Biotechnology  Information (2019) is a great resource for locating free, full text,  peer-reviewed, scholarly articles (National Center for Biotechnology  Information, 2019). If I find a study I know that I definitely want to  use in my work, I will create a citation and save it in a word document.  When I begin writing, I can use my reference list that I started during  my literature review as a guide. I have found that this method of  source organization is both helpful and time-saving. 

References 

National Center for Biotechnology Information. (2019). Retrieved March 4, 2019, from https://www.ncbi.nlm.nih.gov/

Polit, D. F., & Beck, C. T. (2017). Nursing research generating and assessing evidence for nursing practice. Philadelphia: Wolters Kluwer.

Walden  University. (2018). Evidence-Based Practice Research: Levels of  Evidence Pyramid. Retrieved from  https://academicguides.waldenu.edu/healthevidence/evidencepyramid#s-lg-box-8700027