Assessment Description
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.
For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-reviewed research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.
Use the “Literature Evaluation Table” to complete this assignment.
1. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
2. Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
3. The PICOT question will provide a framework for your capstone project.
4. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.
Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.
Literature Evaluation Table (Sample)
Student Name:
Summary of Clinical Issue (200-250 words):
The importance of feeding human milk to infants is well documented and supported from a variety of national as well as international committees. The American Academy of Pediatrics (AAP) confirmed that given the short-term and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public health initiative (AAP, 2012). An increasing number of studies reported an association between breastfeeding and long-term protection against chronic disease in both the infant and mother (Binns, 2016, AAP, 2012). Despite the overwhelming evidence in support of exclusive breastfeeding, the United States current six month breastfeeding rate of 49.4% is well below the goal of 60.6% of infants receiving any breast milk at 6 months set by Healthy People 2020 (CDC, 2015). The current rate of infants being exclusively breastfed at 6 months is 18.8%, with a goal rate of 25.5% as reported in the 2016 Breastfeeding Report Card published through the Center for Disease Control (CDC, 2015). The challenge with the reported data was that the information comes predominately from maternal recall of their feeding practices of full-term healthy infants leaving to question the accuracy of this information (CDC, 2015). Very little information was available regarding the breastfeeding rates of hospitalized infants during the first seven days of life. These infants and mothers were often placed into a healthcare system that was not prepared to address the mother infant dyad, but rather a system focused primarily on the needs of the infant. Pediatric health care systems were not prepared for the breastfeeding mother and infant during the first week of life and were challenged to provide effective support that would allow for the mother to continue to breastfeed while the infant was hospitalized. When an interruption in breastfeeding occurred during the first week, this caused significant changes to a mother’s milk supply, the amount of milk the infant demanded, and other barriers created a significant challenge for mothers to reach their breastfeeding goals (Binns, 2016).
PICOT Question:
Does providing a breastfeeding educational program for pediatric nurses within Cook Children’s Medical Center increase their knowledge of breastfeeding support to hospitalized infants as compared to nurses having no breastfeeding education?
P = Pediatric nurses within a specific medical center
I = Implementation of a breastfeeding education program
C = Nurses that received no breastfeeding education
O = Increase breastfeeding support to hospitalized infants
Criteria
Article 1
Article 2
Article 3
APA-Formatted Article Citation with Permalink
Radzyminski, S., & Callister, L.C. (2015). Health professionals’ attitudes and beliefs about breastfeeding. The Journal of Perinatal Education, 24(2), 102-109.
Permalink:
Garner, C.D., Ratcliff, S.L., Thornburg, L.L., Wethington, E., Howard, C.R., & Rasmussen, K.M. (2016). Discontinuity of breastfeeding care: “There’s no captain of the ship”. Breastfeeding Medicine, 11(1), 32-39.
Permalink:
Cross-Barnet, C., Augustyn, M., Goss, S., Resnik, A., & Paige, D. (2012). Long-term breastfeeding support: Failing mothers in need.
Permalink:
How Does the Article Relate to the PICOT Question?
Looking at how health care professional’s perceptions impacts breastfeeding support.
By learning what health care professionals understand about breastfeeding and support.
By identifying how healthcare has failed breastfeeding mothers allows for a better understanding.
Quantitative, Qualitative (How do you know?)
Qualitative design – descriptive study using a convenience sampling of staff using interview sessions.
Qualitative design – Semi structured in-depth interview
Qualitative study using semi-structured interviews.
Purpose Statement
The purpose of this study was to determine the perceptions of health care providers regarding breastfeeding and support of breastfeeding.
To understand health professionals perspectives on their experiences providing breastfeeding care across the continuum.
Sought to explore the comprehensive infant feeding education and support experiences of mothers enrolled in the Maryland WIC program.
Research Question
Does the perception of breastfeeding and support impact how healthcare professionals support breastfeeding mothers and infants?
Does a health professionals personal perspective impact the support that they provide to breastfeeding mothers.
Does a comprehensive breastfeeding educational program at different levels of health care, improve the rate of breastfeeding.
Outcome
Four themes identified:
1. Understanding the benefits of breastfeeding
2. Lacking consistency
3. Not knowing how to help
4. Understanding the barriers to breastfeeding
Six themes identified:
1. Gaps within healthcare system structure
2. Reliance on other health professionals
3. Time: limited or not the right time.
4. Lack of skills or not their role.
5. Inconsistent message
6. Potential strategies to improve continuity
This study looked at mothers breastfeeding at three different stages:
1. Prenatal care – the intent of the mothers to breast feed. Almost half of mothers received some education.
2. Hospitals – of the mothers identified as wanting to breastfeed, there were approximately 20% of mothers that received no breastfeeding education.
3. Pediatricians – many mothers identified their pediatrician as their primary source of breastfeeding information.
Setting
(Where did the study take place?)
Within one health care setting including pediatricians, OB’s , nurse midwife
Two central New York counties.
Three different Maryland WIC office
Sample
53 health care professional providing care to breastfeeding mothers and infants.
Purposive sampling used from different health professional settings. 34 health professionals interviewed.
Convenience sample of 75 mothers
Method
Qualitative descriptive study
Qualitative semi structured in depth interviews
Key Findings of the Study
Identification of themes that relate to breastfeeding. Clinical implications: improve education, assess maternal knowledge
Identified theses associated with the limitation of the health professionals knowledge associated with breastfeeding.
This study identified different opportunities to offer breastfeeding education.
Recommendations of the Researcher
Provide additional education to health care providers that support breastfeeding mothers and infants.
Identification that more breastfeeding education is needed across all areas of health care.
Breastfeeding education is critical at all levels of healthcare to support the breastfeeding mother.
T = Within a 6 month time frame
| Criteria |
Article 4 |
Article 5 |
Article 6 |
|
|
Cobb, M.S. (2014). Nurses’ current breastfeeding knowledge: An evidence-based change project. Clinical Scholars Review 7(1), 42-47. Permalink: |
Bozzette, M., & Posner, T. (2013). Increasing student nurses’ knowledge of breastfeeding in baccalaureate education. Nurse Education in Practice, 13, 228-233. Permalink: |
Rosen-Carole, C., Waltermaurer, E., Goudreault, M., Larimer, A., Pokharel-Wood, M., Rajupet, S., & Kouba, N. (2016). Assessing the efficacy of a breastfeeding-friendly quality improvement project in a large federally qualified health center network. Journal of Human Lactation, 32 (3), 489-497. Permalink: |
||
|
By assessing the current knowledge that nurses have to identify what is needed. |
Identifying the amount of education that is provided in the baccalaureate program. |
By reviewing the effectiveness of a quality improvement project. |
||
|
Quantitative design using a pre – post survey design. |
Quantitative design using a convenience sample using a pre and post survey. |
Quantitative design using a pre-post design. |
||
|
Discuss the application of an evidence-based practice project to postpartum nurses to support, protect and promote breastfeeding in the hospital setting. |
To examine the changes in student knowledge after receiving content on breastfeeding and lactation in their obstetrical course. |
Evaluate the effect of a Breastfeeding-Friendly Initiative in the complex environment of a Federally Qualified Health Center. |
||
|
What is the nurses current knowledge associated with the support of breastfeeding information. |
Does education increase the knowledge that students provide to mothers during their baccalaureate education. |
Does a breastfeeding friendly initiative influence the breastfeeding rates of a large federally funded health center |
||
|
Using a paired t test analysis of the pretest and posttest scores. Statistical significance established and demonstrated that education improved the participants breastfeeding knowledge. |
Improvement was noted within each course objective from pre- and post- test. |
Of those that completed both the pre survey, the education and then the post survey, there was a statistical difference in the knowledge that the providers had regarding breastfeeding. |
||
|
Nurses within a single postpartum unit. |
A single baccalaureate nursing program. |
31 health centers stratified by size and location in order to randomly assign half of the 709 direct contact employees to either of 2 interventions |
||
|
41 nurses agreed to participate. All staff members that are in contact with the breastfeeding mother were solicited. |
28 nurses were in attendance and the final sample was 24 students |
31 health centers recruited. 709 direct care providers participated. 220 attended the face-to-face education 150 staff members accessed the web-based education |
||
|
Method |
Postpartum nurses were solicited to participate in a pretest prior to the initiation of an individual breastfeeding education session and completion of the same questionnaire after the session. |
Two phase study with a pre and post design. Pre-test was used to evaluate the beginning knowledge and a post test was used to evaluate the knowledge after an educational program. |
Two interventions evaluated, one was a face-to-face education session and the other was a web-based module process. Two questionnaires were administered to participants. |
|
|
Postpartum nurses play a key role in the support of breastfeeding mothers. It is critical that they have a solid breastfeeding knowledge. |
Benefits of breastfeeding have been clearly established and nurses have been identified as having a significant impact. |
This study showed that face to face education was a better mechanism to provide comprehensive breastfeeding as compared to the web-based education. |
||
|
Increase the amount and type of breastfeeding education that is provided. |
Develop and provide breastfeeding education in all nursing and physician programs. |
Breastfeeding education should be included in all health care settings that work with mothers and infants. |
Reference
AAP. (2012). Breastfeeding and the Use of Human Milk. Pediatrics, 129(3), e827-e841.
Binns, C. L. (2016). The long-term public health benefits of breastfeeding. Asia-Pacific Journal of Public Health, 28(1), 7-14.
CDC. (2015). Breastfeeding Report Card. Retrieved 11 18, 2016, from Center for Disease Control and Prevention: cdc.gov/breastfeeding/pdf/2014breastfeedingreportcard
LITERATURE EVALUATION 4
Literature Evaluation Table
Student’s Name
Institution Affiliation
Course Number
Instructor’s Name
Date
Summary of Clinical Issue (200-250 words):
Today, obesity is twice as common in teenagers as it was thirty years ago. Statistics classify around 12.7 million adolescents as obese. This figure represents 17% of adolescents (Sanyaolu et al, 2019). These numbers are worrying as they seem to go grow each day and yet they have reached epidemic levels. Among many causes for the growth of these trends are unhealthy lifestyle choices and psychological factors. Adolescents should be taught how to manage their lifestyles and eat much healthier. Parents have a huge role to play when it comes to monitoring and coaching their children on matters of diet and exercise. They also have to try and improve their self-esteem by emphasizing their strengths and trying to improve their weaknesses. Most of the time obesity becomes a lifelong issue that is associated with the risk of other critical conditions such as heart disease and high blood pressure (Sanyaolu et al, 2019). Its association with such diseases is worrying since their prevalence increases with age. This puts obesity as a condition that is a life risk. Both primary and secondary prevention measures are necessary for the numbers to decline. In the meantime, it is necessary to research to further understand the prevalence and risk factors associated with obesity among adolescents in the United States.
PICOT Question:
Why is the prevalence of obesity among adolescents in the United States high and what causes the rise in these numbers?
2. 2: Less T PICOT question is provided but is incomplete. The PICOT question format is used incorrectly.
Criteria Comments The PICOT question is not a clear and measurable question
P = Adolescent children between the age of 12-18 years of age.
I = Use of data based on weight, age, sex, and other lifestyle habits.
C = Prevalence of obesity ten years before our current research
O = Realize the current trends and prevalence of obesity to help the health care system.
T= Last five years.
2. 2: Less Than Satisfactory Six research articles are presented. Three articles do not meet the assignment criteria for a quantitative, qualitative Criteria Comments You were able to identify six quantitative studies, but did not select any qualitative studies.
Criteria
Article 1
Article 2
Article 3
APA-Formatted Article Citation with Permalink
Cureau, F., Sparrenberger, K., Bloch, K., Ekelund, U., & Schaan, B. (2018). Associations of multiple unhealthy lifestyle behaviors with overweight/obesity and abdominal obesity among Brazilian adolescents: A country-wide survey. Nutrition, Metabolism and Cardiovascular Diseases, 28(7), 765–774. https://doi.org/10.1016/j.numecd.2018.04.012
Yang, L., Bovet, P., Ma, C., Zhao, M., Liang, Y., & Xi, B. (2018). Prevalence of underweight and overweight among young adolescents aged 12–15 years in 58 low-income and middle-income countries. Pediatric Obesity, 14(3), e12468. https://doi.org/10.1111/ijpo.12468
Ahmad, A., Zulaily, N., Shahril, M. R., Syed Abdullah, E. F. H., & Ahmed, A. (2018). Association between socioeconomic status and obesity among 12-year-old Malaysian adolescents. PLOS ONE, 13(7), e0200577. https://doi.org/10.1371/journal.pone.0200577
How Does the Article Relate to the PICOT Question?
The report analyzes the prevalence of obesity in Brazil while relating it to unhealthy lifestyle habits as the main cause of obesity.
The study sought to analyze the causes of obesity in different countries while at the same time analyzing its prevalence.
The study seeks to look into one of the factors that affect the prevalence of obesity which gives rise to the current trends observed.
Quantitative, Qualitative (How do you know?)
Quantitative research- it was a cross-sectional study that took measurements for various factors influencing obesity.
Quantitative research- the research relied on data from previous surveys that researched obesity among adolescents from the Global School-based student survey.
Quantitative research- there was a cross-sectional study that took measurements from the participants.
Purpose Statement
To investigate the association of unhealthy lifestyle habits with obesity among adolescents.
The study aims to give a current report on the prevalence of underweight, overweight, and obesity trends among adolescents.
To determine how socioeconomic factors influence the prevalence of obesity in adolescents in the Terengganu area.
Research Question
How does lifestyle habits influence obesity development and body weight?
The coexistence between overweight and underweight brings challenges in the health care system and their prevalence needs to be known to be well catered and monitored.
What is the relationship between socioeconomic factors and obesity among adolescents?
Outcome
The article identifies the following themes;
· The unhealthy lifestyle habits of participants.
· Obesity development based on physical inactivity
· The age and sex of the participants.
The following themes were identified in the study
· The WHO obesity criteria for low and middle-income countries.
· Prevalence is based on countries and regions.
· The causes of obesity among adolescents.
The study identified the following themes for the study;
· The BMI status between boys and girls.
· Education status of the children
· Occupational status of the parents.
Setting
(Where did the study take place?)
A country-wide survey in Brazil
58 low income and middle-income countries.
Government primary schools in Kuala, Terengganu and Besut District in Malaysia.
Sample
62063 school going students.
177,325 adolescents aged 12-15 years.
3798 school adolescents.
Method
A cross-sectional study based on self-reports by students about their physical inactivity, fiber intake, and other factors.
Analysis from the Global School-based student survey.
Cross-sectional analysis of collected data about height, weight, and age collected through school surveys.
Key Findings of the Study
There was found to be a synergetic relationship between obesity and unhealthy lifestyle habits.
There was no difference in prevalence based on age and sex in the compared countries.
There is a direct link between family income and obesity was realized.
Recommendations of the Researcher
There should be combined efforts that target combined unhealthy lifestyle habits to reduce its prevalence.
Policies to be put in place to address both underweight and overweight conditions.
The need to have multi-faceted and community countrywide approaches to include the role of the authorities, community, and family in reducing the number of cases.
Criteria
Article 4
Article 5
Article 6
APA-Formatted Article Citation with Permalink
Arfines, P. P., Luglio, H. F., & Kusumawardani, N. (2020). Prevalence and Lifestyle Risk Factors of Overweight and Obesity Among Indonesian Adolescents: An Analysis of Global School-Based Health Survey 2007 and 2015. Proceedings of the 4th International Symposium on Health Research (ISHR 2019). https://doi.org/10.2991/ahsr.k.200215.098
Al-Hussaini, A., Bashir, M., Khormi, M., AlTuraiki, M., Alkhamis, W., Alrajhi, M., & Halal, T. (2019). Overweight and obesity among Saudi children and adolescents: Where do we stand today? Saudi Journal of Gastroenterology, 25(4), 229. https://doi.org/10.4103/sjg.sjg_617_18
Zhang, J., Wang, H., Wang, Z., Du, W., Su, C., Zhang, J., Jiang, H., Jia, X., Huang, F., Ouyang, Y., Wang, Y., & Zhang, B. (2018). Prevalence and stabilizing trends in overweight and obesity among children and adolescents in China, 2011–2015. BMC Public Health, 18(1). https://doi.org/10.1186/s12889-018-5483-9
How Does the Article Relate to the PICOT Question?
The article looks into the current trend and prevalence of obesity in Indonesia
The research question sought answers on the prevalence and ongoing trend of obesity.
The data collected offers an in-depth view of the prevalence of obesity among adolescents.
Quantitative, Qualitative (How do you know?)
Quantitative research- data was collected through questionnaires and anthropometrics. Questionnaires asked about certain measurable aspects of obesity.
Quantitative research- the researchers took data on body mass, age, and gender.
Quantitative research- the researchers used data from the China Health Nutrition Survey and China National Transition Cohort Study and took into consideration aspects such as age and gender.
Purpose Statement
To evaluate the important dominant lifestyle factor associated with obesity.
To give the most recent statistics on the prevalence and trends of obesity and overweight in Riyadh city.
His study sought to update the public on the recent prevalence and trends in obesity among adolescents in China.
Research Question
What are the factors that influence obesity prevalence and what are the current trends on obesity?
How does the prevalence and trends on obesity and overweight compare with those of the past two decades in terms of geography and sample age?
Childhood obesity seems to be plateauing. What are the current trends in obesity among children and adolescents?
Outcome
The study identified the following themes;
· The prevalence according to age and sex.
· Lifestyle factors that influence obesity,
· The body mass compared to the height of the participant.
There was a comparison between data from the past decade and another set from the previous decade. It showed that prevalence had doubled over the last ten years.
The major themes identified in the study included;
· The prevalence of obesity and overweight in terms of gender.
· Age and eating habits of the participants.
Setting
(Where did the study take place?)
Analysis of data collected from the Global School-based Health Survey in Indonesia.
Schools in Riyadh city.
Data had been collected from 15 provinces in China.
Sample
116 students from the first survey and 110 students in the second survey.
7930 school-going children in Riyadh city.
A survey was conducted in two waves-the first was done in 12 provinces while the second was done in 15 provinces in China.
Method
Use of questionnaires and anthropometrics
Cross-sectional study enquiring on body mass, gender, and age.
Data analysis from a survey by the China Health Nutrition Survey.
Key Findings of the Study
Programs to prevent adolescent obesity have been limited and unprioritized.
Obesity has risen at alarming rates among children in Saudi.
Trends in obesity and overweight had remained stable in the last years in children but had increased for adolescents.
Recommendations of the Researcher
Interventions should not be only limited to the promotion of healthy lifestyles. Policies such as taxes on sugar-sweetened beverages should also be put into consideration to be implemented in the future.
There should be the initiation and implementation of effective obesity preventive measures.
Effective policies and interventions need to be intensified and sustained to reduce the number of cases among children and adolescents.
Reference
Sanyaolu, A., Okorie, C., Qi, X., Locke, J., & Rehman, S. (2019). Childhood and Adolescent Obesity in the United States: A Public Health Concern. Global Pediatric Health, 6, 2333794X1989130. https://doi.org/10.1177/2333794×19891305
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
