Nusing

see the attached 

fill the appendix B using My project theses topic 

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1. What are you proposing as the topic for your EBP project?

I am proposing my topic for the EBP project, psychiatric care, and

mental health issues in adolescences.

2. Why is this topic of interest to you? I chose this topic because, as a

Psychiatric nurse, I work with adolescents with mental health

disorders, and I would like to talk about it. People mostly don’t

believe it or mention it due to its stigma when it comes to mental

health. A lot of time, it is hidden. due to the increasing number of

adolescents with psychiatric symptoms became unrecognized in

our current health care system, the ability to identify and treat

these issues in many health care settings has become vitally

important (Yearwood, al, el, 2012).

3. Would you classify the topic related to service, practice, or patient

outcomes? I would classify this topic as practice and patient

outcome.

In the outpatient setting, would educating clinic staff (or whoeve r) on

the signs and symptoms of mental illness in adolescents vs (whatever

current practice is) help with early intervention and treatment?

Paus, Giedd, J. N., & Keshavan, M. (2008). Why do many psychiatric disorders emerge during
adolescence? Nature Reviews. Neuroscience, 9(12), 947–957. https://doi.org/10.1038/nrn2513

Yearwood, Pearson, G. S., & Newland, J. A. (2012). Child and adolescent behavioral health : a
resource for advanced practice psychiatric and primary care practitioners in nursing. Wiley-
Blackwell.

JohnsHopkins Nursing Evidence-Based Practice

Appendix B: Question Development Tool

1. What is the problem?

2. Why is the problem important and relevant? What would happen if it were not addressed?

3.

  • What is the current practice?
  • 4.

  • How was the problem identified?
  • (Check all that apply.)

    ❑ Safety and risk-management concerns

    ❑ Quality concerns (efficiency,
    effectiveness, timeliness, equity, patient-
    centeredness)

    ❑ Unsatisfactory patient, staff, or
    organizational outcomes

    ❑ Variations in practice within the setting

    ❑ Variations in practice compared to community
    standard

    ❑ Current practice that has not been validated

    ❑ Financial concerns

    5.

  • What are the PICO components?
  • P – (Patient, population, or problem)

    I – (Intervention)

    C – (Comparison with other interventions, if foreground question)

    O – (Outcomes are qualitative or quantitative measures to determine the success of change)

    6.

  • Initial EBP question
  • ❑ Background ❑ Foreground

    Johns Hopkins Nursing Evidence-Based Practice

    Appendix B: Question Development Tool

    7.

  • List possible search terms, databases to search, and search strategies.
  • 8.

  • What evidence must be gathered?
  • (Check all that apply.)

    ❑ Publications (e.g., EBSCOHost, PubMed,
    CINAHL, Embase)

    ❑ Standards (regulatory, professional,
    community)

    ❑ Guidelines

    ❑ Organizational data (e.g., QI, financial data, local
    clinical expertise, patient/family preferences)

    ❑ Position statements

    9.

  • Revised EBP question
  • (Revisions in the EBP question may not be evident until after the initial evidence review; the revision
    can be in the background question or a change from the background to a foreground question.)

    10. Outcome measurement plan

    What will we
    measure?

    (structure,
    process,
    outcome
    measure)

    How will we
    measure it?

    (metrics are
    expressed as

    rate or percent)

    How often will
    we measure it?

    (frequency)

    Where will we
    obtain the

    data?

    Who will
    collect the data?

    To whom will
    we report the

    data?

    Johns Hopkins Nursing Evidence-Based Practice
    Appendix B: Question Development Tool

    Directions for Use of the Question Development Tool

  • Purpose
  • This form is used to develop an answerable EBP question and to guide the team in the

    evidence search process. The question, search terms, search strategy, and sources of

    evidence can be revised as the EBP team refines the EBP

    question.

  • What is the problem, and why is it important?
  • Indicate why the project was undertaken. What led the team to seek evidence?

    Ensure that the problem statement defines the actual problem and does not include a

    solution. Whenever possible, quantify the extent of the problem. Validate the final

    problem description with practicing staff. It is important for the inter- professional

    team to take the time together to reflect, gather information, observe current practice,

    listen to clinicians, visualize how the process can be different or improved, and probe

    the problem description in order to develop a shared under- standing of the problem.

    What is the current practice?

    Define the current practice as it relates to the problem. Think about current policies and

    procedures. Observe practices. What do you see?

    How was the problem identified?

    Check all the statements that apply.

    What are the PICO components?

    P (patient, population, problem) e.g., age, sex, setting, ethnicity, condition, disease, type

    of patient, or population

    I (intervention) e.g., treatment, medication, education, diagnostic test, or best

    practice(s)

    C (comparison with other interventions or current practice for foreground questions; is

    not applicable for background questions, which identify best practice)

    Johns Hopkins Nursing Evidence-Based Practice
    Appendix B: Question Development Tool

    O (outcomes) stated in measurable terms; may be a structure, a process, or an

    outcome measure based on the desired change (e.g., decrease in falls, decrease in length

    of stay, increase in patient satisfaction)

    Initial EBP question

    A starting question (usually a background question) that is often refined and adjusted as

    the team searches through the literature:

    ■■ Background questions are broad and are used when the team has little knowledge,

    experience, or expertise in the area of interest. Background questions are often used

    to identify best practices.

    ■■ Foreground questions are focused, with specific comparisons of two or more ideas or

    interventions. Foreground questions provide specific bodies of evidence related to the

    EBP question. Foreground questions often flow from an initial background question

    and literature review.

    List possible search terms, databases to search, and search strategies.

    Using PICO components and the initial EBP question, list search terms. Terms can be added

    or adjusted throughout the evidence search. Document the search terms, search strategy,

    and databases queried in sufficient detail for replication.

    What evidence must be gathered?

    Check the types of evidence the team will gather based on the PICO and initial EBP

    question.

    Revised EBP question

    Often, the question that you start with may not be the final EBP question. Back- ground

    questions can be refined or changed to a foreground question based on the evidence

    review. Foreground questions are focused questions that include specific comparisons and

    produce a narrower range of evidence.

    Johns Hopkins Nursing Evidence-Based Practice
    Appendix B: Question Development Tool

  • Measurement plan
  • Measures can be added or changed as the review of the literature is completed and

    the translation planning begins:

    ■■ A measure is an amount or a degree of something, such as number of falls with

    injury. Each measure must be converted to a metric, which is calculated before

    and after implementing the change.

    ■■ Metrics let you know whether the change was successful. They have a numerator

    and a denominator and are typically expressed as rates or percent. For

    example, a metric for the measure falls-with-injury would be the number of falls

    with injury (numerator) divided by 1,000 patient days (denominator). Other

    examples of metrics include the number of direct care RNs (numerator) on a

    unit divided by the total number of direct care staff (denominator); the number

    of medication errors divided by 1,000 orders.

      Purpose
      What is the problem, and why is it important?
      What is the current practice?
      How was the problem identified?
      What are the PICO components?
      Initial EBP question
      List possible search terms, databases to search, and search strategies.
      What evidence must be gathered?
      Revised EBP question
      Measurement plan

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