2

Student Name:

PICO and Literature Search

NUR4440

Scenario: Non-Pharmacological Management of Dementia: On the neurology inpatient unit, there are increasing numbers of patients with dementia. Some of the symptoms noted in these patients include agitation, wandering and even screaming and violence. A nurse on the unit was recently injured by an elderly man who attacked and hit her while she was providing nursing care to him. Your task is to propose a plan that will address the non-pharmacological management of dementia on the unit and train the nurses to provide quality care to patients with dementia.

PICO Question: In adults with Alzheimer’s disease, what is the effect of animal-assisted therapy compared to usual care on the intensity of agitation?

P: adults with Alzheimer’s disease

I: animal-assisted therapy

C: usual care

O: intensity of agitation

3 Keywords: Alzheimer’s, animal-assisted therapy, agitation

1 Synonym: dementia

1 MeSH term: psychomotor agitation

References

Majic, T., Gutzmann, H., Heinz, A., Lang, U. E., & Rapp, M. A. (2013). Animal-assisted therapy and agitation and depression in nursing home residents with dementia: A matched case-control trial. American Journal of Geriatric Psychiatry, 21(11), 1052-1059.

https://doi.org/10.1016/j.jagp.2013.03.004

Nordgren, L., & Engström, G. (2014). Effects of dog-assisted intervention on behavioural and psychological symptoms of dementia. Nursing Older People, 26(3), 31-38.

https://doi.org/10.7748/nop2014.03.26.3.31.e517

Olsen, C., Pedersen, I., Bergland, A., Enders‐Slegers, M., Patil, G., & Ihlebæk, C. (2016). Effect of animal-assisted interventions on depression, agitation and quality of life in nursing home residents suffering from cognitive impairment or dementia: A cluster randomized controlled trial. International Journal of Geriatric Psychiatry, 31(12), 1312-1321.

https://doi.org/10.1002/gps.4436

Swall, A., Ebbeskog, B., Lundh Hagelin, C., & Fagerberg, I. (2017). Stepping out of the shadows of Alzheimer’s disease: A study of older people with Alzheimer’s disease caring for a therapy dog. International Journal of Studies on Health & Well-Being, 12(1), 124-127.

https://doi.org/10.1080/17482631.2017.1347013

Updated 8/29/2020 CJP

PICO and Literature Search Scenarios

1

:

Delegation: A unit employs RNs, LPN’s and PCTs (patient care techs) to provide direct care. The unit has had an issue with appropriate delegation. The PCTs and LPNs report that they are being asked to perform more than their “fair share”, and things they should not do. The RN’s state that they are the only ones who do anything, and every time they ask the LPNs and PCTs to do anything they are told the PCTs and LPNs are not allowed to perform the task. The Unit manager recognizes that efforts to improve delegation need to be made. Your task is to research an intervention to enhance the quality and practice of delegation on this unit.

2:

Decreasing wait times in ER or patient flow time to move from ED: A manager of an Emergency Department is concerned that patient satisfaction scores have dropped significantly for the department. The primary complaint is long wait times. Internal tracking of patient flow has shown patients are waiting up to 7 hours for transfers to patient care areas, or to hospital units. Your task is to research an intervention to decrease wait times with improved flow to the care areas.

3:

New grad nurse retention: The manager of a medical surgical unit that is expanding needs to hire additional staff. Over the last 3 years 90% of the new graduates hired have quit within the first year of hire. The current RN staff is comprised of 8 nurses with greater than 10 yrs experience, 6 nurses with 5-10 yrs experience and 7 nurses with less than 5 yrs experience on the unit. Six new graduates are hired for the expansion. They will start 3 months before the new beds open. Your task is to research an intervention to enhance retention of the new graduates.

4:

Reducing medication errors: A medical surgical unit manager has had a significant increase in medication administration errors over the last two months. The errors involve many staff members and are occurring on all shifts. The budget does not allow for the purchase of new administration system. Your task is to research an intervention to decrease medication administration errors from the nursing staff within these parameters.

5:

Patient family centered care: The manager of a medical surgical unit has experienced a significant drop in patient satisfaction with the primary complaints being a lack of communication to patients and their family members. Your task is to research an intervention to increase patient-family centered care environment that would address this issue.

6:

Evidence-based practice: A hospital is seeking Magnet Hospital status. The managers of the units are charged with enhancing the incorporation of evidenced based practice on a unit level. Your task is to research an intervention to enhance the exposure to and application of evidence-based practice among nurses on the medical surgical unit.

7:

Enhancing teamwork across care provider levels: The manager of a medical surgical unit has observed, and had complaints about, lack of teamwork between the RN’s and the patient care techs (PCT’s). Your task is to research an intervention to enhance teamwork on the unit.

8:

Call light response time: The manager of a medical surgical unit that employs RN’s and patient care techs (PCT’s) has had a significant increase in call light response time and decrease in patient satisfaction related to the answering of call lights. Your task is to research an intervention that addresses the answering of call light in a timely, respectful manner.

9:

Decreasing the incidence of DVT’s in post-op orthopedic patients: Quality assurance reports for an orthopedic surgery unit identify an increase in the incidence of DVT’s over the last 6 months. The unit uses a standard prevention plan of Lovenox subQ and sequential compression devices (SCD’s) for all appropriate post-op patients. A recent survey found that 64% of the patients did not have SCD’s on while in bed and 32% did not receive Lovenox with the notation “refused”. Your task is to research an intervention to increase the use of SCD’s and decrease the number of refused Lovenox doses.

1

PICO and Literature Search.

Purpose:

PICO questions are used by practicing nurses and researchers to focus research questions and develop an efficient literature search strategy.  It is essential that future nurses learn how to do this to develop evidenced-based solutions to patient care problems in a healthcare organization.  

Instructions:

1. Write a PICO question based on a scenario you choose from the list of scenarios attached below.  Use the templates in the EBP Step by Step 3 article to help create your questions. You may need to do a pre-search to finding an intervention (the “I”) that has been studied and published to solve the problem.

2. Identify the PICO elements for each question. 

3. Develop a search strategy using at least 3 keywords from the P, I, and O parts of your PICO, 1 synonym for one of the keywords, and 1 MeSH term for one of your keywords. 

4. Locate 4 articles that help answer your PICO question.  The articles must meet the following requirements: 

· must be primary source quantitative research articles.  

· No article can be older than 2017. 

5. Obtain pdfs of the four articles you selected from the ResU database.  They must show the full text of the entire article. If not available for the ResU database, you may request access from the ResU Library, or you can email me the citation for the article, and I will attempt to locate a pdf of it. 

6. On a Word document, include your scenario; write your PICO question as a sentence; identify the P, I, C, and O for each question; and list the search terms (3 keywords, 1 synonym, 1 MeSH term) for each. You may use the template attached here. See also the link to the MeSH terms website below.

7. Provide a properly formatted APA reference page for your selected articles from Step 4 of these instructions. See the link to the APA and Writing LibGuide below.

8. Name each document (one Word doc and 4 article pdfs) as follows and upload to this submission folder:  

· Lastname PICO, 

· Lastname article 1,

· Lastname article 2,

· Lastname article 3,

· Lastname article 4

Link to MeSH Terms Website