Purpose

The purpose of this activity is to deepen learning through reflective inquiry. It will allow for expansion in self-awareness, identification of knowledge gaps, and assessment of learning goals.

Course outcomes: This assessment enables the student to meet the following course outcomes.

· Compare and contrast differences and similarities of qualitative, quantitative, and mixed method designs.

· Analyze qualitative and quantitative data for the purposes of critical appraisal of evidence.

· Appraise systematic reviews for translation science.

· Differentiate selected statistical methods for the purposes of translation science. 

· Evaluate selected statistical methods for the purposes of critical appraisal of evidence. 

· Synthesize literature relevant to practice problems.

· Formulate PICOT/PICoT questions relevant to advanced nursing practice. 

Preparing the Assessment

Follow these guidelines when completing this assignment. 

1. Write a brief 1–2 paragraph weekly reflection addressing the questions posed in the Reflect section of each week. Edit your Reflection to include each weekly reflection.

2. Include the following sections in your Reflection.

1. Week 1

– Provide one specific example of how you achieved the weekly objectives.

– What did you learn about your capacity to read and appraise original qualitative research? What changed, if anything, following the week’s activities?

– How will this skill improve your effectiveness as a practice scholar?

2. Week 2

– Provide one specific example of how you achieved the weekly objectives.

– What did you learn about your capacity to read and appraise original quantitative research? What changed, if anything, following the week’s activities?

– How will this skill improve your effectiveness as a practice scholar?

3. Week 3

– Provide one specific example of how you achieved the weekly objectives.

– What did you learn about your capacity to read and appraise summaries of research evidence? What changed, if anything, following the week’s activities?

– How will this skill improve your effectiveness as a practice scholar?

4. Week 4

– Provide one specific example of how you achieved the weekly objectives.

– How has the course information influenced your understanding of descriptive statistics?

– How can you bring this information of statistical analysis to practice?

5. Week 5

– Provide one specific example of how you achieved the weekly objectives.

– In what ways did course information influence your understanding of parametric statistics?

– What goals will you set in accordance with what you have learned this week?

6. Week 6

– Provide one specific example of how you achieved the weekly objectives.

– What was the most rewarding learning experience you had this week?

– How could you amplify the effectiveness of your skill in evidence synthesis and translation science?

7. Week 7

– Provide one specific example of how you achieved the weekly objectives.

– How has course information changed your ways of knowing?

– How does the knowledge gained advance your professional formation as a practice scholar?

8. Writing Organization and Mechanics

– Grammar and mechanics are free of errors.

Requirements 

1. Addresses all aspects of the weekly reflection 

2. Assesses own learning 

3. Assesses value of the learning experience

I ATTACHED EVERY WEEK DISCUSSION BOARD FOLLOWING THE GUIDE FOR THIS ASSIGNMENT AND THE ATTACHED, YOU CAN COMPLETE EVERY WEEK. REMEMBER IS 1 TO 2 PARAGRAPH FOR EACH WEEK AND USE AT LEAST 5 SOURCES NO LATER THAN 5 YEARS. PLEASE COMPLETE EACH WEEK SEPARATED, EXAMPLE:

WEEK 1

WEEK 2

ETC.

Hello Dr Kyzar and Class

· Does the research design answer the research question? Explain your rationale.

Lloyd et al., 2018 focused at establishig whether the school-based interventions for children of ages 9-10 years would help in preventive excessive weight gain after 24 months. The researchers used pragmatic cluster randomized controlled trial of the Healthier Lifestyle Programme (HeLP) which is a school-based obesity prevention intervention that was performed in 32 schools found in the southwest England. This method is revealing school as the ideal location for the childhood obesity preventiuon programs due to the near-universal reach f children in the socioeconomic spectrum. It also shows the importance of the change in the diet and physical activity behaviors and their impacts on the weight status (Lloyd, et al., 2018). Were the study sample participants representative? Why or why not?

The sample calculation assumed a mean of 35 children age 9-10 years in every school and this implies that a total of 1,120 samples were used. This is a good number that can represents the problems at the 32 schools that were being targeted by the researchers.

Compare and contrast the study limitations in this study.

The findings of the study shows that the effectiveness of the school-based obesity prevention programmed is inconclusive and contradictory. The interventions used are highly heterogenous in the design and most of the studies used for the research have some methodological weaknesses for example the inadequate statistical power, greater levels of attrition, differential uptake, follow-up, and the short-lived follow-up.

· Based on this evidence summary, would you consider this systematic review as support for your selected practice problem? Explain your rationale.

Two themes were considered to be important i.e. energy in and decision making and the responsibility. It is clear that school hosts many children and can therefore be used as ideal place to deliver the population-based interventions. Even though it might not adequately intensed to affect both school and the family environment hence wieght of the children, it needs to be promoted since it helps in changing the health behaviors of the children. This is important in addressing the issue of childhood obesity sinnce it helps in promoting healthy behaviors among children (Lloyd , et al., 2018).

References

Lloyd, J., CStat, C. S., Logan, S., Green, C., Dean, S., Hillsdon , M., Abraham, C., Tomlinson, R., Pearson, V., Taylor, R., Ryan, E., Price, L., Streeter, A., Wyatt, K., & Wyatt, K. (2018). Effectiveness of the Healthy Lifestyles Programme (HeLP) to prevent obesity in UK primary-school children: a cluster randomised controlled trial. The Lancet Child & Adolescent Health, 2(1), 35-45. https://doi.org/10.1016/S2352-4642(17)30151-7

2

Hi Dr Kyzar and Class

Does the research design answer the research question?

The research questions of the article by Lidgate & Lindenmeyer (2018) seek to look at the experiences of the parents and the informal caregivers in receiving and providing informal childcare for the British children of ages 0-5 years; the perceptions about the relationship existing between the informal childcare and the childhood obesity; and the proposed intervention thoughts and the delivery approaches in preventing obesity amongst children who are receiving informal care (Lidgate & Lindenmeyer 2018).

Through adopting the in-depth focus groups of 14 participants, the researchers managed to offer answers to the research questions. Based on the outcome of the study, the informal carers were identified to be offering both practical and the emotional support roles for the parents. There was a perception that informal care is contributing to childhood obesity through cross generation conflicts that prevents the adoption of the healthy practices; the trade-off for the parents between the receiving childcare and the maintenance of the control; reduction of the energy capacity of the carers; and increase in the snacking. The findings is supporting the idea of and informing the development towards an information based and the cheaper intervention that is being provided through the present primary care platforms (Lidgate & Lindenmeyer 2018).

Tremblay et al. (2017) was focused on the Canadian 24-Hour movement Guidelines for the early (0-4 years) that involves the integration of the physical, sedentary, behaviors, and the sleep. This study involved a systematic review that examined the physical activity, sedentary behavior, sleep, and the combined behaviors that looks into the relationship within among the movement behaviors and several health indicators that were completed usign the Guideline Development Panel. This study method helped in the generation of the evidence-informed proposals that invlved the combinations of the light, moderate, and the vigorous-intensity physical activity, the sedentary behaviors, and the sleep among individuals from ages 1 to 4 years in the achievement of the healthy day. This guideline is offering a public health guideline where there is maximization of the health that is based on the balance of movement (Tremblay et al., 2017).

Lloyd et al., 2018 focused at establishig whether the school-based interventions for children of ages 9-10 years would help in preventive excessive weight gain after 24 months. The researchers used pragmatic cluster randomized controlled trial of the Healthier Lifestyle Programme (HeLP) which is a school-based obesity prevention intervention that was performed in 32 schools found in the southwest England. This method is revealing school as the ideal location for the childhood obesity preventiuon programs due to the near-universal reach f children in the socioeconomic spectrum. It also shows the importance of the change in the diet and physical activity behaviors and their impacts on the weight status (Lloyd, et al., 2018).

Were the study sample participants representative

The sample size used by the Lidgate & Lindenmeyer (2018) were few, therefore, it makes it hard for the outcome of the study to be used to represent or generalized what is happening in other cities. Even though researchers made an effort to recruit both parents and the carers in the study, only 14 participants were involved in the study to ensure that it meets the limited timeframe. Therefore, it is recommended that the interpretation of the study outcome have to be done with some limitations (Lidgate & Lindenmeyer 2018).

In the study by Tremblay et al. (2017), a total of 552 Canadian preschool-aged children from CHMS were used. The sample used in the research work are adequate enough to reveal the events related to the link of the time being used during sleep, sedentary behavior, LPA, and the MVPA (Tremblay et al., 2017).

In a study by Lloyd et al. (2018), the sample calculation assumed a mean of 35 children age 9-10 years in every school and this implies that a total of 1,120 samples were used. This is a good number that can represents the problems at the 32 schools that were being targeted by the researchers.

Comparing the study limitations

The limitation of the study by Lidgate & Lindenmeyer (2018) is linked to the few number of the study participants who took part in the study. The researchers only managed to recruit 14 participants to ensure that the limited timeframe of the project is met. This therefore makes it essential to make an interpretation of the data with some limitations (Lidgate & Lindenmeyer 2018).

The limitation of the research work by Tremblay et al. (2017) is that there was an incomplete evidence-based for the guidelines with low quality. The study is not representing the best available evidence collected through the systematic review and the original research. The research work is lacking adequate research to form specific aspects of guideliens for example the dose-response research studies.

In the article by Lloyd et al. (2018), the findings of the study shows that the effectiveness of the school-based obesity prevention programmed is inconclusive and contradictory. The interventions used are highly heterogenous in the design and most of the studies used for the research have some methodological weaknesses for example the inadequate statistical power, greater levels of attrition, differential uptake, follow-up, and the short-lived follow-up.

Whether the selected qualitative study is supporting the practice problem

The problem in this case is related to the obesity especially on children. There is an increase concern about the rise in the reported cases of obesity among children. Based on the findings by Lidgate & Lindenmeyer (2018), there are four themes that emerged. The most important two themes include the importance of the informal care to families and the society and the potential explanations for the link between childhood obesity and the informal care. These themes are important since they reveal the relationship between the childhood obesity and the informal care as well as revealing the role played by the families and the society when it comes to the implementation of the informal care (Lidgate & Lindenmeyer 2018).

The study by Lidgate & Lindenmeyer (2018) is important since it reveals that obesity in children is associated with the informal childcare and the rising risk factors of the childhood obesity for children of ages 0-5 years. The study reveal that informal education to the carers is important in supporting parents and helping in the prevention of obesity amongst children. The intervention that targets the primary care is helping in the reduction of the risk of childhood obesity (Lidgate & Lindenmeyer 2018).

The study by Tremblay et al. (2017) is based on the proces as well as the outcomes for the development of the Canamdian 24-hour movement guidelines for the early years (0-4 years) which involves the integration of the physical activity, sleep, and the sedentary behavior. The two importance themese emerged from the stufy findings i.e. physical activity and health indicators and the sedentary health behaviors and indicators. The researchers focused on the development of the guidelines that involves the integration of the movement behaviors which followes a shift towards whole-day strategy to the conceptualization of the movement behavior supported by the Canadian 24-hour movement guidelines. It helps in ensuring that the problem of childhood obesity is addressed through promotion of active health lifestyles (Tremblay et al., 2017).

In the research work by Lloyd et al. (2018), two themes were considered to be important i.e. energy in and decision making and the responsibility. It is clear that school hosts many children and can therefore be used as ideal place to deliver the population-based interventions. Even though it might not adequately intensed to affect both school and the family environment hence wieght of the children, it needs to be promoted since it helps in changing the health behaviors of the children. This is important in addressing the issue of childhood obesity sinnce it helps in promoting healthy behaviors among children (Lloyd , et al., 2018).

References

Lidgate , E. D., & Lindenmeyer, A. (2018). A qualitative insight into informal childcare and childhood obesity in children aged 0–5 years in the UK. BMC Public Health, 18, 1229.

https://doi.org/10.1186/s12889-018-6131-0

Lloyd, J., CStat, C. S., Logan, S., Green, C., Dean, S., Hillsdon , M., Abraham, C., Tomlinson, R., Pearson, V., Taylor, R., Ryan, E., Price, L., Streeter, A., Wyatt, K., & Wyatt, K. (2018). Effectiveness of the Healthy Lifestyles Programme (HeLP) to prevent obesity in UK primary-school children: a cluster randomised controlled trial. The Lancet Child & Adolescent Health, 2(1), 35-45.

https://doi.org/10.1016/S2352-4642(17)30151-7

Tremblay, M. S., Chaput , J.-P., & Carson, V. (2017). Canadian 24-Hour Movement Guidelines for the Early Years (0–4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep. BMC Public Health, 17, 874.

https://doi.org/10.1186/s12889-017-4859-6

Lidgate & Lindenmeyer., 2018; Permalink: https://doi.org/10.1186/s12889-018-6131-0

Tremblay et al., 2017; Permalink: https://doi.org/10.1186/s12889-017-4859-6

Lloyd et al., 2018; Permalink: https://doi.org/10.1016/S2352-4642(17)30151-7

1

Hi Dr Kyzar and Class

Whether the research design answer the research question

In Ash et al (2017), the researchers were aiming at profiling the current family-based childhood obesity prevention as an intervention through the employment of the systematic review and the quantitative content evaluation techniques to help in the identification of the present gaps in the awareness. The method employed by the authors was a wide-ranging search approach using the databases PubMed, PsycINFO, and CINAHL. This was done to guide on the identification of the eligible interventions that can help in the prevention of childhood obesity accompanied with lively family component that was developed between 2008 and 2015. The search results reveal that the existence in the few numbers of interventions that target the diverse population and the obesity risk habits beyond the diet and the physical exercises inhibiting the process of developing a all-inclusive, custom-made intervention (Ash et al., 2017).

Whether the study sample participants were representatives

In Ash et al (2017), a total of 84 samples from the underserved population and non-traditional families and as well as the racial or ethnic composition were used. Even though this is a smaller sample, it gives a clear picture of the role played by family-based childhood obesity prevention interventions (Ash et al., 2017).

The limitation of the study

The limitation showed by the researcher in Ash et al (2017) is that the focus was on the articles that were published over relatively narrow time-period. The researchers also failed to evaluate the effectiveness or the quality of the intervention thus limiting the potential of the review. The outcome of the study can be influenced by the number as well as the choice of the databases searched thus subjecting it to the publication bias (Ash et al., 2017).

Whether this quantitative research study would be considered as a support to the selected problem

The key themes identified by the researchers included intervention characteristics, article characteristics, and the sample characteristics. The rise in childhood obesity is a burden to the nation. Therefore, efforts are being made to have an effective intervention. The researchers showed the need of having intervention effort, especially in the low- and middle-income nations. Ash et al (2017) study is therefore revealing the importance of family-based childhood obesity intervention that can be used to tackle the issue of obesity among children (Ash et al., 2017).

References

Ash, T., Agaronov, A., Aftosmes-Tobio, A., & Davidson, K. K. (2017). Family-based childhood obesity prevention interventions: a systematic review and quantitative content analysis. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 113. https://doi:10.1186/s12966-017-0571-2

Analyzing Descriptive Statistics:

Students Name:

Institutional Affiliation:

Professors Name:

Date:

Hi Dr Kyzar and classmates

What statistical procedure is needed to determine an effective sample size to make a reasonable conclusion?

Main objective of having or developing an effective sample size is trying to get both clinically and statistical significant result as this also tries to maximize the use of the resources efficiently. A determinant of sample size may include the size in question, homogeneity of the sample the anticipated attrition, and sometimes the risk of errors which have been considered as being appropriate depending on the research question being studied. In determining the sample size of the given sample, one would have to accurately define the outcome which is the objective being measured. Another determinant is the homogeneity of the sample which shows the similarity of the study units and the best way that this sample would be representing the entire population (Burmeister and Aitken, 2017).

At some point, this also includes determining the different parameters including the standard deviation. It’s important to note the essence of level of significance as this helps in identifying whether some effect may be existing. Power of a test is also important as this includes the probability of not detecting the effect in the event when there is an effect. In that note, I may argue that the sample size determination procedure may include pinpointing the outcome or a given hypothesis which in this case it includes a null and alternative hypothesis, then one selects the smallest effective size then one may specify the significance of the test, estimate the different parameter values that may be required in calculating the sample size and specifying the intended power. In some cases, the sample size may also be dependent on the design and the different parameters that are being measured.

Reading through the study, you observe that the researcher used a chi-square analysis to analyze nominal and ordinal data. Is this the appropriate level of statistical analysis to answer the research question? Explain your rationale.

Chi square analysis is the efficient statistical test that can be incorporated in answering different research questions. From the different study readings, we may denote that chi-square analysis is one of the many statistical tests that may be useful in describing the data as this statistical test does not provide the casual relationship between these two variables. The chi-square analysis may be incorporated in describing and outlining he differences in the nominal and the ordinal variables. Also, it’s worthwhile noting that the study description may also show that the given data was not normally distributed. In that note, we may conclude that chi-square may also be used in the data which may not be depending on normal distribution in interpreting the findings of the study. This makes it a non-parametric test that can be used in checking association among the different categorical variables (McHugh, 2018).

A chi square is essential, just as stated, its can be used in analyzing nominal and categorical data as when the chi-square helps in analyzing both the ordinal and the nominal data, the different statistical tests are incorporated inn finding different problems by approaching the problems of ordinal variables. For instance the Mann-Whitney test is appropriate in evaluating the differences that exists between different populations that are using a given data from an independent measure design. On the other hand, other tests also tries in evaluating the differences between different populations by incorporating the different samples for a given treatment condition.

Reading further, the researcher reports that the p-level led her to conclude that the null hypothesis was rejected. In your critique of the study, you determine that the null hypothesis is true. Do these findings impact your decision about whether to use this evidence to inform practice change? Why or why not?

From the critique, the said findings would have an effect on the decision as I would have to evaluate whether I can incorporate this evidence in informing some practice change. The reason for this is because the researcher committed type 1 error which is likely to lead to inefficient change that may help in adopting newer things or even may lead to erroneous results as there are constant errors in the practice. In trying to avoid such and related errors and sort of mistakes, in my case, I would try controlling for type 1 error as this would help me in correcting the errors that are likely to result to making wrong conclusions and adopt the best change practice that would help in attaining the stipulated results (Weiss and Weiss, 2017).

Statistical errors may legitimate data as this at some point may lead to getting incorrect conclusion. In the study, it’s always crucial to determine if the given results are correct because that what matters most considering the objective of the study. In the event when this results are incorrect, then it would not be necessary to interpret the data any further. Which as stated the fact that when I discover that the research made type 1 error, it would be very hard for me to make any further conclusions on the study. We have different statistics that helps us in getting evidence which helps in determining if there is any relationship that exists between some parameters. This statistics play an important role in every aspect and it’s therefore important to always take it into consideration as this may lead to different series of events of implications irrespective of where a given study was conducted.

References

McHugh, M. L. (2018). The chi-square test of independence. Biochemia medica: Biochemia medica, 23(2), 143-149.

Weiss, N. A., & Weiss, C. A. (2017). Introductory statistics. London: Pearson Education.

Burmeister, E., & Aitken, L. M. (2017). Sample size: How many is enough? Australian Critical Care, 25(4), 271–274. doi:10.1016/j.aucc.2012.07.002

Running head: PARAMETRIC STATISTICS 1

PARAMETRIC STATISTICS 2

Analyzing Parametric Statistics

Student’s name

Professor

Course title

Date

Hi Dr Kyzar and Class

1. When looking at the evidence, one notes that there is an independent variable and that a spearman’s ranked correlation is used in the analysis of the data. The spearman’s correlation can be referred to as the nonparametric version of the Pearson correlation. The correlation coefficient by Spearman’s measures the direction and the strength of the association between two variables which are ranked. For the use of this test, one requires two variables which are either ratio, interval, or ordinal. The spearman correlation is used when the assumptions of the Pearson correlation have been violated. The spearman’s correlation determines the direction and the strength of the monotonic relationship between these two variables as opposed to the strength and direction of the linear relationship (Schober et al., 2018). The person correlation is the one which looks at the linear relationship between the two variables. The monotonic relationship refers to the relationship when either as the value of one increases the other variable is increasing or as the value of one of the variable is increasing, the other variable is decreasing (Bakdash and Marusich, 2017). The spearman correlation is used in measuring the direction and strength of monotonic association between these two variables. The monotonicity is considered to be less restrictive compared to that of the linear relationship. When one normally picks the measure of association, it is after looking at the pattern of the data which is observed. When one looks at the scatterplot and it shows a relationship which looks monotonic, then one would use the spearman’s correlation (Akoglu, 2018). If there is a liner relationship, then one uses a person’s correlation as it shows the direction and strength of the linear relationship. The correct level of correlation analysis which should have been used in this case is Pearson’s correlation analysis. The data that has been presented has a normal distribution and has therefore met all assumptions of the Pearson’s correlation. There is manipulation of the independent variable and the Pearson’s is the better level.

2. Correlational analysis and association are sometimes used interchangeably but they have slightly different meanings when it comes to the technicality. Association refers to the presence of any relationship between two variables but the correlation is used to refer where there is existence of a linear relationship between the variables. The terms are often used interchangeably when it comes to various texts despite the differences. The correlation analysis explores the association which is there between two or more variables. The correlational analysis makes an inference about the strength of the relationship between the variables (Akoglu, 2018). There are several differences which can be shown when it comes to association. A scatter plot, for example, shows the association between two variables. The scatter plot matrix indicates the pairwise scatter plots for the various variables. When it comes to the majority of books, correlated and associated all mean to the same thing. The technical meaning which is there in correlation is that there is strength of the association as measured by the correlation coefficient. Correlation as it is used is mainly a technical term while the association is not. The association simply means that there is a relationship presence (Schober et al., 2018). The association will mean that certain values of one variable tends to co-occur with certain values of the other variable. There is no dependent or independent variable when it comes to the correlation. It’s a descriptive statistic which is bivariate. When it comes to the technical side, one can note that there are several measures of association but only some of them can be referred to as correlations.

3. After the findings I have a different outlook on the decision on whether to use the evidence to inform practice change. A quasi-experimental research study involves the manipulation of an independent variable so as to see how the dependent variable will react. In this case the study sample size is large and the data is normally distributed. I believe that this study makes an error and should have instead used the Pearson’s correlation coefficient to show the relationship. The Pearson’s correlation coefficient fits the purpose and there is no need to use the spearman’s ranked correlation.

References

Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation coefficients: appropriate use and interpretation. Anesthesia & Analgesia, 126(5), 1763-1768.

Akoglu, H. (2018). User’s guide to correlation coefficients. Turkish journal of emergency medicine, 18(3), 91-93.

Bakdash, J. Z., & Marusich, L. R. (2017). Repeated measures correlation. Frontiers in psychology, 8, 456.

1

PICOT Formulation

Student’s Name

Department, Institutional Affiliation

Course Title

Tutor’s Name

Date

Hello Dr Kyzar and Class

According to Abbade et al (2016), PICOT format is used in the comparative research studies on the relationship between the exposure and the outcome. The exposure in this case can be considered to be the newly developed intervention that is targeted at addressing health issues. This discussion is therefore focused on looking at the two-practice question based on the PICOT format to help in driving the practice change (Abbade et al., 2016).

Practice Question 1

Identification of the PICOT components

Population: children of ages between 5 to 19 years with a body mass index (BMI) of more than

Intervention: the use of the motivational interviewing during a regularly well-child scheduled visitation and its influence on the BMI, BP, quality of life, and the daily physical exercise

Compared: Usual practice is compared to the intervention of motivational interviewing in the regular well-child visitation.

Outcome: the implementation intervention i.e. motivational interviewing influences improvement in the BMI, daily physical exercise, and quality of life.

Time: 8-10 weeks

The keywords used in the identification of the practice question

The keywords or terms that guide the search process to facilitate the process of responding to the practice questions include the motivational interviewing, regular well-child visitation, the BMI, the quality of life, the physical exercise, blood pressure (BP), and the 8-10 weeks timeframe.

To respond to the practice question further, a researched-based intervention focused is on the use of motivational interviewing. One of the articles generated from the research work is by Luque et al (2019) that involved the use of the Obemat2.0 trial. The Obemat2.0 trial was used to assess the effectiveness of multi-component motivational program to treat childhood obesity that is linked between the primary care and hospitals specialized services when compared to the usual intervention that is carried out in the primary care (Luque, et al., 2019).

The authors performed a cluster randomized clinical trial through the use of the two intervention arms i.e. the motivational intervention group and usual care group as the control using 167 study subjects. In the motivational intervention, there were motivational interviewing, learning materials, the utilization of the electronic health physical activity monitor and three group-based gatherings. Based on the results from the study, the primary results show an increase in the score of the body mass index before and after 12 or 12 plus 3 months implementation. The secondary results i.e. the pre and post intervention included the compliance to the medication, the waist circumference, fat mass index, the fat-free mass index, the total body weight, and the mineral density of the borne (Luque, et al., 2019).

The research-evidence based intervention being addressed

The research-evidence based intervention was the motivational interventions such as motivational interviewing, learning materials, the utilization of the electronic health physical activity monitor, and the three group-based sessions (Luque, et al., 2019).

The quantifiable outcomes and how they will be measures

The quantifiable outcomes from the article include body mass index, compliance to the treatment, waist circumference, fat mass index, fat-free mass index, the mineral density of the bone, lipid profile of the blood, the glucose metabolism, the psychological issues, and the total body weight. These are the key components that are associated with obesity. The assessment of the outcome is based on looking at whether there is an increase or reduction in the BMI based on the z score after the implementation period; whether there is an improvement in the adherence process to the medication; and looking at the changes in the score of other parameters mentioned above, for example, the waist circumference, glucose metabolism and the mineral density of the bone marrow (Luque, et al., 2019).

The valid measurements or tools

The measurement tool used for the measurement of the quantifiable data was Obemat2.0. This tool was used to assess the effectiveness of the multicomponent motivational program to help in treating childhood obesity. The multicomponent motivation program included the motivational interviewing, the learning materials, and utilization of the electronic health physical activity monitor (Luque, et al., 2019).

Whether the practice question can be answered within the specified period

The 8 to 10 weeks period is inadequate to measure as well as give accurate and reliable data that would reveal the true picture on the impacts of the intervention. The generated data would not be enough to implement the proposed intervention since the reduction in the BMI, the improvement in the physical activities, and the quality of life requires adequate time for the assessment. The time is also limited concerning factors such as resources required, making contact with the patients, and the measurements of the outcomes (Luque, et al., 2019).

Practice Question 2

Identification of the PICOT elements

Population: the adult care patients

Intervention: the implementation of the research-based skincare integrity bundle

Comparison: the implementation of the intervention that involves the use of the researched-based skincare integrity bundle is being compared to the standard care practice that does not involve any intervention to impact the hospital-associated pressure injuries.

Outcome: the implementation of the intervention will influence the rates of the hospital-associated pressures injuries

Time: the 8 to 10 weeks of the implementation process of the proposed intervention

The keywords used identified in practice question

Some of the key terms focused on in this research question include the skincare integrity bundle, standard care, critical care patients or population, hospital-acquired pressure injuries, the incidence of the skincare integrity bundles, and the 8 to 10 weeks timeframe.

Based on the use of the above terms, the generated research-based evidence is by Cruz (2020) that focused on the impacts of using pressure preventive bundle within 2 months. The author aimed at implementing the intervention involving the use of the intervention for the reduction of the rates of the pressure injuries amongst adult in the ICU. The author reports that patient in the ICU units is at high risk of pressure injuries as a result of the acuity diagnosis. Therefore, they need a longer type of healthcare services, medical procedures, and the application of various types of medical equipment (Cruz, 2020 ).

The research-based evidence intervention

In this study, the evidence presented to help in addressing the issue of pressure injuries among patients in the ICU is the preventive bundles. According to the author, this evidence-based intervention helps reduce the reported incidences of the pressure injuries amongst adult patients within the ICU. The author further reveals that the intervention can be used to assess, examine, and to offer continuous bedside support and positive feedback to the healthcare providers (Cruz, 2020).

The quantifiable outcomes, how to measure them, and the potential tool to help in their measurements

According to the author, the successful implementation of the intervention must be able to lead to the attainment of 10 percent or more in the reduction of the rate of pressure injury cases. The author also indicates that the intervention must be able to give about or more than 90 percent of the provider compliance to the implementation of the preventive bundles. The achievement of these expectation confirms the effectiveness of the intervention program (Cruz, 2020 ).

The outcomes from the implementation of the preventive bundles in the prevention of the pressure injuries are analyzed or measured by assessing the changes. There is an expectation that the implementation of the intervention will be improved amongst healthcare providers. There is a need to be a consistency in the process of implementing the bundle towards the prevention of the pressure bundles (Cruz, 2020).

The valid measurement tool that can be used for the quantification of the data to confirm the effectiveness of the intervention is the compliance checklist tool. This tool is used for the monitoring, auditing, and to offer continuous effective feedback to the providers within the ICU units. The tool is useful in providing information concerning adherence to the implementation of the intervention (Cruz, 2020).

Whether the practice question would be answerable within 8 to 10 weeks

The effective implementation can’t generate data that can be relied on concerning the importance of the preventive bundles within 8 to 10 weeks. This is a procedure that deals with health, therefore, requires adequate time for preparation and plan on the types of resources that will be required. It also requires the training of the nurses and other healthcare providers while at the same time allowing the team to ensure that such proposed practices are implemented within the ICU units (Cruz, 2020).

References

Abbade, L. P., Wang, M., Sriganesh, K., Mbuagbaw, L., & Thabane, L. (2016). Framing of research question using the PICOT format in randomised controlled trials of venous ulcer disease: A protocol for a systematic survey of the literature. BMJ Open, 6(11), e013175. doi:https://doi.org/10.1136/bmjopen-2016-013175
Cruz, C. (2020 ). Reducing the Incidence of Pressure Injuries in Adult ICU Patients at McAllen Medical Center with the Implementation of a Pressure Injury Preventive Bundle: A Quality Improvement Project.
Luque, V., Feliu, A., Escribano, J., Ferre, N., Flores, G., Monne, R., . . . Closa-Monasterolo, R. (2019). The Obemat2.0 Study: A Clinical Trial of a Motivational Intervention for Childhood Obesity Treatment. Nutrients, 11(2), 419. doi:https://doi.org/10.3390/nu11020419

2

Evidence Synthesis

Student’s Name

Department, Institutional Affiliation

Course Title

Tutor’s Name

Date

Hi Dr Kyzar and class

Whether the author identified the scope of evidence synthesis

The scope of the evidence synthesis is focused on the issue of patient falls with injuries and the challenges related to the prevention of falls within the acute cares settings. The author has identified this scope by drawing pieces of evidence from various authors. The evidence drawn from the previous studies indicates that the issue of patient falls is a major adverse event that interferes with the quality of healthcare services that are being provided to the patients within the acute care settings for example nursing homes and healthcare facilities. The study reveals that the detrimental effects caused by the issues of patients’ falls are associated with serious bruises, trauma, fractures, and death of the patients when it is not prevented at the right time (Araujo, et al., 2017).

The evidence also supports the focus of the author by revealing that the issue of falls is a common problem that is being experienced by elderly patients. It shows that one in every three individuals more than 65 years old suffer from at least one fall every year. This is associated with either alone of combined factors such as environmental factors, social factors, psychological factors. Therefore, the author has managed to gather the literature that helps in addressing the research area that is to say the issue of patient falls. The author has managed to synthesize the literature by comparing the literature studies referenced in this work. The author has managed to assess and interpret to help in concluding on the issue of patients’ falls and how it is becoming an issue within the acute care and to the healthcare providers (Araujo, et al., 2017).

Whether stronger paraphrased sentences are included to help in supporting the contemporary sources of research evidence

Through providing the description, summary, analysis, and identification of the key concepts; there is successful paraphrasing of the sentences to help in supporting the sources of the research evidence. The evidence from one of the research evidence used i.e. (Gygax Spicer, 2017) shows the issue of falls to be a common problem amongst elderly individuals due to the factors that are either combined or occurring singularly. These factors include social, environmental, and psychological factors. This evidence is supported by the paraphrased sentence which states that the etiology of falls among their elderly patients is as a result of attempting to get out of the bed without any form of assistance from the team of healthcare providers such as nurses. The issue is further increased by other causative factors such as diseases, impulsiveness, urgency, medications, and lack of knowledge about the hospital environment. Another issue that is paraphrased to support the evidence from the research is the turnover problem among healthcare providers. Due to the inadequate number of healthcare providers such as nurses to spend more time with the patients, these elderly remains to be highly exposed to the risk of falls as a result of the low ratio of nurse to the patient (Gygax, 2017).

Whether the facts presented are related to the practice problem that has been presented in an objective way

The facts presented in the article through research evidence and conclusion from the research findings have been done objectively and they are based on the issue of patient falls and injuries and fall prevention. One of these facts is that the issue of patient falls is a common problem within acute care facilities such as nursing homes and hospitals. They are linked to some of the preventable factors related to the social, environmental, and psychological factors. Due to the reduction in the ability to perform most of the ADLs, elderly patients are considered to be high-risk individuals who require help from the nurses to overcome the issue of falls which increases the risks of preventable injuries and deaths. These patients also experience the side effects of the medications, illness, impulsiveness, and urgency thus exposing them to a high risk of falls when effective interventions are not developed (Araujo, et al., 2017).

The other key fact linked to the issue of fall prevention is the lack of adequate nurses to help patients with their needs such as pottying and movement within the hospital. Due to the lack of knowledge about the hospital environment as well as lack of adequate to respond to their needs immediately, elderly patients remain highly exposed to severe bruises, fractures, traumas, and preventable deaths (Araujo, et al., 2017).

Whether the author uses sources to support the ideas and claims

The argument presented by the author is supported by the evidence from past studies. According to the argument from the author, the issue of falls among patients occurs as a result of their attempts to get out of bed without any form of assistance from the nurses. The author also argues that patients’ falls is also associated with the urgency, illness, medication being used by the patients, impulsiveness, and unfamiliarity with the hospital environment in addition to the increase in the turnover of the nurse staffing which reduces the number of nurses in the hospitals.

These arguments are supported by the research evidence used by the author. According to Gygax Spicer (2017), one to three persons of ages 65 years and above do suffer from at least one fall every year as a result of multiple factors that are linked to social, environmental, and psychological factors. The issue of illness, impulsiveness, urgency, and medication as presented by the author is the social and psychological factors that are demonstrated in the research evidence. The issue of a low number of patients is an environmental factor within the hospital facility. This increases the level of exposure of these patients to the risk of falls (Gygax, 2017). According to the author, patients always attempt to get out of their bed without any assistance from the nurses. Due to the lack of knowledge about the environment of the hospitals, the majority of them fall. De Medeiros Araujo et al (2015) shows that such falls expose them to mild and severe bruises, fractures, traumas, and even deaths. The few numbers of nurses in the facility imply that there would be no nurses left to keep an eye on other patients who might require help with pottying and bathing (de Medeiros Araujo, et al., 2017).

Whether this exemplar is a true synthesis of the evidence

The exemplar presented is a true synthesis of the evidence concerning the issue of patient falls and the complex nature of preventing such falls. Even though the presentation is majorly based on the arguments based on the research evidence, the information presented is a true reflection of what is happening in acute care settings. Even though efforts have been made to help in addressing the issue of patient falls, the evidence synthesis further confirms that addressing this issue is still complicated as a result of the high turnover that leads to the low number of nurses to care for the growing number of patients who are seeking services for their chronic conditions. The low number of nursing staff makes it impossible to implement the nursing hourly rounds and this complicates the interventions of efforts being made to ensure that there is the successful process of implementing the nursing hourly rounds (Araujo, et al., 2017).

The issue of patient falls is also associated with the problems caused by the medication and the psychological issues of the patients. The reduction in physical strength and mental well-being results in the reduction of the ability of the patients to perform their ADLs such as bathing. In acute care, these patients require help from the patients with the roles such as bathing and pottying. Due to the lack of adequate nurses, it makes it hard for these patients to have their needs rendered at the right time. Therefore, they are forced to get out of bed with no form of help from the nurses. Due to their reduced physical and mental ability as well as lack of knowledge about the hospital environment, they find themselves falling on the ground thus exposing them to mild to severe bruises, fractures, trauma, and death. Therefore, the effective process of addressing the issue of patients’ falls requires the process of dealing with the complications within the facility at first for example addressing the issue of lower nurse-patient ratios and improvement in the hospital environment by increasing the number of caregivers within the wards while nurses are busy caring for other patients (Araujo, et al., 2017).

References

Araujo, J. N., Fernandes, A. P., Moura, L. A., Santos, M. M., Ferreira Junior, M. A., & Vitor, A. F. (2017). Validation of nursing outcome content Fall prevention behavior in a hospital environment. http://www.repositorio.ufc.br/handle/riufc/23831
de Medeiros Araujo, C. X., de Lima Silva, V., Guerra, G. C., Ferreira, A. H., de Araujo Barbosa, S. J., & de Araujo Junior, A. A. (2017). Quality of life, integrative community therapy, family support, and satisfaction with health services among elderly adults with and without symptoms of depression. Psychiatric Quarterly, 88(2), 359-369. https://doi.org/10.1007/s11126-016-9453-z
Gygax, S. J. (2017). The Got-A-Minute Campaign to Reduce Patient Falls with Injury in an Acute Care Setting. MedSurg Nursing, 26(5).