1NURSING Example 1 Answer 1: The main aim of the research project was to implement ABCDE bundle to enhance outcomes in intensive care unit (ICU) in a rural community hospital. Thus, the central focus of this project was quality improvement. Answer 2: The main clinical question asked in this project included ‘Does the implementation of the ABCDE bundle of care versus the usual care decrease the occurrence of delirium, length of stay (LOS), patient total hospital LOS and length of mechanical ventilation of patient and eventually reduce the costs in the ICU settings? The significance of the above question is that it has been developed based on the PICO framework and the question covers all the components of the PICO framework. The components of the question were as follows: Population (P):ICU patients Intervention (I):ABCDE bundle of care Comparator (C):Usual care or no ABCDE bundle Outcome (O):Decrease cost in the ICU (Primary outcome) evidenced by other secondary outcomes listed in the research question Answer 3:
2NURSING This project may have adapted problem focused trigger because delirium is a common issue in mechanically ventilated patients in ICU which increase LOS and increase the overall cost care (Kram et al., 2015). Hence, as the project has implemented ABCDE bundle in response to this problem, it can be said that it is based on a problem focused trigger. It can also be based on a knowledge focused trigger as the research outcome gives information on how ABCDE bundle can be cost-effective in enhancing ICU patient outcomes. Example 2 Answer 1 From the review of abstract and introduction of the article by Swenson et al. (2015), one of the clinical questions that could be answered by this study are as follows: What is the effectiveness of parent’s use of praise and criticism on increasing the quality of parent-child interaction and mental health outcomes in young children seeking mental health services? The PIO element that has been captured in this research question are as follows: Population (P): Young children seeking mental health services Intervention (I): parent’s use of praise and criticism Outcome (O): quality of parent-child interaction and mental health outcomes
3NURSING Answer 2: The main findings reported by Swenson et al. (2015) were that parent’s praise and criticism are powerful feedback sources that influences children’s behavior and development. The data from the study revealed that parents overestimate their use of praise, whereas they underestimate their use of criticism with preschool children. The evidence from this can be used in a EBP project related to practice improvements in pediatric primary care. The pediatric staffs can be encourages to utilize this evidence to learn more about the type of parenting practices needed to elicit positive behavior in children. The evaluation and analysis of the findings will help pediatric staffs to provide adequate counseling to parents and teach them about positive skills that promote positive child behavior. Hence, the findings have implication in improving individual knowledge related to the topic as well as improving the practices implemented in parent training programs. Example 3 Answer 1 The study byBeck and Watson (2010)could address the following research questions: 1.Can a subsequent childbirth after a previous traumatic birth heal a women or retraumatize them? 2.What is the impact of previous traumatic birth on subsequent birth in women? 3.What is the women’s experience of a subsequent pregnanct after traumatic child birth?
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4NURSING The above three research questions also have PIO or PICO elements that clarify the main population, intervention and outcome of interest for the study. The PIO elements for each of the research question have been listed below in a table: Research questionPopulationInterventionOutcome Question 1Womenaftera previoustraumatic birth subsequent childbirthHeal or retraumatize Question 2Pregnant womensubsequentchildbirth afteraprevious traumatic birth Impactofthe intervention Question 3Womenaftera previoustraumatic birth Subsequent pregnancyExperiences Answer 2: The main purpose of any EBP project is to guide decision making in the context of patient care and achieve better outcomes for a client. The findings from the study byBeck and Watson (2010)can be used for an EBP project too. It will help to enhance skills of health care professionals who deal with a pregnant woman with previous traumatic birth. The finding will help them to understand how to prepare such pregnant woman for a child birth again. This data will increase health professional’s sensitivity towards such women.
5NURSING References: Beck, C. T., & Watson, S. (2010). Subsequent childbirth after a previous traumatic birth.Nursing research,59(4), 241-249. Kram, S. L., DiBartolo, M. C., Hinderer, K., & Jones, R. A. (2015). Implementation of the ABCDE bundle to improve patient outcomes in the intensive care unit in a rural community hospital.Dimensions of Critical Care Nursing,34(5), 250-258. Swenson, S., Ho, G. W., Budhathoki, C., Belcher, H. M., Tucker, S., Miller, K., & Gross, D. (2016). Parents' use of praise and criticism in a sample of young children seeking mental health services.Journal of Pediatric Health Care,30(1), 49-56. Swenson, S., Ho, G. W., Budhathoki, C., Belcher, H. M., Tucker, S., Miller, K., & Gross, D. (2016). Parents' use of praise and criticism in a sample of young children seeking mental health services.Journal of Pediatric Health Care,30(1), 49-56.