Evidence-Based Practice in Nursing

This nursing assignment focuses on conducting an evidence-based review of the use of fish oil in managing osteoarthritis in older women. The student utilizes PICO/PICo framework, searches scholarly databases (2011-2017), and critically evaluates relevant research findings from journals like 'Osteoporosis International' and 'Nutrition Bulletin'. The assignment culminates in a report for a hypothetical patient ('Piggy') addressing the efficacy, safety, and appropriate dosage of fish oil for osteoarthritis. It highlights the importance of evidence-based practice in nursing and emphasizes the role of nurses in staying updated with current research.

Student Name
Unit: HLSC122
Assessment 2: Searching for evidence
Word count:
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Introduction
This assignment is based on scenario one, Fish Oil. Peggy is an older lady aged 65 years
old and has degenerative osteoarthritis in her knees. Her friend Edith has told her that fish oil is
good for arthritis and wants to try it. The clinical question for this scenario is “in older women
with osteoarthritis is fish oil an effective treatment option?” The assignment aims to describe the
search for evidence using the PICO question. Apart from the keywords derived from the
PICO/PICo question, alternative search terms will be introduced to increase the efficiency of the
search and increase chances of getting the required resources. I will two nursing databases will
be used to perform the search.
Searching for evidence
Evidence-based practice (EBP) offers nurses with an approach to use critically analysed
and scientifically proven evidence for delivering quality health care to particular clients or
populations (Majid, et al., 2011). Peggy requires scientifically proven evidence to determine
whether fish oil would improve her condition. The first step is identifying the population,
intervention, comparison and outcome. The PICO format is a helpful technique for summarising
a research question that examines the effect of therapy (Riva, Malik, Burnie, Endicott, & Busse,
2012). The PICO; P is older women with osteoarthritis, I is fish oil, and O is the effective
treatment option. Hence, the search terms are older women, osteoarthritis, fish oil and treatment
option. Alternative search terms are aged ladies, degenerative joint disease, and fish-liver oil.
These search terms and phrases are sufficient to answer the PICO question and determine
whether Peggy can use fish oil to treat osteoarthritis.
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The best two nursing databases that I would use to perform the search are CINAHL
complete and Medline complete. These two databases have been chosen because they are
authoritative, have peer reviewed journals and are simple to use. The Cumulative Index to
Nursing and Allied Health Literature (CINAHL) is an effective source of primary studies for
qualitative evidence synthesis. Besides, CINAHL provides distinct studies for systemic reviews
(Wright, Golder, & Lewis-Light, 2015). The thesaurus of CINAHL contains a variety of terms
associated with research techniques such as action research, ethnographic research and
naturalistic enquiry. Although CINAHL might seem better than MEDLINE Complete, they both
have thousands of peer reviewed articles. A review conducted in 2015 showed that MEDLINE
complete was the biggest companion to MEDLINE (Kaste, 2015). This database offers the full
text of approximately 2500 medical journals. Additionally, most of the medical articles on
MEDLINE Complete are available to users with no restrictions. In fact, users can access the peer
reviewed articles as soon as they are published on the database. Another benefit of MEDLINE
complete is the scope of its content (Kaste, 2015). Searching for evidence in both CINAHL
complete and MEDLINE complete adds significantly to the information need for systemic
reviews. It is evident that both CINAHL complete and Medline complete are effective to search
for evidence in the chosen case scenario.
The table below demonstrates how I used the CINAHL complete to search for evidence
utilising the table from the book by Richardson-Tench and colleagues.
Actions Search mode Results Limiters (or
expanders)
S1 Older women Find all my search
terms
19,498 Scholarly (Peer
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Reviewed) journals
2011-2017
S2 Osteoarthritis Find all my search
terms
12,601 Scholarly (Peer
Reviewed) journals
2011-2017
S3 Fish oil Find all my search
terms
4,976 Scholarly (Peer
Reviewed) journals
2011-2017
S4 Older women and
Osteoarth*
Find all search terms 174 Scholarly (Peer
Reviewed) journals
2011-2017
S5 Degenerative joint
disease and fish oil
Find all my search
terms
8 Scholarly (Peer
Reviewed) journals
2011-2017
S6 Aged wom* and
Osteoarthritis
Find all my search
terms
239 Scholarly (Peer
Reviewed) journals
2011-2017
SI AND S2 AND S3 Find all my search
terms
1 Scholarly (Peer
Reviewed) journals
2011-2017
Adapted from (Richardson-Tench, Taylor, Kermode, & Roberts, 2016).
The final results are related to the PICO/PICo since they offer more information on the
use of fish oil to manage osteoarthritis in older women. Specifically, the results showed literature
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review on effectiveness, side effects and guidance on the use of fish oil for senior women with
the degenerative joint disease. Further, the results of the search introduced the aspect of using
fish oil as a dietary intervention for osteoarthritis. Since the search results are pertinent to the
PICO/PICo questions, I can develop a report for Piggy on whether to use fish oil, how and
appropriate quantities. The best two example journals from my final search are included in the
reference list.
Conclusion
The field of nursing is evolving fast, and evidence-based practice is becoming
indispensable. Nurse practitioners should increasingly rely on research to develop treatment
plans for clients. Thus, nurses should consider improving their research competence to meet the
current client needs. Conclusively, nurses should understand how to filter results of the search in
various databases and especially how to get recently published evidence.
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References
The best two example journals from my final search
Chen, J., Hill, C., Lester, S., Ruediger, C., Battersby, R., Jones, G., & ... March, L. (2016).
Supplementation with omega-3 fish oil has no effect on bone mineral density in adults
with knee osteoarthritis: a 2-year randomized controlled trial. Osteoporosis International,
27(5), 1897-1905.
Davidson, R. K., & Clark, I. M. (2015). Dietary intervention for osteoarthritis: Clinical trials
after the ' Bone and Joint Decade'. Nutrition Bulletin, 40(3), 203-210.
Other references
Kaste, A. (2015). MEDLINE Complete. Journal of the Medical Library Association , 103 (1),
62-63.
Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y., Chang, Y., et al. (2011). Adopting evidence-
based practice in clinical decision making: nurses' perceptions, knowledge, and barriers.
Journal of the Medical Library Association: JMLA , 99 (3), 229-236.
Richardson-Tench, M., Taylor, B., Kermode, S., & Roberts, K. (2016). Inquiry in health care.
South Melbourne: Cengage Learning.
Riva, J., Malik, K., Burnie, S., Endicott, A., & Busse, J. (2012). What is your research question?
An introduction to the PICOT format for clinicians. he Journal of the Canadian
Chiropractic Association , 56 (3), 167-171.
Wright, K., Golder, S., & Lewis-Light, K. (2015). What value is the CINAHL database when
searching for systematic reviews of qualitative studies? Systematic reviews , 4 (1), 104.
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