Evidence Based Nursing Practice

Running head: EVIDENCE BASED NURSING PRACTICE
Evidence based nursing practice
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1EVIDENCE BASED NURSING PRACTICE
Introduction:
Heart failure is a life threatening disease condition that increased sufferings for patients
and increase the care burden for caregivers and health care system (McIlvennan & Allen,
2016). The main issue for heart failure patients with advanced heart failure is that such
patients live in frequent cycle of transitions between care settings and they suffer from high
level of distress because of unmet needs and poor management of the condition. Recurrent
hospitalization worsens functional status and quality of life of such patients (Lowey, 2017).
In response to this issue, palliative care is found relevant to address the issue as it can
improve the quality of life and provide a good death to patients. However, as palliative care
utilization among advanced heart failure is limited, there is a need to find robust evidence
that proves the effectiveness of palliative care in management of symptoms. Therefore, this
article will develop a PICO question regarding the effectiveness of palliative care for patients
with heart failure, subsequent database selection, and search strategy.
PICO question:
The main purpose of this paper is to find out the best evidence regarding the efficacy of
palliative care for treatment of heart failure, the development of the PICO (population,
intervention, control, and outcomes) question will guide the search process. According to
Aslam and Emmanuel, (2010), a well-formulated research question guides the
implementation of a research project and the PICO format to help in framing the research
question. The four elements of the PICO supports researcher in the identification of
appropriate information related to the research problem. The PICO framework has been used

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to create the research question for this paper too. The PICO for the research problem is as
follows:
P (Population): Patients in hospital
I (Intervention): Palliative care
C (Comparator): Community-based patients
Outcome (Outcome): Symptom management for heart failure
The PICO question for retrieving relevant research articles is as follows:
Does participation in the palliative care program help in symptom management of heart
failure in patients at the hospital compared to those receiving treatment in a community-based
setting?
Selection and justification for the choice of database:
During a search process it is important to identify the most relevant database that can
give answers to the research question. As the problem of symptom management in patients with
heart failure is a problem related to the health care field, it is vital to select those database that
published research from the field of health care. Some of the important and reliable databases
publishing research from the field of health care includes CINAHL, Medline, and PyschINFO.
Out of these three, CINAHL database has been selected for searching relevant articles as it
publishes in a wide range of literature from the field of nursing, biomedicine, alternative
medicine and allied health disciplines. Hence, searching CINAHL will increase the likelihood of
getting research papers on the research question. Another reason for selecting CINAHL as a
database is that it has an easy-to-use interface with both basic and advanced search features. In

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addition, it also uses Boolean operators to enhance the exclusiveness of the search process
(Wright, Golder & Lewis-Light, 2015). Therefore, it can provide flexibility during the search
process.
Search strategy
The search for relevant literature in CINAHL database was started with the use of key
terms. The key terms used for the search process included ‘patient with heart failure’ and ‘heart
failure at end of life’.
The use of the term ‘patient with heart failure’ without the use of any search limits and
thesaurus yielded the following papers:
Figure 1: Output in CINAHL database after use of basic key term