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• Discuss the significance of the cumulative findings on nursing practice, identifying potential practice change if warranted


I will attach the paper’s description. I will need a copy of the articles used in the paper in their entirety, because I have to hand the articles in to my professor.

I would like the main paper to be 8 pages and the other two pages I ordered are for the FACT table. I attached samples of the paper so you have a format to follow and a sample of the FACT table. Also the research needs to be based on the PICOT question below

PICOT question that paper needs to be based on…

In patients diagnosed with insomnia (population/patient) how does the use of the prescription sleep medication zolpidem tartrate, brand name Ambien or zolpidem CR, brand name Ambien CR (intervention/treatment) compared to non-prescription interventions melatonin and/or a strict sleep regimen (comparison) influence or increase the time of restful sleep as defined by 5 or more hours of sleep per night as documented in a sleep journal (outcome) over a six month time period (time period)?

I received the following from my professor wanting me to narrow down my paper a bit.
. In looking at this again, maybe you use either “influence” or “increase” in your outcome instead of both. Just a thought. Base it on your interest and what you are seeing in the literature.
This assignment meets the following course objectives related to the provision of research and evidenced based nursing care:

• Demonstrate the ability to formulate relevant clinical questions to be used in the process of EBP.
• Demonstrate the ability to retrieve, appraise and synthesize evidence to improve patient outcomes.
• Demonstrate an understanding of the process of integration of evidence, clinical judgment, inter-professional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care.
• Identify strategies to disseminate evidence to support change in nursing policy and practice.

The student will:

1. Identify a clinical problem of relevance to nursing (must be nursing focused) that is associated with a potential area of practice improvement. A question from this topic area will be become the basis for the project outlined below. This aspect of the assignment will be posted in a designated D2L discussion as EBP Project Part 1; ten points will be awarded for the completed submission by the due date.
(As you are choosing a clinical problem to be used for your EBP Project, you may want to
consider dove-tailing this assignment with your final N473 Professional Pathways Leadership Project. Choosing a clinical problem for your EBP Project in this course that would also support your future project may be of interest and benefit to you.)

2. Construct a single relevant clinical question that relates to the identified clinical problem and falls within one of the following three areas of foreground questions (Melnyk & Fineout-Overholt, 2013):
• Intervention questions that ask what intervention most effectively leads to an outcome.
• Prognosis/prediction questions that ask what indicators are most predictive of or carry the most associated risk for an outcome.
• Etiology questions that ask to what extent a factor, process or condition is highly associated with an undesirable outcome.

The question should be constructed using the PICO(T) component template (Melnyk & Fineout- Overholt, 2011) provided in your course content, which will frame it optimally for database searches and lead to discovery of the evidence base for current nursing practice or to support a practice change. This aspect of the assignment will also be posted in a designated D2L discussion as EBP Project Part 1; ten points will be awarded for completed submission by the due date.

3. Retrieve 3 peer reviewed primary source quantitative research articles (original reports of studies from peer reviewed professional journals written by the researcher/s within the last 5-10 years) that address the clinical question (PICO). Full text articles should be submitted as PDF’s to the dropbox. Please post your PICOT question in the comments of the dropbox when submitting. This aspect of the assignment will be submitted to a dropbox designated as EBP Project Part 2; ten points will be awarded for completed submission by the due date.

4. Critically appraise the evidence obtained in the literature search to determine its validity, reliability and applicability to answer the posed clinical question. Use the Literature Review Fact Table included on page four to organize the critical information obtained from the primary source articles and synthesize the findings for use in the EBP process. The information placed in the table should be concise and in abbreviated form to be used as a tool.

5. Integrate the evidence with clinical expertise, interprofessional perspectives and patient preferences to make the best clinical decision for planning, implementing and evaluating outcomes of evidence based care. Consideration should also be given to the healthcare resources available to implement a practice change or treatment decision.

6. Document the Evidence Based Project in an 8-10 page paper (including title page and reference pages—no abstract is needed) in APA format. The provided paper outline contains all the necessary aspects of the project paper; respond to each aspect for full credit. Use the topic headings in the outline as section headings for the paper. Review the grading rubric provided to assure clear understanding of the grading parameters. Submit the paper and the completed Fact Table to the dropbox designated EBP Project Part 3 – EPB Paper & Fact Table at the designated due date. The completed Project Paper is worth a total of 110 points (this includes 10 points for PICOT submission and 10 points for selection of primary source articles as mentioned above).
As you are choosing a clinical problem to be used for your EBP Project, you may want to consider dove-tailing this assignment with your final N473 Professional Pathways Leadership Project which you were introduced to in N301.

Final EBP Project Paper Outline
(Section One)–Title (per APA guidelines)
• Clear, concise title with inclusion of research variables –the title should describe what the paper is about.
Paragraph 1
• Introduce the clinical problem and provide background information and theoretical underpinnings to provide context and rationale for the project (include at least three scholarly/credible sources – these are the primary sources)
• Discuss significance of problem to nursing
Paragraph 2

• Provide the overall purpose for the project.
• Define PICOT with relevance to EBP, nursing and this project.
• Provide the clinical question per the PICO(T) template format provided in the course content.
• Identify search strategies including key words, data bases used, and limitations you placed on the search (time publication date, type of study, etc).

(Section Two)–Presentation of the Evidence
• Provide a concise introduction of the studies (one paragraph each), which includes their purposes, designs, findings and conclusions. (Titles of the studies are not needed—just provide the in-text citation (author, year) per APA).

(Section Three)–Critique of the Evidence
This is your chance to “make sense of” the information from the studies for your reader.
• Provide a synthesis of the evidence, comparing and contrasting the strengths and limitations of the studies and their applicability to answer the clinical question. (Refer to
the study aid on “How to Write a Synthesis” provided in the course content.)
• Include reference to the level of evidence based on the pyramid of evidence provided on the back cover of your text and provide an explanation of its significance to the project.
• Provide a statement reflecting the cumulative findings from the three studies.

(Section Four)–Implications for Practice
• Discuss the significance of the cumulative findings on nursing practice, identifying potential practice change if warranted
• Discuss the integration of the identified best evidence with clinician expertise and patient preference and values
• Address issues regarding resource utilization/management relevant to practice change
• Discuss how a practice change would best be evaluated.
• Discuss if this will be implemented into practice; if so, what barriers will need to be addressed

(Section Five)—Conclusion
• Provide a single paragraph summary of how the EBP process was used to accomplish the objectives of the project.

Additional issues to consider:
• Tone and terminology should be appropriate for a general audience of healthcare professionals.
• Refrain from reference to self in this paper; present content objectively.
• Strive toward clear, precise and concise writing for this type of clinical report. Avoid redundant repetition of content.
• APA guidelines must be followed
EBP Project Paper Grading Rubric
Components Consistently
92-100 pts. Usually
84-91 pts. Sometimes
83-75 pts. Rarely
(</= 74%)
<74 pts.
Submission of PICO(T) question per EBP part 1.
(10 points)
Submission of 3 primary source article sources per EBP part 2.
(10 points)
• Grammatically correct sentences (subject-verb agreement, appropriate verb tense, etc.)
• Appropriate sentence structure and punctuation (no run-on sentences, sentence fragments or awkwardly constructed sentences; correct use of commas, periods, colons, and semicolons)
• Appropriate word usage (no unprofessional or informal/conversational word usage, clichés, jargon, acronyms, misspelled or misused words)
(10 points)
• Appropriate organization of content into unified and coherent paragraphs
• Logical and clear arrangement of paragraphs. Purpose is clearly defined. Sections are organized. Conclusion is present.
• Clear and appropriate topic sentences
• Effective use of transitions between thoughts, topics, and paragraphs
• Thorough development of ideas as prescribed by assignment
• APA format used correctly (title page, running head, levels of headings, pagination, etc.). Reflects APA style guidelines.
(15 points)

• Appropriate selection and utilization of research materials
• Adequate documentation of sources used
• Appropriate selection and citation of quotations
• Correct format of documentation (APA)
• Reference list in APA format
(15 points)

Critical Thinking/Synthesis
• Presentation of evidence is discussed per assignment guidelines
• Critique of evidence is discussed per assignment guidelines
• Implications for practice is discussed per assignment guidelines
• Interpretation of assignment, fulfillment of assignment requirements, and adherence to assignment guidelines
• Range and depth of ideas presented
• Evidence of original thought
• Evidence of synthesis of ideas
• Tone, frame of reference, terminology and articulation of ideas appropriate to audience and consistent with purpose of assignment
(50 points)
Total: /110 points
• State the PICOT question using the appropriate template format. Submit as EBP part #1 to Discussion Forums.
o Population/Patient– Who are the patients of interest? Is there a particular age group, gender or population? What is the health concern?
o Intervention/treatment–What healthcare intervention are you interested in knowing more about?
o Comparison– Is there a comparison to be evaluated against the intervention?
o Outcome– What is the desired outcome to be evaluated? How will the patient or population be affected, or not affected, by the intervention?
o Time period (when applicable)
o Adapted from: Melynk & Fineout Overvolt (2011).
Question Type Question Format

In ______________ (P), how does _____________(I) compared to ____________ (C) affect ______________(O) within_____________(T)?

In __________ (P), how does ___________ (I) compared to _____________ (C) influence/predict _____________ (O) over __________ (T)?

Are ____________ (P), who have _____________ (I) compared with those without ______________ (C) at risk for/of _____________ (O) over ______________ (T)?

Evaluation Fact Table
PICO(T) Question:
Study ID Research Question and/or
Hypothesis Design/Sample/Setting Data Collection & Analysis Results/Conclusions Level of evidence on Haynse’s
(2006) Pyramid (back of text) Strengths/Weakness Implications to PICO(T)

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