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Literature Review

This is a formal 10-12-page paper on your EBP practice improvement project (This does not include the title page, abstract, and references). This assignment requires the use of evidence-based references. Preferable systematic reviews, clinical practice guidelines, and protocols, RTCs, and other higher levels of evidence.


1. Write a 10-12 paper (excluding cover and reference page). Include the body of the paper with the following titled sections:

· Abstract

· Title (introduction) with purpose

· Background

· Methods

· Literature Review of the proposed change

· Discussion (what was learned)

· Proposed change implementation

· Proposed methods to measure outcomes of the change

· Recommendations for Practice change.

· Conclusion and implications for nursing.

2. Identifies the significant clinical problem and the intervention that will resolve the problem.

3. Describe the problem (PICO the question and write as a statement), including the purpose and goal of the EBP review (EBP proposal paper). Start with a global description of the importance of nursing and narrow your topic to the organizational level. Finalize these paragraphs with the purpose of the paper. What are you trying to achieve?

4. Explain the Background of your problem, the definition of the variables. Include any pertinent background and history pertaining to your problem or topic of interest and what has led you to believe this problem is of great significance to the nursing profession. The aim of this section is to help the reader understand the concepts and definitions of your topic of study.

5. Identify your source and method for searching the evidence (keywords, databases, inclusion, exclusion criteria). Find the highest level of evidence first and then proceed methodically through the hierarchy of evidence to answer the focused question. Remember “Not all evidence is created equal.” That is, we can have more confidence in some types of evidence than in others. Just because the evidence you have maybe a study or a clinical guideline published by an organization does not mean that it is the best evidence (i.e., the most objective or the most trustworthy). Refer to the levels of evidence and explain in this section how do you searched and classify the evidence (Use the literature matrix). Why are you trusting the results?

6. Include a review of the literature on your proposed change (intervention), practice guidelines, or other synthesis reports. Your paper should serve as a synthesis of what is currently known about your change, and what is being investigated. Do not simply summarize each of your sources; rather, integrate the information presented, and come up with your own interpretation of the data (you may use tables in this section to summarize the evidence).

7. Discuss, appraise and synthesize evidence. A critical review of all evidence that you will use to support your improvement efforts. Once the evidence is gathered, you must critically appraise each study to ensure its credibility and clinical significance. An easy method for conducting critical appraisal is to answer these three key questions:


1. What were the results of the study? (In other words, what is the evidence?)

1. How valid are the results? (Can they be trusted?)

1. Will the results be helpful in caring for other patients? (Are they transferable?)

1. Include suggestions for improvement/change (Aim) to whatever it is you are researching. For example, If you are proposing policy changes to current urinalysis protocols, how will this policy impact the organization and stakeholders? Patient and/or population expected to benefit directly from improved flow or process. The risk of participation is the same as receiving usual care. If risk or burden is higher than with usual care, consider research & IRB.

1. State what EBP model will you use to plan for your project. What plans do you have to measure key indicators, what about tools used to measure the outcomes, what is the validity or reliability if any. Measures may include knowledge, attitude, behavior/practices, and outcomes What about the sample? You may propose small but large enough samples to observe changes. What is the feasible for data collection, the minimal time needed, resources, costs? How will you conduct the data analysis? Who will be involved in the Organization?

1. Recommendations for practice change.

1. Write the conclusion of your paper, summarizing the main points and explaining its main purpose. Restate the topic, purpose, main points, and the significance of your findings. End this section with the implications for practice makes emphasis on the future of your topic.

1. Format references and citations using 7th ed. APA guidelines.

For this assignment focus on the following PICO question “In postoperative patients, does the implementation of multimodal pain management strategies compared to traditional single-modal approaches result in reduced postoperative pain scores within the first 48 hours post-surgery?”

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