The purpose of this assignment is to refine the PICOT question you developed in the discussion forum this week and begin evaluating literature that you will use in subsequent weeks to write your research paper
The purpose of this assignment is to refine the PICOT question you developed in the discussion forum this week and begin evaluating literature that you will use in subsequent weeks to write your research paper.
Use the “Literature Evaluation Table” to complete this assignment. Prior to starting the “Literature Evaluation Table,” complete the following:
- Review the feedback you have received in the discussion forum related to your PICOT question so far. Make any necessary edits to your PICOT question.
- Conduct a literature search to locate four research articles focused on your selected nursing practice problem of interest. Note: This literature search should include two quantitative and two qualitative, peer-reviewed, primary research articles to support your nursing practice problem. A mixed methods article can qualify towards meeting a qualitative or quantitative methodology. The two articles identified in Topic 1 DQ 2 can be used should you still find them relevant to your PICOT question.
Articles must be published within the past 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
The PICOT question and four peer-reviewed research articles you chose will be utilized for subsequent assignments.
Note: For best search results, do not include the words qualitative and quantitative in your search terms. Do include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic reviews, literature reviews, and metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
American Association of Colleges of Nursing Core Competencies for Professional Nursing Education
This assignment aligns to AACN Core Competency 1.2, 3.5, 4.1, 4.2
Expert Answer and Explanation
NRS-445 Topic 1: Literature Evaluation Table
Student Name:
Faculty Name:
Background of Nursing Practice Problem
The nursing problem identified in patients with chronic diseases centers on the challenges associated with managing complex, long-term conditions that often require continuous and multifaceted care. Chronic diseases such as diabetes, heart disease, and COPD require comprehensive treatment plans that encompass medication management, lifestyle modifications, regular monitoring, and preventive measures. However, the usual care model, which often involves isolated and uncoordinated visits to various healthcare providers, leads to fragmented care (Brooks et al., 2023).
This fragmentation can result in inadequate communication among healthcare providers, inconsistent care plans, and ultimately, poor health outcomes for patients. The lack of a cohesive approach to managing chronic diseases can lead to higher hospital readmission rates, as patients might not receive timely interventions or follow-up care necessary to prevent complications. This problem is critical to the performance of healthcare facilities and the quality of patient care because high hospital readmission rates are not only costly but also indicative of poor management of chronic conditions.
Frequent readmissions strain hospital resources, increase healthcare costs, and reflect negatively on the facility’s ability to provide effective care. Moreover, fragmented care can significantly impact patient satisfaction, as patients may feel neglected, confused by conflicting medical advice, or overwhelmed by their health management (Leung et al., 2024). Poor patient satisfaction can result in lower compliance with treatment plans and decreased trust in healthcare providers, further exacerbating health issues.
Addressing this nursing problem is essential to improve the overall efficiency of healthcare delivery, enhance patient outcomes, and ensure that patients with chronic diseases receive the comprehensive, coordinated care they need to manage their conditions effectively.
PICO(T) Question:
| PICO(T) Question Template | ||
| P | Population | Patients with chronic diseases |
| I | Intervention | Implementation of a multidisciplinary care team |
| C | Comparison | Usual care |
| O | Outcome | Healthcare outcomes such as hospital readmission rates and patient satisfaction |
| T | Timeline
(optional) |
Six-month follow-up period |
| Intervention | ||
| The intervention is the implementation of a multidisciplinary care team for patients with chronic diseases. This team-based approach involves various healthcare professionals working together to provide coordinated and comprehensive care. | ||
| Problem Statement | ||
| Patients with chronic diseases often experience fragmented care under usual care models, leading to poor health outcomes and high hospital readmission rates. This lack of coordinated care can also negatively impact patient satisfaction, highlighting the need for more integrated and effective care strategies.
It is not known if the implementation of a multidisciplinary care team (I) would impact Healthcare outcomes such as hospital readmission rates and patient satisfaction (O) among patients with chronic diseases (P). |
||
| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| APA Reference
Include the GCU permalink or working link used to access the article |
Brooks, L., Elliott, J., Stolee, P., Boscart, V. M., Gimbel, S., Holisek, B., … & Heckman, G. A. (2023). Development, successes, and potential pitfalls of multidisciplinary chronic disease management clinics in a family health team: a qualitative study. BMC Primary Care, 24(1), 126. https://doi.org/10.1186/s12875-023-02073-x | Donzé, J., John, G., Genné, D., Mancinetti, M., Gouveia, A., Méan, M., … & Schnipper, J. (2023). Effects of a multimodal transitional care intervention in patients at high risk of readmission: the TARGET-READ randomized clinical trial. JAMA Internal Medicine, 183(7), 658-668. https://doi.org/10.1001/jamainternmed.2023.0791 | Mas, M. À., Miralles, R., Ulldemolins, M. J., Garcia, R., Gràcia, S., Picaza, J. M., … & Estrada, O. (2023). Evaluating person-centred integrated care to people with complex chronic conditions: early implementation results of the ProPCC programme. International Journal of Integrated Care, 23(4). https://doi.org/10.5334%2Fijic.7585 | Leung, C., Andersen, C. R., Wilson, K., Nortje, N., George, M., Flowers, C., … & Hui, D. (2024). The impact of a multidisciplinary goals-of-care program on unplanned readmission rates at a comprehensive cancer center. Supportive Care in Cancer, 32(1), 66. https://doi.org/10.1007/s00520-023-08265-6 |
| Purpose/Aim of Study | To understand how a family health team developed interprofessional chronic disease management programs, including successes and areas for improvement. | To evaluate the effects of a multimodal transitional care intervention targeting patients at high risk of hospital readmission. | To share the early implementation results of the ProPCC programme for people with complex chronic conditions. | To examine the 30-day unplanned readmission rate in the medical oncology population before and after implementing a goals-of-care program. |
| Research question(s) | How do family health teams develop interprofessional chronic disease management programs? | Could a transitional care intervention targeting higher-risk medical patients reduce the risk of 30-day unplanned hospital readmission or death? | What are the early implementation results of the ProPCC programme in terms of healthcare resource use and patient outcomes? | How does the implementation of a multidisciplinary goals-of-care program impact 30-day unplanned readmission rates? |
| Design
Is the article qualitative, quantitative, or mixed methods? Explain how you determined the type of research design. |
Qualitative study. Determined by the use of interviews and thematic analysis. | Quantitative, randomized clinical trial. Determined by the use of statistical analysis of intervention and control groups. | Quantitative, retrospective cohort study. Determined by analysis of pre-post intervention data. | Quantitative, retrospective study. Determined by the statistical comparison of pre- and post-implementation readmission rates. |
| Setting
Where did the study take place? What type of setting: inpatient, outpatient, etc.? |
Southwest Ontario, Canada. Outpatient, family health team setting. | Four medium-to-large teaching hospitals in Switzerland. Inpatient setting. | North-Barcelona metropolitan area, Catalonia, Spain. Mixed settings: home and nursing homes. | Comprehensive cancer center. Inpatient setting. |
| Sample
Number and characteristics of participants |
22 health professionals affiliated with a family health team. | 1386 patients at high risk of unplanned readmission, with a mean age of 72 years. | 264 cases, with 91% at home and 9% in nursing homes. | 7028 unique medical patients pre-implementation and 5982 post-implementation. |
| Methods
Interventions/Instruments |
Interviews with health professionals. | Systematic medication reconciliation, patient education, follow-up visits, and phone calls. | Retrospective data analysis of primary care visits, emergency visits, hospital admissions, and hospital stay duration. | Comparison of 30-day unplanned readmission rates and secondary outcomes pre- and post-implementation of the goals-of-care program. |
| Analysis
How were the collected data analyzed? |
Qualitative analysis of interview transcripts identifying key themes and subthemes. | Statistical analysis comparing intervention and control groups for primary and secondary outcomes. | Statistical comparison of healthcare resource use and time spent at home before and after the intervention. | Multivariate analysis model examining associations between readmission rates and program implementation. |
| Outcomes/key findings of the study and implications for nursing practice
Summary of study results |
Better informal communication and shared learning improved care, but formal structures are needed to avoid care fragmentation. | No significant decrease in 30-day unplanned readmissions or deaths with the intervention compared to usual care. | Increased primary care visits, reduced emergency visits and hospital stays, increased time spent at home, and reduced total costs. | Decreased 30-day unplanned readmission rates from 24.0% to 21.3% after program implementation, along with reduced 7-day readmission rates. |
| Recommendations of the researcher | Emphasize formal communication and process structures to optimize interprofessional team effectiveness. | Further research to identify more effective interventions for reducing hospital readmissions. | Continue to monitor and refine the ProPCC programme to maintain and enhance its benefits. | Implement and maintain goals-of-care programs to reduce unplanned readmissions and improve patient outcomes. |
| Explain how this article supports your proposed PICO(T) question. | Demonstrates the benefits and challenges of multidisciplinary care in managing chronic diseases. | Highlights the difficulties in preventing readmissions, even with targeted interventions. | Shows the effectiveness of integrated care in reducing healthcare resource use and improving patient outcomes. | Provides evidence that a multidisciplinary approach can reduce readmission rates, supporting the value of collaborative care teams. |
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Rubric Criteria
|
Criterion |
1. Unsatisfactory |
2. Insufficient |
3. Approaching |
4. Acceptable |
5. Target |
|---|---|---|---|---|---|
|
PICO(T) Question Identification of components within PICO(T) Question template and intervention question. |
0 points Identification of components within PICO(T) Question template and intervention question is not present. |
5.63 points N/A |
5.93 points Identification of components within PICO(T) Question template intervention question is incomplete or inaccurate. |
6.68 points N/A |
7.5 points Identification of components within PICO(T) Question template and intervention question is present and accurate. |
|
Problem Statement Identification of problem statement |
0 points Identification of problem statement is not present. |
5.63 points N/A |
5.93 points Identification of problem statement is incomplete or inaccurate. |
6.68 points N/A |
7.5 points Identification of problem statement is present and accurate. |
|
APA Reference APA reference including permalink or working link used to access article |
0 points APA reference including permalink or working link used to access article is missing from two or more articles. |
5.63 points N/A |
5.93 points APA reference including permalink or working link used to access article is missing from one article, or the references are inaccurate. |
6.68 points N/A |
7.5 points APA reference including permalink or working link used to access the article for all four articles are present. |
|
Purpose/Aim of Study Description of purpose or aim of study |
0 points Description of purpose or aim of study is not present for two or more articles. |
5.63 points N/A |
5.93 points Description of purpose or aim of study is missing for one article or lacks detail. |
6.68 points N/A |
7.5 points Description of purpose or aim of study is thorough for all four articles. |
|
Research Question Identification of research question |
0 points Identification of research question is not present for two or more articles. |
5.63 points N/A |
5.93 points Identification of research question is missing for one article or lacks detail. |
6.68 points N/A |
7.5 points Identification of research question is thorough for all four articles. |
|
Design Explanation of type of study method used |
0 points Explanation of type of study method used is not present for two or more articles. |
5.63 points N/A |
5.93 points Explanation of type of study method used is missing for one article or lacks detail. |
6.68 points N/A |
7.5 points Explanation of type of study method used is thorough for all four articles. |
|
Setting Identification of the location and type of setting |
0 points Identification of the location and type of setting is not present for two or more articles. |
5.63 points N/A |
5.93 points Identification of the location and type of setting is missing for one article or lacks detail. |
6.68 points N/A |
7.5 points Identification of the location and type of setting is thorough for all four articles. |
|
Sample Identification of the number and characteristics of the participants in the sample |
0 points Identification of the number and characteristics of the participants in the sample is not present for two or more articles. |
5.63 points N/A |
5.93 points Identification of the number and characteristics of the participants in the sample is missing for one article or lacks detail. |
6.68 points N/A |
7.5 points Identification of the number and characteristics of the participants in the sample is thorough for all four articles. |
|
Methods Identification of interventions or instruments |
0 points Identification of interventions or instruments is not present for two or more articles. |
5.63 points N/A |
5.93 points Identification of interventions or instruments is missing for one article or lacks detail. |
6.68 points N/A |
7.5 points Identification of interventions or instruments is thorough for all four articles. |
|
Analysis Description of how the collected data was analyzed |
0 points Description of how the collected data was analyzed is not present for two or more articles. |
11.25 points N/A |
11.85 points Description of how the collected data was analyzed is missing for one article or lacks detail. |
13.35 points N/A |
15 points Description of how the collected data was analyzed is thorough for all four articles. |
|
Outcomes Summary of study results including outcomes or key findings and implications for nursing practice |
0 points Summary of study results including outcomes or key findings and implications for nursing practice is not present for two or more articles. |
11.25 points N/A |
11.85 points Summary of study results including outcomes or key findings and implications for nursing practice is missing for one article or lacks detail. |
13.35 points N/A |
15 points Summary of study results including outcomes or key findings and implications for nursing practice is thorough for all four articles. |
|
Recommendations Recommendations of the researcher based on outcomes or key findings of the study |
0 points Recommendations of the researcher based on outcomes or key findings of the study is not present for two or more articles. |
11.25 points N/A |
11.85 points Recommendations of the researcher based on outcomes or key findings of the study is missing for one article or lacks detail. |
13.35 points N/A |
15 points Recommendations of the researcher based on outcomes or key findings of the study is thorough for all four articles. |
|
PICO(T) Question Support Explanation of how this article supports the proposed PICO(T) question. |
0 points Explanation of how this article supports the proposed PICO(T) question is not present for two or more articles. |
16.88 points N/A |
17.78 points Explanation of how this article supports the proposed PICO(T) question is missing for one article or lacks detail. |
20.03 points N/A |
22.5 points Explanation of how this article supports the proposed PICO(T) question is thorough for all four articles. |
|
Mechanics of Writing Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc. |
0 points Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout. |
6.75 points Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent. |
7.11 points Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted. |
8.01 points Few mechanical errors are present. Suitable language choice and sentence structure are used. |
9 points No mechanical errors are present. Appropriate language choice and sentence structure are used throughout. |
|
Format/Documentation Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline. |
0 points Appropriate format is not used. No documentation of sources is provided. |
4.5 points Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident. |
4.74 points Appropriate format and documentation are used, although there are some obvious errors. |
5.34 points Appropriate format and documentation are used with only minor errors. |
6 points No errors in formatting or documentation are present. |
