NSG6999 Graduate Project in Nursing Discussion Assignment Paper

NSG6999 Graduate Project in Nursing Discussion Assignment Paper

Week 4 Discussion

Using the following table—search the 5 databases based on your PICOT Question(week 3 project attached)—under findings note the number of relevant articles found—you may not find something in every database. Under features discuss what you liked about that database. ON the discussion board summarize your search---attach your chart for those that would like to see your search. You may not find what you are looking for in every search—and that is OK—but you must search every database to see what may be out there. NSG6999 Graduate Project in Nursing Discussion Assignment Paper

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Exploring the Literature

Picot Question: 

 Research Tool  Search Tips  Search Terms &  Limits  Findings  Features
CINAHL

CINAHL is an SU subscription-onlyresource that offers full text access to 336 scholarly journals and indexes over 3,000 journals from the fields of nursing and allied health. Indexed journals do not provide access to full-text. Just because it is indexed in does not mean the library has full-text access to the journal. SU can always request articles for students via Interlibrary Loan, but the service is not instantaneous.NSG6999 Graduate Project in Nursing Discussion Assignment Paper

§  Look at the Major Subject Heading in the Full Record

§  Use the Limits Feature:

o    Example: Publication Type=Systematic Review

§  Try the CINAHL Heading search:

NSG6999 Graduate Project in Nursing Discussion Assignment Paper

Keyword search:

Limits:

CINAHL Heading search:

Limits:NSG6999 Graduate Project in Nursing Discussion Assignment Paper

   
PubMed

PubMed is a free health science citation & abstracts index from the National Center for Biotechnology Information at the U.S. National Library of Medicine.

NSG6999 Graduate Project in Nursing Discussion Assignment Paper

§  Look at MeSH Terms in Full Record

§  Use the Limits Feature:

o    Examples: Article Type=Meta-Analysis; Age=All Adult

§  Look for the open access Free articles!

NSG6999 Graduate Project in Nursing Discussion Assignment Paper

Keyword search:

Limits:

NSG6999 Graduate Project in Nursing Discussion Assignment Paper

MESH search:

Limits:

 

   
Cochrane Library

Cochrane Library provides access to the Cochrane Library of Systematic Reviews. Full text of reviews are subscription only. Index summaries are a public resource. Indexed journals do not provide access to full-text. Just because it is indexed in does not mean the library has full-textaccess to the journal. SU can always request articles for students via Interlibrary Loan, but the service is not instantaneous

§  Use the Simple Search and the Advance Search Features

§  Allows you to search with MeSH Terms

§  Check out the New Reviews

 Browse reviews by topic

NSG6999 Graduate Project in Nursing Discussion Assignment Paper

Keyword search:

 

Limits:

MESH search:

Limits:

NSG6999 Graduate Project in Nursing Discussion Assignment Paper

   
Dynamed

 

·         Use the Simple Search and the Advance Search Features

·         Allows you to search with MeSH Terms

·         Check out the New Reviews

Browse reviews by topic

Keyword search:

 

Also browse by:

 

   
TRIP Database

TRIP is a clinical search engine to locate publicly available clinical evidence. NSG6999 Graduate Project in Nursing Discussion Assignment Paper

 

§  Limit to:

§  Systematic Reviews

§  Guidelines-US

 

Keyword search:

Limits:

NSG6999 Graduate Project in Nursing Discussion Assignment Paper

   
SU Library Search ·         Library Search is setup just like an EBSCO

·         The Library even has a specialized PICOT search setup in Library Search—must go to Advance search to get to PICOT option

 
Other Databases:        

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As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. By the due date assigned, go to the Discussion Area and post responses to the discussion question. All responses should be posted to the appropriate topic in this Discussion Area. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources. Be sure to spend some time in Library Search it is setup just like an EBSCO database and gives you the experience of learning how to navigates databases, and provides you with a larger pool of information within which to search. NSG6999 Graduate Project in Nursing Discussion Assignment Paper

Supporting one—Challenging one.

By the end of the week, comment on the responses of at least two other students by supporting a minimum of one post and challenging a minimum of one post. You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language. All comments should be posted to the appropriate topic in this Discussion Area. Please only start a new thread with your original post. Hit reply to respond to a peer. NSG6999 Graduate Project in Nursing Discussion Assignment Paper

More info on Week 4 assignment above

This week you will begin your literature search to find best evidence using the words from your PICOT question to guide you. You will begin to appraise the studies you find using the appropriate rapid critical appraisal tool. You will decide on an approach to build your Evidence Synthesis Table and be on your way. Sharing your search strategy with classmates and faculty will provide helpful ideas. NSG6999 Graduate Project in Nursing Discussion Assignment Paper

Reading Chapter 3 & 4, chapter 8 pages 184-188

EBP step by step Searching for the Evidence 

Lecture 1-4

Discussion Board—Summarize the Literature for 5 database searches

Project --none

After mastering the contents of this chapter, the learner should be able to:

  1. Compare the strengths and weaknesses of three commonly used evidence search strategies.
  2. Discuss at least one advantage to using pre-appraised evidence.
  3. Describe the three key questions that should be asked when deciding which databases should be used to answer a clinical question. NSG6999 Graduate Project in Nursing Discussion Assignment Paper
  4. Describe the difference between the use of the Boolean operators “AND” and “OR.”
  5. Discuss the advantages and disadvantages of using the “limits” function when performing an evidence search.
  6. Compare and contrast several databases of external evidence for the type of documents and related information available and the search strategies that they support.
  7. Describe the three main knowledge sources on which evidence-based practice (EBP) should stand.
  8. Articulate the difference between internal and external evidence. NSG6999 Graduate Project in Nursing Discussion Assignment Paper

Your Learning Objectives for the Week:

  • Demonstrate synthesis of the knowledge and skills acquired in preceding graduate nursing core and specialty curriculum content through creation of a scholarly project
  • Incorporates evidence-based research methods, scientific writing and critical thinking demonstrative of graduate level professional nursing practice
  • Identify the three key questions that are part of the rapid critical appraisal process used to evaluate evidence.

Introduction

From adolescent to adulthood, obesity is a major health crisis in the United States. Obesity can be defined as an excess amount of body fat. Currently over two-thirds of Americans are overweight (CDC, 2018). It is very important to start education and weight reduction interventions as early in life as possible, however this is not always an easy task and the obesity carries on from childhood into adulthood. There are so many preventable diseases that can be minimized or by maintaining proper weight. Two main examples are diabetes and cardiovascular disease. Weight-loss is associated with delayed or decreased onset of diabetes (Kelly and Maloney, 2015) NSG6999 Graduate Project in Nursing Discussion Assignment Paper. There are many methods, diets, and medications that provide weight-loss. The purpose of this project is to find out if patients will have a greater reduction in percentage of weight-loss during a six-month period when receiving weight-loss guidance and education compared to the use of weight-loss medications alone. The evidence presented at the end of the 6 month period will lead to providing new evidence based information that will hopefully lead to new evidenced based practices that can be used as effective interventions for obesity in the future. NSG6999 Graduate Project in Nursing Discussion Assignment Paper

Definition

The CDC helps to define obesity as a medical condition where an individual has excess body fat. To further help clarify, we use the body mass index to assist in categorizing the certain degree that a person is overweight or obese (CDC, 2018). Listed below is the breakdown of BMI:

  • BMI of 25.0 to 29.9 – Overweight
  • BMI of 30.0 to 34.9 – Class 1 obesity (low risk obesity)
  • BMI of 35.0 to 39.9 – Class 2 obesity (moderate obesity)
  • BMI > 40.0 – Class 3 obesity and (high risk obesity) NSG6999 Graduate Project in Nursing Discussion Assignment Paper

The BMI chart is meant to be used as a guideline to help assist with clarification and provide a starting point if a patient is overweight or obese (Yui, 2015).  The BMI chart is the most widely used method to determine obesity.

Epidemiology

In the United States, approximately two-thirds of the population are overweight or obese and this number includes the adolescent and young adult population as well (Black, 2017). The National Health and Nutrition Examination Survey (HANES) estimates that the  over 32.5% of people are overweight with a BMI of 25-30, 37.7% of people are obese with a BMI of over 30, and 7.7% of people are morbidly obese with a BMI of over 40. According to the CDC, statistics show that in certain groups the percentages can be higher. For example, about 51% of Mexican American women over the age of 20 have a BMI of greater 30 and 57% of non-hispanic black women over age 20 also have a BMI of greater 30 (CDC, 2018). NSG6999 Graduate Project in Nursing Discussion Assignment Paper

Clinical Presentation

There are several clinical presentations of obesity:

  • Appearance – Visible fat deposits on body. Stretch marks may be present on abdomen, hips, thighs, buttocks, and even arms. Skin may be darkened around the neck.
  • Psychological – Poor eating habits such as eating high fat high calorie foods. Overeating or binging. Low self esteem
  • Pulmonary – Shortness of breath at rest or on exertion and/or sleep apnea may be present.
  • Gastrointestinal : Upset stomach, heartburn/reflux, constipation/diarrhea or irregular bowels may be present.
  • Orthopedic: Joint pain, particularly knee and/or back pain, flat feet can also be present (SOB, 2016).

Complications

There are many complications that can arise from obesity. These complications include:

  • Diabetes
  • High blood pressure
  • High blood cholesterol
  • Heart complications
  • Sleep apnea
  • Gallstones and liver complications (Yui, 2015). NSG6999 Graduate Project in Nursing Discussion Assignment Paper

Diagnosis

The most common method of diagnosis is use of the BMI. The actual calculation is weight divided by height squared. The only caveat to BMI is it does not take into account for age, gender, bone structure or muscle mass, but it is the best standard diagnostic tool we use (Yui, 2015). To review, previously listed under the section titled “Definition”, a BMI of greater than 30 is classified as obese. A tool that is commonly used as an indicator of obesity risk is waist circumference. It does not substitute for BMI nor is it a diagnostic tool for obesity but it is a great tool for helping to associate risk factors that tend to develop with an elevated waist circumference such as hypertension, diabetes, and metabolic syndrome. Another test that can be helpful but are not used for diagnosis is basic laboratory tests to rule out secondary causes of obesity. NSG6999 Graduate Project in Nursing Discussion Assignment Paper

Conclusion

Obesity is an epidemic of great and tragic proportions (Kelly and Maloney, 2015) . This following research will help to show that evidenced based interventions can in fact be helpful and are what is needed to make a change. The research will follow my PICOT statement: Will adolescents/adults suffering from obesity (P) respond better to weight loss guidance and education(I) rather than the use of diet medication alone (C) by producing a greater percentage of weight-loss(O) over a specific time period of six months (T)? NSG6999 Graduate Project in Nursing Discussion Assignment Paper