Friday, June 2, 2017

EBP Project Proposal Part II: Lit Review

A comprehensive literature review using the PICO question described in the last post will help to reveal if the chosen intervention is beneficial based on the best available evidence (Everett & Titler, 2006; Hall & Roussel, 2014). This is a vital step prior to trialing the chosen intervention on a pilot unit (Everett & Titler, 2006; Hall & Roussel, 2014). Using a team approach to allow for division of labor will help tremendously by distributing the research burden but also removes potential selection bias caused by an individual completing the literature review alone.
When completing a literature review, the team must identify databases that may contain research relevant to the EBP project; examples include CINAHL, MEDLINE, PubMed Clinical Queries, National Guideline Clearinghouse, Scopus, the Cochrane Library, Joanna Briggs Institute, National Academies, and Agency for Healthcare Research and Quality (Hall & Roussel, 2014). Meeting with a research librarian who specializes in healthcare, nursing, medicine or a field related to the project may also reveal other relevant resources. Seeking advice from an EBP expert will also be helpful to identify potential resources.
Once several databases have been chosen, the research team needs to identify appropriate search terms and date range (Hall & Roussel, 2014). Starting the search in PubMed is helpful because it allows researchers to identify Medical Subject Headings (MeSH®), which is the “National Library of Medicine's controlled vocabulary thesaurus” (National Library of Medicine [NLM], 2015). Using MeSH® Terms will most likely generate the most comprehensive search results because it identifies terms related to the topic (e.g. vitamin C, ascorbic acid) (NLM, 2015). PubMed also offers tutorials that describe how to best utilize the database (NLM, 2016).
Many databases allow the search to be narrowed to a specific date range. This allows researchers to keep the body of evidence needing review to a manageable level as well as ensures data used is up-to-date. In general, the team should choose evidence published in the last five to ten years, depending on the nature of the project and number of available studies (Hall & Roussel, 2014).
Finally, there are special considerations for scholarly EBP projects. First, it is important to choose a phenomenon of interest that gets you excited. Combing a problem or knowledge focused trigger with a personal passion is vital to carry you through the arduous process of scholarly writing and research (Everett & Titler, 2006). Secondly, once you have browsed the literature, write an outline and a concept map, which will help reveal relationships between concepts (Moran et al., 2014). Setting achievable goals with deadlines is also paramount for completing the project on time (Moran et al., 2014; Zaccagnini & White, 2017).
Finally, find an EBP champion to mentor you through the process; hopefully this person can be your scholarly project chair. Make a conscious effort to communicate regularly with your project chair. Experience writing an undergraduate honors thesis taught me to give myself extra time to complete a project to allow for unforeseen barriers that come up along the way. Lastly, do not give up. Expect detours; that way when they come you have already mentally visualized yourself successfully navigating through them. YOU CAN do it! 
Everett, L. Q., & Titler, M. G. (2006). Making EBP part of clinical practice: The Iowa Model. In Teaching Evidence-Based Practice in Nursing (pp. 295-324). New York: Springer Publishing Company.
Hall, H. R., & Roussel, L. (2014). Evidence-based practice: An integrative approach to research, administration, and practice. Burlington, MA: Jones & Bartlett Learning.
Moran, K. J., Burson, R., & Conrad, D. (2014). The Doctor of Nursing Practice scholarly project: A framework for success. Burlington, Mass: Jones & Bartlett Learning.
National Library of Medicine. (2015). Fact sheet: Medical Subject Headings (MeSH®). Retrieved from
National Library of Medicine. (2016). PubMed Tutorial. Retrieved from
Zaccagnini, M. E., & White, K. W. (2017). The doctor of nursing practice essentials: A new model for advanced practice nursing (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

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