FINISHED PICO

docx

School

Edith Cowan University *

*We aren’t endorsed by this school

Course

NUR1101

Subject

Mechanical Engineering

Date

Oct 30, 2023

Type

docx

Pages

Uploaded by MasterValor11560

NUM1204 Assessment 1 PICO Question In patients with cystic fibrosis, is physical activity as effective as airway clearance therapy at loosening mucus in the lungs. P: Population/ problem People with cystic fibrosis I: Intervention Exercise C: Comparison Airway clearance therapy O: Outcome Loosened mucus at faster rates With appropriately constructed academic paragraphs, argue the importance of your PICO topic (500 words). Why does it need to be searched (could be more than one reason)? Is it because there is not much evidence already? Is it because it is a safety issue? Is it an emerging issue? All arguments must be supported with reference to scholarly literature. Cystic Fibrosis or CF is one of the most common genetic diseases among Caucasian individuals and is characterised by an accumulation of thick mucus that causes frequent infections in the lungs and airway (Rowbowtham et al., 2020). Due to the nature of Cystic Fibrosis (CF) it is crucial that each diagnosed individual participates in life-preserving Airway Clearance Therapy (ACT) at least once a day for 30 minutes to aid in the loosening of secretions (Rimler, 2017). Traditional ACT techniques include inflatable vests that work by applying pulses to the chest wall at low volume (Leemans et al., 2020) and although this is an efficient route to take for airway clearance, a study conducted by Ward et al. (2019) found that adherence to this form of therapy is as low as 40% among people with CF. Low compliance is commonly due to insufficient time, the mental burden of needing these interventions and the high level of effort and energy required (Ward et al., 2019). It has been found in several studies that specific exercise such as running and lifting weights can be just as efficient at clearing airway secretions, although other physical activities including stationary cycling do not have the same impact due to the lack of abdominal movement (Ward et al., 2018). Further research on the effectiveness of physical activity versus traditional ACT is important in the realm of Cystic Fibrosis management as not enough study has been done to validate the

beneficial values of exercise; but research that has been conducted with participants proves there is room for these theories to become part of clinical practice (Ward et al., 2019). A study conducted by Rowbowtham et al. (2020) found that out of 277 participants that swapped out their daily ACT for some form of cardiovascular exercise, only 2 individuals reported that their lungs were not better off after exercising compared to ACT. Further research into exercise as a form of CF treatment would significantly lower the burden for sufferers according to a survey completed by the US Cystic Fibrosis Foundation Insight, where they argue making treatments easier to complete is at the top of the priority list on a global scale (Davies et al., 2020). As a result of a study led by Davies et al. (2020), it was found that the daily median time spent on CF treatments is between two and three hours and it was not uncommon for people with CF to skip out treatments, specifically ACT due to the mental and physical burden of them. To conclude, looking at prioritising research into this PICO question can significantly lift the mental, physical and social burdens of living with Cystic Fibrosis, although there is too little research to solidify any changes to clinical practice at this stage. Search keywords used (developed from your PICO question). Cystic fibrosis, Airway Clearance Therapy, Exercise, Physical Activity. Initial search strategy “Cystic Fibrosis” OR “Adults with Cystic Fibrosis” AND “Chest Wall Oscillation” AND “Exercise” OR “Physical Activity” Databases accessed CINAHL, MEDLINE With appropriately constructed The databases CINAHL and MEDLINE were chosen because they both share appropriate sources of a high quality related to the nursing scope of

academic paragraphs, argue the importance of only using high quality evidence from high quality sources (eg electronic databases) to support nursing practice (300 words). What might happen if low quality sources are used to inform practice? Identify and briefly discuss some high- quality sources. All arguments must be supported with reference to scholarly literature. knowledge. Using sources based on the most accurate evidence is essential in the nursing field as it directly improves patient outcomes through the nurses’ own knowledge, education and standards of work (Abu-Baker et al., 2021). According to a study conducted by Vassar et al. (2017), MEDLINE is validated as one of the most widely used databases for medical related research worldwide, with CINAHL following closely behind in fifth place out of 39 total. Vassar et al. (2017) further argues that MEDLINE has been the number one database for clinical neurology related systematic reviews for a number of years. As per the Nursing and Midwifery Board of Australia [NMBA] (2016) Nursing Standard 1.1, nurses must ensure safe practice by analysing and finding the best evidence available to them with their patients’ best interest in mind, and reliable databases aid in this endeavour. CINAHL has been recognised for its ability to find the most relevant sources with the filters that are applied, with 19 total search strategies for qualitative research found in a study done by Rosumeck et al. (2020). Both of these clinical databases help reinforce the importance of Evidence-Based Practice (EBP) in the nursing sector, and it has been concluded that a strong belief in EBP leads to better implementation in the workforce compared to those nurses who do not follow the EBP theory (Abu-Baker et al., 2021). For this reason, CINAHL and MEDLINE were the identified databases and aided in uncovering the most relevant research that is in the interest of best patient outcomes. Filters/limits applied and why they were applied. -Publication years were limited from 2014-2021 to aid in the retrieval of most accurate information. -Full text and Peer Reviewed filters were applied. -English language was chosen. Total number of hits from all databases. 14

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

Outline refinements to the search strategy. Did you need to narrow or broaden your search? How? Multiple words had to be cut to ensure the search was as refined as possible Insert your final search strategy (hint: should result in about 5-15 hits) “Cystic Fibrosis” OR “P* with Cystic Fibrosis” OR “Cystic Fibrosis Sufferer” AND “Airway Clearance T*” OR “ACT” OR “Chest Wall Oscillation” OR “Positive Expiratory Pressure” AND “Exercise” OR “Physical Activity” OR “Fitness” Select the most relevant articles located by your final search (maximum ten). There is no minimum but remember that if you haven’t identified any relevant literature, that will raise questions about the quality of your PICO questions and search strategy. Provide the references (APA 7 th format) for your selected articles here. Abu-Baker, N. N., AbuAlrub, S., Obeidat, R. F., & Assmairan, K. (2021). Evidence-based practice beliefs and implementations: A cross-sectional study among undergraduate nursing students. BMC Nursing, 13, 2-8. https://doi.org/10.1186/s12912-020-00522-x Davies, G., Rowbowtham, N. J., Smith, S., Elliot, Z. C., Gathercole, K., Rayner, O., Leighton, P. A., Herbert, S., Duff, A. JA., Chandran, S., Daniels, T., Nash, E. F., & Smyth, A. R. (2020). Characterising burden of treatment in cystic fibrosis to identify priority areas for clinical trials. Journal of Cystic Fibrosis, 19 (3), 499-502. https://doi.org/10.1016/j.jcf.2019.10.025 Leemans, G., Belmans, D., Van Holsbeke, C., Becker, B., Vissers, D., Ides, K., Verhulst, S., & Van Hoorenbeeck, K. (2020). The effectiveness of a mobile high-frequency chest wall oscillation (HFCWO) device for airway clearance. Pediatric Pulmonology, 55 (8), 1984-1992. https://doi- org.ezproxy.ecu.edu.au/10.1002/ppul.24784 Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice. https://www.nursingmidwiferyboard.gov.au/codes-

guidelines-statements/professional-standards/registered-nurse-standards- for-practice.aspx Rimler, R. (2017). For CF patients, no one right device for airway clearance therapy. The Journal for Respiratory Care Practitioners, 30 (5), 16-20. Rosumeck, S., Wagner, M., Wallraf, S., & Euler, U. (2020). A validation study revealed differences in design and performance of search filters for qualitative research in PsycINFO and CINAHL. Journal of Epidemiology, 128, 101-108. https://doi.org/10.1016/j.jclinepi.2020.09.031 Rowbowtham, N. J., Smith, S. J., Davies, G., Daniels, T., Elliott, Z. C., Gathercole, K., Rayner, O., C., & Smyth, A. R. (2020). Can exercise replace airway clearance techniques in cystic fibrosis? A survey of patients and healthcare professionals. Journal of Cystic Fibrosis, 19 (4), 19-24. https://doi-org.ezproxy.ecu.edu.au/10.1016/j.jcf.2019.10.026 Vassar, M., Yerokhin, V., Sinnett, P. M., Weiher, M., Muckelrath, H., Carr, B., Varney, L., & Cook, G. (2017). Database selection in systematic reviews: an insight through clinical neurology. Health Information & Libraries Journal, 34 (2), 156-164. https://doi- org.ezproxy.ecu.edu.au/10.1111/hir.12176 Ward, N., Stiller, K., Rowe, H., Morrow, S., Morton, J., Greville, H., & Holland, A. E. (2018). Airway clearance by exercising in mild cystic fibrosis (ACE-CF): a feasibility study. Respiratory Medicine, 142 , 23-28.

https://doi-org.ezproxy.ecu.edu.au/10.1016/j.rmed.2018.07.008 Ward, N., Stiller, K., & Holland, A. E. (2019). Exercise is commonly used for traditional airway clearance techniques by adults with cystic fibrosis in Australia: a survey. Journal of Physiotherapy, 65 (1), 43-50. https://doi.org/10.1016/j.jphys.2018.11.006 Ward, N., Stiller, K., & Holland, A. E. (2019). Exercise as a therapeutic intervention for people with cystic fibrosis. Expert Review of Respiratory Medicine, 13 (5), 499-458. https://doi.org/10.1080/17476348.2019.1598861 References Abu-Baker, N. N., AbuAlrub, S., Obeidat, R. F., & Assmairan, K. (2021). Evidence-based practice beliefs and implementations: A cross-sectional study among undergraduate nursing students. BMC Nursing, 13, 2-8. https://doi.org/10.1186/s12912-020-00522-x

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

Davies, G., Rowbowtham, N. J., Smith, S., Elliot, Z. C., Gathercole, K., Rayner, O., Leighton, P. A., Herbert, S., Duff, A. JA., Chandran, S., Daniels, T., Nash, E. F., & Smyth, A. R. (2020). Characterising burden of treatment in cystic fibrosis to identify priority areas for clinical trials. Journal of Cystic Fibrosis, 19(3), 499-502. https://doi.org/10.1016/j.jcf.2019.10.025 Leemans, G., Belmans, D., Van Holsbeke, C., Becker, B., Vissers, D., Ides, K., Verhulst, S., & Van Hoorenbeeck, K. (2020). The effectiveness of a mobile high-frequency chest wall oscillation (HFCWO) device for airway clearance. Pediatric Pulmonology, 55(8), 1984-1992. https://doi- org.ezproxy.ecu.edu.au/10.1002/ppul.24784 Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional- standards/registered-nurse-standards-for-practice.aspx Rimler, R. (2017). For CF patients, no one right device for airway clearance therapy. The Journal for Respiratory Care Practitioners, 30(5), 16-20. Rosumeck, S., Wagner, M., Wallraf, S., & Euler, U. (2020). A validation study revealed differences in design and performance of search filters for qualitative research in PsycINFO and CINAHL. Journal of Epidemiology, 128, 101-108. https://doi.org/10.1016/j.jclinepi.2020.09.031 Rowbowtham, N. J., Smith, S. J., Davies, G., Daniels, T., Elliott, Z. C., Gathercole, K., Rayner, O., C., & Smyth, A. R. (2020). Can exercise replace airway clearance techniques in cystic fibrosis? A

survey of patients and healthcare professionals. Journal of Cystic Fibrosis, 19(4), 19-24. https://doi-org.ezproxy.ecu.edu.au/10.1016/j.jcf.2019.10.026 Vassar, M., Yerokhin, V., Sinnett, P. M., Weiher, M., Muckelrath, H., Carr, B., Varney, L., & Cook, G. (2017). Database selection in systematic reviews: an insight through clinical neurology. Health Information & Libraries Journal, 34(2), 156-164. https://doi- org.ezproxy.ecu.edu.au/10.1111/hir.12176 Ward, N., Stiller, K., Rowe, H., Morrow, S., Morton, J., Greville, H., & Holland, A. E. (2018). Airway clearance by exercising in mild cystic fibrosis (ACE-CF): a feasibility study. Respiratory Medicine, 142, 23-28. https://doi-org.ezproxy.ecu.edu.au/10.1016/j.rmed.2018.07.008 Ward, N., Stiller, K., & Holland, A. E. (2019). Exercise is commonly used for traditional airway clearance techniques by adults with cystic fibrosis in Australia: a survey. Journal of Physiotherapy, 65(1), 43-50. https://doi.org/10.1016/j.jphys.2018.11.006 Ward, N., Stiller, K., & Holland, A. E. (2019). Exercise as a therapeutic intervention for people with cystic fibrosis. Expert Review of Respiratory Medicine, 13(5), 499-458. https://doi.org/10.1080/17476348.2019.1598861