Scenario: Managing Chronic Heart Failure
You are working as a clinical nurse specialist in the heart failure clinic and service in Dubbo. One of your patients travels 2 hours by car from Coonabarabran for his monthly consultation. His wife and he find the long trip from home very difficult and an added burden in their lives. Particularly as he takes frusemide for his chronic heart failure that causes diuresis, which means they have to stop the car often which is frustrating and makes the trip even longer and tiring. They tell you that a friend of theirs, who also lives in regional NSW, uses a remote telemonitoring device to monitor their condition from their home. This means that their friend doesn't have to travel to their clinic so much. They ask you whether you think it is better to keep coming into the clinic or to see about getting a remote telemonitoring device to help them manage the chronic heart failure.
You are a little unfamiliar with telemonitoring, but you also don't want your patient to have to travel unnecessarily. You tell the couple that you will search for the available research on the management of chronic heart failure using telemonitoring and bring this back to them.
There are two databases research to be done one from Medline and Cinhal.
Please complete the following the activities -
PART 1: PARTICIPATES IN THE FIRST AND THE SECOND ONLINE DISCUSSION FORUMS
PART 2.1: DEVELOPING A FOCUSED QUESTION AND ACQUIRING RELEVANT EVIDENCE
1. Use the following categories to help define your problem and what you are looking at in simple terms PICO: Patient/Problem, Intervention, Comparison, and Outcome.
2. Now use these terms from the question above to create your PICO research question so that you have a clear purpose for your search:
3. What type of clinical question do you think this PICO answers?
4. The table below will help you to think of the other terms that you might also like to look up when searching for evidence to help you answer your question - this is part of basic planning for a research search.
|
Population
|
Intervention
|
Comparison
|
Outcome
|
|
What is your population?
What other terms might have been used?
|
What is your intervention?
What other terms might have been used?
|
What is your comparison?
What other terms might have been used?
|
What is your outcome?
What other terms might have been used?
|
5. Is there a particular group of people that you want to look at? List here any inclusion criteria you might use to refine your search if you have too many papers:
6. What kind of study do you think would best answer your question? Select here which type of article you might want to access. You can also use these to refine your search if you have a lot of papers.
Systematic Search Strategy Worksheet
7. Now that you have decided on WHAT you will be searching, you need to put down a plan of HOW you will search for your articles. This helps you and others to see how you got your evidence and how you made sure you got the best evidence to help you decide on your clinical action.
PART 2.2: EVIDENCE OF APPLICATION OF SEARCH STRATEGY (PLAN) IN DATABASE SEARCHES
Enter your planned search into two different databases of your choice (such as Medline and CINHAL) using the skills you have learnt in the library session, online library videos, and library workshops.
8. Place the screenshots/screengrabs/digital pictures of your two (2) database searchers here. Please ensure your screenshots provide all steps of your search (see the example in Assessment one templet) and are clear enough to be legible - these must be READABLE!!
9. Select a randomised controlled trial that can help you answer your PICO question and place the abstract here. Please add this as a screenshot, do not retype this yourself. (The abstract must be readable)
10. Choose a qualitative study that is relevant to your PICO from the list of provided articles in Assessment 3 folder and place the abstract here. It is ok if your qualitative study does not exactly match your PICO, but it should be relevant. Please add this as a screenshot, do not retype this yourself. (The abstracts must be readable).
PART 3.1 APPRAISAL OF YOUR RANDOMISED CONTROLLED TRIAL
Assessing the quality of the available evidence has also been a key focus this semester. Use the CASP tool for RCTs below to appraise the quality of your selected RCT.
Section A: Are the results of the trial valid?
Screening Questions
1. Did the trial address a clearly focused issue?
2. Was the assignment of patients to treatments randomised? (Max 50 Words)
3. Were all of the patients who entered the trial properly accounted for at its conclusion? (Max 50 words)
4. Were patients, health workers and study personnel 'blind' to treatment? (Max 50 words)
5. Were the groups similar at the start of the trial? (Max 50 words)
6. Aside from the experimental intervention were the groups treated equally? (Max 50 words)
7. How large was the treatment effect? (Max 150 words)
8. How precise was the estimate of the treatment effect? (Max 100 words)
9. Can the results be applied in your context? (or to the local population?) (Max 100 words)
10. Were all clinically important outcomes considered? (Max 50 words)
11. Are the benefits worth the harms and costs?
PART 3.2 APPRAISAL OF YOUR QUALITATIVE ARTICLE
Use the CASP Appraisal for Qualitative Research below to decide whether the information presented in your paper is trustworthy and truly reflective of the participant's voice.
SCREENING QUESTIONS
1. Was there a clear statement of the aims?
2. Is a qualitative methodology appropriate?
2. Is a qualitative methodology appropriate?
3. Was the research design appropriate to address the aims of the research?
4. Was the recruitment strategy appropriate to the aims of the research?
5. Was the data collected in a way that addressed the research issue?
6. Has the relationship between researcher and participants been adequately considered?
7. Have ethical issues been taken into consideration?
8. Was the data analysis sufficiently rigorous?
9. Is there a clear statement of findings?
10. How valuable is the research?
PART 4 OVERALL SUMMARY
PART 4.1 PROVIDE AN OVERALL SUMMARY OF WHAT THESE TWO PAPERS CONTRIBUTE TO ANSWERING YOUR RESEARCH QUESTION
PART 4.2 SYNTHESISING THE EVIDENCE
Finally, you need to summarise the evidence that relates to your clinical questions in plain language as if you were explaining the rationale for your clinical decision making to a patient within your care.
Assignment content -
- What is a PICO?
- What is a systematic search plan?
- Does the assignment need an introduction? No, just the activities in the worksheets. This is a process assignment - you need to show us you understand and can apply the process.
- What if I don't know how to do the search?
Attachment:- Assignment Files.rar