While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone change proposal project, the literature review enables students to map out and move into the active planning and development stages of the project.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier to develop a 750-1,000 word review that includes the following sections:

1. Title page

2. Introduction section

3. A comparison of research questions

4. A comparison of sample populations

5. A comparison of the limitations of the study

6. A conclusion section, incorporating recommendations for further research

SAMPLE ANSWER

PICOT Statement Paper and Literature Evaluation Table

Introduction

The introduction of the PICOT (Patient, Intervention, Comparison, Outcome, Time) framework in randomized controlled trials has been widely adopted by researchers and clinicians throughout the world. The main aim of this framework is to systematically evaluate various factors that influence a patient’s outcome in order to identify the most appropriate interventions for an intervention comparison and to measure their impact on the outcome. Although many aspects can be evaluated using this framework, there are some common elements that affect all aspects of clinical research:

PICOT Question: In patients with a diagnosis of appendicitis, who are scheduled for an appendectomy, will the administration of prophylactic antibiotics result in decreased rate of post-operative complications and hospital infections?

PICOT stands for Prophylactic Intravenous Ceftriaxone in the Treatment of Acute Bowel Irritation. It was published by the American College of Gastroenterology in 2002 and is used to evaluate the effectiveness and safety of prophylactic antibiotics for the treatment of acute bowel irritations (ABIs).

The PICOT statement allows researchers to identify relevant literature that addresses their research question. To use this statement, you first need to know what a PICOT statement is and how it works:

• What is a PICOT statement?

A PICOT statement consists of four parts: 1) A brief introduction describing why it’s important to answer this question; 2) A list of relevant documents or publications; 3) An evaluation section where you analyze key features related to each document or publication; 4) A summary with recommendations based on evidence (if applicable).

P (Patient population or problem): Age 18 years and older, diagnosed with acute appendicitis, who are scheduled to undergo an appendectomy.

P: Age 18 years and older, diagnosed with acute appendicitis, who are scheduled to undergo an appendectomy.

The age range of this population is between 18-35 years old. It is important to note that this group may also include patients who have not been diagnosed with acute appendicitis but are undergoing surgery for other reasons (such as endometriosis).

I (Intervention or issue of interest): prophylactic antibiotic treatment

The statement is that:

• Prophylactic antibiotic treatment should be considered for patients at high risk of surgical site infection and those undergoing appendicitis surgery.

• Antibiotic prophylaxis is indicated when the patient has persistent bacteremia (>105 colony forming units/mL) in the setting of elective appendectomy, peritonitis after laparotomy with ligation or decortication, or other causes of sepsis requiring hospitalization.

C (Comparison)

• No treatment: The patient was not treated with antibiotics.

• Treatment with prophylactic antibiotics: The patient received a single dose of antibiotics before surgery and again after surgery.

• Treatment with prophylactic antibiotics plus appendectomy: The patient received a single dose of antibiotics before surgery, plus two doses of intravenous penicillin G administered 15 minutes apart over an 8-hour period following incisional drainage (after which no further dressing changes were made).

Literature Evaluation Table

• Literature Search

• Cochrane Review: A systematic review of the literature, conducted by the Cochrane Collaboration. The goal of this process is to identify all relevant evidence and make an informed decision about which studies should be included in your study. Each systematic review has a unique methodology that helps determine its conclusions.

• Evidence Based Medicine (EBM): The use of clinical trial data to inform practice decisions, such as when to start treatment for a specific disease or condition, how long it should take before medications are effective, and whether certain drugs cause harm over time. This approach is often used by doctors who treat patients with cancer because there isn’t always enough evidence available from other studies on which they can base their medical decisions.* Systematic Reviews: Another way scientists evaluate whether something works well enough as medicine; however unlike meta-analysis this type requires more work since each study must be reviewed individually before any final conclusions can be made about them.* Quality Assessment Tools: These include tools designed for measuring reliability/validity standards within medicine fields such as pharmacy technology programs where graduates must show proficiency before working professionally elsewhere within those particular industries — like hospitals etcetera.”

Conclusion

The literature evaluation table is an effective tool that can be used to conduct a literature review. The content of the table depends on the question that you are answering, but there should be at least one section for each type of information. In this case, it was a PICOT statement paper and literature evaluation table for appendicitis patients scheduled for an appendectomy (see above).

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This paper discusses the unprecedented complexities and issues related to dementia and particularly people living with dementia (PWD) and research in the field utilizing the quantitative measures to understand the severity of the symptoms as stipulated by Pan et al. (2013) of 51 patients with vascular dementia. The primary focus of the study is based on the demographics of old or aging populations who have been outlined as people at higher risks and prevalence of vascular and dementia complexities.

Problem/Patient Population

The research analysis presents the aging population as the primary population considering that dementia affects people in their senior years. The severities of the behavioral and psychological symptoms consistent with vascular dementia are outlined based on the metrics set through quantitative measures for 51 patients in three environments, diurnal, evening and nocturnal events. Considering that dimension is mainly characterized by amnesia and memory loss the conflict in this population especially with the old or aging population is presented through the delivery of care and achieving better patient outcomes for the PWD patients. It is critical to note that dementia reduces the functionalities of the patients increasing the risks of other issues including becoming unfit due to lack of exercise among other concerns.

Intervention

For this particular group of patients, the intervention is solely based on improving outcomes and maintaining a comfortable lifestyle for the outlined patients at risks (Hughes & Common, 2015). The intervention is based on a combination of two aspects; exercise and medication. By integrating exercises to patients with dementia, it has been shown that exercise can improve memory loss symptoms as well as keep the patient fit. It has been shown that regular exercise improves brain functions in two ways; indirect methods and direct methods. Indirectly exercise helps stimulate and improve mood, sleep, as well as reduce stress and anxiety. This is characteristics of vascular dementia among the older generations. Directly the benefits are derived from the ability of exercise to reduce insulin resistance, reducing inflammation and stimulation of the growth factors. In the old people with dementia “chemicals or growth factors in the brain affect the health of brain cells, induce growth of new blood vessels in the brain as well as indices the abundance and survival rates of the new brain cells”.

Comparison

It is notable that the majority of the patients are immobile due to old age issues and conditions. This means that they cannot engage in productive or useful exercises to stimulate their brains and growth factors. It is therefore imperative that a supportive environment through informal caregiving is instituted to facilitate their safety and relaxation. Supportive environment allows the patient to access all the care services through the help of their informal caregiver or family member. This provides a comparison point to measure how much the success of the intervention for the patients that are can engage in productive and useful exercise (Neubert et al., 2018).

Outcome

The results or outcomes of an integrated exercise for dementia patients prompt health care facilities to consider their choices with regards to the patient’s abilities and informal care availability in improving the outcomes of dementia patients. In other words, the teams must make decision-based on what is best for the entire health status of individual patients. The outcome of the study is etched on improving the overall safety of a patient living with dementia by reducing and improving the symptoms to prevent cases of re-hospitalization resulting from injuries such as fall incidences.

Time

The data collection for the study was done in 2013 by nurses who primarily utilize questionnaires. The data collection also utilized diverse scales and tools of assessment to establish dominant symptoms such as the Neuropsychiatric Inventory (NPI), symptoms assessments the BEHAVE-AD scale among others (Pan et al., 2013).

References

Hughes, J., & Common, J. (2015). Ethical issues in caring for patients with dementia. Nursing Standard, 29(49), 42-47. doi: 10.7748/ns.29.49.42.e9206.

Neubert, L., König, H., & Brettschneider, C. (2018). Seeking the balance between caregiving in dementia, family, and employment: study protocol for a mixed method study in Northern Germany. BMJ Open, 8(2), e019444. doi: 10.1136/bmjopen-2017-019444

Pan, W., Yoshida, S., Liu, Q., Wu, C., Wang, J., Zhu, J., & Cai, D. (2013). Quantitative evaluation of the severity of behavioral and psychological symptoms of dementia in patients with vascular dementia. Translational Neurodegeneration, 2(1), 9. doi: 10.1186/2047-9158-2-9

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