In the adult hospitalized inpatient receiving antibiotic therapy (P), how does the addition of probiotic therapy (I) compared with no probiotic therapy (C)

affect the probability of developing antibiotic-associated diarrhea (O) during antibiotic therapy (T)?
Paper details

Purpose of the Paper:

The purpose of this paper is to begin the review of literature and other written materials and determine the current evidence base for your clinical question. You will

not be able to review all of the evidence during this course. However, at the conclusion of the course you should have reviewed a substantial amount of literature and

become somewhat of an “expert” on the knowledge base related to your clinical question.

You can expect to continue reviewing literature and additional evidence when you enroll in the professional project as a capstone to your curriculum. Knowledge

development is ongoing, not usually stagnant, and it is important to keep abreast of new publications and findings in your area.

The following should be included in the paper:

a. INTRODUCTION

The introduction presents the need for the study you are proposing. Provide references that support this topic as a compelling issue in nursing today. Avoid using

opinion statements unless you are quoting an expert from printed materials. A scientific paper such as this assignment is based on printed authoritative data and not

your opinion. Avoid use of terms such as “should” and “must do…..” This is a report on others printed data. Also avoid use of adjectives such as “absolutely

must.”….”extremely.” Instead, again state the printed facts that are supported by references.

This is a good place to introduce information that does not fit in your literature review such as general statistics about the problem, etc. Include cost issues to

health care, if relevant; usually cost is very relevant. Include quality of life issues for the targeted population. Make a clear point as to how the clinical issue

relates to your practice as a MSN or DNP student.

b. STATEMENT OF CLINICAL QUESTION

You should include the variables of study and population of study. This is a good place to use the PICO format (Melnyk & Fineout-Overholt, 2011).

c. THEORETICAL FRAMEWORK (brief overview)
Choose and describe a theoretical framework useful for understanding the variable(s) in your clinical question. Provide a brief overview of the theory or framework

including author(s), major concepts, and relationships among concepts. Include a diagram of how your paper topic variables fit in the proposed framework.

d. THEORETICAL AND OPERATIONAL DEFINITIONS

Define the study variables in a theoretical format and an operational format.
Another way to think of the study variables is to identify the PICO statement components as concepts. The concepts are variables.

The theoretical definition(s) will be cited from an authoritative source and describes what another author means when using this term. The operational definition(s)

will be the meaning you hold for your chosen variables in this literature search. You may use another author’s definition as your own, but you must identify that you

have done so. Cite a reference when indicated.

e. TRANSITION PARAGRAPH

This paragraph serves as a transition from the above content to introducing the review of major variables found in the literature.

f. REVIEW OF LITERATURE – A MINIMUM OF 3-5 ARTICLES SHOULD BE
DISCUSSED

1. Discuss electronic search strategies used including databases searched, search terms per database, and years searched per database. Include the number of “hits”

with each search strategy. Identify the iterative process you followed to narrow or expand your search to find the best evidence.
2. State inclusion and exclusion criteria for literature and rationale for inclusion and exclusion criteria.
3. Critique the literature including research design, sampling method, research methodology, analysis of data, conclusions derived from findings, scientific and/or

clinical significance of findings. Address the internal validity of the cited study. Place this content into a concise table with these column headings. In the

narrative of your paper give a general description (overview) of what you found.
4. Studies reviewed should be relevant to the clinical question and variables. Important studies should be discussed in depth with regard to methodology and findings.
5. Primary sources should be reviewed

g. DETERMINATION OF THE EVIDENCE-BASE FOR YOUR CLINICAL QUESTION

Grade the literature you reviewed. Discuss what criteria you are using to determine the strongest evidence for your literature base. You may choose to use the criteria

in the Evans article, any of your textbooks, or another source as a guide. But you must use a source and its documented criteria. You may choose to include a table of

the material reviewed, or some other way to organize your decision-making. Include text about the state of the current evidence and include:

1. Report areas of agreement and disagreement
2. Report gaps in evidence base

h. CONCLUDING PARAGRAPH

Summarize the findings and link the findings to your clinical question. Get to the point, state the point, and wrap it up. Include a statement about each of the above

sections, e.g. what nursing theory guides the need for this clinical question? What is the answer to your clinical question based on the literature reviewed? What is

the strength of the evidence? What is the next step for you with this topic? Will you drop this topic based on not enough literature to support further study? Is the

PICO statement too simple? Do you need to adapt the PICOT question and search further in the next courses? Identify what is next with the paper findings.

The paper grading criteria are:

1. 25% Clarity: Organization of paper is evident through use of headings, introductory and transition sentences. Terms are clearly defined. Discussion points are

clear.

2. 25% Coherence: Ideas build on one another throughout the paper. Discussion is logically presented and relevant to the purposes of the paper. Critical reasoning is

evident and accurate.

3. 40% Content: Content is adequately and accurately presented, including breadth and depth of literature reviewed related to your proposed study variables. Review

includes each item under above “items to include in paper”. Application to advanced practice nursing is evident.

4. 10% Format: Paper reflects accepted standards for graduate level written work. Grammar, sentence structure, punctuation, spelling and abbreviations are correct. APA

format is followed in the text, tables and reference pages.

Note: Paper length allowed is maximum 8-10 pages for the body of the paper; and 4-5 pages to include Title Page, Abstract, References, Table(s) and any other

appropriate appendices. Content beyond 15 pages will deduct from your grade.

Content Required in Review Paper
Note: Paper length allowed is maximum 8-10 pages for the body of the paper and 4-5 pages to include Title Page, Abstract, References, Table(s), and any other

appropriate appendices. Content beyond 15 pages will deduct from your grade.
Student Self-Assessment of criteria

Student Name:
Faculty Assessment
1. INTRODUCTION
Your introduction presents the need for the study you are proposing. This is a good place to introduce information that does not fit in your literature review such as

general statistics about problem, etc. This section should grab the reader’s interest; however, avoid personal opinion statements. State ONLY what is found in the

literature. This is a scientific paper, not an opinion paper. Cite all references following APA format.

Your study should have importance in your workplace (your boss agrees it is important) and will include a cost-saving benefit. You need to state those items in your

paragraph. Tell the reader what the paper is about. Hint: Write this part last, after you know what the paper says.

1. Is it clearly stated?

2. Is it coherent?

3. Required content included and accurate?

4. APA format and graduate level work?

2. STATEMENT OF CLINICAL QUESTION

Write the clinical question (aka research question) using the PICO format (Melnyk, B. & Fineout-Overholt. E., latest edition). Provide a few statements that support

the importance of this clinical question. Your study must have importance in your workplace (your boss agrees it is important) and includes the likelihood of a cost-

saving benefit. Cite the Melynk reference in your narrative.

1. Is it clearly stated?

2. Is it coherent?

3. Required content included and accurate?

4. APA format and graduate level work?

3. THEORETICAL FRAMEWORK (brief overview)

Choose and describe a theoretical framework useful for understanding the variable(s) in your clinical question. Select a nursing theory. You may ALSO use another

theory, if desired; however, again a NURSING THEORY is required. This is a nursing theory course. Provide a brief overview of the theory or framework including author

(s), major concepts, and relationships among concepts. Include a diagram of how your variables fit in the proposed framework.
1. Is it clearly stated?

2. Is it coherent?

3. Required content included and accurate?

4. APA format and graduate level work?

4. THEORETICAL AND OPERATIONAL DEFINITIONS

You need to theoretically and operationally define your major study variables.

Theoretical definitions come from an authoritative source and require a reference citation. Document definitions from the theoretical framework or literature review or

whatever sources you have used to define your variables.

Operational definitions are YOUR definition of the same variables for use in your study. This is not the same as the theoretical definition. In some cases, you will

not need a citation for the operational definition. But if you use some other author’s definition you will give that author credit.

1. Is it clearly stated?

2. Is it coherent?

3. Required content included and accurate?

4. APA format and graduate level work?

5. TRANSITION PARAGRAPH

This paragraph serves as a transition to introducing the review of major variables.

1. Is it clearly stated?

2. Is it coherent?

3. Required content included and accurate?

4. APA format and graduate level work?

6. REVIEW OF LITERATURE – A MINIMUM OF 5 ARTICLES SHOULD BE DISCUSSED
a. Discuss electronic search strategies used including databases searched, search terms per database, and years searched per database. Report how many “hits” you

obtained from each search strategy. Describe how you narrowed or expanded your search to find the best evidence.
b. State inclusion and exclusion criteria for literature and rationale for inclusion and exclusion criteria, e.g. include why you limited your search to the years you

included.
c. Critique the literature including research design, sampling method, research methodology, analysis of data, conclusions derived from findings, scientific and/or

clinical significance of findings. This content can be the title of your TABLE headings. In your narrative, address the internal validity of the study and general

overview comments about the studies. Refer to your table in the narrative.
d. Studies reviewed should be relevant to the clinical question and variables.
e. Important studies should be discussed in depth with regard to methodology and findings.
f. Primary sources should be reviewed

1. Is it clearly stated?

2. Is it coherent?

3. Required content included and accurate?

4. APA format and graduate level work?

7. DETERMINATION OF THE EVIDENCE-BASE FOR YOUR CLINICAL QUESTION

a. Discuss what criteria you are using to make your determination. You may choose to use the criteria in the Evans article, any of your textbooks, or another source as

a guide. But you must use a source and its documented criteria. You may choose to include a table of the material reviewed or some other way to organize your

decision-making.

b. Include text about the state of the current evidence and include:
Report areas of agreement and disagreement
Report gaps in evidence base
1.

8. CONCLUDING PARAGRAPH Summarize findings and link findings to your clinical question.
1. Is it clearly stated?

2. Is it coherent?

3. Required content included and accurate?

4. APA format and graduate level work?

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