Description
Your poster should include:Explanation of the nursing issue significance with three statementsDescription of your position on the issue and three statements on how a nurse can impact this issueInclude only the two approved journal sources used in your Week 6 appraisals to support your position.Attached below is an example of a poster and the documents that should be used to complete the poster project.
Unformatted Attachment Preview
NURS 350
Title
DESCRIPTION OF THE
ISSUE
NAME
In this section, you will discuss the issue.
This is a good place to get information
from your initial Week 2 paper where you
described the background and the
importance to nursing (APA citation).
Make 1-2 sentences about the background
and then the significance in bullet points
SIGNIFICANCE TO NURSING
•
•
•
Most newly graduated nurses will
join the workforce through a Nurse
Residency Program (APA citation)
Nurse Residency Programs focus
on evidence-based practice (APA
Citation)
Newly graduated nurses will need to
present evidence-based practice in
poster format (APA citation)
POSITION STATEMENT
DON’T USE “I” STATEMENTS, JUST
GIVE A SCHOLARLY EXPLANATION:
NEWLY GRADUATED NURSES
NEED TO BE ABLE TO USE AND
PRESENT EVIDENCE-BASED
PRACTICE TO CARE FOR PATIENTS
IN THE CURRENT HEALTHCARE
ENVIRONMENT
YOU CAN ADD A DESIGN OR CLIPART
BELOW. REMEMBER THAT YOU NEVER
TAKE IMAGES FROM A SOURCE WITHOUT
PERMISSION– ONLY APPROPRIATE
CLIPART
YOU CAN ADD A DESIGN OR CLIPART
HERE. REMEMBER THAT YOU NEVER
TAKE IMAGES FROM A SOURCE WITHOUT
PERMISSION– ONLY APPROPRIATE
CLIPART
How Nurses Can
Impact this Issue
• Make three bullet points
here from the
information you learned
from the articles you
used in Week 4
• Be sure to cite the
source for each
intervention
• Make it scholarly – what
does the evidence say?
References
PUT YOUR REFERENCES HERE – ALL
THREE ARTICLES IN APA FORMAT
APPENDIX C
Appraisal Guide
Conclusions of a Systematic Review with Narrative Synthesis
Citation:
____________________________________________________________________________
Patel, P., Patel, P., Bhatt, M., Braun, C., Begum, H., Nieuwlaat, R., … & Mustafa, R. A. (2020).
Systematic review and meta-analysis of outcomes in patients with suspected deep vein
thrombosis. Blood Advances, 4(12), 2779-2788.
https://doi.org/10.1182/bloodadvances.2020001558
____________________________________________________________________________
____________________________________________________________________________
Synopsis
What organization or persons produced the systematic review (SR)?
The systematic review “Systematic review and meta-analysis of outcomes in patients with
suspected deep vein thrombosis” was produced by Patel et al. (2020).
How many persons were involved in conducting the review?
Seven people were involved.
What topic or question did the SR address?
The results of patients with suspected deep vein thrombosis were the subject of the systematic
review. Its specific goal was to examine and compile the information on this condition’s impacts
that was currently accessible.
How were potential research reports identified?
The paper “Systematic review and meta-analysis of outcomes in patients with suspected deep
vein thrombosis” describes systematic searches on electronic databases like PubMed, EMBASE,
and Cochrane Library as well as manual searches for relevant journals’ content pages or
conference abstracts that could be research reports. To find any other studies, professional
consultations were used to identify them.
What determined if a study was included in the analysis?
The inclusion of studies was based on certain factors. The primary one was predefined eligibility
criteria that were generally related to study design, patient population, and relevant outcomes.
How many studies were included in the review?
The total number of studies that were included in the review process was 39.
What research designs were used in the studies?
Brown
APP C-1
Patel et al. (2020) article “Systematic Review and Meta-analysis of Outcomes in Patients with
Suspected deep vein thrombosis” used observational research designs, including cohort studies
and case-control studies, to explore the outcomes associated with patients having suspected deep
venous thrombosis.
What were the consistent and essential across-studies conclusions?
The dependable and significant across-study conclusions in the systematic review revealed a
significant limitation based on the small population size (Patel et al., 2020).
Credibility
Was the topic clearly defined?
Yes
No
Not clear
Was the search for studies and other
Is evidence comprehensive and unbiased?
Yes
No
Not clear
Was the screening of citations for
Inclusion based on explicit criteria?
Yes
No
Not clear
*Were the included studies assessed
For quality?
Yes
No
Not clear
Were the design characteristics and
findings of the included studies displayed
Or discussed in sufficient detail?
Yes
No
Not clear
*Was there a true integration (i.e., synthesis) of the findings—not
merely reporting of findings from
Each study individually?
Yes
No
Not clear
*Did the reviewers explore why differences
In findings might have occurred?
Yes
No
Not clear
Did the reviewers distinguish between
conclusions based on consistent findings
from several good studies, and those
Based on inferior evidence (number or quality)?
Yes
No
Not clear
Which conclusions were supported by
consistent findings from two or more
good or high-quality studies?
List
____________________________________________________________________________
•
•
•
APP C-2
The research discovered congruent findings from numerous good or high-quality studies.
These findings included that patients with low pretest probability
It also included a negative D-dimer at three months and had a similar risk of VTE (1%)
as individuals with a negative US ultrasound (Patel et al., 2020).
Brown
.____________________________________________________________________________
____________________________________________________________________________
ARE THE CONCLUSIONS
CREDIBLE?
Yes All
Yes Some
No
Clinical Significance
*Across studies, is the size of the
treatment or the strength of the
The association found or the
meaningfulness of qualitative findings
strong enough to make a difference
in patient outcomes or experiences of care?
Yes
No
Not clear
Are the conclusions relevant to the
Care the nurse gives?
Yes
No
Not clear
ARE THE CONCLUSIONS
CLINICALLY SIGNIFICANT?
Yes All
Yes Some
No
Applicability
Does the SR address a problem,
What situation or decision we are addressing in our setting?
Yes
No
Not clear
Are the patients in the studies or a
subgroup of patients in the studies
Similar to those we see?
Yes
No
Not clear
What changes, additions, training, or
Purchases would be needed to implement
And sustain a clinical protocol-based
on these conclusions?
Specify and list
____________________________________________________________________________
According to the article, healthcare systems must invest in certain aspects. They include:
•
Standardized training programs and strong medication reconciliation processes.
•
Adopting cutting-edge technology solutions for medication management and creating a
safety culture that encourages reporting and learning to implement and maintain a clinical
protocol based on their findings (Patel et al., 2020).
This ensures the region improves patient safety and reduces effects of the
condition______________________________________________________________________
______
Is what we will have to do to implement
Brown
APP C-3
the new protocol realistically achievable
by us (resources, capability, commitment)?
How will we know if our patients are
benefiting from our new protocol?
Yes
No
Not clear
Specify
____________________________________________________________________________
The outcomes could be evaluated by recording patient health changes, fewer side effects, quicker
recovery periods, and lower complication rates (Patel et al., 2020). Furthermore, regular
assessments, data analysis, and patient and healthcare professional feedback can yield insightful
information.
____________________________________________________________________________
ARE THESE CONCLUSIONS
APPLICABLE TO OUR SETTING?
Yes All
Yes Some
No
SHOULD WE PROCEED TO DESIGN
A PROTOCOL INCORPORATING
THESE CONCLUSIONS?
Yes All
Yes Some
No
* = Important criteria
Comments
Without a doubt, the paper is pertinent to the discussion of venous thromboembolism. This is
because it entails a systematic evaluation and meta-analysis of the results in individuals with
suspected deep vein thrombosis (DVT). Such research is essential because it can assist in
synthesizing earlier investigations into vein thrombosis, look for the most effective approaches
for diagnosis and treatment, and provide an overview of the general prognosis for persons who
frequently express suspicions about DVT. Findings from these studies may help guide clinical
judgments that healthcare providers should use when handling instances involving the
management of
VTE._________________________________________________________________________
___
APP C-4
Brown
References
Patel, P., Patel, P., Bhatt, M., Braun, C., Begum, H., Nieuwlaat, R., … & Mustafa, R. A. (2020).
Systematic review and meta-analysis of outcomes in patients with suspected deep vein
thrombosis. Blood Advances, 4(12), 2779-2788.
https://doi.org/10.1182/bloodadvances.2020001558
Brown
APP C-5
APPENDIX E
Appraisal Guide
Findings of a Qualitative Study
Citation:
___________________________________________________________________________
Hernandez‐Nino, J., Thomas, M., Alexander, A. B., Ott, M. A., & Kline, J. A. (2021). The use of
qualitative methods in venous thromboembolism research. Research and Practice in Thrombosis
and Haemostasis, 5(6), e12593.
https://doi.org/10.1002/rth2.12593__________________________________________________
_________________________
___________________________________________________________________________
Synopsis
What experience, situation, or subculture does the researcher seek to understand?
The researchers intend to delineate the lived experiences and unique realities of persons who
have been diagnosed with venous thromboembolism (VTE), a condition that encompasses blood
clots in the veins, hence providing insights into patients’ illness trajectory, treatment adherence,
and quality of life within this health subculture (Hernandez‐Nino et al., 2021). Their qualitative
research design.
Does the researcher want to produce a description of an experience, a social process, or an
event, or is the goal to generate a theory?
Instead of developing a theory in this paper, the researchers want to explain an experience, a
social process, or an event (Hernandez-Nino et al., 2021).
How was data collected?
Generally, a qualitative research method involves in-depth interviews and focus group
discussions of participants to provide rich insights into the experiences and views of the people
relating to venous thromboembolism (Hernandez‐Nino et al., 2021). The description did not
indicate whether data collection was obtained through semi-structured interviews or focus group
discussions for the case at hand or other techniques such as thematic analysis and content
analysis. However, these are common techniques employed during qualitative research studies
while collecting and analyzing their study participants’ qualitative data.
How did the researcher control their biases and preconceptions?
The researcher controlled biases and preconceptions by employing rigorous qualitative research
methods, such as thematic analysis or constant comparative analysis, which involve systematic
data collection and interpretation to ensure that personal biases do not unduly influence the
research findings (Hernandez‐Nino et al., 2021). Additionally, the researcher may have utilized
reflexivity, acknowledging their perspectives and potential biases and engaging in ongoing
Brown
APP E-1
critical self-examination throughout the research process to minimize the impact of
preconceptions on the study.
Are specific pieces of data (e.g., direct quotes) and more generalized statements (themes,
The article by Hernandez-Nino et al. (2021) titled “The Use of Qualitative Methods in Venous
Thromboembolism Research” undoubtedly offers a variety of elements, including themes and
theories that are generalized statements in addition to direct quotes, as one of the data it offers for
the conclusions from its qualitative research.
What are the main findings of the study?
The key conclusion of the study was the fact that video interviews were at least as successful as
in-person interviews. Interviews revealed that each participant had a different post-VTE
experience, with varying effects on quality of life. The impressions of medical communication,
the fear of a recurrence, and worries about death were the most prevalent themes.
Credibility
Is the study published in a source?
That required peer review?
Yes
No
Not clear
Were the methods used appropriate
to the study purpose?
Yes
No
Not clear
Was the sampling of observations or
interviews appropriate and varied
enough to serve the purpose of the study?
Yes
No
Not clear
*Were data collection methods
effective in obtaining in-depth data?
Yes
No
Not clear
Did the data collection methods
avoid the possibility of oversight,
underrepresentation, or
overrepresentation from certain
types of sources?
Yes
No
Not clear
Were data collection and analysis
intermingled dynamically?
Yes
No
Not clear
*Is the data presented in ways that
provide a vivid portrayal of what was
experienced or happened, and its
context?
Yes
No
Not clear
*Does the data provided justify
generalized statements, themes,
or theory?
Yes
No
Not clear
ARE THE FINDINGS CREDIBLE?
Yes All
APP E-2
Brown
Yes Some
No
Clinical Significance
*Are the findings rich and informative?
Yes
No
Not clear
*Is the perspective provided
potentially useful in providing
insight, support, or guidance
for assessing patient status
or progress?
Yes
Some
No
ARE THE FINDINGS
CLINICALLY SIGNIFICANT?
Yes All
Yes Some
Not clear
No
* = Important criteria
Comments
___________________________________________________________________________
This article explores the qualitative research methods for exploring venous thromboembolism. It
looks at how some knowledge about patients’ experiences and views on venous
thromboembolism could be a rich source of information that could help towards patient-centered
care and improve treatment outcomes for this condition (Hernandez‐Nino et al., 2021). The
article stresses promoting the use of qualitative research within the wider discipline of venous
thromboembolism research with quantitative approaches, which would support one another to
result in more rounded strategies for patients’
care.__________________________________________________________________________
_
Brown
APP E-3
References
Hernandez‐Nino, J., Thomas, M., Alexander, A. B., Ott, M. A., & Kline, J. A. (2021). The use of
qualitative methods in venous thromboembolism research. Research and Practice in
Thrombosis and Haemostasis, 5(6), e12593. https://doi.org/10.1002/rth2.12593
APP E-4
Brown
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Volume 4, Issue 12
SYSTEMATIC REVIEW | JUNE 22, 2020
Systematic review and meta-analysis of outcomes in patients with suspected
deep vein thrombosis
Payal Patel, Parth Patel, Meha Bhatt, Cody Braun, Housne Begum, Robby Nieuwlaat, Rasha Khatib, Carolina C. Martins,
Yuan Zhang, Itziar Etxeandia-Ikobaltzeta, Jamie Varghese, Hani Alturkmani, Waled Bahaj, Mariam Baig, Rohan Kehar,
Ahmad Mustafa, Rakesh Ponnapureddy, Anchal Sethi, Merrill Thomas, David Wooldridge, Wendy Lim, Shannon M. Bates,
Eddy Lang, Grégoire Le Gal, Marc Righini, Wojtek Wiercioch, Holger J. Schünemann, Reem A. Mustafa
June 23 2020
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Blood Adv (2020) 4 (12): 2779–2788.
https://doi.org/10.1182/bloodadvances.2020001558
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Abstract
After deep vein thrombosis (DVT) is diagnosed, prompt evaluation and therapeutic intervention are of
paramount importance for improvement in patient-important outcomes. We systematically reviewed patientimportant outcomes in patients with suspected DVT, including mortality, incidence of pulmonary embolism (PE)
and DVT, major bleeding, intracranial hemorrhage, and postthrombotic sequelae. We searched the Cochrane
Central Register of Controlled Trials, Ovid Medline, Embase for eligible studies, references lists of relevant
reviews, registered trials, and relevant conference proceedings. Two investigators screened and abstracted data.
Nine studies with 5126 patients were included for lower extremity DVT. Three studies with 500 patients were
included for upper extremity DVT. Among patients with lower extremity DVT, 0.85% (95% confidence interval
[CI], 0% to 2.10%) and 0% developed recurrent DVT and PE, respectively, at 3 months. Among patients with
upper extremity DVT, 0.49% (95% CI, 0% to 1.16%) and 1.98% (95% CI, 0.62% to 3.33%) developed recurrent DVT
and PE, respectively, at 3 months. No major bleeding events were reported for those anticoagulated, which is
lower than in other systematic reviews. For both upper and lower extremity DVT, low pretest probability patients
with a negative D-dimer had a comparable incidence of VTE at 3 months (∼1%) as patients with a negative
ultrasound (US). At higher pretest probabilities, negative US testing with or without serial US appears to be the
safer option. In this review, we summarized the outcomes of patients evaluated by various diagnostic pathways.
In most instances, there was significant limitation due to small population size or lack of direct evidence of
effects of using a specific pathway. This systematic review was registered at PROSPERO as CRD42018100502.
Potential Articles of Interest
Systematic review and meta-analysis of outcomes
in patients with suspected pulmonary embolism
Parth Patel et al., Blood Advances, 2021
Diagnosis of deep vein thrombosis of the lower
extremity: a systematic review and meta-analysis
of test accuracy
Subjects: Health Services and Outcomes, Systematic Review, Thrombosis and Hemostasis
Meha Bhatt et al., Blood Advances, 2020
Topics: deep vein thrombosis, deep venous thrombosis of upper extremity, venous thromboembolism, leg,
hemorrhage, fibrin fragment d substance, intracranial hemorrhages
Introduction
American Society of Hematology 2020 guidelines
for management of venous thromboembolism:
treatment of deep vein thrombosis and pulmonary
embolism
Thomas L. Ortel et al., Blood Advances, 2020
The annual incidence of deep vein thrombosis (DVT) in the general population is 48 per 100 000 and can be
associated with significant morbidity and mortality.1 Prompt evaluation and expeditious therapeutic intervention
Disease profile and plasma neutralizing activity of
post-vaccination Omicron BA.1 infection in Tianjin,
China: a retrospective study
when DVT is confirmed is of paramount importance for optimal patient management. Various strategies are
Hong Zheng et al., Cell Research, 2022
currently used for the evaluation of suspected DVT. The first step involves determining the pretest probability
Long-Term Use of Insomnia Medications: An
Appraisal of the Current Clinical and Scientific
Evidence
(PTP) of DVT, either formally using a clinical decision rule or informally through clinical judgment, prior to
diagnostic testing. Following this, options for diagnostic tests include compression ultrasound (US) with or
without Doppler US of the proximal leg veins (duplex US), whole-leg US, serial US, and D-dimer assays. These
Phyllis C. Zee et al., Journal of Clinical Medicine,
2023
The MDM2–p53 Antagonist Brigimadlin (BI
907828) in Patients with Advanced or Metastatic
Solid Tumors: Results of a Phase Ia, First-inHuman, Dose-Escalation Study
tests can be used alone or in sequence, depending on the pre-test probability.
While the diagnostic pathway is an important consideration in determining the optimal strategy for the
evaluation of suspected DVT, this review focuses on patient-important outcomes. These outcomes assess the
Patricia LoRusso et al., Cancer Discovery, 2023
consequences of missed or incorrect diagnoses when anticoagulant treatments are mistakenly withheld or
administered unnecessarily. Anticoagulant treatment of DVT is associated with risks of bleeding, with major
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bleeding (bleeding requiring red cell transfusion or intervention to stop bleeding or bleeding into a critical area,
such as intracranial hemorrhage) being the most clinically relevant. Missed diagnoses can be associated with an
increased risk of recurrent DVT, development of pulmonary embolism (PE), and postthrombotic syndrome. We
conducted a systematic review and meta-analysis to evaluate the outcomes of patients with suspected DVT
View Metrics
evaluated by various diagnostic pathways to determine the frequency of such outcomes. This systematic review
was performed in conjunction with upper and lower extremity DVT test accuracy reviews that evaluated optimal
diagnostic pathways based on PTP to inform an overall guideline on management of venous thromboembolism,
Cited By
detailed further in “Methods.”2-4
Web Of Science (8)
Methods
Google Scholar
Determining outcomes of interest
This systematic review was undertaken for the purposes of informing the American Society of Hematology
Guidelines on Management of Venous Thromboembolism, specifically diagnosis of venous thromboembolism
(VTE). The review process began with a multidisciplinary panel coordinated by the American Society of
Hematology Venous Thromboembolism Guideline Coordination Committee consisting of physicians with clinical
and research expertise on the guideline topic, methodologists with expertise in evidence appraisal and guideline
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development, and patient representatives. These panel members developed clinical questions of interest
regarding the diagnosis of VTE. The process is briefly described below; however, for detailed information, refer
to the original guideline publication.2
After the primary questions were developed, the panel chairs developed diagnostic pathways that were refined
through an iterative process with input from the panel (supplemental Material 1). The diagnostic strategies for
DVT are based on the PTPs for individual patients, which provide an estimate of the expected prevalence of DVT
at a population level. PTP can be determined using validated clinical decision rules, such as the Wells criteria.5
The original Wells criteria divided outpatients into 3 categories (low, intermediate, and high), and the
dichotomized Wells criteria divided patients into 2 categories (unlikely and likely). In patients with suspected
lower extremity DVT, the guideline assumed the prevalence in patients with low, intermediate, and high PTP to
be 10%, 25% to 35%, and >50%, respectively. In patients with suspected upper extremity DVT using the
Constans score,6 the guideline assumed the prevalence in patients with unlikely and likely PTP to be 10% and
40%, respectively. Therefore, when possible, outcomes were also further classified by PTP.
The panel then selected outcomes of interest for each question a priori, following the approach described in
detail elsewhere.7 The panel brainstormed all possible outcomes and then rated their relative importance for
decision making following the Grading of Recommendation, Assessment, Development and Evaluation (GRADE)
approach.8 During this rating process, the panel used definitions of the outcomes (“marker states”) that were
developed for these guidelines by the McMaster Grading of Recommendations, Assessment, Development and
Evaluation (GRADE) Center. Rating outcomes by their relative importance can focus attention on those
outcomes that are considered most important and help to resolve or clarify potential disagreements. The panel
rated the following outcomes as critical for decision making across the DVT diagnosis questions: all-cause
mortality, mortality from VTE, development of PE, development of DVT, development of recurrent DVT,
development of postthrombotic sequelae, major bleeding, and intracranial hemorrhage; in addition to the
diagnostic accuracy outcomes (false positive [FP], false negative [FN], true positive [TP], and true negative [TN]
test results).
Data sources and searches
We conducted this systematic review in accordance with a prespecified registered protocol available on the
International Prospective Register of Systematic Reviews (PROSPERO; registration number CRD42018100502).
We reported the results according to preferred reporting items for systematic reviews and meta-analyses
(PRISMA) guidelines.9 The primary source of information was obtained from the studies that were included for
the analysis of test accuracy, represented in Figure 1 and discussed in a separate paper.3,4 The secondary
source included studies identified as having potential information for outcomes when the initial search was
completed, regardless of whether the study contained test accuracy information. The final source was any
additional studies suggested by experts in the field or other guidelines.
Figure 1.
VIEW LARGE
DOWNLOAD PPT
Flowchart of the article selection process for included studies.
We performed an electronic search of CENTRAL (until May 2019), Ovid Medline (from 1976 to May 2019), and
EMBASE (from 1974 to May 2019). A methodological filter was applied to limit retrieval of studies with data for
test accuracy (prospective studies, cross-sectional studies, cohort studies, or abstracts and conference posters
after 2014, limited to humans); a detailed search strategy provided in supplemental Material 2. We also reviewed
the reference lists of relevant articles and reviews.
Study selection
We used the following eligibility criteria for the outcomes studies:
Study design.
Prospective studies, cross-sectional studies, cohort studies from January 1974 to May of 2019, or abstracts and
conference posters after 2014 were used.
Participants.
All adult patients (age ≥18 years) suspected of having a symptomatic first or recurrent DVT were included.
Outcomes.
Studies assessing all-cause mortality, mortality from VTE, development of PE or DVT, development of recurrent
DVT, or postthrombotic sequelae, major bleeding, and intracranial hemorrhage in patients with suspected first or
recurrent episode of symptomatic DVT were included.
Language.
We included studies published in any language.
Publication status.
We reviewed all published and unpublished studies. Abstracts with relevant information were also reviewed.
Exclusion criteria.
Studies that did not assess or provide information on the outcomes of interest (eg, narratives, letters to editor
without primary data), abstracts before 2014, duplicate populations, and studies with missing or incomplete
outcomes results were excluded.
We used the following eligibility criteria for the studies with test accuracy information3,4 :
Study design.
Prospective studies, cross-sectional studies, cohort studies from January 1974 to May 2019, or abstracts and
conference posters after 2014 were included.
Participants.
All adult patients (age ≥18 years) suspected of having a symptomatic first or recurrent DVT were included.
Outcomes.
Studies assessing test accuracy of whole leg US, compression US, serial US, and high-sensitivity quantitative Ddimer (Vidas, STA Liatest, TinaQuant, Innovance, and HemoSIL) to diagnose a first or recurrent symptomatic
DVT were included.
Language.
We included studies published in any language.
Publication status.
We reviewed all published and unpublished studies. Abstracts with relevant information were also reviewed.
Exclusion criteria.
We excluded studies that did not assess test accuracy or had missing data (eg, narrative reviews, letters to the
editor without primary data), abstracts before 2014, duplicate populations, and studies that included
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