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Writing Synthesis of Evidence Chapter in a Nursing PICOT Paper

The synthesis of evidence (literature review) in a nursing PICOT paper (Population, Intervention, Comparison, Outcome, Timeframe) refers to the process of reviewing and analyzing relevant literature to inform and support your research question and study objectives. It involves systematically searching for, summarizing, and critiquing existing evidence from various sources to identify key findings, trends, gaps, and controversies in the literature.

Review: Writing Nursing PICOT Paper Chapters

Key Components of a Synthesis of Evidence in a Nursing Research Paper

Here’s a breakdown of the key components to include in the synthesis of evidence when writing an effective nursing PICOT paper:

  1. Evidence Search: Conduct a comprehensive literature search using databases, academic journals, and other reliable sources to identify relevant studies, articles, systematic reviews, or meta-analyses. Use specific keywords and search terms related to your clinical topic and research question to ensure a focused and comprehensive search.
  2. Selection of Literature: Evaluate the identified sources based on their relevance and quality. Select articles that provide the most valuable information and align with your research question and objectives. Exclude sources that are outdated, not peer-reviewed, or not directly applicable to your study.
  3. Summary of Evidence: Summarize the key findings, methodologies, and outcomes of the selected literature. Provide a concise overview of each study, highlighting the population, intervention, comparison, outcome measures, and results. Identify any patterns or trends observed across multiple studies.
  4. Critique of Evidence: Evaluate the quality and credibility of the selected literature. Assess the strength of the research design, sample size, data collection methods, and statistical analyses used in each study. Consider the limitations, biases, or potential sources of error that may affect the validity and generalizability of the findings.
  5. Identification of Gaps and Controversies: Identify any gaps or inconsistencies in the literature. Determine if there are conflicting findings or unresolved controversies within the existing evidence. Discuss the limitations or gaps in the current knowledge and how your study aims to address or contribute to filling those gaps.
  6. Integration with Research Question: Analyze how the synthesized evidence aligns with or supports your research question and objectives. Evaluate the relevance and applicability of the evidence to your specific population, intervention, and outcomes of interest.
  7. Implications for Practice: Discuss the implications of the synthesized evidence for nursing practice. Highlight how the findings can inform clinical decision-making, guide interventions, or influence healthcare policies or protocols. Consider any recommendations or guidelines that arise from the evidence synthesis.

Review: Nursing PICOT Research Papers Writing Guide

  1. List of Suitable Nursing PICOT Questions
  2. Sample Nursing PICOT Papers:
  • By conducting a thorough synthesis of evidence, you can strengthen the rationale and justification for your study, identify areas for further research, and ensure that your research question and study design are informed by the best available evidence in the field of nursing.
  1. Search Strategies:

    1. Identify and report the search terms used to retrieve relevant articles. These terms should be carefully selected to capture the key concepts of your research question. For example, if your research question is about the effectiveness of a specific intervention in reducing blood pressure in hypertensive patients, relevant search terms may include “intervention,” “blood pressure,” “hypertension,” and related synonyms.
    2. Specify the databases used for the literature search. Common databases for healthcare research include PubMed/MEDLINE, CINAHL, Embase, and Cochrane Library.
    3. Describe any inclusion criteria applied during the search process, such as language (e.g., English), population (e.g., adults with hypertension), publication dates, and peer-reviewed journals.
    4. Indicate any additional parameters applied, such as subject types (e.g., human studies) and journal types (e.g., academic journals).
    5. State the results of the search, including the initial number of articles obtained and the final number of selected articles.
      For example:

      • Number of articles initially obtained: X
      • System for narrowing the search (e.g., screening titles and abstracts, full-text review): Briefly describe the process used to select relevant articles for further analysis.
      • Final number of selected articles: Provide the final number of articles that met the inclusion criteria for your review.
    6. Tips on selection criteria for final articles to use:
      Summarize at least eight research articles, which meet the following criteria:

      • Original, peer-reviewed (scholarly; journals preferred) research studies, preferably published within the last 10 years; preferably 5 years old.
      • At least six of the eight studies should be quantitative.
      • Two studies may be qualitative (but this is not a requirement).
  2. Flow Diagram:

    • Provide a flow diagram illustrating the steps taken to narrow down the search results.
    • This diagram can follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format, showcasing the number of articles at each stage (e.g., identification, screening, eligibility, inclusion).
  3. Complete a Literature Summary Table:

    Include the following columns:

    1. Authors
    2. Title
    3. Publication Date
    4. Problem
    5. Purpose
    6. Data collection and research methods for each original research article
    7. Sample
    8. Major Findings/Conclusions

Table 1.1: Literature Summary Table

PICO Question Example for this Literature Summary Table: In patients with diabetes mellitus/older adults/heart failure/hypertension, do educational interventions/physical activity promotion/discharge planning interventions/medication adherence interventions improve knowledge and self-management skills/physical activity levels and fitness/hospital readmissions rates/medication adherence rates compared to control groups or usual care?

Authors Title Publication Date Problem Purpose Data Collection Method Sample Major Findings/Conclusions
Johnson et al. The Impact of Educational Interventions on Self-Management in Patients with Diabetes Mellitus 2021 The lack of effective educational interventions on self-management among patients with diabetes mellitus To evaluate the effectiveness of educational interventions Quasi-experimental design, Pre-test/post-test surveys, health assessments Intervention group: N = 50

Control group: N = 50

The educational interventions significantly improved knowledge and self-management skills in the intervention group compared to the control group.
Smith et al. Promoting Physical Activity in Older Adults 2020 Low levels of physical activity in older adults To assess the impact of a physical activity intervention Randomized controlled trial, Assessments, accelerometers Intervention group: N = 100

Control group: N = 100

The physical activity intervention led to a significant increase in weekly physical activity levels and improved overall fitness compared to the control group.
Anderson et al. Reducing Hospital Readmissions in Patients with Heart Failure 2019 High hospital readmission rates To investigate the effectiveness of a discharge planning intervention Quasi-experimental design,

Medical record review, patient surveys

Intervention group: N = 300

Control group: N = 300

The discharge planning intervention significantly reduced hospital readmissions within 30 days compared to the control group, demonstrating its efficacy in improving post-discharge outcomes.
Williams et al. Improving Medication Adherence in Patients with Hypertension 2022 Poor medication adherence To evaluate the impact of a medication adherence intervention Randomized controlled trial,

Self-report questionnaires

Intervention group: N = 80

Control group: N = 80

The medication adherence intervention significantly improved medication adherence rates and resulted in better health outcomes compared to the control group.
  • The purpose of a literature summary table is to help you identify a research article’s problem, purpose, methodology, sample, findings, and relevance/significance
  • In addition, it helps to ensure you follow the inclusion/exclusion criteria for original research article selection.

How to Write a Summary and Critique of Research Literature in a PICOT Paper

In about a ½ -1 page per article summary, write a summary and critical appraisal of evidence for each article chosen. In your synthesis, include:

  1. Level of Evidence:
    • Summarize the overall level of evidence for the compiled research literature, considering factors such as study design, sample size, and quality of research methodology.
    • Discuss the strength of the evidence base and its applicability to the PICOT question.
  2. Description of Research Studies:
    • Provide a concise description of each research study included in the literature review.
    • Briefly outline the research problem and the purpose of each study, highlighting the specific focus and objectives of the research.
  3. Description of Research Methods:
    • Describe the research methods employed in each study, including the process of data collection, sampling methods, and data analysis techniques.
    • Discuss the strengths and limitations of the research methods, drawing upon established criteria for evaluating research as mentioned in your textbook.
  4. Description of Major Findings and Conclusions:
    • Summarize the significant findings and conclusions of each research study.
    • Highlight the key outcomes and any noteworthy trends or patterns observed in the results.
    • Emphasize how these findings contribute to the body of evidence relevant to your PICOT question.
  5. Identify Overall Themes and/or Categories:
    • Identify common themes and/or categories that emerge from the overall body of evidence.
    • Analyze the similarities and differences across the literature review, considering factors such as the purpose, research methods, results, and conclusions of the studies.
    • Discuss any variations or inconsistencies found within the outcomes.
  6. Identify the Strengths and Weaknesses:
    • Critique the strengths and weaknesses of the research methods employed in the included studies.
    • Assess the rigor, validity, and reliability of the research designs, data collection procedures, and data analysis techniques.
    • Use your textbook and other relevant resources to support your critique and provide a well-rounded evaluation.
  7. Identify Variations in Outcomes:
    • Comment on any variations or contradictions in the outcomes reported across the studies.
    • Discuss any inconsistencies or conflicting findings and explore potential reasons for the variations.
    • Consider the implications of these variations for your PICOT question and the overall body of evidence.
  • Remember to cite relevant sources, including your textbook, when discussing research methods or criteria for evaluating research.
  • In addition, all supportive evidence such as tables, figures, data analysis, literature summary tables, and evidence-based models should be included in the appendix and named accordingly.

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