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NU 631 Week 9 Assignment 1: Writing Your Literature Review Section NU 631 REGIS Week 9 Assignment 1 Writing Your Literature Review Section NU 631 Week 9 Assignment 1: Writing Your Literature Review Section Review of Literature Introduction This literature review will cover a topic that has continued to command the attention of the nursing profession for the longest time in years and remains a clinical challenge today, impacting negatively on health and financial gain; and that is pressure ulcers (Rodrigues, 2016). The research question is does increased nursing staff education and training impacts the prevention of pressure ulcer development in immobile nursing home patients?” The literature review is aimed at obtaining the most current knowledge regarding the education and training of nurses and how they impact the prevention of pressure ulcer in immobile patients. This review includes both empirical and theoretical literature and the following databases were used: EBSCO host, EBSCO Cochrane collection, CINAHL Plus, MEDLINE, Health Source:  Nursing/Academic Edition and Psych. All articles obtained with full text through Regis College Library. The other online search engines used were Google scholar, PubMed.gov and Google search to find articles and other reading materials that provided information regarding evidence-based research on pressure ulcer prevention. The keywords used were pressure ulcers, nursing education and pressure ulcer prevention. The search generated hundreds of written articles that contained the words pressure ulcer. Nursing education and research books were also used to gain supporting information on pressure ulcers prevention as well as official government sources. The final search includes eight research articles; both qualitative and quantitative designs were used in the selected studies. Sample size in reviewed studies varied from n=14 to n=99,396. Participants of these studies were recruited from different health care settings such as hospital and long term care facilities, and they included both men and women, Different types of research designs were used both in quantitative and qualitative study, and all the studies were approved by the respective ethics and review boards of the respective countries in which the studies took place. Empirical Literature A lot of advanced studies have been conducted in regard to pressure ulcer prevention and wound healing techniques. These studies range from skin products for instance topical growth therapy, modified therapy for scar tissue production, use of skin cleaners and protectors to help manage and maintain skin integrity and hence preventing incontinence-associated dermatitis (Avsar and Karadag,2018). Samuriwo, (2010), conducted a qualitative research study where (n=16) on the effects of education and experience on nurses’ value of pressure ulcer prevention. Results showed a significant relationship between education, experience and values as evidenced by nurses’ prior exposure to high grade pressure ulcers and post education, increased the value they placed on pressure ulcer prevention. In his research article, Samuriwo greatly appreciated nursing education on pressure ulcer prevention. He emphasized that little or no knowledge on pressure ulcer presented low value of pressure ulcer prevention thus nurses were less likely to undertake preventative interventions in clinical practice. In another cohort study different stages of bundle implementation, Lavalle et al., (2019) concluded that the use of pressure ulcer prevention bundles increased staff motivation to provide comprehensive care to the clients hence reducing the pressure ulcer incidents. The implication to current practice is that the pressure ulcer bundles placed a high value on pressure ulcer leading to proactive preventative measures of pressure ulcers. Nurses place a lower value on pressure ulcer prevention than with any other aspects of nursing (Samuriwo, 2010). Due to the above findings, the investigator therefore argues the need to revise the nursing curriculum today. In nursing education and schools, several clinical rotations are completed in places such as hospitals, rehabilitation centers, long term care facilities, community nursing, home health care with school nursing. However, no rotations have been scheduled in wound care centers to expose and teach new nurses what wound care is all about and how to maintain proper skin care. In a retrospective mixed research study with time series diagram, the focus was on quality improvement on an orthopedic unit and looking more closely into pressure ulcers. Unbeck et al., assessed the effects of implementing the two-month theme improvements, focusing on one cycle at a time. There was believed to be a gap between the theory and practical knowledge that was affecting the professional and outcome improvement (Batalden and Stoltz; Brandrud et al., Unbeck, 2013). Noting that there was no best way of implementation (Bate et al., Unbeck, 2013), a design and application was set up, making it easy to understand and apply. And any changes in the nursing practices had been approved and in accordance with safe practices. Through Prevention of pressure ulcers is a two-step process the first being to identify patients at risk of developing pressure ulcers and the second step to reliably implement effective prevention strategies. Pressure ulcers are an important and potentially preventable problem in long term care (Poss, Murphy, Woodbury, Osted, Stevenson, Williams et al 2010; Moore 2010). Occurences of pressure ulcers vary among facilities despite the availability of validated tools for evaluating at risk individuals. The key risk factors reported in the literature are both intrinsic and extrinsic including impaired mobility, poor nutrition, poor physical health, advanced age, moisture, medical device such as adhesive tape, impaired cognition, and sensory perception (Poss, et al 2012). During a non-experimental correlation descriptive study (n=866), three dependent variables likely to be sensitive to nursing practice were identified to examine the proportion of certified nurses and patient outcome. Even though there was no significant relationship found, all certified and non-certified personnel contributed to patient outcome (Krapohl, et al 2010). Evidence-based practice points out that lack of identification of patients at risk for pressure ulcers, demonstrates the need for health care facilities to increase prediction, early assessment, and preventative strategies. A quantitative quasi experimental nonequivalent study carried out by Poss et al 2010 (n= 99,398) examined the potential of the Minimum data Set (MDS) assessment, mandated for use in Long term care (LTC) homes to inform the risk of pressure ulcer using the Braden scale. The study was meant to stimulate Braden scale domains with MDS items using clinical expert input and use it as a starting point to develop a bed side MDS-based scale identifying residents at different levels of risk for developing pressure ulcers. In a comparative descriptive study (n=31) comparing in person and digital photograph assessment of stage III and IV pressure ulcers among veterans with spinal injuries; concluded that wound assessment can be improved towards the movement of automated system but noted that variations may be expected when assessors of different levels and training were involved as well as using digital media than with live viewing (Terris et al 2011). Theoretical Literature Education of nurses influences the way of nursing practice as nurse educators are required to provide up-to-date educational material and textbooks are the most frequently used sources of knowledge. In a content analysis study (n=92) of nursing schools in German investigate the extent to which textbooks were evidence based, regarding preventing pressure ulcers and what recommendations to make to nursing students; to address the question if evidence-based education and nursing pressure ulcer prevention textbooks do match. The study then concluded that only one of the four analyzed textbooks used in the nursing schools complied with the recommendations of the German Expert Standards, the other books were incomplete (Wilborn, Halfens, Dassen, 2009). Education of health care professionals is a very important factor in the prevention of pressure ulcers (Wilborn et al, 2008). However, due to staff shortages that are evident today, releasing staff to attend training sessions is a big challenge; therefore, to address the education needs of nurses with respect to pressure ulcers, e-based education is seen as the best alternative method of delivering education (Jones, 2007). It was then concluded that to be able to minimize the risks of pressure ulcer effects, nursing needed to be educated on how to recognize the early signs of pressure damage and plan appropriate care (Jones,2007). While in another research (n=4), improving wound and pressure area care in nursing homes Sprakes (2010) described a collaborative project between a community skin care service and nursing home. The major purpose of the study was to establish whether implementation of wound and pressure ulcer management competency framework within a nursing home would improve patient outcomes and reduce the severity and number of wounds and pressure ulcers. In conclusion there was a reduction in the number of wounds and pressure ulcers, hospital admissions and district nursing visits and nursing staff reported an increase in their knowledge and skills. For effective practice pressure ulcer prevention, it’s important for nurses to receive adequate education and training to practice competently as education is often cited as one of one of the reasons for the continuing high prevalence and incidence of pressure ulcer (Moore, 2010). References Jones, M. L. (2007). E-learning in wound care: developing pressure ulcer prevention education. British Journal of Nursing, 16(Sup3). https://doi.org/10.12968/bjon.2007.16.sup3.24529 Kraphol,G., Manojlovich,M.,Redman, R., Zhang,L.(2010). Nursing specialty certification and nurse –sensitive patient outcomes in the intensive care unit. American Journal of Critical Care. 19(6), 490-499. Moore, Z. (2010). Bridging the theory–practice gap in pressure ulcer prevention. British Journal of Nursing, 19(Sup5). https://doi.org/10.12968/bjon.2010.19.sup5.77703 Poss, J., Murphy, K.M., Woodbury,G.M., Orsted,H., Stevenson,K. Williams,G. et al(2010). Development of inter RAI pressure ulcer risk scale(PURS) for use in long-term care and home care settings. BioMedCentral  10(67), 1471-2318 Samuriwo, R. (2010). Effects of education and experience on nurses’ value of ulcer prevention. British Journal of Nursing, 19(Sup10), 11–24. https://doi.org/10.12968/bjon.2010.19.sup10.79689 Sprakes, K., & Tyrer, J. (2010). Improving wound and pressure area care in a nursing home. Nursing Standard, 25(10), 43–49. https://doi.org/10.7748/ns.25.10.43.s48 Terris, D. D., Woo, C., Jarczok, M. N., & Ho, C. H. (2011). Comparison of in-person and digital photograph assessment of stage III and IV pressure ulcers among veterans with spinal cord injuries. The Journal of Rehabilitation Research and Development, 48(3), 215. https://doi.org/10.1682/jrrd.2010.03.0036 Unbeck, M., Sterner, E., Elg, M., Fossum, B., Thor, J., & Pukk Härenstam, K. (2013). Design, application and impact of quality improvement ‘theme months’ in orthopaedic nursing: A mixed method case study on pressure ulcer prevention. International Journal of Nursing Studies, 50(4), 527–535. https://doi.org/10.1016/j.ijnurstu.2013.02.002 Wilborn, D., Halfens, R., & Dassen, T. (2009). Evidence-Based Education and Nursing Pressure Ulcer Prevention Textbooks: Does It Match?, 6(3), 167–172. https://doi.org/10.1111/j.1741-6787.2008.00129.x       Week 9 Assignment 1: Writing Your Literature Review Section Value: 100 points Due: Day 7 Grading Category: Assignments Overview You will write your Literature Review Section of your EBP Project Proposal. Here is a Review of Literature Example (Word) to use as a model or guide. To conduct your literature review, you begin with the search strategy, gather your resources, then start writing your literature review and gap analysis. Search Strategy In the literature review section, you are to identify your search strategy, which can include the following: the databases and internet sites or search engines used to explore the literature (CINAHL, Medline, Google, Yahoo, etc.) the search terms you used the beginning and ending dates of the period covered in this study the time period when the search was conducted (e.g., Fall 2008) any special journals hand-searched and any relevant sources used in performing the literature search Description of Literature or Gaps in the Literature The literature review section is a review of studies that are related to your phenomenon. It should take up about eight to ten pages, or approximately 3,000 to 4,000 words. The purpose is to tell the reader what is known about your phenomenon and lead the reader to what is not known about your phenomenon (your research problem). You should have sub-headings throughout this section of the paper. The literature section discusses the relevant research related to your study. Do not discuss each study individually; instead, synthesize the literature based on your literature matrix. You can discuss individual findings of studies (include all eight studies that you described in your literature matrix in Weeks 4 and 9) as appropriate including the statistical findings and study samples. This section needs to tell the reader what is known about your clinical area of interest. You will also summarize your review of the literature and discuss the gaps you have identified. Assignment Instructions Your assignment should be: Eight to ten pages, or approximately 3,000 to 4,000 words, no cover page required, and the page count doesn’t include the references list Your search strategy Description of articles (who, population, sample, what was done, statistical findings, limitations, and so on) Gaps section: the gaps you have identified from your literature search Please refer to the Grading Rubric for details on how this activity will be graded. To Submit Your Assignment: Select the Add Submissions button. Drag or upload your file to the File Picker. Select Save Changes. Literature Review (Level 1) NU 631 REGIS Week 9 Assignment 1 Writing Your Literature Review Section Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS:NU 631 Week 9 Assignment 1: Writing Your Literature Review Section Remember to start each new section (or thesis chapter) on a new page when conducting a larger assignment. Also remember that paragraphs represent concepts, and concepts are usually made up of multiple ideas (sentences). This is why, generally, there are no paragraphs less than three sentences. The literature review establishes what is known about the topic in order to build upon the wisdom of earlier works. What has already been established about a topic helps you narrow in on a specific theoretical framework. This means it is usually necessary to review the literature before choosing a specific theoretical framework. The literature review can be divided by themes, by authors, or chronologically. The most common division is by topic as this shows a more complex understanding of the literature. Children learn to do book reports around fifth grade. A literature review by authors is a compilation of short book reports. This means that literature reviews divided by authors normally lack the global understanding provided by a topical overview and are, therefore, not considered as sophisticated as topical reviews. Chronological reviews are often most helpful when the focus of the paper is historical in nature. The choice of organization depends on the objective of the paper. Literature Genres (Level 2) Introduce the genres of literature that have been used to study the topic (journal articles, conferences popular press, books, television documentaries, interviews, and so on). Explain whether or not your review was time-sensitive (you only used literature within a certain timeframe, such as 2000-2020), limited by language (only sources in English, for example), and if specific key words were used in your search. Also indicate if you were limited by specific databases as determined by your university, or multiple databases (EBSCO, ProQuest, HOLLIS, and so on). If you “snowballed” the literature finds (used the references from key articles to build your source list), indicate this as well. If a large number of documents came from a specific source, mention this here. For example, if you discovered that the Journal of Molecular Psychiatry published a significant number of the articles in your review, mention this. Topic 1 (or Author 1 or Date 1). (Level 3). This section should help the reader understand the state-of-the-art information in each of the sub-thematic areas. The topics in your literature review are normally determined by your research question. Make a mind-map around your research question and identify the key terms and concepts. Consider how literature from the terms and concepts will contribute to an answer to your research question and then select the most vital topics for review. Some papers have just two or three topics, other have dozens. The number of topics in your review depends on the objective of the paper. If available, this section should use a previously constructed annotated bibliography. Topic 1.1 (or Author 1.1 or Date 1.1). (Level 4).  Many themes have sub-elements worth mentioning. Use a Level 5 header to set off these sub-elements, if necessary. Topic 1.1.1 (Level 5). If your topic merits further sub-divisions, you can use a Level 5 header to show the hierarchy among concepts. Topic 2 (or Author 1 or Date 1). (Level 3). Remember to give each topic a clear name or title. That is, do not leave “Topic 2” as a header. Topic 2.1 (or Author 1.1 or Date 1.1). (Level 4).  Many themes have sub-elements worth mentioning. Use a Level 5 header to set off these sub-elements, if necessary. Topic 3 (or Author 1 or Date 1). (Level 3). This section should help the reader understand the state-of-the-art information in each of the sub-thematic areas. If available, this section should use a previously constructed annotated bibliography. Topic 3.1 (or Author 1.1 or Date 1.1). (Level 4).  Many themes have sub-elements worth mentioning. Use a Level 5 header to set off these sub-elements, if necessary. Topic 4 (or Author 1 or Date 1). (Level 3). This section should help the reader understand the state-of-the-art information in each of the sub-thematic areas. If available, this section should use a previously constructed annotated bibliography. Topic 4.1 (or Author 1.1 or Date 1.1). (Level 4).  Many themes have sub-elements worth mentioning. Use a Level 5 header to set off these sub-elements, if necessary. Writing the Literature Review Section Rubric Writing the Literature Review Section Rubric – 100 Points Criteria Exemplary Exceeds Expectations Advanced Meets Expectations Intermediate Needs Improvement Novice Inadequate Total Points Introduction Introduction includes all of the following components and they are clearly stated: The purpose of the ROL (may want to repeat research questions). How the ROL is organized (empirical literature, conceptual/theoretical literature, and the theory that will guide your study if appropriate). Databases, internet sites, and search engines, and other sources that were used to explore the literature. Search words used. Time period when the search was conducted. 10 points Introduction includes most of the introduction components and they are clearly stated. 9 points Introduction is somewhat clear, but only partially addresses the components of the ROL introduction. 8 points Introduction is vague and unclear and does not include the purpose or any of the components of the ROL introduction. 7 points 10 Empirical Research The first paragraph of the empirical literature clearly tells the reader what is included and how it is organized. Critical thinking is present and there is evidence of synthesis of the literature that is based on the literature matrix. Individual studies are presented as needed. All of the following elements are included and clearly stated: The review includes all of the major studies on the topic. The review includes recent research. Studies from other related disciplines are included, if appropriate. The eight articles from the literature matrix are in the review of literature (ROL). The last paragraph summarizes what is known about the research area and identifies the gaps in the literature. The paragraph includes a statement about how the literature supports your study. 50 points The first paragraph of the empirical literature clearly tells the reader what is included and how it is organized. Critical thinking and synthesis of the literature is clearly evident. Most of the ROL elements are included but some are missing. The last paragraph summarizes what is known about the research area and identifies the gaps in the literature. The paragraph includes a statement about how the literature supports your study. 45 points The first paragraph of the empirical literature minimally tells the reader what is included and how it is organized. Critical thinking and synthesis of the literature is not always evident. Many of the ROL elements are missing. The last paragraph does not clearly summarize what is known about the research area and identifies the gaps in the literature. The paragraph does not include a statement about how the literature supports your study. 40 points The first paragraph of the empirical literature does not tell the reader what is included and how it is organized. Critical thinking and synthesis of the literature is seldom evident. Most of the ROL elements are missing. The last paragraph does not summarize what is known about the research area and omits the gaps in the literature. The paragraph does not include a statement about how the literature supports your study. 35 points 50 Gaps from ROL and Summary Gaps from the literature are identified and described. Critical thinking is evident in summarizing the ROL. The summary includes all the key elements of the ROL. 20 points Gaps from the literature are identified. Critical thinking is evident. Some key elements of the ROL are missing. 18 points Some gaps from the ROL are identified. Critical thinking is not evident consistently. Many of the key elements of the ROL are missing. 16 points Gaps from the literature are not identified and/or described. Critical thinking is not evident. Most of the key elements are missing. 14 points 20 Writing Mechanics and APA Format APA is used throughout the paper with few to no errors. Correct title page, headers, page numbers, grammar, and correct referencing format are used. Few to no writing mechanic errors. The writing was clear and easy to read. Follows page recommendations: Empirical Section: eight to ten pages Theoretical/Conceptual: one to two pages. Page length may vary depending on the literature found. 20 points APA format was generally used correctly most of the time. Few APA errors were included: title page, headers, page numbers, grammar, and referencing format. Some writing mechanic errors. The writing was not clear at times. It was difficult to read and understand at times. Page recommendations are followed almost perfectly. 18 points APA format was seldom used. Many APA errors were included: title page, headers, page numbers, grammar, and referencing format. Moderate to many writing mechanic errors. The writing was unclear some of the time. It was very difficult to read and understand at times. 16 points APA format was not used. Many APA errors were included: title page, headers, page numbers, grammar, and referencing format. Many writing mechanic errors. The writing was unclear most of the time. It was not possible to read and understand at times. 14 points 20 Total Points 100 Order Now