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Evidence-Based Practice Assignment –

DIRECTIONS: Please read the Evidence-Based Practice Guideline-Searchable Clinical Questions Form Guidelines and Rubric located in Course Resources, for instructions on how to complete this form. You may add more rows to each table to fit your search.
1. CLINICAL QUESTION:
In the adult patient does hypothermia verses maintaining normothermia during surgery increase infection rate

2. Identify the PICO (T) Terms:

P- Adult surgical patients
I- Hypothermia
C- Maintaining Normothermia
O- Increased postoperative infections
T- N/A

3. SEARCH: PUBMED/MEDLINE
Go to MEDLINE at http://www.pubmed.gov and conduct a search on your clinical question. Please type your search history in the table below:
Search Number P I C O T # of Results Notes

4. SEARCH: EBSCO/CINAHL
Go to the Chamberlain Library at http://www.chamberlain.edu/library and enter EBSCO. Conduct a search on your clinical question. Please type your search history in the table below:
Search Number P I C O T # of Results Notes

5. SEARCH: THE JOANNA BRIGGS INSTITUTE
Go to The Joanna Briggs Institute via the CCN Library. Conduct a search on your clinical question. Please type your search history in the table below:
Search Number P I C O T # of Results Notes

EBP Searchable Clinical Questions
with Annotated Bibliography
Guidelines with Scoring Rubric
Purpose
The purpose of this assignment is to: a) formulate a PICO (T)-formatted clinical question, b) identify key terms for conducting a review of the literature, c) search for relevant evidence in scholarly databases, and provide a summary of research articles to support an answer to the clinical question.
Course Outcomes
Through this assignment, the student will demonstrate the ability to:
(CO#3) Apply research principles to interpretation of the content of published research studies. (PO 9)
(CO#4) Analyze data from relevant sources, including technology, to inform the delivery of care. (PO 4)
(CO#5) Analyze the American Association of Colleges of Nursing (AACN) Essentials of Master s Education in Nursing. (PO 1)

Due Date: Sunday 11:59 PM MT at the end of Week 5.
Total Points Possible: 200
Requirements:
1. Select a health-related topic applicable to your practice setting and formulate a clinical question using the PICO (T) format.
2. Identify key terms that you will use to search the literature, based on the PICO (T) elements.
3. Search for information on your formulated clinical question in each of these three databases: PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and The Joanna Briggs Institute database.
4. Present the results of the searches in the tables provided in the Evidence-Based Practice Searchable Clinical Questions Form found in Course Resources. Place this completed form in the Dropbox.
5. From the articles you found during your database searches, choose four (4) scholarly peer reviewed articles that would help provide an answer or provide insight to your clinical research question and write them in an annotated bibliography format. Include which database you found the 4 articles that you choose for your annotated bibliography. Submit this APA 6th ed format paper into the Dropbox for a Turnitin Review.
6. Submit the Searchable Clinical Questions Form and your annotated bibliography paper to the Dropbox by the due date. The annotated bibliography is the only part of this assignment that you need to have the Turnitin similarity report less than 25%.

PREPARING THE PAPER
1. In Course Resources, you will find the Week 5 Evidence-Based Practice Searchable Clinical Questions Form . This is the form that you can use to document your search process and results. Below, you will find an example of how to complete the tables as you are doing each search
2. The notes section is to be completed in detail as each step of the search process is performed.
3. An optimal range of 10-15 scholarly articles is to be achieved for each database search. If this is not possible, a detailed explanation is to be included in the notes section. Do not stop too soon or you may miss some valuable article to help answer your clinical question. You want to be able to identify ten scholarly peer reviewed articles that would help answer or provide insight to your clinical research question so you can summarize them in an annotated bibliography written in APA 6th ed format. The annotated bibliography will be a separate Word document in APA 6th ed format.

Example: PubMed
Clinical Question: In patients with muscle spasms, is relaxation as good as anti-spasmodic medication in reducing the incidence of muscle spasms *
The PICO (T) elements are:
P = patients with muscle spasms
I = anti-spasmodic medication
C= relaxation
O = reducing incidence of muscle spasms
T = not applicable in this case
Search Number P I C O T # of Results Notes
1 Patients with muscle spasms 8750 I searched on the P, patients with muscle spasms by typing it in the search field and clicking Search
2 antispasmodic 46690 I searched on the I, antispasmodic by typing it into the search field and clicking Search.
3 relaxation 119010 I clicked Clear and typed relaxation in the search field. CINAHL suggested relaxation techniques so I chose to search on this.
4 Relaxation techniques 35602 I added techniques to the search field and clicked Search .
5 muscle spasms 23937 I clicked Clear and typed muscle spasms in the search field and clicked Search.
6 Antispasmodic Relaxation techniques 936 I clicked on advanced search and combined Search #2 and Search #4 using the Boolean operator AND . I clicked Search. .
7 Antispasmodic Relaxation techniques 7120 I clicked on advanced search and used the Boolean Term or . I chose Full text and 5 years then clicked search.
8 Relaxation techniques Muscle spasms 285 I clicked on advanced search and combined relaxation techniques and muscle spasms.
9 Antispasmodic Relaxation techniques Muscle spasms 17 Still using the Advanced Search, I used all three terms with Boolean term And between antispasmodic and relaxation techniques and muscle spasms. Clicked search.
10 Antispasmodic Relaxation techniques Muscle spasms 5 I clicked on advanced search, added Boolean term and plus indicated English only, full-text, and time frame 2011-2016.(5 years) Clicked Search . This was not in the range of 10-15 scholarly articles so decided to look at each of these articles to see if any of them would help answer my clinical research question. I then chose three of these articles for my annotated bibliography.
*This table reports the history of an actual search of this clinical question in PubMed

Category Points % Description
Content 20
10% Clinical Question written in PICO(T) format
Content 20 10% PICO(T) terms clearly identified

Content 20 10% Search performed in PubMed/MEDLINE database

Content 20 10% Search performed in EBSCO/CINAHL database

Content 20 10% Search performed in the Joanna Briggs Institute database

Content 20 10% Article Selection

Content 20 10% Credibility of sources chosen for annotated bibliography

Content 40 20% Annotations explain and support an answer to the clinical question

Grammar 10 5% Rules of grammar, spelling, word usage, and punctuation are followed.
Format 10 5% APA 6th ed followed for annotated bibliography
Total points
200
100% A quality assignment will meet or exceed all of the above requirements.

GRADING RUBRIC
Assignment Criteria Exceptional
(100%)
Outstanding or highest level of performance Exceeds
(88%)
Very good or high level of performance Meets
(80%)
Competent or satisfactory level of performance Needs Improvement
(38%)
Poor or failing level of performance Developing
(0)
Unsatisfactory level of performance
20 18 16 8 0

Clinical Question written in PICO(T) format
Clinical question is clearly written in the PICO(T) format Clinical question is written in the PICO(T) format but may not be clear Clinical question lacks occasional important element or specificity. Clinical question has several instances of inaccuracies and/or is too vague to conduct a search. Clinical question has multiple inaccuracies and/or is missing.
20 18 16 8 0
PICO(T) terms clearly identified Chooses appropriate key search terms for 4(5) PICO(T) elements Chooses appropriate key search terms for 3 PICO(T)terms. Chooses appropriate key search terms for 2 PICO (T) terms. Chooses appropriate key search terms for 1 PICO(T) term. Does not choose appropriate search terms for the PICO(T) terms.
20 18 16 8 0
Search performed in PubMed/MEDLINE database

Search performed in PubMed following guidelines in tutorial and retrieves an appropriate number of journal articles
(10 15 articles) Search performed in PubMed partially follows guidelines in tutorial; however, retrieves an appropriate number of journal articles (10-15 articles) Search performed in PubMed partially follows guidelines in tutorial; Does not retrieve appropriate number of journal articles (less than 10 or more than 20 articles) Search performed in PubMed partially follow guidelines in tutorial and does not retrieve appropriate number of journal articles (less than 5 articles) and notes on search are missing. Does not perform search in PubMed.
20 18 16 8 0
Search performed in EBSCO/CINAHL database

Search performed in CINAHL following guidelines in tutorial and retrieves an appropriate number of journal articles
(10 15 articles) Search performed in CINAHL partially follows guidelines in tutorial; however, retrieves an appropriate number of journal articles (10-15 articles) Search performed in CINAHL partially follows guidelines in tutorial; Does not retrieve appropriate number of journal articles (less than 10 or more than 20 articles) Search performed in CINAHL partially follow guidelines in tutorial and does not retrieve appropriate number of journal articles (less than 5 articles) and notes on search are missing. Does not perform search in CINAHL
20 18 16 8 0
Search performed in the Joanna Briggs Institute database
Search performed in Joanna Briggs Institute following guidelines in tutorial and retrieves an appropriate number of journal articles
(10 15 articles) Search performed in Joanna Briggs Institute partially follows guidelines in tutorial; however, retrieves an appropriate number of journal articles (10-15 articles) Search performed in Joanna Briggs Institute partially follows guidelines in tutorial; Does not retrieve appropriate number of journal articles (less than 10 or more than 20 articles) Search performed in Joanna Briggs Institute partially follow guidelines in tutorial and does not retrieve appropriate number of journal articles (less than 5 articles) and notes on search are missing. Does not perform search in Joanna Briggs Institute
20 18 16 8 0
Article Selection

Articles chosen to answer clinical question are highly relevant to and answer the clinical question. Articles chosen to answer clinical question are relevant to and answer the clinical question. Articles chosen are relevant but only somewhat answer the clinical question. Articles chosen are somewhat relevant to the clinical question but do not answer the clinical question. Articles are not relevant to the clinical question and do not answer the clinical question.
20 18 16 8 0
Credibility of sources chosen for annotated bibliography
All 4 sources are from credible, scholarly peer-reviewed materials published within the past 5 years. 3 sources are from credible scholarly peer-reviewed materials published within the past 5 years. 2 sources are from credible scholarly peer-reviewed materials published within the past 5 years. 1 source is from credible scholarly peer-reviewed materials or are published more than 5 years ago. Sources lack credibility, are not scholarly or not peer-reviewed materials
40 36 32 15 0
Annotations explain and support an answer to the clinical question

All annotations comprehensively summarize the source material and offers insight related to the article helping to answer the clinical question. 3 annotations summarize the source materials and offer insight helping to answer the clinical question. 2 annotations summarize the source materials but lack insight to answer the clinical question. 1 annotation summarizes the source materials and offer very little insight to answer the clinical question. Annotations do not summarize the source materials or offer no insight to answer the clinical question.
10 9 8 4 0
Rules of grammar, spelling, word usage, and punctuation are followed. Grammar, spelling, word usage, and punctuation are consistent with formal written work with no exceptions.

Grammar, spelling, word usage, and punctuation are consistent with formal written work with 1-2 exceptions. Grammar, spelling, word usage, and punctuation are consistent with formal written work with 3-4 exceptions Grammar, spelling, word usage, and punctuation are consistent with formal written work with 5-6 exceptions. Grammar, spelling, word usage, and punctuation are followed with 7 or more errors.
10 9 8 4 0
APA 6th ed followed for annotated bibliography APA format in 6th ed followed with no exceptions. APA 6th ed format followed with 1-2 exceptions. APA 6th ed format is followed with 3-4 exceptions APA 6th ed format followed with 5-6 exceptions. APA 6th ed format is followed with 7 or more errors.
Total points 200 180 160 79 0

22.

3 Practice Problems

P4-5
P4-6
P4-9
P4-15
P4-18

P4-5 Classifying inflows and outflows of cash Classify each of the following items as an inflow (I) or an outflow (O) of cash, or as neither (N).
Item Change ($) Item Change ($)
Cash +100 Accounts receivable -700
Accounts Payable -1,000 Net Profits +600
Notes Payable +500 Depreciation +100
Long-term debt -2,000 Repurchase of stock +600
Inventory +200 Cash dividends +800
Faxed assets +400 Sale of stock +1,000

P4-6 Keith Corporation Balance Sheets
December 31 December 31
Assets` 2015 2014
Cash $ 1,500 $ 1,000
Marketable securities 1,800 1,200
Accounts receivable 2,000 1,800
Inventories 2,900 2,800
Total current assets $ 8,200 $ 6,800
Gross fixed assets $29,500 $28,100
Less: Accumulated depreciation 14,700 13,100
Net fixed assets $14,800 $15,000
Total assets $23,000 $21,800

Liabilities and stockholders equity
Accounts payable $ 1,600 $ 1,500
Notes payable 2,800 2,200
Accruals 200 300
Total current liabilities $ 4,600 $ 4,000
Long-term debt 5,000 5,000
Total liabilities $ 9,600 $ 9,000
Common stock $10,000 $10,000
Retained earnings 3,400 2,800
Total stockholders equity $13,400 $12,800
Total liabilities and stockholders equity $23,000 $21,800

Continuation of p4-6
P4-6 Keith Corporation Income Statement Data (2015)
Depreciation expense $1,600
Earnings before interest and taxes (EBIT) 2,700
Interest expense 367
Net profits after taxes 1,400
Tax rate 40%
A. Calculate the firm s net operating profit after taxes (NOPAT) for the year ended December 31, 2015, using Equation 4.1. Definition- Operating Cash Flow A firm s operating cash flow (OCF) is the cash flow it generates from its normal operations: producing and selling its output of goods or services. A variety of definitions of OCF can be found in the financial literature. The definition introduced here excludes the impact of interest on cash flow. We exclude those effects because we want a measure that captures the cash flow generated by the firm s operations, not by how those operations are financed and taxed. The first step is to calculate net operating profits after taxes (NOPAT), which represent the firm s earnings before interest and after taxes. Letting T equal the applicable corporate tax rate, NOPAT is calculated as NOPAT = EBIT * (1 – T)

B. Calculate the firm s operating cash flow (OCF) for the year ended December 31, 2015, using Equation 4.3- OCF = 3EBIT * (1 – T) 4 + Depreciation.

C. Calculate the firm s free cash flow (FCF) for the year ended December 31, 2015, using Equation 4.4. – FCF = OCF – Net fixed asset investment (NFAI) Net current asset investment (NCAI)

P4-9 Cash budget: Basic Grenoble Enterprises had sales of $50,000 in March and $60,000 in April. Forecast sales for May, June, and July are $70,000, $80,000, and $100,000, respectively. The firm has a cash balance of $5,000 on May 1 and wishes to maintain a minimum cash balance of $5,000. Given the following data, prepare and interpret a cash budget for the months of May, June, and July.
1. The firm makes 20% of sales for cash, 60% are collected in the next month, and the remaining 20% are collected in the second month following sale.
2. The firm receives other income of $2,000 per month.
3. The firm s actual or expected purchases, all made for cash, are $50,000, $70,000, and $80,000 for the months of May through July, respectively.
4. Rent is $3,000 per month.
5. Wages and salaries are 10% of the previous month s sales.
6. Cash dividends of $3,000 will be paid in June.
7. Payment of principal and interest of $4,000 is due in June.
8. A cash purchase of equipment costing $6,000 is scheduled in July.
9. Taxes of $6,000 are due in June.

P4-15. Part one. Pro forma income statement The marketing department of Metroline Manufacturing estimates that its sales in 2016 will be $1.5 million. Interest expense is expected to remain unchanged at $35,000, and the firm plans to pay $70,000 in cash dividends during 2016. Metroline Manufacturing s income statement for the year ended December 31, 2015, and a breakdown of the firm s cost of goods sold and operating expenses into their fixed and variable components are given below.
A. Use the percent-of-sales method to prepare a pro forma income statement for the year ended December 31, 2016.
B. Use fixed and variable cost data to develop a pro forma income statement for the year ended December 31, 2016.
C. Compare and contrast the statements developed in parts a and b. Which statement probably provides the better estimate of 2016 income Explain why.

Continuation of P4-15. Part 2
Metroline Manufacturing Income Statement for the Year Ended December 31, 2015
Sales revenue $1,400,000
Less: Cost of goods sold 910,000
Gross profits $ 490,000
Less: Operating expenses 120,000
Operating profits $ 370,000
Less: Interest expense 35,000
Net profits before taxes $ 335,000
Less: Taxes (rate = 40% 134,000
Net profits after taxes $ 201,000
Less: Cash dividends 66,000
To retained earnings $ 135,000

Continuation of P4-15 Part 3.
Metroline Manufacturing Breakdown of Costs and Expenses into Fixed and Variable Components for the Year Ended December 31, 2015
Cost of goods sold
Fixed cost $210,000
Variable cost 700,000
Total costs 910,000
Operating expenses
Fixed expenses $36,000
Variable expenses 84,000
Total expenses $120,000

P4-18. Pro forma balance sheet Peabody & Peabody has 2015 sales of $10 million. It wishes to analyze expected performance and financing needs for 2017, which is 2 years ahead. Given the following information, respond to parts a and b.
(1) (1) The percents of sales for items that vary directly with sales are as follows: Accounts receivable 12% , Inventory 18%, Accounts payable 14%, and Net profit margin 3%.
(2) Marketable securities and other current liabilities are expected to remain unchanged.
(3) A minimum cash balance of $480,000 is desired.
(4) A new machine costing $650,000 will be acquired in 2016, and equipment costing $850,000 will be purchased in 2017. Total depreciation in 2016 is forecast as $290,000, and in 2017 $390,000 of depreciation will be taken.
(5) Accruals are expected to rise to $500,000 by the end of 2017.
(6) No sale or retirement of long-term debt is expected.
(7) No sale or repurchase of common stock is expected.
(8) The dividend payout of 50% of net profits is expected to continue.
(9) Sales are expected to be $11 million in 2016 and $12 million in 2017.
10. The December 31, 2015, balance sheet follows.

P4-18 Part 2, Peabody & Peabody Balance Sheet December 31, 2015 ($000)
Assets Liabilities and stockholders equity
Cash $400 Accounts payable $1,400
Marketable securities 200 Accruals 400
Accounts receivable 1,200 Other current liabilities 80
Inventories 1,800 Total current liabilities $1,880
Total current assets $3,600 Long-term debt 2,000
Net fixed assets 4,000 Total liabilities 3,880
Total assets $7,600 Common equity 3,720
Total liabilities and
stockholders equity $7,600

A. Prepare a pro forma balance sheet dated December 31, 2017.
B. Discuss the financing changes suggested by the statement prepared in part a.

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