The purpose of creating a matrix of a research article is to help you organize your thoughts and to get you started with the process of critique.
Instructions
Locate a minimum of 3primary researcharticles in response to your PICO(T) question. Upload your primary research articles as full text documents with your assignment. Please do not upload library links.
Using the sameMatrix Template (Word)(Links to an external site.)you used for Group Discussion 2.2, fill in the matrix using the research articles you found for your PICO question.
The matrix is much like a comprehensive note card that should contain the basic information of the research.
You are creating a shortcut version of the key elements of the article for your future use in synthesizing the literature.
This teacher grades very strictly on the rubric, if its in the rubric and not covered on the paper, its points deductions. very important. Its brief reviews of the articles as you can view in the example matrix I have attached. The format is APA (only apa formatting is the article citation above the matrix, thats its! no other APA needed. This assignment is for 3 matrices on the 3 articles I have attached, all 3 are to be on the same document per the instructor. Thank you for your time and this assignment is crucially important.
Running head:TITLE [Type text][Type text][Type text] 2 TITLE Matrix Document Student Name Maryville University Course Date Matrix APA Citation: Variable and key concepts · List the important points of the article, variables, framework, and concepts mentioned. · Were hypothesis stated or implied? · What was the research question? Was it clearly stated? Sampling · Who were the participants · How many? What it enough? · How were participants gathered (sampling plan) · Did any drop out? Why? Design and Method · How was the research designed? · Quantitative? Qualitative, mixed? · What it appropriate to answer the question? Instruments/Data Collection · What data was collected? · Was the data sufficient? · What instrument was used? Survey? Interview? Questionnaire? · Was the instrument valid? Results · What were the results? · Is it what you expected? · Does it make sense? Strengths & Limitations Strengths: · What were the strengths of the study? · Did it show a statistical difference? Was it supported? Limitations: Critique Overall, what is your opinion of the study? Can you use this study for your literature review? Did the researchers explain their research well? Was it easy to understand? Does the research make sense? Feature ©2020 American Association of Critical-Care Nurses doi:https://doi.org/10.4037/ccn2020632 CE 1.0 hour, CERP B This article has been designated for CE contact hour(s). The evaluation tests your knowledge of the following objectives: 1. Describe the implementation of the American Association of Critical-Care Nurses early mobility protocol. 2. Identify the improved outcomes of early mobility of critically ill patients as part of the ABCDEF bundle. 3. Develop a plan for a successful early mobility protocol in your own intensive care unit. To complete evaluation for CE contact hour(s) for test C2043, visit www.ccnonline.org and click the “CE Articles” button. No CE fee for AACN members. This test expires on August 1, 2022. The American Association of Critical-Care Nurses is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation, ANCC Provider Number 0012. AACN has been approved as a provider of continuing education in nursing by the California Board of Registered Nursing (CA BRN), CA Provider Number CEP1036, for 1 contact hour. Background Increasing mobility in the intensive care unit is an important part of the ABCDEF bundle. Objective To examine the impact of an interdisciplinary mobility protocol in 7 specialty intensive care units that previously implemented other bundle components. Methods A staggered quality improvement project using the American Association of Critical-Care Nurses mobility protocol was conducted. In phase 1, data were collected on patients with intensive care unit stays of 24 hours or more for 2 months before and 2 months after protocol implementation. In phase 2, data were collected on a random sample of 20% of patients with an intensive care unit stay of 3 days or more for 2 months before and 12 months after protocol implementation. Results The study population consisted of 1266 patients before and 1420 patients after implementation in phase 1 and 258 patients before and 1681 patients after implementation in phase 2. In phase 1, the mean (SD) mobility level increased in all intensive care units, from 1.45 (1.03) before to 1.64 (1.03) after imple- mentation (P < .001). mean (sd) icu mobility scale scores increased on initial evaluation from 4.4 (2.8) to 5.0 (2.8) (p = .01) and at intensive care unit discharge from 6.4 (2.5) to 6.8 (2.3) (p = .04). complications occurred in 0.2% of patients mobilized. in phase 2, 84% of patients had out-of-bed activity after implemen- tation. the time to achieve mobility levels 2 to 4 decreased (p = .05). intensive care unit length of stay decreased significantly in both phases. conclusions implementing the american association of critical-care early mobility protocol in inten- sive care units with abcdef components in place can increase mobility levels, decrease length of stay, and decrease delirium with minimal complications. (critical care nurse. 2020;40[4]:e7-e17) marilyn schallom, phd, rn, ccns, ccrn-k heidi tymkew, dpt, mhs, ccs kara vyers, bs donna prentice, phd, rn, acns-bc carrie sona, msn, rn, ccrn, ccns, acns-bc traci norris, dpt, gcs cassandra arroyo, phd implementation of an interdisciplinary aacn early mobility protocol www.ccnonline.org criticalcarenurse vol 40, no. 4, august 2020 e7 e8 criticalcarenurse vol 40, no. 4, august 2020 www.ccnonline.org increasing mobility in critically ill patients in the intensive care unit (icu) is a priority of national organizations involved in critical care.1-3 these organizations support the icu liberation model through implementation of the abcdef bundle, which includes assess, prevent and manage pain; both spontaneous awakening and breathing trials; choice of analgesia and sedation; delirium assessment, prevention and manage- ment; early mobility and exercise; and family engagement and empowerment. the abcde bundle was first pro- posed as 5 evidence-based steps to improve care of the icu patient.4 family engagement was later added, and the bundle was further refined with clinical practice guide- lines in 2018.5 a recent quality improvement (qi) initia- tive incorporating the bundle demonstrated improvement of multiple outcomes in the first 7 days of icu admission, including hospital death, next-day mechanical ventila- tion, coma, and discharge location.6 an early mobility program requires an interdisciplin- ary approach involving nurses, physical and occupa- tional therapists, respiratory therapists, and physicians.7 studies have confirmed the benefits of early mobility in the icu,8,9 with decreased days to first time out of bed,10,11 increased peripheral and respiratory muscle strength,12,13 improved functional mobility,12,14 and increased frequency and distance of ambulation.15-18 early mobility and decreased sedation are associated with decreased delirium14,19-21 and may prevent post– intensive care syndrome.20 several studies have demon- strated a link between early mobility and decreased ventilator days19,21,22 and icu or hospital length of stay (los).10,14,17,21-27 safety is a concern when mobilizing patients in the icu. however, several studies have demonstrated the safety of increasing activity.10,15,24,28-30 a recent meta-analysis showed a 2.6% incidence of potential safety events, with only 0.6% of events requiring medical intervention.31 despite the benefits and safety, the number of icu patients mobilized remains low.32-35 a worldwide survey of abcdef bundle implementation indicated that 57% of respondents from 47 countries had implemented vari- ous components of the bundle. the majority of icus did not use a formal mobility scale, and most did not have a mobility team.35 at our institution, we previously imple- mented abcd and f components of the abcdef bun- dle; however, early mobility was unit based rather than patient based. we did not use a mobility scale or a pro- tocol for advancing mobility. at baseline, only 3 icus— the surgical/burn/trauma icu (sbticu) and both cardiothoracic icus (cticus)—had dedicated physical therapists (pts) whose primary treatment population was in the icu. as a result of this inconsistency across units, internal data revealed that over two 4-week peri- ods, only 16% of patients received a pt referral in the medical icu (micu) compared with 71% in the sbticu, and out-of-bed activity was performed a mean of 0.85 times in the micu compared with 1.5 times in the sbticu. thus a qi approach was needed to standardize early mobility for all icu patients. the purpose of this qi project was to examine the impact of an interdisciplin- ary mobility protocol in specialty icus. methods the project was conducted at a 1200-bed, university- affiliated level i trauma medical center in the midwest with 132 icu beds at project initiation. a staggered qi preintervention-postintervention design was used. the institution’s human research protection office deemed the project nonhuman subjects research. the american association of critical-care nurses (aacn) early progres- sive mobility protocol was used.36 baseline data were collected for 2 months in each unit. the presence of in-room ceiling lifts and a dedicated pt varied. a staggered approach with initiation in 2 icus every 2 to 4 months allowed for education of staff. one micu and the sbticu implemented the program in march 2015. the second micu and both cticus imple- mented the program in may 2015. the last 2 units, the cardiac unit and the neurology/neurosurgery unit authors marilyn schallom is director, heidi tymkew and donna prentice are research scientists, kara vyers is a research coordinator, and cassandra arroyo is lead statistical analyst, department of research for patient care services, barnes-jewish hospital, st louis, missouri. carrie sona is a clinical nurse specialist, surgical/burn/trauma intensive care unit, barnes-jewish hospital. traci norris is a clinical specialist, rehabilitation department, barnes-jewish hospital. corresponding author: marilyn schallom, phd, rn, ccns, ccrn-k, barnes-jewish hospital, 4590 children’s pl, ms #90-29-902, st louis, mo 63110 (email:
[email protected]). to purchase electronic or print reprints, contact the american association of critical- care nurses, 27071 aliso creek rd, aliso viejo, ca 92656. phone, (800) 899- 1712 or (949) 362-2050 (ext 532); fax, (949) 362-2049; email,
[email protected]. www.ccnonline.org criticalcarenurse vol 40, no. 4, august 2020 e9 (nnsicu), implemented the program in august 2015. the staggered approach provided time to add a pt dedi- cated to each icu immediately before implementation. project team members met with each unit’s nursing, therapy, and physician leadership to review and modify the aacn screening criteria specific for their patient population (figure 1). each icu developed an imple- mentation plan. the aacn 4-level mobility protocol was implemented with minor modifications (figure 2).36 education about the project occurred over a 2-week period in the second month of preimplementation data collection. unit champions helped with education, served as a resource, and assisted with overcoming barri- ers. bedside data collection included morning and eve- ning mobility goal, complications, and reasons the goal was not achieved. the nurse performed the safety screen during daily spontaneous awakening and breathing trials. if screening criteria were met, the patient began at mobility level 2. the goal was written on the goals board at the entrance figure 1 modified aacn screening criteria examples. abbreviations: aacn, american association of critical-care nurses; et, endotracheal tube; fio2, fraction of inspired oxygen; icp, intracranial pressure; icu .001).="" mean="" (sd)="" icu="" mobility="" scale="" scores="" increased="" on="" initial="" evaluation="" from="" 4.4="" (2.8)="" to="" 5.0="" (2.8)="" (p=".01)" and="" at="" intensive="" care="" unit="" discharge="" from="" 6.4="" (2.5)="" to="" 6.8="" (2.3)="" (p=".04)." complications="" occurred="" in="" 0.2%="" of="" patients="" mobilized.="" in="" phase="" 2,="" 84%="" of="" patients="" had="" out-of-bed="" activity="" after="" implemen-="" tation.="" the="" time="" to="" achieve="" mobility="" levels="" 2="" to="" 4="" decreased="" (p=".05)." intensive="" care="" unit="" length="" of="" stay="" decreased="" significantly="" in="" both="" phases.="" conclusions="" implementing="" the="" american="" association="" of="" critical-care="" early="" mobility="" protocol="" in="" inten-="" sive="" care="" units="" with="" abcdef="" components="" in="" place="" can="" increase="" mobility="" levels,="" decrease="" length="" of="" stay,="" and="" decrease="" delirium="" with="" minimal="" complications.="" (critical="" care="" nurse.="" 2020;40[4]:e7-e17)="" marilyn="" schallom,="" phd,="" rn,="" ccns,="" ccrn-k="" heidi="" tymkew,="" dpt,="" mhs,="" ccs="" kara="" vyers,="" bs="" donna="" prentice,="" phd,="" rn,="" acns-bc="" carrie="" sona,="" msn,="" rn,="" ccrn,="" ccns,="" acns-bc="" traci="" norris,="" dpt,="" gcs="" cassandra="" arroyo,="" phd="" implementation="" of="" an="" interdisciplinary="" aacn="" early="" mobility="" protocol="" www.ccnonline.org="" criticalcarenurse="" vol="" 40,="" no.="" 4,="" august="" 2020="" e7="" e8="" criticalcarenurse="" vol="" 40,="" no.="" 4,="" august="" 2020="" www.ccnonline.org="" increasing="" mobility="" in="" critically="" ill="" patients="" in="" the="" intensive="" care="" unit="" (icu)="" is="" a="" priority="" of="" national="" organizations="" involved="" in="" critical="" care.1-3="" these="" organizations="" support="" the="" icu="" liberation="" model="" through="" implementation="" of="" the="" abcdef="" bundle,="" which="" includes="" assess,="" prevent="" and="" manage="" pain;="" both="" spontaneous="" awakening="" and="" breathing="" trials;="" choice="" of="" analgesia="" and="" sedation;="" delirium="" assessment,="" prevention="" and="" manage-="" ment;="" early="" mobility="" and="" exercise;="" and="" family="" engagement="" and="" empowerment.="" the="" abcde="" bundle="" was="" first="" pro-="" posed="" as="" 5="" evidence-based="" steps="" to="" improve="" care="" of="" the="" icu="" patient.4="" family="" engagement="" was="" later="" added,="" and="" the="" bundle="" was="" further="" refined="" with="" clinical="" practice="" guide-="" lines="" in="" 2018.5="" a="" recent="" quality="" improvement="" (qi)="" initia-="" tive="" incorporating="" the="" bundle="" demonstrated="" improvement="" of="" multiple="" outcomes="" in="" the="" first="" 7="" days="" of="" icu="" admission,="" including="" hospital="" death,="" next-day="" mechanical="" ventila-="" tion,="" coma,="" and="" discharge="" location.6="" an="" early="" mobility="" program="" requires="" an="" interdisciplin-="" ary="" approach="" involving="" nurses,="" physical="" and="" occupa-="" tional="" therapists,="" respiratory="" therapists,="" and="" physicians.7="" studies="" have="" confirmed="" the="" benefits="" of="" early="" mobility="" in="" the="" icu,8,9="" with="" decreased="" days="" to="" first="" time="" out="" of="" bed,10,11="" increased="" peripheral="" and="" respiratory="" muscle="" strength,12,13="" improved="" functional="" mobility,12,14="" and="" increased="" frequency="" and="" distance="" of="" ambulation.15-18="" early="" mobility="" and="" decreased="" sedation="" are="" associated="" with="" decreased="" delirium14,19-21="" and="" may="" prevent="" post–="" intensive="" care="" syndrome.20="" several="" studies="" have="" demon-="" strated="" a="" link="" between="" early="" mobility="" and="" decreased="" ventilator="" days19,21,22="" and="" icu="" or="" hospital="" length="" of="" stay="" (los).10,14,17,21-27="" safety="" is="" a="" concern="" when="" mobilizing="" patients="" in="" the="" icu.="" however,="" several="" studies="" have="" demonstrated="" the="" safety="" of="" increasing="" activity.10,15,24,28-30="" a="" recent="" meta-analysis="" showed="" a="" 2.6%="" incidence="" of="" potential="" safety="" events,="" with="" only="" 0.6%="" of="" events="" requiring="" medical="" intervention.31="" despite="" the="" benefits="" and="" safety,="" the="" number="" of="" icu="" patients="" mobilized="" remains="" low.32-35="" a="" worldwide="" survey="" of="" abcdef="" bundle="" implementation="" indicated="" that="" 57%="" of="" respondents="" from="" 47="" countries="" had="" implemented="" vari-="" ous="" components="" of="" the="" bundle.="" the="" majority="" of="" icus="" did="" not="" use="" a="" formal="" mobility="" scale,="" and="" most="" did="" not="" have="" a="" mobility="" team.35="" at="" our="" institution,="" we="" previously="" imple-="" mented="" abcd="" and="" f="" components="" of="" the="" abcdef="" bun-="" dle;="" however,="" early="" mobility="" was="" unit="" based="" rather="" than="" patient="" based.="" we="" did="" not="" use="" a="" mobility="" scale="" or="" a="" pro-="" tocol="" for="" advancing="" mobility.="" at="" baseline,="" only="" 3="" icus—="" the="" surgical/burn/trauma="" icu="" (sbticu)="" and="" both="" cardiothoracic="" icus="" (cticus)—had="" dedicated="" physical="" therapists="" (pts)="" whose="" primary="" treatment="" population="" was="" in="" the="" icu.="" as="" a="" result="" of="" this="" inconsistency="" across="" units,="" internal="" data="" revealed="" that="" over="" two="" 4-week="" peri-="" ods,="" only="" 16%="" of="" patients="" received="" a="" pt="" referral="" in="" the="" medical="" icu="" (micu)="" compared="" with="" 71%="" in="" the="" sbticu,="" and="" out-of-bed="" activity="" was="" performed="" a="" mean="" of="" 0.85="" times="" in="" the="" micu="" compared="" with="" 1.5="" times="" in="" the="" sbticu.="" thus="" a="" qi="" approach="" was="" needed="" to="" standardize="" early="" mobility="" for="" all="" icu="" patients.="" the="" purpose="" of="" this="" qi="" project="" was="" to="" examine="" the="" impact="" of="" an="" interdisciplin-="" ary="" mobility="" protocol="" in="" specialty="" icus.="" methods="" the="" project="" was="" conducted="" at="" a="" 1200-bed,="" university-="" affiliated="" level="" i="" trauma="" medical="" center="" in="" the="" midwest="" with="" 132="" icu="" beds="" at="" project="" initiation.="" a="" staggered="" qi="" preintervention-postintervention="" design="" was="" used.="" the="" institution’s="" human="" research="" protection="" office="" deemed="" the="" project="" nonhuman="" subjects="" research.="" the="" american="" association="" of="" critical-care="" nurses="" (aacn)="" early="" progres-="" sive="" mobility="" protocol="" was="" used.36="" baseline="" data="" were="" collected="" for="" 2="" months="" in="" each="" unit.="" the="" presence="" of="" in-room="" ceiling="" lifts="" and="" a="" dedicated="" pt="" varied.="" a="" staggered="" approach="" with="" initiation="" in="" 2="" icus="" every="" 2="" to="" 4="" months="" allowed="" for="" education="" of="" staff.="" one="" micu="" and="" the="" sbticu="" implemented="" the="" program="" in="" march="" 2015.="" the="" second="" micu="" and="" both="" cticus="" imple-="" mented="" the="" program="" in="" may="" 2015.="" the="" last="" 2="" units,="" the="" cardiac="" unit="" and="" the="" neurology/neurosurgery="" unit="" authors="" marilyn="" schallom="" is="" director,="" heidi="" tymkew="" and="" donna="" prentice="" are="" research="" scientists,="" kara="" vyers="" is="" a="" research="" coordinator,="" and="" cassandra="" arroyo="" is="" lead="" statistical="" analyst,="" department="" of="" research="" for="" patient="" care="" services,="" barnes-jewish="" hospital,="" st="" louis,="" missouri.="" carrie="" sona="" is="" a="" clinical="" nurse="" specialist,="" surgical/burn/trauma="" intensive="" care="" unit,="" barnes-jewish="" hospital.="" traci="" norris="" is="" a="" clinical="" specialist,="" rehabilitation="" department,="" barnes-jewish="" hospital.="" corresponding="" author:="" marilyn="" schallom,="" phd,="" rn,="" ccns,="" ccrn-k,="" barnes-jewish="" hospital,="" 4590="" children’s="" pl,="" ms="" #90-29-902,="" st="" louis,="" mo="" 63110="" (email:=""
[email protected]).="" to="" purchase="" electronic="" or="" print="" reprints,="" contact="" the="" american="" association="" of="" critical-="" care="" nurses,="" 27071="" aliso="" creek="" rd,="" aliso="" viejo,="" ca="" 92656.="" phone,="" (800)="" 899-="" 1712="" or="" (949)="" 362-2050="" (ext="" 532);="" fax,="" (949)="" 362-2049;="" email,=""
[email protected].="" www.ccnonline.org="" criticalcarenurse="" vol="" 40,="" no.="" 4,="" august="" 2020="" e9="" (nnsicu),="" implemented="" the="" program="" in="" august="" 2015.="" the="" staggered="" approach="" provided="" time="" to="" add="" a="" pt="" dedi-="" cated="" to="" each="" icu="" immediately="" before="" implementation.="" project="" team="" members="" met="" with="" each="" unit’s="" nursing,="" therapy,="" and="" physician="" leadership="" to="" review="" and="" modify="" the="" aacn="" screening="" criteria="" specific="" for="" their="" patient="" population="" (figure="" 1).="" each="" icu="" developed="" an="" imple-="" mentation="" plan.="" the="" aacn="" 4-level="" mobility="" protocol="" was="" implemented="" with="" minor="" modifications="" (figure="" 2).36="" education="" about="" the="" project="" occurred="" over="" a="" 2-week="" period="" in="" the="" second="" month="" of="" preimplementation="" data="" collection.="" unit="" champions="" helped="" with="" education,="" served="" as="" a="" resource,="" and="" assisted="" with="" overcoming="" barri-="" ers.="" bedside="" data="" collection="" included="" morning="" and="" eve-="" ning="" mobility="" goal,="" complications,="" and="" reasons="" the="" goal="" was="" not="" achieved.="" the="" nurse="" performed="" the="" safety="" screen="" during="" daily="" spontaneous="" awakening="" and="" breathing="" trials.="" if="" screening="" criteria="" were="" met,="" the="" patient="" began="" at="" mobility="" level="" 2.="" the="" goal="" was="" written="" on="" the="" goals="" board="" at="" the="" entrance="" figure="" 1="" modified="" aacn="" screening="" criteria="" examples.="" abbreviations:="" aacn,="" american="" association="" of="" critical-care="" nurses;="" et,="" endotracheal="" tube;="" fio2,="" fraction="" of="" inspired="" oxygen;="" icp,="" intracranial="" pressure;="">