NUR 499-Translational Research Graphic Organizer Example

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Translational Research Graphic Organizer

PICOT Question – In mechanically ventilated ICU patients, does positioning the patient in semi-fowlers result in a lower incidence of nosocomial pneumonia when compared to the supine position?

Nursing Practice Problem: Ventilated-Associated Pneumonia is a common disease that has increased due to inappropriate positioning of mechanically ventilated patients in ICU. The problem can be prevented by implementing effective positioning which increases safety and quality of care to ICU patients and recommendations aimed to compare semi-fowler or semi-recumbent positioning against supine positioning.

Comparison 1: Translational Research vs. Qualitative Research

Criteria	Effects of 60° Semi-recumbent Position on Preventing Ventilator-associated Pneumonia: A Single-blind Prospective Randomized Clinical Trial Traditional Research Type: Qualitative research	Semi‐recumbent position versus supine position for the prevention of ventilator‐associated pneumonia in adults requiring mechanical ventilation Translational Research Type: Translational research	Observations (Similarities/Differences)
Methodology	Randomized clinical trial of using 25 patients recruited in surgical ICU units for ventilation mechanical surgery (Hassankhani et al., 2017). The patients were designated to be positioned differently over a year of intensive care with the aim of providing insights about the risks associated with positioning and VAP. Translational Research Graphic Organizer Example	Search for evidence from online libraries and randomized controlled trials (Wang et al., 2016). The evidence obtained from online libraries such as CENTRAL, MEDLINE, EMBASE, CINAHL, and CBM comparing the impacts of semi-recumbent positioning and supine positioning to prevent ventilated-associated pneumonia (VAP).	Head-of-bed-elevation (HOBE) was effective to lower pulmonary infiltration of chests for patients. Both methods were effective to prevent VAP. Semi-recumbent position helped reduce the risks of VAP. Both used randomized clinical trials over a period of time. Both methods did not provide information about the change of positioning by slight change of degrees of elevation.
Goals	To help assess and present insights of the benefits and effectiveness of Head-of-bed-elevation (HOBE) on 60 degrees in the prevention of VAP. Compare HOBE of 60 degrees against 45 degrees for patients in ICU and the prevention of VAP (Hassankhani et al., 2017). To measure how HOBE 60 degrees helps improve gas circulation and air circulation	To evaluate the safety of patients receiving intensive care during mechanical intubation. To assess the effectiveness of semi-recumbent position in reducing the risks of VAP (Wang et al., 2016). To help patients in ICU avoid complications that would interfere with their recovery process.	Both have similar goals and objectives as they dictate the impacts of semi-recumbent positioning and head-of-bed-elevation in preventing cases of VAP infections (Bassi et al., 2017). Both methods are effective and are prevents the issues associated with VAP to patients receiving mechanical ventilation intubation.
Data Collection	Data was obtained from a single-blind prospective randomized clinical trial which involved 25 patients. Each group (HOBE 60^0 and HOBE ^45) were recruited and results obtained for a year (Hassankhani et al., 2017). Data on progress was recorded in each morning and evening by nurses which included age, weight, underlying disorders, etiology of hospitalization, history of medication, and drug sensitivity.	Quality of evidence was utilized as it involved the evaluation of data from peer-reviewed articles (Wang et al., 2016). Authors screened titles, abstracts, and full-texts containing information about the comparison of semi-recumbent positioning versus supine position for patients in ICU and the prevention of VAP. 10 Trials were involved but only eight were successful due to loss of track of records.	Data collection was different as one involved perusal of evidence from peer-reviewed clinical articles and the other one used clinical trials. The exclusion criterion was used by qualitative data collection while the translational data collection involved the evaluation of evidence obtained from various peer-reviewed literatures.

Comparison 2: Translational Research vs. Quantitative Research

Criteria

Supine versus semi-Fowler’s positions for tracheal extubation in abdominal surgery-a randomized clinical trial

Translational Research Type: Quantitative

Semi‐recumbent position versus supine position for the prevention of ventilator‐associated pneumonia in adults requiring mechanical ventilation

Translational Research Type: Translational research

Observations (Similarities/Differences)

Methodology

Randomized clinical trials were used with 141 participants where two groups of supine and semi-fowlers positioning were utilized.

The participants were grouped depending on the supine and semi-fowlers positioning whereby, 70 patients after surgery were positioned in supine while the other 71 were positioned in semi-fowlers position (Zhu et al., 2020).

Evidence was obtained from records of changes and vital signs such as coughs, comfort, pain, and comfort-scores before and after surgery.

Search for evidence from online libraries and randomized controlled trials. The evidence obtained from online libraries such as CENTRAL, MEDLINE, EMBASE, CINAHL, and CBM comparing the impacts of semi-recumbent positioning and supine positioning to prevent ventilated-associated pneumonia (VAP) (Wang et al., 2016).

Both utilized the randomized clinical trials

The traditional method used online peer-review methods while the quantitative method used participants to obtain data at the end of the trial

Evidence was obtained from changes of patients’ healing process for both medical positions but the traditional research utilized evidence from reviewed articles on insights of the discussed positioning methods (Bassi et al., 2017).

Goals

To ascertain that semi-fowlers position is considered effective and more comfortable after mechanical ventilation surgery and prevents VAP (Zhu et al., 2020).

To improve the quality of care offered in ICUs and prevent prolonged hospice stay and reduce the risks of infections that might prolong the recovery process of patients.

To evaluate the safety of patients receiving intensive care during mechanical intubation.

To assess the effectiveness of semi-recumbent position in reducing the risks of VAP (Wang et al., 2016).

To help patients in ICU avoid complications that would interfere with their recovery process.

Both methods aimed to provide insights on the effective positioning after mechanical intubation surgery for patients in ICU

Both methods ascertained that semi-fowler or semi-recumbent methods were deemed effective to prevent VAP.

Data Collection

Demographic data was obtained before surgery

After surgery, data obtained included heartbeat rates, mean arterial pressure, peripheral capillary oxygen saturation, temperature, and respiratory rate (Zhu et al., 2020).

Monitoring of recovery process for both groups were implemented and changes recorded by nurses.

Quality of evidence was utilized as it involved the evaluation of data from peer-reviewed articles. Authors screened titles, abstracts, and full-texts containing information about the comparison of semi-recumbent positioning versus supine position for patients in ICU and the prevention of VAP. 10 Trials were involved but only eight were successful due to loss of track of records (Wang et al., 2016).

The traditional research methods collected data from peer reviewed articles and abstracts concerning the difference of supine and semi-fowler positioning in preventing VAP.

The quantitative method obtained data from clinical operations and real-time patients in a hospital and the evidence offered insights on the benefits of semi-fowler when compared to supine positioning in preventing VAP.

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References

Bassi, G. L., Xiol, E. A., Pagliara, F., Hua, Y., & Torres, A. (2017, June). Body position and ventilator-associated pneumonia prevention. In Seminars in respiratory and critical care medicine (Vol. 38, No. 03, pp. 371-380). Thieme Medical Publishers.

Hassankhani, H., Akbarzadeh, S., Lakdizaji, S., Najafi, A., & Mamaghani, E. A. (2017). Effects of 60 degrees Semi-recumbent Position on Preventing Ventilator-associated Pneumonia: A Single-blind Prospective Randomised Clinical Trial. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 11(12), OC36-OC39.

Wang, L., Li, X., Yang, Z., Tang, X., Yuan, Q., Deng, L., & Sun, X. (2016). Semi‐recumbent position versus supine position for the prevention of ventilator‐associated pneumonia in adults requiring mechanical ventilation. Cochrane Database of Systematic Reviews, (1).

Zhu, Q., Huang, Z., Ma, Q., Wu, Z., Kang, Y., Zhang, M., … & Huang, F. (2020). Supine versus semi-Fowler’s positions for tracheal extubation in abdominal surgery-a randomized clinical trial. BMC anesthesiology, 20(1), 1-9. Translational Research Graphic Organizer Example