NSG 6999 Capstone Project

Already completed week 1

The effects of exercise on depression is a topic of special interest during my years of practice as a nurse. As a bedside nurse, I have always wondered and questioned on weather or not so many patients need to be on anxiolytic and antidepressant medications. My practice has made me question often if our medical world is too quick to prescribe medications instead of prescribing non pharmaceutical methods of treatment. I have also wondered how the incidence of depression would be lowered if individuals were educated on exercise instead of given prescriptions.

Already completed week 2

My background question for the capstone will be as follows:

In adult patients how effective is exercise as a treatment for depression when compared to pharmacological treatment?

Antidepressants are the main treatment considered for depression disorder, unfortunately, antidepressants are known to have many side effects. Many clinicians are willing to view and in fact encourage exercise as an adjunct therapy, however, clinicians are skeptical about substituting pharmaceutical treatment with exercise. NSG 6999 Capstone Project

My question is rooted in the fact that many adult patients with depression are not compliant with pharmaceutical treatment given all the unwanted side effects these medications are likely to produce. Second, much available research indicates many antidepressants are not effective for many individuals. Given these facts, exercise has been under the radar as an option for treating depression (Netz, 2017). NSG 6999 Capstone Project

In order to arrive at my PICOT, I will be examining numerous research and reviews conducted which present evidence-based facts regarding the effects of exercise on depression disorder. Kandola et al, 2016 concluded the “hippocampus in depressed individuals may be affected by neuron atrophy.

Additionally, the study identifies aerobic exercise as a potentiator for promoting neuroplasticity and facilitating hippocampus function. Kandola et al, 2016 further backed this claim by concluding an increase in neuroplasticity in the hippocampus may change the structure of the region’s function thereby producing beneficial effects on cognitive malfunction of depressive disorder. NSG 6999 Capstone Project

According to another study “it is possible that the antidepressant effect of exercise is caused by the interaction of several neurobiological mechanisms rather than by one mechanism exclusively. It is certain that exercise generates both acute and chronic responses, mainly in hormones, neurotrophines, and inflammation biomarkers” (Schuch et al, 2016).

NSG 6999 Capstone Project References:

Kandola, A., Hendrikse, J., Lucassen, P. J., & Yücel, M. (2016). Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment. Frontiers in human neuroscience, 10, 373. doi:10.3389/fnhum.2016.00373
Netz Y. (2017). Is the Comparison between Exercise and Pharmacologic Treatment of Depression in the Clinical Practice Guideline of the American College of Physicians Evidence-Based?. Frontiers in pharmacology, 8, 257. doi:10.3389/fphar.2017.00257
Schuch F. B., Deslandesc A. C., Stubbs B., Gosmannb N. P., Silva C. T., Fleck M. P. (2016a). Neurobiological effects of exercise on major depressive disorder: a systematic review. Neurosci. Biobehav. doi: 10.1016/j.neubiorev.2015.11.012

Currently working on week 3. ( I will provide you the information Sunday

Principio del formulario

Due July 27 at 11:59 PM NSG 6999 Capstone Project

Final del formulario

State your PICOT question.
Indicate in parentheses after each segment, what part of PICOT the preceding words represent.
For example: In patients recently discharged from the hospital following care for heart failure (P), do hand-off calls by the nurse to the primary care provider using the SBAR format (situation, background, assessment, recommendation) (I) compared to no calls (C) decrease readmission rates (O) over a one year period (T).
Provide feedback to your classmates that focuses on:
The use of correct PICOT format for the question to guide the literature search.
Does the question reflect a clinical issue and one appropriate for an evidence-based practice project?
Provide feedback to your classmates that focuses on:
The use of correct PICOT format for the question to guide the literature search.
Does the question reflect a clinical issue and one appropriate for an evidence-based practice project?
Support a minimum of one and challenge a minimum of one.

********DO NOT DO ANY OF WEEK 1-3, AS I HAVE ALREADY COMPLETED MOST OF IT, AND AM FINISHING UP WEEK 3******

NSG 6999 Capstone Project NSG 6999 Capstone Project

Principio del formulario

Due July 31 at 11:59 PM

Final del formulario

PICOT question (200 points) Submit to Project

To complete this week, after reading chapter two in Melnyk and reviewing the lectures you submit a 2-3 page paper that explores the background of your issue. For this paper #1 you will be defining this issue or disease using the literature. It will end with the PICOT question. The parts of your paper should include:

Introduction
Definition
Epidemiology
Clinical Presentation
Complications
Diagnosis
Conclusion with PICOT Question

Due August 3 at 11:59 PM

Using the following table—search the 5 databases based on your PICOT Question—under findings note the number of relevant articles found—you may not find something in every database. Under features discuss what you liked about that database. ON the discussion board summarize your search—attach your chart for those that would like to see your search. You may not find what you are looking for in every search—and that is OK—but you must search every database to see what may be out there. NSG 6999 Capstone Project

Exploring the Literature

Picot Question:

Research Tool	Search Tips	Search Terms & Limits	Findings	Features
CINAHL CINAHL is an SU subscription-only resource that offers full text access to 336 scholarly journals and indexes over 3,000 journals from the fields of nursing and allied health. Indexed journals do not provide access to full-text. Just because it is indexed in does not mean the library has full-text access to the journal. SU can always request articles for students via Interlibrary Loan, but the service is not instantaneous	§ Look at the Major Subject Heading in the Full Record § Use the Limits Feature: o Example: Publication Type=Systematic Review § Try the CINAHL Heading search:	Keyword search: Limits: CINAHL Heading search: Limits: NSG 6999 Capstone Project
PubMed PubMed is a free health science citation & abstracts index from the National Center for Biotechnology Information at the U.S. National Library of Medicine.	§ Look at MeSH Terms in Full Record § Use the Limits Feature: o Examples: Article Type=Meta-Analysis; Age=All Adult § Look for the open access Free articles!	Keyword search: Limits: MESH search: Limits: NSG 6999 Capstone Project
Cochrane Library Cochrane Library provides access to the Cochrane Library of Systematic Reviews. Full text of reviews are subscription only. Index summaries are a public resource. Indexed journals do not provide access to full-text. Just because it is indexed in does not mean the library has full-text access to the journal. SU can always request articles for students via Interlibrary Loan, but the service is not instantaneous	§ Use the Simple Search and the Advance Search Features § Allows you to search with MeSH Terms § Check out the New Reviews Browse reviews by topic NSG 6999 Capstone Project	Keyword search: Limits: MESH search: Limits: NSG 6999 Capstone Project
Dynamed	§ Use the Simple Search and the Advance Search Features § Allows you to search with MeSH Terms § Check out the New Reviews Browse reviews by topic	Keyword search: Also browse by:
TRIP Database TRIP is a clinical search engine to locate publicly available clinical evidence.	§ Limit to: § Systematic Reviews § Guidelines-US	Keyword search: Limits: NSG 6999 Capstone Project
SU Library Search	§ Library Search is setup just like an EBSCO § The Library even has a specialized PICOT search setup in Library Search—must go to Advance search to get to PICOT option	NSG 6999 Capstone Project
Other Databases:

Principio del formulario

Due August 10 at 11:59 PM

Final del formulario

We will be reviewing a “keeper study” this week—evaluate an article by working through the following 7 question

Again, keeper studies can be identified using handy Rapid Critical Appraisal checklists consisting of a set of simple but important questions. Below are sample questions developed for use with quantitative studies that are applicable to most appraisal situations (it’s important to note that qualitative evidence, if it’s relevant to the clinical question, should not be dismissed): NSG 6999 Capstone Project

Why was the study done? Make sure the study is directly relevant to the clinical question.
What is the sample size? Size can and should vary according to the nature of the study. Since determining a valid minimum sample size in a single study can be difficult, taking into account multiple studies is beneficial.

The answer to this question alone should not remove a study from the appraisal process.

Are instruments of the variables in the study clearly defined and reliable? Make sure the variables were consistently applied throughout the study and that they measured what the researchers said they were going to measure.
How was the data analyzed?

Make sure that any statistics are relevant to the clinical question. NSG 6999 Capstone Project

Were there any unusual events during the study? If the sample size changed, for example, determine whether that has ramifications if you wish to replicate the study.
How do the results fit in with previous research in this area? Make sure the study builds on other studies of a similar nature.
What are the implications of the research for clinical practice? Ask whether the study addresses a relevant and important clinical issue.

NSG 6999 Capstone Project

Principio del formulario

Due August 17 at 11:59 PM

Final del formulario

On the discussion board, using a minimum of two articles that are supporting your PICOT question, submit one paragraph synthesizing the research into clear, concise statements without separately reviewing each of the studies in the paragraph—but by paraphrasing and synthesizing the work that was done. NSG 6999 Capstone Project

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. By due date assigned , go to the Discussion Area and post responses to the discussion question. All responses should be posted to the appropriate topic in this Discussion Area.

It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources. NSG 6999 Capstone Project

Principio del formulario

Due August 21 at 11:59 PM

Final del formulario

Complete Evidence Table as described in the Evidence Table Worksheet. Include Week 4 worksheet with completed Evidence Table.

Principio del formulario

Due August 24 at 11:59 PM

Final del formulario

This week you will be creating an Implementation Plan that will be attached to your final EBP. For the discussion board this week—outline your implementation in steps. It should describe the plan that implements your project into your practice. You have found support for your question–now you are translating this evidence into your practice. NSG 6999 Capstone Project

Remember–your PICOT was used to find support for your practice change! The implementation plan is involving this change…not the question.

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. By the due date assigned, go to the Discussion Area and post responses to the discussion question. All responses should be posted to the appropriate topic in this Discussion Area. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources. NSG 6999 Capstone Project

NSG 6999 Capstone Project

Principio del formulario

Due August 31 at 11:59 PM

Final del formulario

This week you will be working on an evaluation plan that will be attached to your EBP in Week 9. Submit your Evaluation Plan to the DB –listed as 1-2-3…

We used a PICOT question to assist us in our search for evidence–thus making you think there is research involved in your project. In truth, I can understand the confusion–but the purpose of the PICOT is to assist in your search for support in implementing the change. Once you have the support them you are evaluating the change not the question. NSG 6999 Capstone Project

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. By due date assigned, go to the Discussion Area and post responses to the discussion question. All responses should be posted to the appropriate topic in this Discussion Area.

Principio del formulario

Due September 7 at 11:59 PM

Final del formulario

Post your Presentation of your EBP on Discussion Board for feedback before final submission of your presentation will be in Week 10–the presentation can be a power point or any of the presentations methods discussed this week in the lectures and in your reading. NSG 6999 Capstone Project

Please note that the assignment this week is submission of your final EBP project.

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. By due date assigned , go to the Discussion Area and post responses to the discussion question.

All responses should be posted to the appropriate topic in this Discussion Area. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources. NSG 6999 Capstone Project

Principio del formulario

Due September 11 at 11:59 PM

Final del formulario

Submit EBP project with Implementation Plan and Evaluation Plan. Note EBP plan should resemble plan on page 248 of the Melnyx text.

Principio del formulario

Due September 14 at 11:59 PM

Final del formulario

Post Final EBP presentation to DB. As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. By the due date assigned, go to the Discussion Area and post responses to the discussion question. NSG 6999 Capstone Project

Principio del formulario

Due September 18 at 11:59 PM

Final del formulario

Post EBP Presentation to Discussion Board and Project.

Please note the entire CAPSTONE must be in Times New Roman, 12 Pt, double spaced.

Also all references must be 5 years or newer; references older than 5 years will not be accepted. Finally, references must be scholarly reviewed (Peer reviewed journals), no web sites. Books are accepted as long as all the information is provided APA.

NSG 6999 Capstone Project

NSG 6999 Capstone Project

NSG 6999 Capstone Project

NRS 410 CLC Assignment: CHF Exacerbation and Increased Dyspnea

NRS 410: Patient with Cardiomyopathy and Congestive Heart Failure

NRS 410: Anemia Case Study Essay Assignment

NRS 410: Approach to Care of Cancer Assignment

Week 4: Cardiovascular System, Part 1