RESEARCH:QUIET TIME IN NEURO ICU 5 Running Head: RESEARCH: ICU QUIET TIME 1 Researchable Topic: ICU Quiet time Ese Nosakhare Nurs-6052N Essentials of Evidence-Based Practice June 13, 2015 Researchable Topic: ICU Quiet time DS Dr. Sullivan Title needed when you begin on page two. This title should be the same as the title page, centered and not bolded The identification of research problem is the first and foremost step that every researcher has to undertake. What is hard for a nurse to do in evidence-based practice (EBP) is coming up with a clinical question that can be answered with research evidence (Polit & Beck, 2012). Knowing this, a clinical question that is patient focuseds and important significant to nursing can help obtain the knowledge needed to addressing the needs of certain patient populations (Thibane, Thomas & and Ye, 2009). A nurse making a clinical question that can be answered requires a game plan that can identify pertinent nursing issues. Furthermore, the nurse must put that nursing issue into an easy format to research. Doing so will endure allow the best evidence to realize EBP (Richardson, 2009). Analyzing present issues in nursing connected to evidence based practices for ICU delirium, a nurse should have the capability to identify certain steps in making a well-rounded clinical question that is structured and focusesd on the key features to help complete evidence based practice DS Dr. Sullivan Your introductory paragraph is good but you could make it better by including one sentence that clearly defines the purpose of the paper. This is usually the last sentence in the introductory paragraph. . Developing a research problem is a creative process (Polit and Beck, 2012, p.76). Neuro-trauma ICU patients typically have an increased need for sleep. However, the ICU setting predisposes ICU patients to sleep deprivation due to exposure to bright lights, high noise levels, regular intrusion of staff and visitors, and patient care activities. Current evidence suggests that a relationship exists among sleep, delirium, and mortality DS Dr. Sullivan Use of resources or references would have added credibility to your discussion . Delirium is commonly linked to higher medical costs, increased risk for death and extended stays DS Dr. Sullivan Need a citation . There has not been a direct link between lack of sleep and delirium has yet to be proven. Current knowledge that sleep deprivation affects cognitive function, points to a very direct connection between the two. Extended hospital stays, increased medical costs, and high risk for mortality have been associated with delirium DS Dr. Sullivan Need a citation . Nurses can assist with decreasing the incidence delirium in ICU patients by using simple methods and hence help improve health outcomes. Some of these methods include turning off lights or dimming them, reducing noise levels, reducing the number of visits/intrusions, proper positioning of ...

1. RESEARCH:QUIET TIME IN NEURO ICU 5
Running Head: RESEARCH: ICU QUIET TIME 1
Researchable Topic: ICU Quiet time
Ese Nosakhare
Nurs-6052N Essentials of Evidence-Based Practice
June 13, 2015
Researchable Topic: ICU Quiet time DS Dr. Sullivan Title
needed when you begin on page two. This title should be the
same as the title page, centered and not bolded
The identification of research problem is the first and
foremost step that every researcher has to undertake. What is

2. hard for a nurse to do in evidence-based practice (EBP) is
coming up with a clinical question that can be answered with
research evidence (Polit & Beck, 2012). Knowing this, a
clinical question that is patient focuseds and important
significant to nursing can help obtain the knowledge needed to
addressing the needs of certain patient populations (Thibane,
Thomas & and Ye, 2009). A nurse making a clinical question
that can be answered requires a game plan that can identify
pertinent nursing issues. Furthermore, the nurse must put that
nursing issue into an easy format to research. Doing so will
endure allow the best evidence to realize EBP (Richardson,
2009). Analyzing present issues in nursing connected to
evidence based practices for ICU delirium, a nurse should have
the capability to identify certain steps in making a well-rounded
clinical question that is structured and focusesd on the key
features to help complete evidence based practice DS Dr.
Sullivan Your introductory paragraph is good but you could
make it better by including one sentence that clearly defines the
purpose of the paper. This is usually the last sentence in the
introductory paragraph.
.
Developing a research problem is a creative process (Polit
and Beck, 2012, p.76). Neuro-trauma ICU patients typically
have an increased need for sleep. However, the ICU setting
predisposes ICU patients to sleep deprivation due to exposure to
bright lights, high noise levels, regular intrusion of staff and
visitors, and patient care activities. Current evidence suggests
that a relationship exists among sleep, delirium, and mortality
DS Dr. Sullivan Use of resources or references would have
added credibility to your discussion
. Delirium is commonly linked to higher medical costs,
increased risk for death and extended stays DS Dr. Sullivan
Need a citation . There has not been a direct link between lack
of sleep and delirium has yet to be proven. Current knowledge
that sleep deprivation affects cognitive function, points to a

3. very direct connection between the two. Extended hospital
stays, increased medical costs, and high risk for mortality have
been associated with delirium DS Dr. Sullivan Need a citation .
Nurses can assist with decreasing the incidence delirium in ICU
patients by using simple methods and hence help improve health
outcomes. Some of these methods include turning off lights or
dimming them, reducing noise levels, reducing the number of
visits/intrusions, proper positioning of patients and adequate
pain control etc. all help the patient have some quiet time DS
Dr. Sullivan Need a citation .
Thabane, et.al DS Dr. Sullivan Be careful with your
punctuation here. To cite with et al., use this method: (Jones et
al., 2009). For more on using et al., see
http://writingcenter.waldenu.edu/34.htm.(2009), states that the
practicality of doing any research project is “based on the
research question and should be considered early in the process
in order to avoid waste of resources and intellectual energy DS
Dr. Sullivan Please correct quotation(s). See APA book p. 91,
170, 172. ”. Once an identified a topic of interest, you can ask
wide-range questions that can lead you to a problem that is
researchable (Polit and Beck, 2012, p.76 DS Dr. Sullivan If this
is a direct quote then please use quotation marks. See APA book
p. 170-173. ). These questions can help one place emphasis on
the research problem and give the focus better clarity. The
questions to add to the background are: 1)What are the current
practices regarding delirium management in the neuro ICU?
2)What are the main influencing factors for the implementation
of the ICU delirium guidelines in the neuro ICU as reported by
doctors, RN’s and administration? 3)What should be the
specific information to improve delirium guidelines based on
the answers to the first two questions DS Dr. Sullivan You
needed 5 questions DS Dr. Sullivan You could have added to
this discussion by explaining how you used these questions to
develop your PICOT. Another way would be to explain why
these questions were not used (not feasible).
?

4. The formula to creating an answerable question is
following PICO format; Population, Intervention, Comparison,
Outcome. PICO is a systematic and consistent method used to
identify the components of a clinical issue. The use of the PICO
format to formulate a clinical question aids in the clarification
certain aspects of the clinical issue. This clarification will help
guide the research for the evidence. When a PICO question is
well-definedwell defined, the probability of finding the best
evidence to guide clinical practice in a quickly and efficient
manner increases DS Dr. Sullivan What is your PICO question?
.
A literature search was conducted using CINAHL,
EBSCOhost and PubMed databases. The keywords used for the
searches were: ICU, delirium, quiet time, delirium and sleep,
enforced visitation, rest periods, patient outcomes. The
inclusion criteria was only articles that were from the last 105
years, inpatient, adult critical-care patients. The initial search
yielded 70 articles. Using these terms in databases search
engines mentioned above will help find research evidence to
answer this specific PICO question DS Dr. Sullivan It would
have added to your discussion in this section if you would have
correlated the key terms with the variables. For example: For
the intervention variable of Catheter cleaning with CHG, the
key words CHG, “catheter care,” “perineal care,” “antimicrobial
cleanser,”and so on.
.
The objective of this research is to investigate if strict
enforcement of scheduled hours of rest time would decrease the
multiple incidences of delirium in adult critical-care patients in
the ICU. ICU patients have a very high risk for lack of sleep
which leads to a source of concern for multi-disciplinary teams
in health care. Nurses have vital role to play in executing and
leading changes to improve patient’s sleep. Prevention and
adequate management of sleep deprivation in ICU patients may

5. help reduce the incidence of delirium in ICU patients and its
attendant negative effects. Studies have correlated sleep
deprivation with incidences of delirium in ICU patients, which
lead to impaired cognitive function and longer hospital stays.
With this specific topic and PICO question, I fully commit to
answering my background questions and sharing the findings.
References
Gardner, G., Collins, C., Osborne, S., Henderson, A., &
Eastwood, M. (2009). Creating a therapeutic environment: A
non-randomised controlled trial of a quiet time intervention for
patients in acute care. International Journal of Nursing Studies,
778-786.
Richardson, A., Thompson, A., Coghill, E., Chambers, I., &
Turnock, C. (2009) Development and implementation of a noise
reduction intervention program: A pre- and post-audit of three
hospital wards. Journal of Clinical Nursing, 3316-3324.
Thabane L, Thomas T, Ye C, Paul J (2006).. Posing the research
question: Not so simple. Exploring patient, visitor and
staff views on open visiting. Nursing Times.
Weinhouse, G. L., Schwab, R. J., Watson, P. L., Patil, N.,
Vaccaro, B. & Ely, E. W (2009). Bench-to-bedside review:
Delirium in ICU patients - importance of sleep
deprivation. Critical Care, 234-241.
Walden University M.S. in Nursing
Formative Evaluation Criteria for Applications and Formal

6. Papers
Categories and Criteria
Possible Points
Points
QUALITY OF WORK SUBMITTED - 35 Possible Points
1. The extent to which work meets the assigned criteria and
work reflects graduate level critical and analytic thinking (0-
30 Points)
Assignment exceeds expectations. All topics are addressed with
a minimum of 75% containing exceptional breadth and depth
about each of the assignment topics.
25-30
20
Assignment meets expectations. All topics are addressed with a
minimum of 50% containing good breadth and depth about each
of the assignment topics.
20-24
Assignment meets most of the expectations. One required topic
is either not addressed or inadequately addressed.
16-19
Assignment superficially meets some of the expectations. Two

7. or more required topics are either not addressed or inadequately
addressed.
2. Purpose of the paper is clear (0-5 Points)
A clear and comprehensive purpose statement is provided which
delineates all required criteria.
5
3
Purpose of the assignment is stated, yet is brief and not
descriptive.
4
Purpose of the assignment is vague.
3
No purpose statement was provided.
0
ASSIMILATION AND SYNTHESIS OF IDEAS - 50 Possible
Points
The extent to which the work reflects the student’s ability to-
1. Understand and interpret the assignment’s key concepts (0-
10 Points)

8. Demonstrates the ability to critically appraise and intellectually
explore key concepts.
10
8
Demonstrates a clear understanding of key concepts.
8
Shows some degree of understanding of key concepts.
7
Shows a lack of understanding of key concepts, deviates from
topics.
0-4
2. Apply and integrate material in course resources (i.e. video,
required readings, and textbook) and credible outside resources
(0-20 Points)
Demonstrates and applies exceptional support of major points
and integrates 2 or more credible outside sources, in addition to
3-4 course resources to support point of view.
15-20
6
Integrates specific information from 1 credible outside resource
and 3 to 4 course resources to support major points and point of
view.
10-14
Minimally includes and integrates specific information from 2-3

9. resources to support major points and point of view.
3-9
Includes and integrates specific information from 0 to 1
resource to support major points and point of view.
0-2
3. Synthesize (combines various components or different ideas
into a new whole) material in course resources (i.e. video,
required readings, and textbook) by comparing different points
of view and highlighting similarities, differences, and
connections. (0-20 Points)
Synthesizes and justifies (defends, explains, validates,
confirms) information gleaned from sources to support major
points presented. Applies meaning to the field of advanced
nursing practice.
18-20
17
Summarizes information gleaned from sources to support major
points, but does not synthesize.
16-17
Identifies but does not interpret or apply concepts, and/or
strategies correctly; ideas unclear and/or underdeveloped.
14-15
Rarely or does not interpret, apply, and synthesize concepts,
and/or strategies.
0-13

10. WRITTEN EXPRESSION AND FORMATTING - 15 Possible
Points
1. Paragraph and Sentence Structure: Paragraphs make clear
points that support well developed ideas, flow logically, and
demonstrate continuity of ideas. Sentences are clearly
structured and carefully focused--neither long and rambling nor
short and lacking substance. (0-5 Points)
Paragraphs and sentences follow writing standards.
5
4
Paragraphs and sentences follow writing standards 80% of the
time.
4
Paragraphs and sentences follow writing standards 70% of the
time.
3
Paragraphs and sentences follow writing standards < 70% of the
time.
0-2
2. English writing standards: Correct grammar, mechanics, and
proper punctuation (0-5 Points)
Uses correct grammar, spelling, and punctuation with no errors.
5
3

11. Contains a few (1-2) grammar, spelling, and punctuation errors.
4
Contains several (3-4) grammar, spelling, and punctuation
errors.
3
Contains many (≥ 5) grammar, spelling, and punctuation errors
that interfere with the reader’s understanding.
0-2
3. The paper follows correct APA format for title page,
headings, font, spacing,margins, indentations, page numbers,
running head, parenthetical/in-text citations, and reference list
(0-5 Points)
Uses correct APA format with no errors.
5
2
Contains a few (1-2) APA format errors.
4
Contains several (3-4) APA format errors.
3
Contains many (≥ 5) APA format errors.
0-2

12. Total Points for Assignment:
63
Guidance for Application Assignments:
Application Assignments require a title page, introduction, body
of the paper, conclusion, and reference page. The title page
needs to follows APA style and includes a title, student name,
course number and section, and date. An abstract is not
required. APA style headings are to be used appropriately to
separate and organize sections of the paper. The use of direct
quotes is discouraged and should only be used when the source
material uses language that is particularly striking or notable.
The introduction should provide an overview of the topic, the
purpose of the paper, and topics that will be addressed. The
body of the paper needs to address all required topics. The
conclusion ought to provide closure for the reader, synthesize
the content, and tie everything together to help clarify the main
points of the paper. The reference page should include all
references cited in the assignment in correct APA format.. Some
course assignments may require the use of more than 2 credible
outside resources. In these cases, the minimum outside sources
specified in the instructions for the assignment will be applied
in the grading of these course assignments. Credible sources
include scholarly peer-reviewed journal articles, evidence based
resources, and professional (.org), educational (.edu), and
government websites (.gov). Commercial websites (.com) are
not considered credible sources. Please note: When selecting

13. articles for course assignments, you are advised (unless you are
referencing seminal information) to focus on work published
within the past five years.
Late Policies:
Assignments submitted late without prior agreement of the
Instructor, outside of an emergency absence, or in violation of
agreements for late submission, will receive a grade reduction
for the Assignment amounting to a 20% point loss. After 5
days, the Assignment will not be graded. Students should be
aware that late Assignments may not receive the same level of
written feedback as do Assignments submitted on time.
Notes:

14. You have done nice work of summarizing your area of interet,
developing your PICOT question and identifying your search
terms. This should be an interesting project as we progress.
Excellent work!
Week 2 Assignment Expectations:
1) Summary of area of interest, identify problem, explanation of
significance in nursing
2) 5 questions with how analyzed them for feasibility, chose one
for PICOT and give rationale.
3) Preliminary PICOT, delineate variables, and description of
each variable

15. 4) 10 possible keywords