Benchmark -Evidence-Based Practice Project: Literature Review

NUR 550 Benchmark -Evidence-Based Practice Project: Literature Review

Benchmark -Evidence-Based Practice Project: Literature Review

Literature Review

The experiences of pain in which patients have post-surgical procedures in the PACU has attracted attention from various stakeholder in recent times. As such, while some researchers have focused on pain management using opioid-based medications, others have explored the application of non-opioid medications to manage the pain experienced by the patients. Therefore a literature review was conducted to find relevant peer-reviewed articles that deal with pain management in the PACU and articles which support the proposed project. The formulated PICOT statement was used as a guide to conduct a search for relevant articles that support the proposed project. Therefore a comprehensive search was conducted in various article databases. One of the useful databases was google scholar. In addition, a search was also conducted using CINHAL, PubMed, Cochrane Library, and Trip database. The search was conducted using various keywords such as pain management, PACU, non-opioid medication, and opioid medication.

Literature synthesis

The literature search led to several peer-reviewed articles. However, only the eight most relevant articles were chosen and therefore reviewed and synthesized in this section. Recently, Ali et al. (2021) carried out research with the aim of comparing the impacts of opioid-free and opioid-based medication in managing pain among patients undergoing functional endoscopic sinus surgeries. The study used a randomized comparative clinical study design. While the participants in the opioid-free group were given lidocaine infusion, magnesium sulfate, and paracetamol, those in the opioid group were given fentanyl. Upon the analysis of the data, the researchers realized that those who were recruited in the opioid-free group showed a better capacity to manage the pain, as shown in superior VAS scores. It, therefore, shows that non-opioid-based medications can be efficacious in pain management.

Bhardwaj et al. (2019) also conducted another relevant study that focused on comparing the effect of opioid-free and opioid-based anesthesia in pain management among urological surgery obese patients. The researchers recruited a total of eight patients, where half were randomized into the control group and study groups, respectively, in a randomized controlled trial. While the control group used fentanyl and Atracurium, the intervention group used Dexmedetomidine and Atracurium. The analysis of the data showed that the postoperative analgesic requirements and discharge times were less among the individual in the intervention group. The intervention group also had fewer side effects, showing that the use of opioid-free medication is largely tolerable. As such, opioid-free medication use in pain management is again supported in this source.

Another study was conducted by Hakim & Wahba (2019) with the aim of comparing the impact of opioid-based and opioid-free medications in controlling pain among patients in the postoperative patient recovery mode. These researchers employed a prospective randomized controlled comparative study design. The participants in the opioid-based group were offered intravenous fentanyl, while the ones in the opioid-free group were given intravenous Dexmedetomidine. The Analysis of the data revealed findings that are key to this proposed project. For example, the patients in the opioid-free group showed better pain management as shown by their better pain scores as compared to the individuals in the opioid-based medication group. This study also shows the efficacy of non-opioid-based medications in postoperative pain management.

Recently, Toleska & Dimitrovski (2019) carried out a study that compared the impact of using opioid-based and opioid-free medication in managing pain among patients undergoing laparoscopic cholecystectomy. In a prospective randomized clinical study, the researchers divided the participants into opioid-based and opioid-free medication groups. Whereas the patients in the control group were given fentanyl, those in the study group were offered dexamethasone. Upon analysis of the data, the researchers realized that the patients in the control group reported higher pain scores in comparison to the ones in the intervention group. This indicated the efficacy of non-opioid-based medications in managing pain as they can be superior when compared to opioid-based medications.

Another study that compared the efficacy of the opioid-based medication and opioid free-medication in pain management was recently accomplished by Aboelela & Alrefaey (2021). This research focused on managing pain among patients undergoing abdominal gynecological surgery. The researchers recruited a total of sixty-eight patients to participate in the prospective randomized double-blinded study. The patients were equally divided into the control and the intervention groups. While the patients in the intervention group were offered Atracurium and Ketamine, the individuals in the control group were given Atracurium and fentanyl to help in managing their pain. The analysis of the data showed that the individuals in the intervention group displayed lower pain scores in the first four hours post-operation when compared to the individuals in the control group. This research shows that non-opioid-based medications can be used to effectively manage patients’ pain post-operation.

The next study was carried out by Arif et al. (2019). This study had the main objective of exploring the effectiveness of non-opioid-based (lidocaine) intravenous infusion on postoperative pain scores among individuals undergoing abdominal surgery. The researchers recruited a total of eighty patients to participate in the study, with forty of them randomized into the control group while the rest formed part of the study group. This study used a randomized controlled study design. The individuals in the study group experienced lower pain scores in the first 12 hours post-operation. In addition, these patients gave no reports of toxicity. The implication is that non-opioid-based medications can be key in controlling pain during the post-operation period.

More recently, Rudikoff et al. (2022) carried out a study that investigated if the introduction of a combination of Dexmedetomidine and acetaminophen can eliminate the need to use opioid-based medication in managing pain post-operation. These researchers compared the efficacy of this combination of medications with the impact of fentanyl, which is one of the most common opioid-based medications used in controlling and managing pain. Upon the analysis of the data, the researchers realized that the use of the combination of the medication eliminated the need to use fentanyl to manage pain in the postoperative recovery time. This source also shows the efficacy of non-opioid-based medication in managing pain.

The next study was conducted by Leas et al. (2019), who aimed to examine the safety, feasibility, and efficacy of the use of opioid-free medication in managing patient among patients undergoing shoulder arthroplasty. These researchers gave the patients gabapentin and celecoxib before undergoing the operation and gabapentin and ketorolac after the operation. The researchers observed low pain scores, which were stable even after one day. This observation indicated that non-opioid-based medications could be key in managing pain post-operation.

The purpose of this assignment is to write a review of the research articles you evaluated in your Topic 5 “Evidence-Based Practice Project: Evaluation of Literature” assignment. If you have been directed by your instructor to select different articles in order to meet the requirements for a literature review or to better support your evidence-based practice project proposal, complete this step prior to writing your review.

Benchmark -Evidence-Based Practice Project: Literature Review

A literature review provides a concise comparison of the literature for the reader and explains how the research demonstrates support for your PICOT. You will use the

Benchmark -Evidence-Based Practice Project Literature Review Papers
Benchmark -Evidence-Based Practice Project Literature Review Papers

literature review in this assignment in NUR-590, during which you will write a final paper detailing your evidence-based practice project proposal.

In a paper of 1,250-1,500, select eight of the ten articles you evaluated that demonstrate clear support for your evidence-based practice and complete the following for each article:

  • Introduction – Describe the clinical issue or problem you are addressing. Present your PICOT statement.
  • Search methods – Describe your search strategy and the criteria that you used in choosing and searching for your articles.
  • Synthesis of the literature – For each article, write a paragraph discussing the main components (subjects, methods, key findings) and provide rationale for how the article supports your PICOT.
  • Comparison of articles – Compare the articles (similarities and differences, themes, methods, conclusions, limitations, controversies).
  • Suggestions for future research: Based on your analysis of the literature, discuss identified gaps and which areas require further research.
  • Conclusion – Provide a summary statement of what you found in the literature.
  • Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper. Benchmark -Evidence-Based Practice Project: Literature Review

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

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You are required to cite eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. Benchmark -Evidence-Based Practice Project: Literature Review

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSNMSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

3.2: Analyze appropriate research from databases and other information sources to improve health care practices and processes.

Course Code Class Code Assignment Title Total Points
NUR-550 NUR-550-O503 Benchmark -Evidence-Based Practice Project: Literature Review 175.0

Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (80.00%) Satisfactory (88.00%) Good (92.00%) Excellent (100.00%)
Content 70.0%
Introduction 5.0% The clinical issue or problem and PICOT statement are omitted. The clinical issue or problem and PICOT statement are incomplete or incorrect. The clinical issue or problem and PICOT statement are presented. Some aspects are vague. There are minor inaccuracies. The clinical issue or problem and PICOT statement are adequately described. The clinical issue or problem and PICOT statement are thoroughly described.

Search Methods 10.0% The search strategy and criteria used in choosing and searching for articles are omitted. The search strategy and criteria used in choosing and searching for articles are only partially described. The search strategy and criteria used in choosing and searching for articles are summarized. More information is needed. The search strategy and criteria used in choosing and searching for articles are described. Some detail is needed for clarity or accuracy. The search strategy and criteria used in choosing and searching for articles is thoroughly described.

Benchmark -Evidence-Based Practice Project: Literature Review Synthesis of Literature 10.0% A well-developed paragraph for each article is presented. The main components (subjects, methods, key findings) are thoroughly discussed, and substantial rationale for how each article supports the PICOT is clearly provided. A paragraph for one or more article is missing. All articles are presented, but the synthesis of literature is incomplete. A summary for each article is presented. The main components (subjects, methods, key findings) are generally discussed. General rationale for how each article supports the PICOT is provided. More information is needed. A paragraph for each article is presented. The main components (subjects, methods, key findings) are adequately discussed, and rationale for how each article supports the PICOT is provided. Some detail is needed for clarity or accuracy.

Comparison of Articles 10.0% One or more article is missing in the comparison. All articles are presented, but the comparison is incomplete. A general comparison of the similarities, differences, themes, methods, conclusions, limitations, and controversies among the articles is presented. Some aspects are unclear. More information is needed. A comparison of the similarities, differences, themes, methods, conclusions, limitations, and controversies among the articles is adequately presented. Some detail is needed for clarity or accuracy. A detailed comparison of the similarities, differences, themes, methods, conclusions, limitations, and controversies among the articles is thoroughly presented.

Suggestions for Future Research 10.0% Identified gaps and areas requiring further research are omitted. Identified gaps and areas requiring further research are only partially presented. Some identified gaps and areas requiring further research are generally discussed. The narrative is generally based on the analysis of the literature. More information is needed. Identified gaps and areas requiring further research are adequately discussed. The narrative is based on the analysis of the literature. Some detail is needed for clarity or accuracy. Identified gaps and areas requiring further research are thoroughly discussed and clearly based on the analysis of the literature. The narrative is insightful and demonstrates an understanding of research analysis necessary for future study.

Conclusion 5.0% The conclusion is omitted. A conclusion is presented but fails to present a summary statement of what was found in the literature. The conclusion presents a vague summary statement of was found in the literature. There are inaccuracies. The conclusion presents an adequate summary statement of what was found in the literature. The conclusion is well-developed and presents a clear and accurate summary statement of what was found in the literature.

Ability to Analyze (C3.2) 10.0% The literature review presented does not demonstrate an ability to analyze appropriate research from databases and other information sources to improve health care practices and processes. The literature review presented does not consistently demonstrate an ability to analyze appropriate research from databases and other information sources to improve health care practices and processes. The literature review presented demonstrates a general ability to analyze appropriate research from databases and other information sources to improve health care practices and processes. The literature review presented demonstrates an adequate ability to analyze appropriate research from databases and other information sources to improve health care practices and processes. The literature review presented demonstrates a strong ability to analyze appropriate research from databases and other information sources to improve health care practices and processes.

Appendix 5.0% The appendix and required resources are omitted. The APA Writing Checklist is attached, but an appendix has not been created. The paper does not reflect the use of the APA Writing Checklist during development The APA Writing Checklist is attached and in the appendix. The APA Writing Checklist was generally used in development of the paper, but some aspects are inconsistent with the paper format or quality. The APA Writing Checklist is attached in the appendix. It is apparent that the APA Writing Checklist was used in development of the paper. The APA Writing Checklist is attached in the appendix. It is clearly evident by the quality of the paper that the APA Writing Checklist was used in development.

Required Sources 5.0% Sources are not included. Number of required sources is only partially met. Number of required sources is met, but sources are outdated or inappropriate. Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content. Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.

Organization and Effectiveness 20.0%
Thesis Development and Purpose 7.0% Paper lacks any discernible overall purpose or organizing claim. Thesis is insufficiently developed or vague. Purpose is not clear. Thesis is apparent and appropriate to purpose. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.  Benchmark -Evidence-Based Practice Project: Literature Review Synthesis of Literature

Argument Logic and Construction 8.0% Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. Writer is clearly in command of standard, written, academic English.

Format 10.0%
Paper Format (Use of appropriate style for the major and assignment) 5.0% Template is not used appropriately or documentation format is rarely followed correctly. Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style. All format elements are correct.

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Topic 7 DQ 1

Identify two major policy issues that affect the current state of health care delivery and population health equity in the United States (may be state or federal). What impact do these population health policies and initiatives have on advanced nursing practice?

Re: Topic 7 DQ 1

Policy issues are critical determinants of the healthcare approaches that would be adopted by the healthcare organizations and professionals to address the health disparities. The United States healthcare system is structured upon a set of policy structure that guides the implementation and application of healthcare practices. One of the major policy issues in the country is staffing. For the past decade, the healthcare industry has been reporting a significant shortage of healthcare workers attributed to the increase in population and healthcare demands (Snavely, 2016). The elderly population has immensely grown leading to increased patient demands which impact the provider-to-patient ratio. One of the changes experienced in advanced nursing practice due to this policy issue is adjustments in the scope of practice. The majority of states are considering options for increasing the scope of APRNs for the primary goals of counteracting challenges in physician shortages (Snavely, 2016). Some states have considered giving APRNs prescription authority which would ultimately enhance the hospitals’ preparedness in addressing the increased population health needs.

The other policy issue affecting the healthcare industry at the federal level is privacy and confidentiality responsibilities collectively heightened by the increased adoption of technology by the healthcare industry. In the past two decades, healthcare organizations have rapidly adopted some of the technological trends including telehealth, Clinical Decision Support Systems, and electronic health recording systems (Bhuyan et al., 2017). The continuous adoption has raised concerns on the protection of patient information and elevated the need for including patients in their case management as critical decision-making stakeholders. Advanced practice nursing has been subjected to more serious consideration on healthcare informatics which is more of an integration of the medical principles with technological standards. Therefore, APRNs are now required to have background knowledge in computing and technology to enhance their compatibility with the current healthcare delivery system.

References

Bhuyan, S. S., Kim, H., Isehunwa, O. O., Kumar, N., Bhatt, J., Wyant, D. K., … & Dasgupta, D. (2017). Privacy and security issues in mobile health: Current research and future directions. Health policy and technology6(2), 188-191.

Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage in the United States. Nursing Economics34(2), 98-101.