NUR 550 Benchmark -Evidence-Based Practice Project Literature Review Assignment
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.
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.
Benchmark -Evidence-Based Practice Project: Literature Review
A significant proportion of children spend a lot of time on screens watching television, gaming, and social interaction, among other ways. Increased screen time increases obesity prevalence since it is associated with too much energy intake and low physical activity (Schwarzfischer et al., 2020). Obesity puts children at risk of diabetes and cardiovascular, physical, and mental health problems. The increased illness burden increases health care costs and nurses’ workload, and evidence-based interventions are necessary. To improve health outcomes and reduce obesity-related problems, nurses can help patients and families to understand the risks of obesity and educate them on the recommended amount of screen time and physical activity. The purpose of this paper is therefore to conduct a literature review based on the PICOT statement below.
PICOT: In children with obesity (P), can educating parents and children on reducing screen time and increasing physical activity (I) compared to no education (C) reduce obesity rates (O) in six months (T)?
When promoting change through EBP projects, nurses must use evidence-based interventions backed by scientific evidence. Appropriate evidence is obtained from scholarly sources. After formulating the PICOT question, scholarly sources were obtained from leading nursing databases such as CINAHL, PubMed, Medline, and the Cochrane Database of Systematic Reviews. Keywords used for the search included: childhood obesity, screen time, physical activity, and education. In each database, articles were further filtered according to the information and publication dates. Peer-reviewed and primary research articles that explored the role of knowledge improvement, reducing screen time, and parental education to reduce childhood obesity were chosen. The selected articles had to be published in the last five years.
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.
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 literature review in this assignment in NUR-590, during which you will write a final paper detailing your evidence-based practice project proposal.
Click here to ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT on NUR 550 Benchmark -Evidence-Based Practice Project Literature Review Assignment
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. NUR 550 Benchmark -Evidence-Based Practice Project Literature Review Assignment
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.
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.
NUR 590 Topic 1 DQ 2
Explain the importance of a “spirit of inquiry” in an evidence-based culture and what you can do as an advanced registered nurse to encourage this within your practice or organization. In response to your peers, compare the role and implementation of EBP in your specialty area with another advanced registered nurse specialty.
Science teaches us to explore and question. In medicine, it the same. There is always something to explore in medicine, whether its to improve upon interventions or to learn complex diseases. Throughout my career as a nurse and nursing student, it was always expressed to me that in order for me to become a successful nurse I would need to engage in continuing education for the life of my career. In life, we should always strive for continuing education for personal development and growth. The future of nursing will require nurses to question, explore and take initiative making decisions on patient care, interventions, in leadership and public health. “Explain the importance of a spirit of inquiry in an evidence-based culture and what you can do as an advanced registered nurse to encourage this within your practice or organization. In response to your peers, compare the role and implementation of EBP in your specialty area with another advanced registered nurse specialty” (National League of Nursing, 2014, para. 1). The COVID-19 pandemic was a wake up call in that we as a nation need to focus on improving our nursing practice. Nurses will need to be encourage and pushed into leadership roles, executive positions and in the areas a research and development. Many nurses took the lead in saving their patients and hospitals as the pandemic ravaged hospitals throughout the country. There was also a spike in people researching how to get into the field of medicine (particularly in nursing and nursing research). There became a fascination into epidemiology, public health and medical research as people and nurses became curious about vaccine development and how outbreaks of disease and virus happen. As a advanced registered I would encourage evidence based culture by being an example of someone who uses EBP and work in collaboration with other staffers to implement EBP research into the real world. During the heigh of the pandemic, EBP research was used to help patients as other interventions and methods failed.
In the field of advanced nursing practice, there are various ways advanced nurses implement EBPs. Nurse practitioners implement and EBP “when she/he prescribes a treatment for a patient that is substantiated by scientific research; Often, nurse practitioners look for an experimental study that compares the efficacy of a treatment with an untreated control group” (Nurse Practitioner Schools, 2021).
For nursing midwives, EBP is are used to enhance the lives of the mother, child and community. Mothers are the backbone of communities and the health and safety of woman determines the health and safety of their respective communities. Areas of challenges are identified and EBP are used to improve the lives of women in order to safely carry, deliver and raise children.
National League of Nursing. (2014). Practical/Vocational Nursing Program Outcome: Spirit of Inquiry. https://www.nln.org/docs/default-source/default-document-library/spirit-of-inquiry-final.pdf?sfvrsn=0
Nurse Practitioner Schools. (2021). Guide to Evidence-Based Nursing Practice for NPs. Retrieved from https://www.nursepractitionerschools.com/resources/guide-to-evidence-based-nursing-practice/