Evidence Based Practice

Evidence Based Practice

Evidence Based Practice

Two articles chosen are:

 A randomized controlled trial of mindfulness to reduce stress and burnout among intern medical practitioners (Quantitative)

Is self-esteem actually the protective factor of nursing burnout? (Qualitative)

Attached are directions, grading rubric as well as an example of a submission by another student.

EBP and Applied Nursing Research Insert your name here Western Governors University C361 TASK 1

EBP and Applied Nursing Research

A. Evaluate a primary, quantitative research, peer-reviewed journal article

The primary, quantitative research, peer-reviewed journal article that I chose to evaluate is:

(put the reference for your article here)

A1. Describe how the researcher addresses the following four areas in the article:

a1a. Background or introduction.

1 paragraph here, citing your article

a1b. Review of the literature

1 paragraph here, citing your article

a1c. Data Analysis

1 paragraph here, citing your article

a1d. Methodology

1 paragraph here, citing your article

A2. Evaluate whether the evidence presented in each of the four areas supports the outcome of the study and implications for future research.

a2a. Background or introduction supports the outcome of the study

1 paragraph here, citing your article

a2b. Review of the literature supports the outcome of the study

1 paragraph here, citing your article

a2c. Data Analysis supports the outcome of the study

This was 2 sentences, citing your article

a2d. Methodology supports the outcome of the study

This was 3 sentences, citing your article

A3. Explain how the protection of human subjects and cultural considerations were addressed by the researcher, using specific information from the chosen journal article.

This was 3 sentences, citing your article

A4. Describe one strength and one limitation of the study.

This was 2 paragraphs (one for strength and one limitation), citing your article on each

A5. Describe how the evidence from the article informs current nursing practices.

1 paragraph here, citing your article

B. Evaluate a primary, qualitative research, peer-reviewed journal article

The primary, quantitative research, peer-reviewed journal article that I chose to evaluate is:

(put the reference for your article here)

B1. Describe how the researcher addresses the following four areas in the article:

b1a. Background or introduction.

1 paragraph here, citing your article

b1b. Review of the literature

1 paragraph here, citing your article

b1c. Data Analysis

1 paragraph here, citing your article

b1d. Methodology

1 paragraph here, citing your article

B2. Evaluate whether the evidence presented in each of the four areas supports the outcome of the study and implications for future research.

b2a. Background or introduction supports the outcome of the study

1 paragraph here, citing your article

b2b. Review of the literature supports the outcome of the study

1 paragraph here, citing your article

b2c. Data Analysis supports the outcome of the study

1 paragraph here, citing your article

b2d. Methodology supports the outcome of the study

1 paragraph here, citing your article

B3. Explain how the protection of human subjects and cultural considerations were addressed by the researcher, using specific information from the chosen journal article.

1 paragraph here, citing your article

B4. Describe one strength and one limitation of the study.

This was 2 paragraphs (one for strength and one limitation), citing your article on each

B5. Describe how the evidence from the article informs current nursing practices.

1 paragraph here, citing your article

Running Head: EVIDENCE BASED PRACTICE

EVIDENCE BASED PRACTICE

Evidence Based Practice and Applied Nursing Research

Task 1 -XAP1

Adrianna Thorstad

November 20, 2019

Western Governors University

A: Quantitative Article: Song, I.-K., Park, Y.-H., Lee, J.-H., Kim, J.-T., Choi, I. H., & Kim, H.-S. (2016). Randomized controlled trial on preemptive analgesia for acute postoperative pain management in children. Pediatric Anesthesia, 438–443. doi: 10.1111/pan.12864

Background or Introduction

This study was aimed to assess the use of intravenous preemptive analgesia in the treatment of acute pain from surgical corrective osteotomies, preformed in children over two years.

Review of the Literature

The researchers of this study cited a total of 25 different articles that were used to support the study conducted. Some of these topics include the recommended use of morphine in children, the effects of early pain experience in adolescents, emergence delirium and preemptive analgesia.

Data Analysis

The data gathered during the research was analyzed using four different types of tests. These included the T-test, Fishers Exact test, Mann-Whitney U, and x^2 test.

Discussion of Methodology

The method the researcher’s used was a quantitative randomized controlled trial. 51 patients were chosen because of their similar ages and intended surgical procedures. The group was split and randomly assigned to a control group and a test group. The test group received preemptive analgesia five minutes before the first surgical incision was made, the control group was given routine analgesia five minutes after the surgery began.

Quantitative: Conclusions

The introduction of the study was very well thought out and offered factors that contributed to inadequate pain relief and the potential negative future adverse events that adolescents could undergo if their postoperative pain is not managed appropriately. The literature used by the researchers to support their study was intentional and included several uses of preemptive analgesia in different types of surgeries. The literature also accounted for the ages of the children and their ethnicity, which was Asian in this case. The data analysis used was statistical and objective which led to exact results with no gray areas. The methodology used was appropriate for maintaining the integrity of the study, including the use of an independent outcome assessor who was also blind to the randomization results. An implication for further research could be done as the test and control group only had a ten-minute difference in the delivery of the analgesic for pain management.

Quantitative: Protection and Considerations

The researchers protected the participants of the study by obtaining approval from the Seoul National University Hospital Institutional Review Board before research began. The researchers also obtains written informed consents from the parents and legal guardians for each child involved. Children with histories of drug allergies, who had experienced side effects from opioids, or had developmental delays were excluded for their safety.

Quantitative: Strengths and Limitations

A strength of the study was the researchers drive to keep the study as randomized as they could, first by using an online software to randomize the groups and secondly by having a blind independent outcome assessor. A limitation of the study was the small sample size of the resulted data. The study began with 51 patients but the data was only collected on 41 due to surgery changes and loss of data on the patient controlled analgesia pumps.

Quantitative: Evidence Applications

The conclusion of this study informs nursing practice by potentially changing the way nurses manage postoperative pain. The researchers state in the study that there was only a ten-minute time gap in between control and test group. This may have not been sufficient allotted time for the pain medication to work and truly make a difference in the children’s pain. If this is investigated further and preemptive analgesics are given even earlier in pre-surgical stages, it could lead to results that state preemptive analgesia is helpful and does make a difference in postoperative pain. Nurses may find themselves never having the encounter things such as breakthrough pain or even moderate/severe pain that many experience post-surgery. On the other hand, if no difference is found using preemptive analgesia, maybe there will be more research into multimodal approaches to pain management. This would also affect nursing practice because nurses in post-surgical situations would find themselves needing to be up to date and informed of best practices for pain management.

B: Qualitative Article: Harvey, K. A., & Kovalesky, A. (2018). Post-Operative Pain and Comfort in Children After Heart Surgery: A Comparison of Nurses and Families Pre-operative Expectations. Journal of Pediatric Nursing, 43, 9–15. doi: 10.1016/j.pedn.2018.07.014

Background or Introduction

The purpose of the study was to gain insight into the expectations of the parents and nurses about pain control and comfort in children after heart surgery in hopes of contributing to evidence-based family-centered interventions.

Review of the Literature

The researchers cited 42 articles to support their study throughout the article. A couple of the topics that the researchers discussed to support their study included: parent stress levels during children’s hospital recovery, holistic comfort, coping, parent education, and post-operative pain management.

Data Analysis

The data was collected during semi-structured interviews to obtain qualitative data. The interviews were audio recorded and transcribed verbatim. The interviews were then analyzed for themes in the narratives that represented perceptions and expectations around comfort for the hospitalized child.

Discussion of Methodology

The method the researchers used was qualitative. 20 nurses and 23 parents or legal guardians were interviewed about their perceptions of pain management in the hospitalized child post heart surgery.

Qualitative: Conclusions

The articles introduction does a great job in painting the picture of why this study was carried out. It explains how many children each year are born with heart defects requiring surgery, how peri-operative times for families and parents of children with CHD can be very stressful and reinforces a family centered care approach to maximize comfort in the hospitalized child. The review of the literature is extensive and very intentional with articles specific to the necessity of parental involvement in pain management for adolescents. The data analysis was thorough and appropriate, using recorded interviews with open ended questions and content analysis to find themes. The methodology used was applicable to a qualitative research article, using interested parents and nurses who were interviewed over a six-month period. This research article offers an insight into the perceptions and expectations of parents and nurses taking care of post-surgical children in pain. With these themes, research can be done to find and implement better practices in the preparation of nurses and families regarding post-surgical pain in children. Qualitative: Protection and Considerations

The researchers protected the study participants by obtaining ethics committee approval at the study site, a tertiary pediatric center in the Pacific Northwest. The participants both nurses and family members signed written informed consents before their interviews were given.

Qualitative: Strengths and Limitations

A strength of the study was the interviews that were given to the participants. The principle investigator conducting the interviews asked open-ended questions that resulting in narratives from which themes were gathered. A limitation of the study was that almost all of the participating family members were mothers of the children undergoing surgery. This means that perceptions of pain management for the child from the father or other family members was not recorded and addressed.

Qualitative: Evidence Application

The conclusion of this study informs nursing practice that the nurse-parent relationship and collaboration surrounding adolescent post-surgical pain management needs to be improved. Although education pre-operatively regarding pain management is handled by other staff excluding nurses, re-education for families in these situations by nurses may need to be necessary. This conversation may help to build a stronger rapport for the family and nurse assigned to their child. This may also include the implementation of goals for pain levels and care plans for the post-surgical adolescent decided on by the nurse and families. Lack of staff, level of acuity or other things negatively impacting the nurse-parent relationships will need to be addressed so that parent’s feel their child is being prioritized and handled with the highest quality of care. Education, goal setting and more time spent with families to discuss their child’s pain management will aid in the stronger satisfaction, better outcomes, and less stress on the families in these situations.

References

Harvey, K. A., & Kovalesky, A. (2018). Post-Operative Pain and Comfort in Children After Heart Surgery: A Comparison of Nurses and Families Pre-operative Expectations. Journal of Pediatric Nursing, 43, 9–15. doi: 10.1016/j.pedn.2018.07.014

Song, I.-K., Park, Y.-H., Lee, J.-H., Kim, J.-T., Choi, I. H., & Kim, H.-S. (2016). Randomized controlled trial on preemptive analgesia for acute postoperative pain management in children. Pediatric Anesthesia, 438–443. doi: 10.1111/pan.12864