Posted: May 19th, 2024

Assignment: Evidence-Based Project Matrix Worksheet

Evidence-Based Practice in Nursing: Identifying Clinical Issues and Researching Best Practices

Nurses are uniquely positioned to question common practices in healthcare and propose changes based on the latest evidence. This process of clinical inquiry involves identifying areas of interest, searching for relevant research, and analyzing the methodologies used in order to determine best practices (Melnyk & Fineout-Overholt, 2018). The purpose of this presentation is to introduce a clinical issue of interest and the process of researching it using peer-reviewed articles.
Clinical Issue of Interest
The chosen clinical issue is the use of patient-controlled analgesia (PCA) pumps for postoperative pain management. PCA allows patients to self-administer pain medication within preset limits, but there are risks of adverse events like oversedation and respiratory depression (Palmer & Miller, 2010). The question is whether PCA represents a best practice compared to nurse-administered pain medication.
Keyword Search
To research this issue, the keywords “patient-controlled analgesia”, “postoperative pain”, and “adverse events” were used. Searching for peer-reviewed articles required accessing research databases through the university library.
Databases Used
The four databases used to conduct the search were:

CINAHL Complete
MEDLINE with Full Text
Cochrane Database of Systematic Reviews
Joanna Briggs Institute EBP Database

Peer-Reviewed Articles

Palmer, P. P., & Miller, R. D. (2010). Current and developing methods of patient-controlled analgesia. Anesthesiology Clinics, 28(4), 587-599. https://doi.org/10.1016/j.anclin.2010.08.010
Morlion, B., Schäfer, M., Betteridge, N., & Kalso, E. (2018). Non-invasive patient-controlled analgesia in the management of acute postoperative pain in the hospital setting. Current Medical Research and Opinion, 34(7), 1179-1186. https://doi.org/10.1080/03007995.2018.1462785
Dinges, H. C., Otto, S., Stay, D. K., Bäumlein, S., Waldmann, S., Kranke, P., Wulf, H., & Eberhart, L. (2019). Side effects of opioid analgesia: Prevention and treatment. Deutsches Ärzteblatt International, 116(4), 37. https://doi.org/10.3238/arztebl.2019.0037
Patel, S., Sternberg, P., & Saadeh, P. (2020). Enhanced recovery pathways: Reducing opioid use and optimizing postoperative pain management. Journal of Surgical Oncology, 122(5), 978-982. https://doi.org/10.1002/jso.26115

See the attached matrix for an analysis of the research methodologies used in these articles. By examining the evidence on PCA using a methodical approach, nurses can implement pain management practices that maximize patient safety and comfort.
[Matrix Attached]
References:
Dinges, H. C., Otto, S., Stay, D. K., Bäumlein, S., Waldmann, S., Kranke, P., Wulf, H., & Eberhart, L. (2019). Side effects of opioid analgesia: Prevention and treatment. Deutsches Ärzteblatt International, 116(4), 37. https://doi.org/10.3238/arztebl.2019.0037
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer.
Morlion, B., Schäfer, M., Betteridge, N., & Kalso, E. (2018). Non-invasive patient-controlled analgesia in the management of acute postoperative pain in the hospital setting. Current Medical Research and Opinion, 34(7), 1179-1186. https://doi.org/10.1080/03007995.2018.1462785
Palmer, P. P., & Miller, R. D. (2010). Current and developing methods of patient-controlled analgesia. Anesthesiology Clinics, 28(4), 587-599. https://doi.org/10.1016/j.anclin.2010.08.010
Patel, S., Sternberg, P., & Saadeh, P. (2020). Enhanced recovery pathways: Reducing opioid use and optimizing postoperative pain management. Journal of Surgical Oncology, 122(5), 978-982. https://doi.org/10.1002/jso.26115

Matrix Worksheet Template

Use this document to complete Part 2 of the Module 2 Assessment, Evidence-Based Project, Part 1: An Introduction to Clinical Inquiry and Part 2: Research Methodologies

Full citation of selected article Article #1 Article #2 Article #3 Article #4

Why you chose this article and/or how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical issue of interest)

Brief description of the aims of the research of each peer-reviewed article
Brief description of the research methodology used Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.

A brief description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

General Notes/Comments

Assignment: Evidence-Based Project
Is there a difference between “common practice” and “best practice”?
When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.
Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.
Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?
In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.
To Prepare:
• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest.
• Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
• Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.
Part 1: An Introduction to Clinical Inquiry
Create a 4- to 5-slide PowerPoint presentation in which you do the following:
• Identify and briefly describe your chosen clinical issue of interest.
• Describe how you used keywords to search on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four peer-reviewed articles you selected.
Part 2: Identifying Research Methodologies
After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:
• The full citation of each peer-reviewed article in APA format.
• A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
• A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
• A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
• A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
• Chapter 2, “Asking Compelling Clinical Questions” (pp. 33–54)
• Chapter 21, “Generating Evidence Through Quantitative and Qualitative Research” (pp. 607–653)
Grant, M. J., & Booth, A. (2009). A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information and Libraries Journal, 26, 91–108. doi:10.1111/j.1471-1842.2009.00848.x. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1471-1842.2009.00848.x
Note: You will access this article from the Walden Library databases.

Hoare, Z., & Hoe, J. (2013). Understanding quantitative research: Part 2. Nursing Standard, 27(18), 48–55. doi:10.7748/ns2013.01.27.18.48.c9488. Retrieved from https://www.researchgate.net/publication/239615585_Understanding_quantitative_research_part_2
Note: You will access this article from the Walden Library databases.

Hoe, J., & Hoare, Z. (2012). Understanding quantitative research: Part 1. Nursing Standard, 27(15), 52–57. doi:10.7748/ns2012.12.27.15.52.c9485. Retrieved from https://www.researchgate.net/profile/Juanita_Hoe/publication/235369193_Understanding_quantitative_research_part_1/links/00b7d5152ea97eef23000000/Understanding-quantitative-research-part-1.pdf
Note: You will access this article from the Walden Library databases.

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