NUR 590 Assignment Professional Work Setting
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 Proposal Final Paper
Throughout this course, you have developed a formal, evidence-based practice proposal.
The proposal is the plan for an evidence-based practice project designed to address a problem, issue, or concern in the professional work setting. Although several types of evidence can be used to support a proposed solution, a sufficient and compelling base of support from valid research studies is required as the major component of that evidence. Proposals must be submitted in a format suitable for obtaining formal approval in the work setting. Proposals will vary in length depending upon the problem or issue addressed (3,500 and 5,000 words). The cover sheet, abstract, references pages, and appendices are not included in the word count.
Section headings for each section component are required. Evaluation of the proposal in all sections will be based upon the extent to which the depth of content reflects graduate-level critical thinking skills.
Each section (A-F) will be submitted as a separate assignment in Topics 1-6 so your instructor can provide feedback (refer to applicable topics for complete descriptions of each section).
The final paper submission in Topic 7 will consist of the completed project (with revisions to all sections), title page, abstract, compiled references list, and appendices. Appendices will include a conceptual model for the project, handouts, data and evaluation collection tools, a budget, a timeline, resource lists, and approval forms, as previously assigned in individual section assignments.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is 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. Please refer to the directions in the Student Success Center.
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
NUR 590 Topic 4 DQ 2
Identify which statistical test you would use in conjunction with your selected research design from DQ 1 to evaluate the outcomes for your evidence-based project proposal and explain why you selected this test. What kind of information will this test provide about your outcomes?
According to Parab & Bhalerao, “statistical tests are mathematical tools for analyzing quantitative data generated in a research study” (2010). There are a number or test that researchers can use which can also become overwhelming and cause confusion for the research, and that can lead to sabotaging and tainting their study. Selecting the statistical test helps the researcher understand what to look for in the study as well as help organize their data. Parab & Bhalerao (2010) stated that “Before selecting a statistical test, a researcher has to simply answer the following six questions, which will lead to correct choice of test:”.
- How many independent variables covary (vary in the same time period) with the dependent variable?
- At what level of measurement is the independent variable?
- What is the level of measurement of the dependent variable?
- Are the observations independent or dependent?
- Do the comparisons involve populations to populations, a sample to a population, or are two or more
- Is the hypothesis being tested comparative or relationship?
Statistical testing is used explain the results of a study. The test that I would use would be the t-test. “A t-test is a type of inferential statistic used to determine if there is a significant difference between the means of two groups, which may be related in certain features” (Investopedia, n.d.). I would used this test because of show the averages of nurses to patient ratios to help determine the correlation between low staffing and high staffing and whether each has a positive or negative effect on patient health outcomes.
Investopedia. (n.d.). T-Test. Retrieved from https://www.investopedia.com/terms/t/t-test.asp
Parab, S. & Bhalerao, S. (2010). Choosing Statistical Test. International Journal of Ayurveda Research. 1(3): 187-191. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2996580/