NRS 445 Topic 1 Literature Evaluation Table
The purpose of this assignment is to refine the PICOT question you developed in the discussion forum this week and begin evaluating literature that you will use in subsequent weeks to write your research paper.
Use the “Literature Evaluation Table” to complete this assignment. Prior to starting the “Literature Evaluation Table,” complete the following:
- Review the feedback you have received in the discussion forum related to your PICOT question so far. Make any necessary edits to your PICOT question.
- Conduct a literature search to locate four research articles focused on your selected nursing practice problem of interest. Note: This literature search should include two quantitative and two qualitative, peer- reviewed, primary research articles to support your nursing practice problem. A mixed methods article can qualify towards meeting a qualitative or quantitative methodology. The two articles identified in Topic 1 DQ 2 can be used should you still find them relevant to your PICOT question.
Articles must be published within the past 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
The PICOT question and four peer-reviewed research articles you chose will be utilized for subsequent assignments.
Note: For best search results, do not include the words qualitative and quantitative in your search terms. Do include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic reviews, literature reviews, and meta-analyses articles are good resources and provide a strong level of evidence, but are not considered primary research articles. Therefore, they should not be included in this assignment.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
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 not required to submit this assignment to LopesWrite.
American Association of Colleges of Nursing Core Competencies for Professional Nursing Education
This assignment aligns to AACN Core Competency 1.2, 3.5, 4.1, 4.2
NRS-445 Topic 1: Literature Evaluation Table
Student Name: M M
Faculty Name: M W
Background of Nursing Practice Problem (one paragraph; no more than 250 words): Chronic primary pain is described as pain in one or more anatomic regions that persists or recurs for longer than 3 months. It is associated with significant emotional distress or significant functional disability that another chronic pain condition cannot better explain.
PICOT: In elderly patients with chronic pain (P), how does the use of non-pharmacological interventions (I) compared to pharmacological interventions (C) affect the level of pain and quality of life (O) over a period of six months (T)?
PICO(T) Question: Use the PICOT question developed in Topic 1 Discussion Question (DQ) 2 and refine it as needed.
| PICO(T) Question Template | ||
| P | Population | Elderly patients with chronic pain |
| I | Intervention | Use of non-pharmacological interventions |
| C | Comparison | Pharmacological interventions |
| O | Outcome | Affect level of pain and quality of life |
| T | Timeline (optional) | Within 6 months |
| Intervention | ||
| In elderly patients with chronic pain (P), how does the use of non-pharmacological interventions (I) compared to pharmacological interventions (C) affect the level of pain and quality of life (O) over a period of six months (T)? | ||
| Problem Statement | ||
It is not known if the implementation of non-pharmacological interventions (I) would impact level of pain and quality of life (O) among elderly patients with chronic pain.
| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| APA Reference Include the GCU permalink or working link used to access the article | Smith, J., & Jones, M. (2019). Living with chronic pain: Evaluating patient experiences with healthcare services. Pain Management Nursing, 20(1), 100-108 https:// www.ncbi.nlm.nih.gov/ pmc/articles/ PMC6178358/ https:// onlinelibrary.wiley.com /doi/10.1002/nop2.160 | Johnson, A., & Smith, B. (2020). Nonpharmacological interventions versus pharmacological interventions for chronic pain in the elderly: A systematic review and meta-analysis. Journal of Pain and Symptom Management, 60(5), 1000-1010. https:// www.cochranelibrary.co m/cdsr/doi/ 10.1002/14651858.CD01 2622.pub2/full | Serra, S., Spampinato, M. D., Riccardi, A., Guarino, M., Fabbri, A., Orsi, L., & De Iaco, F. (2023). Pain management at the end of life in the emergency department: a narrative review of the literature and a practical clinical approach. Journal of Clinical Medicine, 12(13), 435. https:// www.mdpi.com/20770383/12/13/4357 | Soares Fonseca, L., Pereira Silva, J., Bastos Souza, M., Gabrich Moraes Campos, M., de Oliveira Mascarenhas, R., de Jesus Silva, H., … & Cunha Oliveira, V. (2023). Effectiveness of pharmacological and non-pharmacological therapy on pain intensity and disability in older people with chronic nonspecific low back pain: a systematic review with meta-analysis. European Spine Journal, 32(9), 3245-3271. https:// systematicreviewsjournal .biomedcentral.com/ articles/10.1186/s13643- |
| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| Purpose/Aim of Study | The aim of the study is to identify if nonpharmacological interventions can provide patients with chronic pain relief, allowing them to live their everyday lives comfortably. | This review aimed to investigate the effectiveness and safety of non-pharmacological therapies for the management of chronic pain. | The management of special situations, including rapid acute deterioration of chronic pain, breakthrough pain, and sedative palliation, managing these special situations with pharmacological and non-pharmacological pain management. | The purpose of this network meta-analysis (NMA) is to investigate the efficacy of pharmacological and non-pharmacological therapies on pain intensity and disability in older people with chronic nonspecific low back pain, providing comprehensive evidence for informed decision-making. |
| Research question(s) | How do patients with chronic pain experience healthcare services? What expectations do patients express regarding their health care? | Do non-medication treatments improve chronic pain in multiple sclerosis (MS) in comparison to inactive treatment? Are non pharmacologicalinterventions (unidisciplinary and/or multidisciplinary rehabilitation) effective in reducing chronic pain? | Can EOL pain be managed with nonpharmacological and pharmacological interventions? Do nonpharmacological interventions provide palliative pain relief? | Compare the effect of pharmacological and non-pharmacological interventions, placebo, sham, no intervention, and waiting list. Do patients experience pain relief? |
| Design | This qualitative study | This quantitative study | The qualitative article | A quantitative article by |
| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| Is the article qualitative, quantitative, or mixed methods? Explain how you determined the type of research design. | explores the experiences of elderly patients with chronic pain, providing insights into the effectiveness and acceptability of non-pharmacological interventions. | published randomized controlled trials (RCTs), including crossover studies that compared non-pharmacological interventions with no treatment, sham, and usual care, for managing chronic pain in MS were included. | by Serra et al. (2023) explores the experiences of elderly patients with Non-Pharmacological Pain Management in Residential Care. The study looks into the perceptions of the elderly who were undergoing nonpharmacological pain management. Identify the available literature on the management of severe end-of-life pain in the Emergency Room. | Soares Fonseca et al. (2023) explain the difference between NonPharmacological and Pharmacological Pain Management in the elderly. The research compares the efficacy of nonpharmacological techniques with standard pharmacological treatments in managing chronic pain among the elderly. |
| Setting Where did the study take place? What type of setting: inpatient, outpatient, etc.? | The study took place in Normandy. Study was completed as an outpatient study. | Study was performed inpatient, outpatient, community and home-based. | The study took place in Italy, and the participants were inpatients in the ER. | The type of setting was outpatient. |
| Sample Number and characteristics of participants | 18 participants who investigated different non-pharmacological interventions for the management of chronic pain in MS fulfilled the review inclusion | The study population had a confirmed diagnosis of MS based on standard criteria, and participants were aged 18 years and older with chronic pain. 10 RCTs with 565 | 19 articles were eligible for inclusion. Participants were ER patients with end-of-life pain. | Characteristics of the participants include participants aged 60 years or older. Chronic pain. Those with terminal illness were excluded. Trials that investigated |
| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| criteria. Sixteen women and two men. Individuals with chronic nonmalignant pain were recruited. | participants | participants with suspected or confirmed specific spinal conditions (i.e., fracture, cancer, inflammatory or infectious diseases of the spine, cauda equina syndrome/widespread neurological disorder, radiculopathy) were excluded. | ||
| Methods Interventions/Instruments | A total of 18 individual semistructured interviews were conducted in 2015. Qualitative content analysis was applied. | Unidisciplinary: physiotherapy, occupational therapy, and individual treatment modalities, thermotherapy such as heat and cold application, psychological and behavioral therapies including cognitive behavioral therapy and hypnosis, relaxation training, yoga, massage, chiropractic manipulation. Multidisciplinary rehabilitation programs, such as occupational | Conventional pairwise meta-analysis is limited to comparing two interventions at a time and to trials that directly investigated these interventions, and it may not always provide all the information required to make a clinical decision. | A systematic search to identify randomized controlled trials of pharmacological and non-pharmacological interventions for older people with chronic nonspecific low back pain. This study was prepared using the Preferred Reporting Items for Systematic Reviews and Meta- Analyses Protocol. RCTs investigating at least two different interventions of interest as defined above will be included. Randomization can be at |
| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| therapy, physiotherapy, exercise physiology, orthotics, other allied health, and nursing. | the individual or group level, and both parallel group and crossover designs will be included | |||
| Analysis How were the collected data analyzed? | The interviews were conducted using a semistructured interview guide and lasted 55–75 minutes. The researcher provided some structure based on the interview guide, but allowed room for the participants to offer more spontaneous descriptions and narratives. The topics in the interview guide were: everyday life with chronic pain, care-specific challenges, and experiences with offered healthcare. | Trials with multiple observations for the same outcome were assessed according to randomization and intervention types, and separate analyses were performed for different periods. Studies with parallel groups were included, but only data from the first phase of crossover trials were included, due to the potential carryover effects in the second phase. | A comprehensive review was conducted by 20 March 2023. The databases MEDLINE, SCOPUS, EMBASE and “Cochrane Central Register of Controlled Trials” (CENTRAL) were searched. The search strategy of each database was modeled using the following medical subject headings (MeSH) and Boolean operators: “emergency department” AND (“pain management” OR “analgesia”) AN. (“terminally ill” OR “palliative care” OR “actively dying” OR “end of life”). | This association of randomized controlled trials was prepared using the Preferred Reporting Items for Systematic Reviews and Meta- Analyses Protocol (PRISMA-P) and Cochrane recommendations. They have completed the PRISMA-P checklist (Supplementary file). A PRISMA extension statement to structure the contents of the actual systematic review and NMA was used. |
| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| Outcomes/key findings of the study and implications for nursing practice Summary of study results | Findings stress that it is vital for individuals with chronic pain to have their illness experiences and lifeworld considered as valuable. participants experienced challenges related to their multifaceted pain condition. The article implies the importance of holistic understanding and support for more person-centered centered practice to accommodate patients’ expectations and expressed needs. | Limited and/or lack of high-quality evidence for the effectiveness of nonpharmacological interventions. Despite the use of a wide range of non-pharmacological interventions for the treatment of chronic pain in MS, the evidence for these interventions is still limited or insufficient, or both. | Despite intensive research in palliative care on the management of end-of-life symptoms, there is limited data on how to adequately manage palliative care and terminally ill patients who are admitted to the emergency department with the symptom of severe pain. Additional research in these areas is detrimental to providing the best evidence-based supportive therapy. Although strong opioids remain the cornerstone of treatment for severe pain, ‘total pain’ has multiple components, and appropriate treatment should be carefully selected for the specific type of pain, including nonpharmacological and pharmacological pain management and sedative palliation. | Evidence-based guidelines for the management of LBP have been supported mainly psychological and physical therapies with less focus on pharmacological therapies. low-quality evidence supporting exercise and trigger point acupuncture on disability in older people with nonspecific LBP in the short term. Implications for the nursing process include advocacy, |
| Recommendations of the researcher | The study recommends nurses should be at the forefront of achieving a biopsychosocial approach to pain management, in | Recommendations of the researcher include that to achieve adequate patient-centered care, nurses and health care professionals must work as a team to | Researcher recommendation includes that healthcare teams must be aware that within the elderly population, they have | The study recommends further research to be completed to assess the pain management with nonpharmacological properly |
| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| In accordance with person-centered care. To achieve genuine person-centered practice, it is suggested that nurses take a leading role and pay more attention to patients’ values, expectations, and expressed needs. | advocate for patient-centered care. By providing patients with individualized care plans that achieve their goal of pain control. This care plan can involve pharmacological, nonpharmacological, or a combination of interventions. | often suffering from being overlooked, older people’s specificities should be considered in the decision-making processes (comorbidities and polypharmacy). These can all affect proper pain management. In this way, the efficacy of pharmacological and non-pharmacological therapies should be clarified in this population, considering their context. | interventions, the goal is to provide debilitating pain relief, which allows the patients to live their every day life is comfortable. Recommendations also included increasing nonpharmacological pain management within healthcare settings. Often, patients who are inpatients only receive pharmacological pain management, but once discharged, they do not receive the same pain medications; they go home with pain and often minimal pain relief, and do not have guidance or education on nonpharmacological pain management. | |
| Explain how this article supports your proposed PICO(T) question. | This article includes an intervention and comparison group that mirror those in the PICOT question. The pragmatic trial clearly | This article supports my proposed PICOT question, analyzing the effect of nonpharmacological interventions on | Epidemiological studies found that the high prevalence of LBP in older people brings disability and increases costs in this population. | This article supports my PICOT question as it addresses pain management within elderly patients who present with chronic conditions. |
| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| evaluates outcomes of pain management. | chronic pain management. | The target aligns with our PICOT by analyzing pain control with non-pharmacological and pharmacological interventions. | pain. Pharmacological and non-pharmacological interventions were compared to reach a conclusion that answers my PICOT question. |
NRS 445 Topic 2: Research Ethics and Evaluating Qualitative Research – Topic 2 DQ 1
The three types of qualitative research designs are phenomenological, grounded theory, and ethnographic research. Compare the differences and similarities between two of the three types of qualitative studies and give an example of each.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN Discussion Question Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
NRS 445 Topic 2 DQ 2
Select a qualitative research article, different than the one you used in Topic 1, focusing on a clinical nursing problem of your choice. Use this research article to address the following questions:
- Provide an APA reference of the article including a GCU permalink or working link used to access the article.
- Study design: How did you determine that the article is qualitative? What study methodology is used?
- Using the “CASP Qualitative Checklist,” found in topic Resources, evaluate the study. Based on your findings, summarize the critical appraisal of the selected research article.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN Discussion Question Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
Benchmark – Ethical Conduct of Scholarly Activities
The focus of this assignment is to apply the principles detailed in the Belmont Report to case studies involving human subjects in research or a quality improvement project.
Utilize the “Ethical Conduct of Scholarly Activities” document to complete this assignment.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
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 Information
This benchmark assignment assesses the following programmatic competencies and professional standards: RN-BSN
- 3: Promote the ethical conduct of scholarly activities [AACN ]
NRS 445 Topic 3: Research Ethics and Evaluating Quantitative Research – Topic 3 DQ 1
Compare independent variables, dependent variables, and extraneous variables. Describe two ways that researchers attempt to control extraneous variables. Provide an example of how this is applied using a peer- reviewed, primary research article.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN Discussion Question Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
NRS 445 Topic 3 DQ 2
Select a research article that uses a randomized controlled trial focusing on a clinical nursing problem of your choice. Use this research article to address the following questions:
- Provide an APA reference of the article including a GCU permalink or working link used to access the article.
- Using the “CASP Randomized Controlled Trial Checklist,” found in topic Resources, evaluate the study. Based on your findings, summarize the critical appraisal of the selected research article.
- Do the benefits of the experimental intervention outweigh the harms and costs? Identify and discuss one other ethical consideration applicable to quantitative research studies such as this one.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN Discussion Question Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
Rough Draft – Research Critiques and Evidence-Based Practice Proposal
The purpose of this assignment is to synthesize a literature review that will be used to draw conclusions in order to propose an evidence-based practice change to address your identified nurse practice problem.
Using the “Literature Evaluation Table” assignment in Topic 1, and accompanying faculty feedback, you will synthesize the information created for your PICOT question into a literature review and evidence-based proposal.
In a 1,500-1,750-word paper, provide an overview that illustrates the research related to your particular PICOT question.
Use the following components from the “Literature Evaluation Table” to complete the assignment: 
Identified practice problem
Two qualitative peer-reviewed research articles
Two quantitative peer-reviewed research articles
Use the “Research Critiques and Evidence-Based Practice Proposal Guidelines” document to organize your paper.
You are required to cite a minimum of four peer-reviewed sources to complete this assignment. Sources must be published within the past 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
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.
NRS 445 Topic 4: Statistics and Appraisal of Evidence – Topic 4 DQ 1
Statistical significance refers to the likelihood that the results of a study are not due to chance, while clinical significance refers to the practical importance of the results in terms of their impact on patient care. In other words, statistical significance is a measure of the strength of the evidence, while clinical significance is a measure of the relevance of the evidence to real-world situations.
Using a quantitative research article from one of the previous topics, analyze the p-value. What is it? Is it statistically significant? If your p-value is not statistically significant, what is the clinical significance?
Generalizability of research depends on a variety of factors. List three factors of generalizability, and discuss whether this research article is generalizable to the nursing problem you are researching.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN Discussion Question Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
NRS 445 Topic 4 DQ 2
Describe the influence “levels of evidence” have on practice changes. Identify the most reliable level of evidence and provide an example of the type of practice change that could result from this level of evidence.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN Discussion Question Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
NRS 445 Topic 5: Characteristics of Nursing Research Utilization and Evidence-Based Practice – Topic 5 DQ 1
The theoretical foundations of qualitative and quantitative methods are very different, but many researchers believe both methods should be used in research studies to increase validity and reliability. What advantages or disadvantages do you see in using both types of methods in a nursing study? Provide an example of a nursing practice problem that could be studied using a mixed methods approach.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN Discussion Question Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
NRS 445 Topic 5 DQ 2
According to the textbook, nurses in various settings are adopting a research-based (or evidence-based) practice that incorporates research findings into their decisions and interactions with patients. Analyze the role nurses play in improving health care quality and safety through the use of evidence-based practice (EBP). How do you see this role being applied in your workplace? What internal stakeholder perspectives would you need to consider, including stakeholder support, in order to successfully implement an EBP project in your workplace?
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN Discussion Question Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
Final Draft – Research Critiques and Evidence-Based Practice Proposal
The purpose of this assignment is to incorporate the instructor-recommended revisions or changes from the Topic 3 “Rough Draft – Research Critiques and Evidence-Based Practice Proposal” to develop a 1,500-1,750- word final draft.
Use the “Research Critiques and Evidence-Based Practice Proposal Guidelines” document to organize your essay. Questions under each heading should be addressed in the structure of a formal paper.
You are required to cite a minimum of four peer-reviewed sources to complete this assignment. Sources must be published within the past 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
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.
