(Solution) NR585NP Week 5 Assignment Literature Summary

NR585NP Week 5 Assignment Literature Summary

Preparing the Assignment

Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.

General Instructions

  1. Select and review five research articles related to the practice issue and proposed intervention of your PICOT question developed in Week 2. These articles may include quantitative, qualitative, or mixed methods studies (original research), systematic reviews, meta-analyses, or meta-syntheses (synthesis), or clinical practice guidelines (CPGs).
  2. Download the Week 5 Literature Summary TemplateLinks to an external site.Open this document with ReadSpeaker docReader to complete the assignment. Use of the template is required. A 10% deduction will be applied if the template is not used. See the rubric. Save the template and include your name in the file name.
  3. Select the correct table for each of the five articles and complete the Literature Summary Template with one table for each selected article.
  4. Follow APA grammar, spelling, word usage, and punctuation rules consistent with formal, scholarly writing.
  5. Abide by Chamberlain University’s academic integrity policy.

Include the following sections (detailed criteria listed below and in the grading rubric).

  1. State the PICOT statement from Week 2, including:
    1. Population
    2. Intervention
    3. Comparison
    4. Outcome
    5. Timeframe
    6. Use standard PICOT format and label each element
  2. For each article, identify the correct table and complete with the information appropriate for the type of article selected, including
    1. Full APA reference and Chamberlain Library permalink
    2. Purpose
    3. Methods/search strategy/systematic review of literature
    4. Sample and participants/discussion of inclusion criteria/stakeholders and peer review
    5. Findings
    6. Limitations/strength of recommendations
    7. Relevance to the identified practice issue or proposed intervention
  3. Ensure each article meets the following
    1. Article is published in a peer-reviewed, provider-focused journal or is a current clinical practice guideline
    2. Publication date is current within five years

Solution:NR585NP Week 5 Assignment Literature Summary

PICOT Statement
In postoperative adult surgical patients (Population), how does ERAS protocol (Intervention) compared to standard opioid-centered pain management (Comparison) affect postoperative pain levels (Outcomes) within 8 weeks post-surgery (Time)?

 

 

Original Research Articles
Full reference for article (APA Format) and Chamberlain University hyperlink Townsend, W. B., Worrilow, W. M., Robinson, M. M., Beano, H., Parker, B., Gaston, K. E., Clark, P. E., & Riggs, S. B. (2020). Implementation of a dedicated enhanced recovery after surgery (ERAS) program for radical cystectomy patients is associated with decreased postoperative inpatient opioid usage and pain scores. Urology, 143, 186-193. https://doi.org/10.1016/j.urology.2020.04.110
Purpose and Type of Research The study aimed to measure differences in postoperative opioid usage and pain scores between pre- and post-ERAS radical cystectomy patients. This is a quantitative retrospective cohort study.
Methods A retrospective cohort study design was used, comparing 86 pre-ERAS and 108 post-ERAS patients from a single institution. Primary endpoints included total mean opioid usage (MEDD) and mean pain scores (VAS) on postoperative days 1-3.
Sample and Participants The study included adult patients (age ≥18) who underwent radical cystectomy at a single institution from January 1, 2015, to July 31, 2018. Patients who had salvage cystectomies or cystectomies for benign causes were excluded.
Study Findings Post-ERAS patients had significantly lower mean opioid usage (32.90 MEDD vs. 99.86 MEDD, P ≤ .001) and lower mean pain scores (3.51 vs. 4.17, P = .003) across postoperative days 1-3. The median number of opioid pills prescribed at discharge was also lower in the post-ERAS group (30 vs. 45 pills, P = .046).
Limitations of the Study Limitations include the retrospective nature of the study, potential selection bias, a relatively small sample size, and the possibility of temporal trends impacting opioid usage due to increased awareness among the healthcare team.
Relevance to Practice Issue or Proposed Intervention The findings support the implementation of ERAS protocols to minimize opioid use and improve pain management in postoperative patients, addressing the opioid crisis and enhancing patient recovery.

 

Original Research Articles
Full reference for article (APA Format) and Chamberlain University hyperlink Weston, E., Noel, M., Douglas, K., Terrones, K., Grumbine, F., Stone, R., & Levinson, K. (2020). The impact of an enhanced recovery after minimally invasive surgery program on opioid use in gynecologic oncology patients undergoing hysterectomy. Gynecologic Oncology, 157(1), 176-182. https://doi.org/10.1016/j.ygyno.2020.01.041
Purpose and Type of Research The purpose of this study was to evaluate the effects of an enhanced recovery after minimally invasive surgery (MIS-ERAS) protocol on opioid requirements and postoperative pain levels in gynecologic oncology patients undergoing minimally invasive hysterectomy. This is a quantitative retrospective cohort study.
Methods This study compared opioid use and postoperative pain scores between patients who underwent minimally invasive hysterectomy before and after the implementation of the MIS-ERAS protocol. The study used statistical analyses, including Wilcoxon Rank Sum, Student’s t-test, and multiple linear regression to compare outcomes between groups.
Sample and Participants The MIS-ERAS cohort included 127 patients who underwent minimally invasive hysterectomy after protocol implementation, while a historical control group of 99 patients was used for comparison. Exclusion criteria included patients with chronic opioid use or chronic pain.
Study Findings ·      The MIS-ERAS cohort showed a median intra-operative opioid use of 12.0 OME compared to 32.0 OME in the control group (p < .0001).

·      Post-operative opioid use was also lower in the MIS-ERAS group (20.0 OME vs. 35.0 OME, p = .02).

·      Pain scores were significantly lower in the MIS-ERAS group (mean score of 3.6 vs. 4.1, p = .03).

·      Compliance with the protocol exceeded 75% overall.

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