Evidence Based Clinical Question Search

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Evidence-Based Clinical Question Search Assignment


The purpose of this Assignment is to give you a practical application to implement your PICOT idea, supported by the evidence-based research you have obtained in during your systematic review. You will apply evidence-based research findings, discovered from your clinical question, and then integrate those to support your suggested change in nursing practice.


  1. Identify your refined PICOT question.
  2. Using PubMed and the Cochrane collaboration database, do a systematic review of your clinical question.
  3. Describe your systematic review and include an errors analysis.
  4. Determine an evidence-based quantitative article from the search that contains an evidence-based randomized control trial.
  5. Summarize the case study selected.
  6. Describe the study approach, sample size, and population studied.
  7. Apply the evidence from this review to your practice specifically in your overview.
  8. Evaluate the outcomes, identifying the validity and reliability.
  9. Discuss if the study contained any bias.
  10. Determine the level of evidence identified in the review.
  11. The length should be no less than 10 Pages in APA format.

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Assignment Requirements:

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  • use APA 6th edition format

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Explanation & Answer



Evidence-Based Clinical Question Search Assignment
Institutional Affiliation




Refined PICOT question
Pain management has become one of the defining issues of our time. In the United States,
more than 70 million people undergo surgery and studies have established that 80 percent
experience acute postoperative pain. The PICOT question focused in this paper is to examine the
effectiveness of Patient Controlled Analgesia (PCA) in helping to reduce the postoperative
complications as compared to the use of intermittent nurse administered injections within the
healing duration after surgery.
PubMed and Cochrane Systematic review
The systematic reviews of PubMed and Cochrane mainly involve analyzing the type of
study, inclusion and exclusion criteria, study selection, data extraction and quality assessment,
data analysis, heterogeneity, and interpretation and reporting results. The type of study employed
is randomized controlled trials. The inclusion and exclusion are determined based on PCA
patients and those receiving intermittent dosing. Those receiving PCA are included in the study
whereas patients receiving intermittent dosing are excluded.
Cochrane Library
In a well-researched randomized controlled trials (RCTs) conducted by McNicol,
Ferguson & Hudcova (2015) to evaluate the safety and efficacy of Patient Controlled Analgesia
(PCA) versus non-patient controlled opioid analgesia, Cochrane Central Register of Controlled
Trials (CENTRAL 2014), MEDLINE for (1967 to 2015, January 28) and EMBASE (1981 to
January 28, 2015) were used as search methods. To extract reliable facts, the selection criteria for
RCTs was based on PCA without a continuous background infusion with intermittent nursed



administered opioid analgesia regimes. The study excluded studies that involved patients with
acute pain.
The RCTs conducted by McNicol, Ferguson & Hudcova (2015) relied on 49 studies with
1725 participants receiving PCA treatment and 1687 participants assigned to a controlled group.
The study found that patients receiving PCA had lower pain intensity scores as compared to
patients receiving intermittent nurse injections. Between a time spell of 0 to 24 hours, the
confidence interval (CI) was (95 percent (CI) -13 to 5, moderate quality evidence), whereas
between 0 to 48 hours the CI was (95 percent CI -12 to -7, lower quality evidence). The
outcomes give a clear indication that patients receiving PCA injections were satisfied.
PubMed Central
In a Randomized Controlled Trials (RCTs) conducted by Weibel et al (2017) to examine
the efficacy of PCA with remifentanil as compared to other parenteral methods for managing
pain in labor, 220 RCTs with 3569 women were included in the study. The results clearly
indicate that women receiving remifentanil PCA were satisfied as compared to those who were
receiving other opioids. The CI for the study was (95 percent CI 0.72, low-quality evidence) as
compared to CI (95 percent CI -0.40, lower quality evidence) for women receiving alternative
dosing. This evidence clearly supports the argument that the remifentanil PCA offer stronger
pain relief.
In the study conducted by Weibel et al (2017), RCTs and cluster-randomized trials
(CRTs) versus PCA with alternative opioids were used. To minimize the errors, a trial sequential
analysis was performed. On the safety perspective, the study found that there is limited on safety



aspects to both newborns and the women. There is no evidence that PCA was linked to risk for
newborns as compared to epidural analgesia (intermittent dosing).
Systematic review and error analysis
To minimize faulty errors that may render the entire study a sham, the systematic review

Awesome! Perfect study aid.


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