Understanding Research Concepts in Evidence-Based Nursing

92440 EVIDENCE FOR NURSING
Assessment Item 2: Understanding research concepts Weight: 35% of overall mark
PART ONE: Contribution to Week 3 and Week 4 Discussion Forums (6 marks)
PART TWO: General content questions (7 marks)
One of the underlying concepts explored through this subject was conveying broad clinical scenarios and questions
to searchable questions and using refined search terms to extract data.
1. Why is it important to use short search terms in database search instead of long descriptive sentences?
(Max 30 words, 1 mark)
Short terms find information relevant to the search because databases are indexed. Long sentences make
the databases search for every word in the sentence which brings unexpected results.
2. Why is it important to use specific search terms in database search instead of broad search terms (Max 30
words 1 mark).
Specific search terms only literature that has the term in the search and has few specific results. Broad
search terms return many articles even including the less the relevant ones.
3. Describe the relationship between the two frameworks that underpin this subject: Tanner’s Model of
Clinical Judgement and Evidence Based Practice? (Max 150 words, 3 marks)
Tanner’s Model of Clinical judgment summarizes an approach to handling health situations. It explains how
health concerns, patients' needs problems and decision for care approach should be taken. This model
highlights the importance of simulation in the enhancement of clinical judgment skills and capabilities. It
emphasizes that clinical judgments require critical thinking creativity and decision making. This research-
based model of highlights the main components as notice, interpretation, response, and reflection.
Evidence-Based Practice (EBP) is an approach that uses current nest evidence conscientiously, explicitly and
judiciously in formulating clinical decisions. It is the integration of the clinical skills to the best possible
external evidence. EBP integrates the clinical expertise, consumers' values, and the reliable research
evidence in the decision-making process. Clinicians bring their expertise, education, then integrates it with
consumers' encounter and lived experience, preferences, unique strengths, expectations, concerns, values,
and beliefs.
4. Describe the purpose of a systematic review compared to a single randomised controlled trial? (Max 50
words, 2 marks)
A systematic review is centered towards a particular clinical topic aiming to provide a specific answer. The
authors search extensively for studies underpinning the topic, review and assess their quality summarizing
the findings in a predetermined manner as per the question. Randomized control trials are experimental,
and they involve practical studies on real patients to identify the outcome
PART THREEE: Research methodology and results (17 marks)
92440 Evidence for Nursing Assessment 2: Understanding research concepts 1

CASE STUDY 1: Read the article carried out by Byrne et al. (2017). A copy of this article is in Assessment 2 folder.
5. What is the benefit of using randomised control trail study design in this study? (1 mark)
Some of the advantages of using randomization method in this study was to eliminate any changes of bias. The
blinding during the data collection minimised the performance bias. The allocation concealment minimised the bias
that could have occurred as assessment or performance bias. The prospective design helped to minimize recall
errors and bias in the selection. Randomization also helped in eliminating confounding factors that could have been
caused by unequal distribution of predictive factors, and it made comparison easier.
6. What are the study’s primary and secondary outcomes? (2 marks)
The first primary outcome was the discharge time which was not significant with or without adjustment of the
surgery. The scores between the groups were (5.8 days) for the chewing group and (6.1 days) for non-chewing
group. Another outcome was the first flatus time. Again, there was no significant different between the two groups
where both scored (P = 0.076): 42.0 (2.9) for chewing group and 58.0 (8.2) non-chewing group. The score was still
not significant after adjusting the surgery type. The last primary outcome was first bowel motion (TBM).
The TBM of the chewing group was 50.0 hours (2.4) and that of non-chewing group 80.0 hours (6.5) which was
significantly lower. There was also a significant decrease in TBM after surgery type adjustment.
Secondary outcomes were complication rates, pain and total morphine equivalent (TMEq) medication for seven days
after the procedure.
One of the secondary outcomes were complication rates. Intraoperative complication from the CG was 7 (9%) and 7
(9%) from the NCG. Early postoperative complication was 36 (44%) for CG and 42 (55%) for NCG. The NCG has 13
patients (17%) with recurrent ileus compared to eight (10%) CG. Reoperation was 3 (4%) patients for NCG and (0) for
CG. Another outcome was in medication where there was no variance in total morphine equivalent for 24 hours.
However, CG had significant reduction of morphine equivalents between day 2-7 post procedure. Another outcome
was pain scores which were higher in patients who had no bowel event in NCG than CG.
7. How did the researchers assess pain? (1 mark)
Pain was first recorded though a paper-based case report form (CRF). The patients reported pain scores were only
recorded until the patient’s TBM. Pain was assessed through a scale of 0-10 with 0 being no pain and 10 the most
extreme pain.
8. Has the study used an adequate sample size? (Justify your answer, 1.5 marks)
The study adequately used the sample size. For instance, the prospective design allowed the researchers to watch
the outcome as the patient’s recovery progress. This design also helped the researchers to the profess with other
factors. With this design, they were able to sufficiently select, allocate and administer the chewing gums to the
treatment group and monitor the development by comparing with the control group. The study was also able to
eliminate bias, succeeded in the blinding, and the observations were consistent.
9. What important baseline differences between intervention and control group participants exist that may affect
the study results? (2 mark)
The important difference that in the baseline that could have affected the study was the considerable difference
while allocating groups from the randomisation. The study had 43% patients in the CG group who had ileostomy
closures while the NCG had 25% patients of ileostomy. An ileostomy closure is a minor surgery for closing the
ileostomy temporary. This resection is less painful, needs less amount of analgesia and the patient gets quick gut
recovery than other surgeries colectomy. Since there was variance in such procedures, this could have also affected
the pain and recovery assessments.
10: how is the patients’ lack of blindness to their group allocation likely to affect the study results (1.5 marks)?
The purpose of blinding is to reduce and where possible eliminate both the ascertainment and performance that
may occur after randomization. The failure to blind patients can have great effects on the trial since they will have
the knowledge of different group assignments. This awareness affects greatly affect the patient’s behaviour during
92440 Evidence for Nursing Assessment 2: Understanding research concepts 2