Evidence-Based Practice: Pain Management in PACU Using Music Therapy

This assignment focuses on evidence-based practice for improving pain management in the Post-Anesthesia Care Unit (PACU). It addresses the use of non-pharmacological methods, specifically music therapy, as an adjunct to pain medication to increase patient satisfaction. The assignment develops a research question using the PICO(T) framework, outlining the population, intervention, comparison, outcome, and timeframe. It identifies CINAHL and MEDLINE as relevant databases for literature search and details a search strategy using subject headings and Boolean operators. The aim is to gather evidence supporting the effectiveness of music therapy in enhancing patient satisfaction within the PACU setting, ultimately contributing to improved pain management practices.

Running head: ASSESSMENT 2
Evidence-Based Practice
Name of the Student
Name of the University
Author Note

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Introduction
Post-Anesthesia Care Units typically comprise of patients who are admitted
temporarily, following any surgical procedure and forms a vital component of medical
facilities and hospitals (Potestio et al., 2015). Pain management is imperative for providing a
relief from the signs and symptoms of nociception (Gatchel et al., 2014). However, treatment
of pain is commonly complex and also results in adverse impacts, when not monitored and
administered in an appropriate manner. In addition, there are two main types of pain
management namely, opioid treatment and non-opioid treatment that are implemented for
reducing pain severity. This assignment will develop a research question by using PICO(T)
framework for effective pain management.
PICO (T) question and its components
According to Straus et al. (2018) the commonly accepted definition of evidence based
practice (EBP) encompasses the explicit, judicious and conscientious usage of best available
and contemporary evidences that help in making decisions realted to the care of particular
patients. In other words, integration of clinical expertise with evidences that are best available
helps in conducting a systematic research. Non-pharmacological management of pain
involves treatment without the administration of medications and utilises different methods
such as, psychological conditioning, education, hypnosis, comfort therapy, neurostimulation,
occupational and physical therapy, and counselling (Koh, Nguyen & Jahr, 2015). Time and
again it has been proved that the initial step for evidence based practice is to formulate a
clinical question that is searchable and answerable (LoBiondo-Wood & Haber, 2017).
Failure to formulate such an accountable question makes the entire practice of
research flawed. The PICOT framework will be utilised for creating a research question that
would focus on an aspect of non-pharmacological pain management. The PICOT question

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framework can be described as a consistent formula that facilitates retrieving scholarly pieces
of evidences that are pertinent to the research phenomenon under investigation (Echevarria &
Walker, 2014). The different components of the framework are presented below:
Component Question element Description
P Patients admitted to Post-
Anesthesia Care Unit
(PACU)
The population or person on
is interested in, in order to
effectively manage some
health abnormality. Cautious
consideration of the setting
and patient of interest is
essential
I Music therapy The strategy that is expected
to bring about a difference
in the selected population.
With an increase in
specificity of the
intervention, the search
becomes more focused
C Pharmacological treatment
for pain management
Comparison is typically
measured against the chosen
intervention and can
comprise of either placebo
or true control
O Increased patient satisfaction This is typically considered
the end point of a research

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where the outcomes are
identified, thereby assisting
the researcher to locate
evidences relevant to the
research question
T 1-2 months It denotes the time required
for the chosen intervention
to accomplish a definite
outcome in the target
population
Table 1- PICO(T) framework for developing a research question
Following the aforementioned PICO(T) framework facilitated the development of a
research question for evidence based practice that is given below:
Does application of music therapy for 1-2 months, as a non-pharmacological
intervention, increase satisfaction among patients admitted to Post-Anesthesia Care Unit?
Databases to be used
There are a large quantity of electronic databases and search engines that are available
for probing relevant pieces of scholarly evidences. While there are a plethora of electronic
databases that provide a complete search function in an unrestricted manner, others have a
controlled level of evidence probing and often offer an all-inclusive search function based on
subscription. Two databases that will be selected for conducting the literature search are
namely, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Medical
Literature Analysis and Retrieval System Online (MEDLINE). Relevant articles published in

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English, on or after 2014 that contain information, in relation to the aforementioned research
question will be selected from the databases, for gaining evidence.
Search strategy
The CINAHL database has been selected for explaining the search strategy that will
facilitate procurement of literature related to the effects of music therapy in increasing PACU
patient satisfaction (Wright, Golder & Lewis-Light, 2015). Usage of subject headings will
form the initial step of database search. Searching with the use of these headings will also
facilitate retrieval of all important references on the topic, regardless of the words that have
been used. After obtaining a list of subject headings, those headings that best match the
intended meaning of the research to be conducted will be selected. Other relevant terms will
also be searched for later, owing to the fact that CINAHL database does not search multiple
headings related to a subject at once.
The tree structure obtained in the webpage will denote the headings, in relation to
more specified or general concepts. Presence of subheadings will further narrow down the
search to precise aspects of the research concept. Following selection of the search term and
clicking on ‘search database’ option, the first hit of results will be generated. The concepts
will be combined by using boolean operators AND and OR that will either broaden or narrow
down the results (McGowan et al., 2016). The search results will be refined by selecting the
publication date range (2014-2019), and source type (academic journals). The results will be
limited by clicking on the checklists for ‘human’, ‘English’, and ‘peer reviewed’. The results
can be sorted from the blue navigation box, based on their relevance or journal. On pointing
the mouse over the symbol of magnifying glass, the abstract of the displayed articles will be
presented. The full texts of articles displayed in the database can be retrieved by clicking on
the ‘PDF Full Text’ or ‘HTML’ link. The search table is provided in appendix.

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Conclusion
To conclude, onset and progress of pain is most often frustrating and debilitating and
interferes with the activities of daily living. Prior to preparing the search, the research
question will be broken down into significant concepts. By following the aforementioned
strategies a comprehensive list of articles, relevant to the PICO(T) framework will be
obtained.

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References
Echevarria, I. M., & Walker, S. (2014). To make your case, start with a PICOT
question. Nursing2018, 44(2), 18-19.
Gatchel, R. J., McGeary, D. D., McGeary, C. A., & Lippe, B. (2014). Interdisciplinary
chronic pain management: past, present, and future. American Psychologist, 69(2),
119.
Koh, W., Nguyen, K. P., & Jahr, J. S. (2015). Intravenous non-opioid analgesia for peri-and
postoperative pain management: a scientific review of intravenous acetaminophen and
ibuprofen. Korean journal of anesthesiology, 68(1), 3.
LoBiondo-Wood, G., & Haber, J. (2017). Nursing research: Methods and critical appraisal
for evidence-based practice. Elsevier Health Sciences.
McGowan, J., Sampson, M., Salzwedel, D. M., Cogo, E., Foerster, V., & Lefebvre, C.
(2016). PRESS peer review of electronic search strategies: 2015 guideline
statement. Journal of clinical epidemiology, 75, 40-46.
Potestio, C., Mottla, J., Kelley, E., & DeGroot, K. (2015). Improving post anesthesia care unit
(PACU) handoff by implementing a succinct checklist. APSF Newsletter, 30(1), 13-
15.
Straus, S. E., Glasziou, P., Richardson, W. S., & Haynes, R. B. (2018). Evidence-based
medicine: how to practice and teach EBM. Elsevier Health Sciences.
Wright, K., Golder, S., & Lewis-Light, K. (2015). What value is the CINAHL database when
searching for systematic reviews of qualitative studies?. Systematic reviews, 4(1), 104.

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Appendix
Search Terms
S1 ‘music therapy’, ‘sound’, ‘harmony’,
‘rehabilitation’
S2 ‘pain’, ‘management’, ‘treatment’, ‘ache’,
‘cure’
S3 ‘patient’, ‘client’, ‘satisfaction’,
‘contentment’
S4 Combine S1 terms with OR
S5 Combine S2 terms with OR
S6 Combine S3 terms with OR
S7 S1 AND S2
S8 S1 AND S3
S9 S1 AND S2 AND S3
S10 Published date 2014/01-2019/03
S11 Published language English
S12 Peer reviewed articles
Table- Search table

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Figure 1

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Figure 2

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Figure 3