Research-Based Nursing Practice Poster Proposal: Botox

This assignment is a research-based poster proposal focusing on the use of Botox therapy for individuals over 65 residing in long-term care facilities. The student addresses a clinical question using the PICO format, investigating Botox injections for muscle stiffness compared to leg braces or non-surgical options, with the outcome of alleviating pain and muscle tenderness. The proposal details the search strategy, including databases like PubMed and CINAHL, keywords, and inclusion/exclusion criteria. Critical annotations of relevant studies, such as those by Jankovic (2018) and Shaikh et al. (2016), are provided to support the research. The appendices summarize the search strategies and results from various databases. The project aims to contribute to evidence-based nursing practice by exploring the therapeutic potential of Botox in managing muscle-related symptoms in the geriatric population. This assignment showcases the student's ability to identify a research question, conduct a literature search, and critically appraise evidence relevant to clinical practice.

Running Head: POSTER PROPOSAL
POSTER PROPOSAL
Name of the Student
Name of the University
Author’s Note

1POSTER PROPOSAL
The clinical question for this poster under the PICO format is:
P- Population/patient: The use of Botox therapy for people above the age of 65 in long term care
facility (LTC).
I-Intervention: Botox injection for muscle stiffness.
C- Comparison/Control: Leg brace, not a candidate for surgery.
O- Outcome: Alleviate pain and muscle tenderness during care.
Search Strategy
The topic was chosen after searching for several nursing literature databases that was related to
the area of specialization. The search terms were used, such as Botulinum, geriatrics, evidence
based practice, nursing practice, Botox therapy, muscle contractions in old age, treatment for
muscle contraction, PICO format for clinical research, spasticity and nursing interventions in
geriatrics. The databases used were Pubmed, CINAHL, CNA, Canadian Journal of Nursing
Research and The National Nursing Database (NCSBN) that gave the topic for research.
The results which were collected gave the idea that Botox is used for several cosmetic
procedures, which includes the injections of botulinum toxin type A also known as BTX-A that
is used widely for the cosmetic related treatments in Canada and USA. It got legally approved
after it was verified by Food and Drug Administration (FDA) for the treatment of glabellar lines.
It is an appreciated route of treatment because it is minimally invasive, easy to administer and
with a quick recovery speed. The filters used were 2014-2019 and the country chosen was
Canada. The criteria that excluded the papers in the review was if the paper focused on other
treatment procedures other than the muscle contraction in older people.

2POSTER PROPOSAL
Critical annotations
Jankovic, J. (2018). An update on new and unique uses of botulinum toxin in movement
disorders. Toxicon, 147, 84-88.
The use of botulinum toxin is used in several therapeutic treatments after it is was approved by
FDA in 1989. It is utilized for the treatment of several movement disorders such as bruxism,
oromandibular dystonia, anterocollis, tremors, levodopa-induced dyskinesia, tardives and restless
leg syndrome. There are several benefits for the patient when it comes to the treatment of such
conditions as it is considered to be safe.
Shaikh, A., Phadke, C. P., Ismail, F., & Boulias, C. (2016). Relationship between botulinum
toxin, spasticity, and pain: a survey of patient perception. Canadian Journal of
Neurological Sciences, 43(2), 311-315.
This study focuses on the use of botulinum toxin type A (BoNTA) for the pain management in
people who have the issue of spasticity. The result of the research justifies that the pain related to
the movement disorders can be treated if BoNTA treatment is used such as the injection.
Kinnear, B. Z., Lannin, N. A., Cusick, A., Harvey, L. A., & Rawicki, B. (2014).
Rehabilitation therapies after botulinum toxin-A injection to manage limb spasticity: a
systematic review. Physical therapy, 94(11), 1569-1581.
Impairment in the central nervous system disorder causes spasm in people, which is a motor
disorder that affects the reflexes and muscle tones. The use of traditional rehabilitation for
spasticity are pharmacotherapy such as botulinum toxin A, occupational therapy and physical
therapy.

3POSTER PROPOSAL
Mills, R., Bahroo, L., & Pagan, F. (2015). An update on the use of botulinum toxin therapy
in Parkinson’s disease. Current neurology and neuroscience reports, 15(1), 511.
Botulinum toxin therapy has been a popular treatment for neurological disorders. One of them in
Parkinson’s disease that is a complex neurodegenerative disorder that seen with the help of
motor and non-motor symptoms. The use of BoNT is used for the therapeutic treatment of
Parkinson’s and disorders related to it.
Mittal, S. O., Machado, D., Richardson, D., Dubey, D., & Jabbari, B. (2018). Botulinum
toxin in restless legs syndrome—A randomized double-blind placebo-controlled crossover
study. Toxins, 10(10), 401.
Restless leg syndrome is a common issue seen in people above the age of 60 as it is caused due
to neuromuscular disorders. The use of Botox therapy has been useful for such patients as seen in
the randomized double blind study because it has certain compounds that helps in treating such
conditions.

4POSTER PROPOSAL
Appendices
Database
Searched
Date
Searched
Search Strategy
Used
(Keywords, phrases,
subject terms)
Limits
(Date range,
language)
No. Results
PubMed 30-12-19 PICO Format,
geriatrics, Botox
therapy.
2014-2019
English
10
CINAHL 1-1-2020 Botulinum toxin,
spasticity, nursing
care.
2014-2019
English
8
Canadian
Journal of
Nursing
Research
30-12-19 Evidence based
practice, geriatrics,
spasticity
2014-2019
English
11
The National
Nursing
Database
(NCSBN)
2-1-2020 Botulinum toxin,
PICO format,
geriatrics.
2014-2019
English
7

5POSTER PROPOSAL
Boolean operators
Keywords Keyword Keyword Keyword
Keyword 1 Botulinum
toxin
Botox
Therapy
Boolean AND
Keyword 2 Spasticity OR Muscle
contraction
Boolean AND
Keyword 3 geriatrics OR Palliative
care
Boolean AND
Keyword 4 Evidence
based
practice
AND Nursing care
for old age
Factors Inclusion Criteria Exclusion Criteria
Years 2014-2019 Articles published before 2014
Type of Articles Peer-reviewed Non peer reviewed
Language English Language other than English

6POSTER PROPOSAL
Types of articles Primary and secondary Grey literatures and websites