Nursing Matrices for PICOT Question Research Paper

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MatrixAPA Citation:Pannucci, C. J., Dreszer, G., Wachtman, C. F., Bailey, S. H., Portschy, P. R., Hamill, J. B., ... & Pusic, A. L. (2011). Post-operative enoxaparin prevents symptomatic venous thromboembolism in high-risk plastic surgery patients. Plastic and reconstructive surgery, 128(5), 1093.Variable and key concepts· Acknowledges that VTE is a significant patient safety issue, hence the need for the Venous Thromboembolism Prevention Study looking specifically at post-operative treatment of plastic surgery patients as they are at times more vulnerable to VTE.· List the important points of the article, variables, framework, and concepts mentioned.· The hypothesis was implied.· The research question was: does the enoxaparin have an impact in thwarting the symptoms and manifestation of VTE in patients after undergoing plastic surgery? It was clearly stated.Sampling· The participants were plastic surgery patients, post operation.· There were 3334 patients included in the study: 1876 control and 1458 enoxaparin patients.· The participants were all over 18 had been given general anesthesia and has post-operative stay in a hospital.· No patients dropped out.Design and Method· The research was a quantitative study that focused on giving patients with a Caprini score of 3 or higher enoxaparin prophylaxis after surgery and for the remainder of the time they were in the hospital. The control group was a historic group of patients who had undergone operations between 2006-2008 but had not received any chemoprophylaxis for two months post-surgery.· Quantitative study· It was appropriate to answer the question, given what a concern VTE is to the medical community.Instruments/Data Collection· The data collected found that there was a marked minimization in risk with patients who had Caprini scores of 8 and between 7 and 8, when they were given the post-operative enoxaparin.· The data was sufficient.· Observation and data recording were the tools used.· The instruments selected were valid.Results· The data found that enoxaparin is effective in preventing VTE, at least with patients who have undergone plastic surgery, so it does offer promise for hip replacement surgery patients.· The study results are what I expected.· The study results to make sense.Strengths & LimitationsStrengths:· The strengths of the study orbited around the large sample size.· The study did show a statistical difference that was supported by data.· Limitations: The study was just limited to plastic surgery patients.CritiqueThe study was very specific, but still very worthwhile and can be used for my literature review. The researchers could have done much more explaining about their research in order to strengthen the study, but it was largely easy to understand and all elements of it made lucid sense.APA Citation:Pannucci, C. J., Wachtman, C. F., Dreszer, G., Bailey, S. H., Portschy, P. R., Hamill, J. B., ... & Pusic, A. L. (2012). The effect of post-operative enoxaparin on risk for re-operative hematoma. Plastic and reconstructive surgery, 129(1), 160.Variable and key concepts· While this study doesn’t look at VTE specifically, it does seek to determine the impact of enoxaparin in preventing post-operative uncontrolled bleeding.· The hypothesis was implied.· The research question was clearly stated and it was: whether receiving post-operative enoxaparin prophylaxis impacted the rates of 2-month re-operative hematoma.·Sampling· The participants were plastic surgery patients.· There were 3,681total participants: 2114 were in the control group and 1567 received the enoxaparin.· The study did not discuss the sampling plan.· There was no mention of patients dropping out.Design and Method· The research was designed as a quantitative study, gathering data through observation about the rate of hematomas in plastic surgery patients when compared to a historic control group.· It was appropriate to answer the question because its important to know how effective or not effective enoxaparin is in reducing bleeding.Instruments/Data Collection· Complete data was available for 3,681 patients was available in the study and the data collected recorded the rates of re-operative hematomas in comparison to control groups, for example 3.38% vs. 2.65%.· The data was reasonably sufficient.· The instrument used was simply observation and recording the rates of hematomas in the participant group.

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· The instrumentation was valid.Results· The results showed no compelling impact of the enoxaparin upon the rate of hematomas.· This was not at all what I expected.· The results don’t quite make sense.Strengths & LimitationsStrengths:· The strengths of the study were that it had a very large sample size to compare the control and experimental groups.·…

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…versus enoxaparin for thromboprophylaxis in medically ill patients. New England Journal of Medicine, 365(23), 2167-2177.Variable and key concepts· The authors of the study wanted to determine the success of using apixaban versus enoxaparin in medically ill patients after they are discharged from the hospital with the intent of preventing VTE.· The hypothesis is mostly stated, as the researchers think apixaban will be more effective.· The research question is clearly stated and seeks to examine the effectiveness of using apixaban as a means of prolonging prophylaxis after hospital discharge rather than enoxaparin.Sampling· The participants were patients who suffered from serious conditions like congestive heart failure or comparable conditions that might provoke VTE.· 6528 were engaged in the process of randomization with ultimately 4495 selected, 2211 that received apixaban and 2284 that received enoxaparin.· The researchers did not describe the sampling plan in great detail.· No participants dropped out.Design and Method· The research design was a “…double-blind, double-dummy, placebo-controlled trial” that focused on the reactions of severely ill patients.· The study was quantitative.· It was appropriate to answer the question to determine the overall effectiveness of these two substances in comparison.Instruments/Data Collection· The data collected was robust and spoke to the overall efficacy of enoxaparin: at the end of one month significant bleeding had occurred in 0.47% of patients who had been given apixaban versus 0.19% of the patients given enoxaparin.· The data was robust and efficient.· The instrument used was observation and data collection, which was valid.Results· The results showed the superiority of enoxaparin over apixaban.· This is not what I expected, and while it makes sense given the rules of science, I was very surprised.Strengths & LimitationsStrengths:· The strengths of the study were the large sample size and the rigorous way the study was implemented.· A statistical difference was shown and supported by data.Limitations:The limitations of the study were that it just looked at really sick people, not quite offering a sense of how these two drugs would manifest in people who are having surgery and in relatively good health.CritiqueThe study was well orchestrated and comprehensive. I can use it for my literature review because it is….....

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