The Assignment (Evidence-Based Project)
Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
Create a 6- to 7-slide PowerPoint presentation in which you do the following:
· briefly describe your chosen clinical issue of interest: Postoperative Nausea and Vomiting.
· Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
· Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
· Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
· Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.
Detailed Instructions:
This Assignment needs to be based on this specific Discussion Post.
PICO(T) Question
PONV is a frequent problem affecting surgical patients causing significant issues with recovery. Using ondansetron as a selective serotonin 5-HT3 receptor antagonist can effectively prevent PONV (Jin et al., 2020). Ondansetron works by reducing the serotonin receptors within the gastrointestinal tract and the CNS that cause nausea and vomiting (Ashour, 2023). Several research investigations have shown that ondansetron effectively decreases PONV incidence when administered before and/or at the time of first PONV occurs. A systematic review pointed out that ondansetron reduces the incidences of nausea and vomiting in several types of surgical operations, especially for patients at elevated risk as those during laparoscopic surgery (Wu et al., 2023). A meta-analysis shows that ondansetron significantly reduces PONV compared to placebo, highlighting its position as the first-line agent in multimodal antiemetic management (Singh et al., 2023). This intervention not only helps relieve the patient’s discomfort and pain but also helps speed recovery time and the patient’s satisfaction level.
PICOT Question: In adult surgical patients (P), how does the administration of ondansetron before or during the onset of postoperative nausea and vomiting (I) compared to a placebo or no antiemetic intervention (C) affect the incidence of postoperative nausea and vomiting (O) within the immediate postoperative recovery period (T)?
In collecting evidence, I performed a database search in the Walden Library using PubMed and CINAHL databases. I started with the general symptoms such as “PONV” and “postoperative nausea” as a search criterion, which produced over 600 articles. I used Boolean operators to narrow further and included detailed terms, including “ondansetron,” an antiemetic, and “intervention.” This adjustment brought the number of results down to approximately 250 articles. I filtered the articles to be peer reviewed and selecting articles that are original research conducted within the last five years. I found four studies investigating the effectiveness of ondansetron in alleviating PONV.
To be more efficient, I will use Medical Subject Headings (MeSH). For instance, if I choose “nausea,” “vomiting,” and “ondansetron” as the MeSH terms, the search results will be more precise. Furthermore, using other databases such as Cochrane Library and Embase could help define a wider variety of studies that could include international data regarding PONV interventions.
References
Ashour, A. M. (2023). The preventive effects of ondansetron on chemotherapy-induced nausea and vomiting in adult cancer patients: Systematic review from ClinicalTrials.Gov. Frontiers in Pharmacology, 14, 1310455. https://doi.org/10.3389/fphar.2023.1310455
Jin, Z., Gan, T. J., & Bergese, S. D. (2020). Prevention and treatment of postoperative nausea and vomiting (PONV): a review of current recommendations and emerging therapies. Therapeutics and Clinical Risk Management, 1305-1317. https://www.tandfonline.com/doi/full/10.2147/TCRM.S256234#d1e168
Singh, K., Jain, A., Panchal, I., Madan, H., Gupta, A., Sharma, A., Gupta, S., Kostojchin, A., Singh, A., Sandhu, I. S., Mittal, J., Bhogal, L., Kolli, S. T., Bejugam, V. R., Chaturvedi, S., Bhalla, A., & Piplani, S. (2023). Ondansetron-induced QT prolongation among various age groups: A systematic review and meta-analysis. The Egyptian Heart Journal, 75(1), 1–11. https://doi.org/10.1186/s43044-023-00385-y
Wu, G., Ma, Y., Wei, W., Zeng, J., Han, Y., Song, Y., Wang, Z., & Qian, W. (2023). Ondansetron: Recommended antiemetics for patients with acute pancreatitis? A population-based study. Frontiers in Pharmacology, 14, 1155391. https://doi.org/10.3389/fphar.2023.1155391
The Assignment (Evidence-Based Project)
Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
Create a 6- to 7-slide PowerPoint presentation in which you do the following:
· briefly describe your chosen clinical issue of interest: Postoperative Nausea and Vomiting.
· Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
· Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
· Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
· Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.
How to setup each slide
This assignment will be an approximately 7 slide ppt presentation. Use these suggestions for your slides:
1. title slide with your name, course, date, etc
2. Introduction and purpose for your inquiry
3. PICO(T) question. Please identify P.I.C.O. and T
My P.I.C.O and T question:
PICOT Question: In adult surgical patients (P), how does the administration of ondansetron before or during the onset of postoperative nausea and vomiting (I) compared to a placebo or no antiemetic intervention (C) affect the incidence of postoperative nausea and vomiting (O) within the immediate postoperative recovery period (T)?
4. The 4 databases you used for your search (You may have new ideas following the suggestions in the forum. Articles should provide RESEARCH for the INTERVENTION you have selected for your inquiry and not just genera in nature. Did the intervention you proposed influence the outcome you named? If you do not already have 4 articles with this detail you will need to search again) You need to USE four databases but your articles no not need to be from each of the 4 databases
5. For each of 4 research articles pertaining to your idea give a brief notation of the level of evidence (your articles should be systematic reviews or highest level of evidence possible). On this slide also be sure to mention the benefit of using a systematic review, even if you do not have a source utilizing one. These articles may be the same as you used for the past assignment if they fit. Some have had to change topics or variables, or your previous articles might not have been high levels of evidence, and therefore you may need new articles. There is reading about “level of evidence”. This is not the purpose or design of the study, it’s the numerical strength of the research and will be graded as level I through level V. Give rationale for your rating.
Here is a reminder of levels of evidence for you:
Level of evidence (LOE)
Description
Level 1:
Evidence from a systematic review or meta-analysis of all relevant RCTs (randomized controlled trial) or evidence-based clinical practice guidelines based on systematic reviews of RCTs or three or more RCTs of good quality that have similar results.
Level II
Evidence obtained from at least one well-designed RCT (e.g. large multi-site RCT).
Level III
Evidence obtained from well-designed controlled trials without randomization (i.e. quasi-experimental).
Level IV
Evidence from well-designed case-control or cohort studies.
Level V
Evidence from systematic reviews of descriptive and qualitative studies (meta-synthesis).
Level VI
Evidence from a single descriptive or qualitative study.
Level VII
Evidence from the opinion of authorities and/or reports of expert committees.
6. Conclusion slide
7. A slide with all your resources typed in APA format (double spaced, indented, properly italicized where pertinent according to the new APA manual). You will have 4 references pertaining to research (cited in the ppt and referenced on last slide). The new APA manual does not use “retrieved” unless you include the date, nor typing of the city of publisher in references.