Module T1

Overview of Nursing Research

SESSION DELIVERABLE

1. Gather studies on evidence-based practice in nursing. Identify a study, (1) one for
each of the following:
a. Quantitative Research
 Quantitative EEG signatures of delirium and coma in mechanically
ventilated ICU patients
b. Qualitative Research
 Metasynthesis of Factors That Influence Parents’ Participation in Pain
Management for Their Infants in the NICU
1.1 Attach the downloaded files/ literatures on this deliverable template
mcnair2020.pdf
Quantitative-EEG-signatures-of-delirium-and-coma-in-mec_2023_Clinical-
Neurop.pdf
1.2 Answer the following:
1.2.1 Discuss each literature and how is it relevant to the nursing practice

A. Quantitative Research: “Quantitative EEG signatures of delirium and

coma in mechanically ventilated ICU patients”
The discussed literature highlights the use of quantitative EEG signatures for
assessing delirium and coma in mechanically ventilated ICU patients. Delirium's early
detection is crucial, and current methods rely on intermittent clinical evaluation. EEG
offers noninvasive neural assessment, with specific metrics aiding delirium
identification. This benefits nursing practice by aiding early intervention, aligning with
nurses' role in critical care. Continuous EEG monitoring is stressed to avoid missing
neural changes. Nurses can contribute by advocating for monitoring implementation
and participating in research for EEG validation. In essence, the literature emphasizes
EEG's potential in delirium assessment and guides nurses in its integration for
enhanced patient care.
 B. Qualitative Research: “Metasynthesis of Factors That Influence Parents’
Participation in Pain Management for Their Infants in the NICU”
The literature offers insights into factors influencing parental engagement in infant
pain management in the NICU. These insights are pertinent to nursing practice as they
guide effective parental support. One key finding underscores the necessity of
comprehensive education for parents to address knowledge gaps and empower
informed pain management decisions. Nurses can enhance parental confidence by
providing accurate information. Additionally, healthcare providers play a pivotal role in
facilitating parental involvement, and nurses can create a collaborative atmosphere by
actively engaging parents in decision-making processes. Factors such as the NICU
environment and parents' emotional well-being also impact participation. Nurses can
advocate for family-friendly facilities and address parents' emotional needs to foster a
trusting relationship and improve overall pain management for infants in the NICU.

1.2.2 What methods were used to arrive at their findings

A. Quantitative Research
The authors of the study used a mixed-effects logistic regression model to assess
the association between clinical characteristics and the presence or absence of delirium
or coma in mechanically ventilated ICU patients. They also used predictive mean
matching to impute missing covariate data. To identify the EEG features most closely
associated with delirium or coma, the authors used penalized regression via lasso. This
approach helped reduce the number of features and avoid overfitting. They compared
the model with the selected EEG features to the base model using the AIC and LRT.
Additionally, the authors computed a hypothetical delirium score by combining the
selected EEG features and weighting them based on their coefficients. This score
served as an indicator of the absence of delirium or other brain dysfunction. Overall,
the study identified four EEG metrics (delta variability, high beta variability, relative
alpha power, and relative theta power) that showed promise in contributing to an EEG-
based indicator of delirium in mechanically ventilated ICU patients.

B. Qualitative Research
The researchers used a metasynthesis or thematic synthesis approach to arrive at
their findings. They conducted a literature search in various databases using MeSH
terminology and identified qualitative studies that explored parental participation in
pain management for infants in the NICU. After screening and selecting relevant
articles, they employed the Critical Appraisal Skills Programme tool to assess the
 quality of the included studies. The researchers independently reviewed the selected
studies multiple times and coded the data line by line using a thematic synthesis
technique. They used NVivo software to help create descriptive themes and compared
codes to generate analytical themes. The coding and synthesis process involved
discussions among the reviewers to ensure reliability and validity. Through this
iterative process, the researchers identified four analytic themes: Learning to Parent a
Hospitalized Infant, Stress and Anxiety, Health Care Providers as Gatekeepers, and
NICU Environment. By analyzing and synthesizing the qualitative data from the
included studies, the researchers were able to derive key insights and
recommendations regarding factors that influence parents' participation in pain
management for their infants in the NICU.

1.2.3 Do proper citation and referencing

McNair, C., Chinian, N., Shah, V., McAllister, M., Franck, L. S., Stevens, B., Burry, L., & Taddio,

A. (2020). Metasynthesis of factors that influence parents’ participation in pain management for their

infants in the NICU. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 49(3), 263–271.

https://doi.org/10.1016/j.jogn.2020.02.007

Roberson, S. W., Azeez, N. A., Fulton, J. N., Zhang, K. C., Lee, A. X. T., Ye, F., Pandharipande,

P., Brummel, N. E., Patel, M. B., & Ely, E. W. (2023). Quantitative EEG signatures of delirium and

coma in mechanically ventilated ICU patients. Clinical Neurophysiology, 146, 40–48.

https://doi.org/10.1016/j.clinph.2022.11.012

DEADLINE: 1 week after T1 class

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BSN – 3D