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Tami Frazier 

Week 10 Initial Discussion Post

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NURS 6052 – Essentials of Evidence-Based Practice

Week 10 Initial Post

Weighing the Evidence

            Evidence-based practice (EBP) is a complex and monumental task that includes initiating research studies.  The first step in EBP is to determine current clinical needs and form a question that is answered with quality research (Polit & Beck, 2017).  Often a research study is initiated to prove the researcher’s hypothesis.

            After researching the articles used previously, I will present an evaluation of evidence on the article, “Systematic Review of the use of Low-Dose Ketamine for Analgesia in the Emergency Department (Ghate, Clark, & Vaillancourt, 2018)”.  The researchers chose to use a systematic review to determine if their PICOT question is true.  The question is:

“If in adult patients requiring acute pain management in the ED (P), the use of low-dose Ketamine (LDK) as an adjunct or alone (I), compared to using opioids (C), offered improved pain control, decreased the need for opioid analgesics, or decreased the occurrence of adverse events (O) (Ghate et al., 2018, p. 37)”.

            This PICOT question clearly defined a hypothesis intended to prove their assumptions.  The population information includes adults over 18 years of age who are in acute pain in the emergency department.  Two reviewers evaluated the chosen articles separately with the same inclusion criteria consisting of using articles affirming Ketamine, disagreements on use, or undecided outcomes (Ghate et al., 2018).  The qualifying outcome measures sought to determine if the analgesic effect of LDK reported by patient’s pain scores met adequate pain control (Ghate et al., 2018).  The overall findings suggest that LDK is safe and an alternative for the management of pain (Ghate et al., 2018).  Due to the conclusion, this research study can be reproduced enforcing its reliability and external validity.  Therefore, the PICOT question is substantiated by the findings. 

             It is possible for the researchers to decide that there was not enough of a sample size to adequately determine if Ketamine was beneficial or not.  This study is based on eight relatively small papers.  By broadening their inclusion criteria possibly, more papers would have qualified.

             An article outlining the uses of Ketamine is also beneficial for researchers to understand its mechanism of action and other uses.  During the preliminary planning phase developing an understanding of this medication is essential.  By understanding the medication, it is easier to design an appropriate PICOT question.

             Expertly researched and planned studies can produce outcomes that are well designed (Rohrig, Baptist du Prel, & Blettner, 2009).  Performing an additional study to determine the effects of Ketamine on children when acute pain does not react to conventional first-line medications could be done to gain a fuller understanding of Ketamine’s usefulness. 

             As seen in this article, despite the small number of papers being reviewed the evidence still suggests that LDK is considered an effective alternative for opioids in the emergency department.

References

Ghate, G., Clark, E., & Vaillancourt, C. (2018). Systematic review of the use of low-dose ketamine for analgesia in the emergency department. Canadian Journal of Emergency Medicine20(1), 36-45. doi:/10.1017/cem.2017.48

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Rohrig, B., Baptist du Prel, J., & Blettner, M. (2009). Study design in medical research. Duetsches Arzteblatt International106(11), 184-189. doi:/10.3238/arztebl.2009.0184

 

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