Comparative Analysis of a nursing practice
Task description
This individual assessment item provides students with an opportunity to use recent and appropriate evidence to achieve best practice. Students will demonstrate their ability to gather evidence from a number of appropriate sources (recent and appropriate literature) about a specified topic, and discuss the various points of view identified from the literature.
Practical application
Essay (refer to Essay Marking Criteria below)
Using recent and appropriate evidence (for example, journal articles and systematic reviews), discuss the different approaches for the following topic.
? Cardiac care: The use of high concentration oxygen for the client with chest pain;
A preparation table, which summarises a sample of the key points [approximately five sources], must be attached to the essay.
Word Limit: 1500 words (not including the preparation table)
Referencing Style: APA 6th.
Resources:
? A resource for this task is located in Assessment tab in the 2801NRS Learning@Griffith website. The preparation table will be discussed in tutorials.
? GU Resources, Workshops and training, researching and writing self-help resources
http://www.griffith.edu.au/library/workshops-training/self-help-resources
http://policies.griffith.edu.au/pdf/Assessment%20Submission%20and%20Return%20Procedures.pdf
 
Example of preparation table to include
Source 1
(Band, 1980)
Source 2
(Maki & Ringer, 1991)
Source 3
(Lai, 1998)
Source 4
(Webster J, Osborne S, Rickard C, & Hall, 2010)
Source 5
(Rickard, McCann, Munnings, & McGrail, 2010)
Argument
Infection/phlebitis risk and catheter dwell time Longer dwell more infection. Needles should be replaced every 72 hours. (p.34, left col, para 2)
7% of patients developed septicaemia. (p.34, left col, para 3) Risk of septicaemia from Teflon or Vialon catheters is minimal. The risk of catheter-related infection is the same for Teflon and Vialon catheters. (Abstract ? Conclusion p.845)
The risk of phlebitis increases equally each day after Day 2. (Discussion, col 2, para 2).
Routine re-site every 3-4 days will minimise phlebitis (last page).
. In peripheral IV lines there was no significant difference in the phlebitis rate between 72 hours and 96 hours.
Where there is a dedicated IV team it is safe to only re-site every 96 hours. No statistically significant differences between groups (change on clinical indication versus change every 72-96 hours) for septicaemia or phlebitis. Costs were less in change on clinical indications groups. (Main results p.3)
The review found no conclusive evidence of benefit in changing catheters every 72 to 96 hours. (Author?s conclusion p.3) (All in Abstract p. 1)
IVD complication rates (all reasons for removal) were no different between groups (change on clinical indication versus change every 72-96 hours).
Time to first complication per patient did not differ between groups
There were no local infections or IVD-related bloodstream infections in either group.
Costs of IV therapy were greater in routine replacement group
Study differences
Type of catheter Steel needle (Abstract & Materials and Methods p.31)
Two types ? Teflon and Vialon Angiocatheter ? Intima = Vialon catheter All types (not in this summary but is mentioned in full review) Not stated ? whatever was normal practice in 2005(?).
Source 1
(Band, 1980)
Source 2
(Maki & Ringer, 1991)
Source 3
(Lai, 1998)
Source 4
(Webster J et al., 2010)
Source 5
(Rickard et al., 2010)
Design of study Observational study of all needles inserted in a specific time frame (Materials and methods p.31) Randomised controlled trial. Groups randomly allocated to different catheter. Dwell time was not part of group allocation. Prospective non-randomised study = observational study ? all catheters in a specific timeframe (Abstract) Systematic review and meta-analysis Randomised controlled trial. Groups randomly allocated to different re-site regimen. Routine (72-96 hours) or clinical indication..
Sample 148 needles in adult haematology patients ? immuno-compromised (Abstract & Materials and Methods p.31) 1054 catheters from 714 adult medical and surgical patients in acute care hospital ? not immunosupressed. 2503 peripheral IV catheters in adult medical-surgical patients Data from six randomised controlled trials were included in meat-analyses (not in summary) ? included data from 3,455 patients 362 adult medical and surgical patients in acute care hospital ? not immunosupressed.
Arguments for benefits of re-site on clinical indication Not mentioned None None Reduces patient discomfort from frequent re-siting.
Reduces patient discomfort from frequent re-siting.
Reduced risk of venous damage as only resited as needed.
Reduced workload for nurses
More studies needed to determine cost benefits (last paragraph) Costs less in change on clinical indication groups compared to routine re-site. Economic ?reduced cost factor for less frequent resites
Include all references in reference list
Nursing Clients with Medical Surgical Conditions 2014
Comparative Analysis (essay) Marking Criteria
Content Possible mark Mark achieved Brief comments
Preparation table
? Clear identification of key benefits and negatives
? Clear presentation of references to support key points within table 15
Introduction
? Has opening sentence to contextualise aim of the essay.
? Clearly identifies the aim of the essay. 5
Analysis
Content:
? Discussion of key benefits and negatives identified from the evidence
Structure:
? Logical comparison of key points throughout the essay. 50
Conclusion
? Summarises the key points outlined in the essay
? Does not introduce new information in conclusion. 5
Written expression
? Consistent and accurate use of:
? Spelling
? Grammar
? Sentence structure
? Paragraphing
? Academic language 10
Presentation
? Correct word count
? Inclusion of a cover page and marking criteria.
? Footer with student number only and page numbers
? 1.5 line spacing.
? A separate page for references. 5
Use of literature
? Recent and appropriate evidence reviewed
? No fewer than 10 sources
? Referencing as per APA Style 6th Edition.
10
Total Mark 100
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