My PICOT question is, in postoperative patients who have undergone abdominal surgery, is the use of an incentive spirometer
My PICOT question is, in postoperative patients who have undergone abdominal surgery, is the use of an incentive spirometer
Post 1:
Most of the scholarly articles I used for my assignments these past weeks were from PubMed. PubMed is a valuable resource that is used for finding scholarly articles related to various topics including mine which was sexually transmitted infections (STIs) and unplanned pregnancies. PubMed was useful for my topic as it is a database with comprehensive coverage that covers a large number of biomedical and life science journals. Another reason this source was useful for me was because it has peer-reviewed content that is reliable, credible and meets academic standards. One issue I have came across a couple other resources when searching for scholarly articles was that they only provide an introduction or abstract of the article; furthermore, there have been multiple times where I have came across a good source, but was not able to use it due to the fact that I did not have access to the whole article. PubMed mainly provides abstracts and bibliographic information as well, but it often also has a link to the full-text article which are usually freely available or freely accessible through institutional subscriptions. Another part of PubMed that I enjoyed was the advanced search features it has; moreover, it allows you to refine your search based on specific criteria making it easier to find the necessary information. With this filter option, you may also use filters such as publication date, study type, language, and more, which was useful as we had to provide articles with recent publication dates for these assignments. It is beneficial as you do not have to go through multiple articles that you can not even use before finally finding one that fits. Lastly, PubMed was a great option for me as it provided detailed information on the citations and references of each article which was useful to find additional relevant sources. It also helps prove the credibility which is crucial for me.
Post 2:
My PICOT question is, in postoperative patients who have undergone abdominal surgery, is the use of an incentive spirometer, compared to early ambulation, most effective in preventing postoperative pneumonia, within five days postoperative?
For my literature review, I mainly used PubMed to search for scholarly articles. I tried to search in Cochrane, however, the articles were outdated and mostly are eight years or older. I found journal articles that relates to my topic, such as the Prevention of postoperative pneumonia in noncardiac surgical patients by Caparelli, et al (2019), Clinical effectiveness of incentive spirometry for the prevention of postoperative pulmonary complications by Eltorai, et al, (2017), and Early mobilization in enhanced recovery after surgery pathways by Tazreean, et al, 2022). These journal articles have brought insight to my topic because some of them are randomized controlled trials to study the effectiveness of the use of incentive spirometry, and/or early mobilization in the prevention of postoperative pneumonia. The authors of each article have also mentioned limitations of their studies, and this gave me ideas of what to control in my change project to gain accurate results. For example, the study by Caparelli, et al, has not taken into consideration the type of surgery the patient had, and in my change project, I have decided to control the study group on patient who only have undergone abdominal surgeries who are ambulatory as their baseline. The literature review has provided me the existing knowledge that I may utilize and give credit to the authors. As I have read these articles, I have noticed that there are still no studies that compares the effectives of incentive spirometry versus early ambulation, and only one of these has been studied without comparison over another kind of intervention. In reading these articles, I have also found also found gaps in knowledge such as the lack of surveillance data on incentive spirometer use, thus there is limited data on its compliance. If there is inaccuracy on compliance with optimal use, I believe that these affects the study results.
Reference:
Caparelli, M. L., Shikhman, A., Jalal, A., Oppelt, S., Ogg, C., & Allamaneni, S. (2019). Prevention of postoperative pneumonia in noncardiac surgical patients: A prospective study using the National Surgical Quality Improvement Program Database. The American Surgeon, 85(1), 8–14. https://doi.org/10.1177/000313481908500104
Eltorai, A. E., Szabo, A. L., Antoci, V., Ventetuolo, C. E., Elias, J. A., Daniels, A. H., & Hess, D. R. (2017). Clinical effectiveness of incentive spirometry for the prevention of postoperative pulmonary complications. Respiratory Care, 63(3), 347–352. https://doi.org/10.4187/respcare.05679
Tazreean, R., Nelson, G., & Twomey, R. (2022). Early mobilization in enhanced recovery after surgery pathways: Current evidence and recent advancements. Journal of Comparative Effectiveness Research, 11(2), 121–129. https://doi.org/10.2217/cer-2021-0258
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