5351 Module 3 Evidence Synthesis Table
Student Name: Karishma Daji & Courtney Elliott
Date: March 28, 2024
PICOT Question: In high-risk septic adults over the age of 65 (P), how does early ambulation with incentive spirometer use compared to (I)
immobilization with incentive spirometer use (C) influence the prevalence of pulmonary complications postoperatively (O) over a two week
period (T)?
Courtney Elliott
Sorour, D. M., Khalil, M. I. M., Sharaan, M. A., & El Geneidy, M. M. (2019). Effect of Deep Breathing Exercises versus Incentive Spirometry on Pulmonary
Complications among Geriatric Patients Undergoing Upper Abdominal Surgery. International Journal of Novel Research in Healthcare and Nursing, 6(3),
537-555. www.noveltyjournals.com
Level of Evidence: Level III - Evidence from a well-designed controlled trials without randomization (quasi-experimental)
Purpose Research Design, Intervention, Data Statistical Results and Findings Implications/Conclusions (related to adoption
Sample Size, Collection, Outcome to practice)
Demographics Measures
Purpose Design Intervention Give statistical result pertaining Answer to your PICOT based on this article
▪ Purpose is to ▪ Design is quasi- Patients were separated into to your PICOT. alone:
determine the experimental. 3 groups, 2 intervention and
effectiveness of Sample Size 1 control. Group 1 (15 ● Descriptive Statistics Research Study Conclusion
deep breathing ▪ Sample size is 60 participants) used IS, group ○ Number & percentage Incentive spirometry or deep breathing have
exercises versus patients, 60 years or 2 (15 participants) used ○ Arithmetic mean (x), similar effectiveness in decreasing the
incentive older. deep breathing exercises standard deviation incidence of post-op pulmonary
spirometry (IS) Demographics and the control group ( used ● Analytical Statistics complications in elderly patients undergoing
use on pulmonary ▪ Sample demographics traditional hospital care. ○ Pearson’s Chi square test - surgery when given education before and
complications are patients over the if 20% of cells have after surgery.
post-operative in age of 60, admitted Data Collection Procedure expected value of 5 or
geriatric patients for upper abdominal Tool 1: Mini Mental State greater Implications
undergoing surgery, can consent Examination (MMSE) ○ Mont Carlo Exact test - if Monitoring Requirements:
abdominal and participate in the Tool 2: Health profile and 20% of cells have expected ● Oxygen saturation, auscultate lung
surgery. study. socio-demographics value less than 5 sounds, pulmonary function test
interview ○ Fisher’s Exact test - Safety Precautions:
Tool 3: Katz activities of expected value of one or ● Conduct a thorough medical and social
1
Level of Evidence Hierarchy Box 1.3, p. 18
Melnyk & Fineout-Overholt, 2019
Dco:12.05.23
, 5351 Module 3 Evidence Synthesis Table
daily living more cells equals 0 history
Tool 4: ARISCAT risk ○ Univariate Regression test - Client Education:
index relation between post-op ● Educate the patient on proper incentive
Tool 5: Melbourne Group pulmonary complications spirometer use and deep breathing
Scale and other variables; P value techniques
less than 0.10 links to post-
Measures (name, outcome, op complications; Odds
reliability & validity) ratios (OR) and 95%
-Tool 1 has been deemed confidence intervals (95%
reliable and valid with a CI) estimate between post-
reliability score of 0.96. op complications and other
-Validity was performed on variables.
tools 4 and 5 by translating
the tools into Arabic and a No real difference in incentive
panel of experts of 5 spirometry use versus deep
professors and they breathing.
determined validity.
Recommendations were
applied to final sheets.
-Reliability was performed
on tools 4 and 5 using intra-
rater (Choen’s Kappa)
reliability test. The
reliability for tool 4 was
0.771 and tool 5 was 0.814.
Recommendations were
applied to final sheets.
Courtney Elliott
Balvardi, S., Pecorelli, N., Castelino, T., Niculiseanu, P., Alhashemi, M., Liberman, A. S., Charlebois, P., Stein, B., Carli, F., Mayo, N. E., Feldman, L. S., & Fiore, J.
F., Jr (2021). Impact of Facilitation of Early Mobilization on Postoperative Pulmonary Outcomes After Colorectal Surgery: A Randomized Controlled Trial.
Annals of surgery, 273(5), 868–875. https://doi.org/10.1097/SLA.0000000000003919
Level of Evidence: Level II - Evidence from well-designed single RCTs
2
Level of Evidence Hierarchy Box 1.3, p. 18
Melnyk & Fineout-Overholt, 2019
Dco:12.05.23
