Evidence-Based Practice Project Research Paper

Evidence-Based Practice Project Research Paper

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Assessment Traits
Benchmark
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Assessment Description
The purpose of this assignment is to write a review of the research articles you evaluated in the Evidence-Based Practice Project: Evaluation of Literature assignment in Topic 5. If you have been directed by your instructor to select different articles in order to meet the requirements for a literature review or to better support your evidence-based practice project proposal, complete this step prior to writing your review.

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A literature review provides a concise comparison of the literature for the reader and explains how the research demonstrates support for your PICOT. You will use the literature review from this assignment in NUR-590, during which you will write a final paper detailing your evidence-based practice project proposal.

In a paper of 1,250-1,500 words, select 4 of the 6 articles you evaluated that demonstrate clear support for your evidence-based practice and complete the following for each article: Evidence-Based Practice Project Research Paper

Introduction – Describe the clinical issue or problem you are addressing. Present your PICOT statement.
Search methods – Describe your search strategy and the criteria that you used in choosing and searching for your articles.
Synthesis of the literature – For each article, write a paragraph discussing the main components (subjects, methods, key findings) and provide rationale for how the article supports your PICOT.
Comparison of articles – Compare the articles (similarities and differences, themes, methods, conclusions, limitations, controversies).
Suggestions for future research: Based on your analysis of the literature, discuss identified gaps and which areas require further research.
Conclusion – Provide a summary statement of what you found in the literature.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.
Refer to “Evidence-Based Practice Project Proposal – Assignment Overview,” located in Class Resources, document for an overview of the evidence-based practice project proposal assignments Evidence-Based Practice Project Research Paper .

You are required to cite four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN Evidence-Based Practice Project Research Paper

Introduction

Opioid use disorder (OUD) is a significant issue in pregnant women with negative consequences on maternal and child health.  The Center for Drug Evaluation and Research (2019) noted that OUD is an epidemic globally and in the U.S.  Studies have also established a relationship between OUD and overdose mortality among reproductive women. An example is Bruzelius and Martins’s (2022) longitudinal study that found the overdose mortality rate among pregnant women rose by 81%. There was also a 38% increase in overdose deaths in women within the reproductive age within the same period. The rising mortality is associated with a lack of access to comprehensive care before, during, and after pregnancy. The inability to access maternal care and the unavailability of substance abuse disorder specialists in the health centers are barriers to getting care for OUD. Another risk factor is inadequate family support (Petersen et al., 2019).  Improving the quality of maternal care and supportive services for pregnant women with OUD can reduce addiction and mortality rates (Rizk et al., 2019).  Understanding the effectiveness of comprehensive care over standard care is the purpose of the evidence-based project. The following PICOT question will guide the project:

“In pregnant women who are opioid addicted (P), does providing a comprehensive set of services delivered in a coordinated and integrated approach (I), when compared to opioid-addicted pregnant women receiving standard care (C), lead to a decrease in maternal deaths (o) in ante/intra/postpartum patients from day 43- 365 days (T)? Evidence-Based Practice Project Research Paper

Search Methods

Four articles were selected for this review. They include three primary studies and one literature review. The articles were drawn from an evidence evaluation table (see Appendix) containing six articles that were previously reviewed.  The studies were searched from PubMed and CINAHL databases. The search keywords and terms included “opioid-addicted pregnant women care,” “opioid addiction in pregnancy,” “Care for opioid addiction in pregnancy and postpartum,” and “interventions for pregnant women with opioid use disorder(OUD).” The inquiry yielded multiple full articles and abstracts. A further evaluation was completed to select articles relevant to the PICOT question, that is, only studies that investigated interventions for OUD were included.  The publication year range was also limited to 3 to 5 years. Six studies passed the criteria. They were critically appraised using the Johns Hopkins Individual Evidence Summary tool.  Four of the articles will be synthesized in this paper.

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Synthesis of the Literature

The first article is Mazel et al.’s (2023) review study. The researchers explored interventions for addiction care in postpartum women. They applied a scoping review design to identify multiple policy, research, and clinical strategies for addressing OUD and substance use disorder (SUD)Evidence-Based Practice Project Research Paper.  The researchers reviewed 41 articles relevant to their study’s topic. They evaluated studies on interventions for managing substance use disorder and systemic enablers. The strategies included pharmacotherapy. Most articles reviewed supported treating opioid addiction in pregnant and postpartum women with buprenorphine. The medication was to minimize drug use and promote mother and child health. The other interventions were non-pharmacological and targeted the healthcare providers. They involved increasing integration and collaboration in delivering care for pregnant and postpartum women through collaborative and integrated models. The last category of interventions was harm reduction strategies. These comprised measures for managing overdose.  The findings revealed the rampant application of pharmacological solutions and the use of a coordinated care approach. However, the authors noted a few studies focused on harm reduction principles. They recommended providing comprehensive care services to pregnant women, including harm reduction interventions through integrative and collaborative delivery models. This study’s results are relevant to the PICOT question.  The researchers recommended bundled interventions to provide optimal care for pregnant women with OUD and SUD.

The second article is by Parlier-Ahmad et al. (2023). The researchers conducted a qualitative descriptive study to evaluate a technology-based educational intervention for pregnant and postpartum women with opioid use disorder and receiving medication for OUD. The intervention was designed to highlight recovery care strategies for women with OUD during pregnancy to the postpartum period, guidance for handling infants at risk of neonatal opioid withdrawal syndrome (NOWS), and child care after delivery.  Recorded interviews with the patients and feedback from the healthcare professionals were used to analyze the effectiveness of the intervention. The results indicated a positive response to the intervention by the patients. The majority rated the educational program positively because it allowed them to continue managing their OUD after discontinuation of the pharmacotherapy. Besides, they acknowledged technology use in delivering patient education. They also applauded the family resources, arguing they would enable them to gain support to improve recovery and resilience. Also, the professional reviewers noted the program supplemented the education that pregnant women receive during antenatal clinics. The authors recommended person-centered care for all pregnant women with OUD to prepare them for the transition after delivery. The study results contribute to the PICOT question because they offer direction on post-delivery care interventions for pregnant and postpartum women Evidence-Based Practice Project Research Paper.

The third article is Rizk et al.’s (2019) clinical case study. The authors used a patient case study to explore the care provided to women with substance use disorders, such as OUD. The case study was about a patient who presented at the antenatal clinic with a substance abuse problem in their 22 weeks of pregnancy. They supplemented the analysis with available evidence from research-based literature. The researchers noted that the pregnant woman was provided a variety of interventions, including SUD and OUD screening, a brief intervention by the healthcare provider and referral for advanced care, and treatment during delivery and after childbirth.  They also observed that pregnant women experienced multiple problems. Therefore, they recommended applying a multidisciplinary care approach to meet the specific needs and enhance clinical outcomes and general well-being. Screening can ensure that pregnant women with OUD are detected early.  The researchers proposed a combination of interventions, including screening, brief intervention, referral, and care coordination for addressing problems of women with OUD before, during, and after child delivery. Their article supports the PICOT question because it identifies the significance of comprehensive services for pregnant women with opioid use disorder.

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The fourth article was a quantitative study by Singleton et al. (2022)Evidence-Based Practice Project Research Paper. The researchers conducted a retrospective study to investigate the effect of medication for opioid use disorder on the discharge of infants with neonatal opioid withdrawal syndrome to their natural parents.  The researchers studied all mothers who had received medication for OUD during pregnancy and neonates who had been discharged within the study period based on records from three Alaskan hospitals. The results showed that mothers on medication had increased efficacy in managing their infants with NOWS. They were more likely to participate in the children’s hospitalization than their counterparts who had no care for their opioid addiction. The findings also indicated that the mothers who had medication for OUD were allowed to take their newborns home after delivery. The assumption was that they were prepared for postpartum. The researchers recommended medication for OUD for all pregnant women with opioid addiction to prepare their transition and care for NOWS.  The article contributes to the PICOT question by recommending pharmacological treatment for substance abuse among the services women receive before, during, and after child delivery.

Comparison of Articles

The four articles reviewed herein compare and contrast based on the themes, methods, conclusions, and limitations. Two major themes that emerged from the review are care for pregnant women with opioid use disorder and medication for OUD.  Each article addresses these themes differently. Mazel et al. (2023) identified both pharmacological and non-pharmacological approaches to managing pregnant women with OUD. The authors highlighted medication, care integration and collaboration, and harm reduction strategies as novel solutions to the OUD problem in pregnant and postpartum women.  Parlier-Ahmad et al. (2023) supported online-based education for women in postpartum to enhance their efficacy in managing their addiction and their infants. Rizk et al. (2019) provided a comprehensive care approach that involves screening, brief intervention, and referral to further treatment. Singleton et al. (2022) tested the effect of medication therapy for OUD on postpartum women and the discharge of neonates with opioid withdrawal syndrome to biological parents.

Aside from the themes, the articles differed in methodologies, limitations, and conclusions used. Three studies, Rizk et al. (2019), Parlier-Ahmad et al. (2023), and Singleton et al. (2022) were primary research (qualitative and quantitative). The only review study was Mazel et al. (2023) article. The different research designs posed varying limitations. For example, Mazel et al. (2023) could not establish the odds of each intervention proposed due to the heterogeneity of the reviewed studies. Singleton et al. (2022) is the only study that employed a quantitative design, allowing the results to be replicated. However, it only investigated the impact of medication on OUD. The conclusions also varied since the research measures and outcomes were different Evidence-Based Practice Project Research Paper.

Suggestions for Future Research

After reviewing the four articles, I recommend further research. While each article contributes to an aspect of the PICOT, no study can substantially answer the evidence-based question. A randomized controlled study that compares comprehensive or holistic care interventions during antepartum, intrapartum, and postpartum for pregnant women with OUD would help answer the PICOT. Also, there is a research gap in the literature on the harm reduction strategies. In the future, researchers should consider exploring harm reduction as a part of care for women with substance use disorder. It would also be appropriate to have quantitative studies to allow results generalization.

Conclusion

Opioid use disorder is a prevalent issue among pregnant women with adverse effects on mother and child. Women with OUD require holistic care that addresses their antenatal needs but also manages their addiction to prevent negative outcomes for the mother and the infant. The reviewed articles propose bundled interventions, including medication, patient counseling and education, and mental therapy for serious addiction. Another recommended intervention is harm reduction approaches to reduce mortality from overdose. It also calls for care collaboration and coordination to meet all the needs of pregnant people with OUD.  The involvement of family and healthcare provider support is also encouraged to enhance motivation to stop substance abuse. The evidence gathered contributes to the PICOT, but further research is required to determine the impact of comprehensive care services over standard care for pregnant and postpartum women with OUD. Evidence-Based Practice Project Research Paper

References

Bruzelius, E., &   Martins, S. S.  (2022). U. S. trends in drug overdose mortality among pregnant and postpartum persons, 2017-2020. JAMA, 328(21), 2159-2161. https://jamanetwork.com/journals/jama/fullarticle/2799164.

Center for Drug Evaluation and Research. (2019). Institutional review boards (IRBS) and protection of human subjects in clinical trials. U. S. Food and Drug Administration. https://www.fda.gov/about-fda/center-drug-evaluation-and-researchcder/institutional-review-boards-irbs-and-protection-human-subjects-clinical-trials.

Mazel, S., Alexander, K., Cioffi, C., & Terplan, M. (2023). Interventions to support engagement in addiction care postpartum: Principles and pitfalls. Substance Abuse and Rehabilitation, 14, 49-59. https://doi.org/10.2147/SAR.S375652.

Parlier-Ahmad, A. B., Eglovitch, M., Martin, S., Svikis, D.S., & Martin, C. E. (2023). Project BETTER: A family-centered, technology-delivered intervention for pregnant people with opioid use disorder. Children, 10(359), 1-8.https://doi.org/10.3390/children10020359.

Petersen, E. E., Davis, N. L., Goodman, D., Cox, S., Mayes, N., Johnston, E., Syverson, C., Seed, K., Shapiro-Mendoza, C. K., Callaghan, W. M., & Barfield, W. (2019). Vital signs: pregnancy-related deaths, United States, 2011–2015, and strategies for prevention, 13 states, 2013–2017. MMWR. Morbidity and Mortality Weekly Report, 68(18), 423-429. https://doi.org/10.15585/mmwr.mm6818e1.

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Rizk, A. H., Simonsen, S. E., Roberts, L., Taylor‐Swanson, L., Lemoine, J. B., & Smid, M. (2019). Maternity care for pregnant women with opioid use disorder: A Review. Journal of Midwifery & Women’s Health, 64(5), 532–544. https://doi.org/10.1111/jmwh.13019.

Singleton, R., Rutz, S., Day, G., Hammes, M., Wilson, A. S., Herrick, M., Mazut, C., Brunner, L., Prince, J., Desnoyers, C., Shaw, J., Hirschfeld, M., Palis, H., & Slaunwhite, A. (2022). Assessing the impact of prenatal medication for opioid use disorder on discharge home with parents among infants with neonatal opioid withdrawal syndrome. Journal of Addiction Medicine, 16(6), 366-373. https://doi.org/10.1097/ADM.0000000000000987. Evidence-Based Practice Project Research Paper