You will prepare and submit a term paper on Evidence-Based Practice in Nursing: Meta-Analysis. Your paper should be a minimum of 1000 words in length. 1. What is the magnitude of the effect of EMLA cream on VE and IV pains 2? Is the effect size of EMLA cream on VE and IV pains moderated by the following variables: study publication date, sample age, sample size, sample health status, anatomical puncture site, duration of application, method of pain measurement and research design (Fetzer,2001).Research question 1 is the direct and useful clinical question as it encourages/discourages clinical use of EMLA in VE & IV whereas question 2 tends to encourage/discourage such use via evidence on several other variables important among them being sample size, sample health status, premedication, anatomical puncture site and duration of application. The topic had immediate relevance for the nursing profession as both IV &VE are widely practiced nursing techniques. While the substantial agreement was achieved on the coding of the substantive variables, methodological variables, and miscellaneous variables. resolution of disagreements was not elaborated and two raters were not identified. 2 The meta-analysis .2 The meta-analysis clearly defined the inclusion and exclusion criteria for selecting primary studies. The databases used by the reviewers were identified and were appropriate. All of the keywords were identified and were adequate. The reviewers documented the use of adequate supplementary efforts to identify relevant studies, including non-published studies. The Sample3 The search strategy yielded an adequate sample (number) of studies-19. Though it was not clearly stated if the sample size in each included study was adequate nevertheless there was substantial agreement on ‘sample size’ methodological variable. The reviewers did not attempt to contact the original researchers for additional information. For instance, several studies failed to report test statistics or raw data, in these cases conservative estimates of study outcomes were made from the provided raw data. The rationale for excluded studies was clearly provided.4 Quality Appraisal5 A quality index for each study was calculated based on the criteria used by Beck (1995). Reviewers did not indicate that all reviewed primary studies were of high methodological quality though they coded 8 methodological variables and two raters had 97% agreement on the coding of such variables. Interrater agreement percentages were reported for all categories of the coded variables but the resolution of disagreement(though minor )was not reported. The methodological comparability of the included studies was specified by means of coding 8 methodological variables as above and coding agreement thereupon. As the inclusion criteria were well defined to have comparable clinical situations and since the coding of substantive variables.
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