General Appraisal Overview and the Rapid Critical Appraisal form

Read the study by Canbulat, N., Ayhan, F., & Inlal, S. (2015). Effectiveness of external cold and vibration for procedural pain relief during peripheral intravenous cannulation in pediatric patients. Pain Management Nursing, 16(1), 33-39.

Independently complete the General Appraisal Overview and the Rapid Critical Appraisal form. Post your results of the appraisals in the discussion area.

Answer

General Appraisal Overview

Date:

Reviewer:

Article Citation (APA): Canbulat, N., Ayhan, F., & Inlal, S. (2015). Effectiveness of external cold and vibration for procedural pain relief during peripheral intravenous cannulation in pediatric patients. Pain Management Nursing, 16(1), 33-39

https://doi.org/10.1016/j.pmn.2014.03.003.

PICOT Question: In pediatric patients aged 7-12 years, does the use of external cold and vibration via Buzzy for procedural pain relief during peripheral intravenous (IV) cannulation, compared to no intervention, reduce pain and anxiety levels during the procedure?

PICOT Question

P- (patient population/patients of interest): Pediatric patients aged 7-12 years

I- (Intervention): Use of external cold and vibration via Buzzy

C- (Comparison): No intervention

O- (Measurable outcome): Reduction in pain and anxiety levels during peripheral IV cannulation

T- (Time frame) During the procedure

Overview/General Description of Study

  • Purpose of Study: The purpose of the study was to evaluate the effectiveness of using external cold and vibration for procedural pain relief during peripheral intravenous cannulation in pediatric patients.

  • Study Design: The study is a prospective, randomized controlled trial, which is a type of experimental study design.

  • General Description of Study: This randomized controlled trial examined the effectiveness of external cold and vibration applied via Buzzy for reducing pain and anxiety in pediatric patients during peripheral intravenous (IV) cannulation. The sample of 176 children ages 7 to 12 were randomly assigned to a control group that received no intervention and an experimental group that received external cold and vibration via Buzzy. Preprocedural and procedural anxiety and pain were assessed with self-reports, parents’ and observer’s reports, and the Wong-Baker Faces Scale. The results showed that the experimental group had significantly lower pain and anxiety levels than the control group, indicating that external cold and vibration via Buzzy may be an effective intervention for pediatric peripheral IV cannulation.

Research Question(s): What is the effect of external cold and vibration stimulation via Buzzy on children’s pain and anxiety levels during peripheral intravenous (IV) cannulation?

Hypotheses:

Hypothesis 1: The use of Buzzy may lead to a decrease in the level of pain experienced by pediatric patients during peripheral IV cannulation procedures.

Hypothesis 2: The use of Buzzy may lead to a decrease in the level of anxiety experienced by pediatric patients during peripheral IV cannulation procedures.

Study Aims: The study aimed to assess preprocedural and procedural anxiety, as well as procedural pain, to determine if the external cold and vibration provided any relief.

Major Variables Studies:

  • Independent Variable: The use of external cold and vibration via Buzzy.

  • Dependent (outcome) Variable(s): Preprocedural anxiety, procedural anxiety, and procedural pain levels of the children.

Variable Analysis Used (include whether appropriate to answer research questions/hypothesis or discover themes): The study used a combination of quantitative and qualitative methods to analyze the effects of cold and vibration stimulation on preprocedural anxiety, procedural anxiety, and procedural pain in children. The independent variables were an experimental group that received the intervention and a control group that did not. Various measures were used to assess the effects, including the Children’s Fear Scale, Wong-Baker Faces Scale, visual analog scale, and reports from children, parents, and an observer. The study was designed to answer the research questions and discover themes.

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Rapid Critical Appraisal

VALIDITY

1. Are the results of the study valid?

a. Were the participants randomly assigned to the experimental and control groups?

Yes

No

Unknown

b. Was random assignment concealed from the individuals who were first enrolling participants into the study?

Yes

No

Unknown

c. Were the participants and providers blind to the study group?

Yes

No

Unknown

d. Were reasons given to explain why participants did not complete the study?

Yes

No

Unknown

e. Were the follow-up assessments conducted long enough to fully study the effects of the intervention?

Yes

No

Unknown

f. Were the participants analyzed in the group to which they were randomly assigned?

Yes

No

Unknown

g. Was the control group appropriate?

Yes

No

Unknown

h. Were the instruments used to measure the outcomes valid and reliable?

Yes

No

Unknown

i. Were the participants in each of the groups similar on demographic and baseline clinical variables?

Yes

No

Unknown

RELIABILITY

2. What are the results?

a. How large is the intervention or treatment effect (NNT, NNH, effect size, level of significance)?

__

__

__

b. How precise is the intervention or treatment (CI)?

__

__

__

APPLICABILITY

3. Will the results help me in caring for my patients?

a. Were all clinically important outcomes measured?

Yes

No

Unknown

b. What are the risks and benefits of the treatment?

c. Is the treatment feasible in my clinical setting?

Yes

No

Unknown

d. What are my patient’s/family’s values and expectations for the outcome that is trying to be prevented and the treatment itself?

Would you use the study results in your practice to make a difference in patient outcomes? If yes, how?

I would use the study results in my practice to make a difference in patient outcomes by using external cold and vibration to provide pain relief during peripheral intravenous cannulation in pediatric patients. Based on the study results, external cold and vibration via Buzzy may be an effective intervention for pediatric peripheral IV cannulation (Canbulat et al., 2015). Therefore, healthcare professionals who perform peripheral IV cannulation in pediatric patients may consider using external cold and vibration as a method of pain relief during the procedure.

Additionally, I would apply a cold pack to the area of the skin where the IV will be inserted to reduce the blood flow to the site and decrease pain. At the same time, I would use a vibrating device on the skin to distract the patient from the pain of the cannulation procedure. The vibration can also help to numb the area, making it less sensitive to pain (Gahlawat & Deol, 2021). Overall, using external cold and vibration as a method of pain relief during pediatric peripheral IV cannulation can be an effective and safe intervention for reducing pain and anxiety for pediatric patients.

Reference

Canbulat, N., Ayhan, F., & Inlal, S. (2015). Effectiveness of external cold and vibration for procedural pain relief during peripheral intravenous cannulation in pediatric patients. Pain Management Nursing, 16(1), 33-39. https://doi.org/10.1016/j.pmn.2014.03.003.

Gahlawat, M., Kodi, M., & Deol, R. (2021). Effect of external cold and thermomechanical stimulation on anxiety and pain during intravenous cannulation among children. Sudanese Journal of Paediatrics, 162–172. https://doi.org/10.24911/sjp.106-1590387019

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