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NUR 342 Health Related Articles Annotated Bibliography

NUR 342 Health Related Articles Annotated Bibliography

Assessment three – critique of the literature
Assessment three builds on your work in the themed discussion boards (Assessment 2). For
this assessment, you will be evaluating four recent journal articles related to your clinical
question. You will do this by summarising and evaluating the articles in an annotated
bibliography. An example of an annotated bibliography and a conclusion has been provided.
Assessment three is divided into three sections to guide your critique of the literature.
General instructions
• Due date – Due Sunday Week 12, 31/05/2020@1300 (CST)
• The word count for the assessment is 1500 words +/- 10%
• Assignments submitted after midnight will be subject to a 5% late penalty for each
day not submitted as per the Higher Education Assessment Procedures.
• Markers will stop reading at the maximum allowable word count
1. Introduction/Background (100 words)
Summarise the clinical problem you identified in the discussion board post and
explain why this is an important healthcare issue
2. Annotated bibliography (4 x 300 words) NUR 342 Health Related Articles Annotated Bibliography
Write an annotated bibliography for each of the four articles. In your annotated bibliography, you
will need to address the following elements:

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• APA 7th reference
• Was the article qualitative or quantitative?
• What was the aim of the research?
• What was the main argument of the study?
• What methodology has been used (how was the study conducted)
• What were the results of the study and do they answer the study question/aim?
• What are the strengths and limitations of the study?
• Overall statement on applicability of research to clinical practice
3. Conclusion (200 words)
Conclude the assignment by bringing together (or Synthesizing) your evaluations and
observations of the individual research articles in order to give the reader an
overview of how the four articles address your clinical question. To conclude your
assignment, decide whether the articles answer your question.
Annotated bibliography example
Smith, Z., & Hawthorn. (2018). Below knee TED stockings compared to thigh high stocking in
preventing DVT. Hospital, 6(32), 99-34. Doi: 1564ert9g34u59g3
Smith and Hawthorn used a quantitative study design to compare the effectiveness of below-knee
ted stockings to thigh high stocking in preventing deep vein thrombosis (DVT) in hospitalised
patients. The authors argued that there was very little evidence supporting the use of thigh high
stockings and that their use was associated with more complications such as pressure injuries. NUR 342 Health Related Articles Annotated Bibliography. In this
study, the authors used a randomised controlled trial design and patients were randomly allocated
to receive either the below-knee or thigh-high TED stockings. All patients admitted to a surgical ward
were approached to participate in the study. A total of 2034 patients were recruited into this study
out of 3000 patients approached to participate.
The study protocol involved patients wearing the stockings during the day and night and were only
to be removed during showering. Patients were monitored for DVTs during their hospitalisation, and
the frequency of DVTs was compared between the two groups. The results from this study showed
no significant difference between rates of DVT in patients who were allocated below-knee stocking
and thigh high stockings. Smith and Hawthorn also report that 48 patients who were allocated thigh
high stockings developed complications, ranging from mild irritation to more serious pressure
injuries. No such complications were reported in the below-knee stocking group.
The study by Smith and Hawthorn has several strengths. Firstly, it’s one of the few studies to
compare below-knee stockings to thigh high stockings, which helps to add to the evidence base
supporting their use. Secondly, this study used a large study population which helps to build
confidence in the study outcomes. Unfortunately, there are several limitations to this study that
need to be acknowledged. Firstly, it is unclear whether true randomisation of study participants
occurred as this is not described in the research article. When randomisation does not occur, this
can introduce bias into the results. Secondly, only surgical patients were used in this study, which
means the results could not be easily generalised to other populations such as medical or paediatric
patients. Lastly, there is no description of how the researchers ensured patients adhered to the
study protocol, which means it is possible some patients did not wear their stockings all the time.
Overall this article adds to the growing body of research supporting the use of below-knee TED
stockings, but due to the limitations mentioned, stronger evidence is needed to support a practice


Conclusion example
The four articles evaluated for this assessment examined whether below-knee TED stockings were as effective as thigh-high TED stockings in preventing DVTs in hospitalised patients.
Smith and Hawthorn (2018) and King and Phillips (2017) reported no difference between DVT rates
when comparing stocking length in surgical patients. The generalizability of these results is limited,
as both studies used surgical adult patients, and most of the participants were young, between 30
and 60 years of age. Moreover, despite reporting a randomised controlled trial study design only,
the study by King and Phillips (2017) made clear their randomisation and blinding process.
In comparison, Henley and Nadeem (2020) and Parveen and Hue (2016) reported increased DVT
rates in both medical and surgical patients allocated to wearing below-knee stockings.NUR 342 Health Related Articles Annotated Bibliography.  It is important to note that these two studies used a weaker study design, using a retrospective cohort design.
Both studies reviewed the notes of medical and surgical patients who were diagnosed with a DVT in
hospital, to determine what stockings they were allocated. This study design meant it was not
possible to know how long the stockings were worn or whether participants wore more than one
pair of stockings throughout their hospitalisation.
Overall the evidence supporting the routine use of below-knee stockings is inconclusive. Only two of
the four reviewed articles reported no difference between DVT rates between the two stocking
types and significant methodological differences between the four studies exist.

The latest approximate of the worldwide dominance of chronic obstructive pulmonary disease (COPD) is sixty-four million, with three million deaths in 2015 alone (WHO, 2017).  COPD is going to be the leading cause of death worldwide by 2030 and that 90% of its victims live in low and middle-income countries.  It is mainly caused by cigarette smoke, primary or secondary, and exacerbated by long-term asthma (WHO, 2017).

COPD refers to progressive multisystemic inflammatory diseases that lead to a limitation of airflow (Jimenez-Ruiz et al., 2015; Yang IA et al., 2017).  COPD patients in developed countries are smokers or have smoked. Smoking cessation in COPD patients has the potential to assist patients to control the disease and predict exacerbations. Treatment to prevent smoking should include pharmacological and behavioral treatments for best results (Jimenez-Ruiz & Fagerstrom, 2015).  The objective of the review is to assess the accuracy of COPD diagnoses in primary care in Australia and to describe the experiences and preferences of smokers to quit smoking. This analysis looks at the impact of a doctor’s lack of involvement and its impact on smoking cessation treatment outcomes among COPD patients who smoke.

Clinical research questions (Qualitative):

(P) Patient problem: COPD from smoking

(I) Intervention: Stop smoking by doctors.

(C) Comparison: A smoking cessation information program for health professionals during medical training to extend their commitment to smoking cessation treatment.

(O) Outcome: Effective commitment of professionals and patients to reduce COPD symptoms caused by smoking.

How do physicians have interaction to assess the effectiveness of smoking cessation for the treatment of COPD and the prognosis of exacerbations?

Van Eerd et al. (2017) reviewed the key factors that influence smoking cessation treatment among COPD patients due to smoking.  Physicians highlight the organizational factors of patients and physicians that impede regular evidence-based smoking cessation treatment (Van Eerd et al., 2017).  The study found that doctors experienced increased dissatisfaction with COPD smokers, as they were not responsible for their treatment, they were not honest about their smoking habits, they avoided health visits, and they did not pay much attention to the effects of tobacco.  This led doctors to develop negative feelings about such patients and, as a result, they were not treated effectively (Van Eerd et al., 2017).  Furthermore, problems with money and time have led to the failure of programs that consider smoking to be a disease. Doctors and patients made little effort to take immediate preventive measures against smoking habits. NUR 342 Health Related Articles Annotated Bibliography

Liang et al. (2018) focused on patients who have been at least forty years old and have visited GPs at least twice in the past twelve months, report that they are current or former smokers with a history of smoking of at least ten packs or have been treated for COPD.  Spirometry test, FEV1/FEV6 is taken into account besides an assessment of the quality of life, dyspnea, and health-related symptoms. Studies show that the effective use of a spirometry test can improve diagnosis. Side effects and difficulties in quitting smoking during attempts to quit smoking are common (Liang et al., (2018). Therefore, health professionals ought to emphasize evidence-based treatment and closely monitor the cessation of the difficulties, and the side effects of termination aids.

The variation between the articles and the way they provide smoking cessation services produces conflicting results from the literature review. Future research should emphasize the standardization of smoking cessation and the predictability of exacerbations. NUR 342 Health Related Articles Annotated Bibliography


Jimenez-Ruiz, C. A., & Fagerstrom, K.O. (2015). Smoking cessation treatment for COPD smokers: the role of pharmacological interventions. Monaldi Archives Chest Disease, 79(1), 27-32. DOI: 10.4081/monaldi.2013.106

Jiménez-Ruiz, C. A., Andreas, S., Lewis, K. E., Tonnesen, P., Van Schayck, C., Hajek, P., … Gratziou, C. (2015). Statement on smoking cessation in COPD and other pulmonary diseases and in smokers with comorbidities who find it difficult to quit. European Respiratory Journal, 46(1), 61-79. doi:10.1183/09031936.00092614

Liang, J., Abramson, M. J., Zwar, N. A., Russell, G. M., Holland, A. E., Bonevski, B., … George, J. (2018). Diagnosing COPD and supporting smoking cessation in general practice: evidence-practice gaps. Medical Journal of Australia208(1), 29-34. doi:10.5694/mja17.00664

Van Eerd, E., Risor, M., Spigt, M., Godycki-Cwirko, M., Andreeva, E., Francis, N., …Kotz, D. (2017). Why do physicians lack engagement with smoking cessation treatment in their COPD patients? A multinational qualitative study. npj Primary Care Respiratory Medicine, 27(41), 1-6.doi: 10.1038/s41533-017-0038-6

WHO. (2017). Chronic obstructive pulmonary disease (COPD). WHO | World Health Organization.

Yang IA, et al., (2017). COPD-X Australian and New Zealand guidelines for the diagnosis and management of chronic obstructive pulmonary disease: 2017 update. – PubMed – NCBI. Retrieved from NUR 342 Health Related Articles Annotated Bibliography


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