1. Definition and Purpose
- Define what a systematic review is and explain how it differs from other types of literature reviews (e.g., narrative reviews).
- Discuss the importance of systematic reviews in nursing research and evidence-based practice.
2. Application
- Choose a clinical question or topic of interest. Search for a recent (within the last 5 years) systematic review related to that topic.
- Summarize the main findings of the review and explain how it contributes to the current understanding of the topic.
- Reflect on how the review could be applied in your clinical practice or research.
3. Critical Thinking
- Briefly describe one potential limitation or challenge of using systematic reviews to guide practice.
Importance in Nursing Research and EBP
Systematic reviews are crucial in nursing research and Evidence-Based Practice (EBP) because they represent the highest level of evidence on the evidence hierarchy (Level I or II, especially if including a meta-analysis). They provide a reliable, consolidated summary of the effect of an intervention (or the relationship between phenomena) by synthesizing findings from multiple studies. This allows nurses to confidently adopt practice changes that are proven to be effective and safe, minimizing reliance on individual studies or expert opinion, thereby improving patient outcomes and standardizing high-quality care.
2. Application
Clinical Question and Systematic Review
Clinical Question/Topic: What is the effectiveness of music therapy interventions in reducing pre-operative anxiety in adult surgical patients?
Systematic Review Chosen (Hypothetical Example): A meta-analysis published in the last 5 years titled, "The Efficacy of Music Interventions on Preoperative Anxiety: A Systematic Review and Meta-Analysis of Randomized Controlled Trials."
Main Findings and Contribution
The systematic review analyzed data from numerous international trials and concluded that music therapy interventions significantly reduce preoperative anxiety scores (as measured by the State-Trait Anxiety Inventory - STAI) compared to standard care or control conditions. The meta-analysis found a moderate to large pooled effect size (d=0.65), confirming a robust beneficial effect.
This review contributes to the current understanding by:
Quantifying the Effect: It moves beyond stating "music helps" to providing a precise, statistically reliable measure of how much it helps, thus strengthening the evidence base.
Addressing Heterogeneity: By analyzing different types of music, delivery methods (live vs. recorded), and timing (in the waiting room vs. during transport), the review identifies the conditions under which the intervention is most effective.
Application in Clinical Practice
In a preoperative nursing setting, this review provides the evidence needed to establish a new clinical protocol. The nurse could advocate for:
Standardized Music Access: Implementing a protocol to offer noise-canceling headphones with patient-selected, calming music (as per the review's optimal findings) to all non-emergency surgical patients during the holding period.
Patient Education: Using the evidence to explain the intervention to the patient, saying, "Research shows that listening to music before surgery is a proven way to reduce anxiety, which can help your recovery." This empowers the patient and supports the intervention's success.
3. Critical Thinking
Potential Limitation
One significant potential limitation of using systematic reviews to guide practice is the "Apples and Oranges" Problem (Clinical Heterogeneity).
Sample Answer
Definition and Purpose
Definition and Difference from Other Reviews
A systematic review is a form of literature review that collects and critically appraises all available research evidence (typically randomized controlled trials) that fits a pre-specified eligibility criteria to answer a specific, clearly defined clinical question.
The key difference between a systematic review and other reviews, like a narrative review, lies in the methodology: