[Expert Solution]: Using the “Levels of Evidence” chart, read…

Using the “Levels of Evidence” chart, read each abstract and then identify the level of evidence of the study. In a brief comment, explain your answer. Level Description Level I Systematic Reviews (Integrative/Meta-analyses) CPGs (Clinical practice guidelines) based on Systematic Reviews/Large Multi-Center Clinical Trials Level II Single Experimental Study (RCTs) Level III Quasi-Experimental Studies Level IV Non-Experimental Studies Level V Case Report/Program Evaluation/Narrative Literature Reviews Level VI Opinions of Respected Authorities Adapted from the work of Stetler, Morsi, Rucki, Broughton, Corrigan, Fitzgerald, et al. (1998); Melnyk and Fineout-Overholt (2011); Levin (2008). Flag question: Question 1 Question 10 pts McDonald, M. V., Pezzin, L. E., Feldman, P. H,, Murtaugh, C. M., & Peng, T. R. (2005). Can just­‐in-time, evidence­‐based “reminders” improve pain management among home health care nurses and their patients. Journal of Pain & Symptom Management, 25(5), 474–488. Abstract: The purpose of this randomized, controlled home care intervention was to test the effectiveness of two nurse-targeted e-mail-based interventions to increase home care nurses’ adherence to pain assessment and management guidelines, and to improve patient outcomes. Nurses from a large urban nonprofit home care organization were assigned to usual care or one to two interventions upon identification of an eligible cancer patient with pain. The basic intervention consisted of a patient-specific, one-time e-mail reminder highlighting six pain-specific clinical recommendations. The augmented intervention supplemented the initial e-mail reminder with provider prompts, patient education material, and clinical nurse specialist outreach. Over 300 nurses were randomized and outcomes of 673 of their patients were reviewed. Data collection involved clinical record abstraction of nurse care practices and patient interviews completed approximately 45 days after start of care. The intervention had limited effect on nurse-documented care practices but patient outcomes were positively influenced. Patients in the augmented group improved significantly over the control group in ratings of pain intensity at its worst, whereas patients in the basic group had better ratings of pain intensity on average. Other outcome measures were also positively influenced but did not reach statistical significance. Our findings suggest that although reminders have some role in improving cancer pain management, a more intensive approach is needed for a generalized, nursing workforce with limited recent exposure to state‐of-the‐art pain management practices. Group of answer choices Level I Level II Level IV Level V/VI Not applicable Flag question: Question 2 Question 20 pts Explain your answer: p Flag question: Question 3 Question 30 pts Clark, L., Fink, R., Pennington, K., & Jones, K. (2006). Nurses’ reflections on pain management in a nursing home setting. Pain Management Nursing, 7(2), 71–77. Abstract: Achieving optimal and safe pain-management practices in the nursing home setting continues to challenge administrators, nurses, physicians, and other health care providers. Several factors in nursing home settings complicate the conduct of clinical process improvement research. The purpose of this qualitative study was to explore the perceptions of a sample of Colorado nursing home staff who participated in a study to develop and evaluate a multifaceted pain-management intervention. Semi-structured interviews were conducted with 103 staff from treatment and control nursing homes, audiotaped, and content analyzed. Staff identified changes in their knowledge and attitudes about pain, and their pain assessment and management practices. Progressive solutions and suggestions for changing practice include establishing an internal pain team and incorporating nursing assistants into the care planning process. Quality improvement strategies can accommodate the special circumstances of nursing home care and build the capacity of the nursing homes to initiate and monitor their own process improvement programs using a participatory research approach. Group of answer choices Level I Level III Level IV Level V/VI Not applicable Flag question: Question 4 Question 40 pts Explain your answer: p Flag question: Question 5 Question 50 pts Dewar, A. (2006). Assessment and management of chronic pain in the older person living in the community. Australian Journal of Advanced Nursing, 24(1), 33–38. Abstract: This paper reviews the nursing research literature on chronic pain in the older person living in the community and suggests areas for future research. Background: Chronic pain is a pervasive and complex problem that is difficult to treat appropriately. Nurses managing chronic pain in older people in domiciliary/home/community nursing sett