| Course | NUR-5300 Evidence-Based Nursing Practice |
|---|---|
| Module | Module 1 |
| Paper type | Clinical question development paper |
| Length | About 1,040 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | Master of Science in Nursing |
| Updated | October 2026 |
Free sample paper for NUR 5300 Module 1
From Every Nauseated Patient to One Searchable Question: Developing a PICOT Question on Inhaled Isopropyl Alcohol in an Ambulatory Surgery PACU
Student Name
Master of Science in Nursing (MSN), Thomas Edison State University
NUR-5300: Evidence-Based Nursing Practice
Mentor Name
Month Day, Year
From Every Nauseated Patient to One Searchable Question: Developing a PICOT Question on Inhaled Isopropyl Alcohol in an Ambulatory Surgery PACU
Graduate evidence-based practice starts where undergraduate courses often stop: with a question narrow enough that the literature can actually answer it. I work as a registered nurse in the post-anesthesia care unit of a freestanding ambulatory surgery center, and the problem I chose for this course is one every recovery nurse knows. Some patients become nauseated after surgery despite prophylaxis, nausea delays discharge, and rescue options are limited by what is ordered. Over several months a few nurses on our unit began offering patients an alcohol prep pad to sniff, and some swore by it. This paper describes how that practice problem was narrowed, step by step, into a searchable clinical question, and why each choice was made.
The Practice Problem in Numbers
Our center performs about 6,500 procedures a year, mostly orthopedic, gynecologic, ear, nose and throat, and general surgery, and discharges almost all patients the same day. A three-month review of PACU records that our unit's quality nurse and I conducted found nausea documented in about one in seven patients in phase one recovery despite prophylaxis, rescue antiemetics given to most of them, and a median delay of about thirty minutes to discharge readiness for patients who received rescue treatment. The center's anesthesia group uses a risk-based prophylaxis protocol, and our rescue order set allows a single dose of an antiemetic from a different class than the one used for prophylaxis.
The problem has a patient side as well as a throughput side. Patients often rank feeling sick after surgery above pain as the part they dread, and some who are nauseated delay drinking, walking or voiding, all of which are discharge criteria. Nurses described frustration at waiting for a provider to order a second rescue drug when the first one failed. The unofficial alcohol pad practice grew out of that frustration, which is exactly why it deserves a proper question rather than either enthusiasm or dismissal.
The informal alcohol pad practice also raised a safety question that made a formal review necessary. No one had agreed on which patients should be offered a pad, how long they should inhale, or whether it should ever replace a rescue drug, and practices that spread informally tend to drift in exactly those directions. A clear question was the first step toward either a sanctioned protocol or a decision to stop.
Placing the Problem in the Existing Evidence
Two bodies of evidence frame the question. The first concerns who is at risk. Apfel et al. (1999) developed a simplified risk score from four factors, female sex, nonsmoking status, a history of motion sickness or prior postoperative nausea, and the use of postoperative opioids, and showed that risk rises with the number of factors present; this score remains the basis of prophylaxis recommendations. The second concerns treatment. The fourth consensus guidelines for postoperative nausea and vomiting recommend risk-based multimodal prophylaxis and rescue treatment with an antiemetic from a class not already given, and they discuss nonpharmacologic options with varying levels of evidence (Gan et al., 2020).
A Cochrane review by Hines et al. (2018) is the most direct source on aromatherapy. It found low-quality evidence that aromatherapy in general did not reduce nausea severity compared with placebo, but moderate-quality evidence that inhaled isopropyl alcohol shortened the time to a fifty percent reduction in nausea compared with standard antiemetics and reduced the need for rescue antiemetics. The review's mixed findings are the clearest sign that the question needed narrowing: aromatherapy is not one intervention, and the evidence differs by agent and comparison.
Narrowing the Question Step by Step
The first version of the question was whether aromatherapy helps postoperative nausea. It was too broad in every element. The population included everyone from children to inpatients after major surgery; the intervention included peppermint, ginger, lavender, blends and alcohol; and the outcome was undefined. Each element was narrowed in turn. The population became adults in phase one recovery after ambulatory surgery who report nausea despite prophylaxis, because that is our setting and because the Cochrane review distinguishes treatment from prevention. The intervention became inhaled isopropyl alcohol from a standard prep pad, because it is the agent with the most consistent evidence, is already stocked in every bay and costs almost nothing.
The comparison was the hardest choice. Comparing alcohol with placebo would answer whether it works at all, but our patients will never receive a placebo; the realistic alternative is a rescue antiemetic. The comparison therefore became standard rescue antiemetic alone. The outcome became nausea severity on an eleven-point verbal numeric rating scale, with the need for additional rescue medication as a secondary outcome, both measured within thirty minutes because that is the window in which a PACU nurse decides whether a patient is improving.
Each narrowing decision was checked against two tests: whether studies of that kind were likely to exist, and whether the answer would change what our nurses do. A question that passes the first test but not the second produces interesting reading and no practice change; one that passes the second but not the first produces no evidence at all.
The Final Question and What It Excludes
The final question reads: in adults with postoperative nausea in phase one recovery after ambulatory surgery (P), does inhaled isopropyl alcohol added to standard rescue antiemetic treatment (I), compared with standard rescue antiemetic treatment alone (C), reduce nausea severity on a verbal numeric scale and the need for additional rescue medication (O) within thirty minutes (T)?
The question deliberately excludes prevention, vomiting as a primary outcome, children and inpatients. Each exclusion narrows the search and keeps the eventual recommendation within what our unit can change. The question also accepts a design limitation that the literature will impose: most trials of isopropyl alcohol compare it with an antiemetic or placebo rather than as an addition to an antiemetic, so the evidence will answer a neighboring question rather than this exact one. Recognizing that gap now will shape how the next modules search for and judge studies. The question is ready to search, and it is honest about what the answer can and cannot show.
References
Apfel, C. C., Läärä, E., Koivuranta, M., Greim, C.-A., & Roewer, N. (1999). A simplified risk score for predicting postoperative nausea and vomiting: Conclusions from cross-validations between two centers. Anesthesiology, 91(3), 693-700. https://doi.org/10.1097/00000542-199909000-00022
Gan, T. J., Belani, K. G., Bergese, S., Chung, F., Diemunsch, P., Habib, A. S., Jin, Z., Kovac, A. L., Meyer, T. A., Urman, R. D., Apfel, C. C., Ayad, S., Beagley, L., Candiotti, K., Englesakis, M., Hedrick, T. L., Kranke, P., Lee, S., Lipman, D., . . . Philip, B. K. (2020). Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesthesia & Analgesia, 131(2), 411-448. https://doi.org/10.1213/ANE.0000000000004833
Hines, S., Steels, E., Chang, A., & Gibbons, K. (2018). Aromatherapy for treatment of postoperative nausea and vomiting. Cochrane Database of Systematic Reviews, 2018(3), Article CD007598. https://doi.org/10.1002/14651858.CD007598.pub3
What the NUR 5300 Module 1 instructions ask for
The opening module of NUR-5300 usually asks for a clinical question developed from a practice problem. Expect to show the problem's size with data, situate it in the existing evidence, write a question in PICOT or a similar format, and explain how each element was chosen. At the graduate level, mentors expect the question to be narrow enough to search and justified against what is already known. Look in the TESU classroom for whether your mentor must approve the question before Module 2, whether unit data may be used, and whether a specific question format is required. De-identify any unit data you include.
Inside the NUR 5300 Module 1 example
The paper opens with the setting and the informal practice that prompted the question. A data section describes volume, nausea frequency, rescue use and discharge delay from a unit review, and adds the patient and nurse perspectives. A background section uses a risk score, the consensus guideline and a systematic review, each for a different purpose, and shows that mixed evidence demands a narrow question. The narrowing section moves element by element from a broad first version to a specific one, explaining each choice, especially the decision to compare against rescue antiemetics rather than placebo. The final section states the question, lists exclusions and anticipates a gap between the question and the available trials.
NUR 5300 Module 1 rubric: what earns full marks
A graduate question paper is marked on the clarity and significance of the practice problem, use of data and evidence to frame it, a well-formed and searchable question, justification of each element, and writing. Mentors give particular weight to justification: why this population, this comparison and this outcome, rather than others. Using existing evidence to show why the question needs narrowing is a mark of graduate reasoning. Significance earns credit when supported by local data or published burden. A question that anticipates limits in the available evidence, without becoming unanswerable, usually reaches the top band. Mentors also check that the outcome named in the question can actually be measured in the student's setting.
Common NUR 5300 Module 1 mistakes, and how to avoid them
Graduate students often write questions that are still too broad, naming a category of intervention rather than a specific one, or an outcome without a measure. Narrow each element until a search would return a manageable set of studies. Another frequent problem is a comparison no one would actually use, such as placebo when the realistic alternative is a standard treatment. Choose the comparison that matches your practice. Students also skip the existing evidence when framing the question, which leaves the mentor unsure whether it has already been answered. Check for a recent systematic review first. A question paper built on a problem from your own unit can be drafted at the desk from your notes.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Thomas Edison State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NUR 5300 Module 1 questions, answered
Where can I find a free NUR 5300 Module 1 sample paper?
You can read the complete clinical question paper above, annotated sheet by sheet. It develops a PICOT question on inhaled isopropyl alcohol for postoperative nausea; follow the same narrowing steps with a problem from your own practice.
How narrow should a graduate PICOT question be?
Tight enough that the search turns up studies you could actually appraise, dozens at most rather than thousands. Specify the population and setting, a single intervention, a realistic comparison, a measurable outcome and, where relevant, a time frame.
Should my comparison be placebo or standard care?
Usually standard care, because that is the realistic alternative in practice. Placebo comparisons show whether something works at all; standard-care comparisons show whether it is worth changing practice.
Do I need unit data for the NUR-5300 problem statement?
It strengthens the paper. A brief review of local records, de-identified and summarized, shows the problem's size in your setting. Published data on the burden of the problem are an acceptable substitute when unit data are unavailable.
What if a systematic review already answers my question?
Use it. A recent review either answers the question, which may shift your project toward implementation, or shows gaps, which can sharpen your question. Either way, cite it when you frame the problem.