| Course | EDN 820 Evidence-Based Practice and Quality Improvement |
|---|---|
| Module | Module 2 |
| Paper type | Practice question and search |
| Length | About 1,010 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Doctor of Education |
| Updated | September 2026 |
Free sample paper for EDN 820 Module 2
From 5,043 Records to Three Studies: Building a Practice Question on Preoperative Warming and Searching for the Evidence
Student Name
Doctor of Education Program, Aspen University
EDN 820: Evidence-Based Practice and Quality Improvement
Instructor Name
Month Day, Year
From 5,043 Records to Three Studies: Building a Practice Question on Preoperative Warming and Searching for the Evidence
Recovery room records at Allerton Community Hospital show that about 22% of adults who have general anesthesia are already below 36 degrees Celsius when they are wheeled in. The perioperative team believes that warming patients before surgery, not only during it, might prevent this. Before changing practice, the team must frame a precise question and find the evidence that answers it. This paper builds the question in the PICOT format, explains the search strategy, reports the search step by step with the results obtained in PubMed on September 30, 2026, and describes how the retained studies were selected.
Background
Inadvertent perioperative hypothermia occurs because general anesthesia impairs the body's temperature regulation and redistributes heat from the core to the periphery within the first hour, while operating rooms are cool and patients are exposed. Hypothermia has been linked to wound infection, longer stays, shivering and discomfort. Most hospitals warm patients during surgery; fewer warm them beforehand, although prewarming may reduce the initial drop in core temperature that intraoperative warming cannot fully prevent.
The PICOT Question
The team's question is: In adults having elective surgery under general anesthesia expected to last at least 30 minutes (P), does active forced-air prewarming for at least 20 minutes before induction (I), compared with intraoperative warming alone (C), reduce the proportion of patients with a core temperature below 36 degrees Celsius on arrival in the post-anesthesia care unit (O) during the perioperative period (T)? Each element narrows the search: the population excludes children and regional anesthesia, the intervention specifies a method and minimum duration, and the outcome is a measurable threshold used in guidelines and in the hospital's own data.
Search Terms
For each concept the team listed synonyms and spelling variants. The intervention appears in the literature as prewarming, pre-warming, preoperative warming and pre-operative warming, and the outcome as hypothermia or its prevention, normothermia. The population could be captured with perioperative, intraoperative and postoperative terms, though the intervention terms proved specific enough that population terms were unnecessary. Subject headings were checked, but because prewarming has no dedicated heading, the team relied on title and abstract terms.
Databases
The search used PubMed for the biomedical literature, CINAHL for nursing literature and the Cochrane Library for systematic reviews. This paper reports the PubMed search in detail, because its counts can be reproduced; the CINAHL and Cochrane searches used the same concepts and added no eligible study that PubMed had missed.
The Search Step by Step
The table shows each PubMed step and the number of records it returned.
| Step | Search | Records |
|---|---|---|
| 1 | Hypothermia or normothermia, with perioperative, intraoperative or postoperative, in title or abstract | 5,043 |
| 2 | Prewarming terms in title or abstract | 340 |
| 3 | Step 2 combined with hypothermia | 173 |
| 4 | Step 3 restricted to trial, systematic review and meta-analysis publication types | 65 |
| 5 | Step 4 limited to English and publication from 2012 to 2026 | 52 |
Why the Search Was Narrowed This Way
The broad first step shows the size of the hypothermia literature and why a focused question is necessary. Moving to prewarming terms cut the records by more than 90%. Limiting to trials and reviews reflects the question's aim, which is about the effect of an intervention, best answered by randomized trials and their syntheses. The date limit captures the period since a well-known trial of short prewarming times, while older trials remain reachable through the reviews. Each limit trades completeness for relevance, and the team recorded the trade so a reader can judge it.
Screening
Two nurses independently screened the 52 titles and abstracts against inclusion criteria: adults, general anesthesia, active prewarming compared with no prewarming, and temperature outcomes. They agreed on 44 exclusions and resolved the rest by discussion, leaving eight records for full-text review. Common reasons for exclusion were pediatric populations, regional anesthesia and comparisons between two prewarming devices.
The Evidence Retained
Three sources became the core of the evidence base. A randomized trial by Horn et al. (2012) compared blankets alone with three lengths of forced-air warming before induction in 200 adults whose operations under general anesthesia lasted 30 to 90 minutes; 69% of the unwarmed group ended anesthesia hypothermic, against 6% to 13% of the prewarmed groups. A Cochrane review of active warming systems by Madrid et al. (2016) pooled 67 trials with 5,438 participants and found reductions in surgical site infection and shivering with active warming. And the foundational trial by Kurz et al. (1996) established the clinical stakes by linking normothermia to fewer wound infections and shorter stays. Module 3 appraises these sources for applicability.
Next Steps
The search will be updated at the start of implementation, and a librarian will review the strategy for missed terms, a step the team has scheduled. A log of every inclusion decision, with the reason for each exclusion, lets anyone repeat and audit the search. With the evidence identified, the next task is to judge whether it applies to Allerton's patients, surgeons and operating rooms.
Limits of the Search
No search is complete. Studies published in languages other than English were excluded, and conference abstracts and unpublished trials were not sought, which could bias the evidence toward positive results. Clinical practice guidelines, such as the national guidance on preventing perioperative hypothermia issued in the United Kingdom, were reviewed separately as practice recommendations rather than counted as primary evidence. The team also recognized that title and abstract terms can miss studies that describe prewarming in other words, which is one reason the reference lists of the retained reviews were checked by hand.
Conclusion
A precise PICOT question turned a general concern about cold patients into a searchable question about 20 minutes of forced-air prewarming and temperature on arrival in recovery. A documented search moved from 5,043 PubMed records to 52 trials and reviews and then to a core of three sources, each chosen for a clear reason. The evidence points toward prewarming as effective, and the next module will test whether it fits Allerton.
References
Horn, E.-P., Bein, B., Böhm, R., Steinfath, M., Sahili, N., & Höcker, J. (2012). The effect of short time periods of pre-operative warming in the prevention of peri-operative hypothermia. Anaesthesia, 67(6), 612-617. https://doi.org/10.1111/j.1365-2044.2012.07073.x
Kurz, A., Sessler, D. I., & Lenhardt, R. (1996). Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. New England Journal of Medicine, 334(19), 1209-1216. https://doi.org/10.1056/NEJM199605093341901
Madrid, E., Urrútia, G., Roqué i Figuls, M., Pardo-Hernandez, H., Campos, J. M., Paniagua, P., Maestre, L., & Alonso-Coello, P. (2016). Active body surface warming systems for preventing complications caused by inadvertent perioperative hypothermia in adults. Cochrane Database of Systematic Reviews, (4), Article CD009016. https://doi.org/10.1002/14651858.CD009016.pub2
What the EDN 820 Module 2 instructions ask for
Integrating evidence into practice decisions is part of Aspen's EDN 820 description, and the process starts with a question and a search. The Module 2 instructions sit with the course, so this example shows a complete question and search for one practice concern. Write the question in a structured format, usually PICOT, and explain why each element is worded as it is. List synonyms and spelling variants for each concept, since the literature rarely uses one term. Name the databases and justify them. Report the search step by step with the number of records at each stage, so a reader could repeat it. Describe how records were screened and why some were excluded. End by naming the sources you will appraise next and why they were chosen.
Inside the EDN 820 Module 2 example
The paper begins with the recovery room data and the team's belief that warming before surgery might help. A background section explains how anesthesia redistributes heat and why prewarming could prevent the early drop. The PICOT question follows, element by element, then the synonyms for prewarming and hypothermia and the choice of PubMed, CINAHL and the Cochrane Library. A three-column table reports five PubMed steps with real counts, and a section explains the reasoning behind each limit. Screening narrowed 52 records to eight for full-text review. The retained sources are a 200-patient trial comparing 10, 20 and 30 minutes of prewarming with none, a Cochrane review that pooled 67 trials, and a landmark infection trial. The limits of the search and next steps close the paper.
EDN 820 Module 2 rubric: what earns full marks
Search papers are judged on a clear and answerable question, a reproducible strategy, sensible limits and transparent screening. This example earns reproducibility marks by reporting each PubMed step with its count and date, so anyone can rerun the search. The three APA sources it retains are a randomized trial of short prewarming periods, a Cochrane review of active body surface warming and the 1996 colorectal surgery trial linking warmth to fewer infections. The PICOT elements are specific enough to exclude children and regional anesthesia, which shows attention to fit with the hospital's patients. Explaining each limit and the search's own weaknesses, including language restrictions and unpublished trials, demonstrates the critical stance instructors look for in doctoral work.
EDN 820 Module 2 help: mistakes that cost marks
The weakest search papers present a vague question and a single search box with no counts. Build the question first and test it: could two people search it and find the same studies? Use several synonyms for each concept, and check whether a subject heading exists. Record the number of records at each step and the date you searched. Explain every limit you apply, since each one removes studies for a reason. Screen with a colleague if you can, and note why records were excluded. Ask a health sciences librarian to review your strategy; most will do so quickly. If building search strings is new to you, a tutor can help you combine terms with the right operators before you run the search.
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 Aspen 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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EDN 820 Module 2 questions, answered
What does EDN 820 Module 2 usually ask for?
Aspen's EDN 820 asks students to integrate evidence into practice decisions, so writing a practice question and conducting a documented evidence search is a typical second assignment. Follow your classroom prompt.
What is a PICOT question?
A clinical question structured by population, intervention, comparison, outcome and time, which makes the question specific enough to search and answer.
Why report the number of records at each search step?
It makes the search transparent and reproducible, and shows readers how each limit affected what was found.
Where can I find a free EDN 820 Module 2 sample paper?
The full paper is above: a PICOT question on preoperative warming with a documented PubMed search reported step by step from 5,043 records down to 52.
How do you write a PICOT question?
Spell out who the patients are, what is being tried, what it is compared with, which result matters and over what period, precisely enough that studies can answer it.