| Course | N415 Research / Evidence-Based Practices |
|---|---|
| Module | Module 4 |
| Paper type | PICOT and search paper |
| Length | About 1,075 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Pre-licensure BSN |
| Updated | September 2026 |
Free sample paper for N415 Module 4
From a Bottle on the Flowmeter to a Searchable Question: A PICOT Question and Documented Search on Humidifying Low-Flow Oxygen
Student Name
Pre-licensure BSN Program, Aspen University
N415: Research / Evidence-Based Practices
Instructor Name
Month Day, Year
From a Bottle on the Flowmeter to a Searchable Question: A PICOT Question and Documented Search on Humidifying Low-Flow Oxygen
Evidence-based practice starts with a question precise enough to search (Melnyk & Fineout-Overholt, 2023). On the 32-bed medical unit where I completed clinical hours, 11 of the 12 patients receiving oxygen by nasal cannula one morning had a bubble humidifier attached, all of them at 4 liters a minute or less. Two of them still complained that their noses were dry. This paper turns that observation into a PICOT question, documents a search of two databases with the real record counts, and shows how the results were screened. The unit and its patients are composites; the searches and counts are real and can be repeated.
The PICOT Question
In adult medical inpatients receiving oxygen at 4 liters a minute or less by nasal cannula (P), does delivering oxygen without a bubble humidifier (I), compared with bubble-humidified oxygen (C), change nasal and throat discomfort, nosebleeds and contamination of oxygen equipment (O) over the hospital stay (T)? The population is limited to adults on low flows because guidelines and trials treat higher flows differently. The intervention is framed as removing a device, which matters later, since stopping a habit meets different barriers than starting one. The outcomes combine what patients feel with a safety outcome, and the time frame is the admission, the period when nurses control the equipment.
Question Type and the Evidence It Needs
Because the question asks whether an intervention works, the strongest answer would come from a systematic review of randomized controlled trials, followed by individual trials (Melnyk & Fineout-Overholt, 2023). Knowing that in advance shapes the search: the goal is to find reviews and trials first, while noting surveys and qualitative studies that may explain practice and patients' views.
Search Terms
Concepts were built from the PICOT elements. For oxygen, the Medical Subject Heading Oxygen Inhalation Therapy was combined with the keyword oxygen. For humidification, the heading Humidifiers was combined with the truncated keyword humidif* and with phrases such as bubble humidifier, non-humidified and dry oxygen. For low flow, keywords included low-flow, low flow, nasal cannula and nasal prongs. Outcome terms such as comfort, dryness and epistaxis were tried as a separate line and later dropped, because they cut relevant trials whose abstracts described outcomes in other words. Terms within a concept were joined with OR so that any synonym would retrieve a record, and the concepts were joined with AND so that each record had to touch every part of the question. Truncation with an asterisk captured humidify, humidified, humidifier and humidification in one term.
PubMed Search Log
The table records each PubMed line as run on September 30, 2026.
| Line | Search | Records |
|---|---|---|
| 1 | Oxygen Inhalation Therapy (MeSH) | 30,485 |
| 2 | humidif* in title or abstract | 5,939 |
| 3 | (line 1 OR oxygen) AND (line 2 OR Humidifiers MeSH) | 1,266 |
| 4 | line 3 AND (nasal cannula OR low-flow OR low flow) | 418 |
| 5 | line 4 AND (comfort OR dryness OR epistaxis OR discomfort); English; adults | 23 |
| 6 | (bubble humidification OR bubble humidifier OR non-humidified OR dry oxygen OR humidified oxygen) AND (low-flow OR low flow OR nasal cannula OR nasal prongs) | 90 |
| 7 | line 6, English, excluding high-flow in the title | 38 |
What the Log Shows
Line 4 looked promising at 418 records, but a scan of line 5 showed that almost every result concerned heated high-flow nasal oxygen, a different therapy that is always humidified. Adding outcome words had narrowed the set without making it relevant. The search was therefore rebuilt around the specific comparison. Line 6 named the intervention and comparison in the words authors actually use, and line 7 removed titles about high-flow therapy. Even the final 38 records included studies of apneic oxygenation during anesthesia, nebulizers and newborn breathing support, so screening by title and abstract was still essential.
Europe PMC and the Trial PubMed Missed
A second search in Europe PMC, run the same day for bubble humidification, bubble-humidified, non-humidified oxygen or dry oxygen in titles and abstracts combined with low flow, nasal cannula or comfort, returned 12 records. One of them was the Oxyrea trial, which randomized patients in nine intensive care units to humidified or dry oxygen (Poiroux et al., 2018), which PubMed line 7 had missed because its abstract describes flows in liters a minute and never uses the terms low-flow or nasal cannula. The lesson is practical: a single database and a single set of words can miss the most relevant trial, and a second source is part of a documented search, not an extra.
Screening and Sources Kept
Records were screened against the PICOT: adults, low-flow delivery, humidified compared with dry oxygen and a patient or safety outcome. Pediatric studies, high-flow studies and bench tests were excluded. The sources kept are listed with their levels of evidence.
| Source | Design | Level |
|---|---|---|
| Wen et al. (2017) | Systematic review and meta-analysis of 27 randomized trials | I |
| Poiroux et al. (2018) | Randomized non-inferiority trial, 354 intensive care patients | II |
| Franchini et al. (2016) | Randomized trial, 18 adults starting long-term oxygen, followed 24 months | II |
| Campbell et al. (1988) | Prospective comparison, 185 patients on nasal oxygen | IV |
Limits of This Search and Next Steps
Only two free databases were searched so that any reader can repeat the log. A complete search for a practice change would add CINAHL through the Aspen library, check the reference lists of the review and the trials, and look for guidelines. Even so, the pattern is clear: a meta-analysis found no benefit of routine humidification at low flows for dryness or nosebleeds and less contamination without it (Wen et al., 2017); a long-term trial found that cold bubble humidification performed no better than none for nasal clearance and symptoms (Franchini et al., 2016); an older comparison found that complaints of nasal and throat dryness did not rise when humidification was left off (Campbell et al., 1988); and the intensive care trial supported dry oxygen at 4 liters or less after 24 hours (Poiroux et al., 2018). The next step is to appraise the review in depth.
Conclusion
A bottle of water on a flowmeter became a question about adults on low-flow oxygen, a set of search terms and a log that another reader can repeat. The search failed once, was rebuilt, and caught a missed trial in a second database. That record, more than the final count, shows how the evidence was found.
References
Campbell, E. J., Baker, M. D., & Crites-Silver, P. (1988). Subjective effects of humidification of oxygen for delivery by nasal cannula: A prospective study. Chest, 93(2), 289-293. https://doi.org/10.1378/chest.93.2.289
Franchini, M. L., Athanazio, R., Amato-Lourenco, L. F., Carreirao-Neto, W., Saldiva, P. H. N., Lorenzi-Filho, G., Rubin, B. K., & Nakagawa, N. K. (2016). Oxygen with cold bubble humidification is no better than dry oxygen in preventing mucus dehydration, decreased mucociliary clearance, and decline in pulmonary function. Chest, 150(2), 407-414. https://doi.org/10.1016/j.chest.2016.03.035
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
Poiroux, L., Piquilloud, L., Seegers, V., Le Roy, C., Colonval, K., Agasse, C., Zinzoni, V., Hodebert, V., Cambonie, A., Saletes, J., Bourgeon, I., Beloncle, F., & Mercat, A. (2018). Effect on comfort of administering bubble-humidified or dry oxygen: The Oxyrea non-inferiority randomized study. Annals of Intensive Care, 8, Article 126. https://doi.org/10.1186/s13613-018-0472-9
Wen, Z., Wang, W., Zhang, H., Wu, C., Ding, J., & Shen, M. (2017). Is humidified better than non-humidified low-flow oxygen therapy? A systematic review and meta-analysis. Journal of Advanced Nursing, 73(11), 2522-2533. https://doi.org/10.1111/jan.13323
Reading the N415 Module 4 assignment instructions
Searching for evidence is part of the N415 content in Aspen's catalog, and this example follows that content since the module's real prompt is unavailable to the public. Expect this kind of assignment to want a practice problem, the question with each element labeled, its question type, the keywords and subject headings you used, and a record of every search with its database, date, limits and result count. Many instructors also want the articles you kept and why. Check which databases are required, whether CINAHL through the Aspen library must be included, whether a search table is expected, and how many sources you should retain at the end. Save a screenshot or export of each search in case your instructor asks to see it.
How this N415 Module 4 example is built
This sample holds about 1,070 words in ten sections and two tables. It opens with an audit of 12 oxygen patients on one unit. The PICOT section writes the question and justifies each element. A short section names the question type and the evidence it calls for. Search terms explain the headings, synonyms, Boolean joins and truncation. The PubMed log table records seven lines with counts. What the log shows explains the failed line and the rebuild. A section on Europe PMC reports the trial PubMed missed and why. Screening criteria and a table of kept sources follow, then limits, next steps and a conclusion. Counts are given exactly as PubMed reported them that day.
Where the marks sit in the N415 Module 4 rubric
Rubrics for this assignment typically award points for a complete and focused question, appropriate terms, a reproducible search record and sensible selection of sources. The question earns its points because each element is justified, not only labeled. Terms include subject headings and synonyms. The log is reproducible, with dates and counts, and a margin note explains why that matters. Selection is shown in a screening statement and a table that places each source at its level. Instructors often add credit for honest reflection, which this paper provides in the explanation of the failed search and the missed trial. APA references for four studies and the evidence-based practice text finish the marks. Keeping the limits section honest about databases not searched also protects those points.
Common N415 Module 4 mistakes, and how to avoid them
Students most often write PICOT questions too wide to search well, like asking if oxygen humidification is good for patients. Narrow the population, name the comparison and pick measurable outcomes. Another common error is listing only keywords and skipping subject headings, or the reverse; use both. Many logs record the final search but not the lines that failed, which hides the reasoning. Keep the failures. Some students also forget the date, although counts change weekly. Finally, do not treat the number of results as the goal. A search that returns 38 records you actually screen is better than one returning 1,000 you cannot. Write down why each excluded record was set aside.
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.
More N415 and Pre-licensure BSN sample papers
- N415 Module 1: The Research Process Traced Through One Study
- N415 Module 2: Critique of a Randomized Oxygen Trial
- N415 Module 3: Critique of a Qualitative Oxygen Study
- N415 Module 5: Levels of Evidence and a Review Appraisal
- N415 Module 6: Failure to Rescue as a Quality Indicator
- N415 Module 7: Implementation and Evaluation Plan
- N415 Module 8: Disseminating Evidence and Informatics
- N437 Module 8: Informatics Presentation on Patient Room Whiteboards
- N455A Module 1: Study Plan From a Diagnostic Exam
- N489 Module 1: Population-Focused Nursing in Pueblo County
- N410 Module 7: The Nurse's Role in Acute Ischemic Stroke
N415 Module 4 questions, answered
What does N415 Module 4 usually ask for?
Aspen's N415 description includes turning practice problems into searchable questions, so a PICOT question with a documented search is a common assignment. Check your classroom for the required databases and format.
Do I have to include the number of results for each search?
Most search logs ask for them, because counts show how each line narrowed the set. Record the date, since counts change as databases grow.
Why search more than one database?
Databases index articles differently, and a single set of words can miss a key study. A second source is how you show the search was thorough.
Where can I find a free N415 Module 4 sample paper?
This page reproduces the complete PICOT and search paper, including both tables and the margin notes, at no cost. It sits fourth in the N415 series and leads into the Module 5 appraisal of the review it found.
How many searches should an N415 Module 4 search log show?
Enough to show how you moved from broad concepts to a focused set: usually each concept on its own, then combined, then limited. Include lines that failed and say what you changed.