| Course | NSG 324 Evidence Based Practice in Nursing |
|---|---|
| Unit | Unit 3 |
| Paper type | Point-of-care evidence search log |
| Length | About 850 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | RN to BSN |
| Updated | October 2026 |
Free sample paper for NSG 324 Unit 3
Searching at the Point of Care: Twenty-Five Minutes of Evidence on Routine Versus Clinically Indicated IV Catheter Replacement
Student Name
Department of Nursing, Herzing University
NSG 324: Evidence Based Practice in Nursing
Instructor Name
February 4, 2026
Searching at the Point of Care: Twenty-Five Minutes of Evidence on Routine Versus Clinically Indicated IV Catheter Replacement
The Question and the Conditions
The question, developed in the previous unit, asks whether replacing peripheral intravenous catheters in hospitalized adults only when clinically indicated, compared with routine replacement every 96 hours, leads to more or fewer cases of phlebitis and line-related bloodstream infection. I searched under the conditions I actually work in: on a night shift, during two breaks of 12 and 13 minutes, on a unit workstation. The resources available were the hospital's intranet, the hospital's licensed point-of-care summary database, the free public versions of PubMed and the Cochrane Library, and, from home the next day, Herzing's library for full texts behind paywalls. I did not have access to a medical librarian at night.
Where to Start and Why
A nurse with little time should begin with sources that have already found and appraised the evidence, and move to individual studies only if those sources do not answer the question. The 6S model arranges sources in that order, from computerized decision support and point-of-care summaries at the top, through synopses and systematic reviews, down to single studies at the base (DiCenso et al., 2009). Starting at the base, with a database search for individual trials, would have used both breaks before I found anything I could rely on.
The Search, Step by Step
The log below records each source in the order searched, with the time spent and what it produced.
| Order | Source and access | Terms or path | Time | What it yielded |
|---|---|---|---|---|
| 1 | Hospital intranet, policy manual (free to staff) | "peripheral IV" | 3 min | Current policy: replace at 96 hours; policy last reviewed 2019; cites a 2011 national guideline |
| 2 | Hospital's licensed point-of-care summary | peripheral catheter replacement | 5 min | Summary states that routine replacement has not been shown to reduce complications and describes clinically indicated removal with regular assessment; cites the Cochrane review and national infusion standards |
| 3 | Cochrane Library (free abstract and plain language summary) | "peripheral venous catheter" replacement | 6 min | Systematic review of randomized trials comparing the two strategies, updated 2019 |
| 4 | Journal of Infusion Nursing, standards supplement (full text via professional association link) | Browsed to the vascular access device removal section | 5 min | 2024 national infusion standards favor removal based on assessment and clinical need rather than a fixed schedule |
| 5 | PubMed, therapy filter, narrow scope, 2019 to present | peripheral catheter AND (routine OR "clinically indicated") AND replacement | 6 min | 12 results; no trial large enough to change the review's conclusion; the review's largest included trial found by title |
What the Evidence Says
The Cochrane review, the highest-level source for an intervention question, pooled randomized trials comparing clinically indicated with routine replacement in adults and found no clear difference between the strategies in catheter-related bloodstream infection or phlebitis, with lower costs when catheters were replaced only when indicated (Webster et al., 2019). The largest trial in the review, conducted in three hospitals and designed to test whether the two strategies were equivalent, also found similar phlebitis rates in the two groups (Rickard et al., 2012). The 2024 national infusion standards reflect this evidence in favoring removal based on assessment rather than dwell time (Nickel et al., 2024).
The hospital's 96-hour policy cites an older national guideline, which advised that adult peripheral catheters need no change sooner than 72 to 96 hours after insertion but explicitly left the question of clinically indicated replacement unresolved (O'Grady et al., 2011). The policy therefore does not contradict the guideline it cites; it reflects a question the guideline left open, which later evidence has addressed.
How Much Confidence the Answer Deserves
Three features raise confidence: the answer comes from a systematic review of randomized trials, the most appropriate design for an intervention question; the point-of-care summary and the national standards reach the same conclusion; and the finding has held across updates of the review. Two features limit it. Bloodstream infection from peripheral catheters is rare, so even pooled trials have limited power to detect a small difference in it. And the trials required regular site assessment in the clinically indicated group, so the evidence supports replacing catheters when clinically indicated with assessment, not simply leaving them in place without it.
What I Did Not Search, and Why
Three sources were deliberately left out. The first was CINAHL, the nursing database the school provides, which requires a school login and would have been the right place to look for nursing studies of site assessment practices; it was not needed for this intervention question once a current systematic review and a guideline agreed, and it is the first place I would go if the council asks how other hospitals implemented the change. The second was a general web search, which returns vendor pages and forum posts mixed with real evidence and would have cost time sorting them. The third was a search for studies in children, which the question excluded.
Stopping is also a decision. I stopped after the PubMed check because the higher-level sources agreed and the check for newer trials found nothing that would change their answer. Continuing to search after that point would have produced more reading, not a better answer.
Access, Honestly Reported
Everything needed to answer the question at the bedside was available during the shift, through the hospital's licensed summary, free Cochrane abstracts, and the infusion standards. The full text of the largest trial was behind the journal's paywall and was read the next day through the school library. A nurse without school access would have had to rely on the abstract, which in this case would have been enough for the decision, but not for a critique of the trial's methods.
What Happens Next
The evidence supports bringing a proposal to the practice council to change the policy from routine replacement at 96 hours to replacement when clinically indicated, with documented site assessment every shift. Until the policy changes, I will follow the current policy and share the search with my manager and the council chair. The largest trial will be critiqued in detail in the fifth unit, because a policy change should rest on more than an abstract.
References
DiCenso, A., Bayley, L., & Haynes, R. B. (2009). Accessing pre-appraised evidence: Fine-tuning the 5S model into a 6S model. Evidence-Based Nursing, 12(4), 99-101. https://doi.org/10.1136/ebn.12.4.99-b
Nickel, B., Gorski, L., Kleidon, T., Kyes, A., DeVries, M., Keogh, S., Meyer, B., Sarver, M. J., Crickman, R., Ong, J., Clare, S., & Hagle, M. E. (2024). Infusion therapy standards of practice, 9th edition. Journal of Infusion Nursing, 47(1S), S1-S285. https://doi.org/10.1097/NAN.0000000000000532
O'Grady, N. P., Alexander, M., Burns, L. A., Dellinger, E. P., Garland, J., Heard, S. O., Lipsett, P. A., Masur, H., Mermel, L. A., Pearson, M. L., Raad, I. I., Randolph, A. G., Rupp, M. E., Saint, S., & Healthcare Infection Control Practices Advisory Committee. (2011). Guidelines for the prevention of intravascular catheter-related infections. Clinical Infectious Diseases, 52(9), e162-e193. https://doi.org/10.1093/cid/cir257
Rickard, C. M., Webster, J., Wallis, M. C., Marsh, N., McGrail, M. R., French, V., Foster, L., Gallagher, P., Gowardman, J. R., Zhang, L., McClymont, A., & Whitby, M. (2012). Routine versus clinically indicated replacement of peripheral intravenous catheters: A randomised controlled equivalence trial. The Lancet, 380(9847), 1066-1074. https://doi.org/10.1016/S0140-6736(12)61082-4
Webster, J., Osborne, S., Rickard, C. M., & Marsh, N. (2019). Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database of Systematic Reviews, (1), Article CD007798. https://doi.org/10.1002/14651858.CD007798.pub5
What the NSG 324 Unit 3 instructions ask for
Unit 3 asks you to search for evidence on your clinical question under realistic time limits. Expect to restate the question, explain where to start and why, log each source searched with time and results, summarize what the evidence says, judge confidence, explain what you did not search and report access honestly. Many versions ask why to start with summaries rather than individual studies and whether to report searches that found nothing. Check whether your section sets a time limit. Pre-appraised sources such as Cochrane reviews and guidelines answer questions faster and more reliably than single studies. Report empty searches, since they show thoroughness. Note any access barriers, such as paywalls, that a bedside nurse would face.
How the NSG 324 Unit 3 example is put together
The search opens with the question and the conditions, a shift with limited time. The starting section explains the evidence pyramid and why summaries come first. The log is a table with source, time, search terms and results, which makes the process transparent. The evidence section summarizes the Cochrane review's findings in plain terms. The confidence section names features that raise and lower certainty. The not-searched section explains choices, such as skipping a database because higher-level sources had answered the question. The access section reports what was available through the hospital library. The final section states the next step. The log shows a search a busy nurse could repeat, which is the point of the assignment.
Where the points sit in the NSG 324 Unit 3 rubric
Herzing's rubric for a point-of-care search usually covers the question, the search strategy, documentation of the search, the summary of evidence, appraisal of confidence and transparency about limits. Strategy and the log carry most of the grade, so pre-appraised sources should come first and every step should be recorded. Summary points reward accurate statements of findings. Confidence criteria look for features that raise or lower certainty. Transparency earns credit for reporting empty searches and access problems. Next steps should follow from the evidence. A log table helps. Search terms recorded for each source let another nurse repeat the search, which graders often credit. The Cochrane review and DiCenso's 6S model belong in the APA 7 references.
Common NSG 324 Unit 3 mistakes, and how to avoid them
Search logs in Unit 3 often slip by starting with individual studies in a database instead of summaries and guidelines. Another frequent problem is not logging searches that found nothing. Students often summarize evidence without stating its level. Confidence is not discussed. Time spent is missing, so the point-of-care element is lost. Access problems are hidden. The question drifts during the search. Next steps are vague. Finally, report what you chose not to search and why, because graders reward a search that shows judgment about when enough high-level evidence has been found to answer the question. Another gap is mixing levels, such as treating one hospital's policy as equal to a systematic review.
Get a NSG 324 Unit 3 example written to your instructions
Send the Unit 3 instructions and the rubric from your NSG 324 classroom, plus your clinical question and what resources you can reach. We write a custom example that works the hierarchy, records the failed attempts and reports the time, returned in 24 to 48 hours. The first custom sample is free.
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NSG 324 Unit 3 questions, answered
Why start with summaries rather than studies?
Because somebody has already done the synthesis. For a practice question a current guideline or a point-of-care summary gives you an appraised answer in minutes, where assembling one yourself from individual studies takes hours you do not have on shift. Start at the top of the hierarchy and move down only when the filtered resources do not address your question.
Should I report searches that found nothing?
Yes, and it strengthens the submission. First attempts routinely return either nothing or thousands of irrelevant results, and the adjustments you made are the skill being assessed. A search reported as one successful string tells a reader you edited the history rather than that you searched well.
What if I cannot access the full text?
Say so and record what you did instead. Paywalls are the ordinary condition of practice, and noting that an apparently relevant study was unavailable, and whether an abstract or a citing guideline gave you enough, is more useful than a submission implying unlimited access. It also shows what your colleagues would face.
Where can I find a free NSG 324 Unit 3 sample paper?
This page shows the whole NSG 324 Unit 3 search log for free, every source with time spent, the Cochrane summary and confidence rating. A search log for your own question can be written on request.
Why start an evidence search with summaries rather than studies?
Systematic reviews and guidelines have already found and appraised the studies, so they answer questions faster and more reliably. This sample starts with the Cochrane review and finds the answer within 25 minutes.