Here is a complete NUR 506 Module 5 evidence table paper: the PICOT question, a table of four studies with design, level, sample, findings and limits, a narrative reading of the pattern across studies, a gap analysis and references. Searches like "nur 506 module 5 assignment", "nur506 module 5 evidence table paper" and "nur 506 module 5 example" land here.
The NUR 506 Module 5 example, in full
Sweet, Held or Nursing: An Evidence Table on Comfort Measures for Newborn Heel-Lance Pain
[Student Name]
Southern New Hampshire University
NUR 506: Evidence-Based Practice
Module Five Evidence Table Paper
[Instructor Name]
[Date]
The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.
Sweet, Held or Nursing: An Evidence Table on Comfort Measures for Newborn Heel-Lance Pain
The Question
On a composite 30-bed mother-baby unit, every healthy newborn has a heel lance for state screening at about 24 hours of age. Current practice is to give oral sucrose on a pacifier, often with the baby lying in a bassinet under a warmer, while the mother watches or waits in the hallway. Several nurses and lactation consultants have asked whether breastfeeding or holding the baby skin-to-skin during the lance would work as well or better. The question is: in healthy term newborns having a heel lance (P), does breastfeeding or skin-to-skin contact (I), compared with oral sucrose (C), reduce pain responses (O) during and immediately after the procedure (T)?
Selecting and Leveling the Sources
The search yielded many trials and several systematic reviews. Four sources were chosen for the table because together they cover every comparison in the question: one current Cochrane review of sucrose for heel lance, one trial comparing breastfeeding with sweet solution, one trial of skin-to-skin contact, and one trial that tested whether sucrose relieves pain in the brain. Levels follow a common nursing hierarchy: a review that pools randomized trials ranks as Level I, and one well-designed randomized study ranks as Level II (Melnyk & Fineout-Overholt, 2023). Level alone does not settle quality, so the limits column records each source's specific weaknesses.
Evidence Table
Each of the four sources occupies one row below, with the same five features recorded for every study.
Table 1
Evidence Table: Comfort Measures for Newborn Heel-Lance Pain
| Source | Design and level | Sample and comparison | Key findings | Limits |
|---|---|---|---|---|
| Yamada et al. (2023) | Systematic review of 55 randomized trials; Level I | 6,273 term and preterm infants; sucrose vs water, no treatment and other measures | Sucrose probably lowers pain scores after heel lance compared with control; effects versus breastfeeding very uncertain | Many small trials; mixed pain scales; certainty moderate to very low |
| Carbajal et al. (2003) | Randomized controlled trial; Level II | 180 term newborns; breastfeeding, held without feeding, water placebo, 30% glucose with pacifier | Breastfeeding and glucose with pacifier both sharply reduced pain scores; no significant difference between them | Venipuncture rather than heel lance; one French hospital |
| Gray et al. (2000) | Randomized controlled trial; Level II | 30 healthy newborns; skin-to-skin holding vs swaddled in crib | Crying reduced 82% and grimacing 65% with skin-to-skin; heart rate lower | Very small sample; no sucrose comparison |
| Slater et al. (2010) | Double-blind randomized trial; Level II | 59 newborns; 24% sucrose vs sterile water before heel lance | Pain-related brain and spinal activity did not differ; behavioral pain scores lower with sucrose | Small; 44 analyzed for primary outcome; neonatal unit sample |
Reading Across the Table
Read together, the sources show a consistent pattern for behavior. Sucrose reduced observed pain scores compared with water or no treatment in the Cochrane review, with moderate certainty for the main pain scale (Yamada et al., 2023). Breastfeeding reduced pain scores as much as a sweet solution with a pacifier did, and far more than holding without feeding or placebo (Carbajal et al., 2003). Skin-to-skin holding produced large reductions in crying and grimacing compared with a baby left in a crib (Gray et al., 2000).
One trial complicates the picture. When researchers measured pain-related activity in the brain and spinal cord, sucrose made no difference, even though the same babies looked more comfortable on a behavioral pain scale (Slater et al., 2010). If sucrose changes how a baby looks more than what the baby's nervous system registers, then behavioral scores alone may overstate its benefit. The trial is small and the finding is debated, but it matters for this question, because it suggests that sucrose should not be treated as a stronger measure than breastfeeding or holding simply because it is standard.
Gaps in the Evidence
The table also shows what is missing. No source compared skin-to-skin contact directly with sucrose in healthy term newborns, so any conclusion about that comparison is indirect. The breastfeeding trial used venipuncture, a different procedure from heel lance, although both are brief needle procedures. The review found the evidence comparing sucrose with breastfeeding to be very uncertain. Most trials measured pain only during and immediately after the procedure, so nothing is known about whether one measure leads to better feeding or settling afterward. Finally, the studies were done in hospitals where mothers were available and willing to breastfeed or hold their babies during the procedure, which is not always true.
What the Table Supports
The table supports three statements. Sucrose reduces behavioral signs of pain during heel lance compared with no treatment. Breastfeeding during a needle procedure reduces pain responses at least as well as a sweet solution. Skin-to-skin contact substantially reduces crying and grimacing compared with a baby left alone in a crib. It does not support the claim that sucrose is superior to breastfeeding or holding, and it raises a reasonable question about whether sucrose relieves pain or mainly changes behavior. These statements will guide the synthesis and recommendation in later modules, where the unit will consider whether the mother should be offered the chance to breastfeed or hold her baby skin-to-skin during screening, with sucrose kept for babies whose mothers are unavailable or choose not to.
Practical Notes for the Unit
Two practical points emerged while the table was built. First, the trials of breastfeeding and holding began the comfort measure before the lance and continued it throughout, so staff would need to time the procedure around a feed or a holding session rather than performing it on a schedule. Second, heel lance for blood collection requires a warm, accessible heel, which is compatible with a baby held skin-to-skin or breastfeeding if the nurse positions the leg carefully. These details will be tested with staff in a later module.
Conclusion
An evidence table on comfort measures for heel lance shows consistent behavioral benefit from sucrose, breastfeeding and skin-to-skin contact, with no evidence that sucrose is superior to the other two and one trial questioning whether it relieves pain at all. Laying the studies side by side makes that pattern visible and points the unit toward involving mothers in their babies' comfort during screening.
References
Carbajal, R., Veerapen, S., Couderc, S., Jugie, M., & Ville, Y. (2003). Analgesic effect of breast feeding in term neonates: Randomised controlled trial. BMJ, 326(7379), 13. https://doi.org/10.1136/bmj.326.7379.13
Gray, L., Watt, L., & Blass, E. M. (2000). Skin-to-skin contact is analgesic in healthy newborns. Pediatrics, 105(1), Article e14. https://doi.org/10.1542/peds.105.1.e14
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing and healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
Slater, R., Cornelissen, L., Fabrizi, L., Patten, D., Yoxen, J., Worley, A., Boyd, S., Meek, J., & Fitzgerald, M. (2010). Oral sucrose as an analgesic drug for procedural pain in newborn infants: A randomised controlled trial. The Lancet, 376(9748), 1225-1232. https://doi.org/10.1016/S0140-6736(10)61303-7
Yamada, J., Bueno, M., Santos, L., Haliburton, S., Campbell-Yeo, M., & Stevens, B. (2023). Sucrose analgesia for heel-lance procedures in neonates. Cochrane Database of Systematic Reviews, (8), Article CD014806. https://doi.org/10.1002/14651858.CD014806
How this NUR 506 Module 5 example is structured
An evidence table is only useful if the reader can see a pattern, so the paper surrounds the table with explanation. It opens with the question and the unit's current practice. A short section explains how sources were chosen and how levels were assigned. The table follows, one row per source. The narrative after it reads across the rows rather than down them, grouping studies by what they compare and naming where they agree and where one result points a different way. A gap analysis and a statement of what the table can and cannot support close the paper.
Get NUR 506 Module 5 written to your instructions
Send the NUR 506 evidence table instructions, the rubric and the studies from your search. An evidence table paper built from those sources comes back within 24 to 48 hours, and the first is free. The paper above is an original model document written by our desk, not a submitted student paper and not an official Southern New Hampshire University document.
NUR 506 Module 5 questions, answered
What goes into a NUR 506 evidence table?
Most evidence tables list each source with its citation, design, level of evidence, sample and setting, intervention and comparison, outcomes, key findings and limitations. Some templates also ask for a usefulness rating. The course template sets the columns, so match it exactly.
How is an evidence table different from an annotated bibliography?
An annotated bibliography describes each source separately. An evidence table puts the same features of every source side by side so that patterns, agreements and conflicts across studies become visible. The narrative that accompanies the table should interpret those patterns.
What is a heel lance?
A heel lance, or heel stick, is a small puncture on the side of a newborn's heel to collect drops of blood, most often for state newborn screening tests. It is brief but painful, which is why nurses use comfort measures such as sucrose, breastfeeding or skin-to-skin holding during the procedure.