NR 452 Week 3 Newborn Heel Stick Literature Matrix Example

Course	NR 452 Capstone Course
Week	3
Paper type	Literature matrix
Length	About 1,100 words, 7 pages
Format	APA 7 student paper
School	Chamberlain University
Program	BSN (pre-licensure)
Updated	October 2026

Free sample paper for NR 452 Week 3

Comforting Newborns During the Heel Stick: A Four-Row Literature Matrix for a Mother-Baby Unit

Student Name

College of Nursing, Chamberlain University

NR 452: Capstone Course

Instructor Name

Month Day, Year

What this page is doingThe title names the procedure, the setting and the number of rows fixed in advance, which tells the reader the matrix was built to end rather than to keep growing. Student APA 7 format, no running head.

Comforting Newborns During the Heel Stick: A Four-Row Literature Matrix for a Mother-Baby Unit

The Question and the Row Count

The problem statement from the previous week described what the writer observed during a maternity rotation: on a composite 28-bed mother-baby unit, healthy term newborns had their heel stick for newborn screening performed in the nursery bassinet, usually while their mothers were asleep or at a meal, with no comfort measure beyond a pacifier. The question for this matrix is which nonpharmacological comfort measure has the strongest evidence for reducing pain during heel lance in healthy term newborns, and which of those a mother-baby unit could offer routinely.

Before searching, the row count was fixed at four. The plan was to find the best available systematic review for each of three measures, skin-to-skin contact, breastfeeding and oral sucrose, and one primary trial showing what the measure looks like in practice with healthy term newborns. Searching stopped when the four rows were filled. Every cell below is written so that the final paper in Week 8 can be drafted from the grid alone, without reopening any article.

The search used CINAHL and PubMed with the terms heel lance, heel stick, newborn, procedural pain, skin-to-skin, kangaroo, breastfeeding and sucrose, limited to English. Cochrane reviews were preferred for each measure because they pool the trials a student would otherwise read one at a time, and the most recent version of each review was used. The primary trial was chosen because it studied healthy full-term newborns specifically, the population of a mother-baby unit, rather than preterm infants in intensive care, whose responses to pain and whose care routines differ.

What this page is doingThe row count is decided before searching and the reason for each row is stated, so the section closes on a decision rather than growing for as long as databases return results. Saying that the final paper will be written from the grid alone sets the standard every cell must meet.

Row 1: Gray et al. (2000)

Design: Randomized controlled trial.

Sample and setting: 30 healthy full-term newborns born at one United States hospital.

Intervention and comparison: Held skin-to-skin on the mother's chest for 10 to 15 minutes before and during the heel lance, compared with swaddled in a crib.

Measure: Crying, grimacing and heart rate during and after the procedure.

Result: Skin-to-skin reduced crying by 82 percent and grimacing by 65 percent compared with the crib, and heart rate rose less.

Sentence for the final paper: A small trial in healthy term newborns showed large reductions in crying and grimacing when the heel stick was done during skin-to-skin contact.

What this page is doingEach cell uses the same kind of phrasing down its column, and the result carries a measure and a number. The last line in every row is the sentence the final paper will need, which is the test of whether the cell is complete.

Row 2: Johnston et al. (2017)

Design: Systematic review and meta-analysis of randomized trials.

Sample and setting: 25 studies, about 2,000 infants, term and preterm, in several countries.

Intervention and comparison: Skin-to-skin care during a painful procedure compared with no intervention, sucrose or other care.

Measure: Composite pain scores such as the Premature Infant Pain Profile, plus heart rate and crying time.

Result: Skin-to-skin care reduced pain indicators for single painful procedures; the authors rated the certainty of the evidence as moderate to low because of small trials and difficulty blinding.

Sentence for the final paper: Across 25 trials, skin-to-skin care reduced measured pain during procedures such as heel lance, though the certainty of the evidence is moderate at best.

Row 3: Shah et al. (2012)

Design: Systematic review and meta-analysis of randomized and quasi-randomized trials.

Sample and setting: 20 studies of newborns, mostly term, undergoing heel lance or venipuncture.

Intervention and comparison: Breastfeeding or expressed breast milk compared with positioning, being held, placebo, sucrose or no intervention.

Measure: Heart rate, crying time and composite pain scores.

Result: Breastfeeding reduced pain indicators compared with positioning, holding or no intervention and appeared similar to sucrose; expressed breast milk alone was less effective than sucrose.

Sentence for the final paper: Breastfeeding during a heel stick reduced newborn pain indicators and performed about as well as sucrose, while expressed milk given by syringe was less effective.

Row 4: Stevens et al. (2016)

Design: Systematic review and meta-analysis of randomized trials.

Sample and setting: 74 studies of term and preterm newborns undergoing single painful procedures.

Intervention and comparison: Oral sucrose given about two minutes before the procedure compared with water, no treatment or other comfort measures.

Measure: Composite pain scores, crying time and heart rate.

Result: Sucrose reduced pain scores during heel lance, venipuncture and intramuscular injection, with high-quality evidence for some comparisons; effects on longer-term outcomes were not established.

Sentence for the final paper: Oral sucrose has the largest and most consistent evidence base for reducing pain during a single heel stick, but it requires a supply, an order or protocol, and a dose timed before the procedure.

What this page is doingThe largest review is placed last, not first, because the rows were ordered by how directly each supports what a mother-baby unit could offer routinely. The final sentence names what sucrose requires, which is exactly the information a later proposal needs.

Reading the Grid Down the Columns

Down the design column, three of the four rows are systematic reviews and one is a small trial, so the grid rests on pooled evidence rather than single studies. Down the result column, all three comfort measures reduce pain indicators during heel lance, and none increases harm. Down the final-sentence column, the differences are practical rather than clinical. Sucrose has the most evidence but requires a product and a protocol. Breastfeeding and skin-to-skin require the mother to be awake and willing and the heel stick to be timed to her, rather than to the nursery schedule. The problem the writer observed, heel sticks done in the bassinet while mothers were asleep or away, is therefore not a lack of evidence. It is a question of when and where the procedure is performed.

The grid closes here. It is enough to support an appraisal next week and a proposal the week after, and a larger search would add more rows of the same kind rather than change the answer.

What this page is doingThe narrative below the grid draws a pattern out of the columns rather than restating each study, and it ends by closing the search. A matrix that never stops is the costliest version of this assignment.

What the Grid Does Not Answer

Three questions fall outside the four rows and are recorded here so they are not forgotten. First, none of the rows compares combinations, such as breastfeeding plus sucrose, against a single measure, so the grid cannot say whether combining them adds benefit for term newborns. Second, the reviews include many preterm infants, whose responses may differ from those of healthy term newborns, and the rows do not separate the two groups cleanly. Third, none of the rows addresses the practical question of whether mothers want to be present for the heel stick, which is the question the observed problem turns on. That last question belongs to the change proposal rather than to the evidence, and the grid is not the place to answer it. Anything new that appears after today goes into a note for the final paper, not into a fifth row.

What this page is doingGaps are recorded briefly so they carry into later weeks without reopening the search. Naming the question that belongs to the proposal rather than the evidence keeps the matrix to its job.

References

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

Johnston, C., Campbell-Yeo, M., Disher, T., Benoit, B., Fernandes, A., Streiner, D., Inglis, D., & Zee, R. (2017). Skin-to-skin care for procedural pain in neonates. Cochrane Database of Systematic Reviews, 2017(2), Article CD008435. https://doi.org/10.1002/14651858.CD008435.pub3

Shah, P. S., Herbozo, C., Aliwalas, L. L., & Shah, V. S. (2012). Breastfeeding or breast milk for procedural pain in neonates. Cochrane Database of Systematic Reviews, 2012(12), Article CD004950. https://doi.org/10.1002/14651858.CD004950.pub3

Stevens, B., Yamada, J., Ohlsson, A., Haliburton, S., & Shorkey, A. (2016). Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database of Systematic Reviews, 2016(7), Article CD001069. https://doi.org/10.1002/14651858.CD001069.pub5

NR 452 Week 3 instructions, in plain terms

The Week 3 matrix asks you to gather and organize research on your capstone problem. Required pieces are usually your question, a search strategy, a set number of sources with consistent columns, a summary of what the grid shows and APA references. Fix the number of rows before searching, and give a reason for each. Keep each column in the same kind of phrasing. Give results with a measure and a number. End each row with the sentence your final paper will need. Order rows by how directly each supports what your unit could do. Read the grid down its columns, close the search and record the questions it leaves open.

Inside the NR 452 Week 3 example

The question section describes healthy term newborns having heel sticks in the nursery bassinet and names three comfort measures. The search section fixes four rows and lists terms. Row 1 reports Gray and colleagues' trial of 30 newborns, with crying reduced by 82% and grimacing by 65% during skin-to-skin contact. Row 2 reports Johnston and colleagues' Cochrane review of 25 studies with moderate to low certainty. Row 3 reports Shah and colleagues' review showing breastfeeding comparable to sucrose and expressed milk less effective. Row 4 reports Stevens and colleagues' review of 74 studies. The grid section notes three reviews and one trial and closes the search. Three unanswered questions, including combinations, are recorded for later weeks.

NR 452 Week 3 rubric: what full points look like

Literature matrix rubrics in the pre-licensure capstone generally score a focused question, a documented search, consistent extraction, accurate results, a summary across columns and APA. Consistent extraction and the summary are the rows that separate a matrix from a list, and this one earns them with parallel cells and a column reading that draws a pattern. The question is credited for linking to the observed problem. The search scores because the row count and terms are fixed in advance. Results earn points for measures and numbers. The final-paper sentence in each row shows planning that graders reward. Recording gaps without reopening the search shows discipline. Four references complete APA.

NR 452 Week 3 help: mistakes that cost points

The costliest matrix is one that never stopped: twenty rows, no column filled consistently and a writer still searching when the proposal is due. Another loss is cells copied from abstracts, which cannot be compared. Students also order rows without a reason, skip numbers or let the summary repeat each row. A capstone grid of four to six rows is typical. When two studies contradict each other, note the difference in design or population. You may add sources for the final paper if they fill a gap you recorded. Send your capstone question and an NR 452 matrix can be built with its rows fixed in advance.

Get a NR 452 Week 3 example written to your instructions

Send the Week 3 instructions, whatever grid your section publishes and the problem statement you had approved, and a custom example is filled into your own columns and returned inside 24 to 48 hours. The first one is free. Which studies belong in the grid stays a judgment only the person who did the reading is placed to make.

More NR 452 papers and pre-licensure samples

NR 452 Week 3 questions, answered

How many studies should the matrix hold?

Meet the number your section names and treat it as a ceiling too, not only a floor. The section is graded on comparison rather than on volume, and every extra row costs time the proposal and the measurement work will need. Where no number is given, pick one yourself, write it at the top of your search notes, and stop once the rows are full.

What if two studies contradict each other?

Enter both and let the columns show why they differ. Who was studied, how much of the thing they got, how long they were followed and what the study was given usually account for most disagreements, and the row that refuses to fit often decides what the proposal can honestly claim. Averaging them into a middle finding hides precisely what the grid was built to expose.

Can I add sources later for the final paper?

Sections differ, so read the instructions before assuming either way. Where late additions are allowed they still have to be entered into the grid instead of appearing for the first time in the paper, since a source with no row behind it reads as unappraised. Where they are not allowed, the fixed row count from this week has done you a favor.

Where can I find a free NR 452 Week 3 sample paper?

The complete Week 3 matrix on comforting newborns during the heel stick, with the question, the fixed search, four rows with final-paper sentences, the column reading, the gaps and four references, is shown here.

Why is the sucrose review placed last in the NR 452 Week 3 matrix?

Because rows were ordered by how directly each supports what a mother-baby unit could offer routinely, and sucrose needs a supply and an order or protocol, unlike skin-to-skin contact or breastfeeding.