My Account

Evidence-Based Project, Part 3: Critical Appraisal of Research

Evidence-Based Project, Part 3: Critical Appraisal of Research

Research evaluation through a critical appraisal of the articles used in evidence-based practice projects is essential as it allows nursing students to identify a best practice that can be implemented to attain set goals or quality improvement outcomes. High readmission rates for heart failure (HF) patients above 65 years is a core patient safety and quality care concern for healthcare providers in different care settings. Multidisciplinary nurse-led education interventions are considered to help improve patient outcomes and reduce the HF readmissions for patients with the condition (Melnyk et al., 2023). The purpose of this paper is to conduct a critical appraisal of research articles on the nurse-led education interventions to determine the best practice for implementation to reduce the readmission rates.

Full APA formatted citation of selected article. Article #1 Article #2 Article #3 Article #4
Son, Y. J., Choi, J., & Lee, H. J. (2020). Effectiveness of nurse-led heart failure self-care education on health outcomes of heart failure patients: a systematic review and meta-analysis. International Journal of environmental research and public health, 17(18), 6559.

Don't use plagiarized sources. Get Your Custom Essay on
Evidence-Based Project, Part 3: Critical Appraisal of Research
Just from $13/Page
Order Essay

DOI: 10.3390/ijerph17186559

 

 

 

 Alcoberro, L., Moliner, P., Vime, J., Jiménez-Marrero, S., Garay, A., Yun, S., & Comin-Colet, J. (2023). Breaking the 30-day barrier: Long-term effectiveness of a nurse-led 7-step transitional intervention program in heart failure. Plos one, 18(2), e0279815. https://doi.org/10.1371/journal.pone.0279815 Qiu, X., Lan, C., Li, J., Xiao, X., & Li, J. (2021). The effect of nurse-led interventions on re-admission and mortality for congestive heart failure: A meta-analysis. Medicine, 100(7). DOI: 10.1097/MD.0000000000024599 Becker, C., Zumbrunn, S., Beck, K., Vincent, A., Loretz, N., Müller, J., & Hunziker, S. (2021). Interventions to improve communication at hospital discharge and rates of readmission: a systematic review and meta-analysis. JAMA Network Open, 4(8), e2119346-e2119346.

DOI: 10.1001/jamanetworkopen.2021.19346
Evidence Level *

(I, II, or III)

 

 I I I I
Conceptual Framework

 

Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**

 

 The conceptual framework in this study is that nurse-led interventions are effective in reducing the HF readmission rates in healthcare facilities.

 

 

 The conceptual framework in this article is that heart failure (HF) initiatives successfully lower the rate of 30-day readmissions. The theoretical basis of this article entail guidelines from European Society for Cardiology that recommends having nurse-led interventions (NLI) to reduce and prevent readmissions for congestive heart failure (CHF) patients. The conceptual framework in this study is that communication interventions at discharge reduce the rates of readmission for patients with heart failure condition
Design/Method

 

Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).

 The researchers used a systematic review and meta-analysis to assess and determine the effectiveness of these interventions and their implementation. The systematic search was in six databases. The review set eligibility criteria based on three aspects while the exclusion criteria was also based on three aspects. Only RCTs were included to reduce sources of bias. The researchers designed a natural experiment aimed at evaluating the implementation of HF program. The inclusion criteria included patients with HF discharged before and after the implementation of the program. The authors used a meta-analysis with the inclusion criteria being publications that reported the effects of NLI on readmissions and mortality for patients with CHF. The The researchers used a systematic review and meta-analysis for the study. The authors included both qualitative and quantitative trials of primary outcomes.
Sample/Setting

 

The number and characteristics of

patients, attrition rate, etc.

 The setting and sample are not mentioned. However, the articles came from various research settings or environments based on the inclusion criteria. Out of the 612 studies, only 8 were eligible for this research.

 

 

 

 

 The sample comprised 440 participants who were patients with 123 in the pre-program and 317 in post-implementation. The setting was the South Metropolitan Barcelona integrated health care area. The sample comprised 3282 CHF subjects with 1571 participants being in the nurse-led intervention group and the 1711 in the control or usual care cohort.

The authors also included comorbidity patients with either hypertension or diabetes or both.

 The sample involved 3953 patients from 19 randomized clinical trials.
Major Variables Studied

 

List and define dependent and independent variables

 Dependent variables include the rate of HF readmission.

The independent variables include different causes of readmissions and their resultant effects on patients

 

 Independent variable included the number of days before readmissions while the dependent variables were the various factors that influenced the rates of readmission like death. The dependent variable was the rate of readmissions for CHF based on the use of the guidelines.

The independent variables include different interventions implemented by nurses in the facilities where the researchers obtained data.

 Independent variables included the various nurse-led interventions like education, higher medication adherence and patient satisfaction.

The dependent variable was the rates of readmission for HF patients after discharge.
Measurement

 

Identify primary statistics used to answer clinical questions (You need to list the actual tests done).

 The authors performed a meta-analysis using Comprehensive Meta-analysis software version 3.0 in measuring the difference between the intervention and the standard care groups on their outcomes. The statistical significance entailed having P<0.05 to measure heterogeneity. The core statistics in this study entailed the pre-and-post implementation rates in the facility. Through this approach, the researchers determined the study’s question. The study also used the 7-steps approach to evaluate the transitional intervention. The primary statistics used in the paper based on the Q test was descriptive. The authors also applied a fixed statistical effect model to determine heterogeneity of the findings. The researchers used the PRISMA guidelines in getting answers to the clinical question.
Data Analysis Statistical or

Qualitative findings

 

(You need to enter the actual numbers determined by the statistical tests or qualitative data).

 The authors used the random-effect model to determine heterogeneity of the design. The article also used the I2 statistic with its 95% CI and X2 test. The authors analyzed the data using retrospective approach from the administrative database by selecting patients who met the eligibility criteria. The information was then clinically associated with readmissions and survival up to six months upon discharge. The authors uses the latest version of the RevMan software with risk ratios of 95% confidence intervals (CI). The authors applied the Q statistic test to determine heterogeneity. The authors consider the P value of less or equal to 0.5 as statistically significant. The reviewers used the Cochrane Risk of Bias Tool to determine the type of articles to analyze and extract data from for the study.
Findings and Recommendations

 

General findings and recommendations of the research

 The authors assert that nurse-led HF self-care education reduced the risk of all-cause readmissions based in the risk ratio attained and the confidence interval of 0.66-0.85. The authors assert that while studies demonstrates effectiveness of nurse-led HF self-care education on patients’ health outcomes, they do not show the effectiveness broadly.

The researchers recommend the review of high quality randomized controlled trials to ascertain the broader effectiveness of these interventions and their implementation in diverse settings.

 The authors found that nurse-led coordinated transitional bundle of interventions lowered the cause of death as well as the causes of readmissions after three months and six months upon discharge.

The researchers recommend the implementation of this model to reduce the overall rates of readmissions of HF patients.

 Nurse-led interventions reduced the readmission rates and mortality among these patients. Based on their findings, the authors suggest or recommend the implementation of NLI to reduce HF readmissions in health care system. The study’s findings demonstrate that communication interventions during discharge lead to reduced readmissions compared to none. The findings also show that effective adherence to treatment, and better satisfaction levels reduce the rate of readmissions.
Appraisal and Study Quality

 

 

Describe the general worth of this research to practice.

 

What are the strengths and limitations of study?

 

What are the risks associated with implementation of the suggested practices or processes detailed in the research?

 

What is the feasibility of use in your practice?

 The article is critical for practice as it shows that these interventions work on patients but the evidence is limited. The article is worth because its main strengths include the use of RCTs to attain best evidence. However, the limited evidence may hinder its overall application in healthcare facilities.

The implementation of the practices may present challenges in the facility since it does not provide explicit evidence.

The feasibility of using this article is average since it has reservations about the effectiveness of nurse-led interventions to reducing readmissions.

 The article is worth to practice in care settings since it implores nurses to develop effective interventions to reduce HF readmissions.

The core strengths of this article include using high level of evidence, and using more days to evaluate the rate of readmissions. However, a limitation is its small sample size which cannot be generalized to the entire population.

The suggested processes can be implemented in my care facility since they do not pose any risks. The implication is that the feasibility of using this article in practice is high due to the interventions that it provides.

 The article is valuable since it shows that using nurse-led interventions can reduce and prevent the occurrence of HF readmissions.

The primary strengths of this article include using a large sample size, being a systematic review, and using randomized control trials.

The implementation of the suggested practices may not present any risks to the healthcare facility since it will improve overall quality of care and patient satisfaction levels.

Based on the limited risks about this article, it can be used in my practice since it is effective in reducing readmissions.

 The research is valuable since it shows that communication interventions led by nurses in the hospital during discharge can reduce readmissions for patients, including HF patients.

The core strength of this article is being a systematic review and meta-analysis meaning that it has the highest level of evidence. The core limitation is the amount of analysis it uses to arrive at its conclusion.

Potential risks in implementing the suggested interventions include limited resources, and support from the management. However, the recommendations can be implemented in the facility.
 

 

Key findings

 

 

 

 The key finding in this article is that NLI are effective in reducing the rates of HF readmissions. These findings are categorical that HF patient can lower readmissions by leveraging nurse-led initiative and their self-care approaches. The main findings from this article include using nurse-led interventions to improve outcomes, reduction of mortality associated with HF readmissions, and ensuring that nurses have sufficient knowledge on different interventions to reduce readmissions The primary findings in this article include having nurse-led interventions, implementing these interventions in care facilities and offering sufficient knowledge to patients on the issue. The key findings are that better communication, higher levels of patient dissatisfaction and adherence to medications reduce readmission rates.
 

 

Outcomes

 

 

 

 The outcomes are explicit that the reduction of readmissions for HF patients in different care facilities is essential in improving their safety and level of quality care. The outcomes from the study show that nurse-led interventions are critical in reducing readmission rates for HF patients in different care settings. The outcomes show that nurses can work with multidisciplinary teams to implement beneficial interventions for patients with HF to reduce their readmissions. The outcomes demonstrate the need for nurses to work collaboratively with all providers to offer a better interventions in multidisciplinary teams.
General Notes/Comments The article is critical as it illustrates the importance of these interventions in reducing readmissions and improving overall patient safety and quality of care.

 

 The article is important as it shows that nurse led strategies are essential in lowering the ever-rising rates of HF readmissions that make patients susceptible to death and other adverse outcomes. The article is important as it illustrates the effects of having better NLIs to reduce readmissions for HF patients in health care facilities. The article is essential in improving understanding of the nurse-led interventions to reduce hospital readmissions for HF patients.

 

 

Part B: Evidence-Based Practices

The critical appraisal of these articles shows that the best evidence practice emanating from the researchers is the implementation of care bundle led by nurses. Heart failure readmissions are a core safety concern and having effective interventions is critical to improving outcomes. Therefore, interventions like nurse-led education as part of the care bundle are essential to ensuring that patients and their families have sufficient information and strategies that they can implement at home or upon discharge to reduce the possibility of readmissions. As illustrated by Son (2020) and Qiu et al. (2021) education interventions led by nurses improve overall knowledge and understanding of the right interventions by patients. These interventions like self-care education and management are critical in attaining patient-centered care and improving management of the condition away from hospitals. While Son et al. (2021) is categorical that present studies focus on patient health outcomes, the evidence is limited and requires more analysis of randomized controlled trials to expressively determine this to improve overall application and use of such measures.

In their study, Hafkamp et al. (2022) suggest that different levels of evidence show the effectiveness of various nurse-led interventions in reducing readmissions for patients with HF. The article notes that nurses should work collaboratively to identify effective patient-centered interventions that can reduce the rates of readmissions. The implication is that education and patient-focused interventions are effective in reducing or lowering the overall rates of readmissions based on patient-level conditions and nursing knowledge and implementation of these interventions (Marques et al., 2022). Again, Ingles (2020) demonstrates that reducing readmissions for HF patients requires the implementation of nurse-navigated approaches as these providers are at the interaction between patients and the health system. Such programs can lower the rate of readmission by close to 22% and ensure that the all-cause 30-day rates drop down for better outcomes and management of the condition. Therefore, nurse-led interventions in managing HF readmissions are essential for nurses and other providers working in multidisciplinary teams.

Conclusion

The critical appraisal of literature based on the selected articles is important to determine a best practice in reducing readmissions among heart failure patients. These interventions as illustrated are explicit that effective communication and nurse education allow organizations to offer better pathways to reduce readmissions by integrating patient-focused approaches. Again, the critical appraisal shows that nurses can implement different approaches and initiatives to improve overall patient outcomes for individuals with heart failure conditions.

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Hafkamp, F. J., Tio, R. A., Otterspoor, L. C., de Greef, T., van Steenbergen, G. J., van de Ven, A. R., … & van Veghel, D. (2022).

Optimal effectiveness of heart failure management—An umbrella review of meta-analyses examining the effectiveness of interventions to reduce (re) hospitalizations in heart failure. Heart Failure Reviews, 27(5), 1683-1748. doi: 10.1007/s10741-021-10212-8.

Ingles, A. (2020). heart failure nurse navigator program interventions based on LACE scores reduces inpatient heart failure

readmission rates. Heart & Lung: The Journal of Cardiopulmonary and Acute Care, 49(2), 219. https://doi.org/10.1016/j.hrtlng.2020.02.029

Marques, C. R. D. G., de Menezes, A. F., Ferrari, Y. A. C., Oliveira, A. S., Tavares, A. C. M., Barreto, A. S., … & Santana-Santos, E.

(2022). Educational Nursing Intervention in Reducing Hospital Readmission and the Mortality of Patients with Heart Failure: A Systematic Review and Meta-Analysis. Journal of Cardiovascular Development and Disease, 9(12), 420. DOI: 10.3390/jcdd9120420

Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.).

            Wolters Kluwer.

 

 

ORDER A PLAGIARISM-FREE PAPER HERE

Evidence-Based Project, Part 3: Critical Appraisal of Research

Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

Resources

 

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

  • Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
    • Chapter 6, “Critically Appraising Quantitative Evidence for Clinical Decision Making” (pp. 189–228)
  • Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. American Journal of Nursing

Required Media

Walden University, LLC. (Producer). (2018). Appraising the Research [Video file]. Baltimore, MD: Author.

Walden University, LLC. (Producer). (2018). Interpreting Statistics [Video file]. Baltimore, MD: Author.

 

To Prepare:

  • Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
  • Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
  • Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.

The Assignment (Evidence-Based Project)

Part 3A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 3B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

By Day 7 of Week 7

Submit Part 3A and 3B of your Evidence-Based Project.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

  1. To submit your completed assignment, save your Assignment as MD4Assgn+last name+first initial.
  2. Then, click on Start Assignment near the top of the page.
  3. Next, click on Upload File and select Submit Assignment for review.

Rubric

NURS_6052_Module04_Week07_Assignment_Rubric

NURS_6052_Module04_Week07_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Part 3A: Critical Appraisal of ResearchCritical Appraisal of Research Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tool Worksheet Template. Be sure to include: · An Evaluation Table
45 to >40.0 ptsExcellent

The critical appraisal accurately and clearly provides a detailed evaluation table. …The responses provide a detailed, specific, and accurate evaluation of each of the peer-reviewed articles selected.

 40 to >35.0 ptsGood

The critical appraisal accurately provides an evaluation table. …The responses provide an accurate evaluation of each of the peer-reviewed articles selected with some specificity.

 35 to >31.0 ptsFair

The critical appraisal provides an evaluation table that is inaccurate or vague. …The responses provide an inaccurate or vague evaluation of each of the peer-reviewed articles selected.

 31 to >0 ptsPoor

The critical appraisal provides an evaluation table that is inaccurate and vague or is missing.
45 pts
This criterion is linked to a Learning Outcome Part 3B: Evidence-Based Best PracticesEvidence-Based Best Practices Based on your appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with the selected resources.
35 to >31.0 ptsExcellent

The responses accurately and clearly suggest a detailed best practice that is fully aligned to the research reviewed. …The responses accurately and clearly explain in detail the best practice, with sufficient justification of why this represents a best practice in the field. …The responses provide a complete, detailed, and specific synthesis of the four peer reviewed articles.

 31 to >27.0 ptsGood

The responses accurately suggest a best practice that is adequately aligned to the research reviewed. …The responses accurately explain the best practice, with adequately justification of why this represents a best practice in the field. …The responses provide an accurate synthesis of at least one outside resource reviewed on the best practice explained.

 27 to >24.0 ptsFair

The responses inaccurately or vaguely suggest a best practice that may be aligned to the research reviewed. …The responses inaccurately or vaguely explain the best practice, with inaccurate or vague justification for why this represents a best practice in the field. …The responses provide a vague or inaccurate synthesis of outside resources reviewed on the best practice explained.

 24 to >0 ptsPoor

The responses inaccurately and vaguely suggest a best practice that may be aligned to the research reviewed or are missing. …The responses inaccurately and vaguely explain the best practice, with inaccurate and vague justification for why this represents a best practice in the field or are missing. …A vague and inaccurate synthesis of no outside resources reviewed on the best practice explained is provided or is missing.
35 pts
This criterion is linked to a Learning Outcome Resource Synthesis
5 to >4.0 ptsExcellent

The response fully integrates at least two outside resources and two or three course-specific resources that fully support the responses provided.

 4 to >3.0 ptsGood

The response integrates at least one outside resource and two or three course-specific resources that may support the responses provided.

 3 to >2.0 ptsFair

The response minimally integrates resources that may support the responses provided.

 2 to >0 ptsPoor

The response fails to integrate any resources to support the responses provided.
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting—Paragraph Development and Organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided, which delineates all required criteria.
5 to >4.0 ptsExcellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. …A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria.

 4 to >3.0 ptsGood

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. …Purpose, introduction, and conclusion of the assignment are stated but are brief and not descriptive.

 3 to >2.0 ptsFair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. …Purpose, introduction, and conclusion of the assignment is vague or off topic.

 2 to >0 ptsPoor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. …No purpose statement, introduction, or conclusion is provided.
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting—English Writing Standards: Correct grammar, mechanics, and proper punctuation.
5 to >4.0 ptsExcellent

Uses correct grammar, spelling, and punctuation with no errors.

 4 to >3.0 ptsGood

Contains a few (one or two) grammar, spelling, and punctuation errors.

 3 to >2.0 ptsFair

Contains several (three or four) grammar, spelling, and punctuation errors.

 2 to >0 ptsPoor

Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting:The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
5 to >4.0 ptsExcellent

Uses correct APA format with no errors.

 4 to >3.0 ptsGood

Contains a few (one or two) APA format errors.

 3 to >2.0 ptsFair

Contains several (three or four) APA format errors.

 2 to >0 ptsPoor

Contains many (five or more) APA format errors.
5 pts
Total Points: 100

 











		


		
		
		
		
	


	
		
			


	


	









	

		

											
Open chat

						
				
				
			
										

			

			

									Dr.Nursingpapers
								

			

			

				

					
Hello
Can we help you?