Nursing

QUANTITATIVE CRITICAL APPRAISAL GUIDELINES

KEY CONCEPTS INAPPRAISAL

STUDENT NAME: SOLVEIG DIAZ

DATE:04/16/2021

APA REFERENCE FOR THE ARTICLE:

Briscoe, G.T., Heerschap, A., Kane, C. F., & Quatrara, B.D. (2018).Using post-discharge telephone follow-up by nephrology nurses to reduce 30-day readmissions and post-discharge complications for the adult patients on hemodialysis. https://doi.org/10.18130/v32m04

Hickson, L., Thorsteinsdottir, B., Ramar, P., Reinalda, M., Crowson, C., Williams, A., Albright, R., Onuigbo, M., Rule, A., & Shah, N. (2018). Hospital readmission among new dialysis patients associated with young age and poor functional status. Nephron, 139(1), 1-12. https://doi.org/10.1159/000485985

218 understanding and making the most of the centers for disease control and prevention’s (CDC) chronic kidney disease (CKD) surveillance system. (2021). American Journal of Kidney Diseases, 77(4), 636. https://doi.org/10.1053/j.ajkd.2021.02.223

Research Problem and Purpose

1. What is the study problem and purpose?

2. Is the problem significant and relevant to nursing? Explain.

The study

problem is the increase in the number of readmissions after discharge from the hospital. These readmissions occur among patients who have end stage renal disease. Besides, some of these patients develop other complications after discharge (Briscoe et al., 2018). The problem is relevant in nursing since nurses are the ones who manage these renal patients. Hence, they need to start using mobile phones in follow-up.

The study

Literature Review

1. 1. Are relevant previous studies identified and described? Explain

2. 2. Are relevant theories and models identified and described? Explain

3. 3. Are the references current? Examine the number of sources in the past 5 and 10 years in the reference list. Explain

4. 4. Is the literature review organized to demonstrate the progressive development of ideas through previous research? Explain

There are studies done by the Institute of Medicine and they have shown that there needs to be proper communication between the patients and the healthcare providers. Besides, there should be proper coordination of care among the healthcare providers. Patients’ follow-up is significant since it helps to know how the patient is doing. The necessary interventions can be done if necessary. Research done in the US has shown that about 35% of patients with end stage renal disease get readmitted( Hickson et al., 2018). In 2015, the US government spent about $64 billion on illnesses related to chronic kidney disease(“218 understanding and making the most of the centers for disease control and prevention’s (CDC) chronic kidney disease (CKD) surveillance system”, 2021).

Study Framework

1. Is the framework explicitly presented or must it be extracted from the literature review? What is it? Explain

2. Does the framework describe and define the concepts of interest? Explain

3. Does the framework present the relationships among the concepts? Is a map or model of the framework provided for clarity? Explain

The framework is the chronic care model (CCM). It is a model that is concerned with patients with chronic illnesses. The model aims at improving the skills and expertise to the healthcare workers. Hence, they can provide better care to the patients. The framework provides a good relationship among the concepts.

Research Objectives, Questions, or Hypotheses

1. Are the objectives, questions, or hypotheses clearly and concisely expressed? What are they?

2. Are the objectives, questions, or hypotheses logically linked to the research purpose? Explain

Research Objectives, Questions,

or Hypotheses

Research Objectives

1. To generate findings that will help make decision on the follow-up of end stage renal patients.

2. To identify ways of preventing complications among kidney patients after discharge.

Questions

1. What do re-admissions increase after discharge of end stage renal patients?

2. What measures can be taken to prevent re-admissions and complications after discharge?

Hypotheses

1. There are re-admissions that occur among end stage renal patients after discharge.

2. There are complications that occur among end stage renal patients after discharge.

These objectives, questions and hypotheses are related to the purpose of the research. The purpose of the research is to come up with measures of preventing re-admissions and complications after discharge. For example, the use of telephones in follow-up.

Variables

1. Identify the major study variables: Be specific

a. Independent

b. Dependent

2. Are the major variables defined (conceptually and operationally)

based on previous research and/or theories? Explain

Independent variables include follow-up and monitoring. Dependent variables include re-admissions and complications that occur after discharge.

These variables play a significant role in the achievement of the purpose of the research.

Design

1. Identify the specific design of the study. Was the best design selected to direct this study? Explain

2. Does the design provide a means to examine all of the objectives, questions, or hypotheses and the study purpose? Explain

The design was cross-sectional since the study was conducted at one point in time. Recording method is the one that was used since the number of re-admissions were counted and recorded. The data obtained was the one used to make decisions.

Sample, Population, and Setting

1. Are the inclusion and exclusion sample criteria described? Explain

2. Did the researchers indicate the method used to obtain the sample? Is the sampling method adequate to produce a sample that is representative of the study population? What are the potential biases in the sampling method? Explain all answers in detail.

3. Discuss the institutional review board approval and informed consent obtained. Are the HIPAA privacy regulations followed? Explain

The sample included all the patients that were admitted with end stage renal disease. Those with renal disease but were below the age of 17 years were not included. The sample was representative. These were patients that were in the hospital setting.

Measurements

Answer the following, dependent on type of tools used in the study:

Scales and Questionnaires

1. Are the instruments clearly described? What are they? Explain

2. Are the techniques to administer, complete, and score the instruments provided? Explain

3. Are the reliability and validity of the instruments described? Did the researcher examine the reliability and validity of the instruments for the present sample? Explain all answers in detail.

Scales and Questionnaires

Scales of measurement included determining whether a patient was on re-admission or not. The questionnaires were given to the healthcare providers to give responses.

Data Collection

1. Is the data collection process clearly described and consistently implemented? What is it? Explain

2.Do the data collection methods address the research objectives, questions, or hypotheses? If so, explain

The data collection exercise involved the use of questionnaires and documents to record the number of re-admissions. Besides, recording was done on the number of patients who had developed complications after discharge.

Data Analyses

1. Do the data analyses address each objective, question, or hypothesis? Explain

2. What statistical analyses are included in the research report? Are the data analysis procedures appropriate to the type of data collected? Explain

The data analyses procedures were in line with the objectives, questions and hypotheses. Retrospective group analysis was done, where there was comparison of post and pre-intervention data. After follow-up with calls, there were reduced re-admissions and complications.

Interpretation of Findings

1. What is the researcher’s interpretation of findings? Are the results related to the study framework? Explain

2. Which findings are consistent with those expected? Which findings are unexpected? Are significant and non-significant findings explained?

3. Were the statistically significant findings also examined for clinical significance? Explain

4. Are the study limitations identified and relevant? How so? Explain

5. What suggestions are made for further studies? Be specific

Interpretation of Findings

The findings were interpreted and they shod that there are high number of re-admissions among those with end stage kidney disease. There are about 35% cases of re-admissions. Moreover, there are many cases of complications among the discharged patients. It means that there is problem in follow-up and monitoring of these patients.

Evaluation

1.Are the study findings consistent with those of previous research? Explain

2. Do you have confidence in the findings? How so? Explain

3.Do the findings add to nursing knowledge? How so? Explain
4.Are the findings ready for use in practice? How so? Explain

The study findings are consistent with those from the previous research. There is a high number of re-admissions and complications among patients discharged from the renal unit.