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[ANSWERED] Evidence Based Practice and Research

Evidence Based Practice and Research

A.  Evaluate a primary, quantitative research, peer-reviewed journal article (suggested length of 3–5 pages) that has healthcare implications by doing the following:

Note: You may select an article focusing on a healthcare topic of your choice or an article focusing on one of the following topics: falls and fall prevention, pain management in children, opioid abuse, hepatitis C, catheter-associated urinary tract infections, or hand hygiene and infections in hospitals. 

1.  Describe how the researcher addresses the following four areas in the selected journal article:

  • background or introduction (e.g., the purpose of the study)
  • review of the literature (e.g., research used to support the study)
  • data analysis (e.g., how the researcher analyzed the data)
  • methodology (e.g., research type and sampling methods)

2.  Evaluate whether the evidence presented in each of the four areas of the journal article from part A1 supports the outcome of the study and implications for future research.

3.  Explain how the protection of human subjects and cultural considerations were addressed by the researcher, using specific information from the journal article from part A.

4.  Describe one strength and one limitation of the study.

5.  Describe how the evidence from the article in part A informs current nursing practices.

B.  Evaluate a primary, qualitative research, peer-reviewed journal article (suggested length of 3–5 pages) that has healthcare implications by doing the following:

Note: You may select an article focusing on a healthcare topic of your choice or an article focusing on one of the following topics: falls and fall prevention, pain management in children, opioid abuse, hepatitis C, catheter associated urinary tract infections, or hand hygiene and infections in hospitals. You may use the same topic that was used in part A.

1.  Describe how the researcher addresses the following four areas in the selected journal article:

  • background or introduction (e.g., the purpose of the study)
  • review of the literature (e.g., research used to support the study)
  • data analysis (e.g., how the researcher analyzed the data)
  • methodology (e.g., research type and sampling methods)

2.  Evaluate whether the evidence presented in each of the four areas of the journal article from part B1 supports the outcome of the study and implications for future research.

3.  Explain how the protection of human subjects and cultural considerations were addressed by the researcher, using specific information from the journal article from part B.

4.  Identify one strength and one limitation of the study.

5.  Describe how the evidence from the article in part B informs current nursing practices.

C.  Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.

D.  Demonstrate professional communication in the content and presentation of your submission.

Expert Answer and Explanation

Evidence Based Practice and Research

Analysis of a Quantitative StudyA1.

A1. The Purpose of the Study

An acute exacerbation can incur a high rate of morbidity on COPD patients. However, Ko et al. (2017) noted that no randomized controlled trials had been conducted to investigate the impact of the comprehensive program combined with multidisciplinary input on COPD who have been treated with acute exacerbation. “This study aimed to assess whether a comprehensive care program would decrease hospital readmissions and length of hospital stay (LOS) for patients with COPD” (Ko et al., 2017).

A2. Review of Literature

Though the study was an RCT, the authors used other research pieces to support their findings and discussion. The majority of studies used to support the conclusions of this article were peer-reviewed pieces of research. The authors ensured the evidence’s credibility to include in their articles by searching the studies in reliable online databases, such as PubMed, Web of Science, and CrossRef. Apart from peer reviews, research from professional organizations, such as the Global Initiative for Chronic Obstructive Lung Disease, was used as evidence.

A3. Data Analysis

The SPSS V.21.0. was used to analyze the data. The researchers employed the intention-to-treat principle to conduct the analysis. The relative risk was compared using negative binomial regression. The log-rank test and the Cox proportional-hazards model were used to perform survival analysis.

A4. Methodology

RCT was the research design applied in this study. 180 COPD patients who had been recently treated with acute exacerbation were included in the study. They were randomized to a usual care group (UG) or an intervention group (IG). The IG group was offered comprehensive, personalized care. The UG was provided care following standard practice. Follow-up care was done using 3-monthly telephone calls and clinical visits every three months. Purposive sampling method was used to sample the participants.

A5. Evaluation of the Journal Areas

The primary outcome of the study was the low hospital readmission rate at 1 year. The secondary outcome was low mortality, QOL, improved exercise, and lung function at 1 year. All the four parts in part A1 supported the outcome of the study. The purposive sampling method allowed the researchers to achieve the study’s outcome because of the selected subjects that fit the research’s purpose. In the future, nurses can reduce readmission rates by following-up patients through telephone calls.

A6. Protection of Humans

Researchers presented the study proposal before the Joint Chinese University of Hong Kong–New Territories East Cluster Clinical Research Ethics Committee for approval before continuing to ensure that they followed all regulations. Also, informed consent was sought from the participant before being included in the study.

A7. Strength and Limitation of the Study

This study’s strength is that they used a good number of participants should be generalized to a larger population. 180 COPD patients who had been recently treated with acute exacerbation were included. The study’s limitation is that it not clear whether the program would be effective in other healthcare environments.

A8. Impact of Current Nursing Practices

The findings of this study will improve the effects of current nursing practices. The study shows that comprehensive, individualized care plans can be used by nurses to reduce the rate of readmission not only for AECOPD but also for any other patient.

Analysis of Qualitative Study

B1. Introduction

The rate of opioid use in the US has increased six times more compared to the past decade. According to Frank et al. (2016), about 9 million people, about 3% of the American population reported longer use of opioids in 2014. The lack of evidence about the benefits of long-term use of opioids. However, there is growing evidence that opioids’ long-term use can cause chronic opioid therapy (COT). Reducing the opioid dose or tapering opioids may reduce COT’s risk but increase patient and affect the patient’ s quality of life. The study “was to explore patients’ perspectives on opioid tapering (Frank et al., 2016).”

B2. Review of Literature

The researcher used multiple studies to support the results. The sources used to support the study are reliable and accurate because they were peer-reviewed articles or credible and authoritative professional organizations, such as the Centers for Disease Control and Prevention (CDCP) and Washington State Agency Medical Directors’ Group. The sources were credible in that they were published in less than ten years.

B3. Data Analysis

Mixed deductive and inductive approaches were used to analyze data in the study. A “top-down” or deductive method was used to analyze data in existing literature, theoretical frameworks, and other related topics. A “bottom-up” or inductive method was used to identify the unanticipated important findings or new themes that emerged from the information collected. Codes were developed to help with analysis.

B4. Methodology

The method and design for this study is a qualitative framework. The design was selected to aid in the examination of the perspectives. The authors used in-depth, semi-structured interviews to collect data. A systematic review was used to sample patients. Flyers posted in the hospital board were used to recruit the subjects. Twenty-four patients experiencing COT noncancer pain were included in the study.

B5. Evaluation of the Journal Areas

The outcome of the study is that tapering can cause anxiety among opioid users. The study design supported this outcome. Qualitative design provided the researchers to observe the perceptions of the users who what to tape the drug. Nurses should deal with patients’ anxiety before helping them reduce opioid use.

B6. Protection of Humans

The researchers took steps to protect the human subjects included in the study. First, the authors protected the human subjects by willingly providing participants with consent forms to sign before being included in the research. The research protocol was taken to review the board before commencing the research to ensure that human subjects were well protected.

B7. Strength and Limitation of the Study

The article’s strength was that the authors included the participants’ actual words when describing their perceptions about opioid tapering during the interview, making the findings more accurate and reliable. The study’s limitation is that the sample size used cannot be generalized to a larger group.

B8. Impact of Current Nursing Practices

The study has changed nursing practices about how to handle patients who want to quit using opioids. Nurses should first help patients pass through anxiety problems before opioid tapering.

References

Frank, J. W., Levy, C., Matlock, D. D., Calcaterra, S. L., Mueller, S. R., Koester, S., & Binswanger, I. A. (2016). Patients’ perspectives on tapering of chronic opioid therapy: a qualitative study. Pain Medicine, 17(10), 1838-1847. https://doi.org/10.1093/pm/pnw078

Harris, S., Lang, B., Percy, R. E., & Patronas, C. (2016). Reducing 30-day readmissions for chronic obstructive pulmonary disease. Medsurg Nursing, 25(6), 403. https://search.proquest.com/openview/cff0676eed450caa9bc7a53df7cbf7dd/1?pq-origsite=gscholar&cbl=30764

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