Critical Appraisal of Research Essay Discussion Paper
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 Critical Appraisal of Research Essay Discussion Paper.
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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 Critical Appraisal of Research Essay Discussion Paper
The Assignment (Evidence-Based Project)
Part 4A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing an Evaluation Table .
Zhao, Y., Bott, M., He, J., Kim, H., Shin H., & Dunton, N. (2019). Evidence on Fall and Injurious Fall Prevention Interventions in Acute Care Hospitals. Journal of Nursing Administration, 49, 86-92. https://doi.org/10.1097/NNA.0000000000000715
Davis, J., Kutash, M., & Whyte IV, J. (2017). A comparative study of patient sitters with video monitoring versus in-room sitters. Journal of Nursing Education and Practice, 7(3), 137-142.
Greeley, A. M., Tanner, E. P., Mak, S., Begashaw, M. M., Miake-Lye, I. M., & Shekelle, P. G. (2020). Sitters as a patient safety strategy to reduce hospital falls: A systematic review. Annals of Internal Medicine, 172(5), 317.
Sand-Jecklin, K., Johnson, J. Tylka, S. (2016). Protecting patient safety: Can video monitoring prevent falls in high-risk patient populations? Journal of Nursing Care Critical Appraisal of Research Essay Discussion Paper Quality, 31, 131-138. https://doi.org/10.1097/NCQ.0000000000000163
| Full APA formatted citation of selected article. | Article #1 | Article #2 | Article #3 | Article #4 |
| Greeley, A. M., Tanner, E. P., Mak, S., Begashaw, M. M., Miake-Lye, I. M., & Shekelle, P. G. (2020). Sitters as a patient safety strategy to reduce hospital falls: A systematic review. Annals of Internal Medicine, 172(5), 317
|
Davis, J., Kutash, M., & Whyte IV, J. (2017). A comparative study of patient sitters with video monitoring versus in-room sitters. Journal of Nursing Education and Practice, 7(3), 137-142. Critical Appraisal of Research Essay Discussion Paper
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Sand-Jecklin, K., Johnson, J. Tylka, S. (2016). Protecting patient safety: Can video monitoring prevent falls in high-risk patient populations? Journal of Nursing Care Quality, 31, 131-138. | Zhao, Y., Bott, M., He, J., Kim, H., Shin H., & Dunton, N. (2019). Evidence on Fall and Injurious Fall Prevention Interventions in Acute Care Hospitals. Journal of Nursing Administration, 49, 86-92. | |
| Evidence Level *
(I, II, or III)
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| Conceptual Framework
Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**
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| Design/Method
Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria). |
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| Sample/Setting
The number and characteristics of patients, attrition rate, etc. |
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| Major Variables Studied
List and define dependent and independent variables |
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| Measurement
Identify primary statistics used to answer clinical questions (You need to list the actual tests done). |
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| Data Analysis Statistical or
Qualitative findings
(You need to enter the actual numbers determined by the statistical tests or qualitative data). |
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| Findings and Recommendations
General findings and recommendations of the research |
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| 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? |
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Key findings
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Outcomes
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| General Notes/Comments |
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Critical Appraisal of Research
| Full APA formatted citation of selected article. | Article #1 | Article #2 | Article #3 | Article #4 |
| Greeley, A. M., Tanner, E. P., Mak, S., Begashaw, M. M., Miake-Lye, I. M., & Shekelle, P. G. (2020). Sitters as a patient safety strategy to reduce hospital falls: A systematic review. Annals of Internal Medicine, 172(5), 317
|
Davis, J., Kutash, M., & Whyte IV, J. (2017). A comparative study of patient sitters with video monitoring versus in-room sitters. Journal of Nursing Education and Practice, 7(3), 137-142. | Sand-Jecklin, K., Johnson, J. Tylka, S. (2016). Protecting patient safety: Can video monitoring prevent falls in high-risk patient populations? Journal of Nursing Care Quality, 31, 131-138. | Zhao, Y., Bott, M., He, J., Kim, H., Shin H., & Dunton, N. (2019). Evidence on Fall and Injurious Fall Prevention Interventions in Acute Care Hospitals. Journal of Nursing Administration, 49, 86-92. | |
| Evidence Level *
(I, II, or III)
|
IV | II | II | V |
| Conceptual Framework
Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**
|
No conceptual framework. | There is no explicit conceptual or theoretical framework
|
No conceptual framework. | There is no explicit conceptual or theoretical framework
|
| Design/Method
Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria). |
This review was part of a larger review commissioned by the Department of Veterans Affairs (of note, the larger review found no studies that evaluated the effect of sitters on prevention of suicide or wandering) | In-room sitters and video monitoring was studied in two adult, medical surgical units, using an evaluative research design, with quasi-experimental approach Critical Appraisal of Research Essay Discussion Paper | This practice change study used a quasi-experimental pre-post design with a targeted sample of hospitalized patients at high risk for falling. | This article provides clinical implications and recommendations for adult inpatient fall and injurious fall prevention through a brief review of factors associated with falls and injurious falls and current fall prevention practices in acute care hospitals. |
| Sample/Setting
The number and characteristics of patients, attrition rate, etc. |
Full-text review was conducted in duplicate by 2 independent team members, with disagreements resolved through discussion. The study included randomized trials, quasi-experimental studies, time-series studies, and pre–post studies.
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The setting was a large, not-for profit, teaching facility in West Central Florida. Participants included adult medical surgical patients 18 years of age or older admitted to either the Cardiology unit or the Neuroscience unit
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The sample was hospitalized patients at high risk for falling | No sample/setting involved. |
| Major Variables Studied
List and define dependent and independent variables |
This was an editorial review of the literature. | No experimental or phenomenological methodology. | Dependent: centralized video monitoring.
Independent: patient safety |
No experimental or phenomenological methodogy. |
| Measurement
Identify primary statistics used to answer clinical questions (You need to list the actual tests done). |
No statistical analysis, but a presentation a summary of the sampled articles. | Statistical analysis was performed using descriptive statistics with standard deviation and independent samples t tests. | Data was analyzed using SPSS version 21.0 software (IBM, Armonk, New York) and cleaned prior to analysis. | No statistical analysis performed. |
| Data Analysis Statistical or
Qualitative findings
(You need to enter the actual numbers determined by the statistical tests or qualitative data). |
Among 4377 potentially relevant citations, the stuidy found 20 studies that met eligibility criteria. Two studies assessed the effect of adding sitters to usual care, and 18 assessed interventions aimed at reducing sitter use. There were no randomized trials. Of the 20 studies identified, 11 used a time-series design, 1 was a retrospective quasi-experiment, and the remainder were pre–post studies Critical Appraisal of Research Essay Discussion Paper | The study observed a significantly higher (p < .001) number of video monitored patient care interventions than sitters due to a change in practice and policy at the organization.
Findings revealed a significant decrease (p < .001) in salary cost per patient sitter day. |
There were a total of 1508 cases of video monitoring on all units during the study periods, 697 for the first 2 units and 811 for the second units implementing CVM. The average number of monitored days per patient was 3.3 (median 1.0), with a positive skew, indicating that a very small number of patients were monitored for many days, while most were monitored for only about 1 day. | No analysis required. |
| Findings and Recommendations
General findings and recommendations of the research |
The principal findings from this review are that there is very-low-certainty evidence that sitters reduce risk for falls in acute care hospitals and moderate-certainty evidence that alternatives exist that can reduce the use of sitters without increasing falls. Remedying this situation presents challenges. | Video monitoring is less expensive than sitters and does not impose a patient safety risk for falls or self-harm.
Evaluating the perception of staff and patients related to the use of video monitoring is beyond the scope of this study and could be a potential qualitative study |
The implementation of CVM as an additional component of the comprehensive fall prevention program was successful on a number of fronts.
Additional studies that examine the implications of CVM utilization need to be conducted to assist organizations with reducing patient falls, controlling costs, and creating a safer patient environment. |
Inpatient falls and injurious falls in acute care hospitals are a complicated phenomenon that makes fall and injurious fall prevention a challenge for nurse administrators and managers. To ensure prevention interventions for falls and, more importantly, injurious falls are successful, multicomponent prevention and valid assessment under strong leadership should be implemented to focus on safety and quality nursing care. |
| 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 conclusions were consistent with that review, which was more broadly focused and included fewer studies.
There were no hypothesis-testing studies of adding sitters as the sole intervention to usual care in hospitals with fall rates similar to those in U.S. hospitals. Studies reported less detail about implementation than is recommended by reporting guidelines and potential harms were rarely assessed. Despite the lack of evidence, the rationale for the use of sitters to prevent falls is compelling, and it seems premature to conclude that their use should be abandoned. The evidence is most consistent with the conclusion that, at best, any effect of sitters on fall risk is modest, thus; it is feasible in my area of practice. |
The study design included analysis of retrospective data that was obtained from hospital databases that were not created for research purposes.
Author bias is also a limitation due to the primary researcher for this study was responsible for implementing video monitoring at the organization. The results of this study support a lower cost nursing practice that does not impose a patient safety risk for falls or selfharm associated with the implementation of video monitoring Critical Appraisal of Research Essay Discussion Paper |
The evidence summary clears uncertainties regarding the benefits of implementing a CVM system.
One of the limitations of this study is the lack of data related to patients who fell while not on video-monitoring surveillance. Additionally, no data were collected about staff response time to VMT notifications of risky patient behavior and the need to check on the patient or the impact of staff response time on the incidence of falls. There are no risks associated with the implementation of the CVM system for patient safety in either research or practice. |
The update contributes towards the worldwide interventions of preventing falls and injuries in acute care settings.
The interventions assist in trouble-free decision-making in preventing falls, thus, significant in improving patient outcomes in my area of practice. There are no risks associated with these interventions. |
|
Key findings
|
There is very-low-certainty evidence that sitters reduce risk for falls in acute care hospitals | Video monitoring is associated with high costs in comparison to sitters and does not reduce patient falls. | CVM of high-risk patients has been demonstrated as an effective intervention to significantly reduce the incidence of patient falls as well as the likelihood of injury if a patient does experience a fall. | Prevention interventions of falls and injurious falls are critical in ensuring safety of vulnerable patients. |
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Outcomes
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The use of sitters was found to have a low significance in the management of patient falls in acute care settings. | Healthcare providers should prioritize sitters over video monitoring. | The use of CVM system was found to bring about increased safety in high-risk patients.
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Involving frontline staff in the development and implementation of fall prevention interventions and fall risk assessment is important for buy-in and successful adherence. |
| General Notes/Comments | The review clears the debate on whether patient sitters should be used to reduce risk of patient falls.
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Future studies that evaluate the effectiveness of other interventions that prevent patient falls and self-harm events are necessary as we continue to require cost-effective alternatives for patient care in the practice of nursing. | Additional studies that examine the implications of CVM utilization need to be conducted to assist organizations with reducing patient falls, controlling costs, and creating a safer patient environment. | Financial burden and decreased revenue to healthcare facilities result from inpatient falls. |
Critical Appraisal of Research Essay Discussion Paper