Essay: Critical Appraisal Frameworks For Journal Papers - A Discussion.

Social relationships have been repeatedly identified as essential to nursing home resident quality of life, life meaning and satisfaction, and psychological wellbeing. Articulating the views of residents, and the work residents engage in to develop relationships with both peers and staff, is necessary to facilitate identification of opportunities for targeted interventions that promote, support, and sustain relationships in practice.

CASp Tool and Polit and Beck Framework

Over the course of years, different types of frameworks for critical appraisal of journal papers have been published by the different authors. These frameworks help students to develop idea about how to critically analyze the papers and reach a conclusion of the positive aspects as well as the missing parts. For such appraisal, Casp tool is of immense helps to the students. The benefit of the Casp tool is that the tool provides a set of easy questions which when solves sequentially will give a clear idea about the positive and negative aspects. The Casp tool has different sets of questions for systematic reviews, qualitative analysis, quantitative analysis and case studies (Hyett et al., 2014). Another tool which is also used by different researchers is the Polit and Beck framework. This framework is helpful in evaluation of both qualitative as well as the quantitative papers providing a student with the scope of critically analyzing of each component in a sequential manner. The researcher named Dr. Simon Budgen is a renowned doctor serving as emergency Physician in the Caboolture hospital. This hospital is registered under the Metro North hospitals and the Health services under the Queensland system of healthcare services. He is helped by his team of eminent colleagues consisting of experienced nurses, doctors, and healthcare professionals. They are always searching for various ways that help in overcoming different barriers that occur along the path of providing best care to patients in the emergency department. They have worked on the growing concern of dislodgement of peripheral intravenous catheter that had severe impacts on lives of people creating barriers to attend the emergency condition that a person is facing. Hence the effectivity of skin glue in such condition has been proposed by them. The journal named as the Annals of Emergency Medicine is actually a contribution of the American college of Emergency medicines that published the works of eminent researchers in the field of emergency medicine (Ello e al., 2014). Not only of the mentioned field, have they also contributed papers in the field of pediatric emergency, disaster management, toxicology as well as also in health policy management. They are the topmost papers among its 25 competitors and had been in fight with another journal which is only 5 years old in comparison to its 9 years of service. Science citation index supports highest votes for this journal among all its competitors. The impact factor which is the best way to measure the importance as well as the influence of a particular journal paper has provided a value of 5.0008 which is the highest among all the competitors. Hence, one can rely on the article as legitimate and authentic one publishing evidence based researches.

Case Study: Dislodgement of Peripheral Intravenous Catheter

Title and abstract:

The title of the paper was successful in providing enough information to the reader about the work that he is going to study. It was apt in giving the reader, the idea about the intervention that need to be provided while handling the device for successful results. The goal and the success of the research were properly reflected in the title. The abstract was short but had ample amount of information that gave the readers a small insight about what how the researcher and his team had proceeded in their experiments. All the procedures were mentioned in brief but were successful in covering important parts of the research (Eisner, 2017).

Structuring of the essay:

The paper had failed to provide a proper literature review of the subject that they had tried to put into focus. This is said so excuse a literature review creates the background of the paper depicting information that had led to the initiation of the researches making it a topic of concern. Moreover, it also depicts the work that had been done by different researchers over the years in the same field in order to depict their ideas or to learn from the mistakes that they have conducted in their studies. All these assure that researchers to undertake a work that would be devoid of any flaws. However the author had provided a short paragraph designated as importance. He had depicted the reasons as why they think that failure of the device may result in severe issues and threats to lives of patients. They have discussed about how it had led to increased mortality and morbidity and interfered with the practices of nurses in emergency departments. However, this cannot be considered as literature reviews as not enough information have been jotted down, that have been found by different authors (Morse, 2015). However the study had correctly identified the participants and the place as they patients admitting I the emergency departments have been correctly identified and researched upon. However, the theoretical framework had not been correctly stated and a proper inclusion of correct information under the right heading is absolutely not done. Information is found to be present in a scattered manner and under improper headings. Moreover the method of data collection was not properly mentioned  and some information of data collection had been present but in scattered manner, with some under the sample section, some under the limitation section and some under the outcome measure section. Hence it is seen that proper collection process was not included in a separate paragraph and often creates confusion among the readers. The limitations of the study has been stated in details which are indeed one of the positive aspects of the study as it helped the readers to know what factors could have made impacts on the research and could have changed the fate of the study.

Evaluation of Paper

Sample:

The sample that had been recruited by the research team was properly described and explained to the readers. All the exclusion as well as inclusion criteria of the patients were clearly provided. Those patients who were agitated had been not included as their agitation may act as a barrier in recruiting them in the research as they may remove the device due to the agitation with their force. Moreover, all those patients who were discharged directly after treatment form the emergency department without hospitalization were also excluded. These clarity in sample selection is a matter of appreciation as it helped the readers to understand who were not apt for the research. Moreover, a tracking data was provided in a diagrammatic method that clearly helped the readers to visualize the number of participants who were enrolled. The numbers of patients, who were allocated, followed up as well as analyzed that ultimately helped in including the number of patients. One negative aspect that can be noticed here is that total number of parents was not mentioned in the same section but was shown in the result section. This showed that the research paper was written in a disorganized manner with lack of this important information in sample section (Tesch, 2013).

Data collection:

The paper had completely omitted the section of data collection procedure and had not included any detailed information about the procedure of data collection as well. This is said so because a reader needs to study the data collection method in order to evaluate how effective the results are and also helps them to understand whether the data collected had been authentic or is containing any error (Marshall & Rossman, 2014). However certain information can be found to be scattered throughout out the research paper and only can be understood when the patient reads the paper twice. Some amount of information in forums in the sample section. In the sample section, it is stated that out of thee eminent emergency dependent nurses of the research team, one was committed to carry out the screening procedure and always used to be present on the spot. The screening mechanism is not at all discussed creating a sense of confusion and dissatisfaction among the readers except the information that they were engaged for 16 hours in each day for about 7 days. Again in the outcome section, one can see some amount of information is present stating that the outcomes were measured and assessed by nurses either in person in case of patients when they are in hospitals and by telephonic conversation in case of patients who are already discharged. After this amount of information in the outcome section, some more information had been included in the limitation section. In this section, it is mentioned that standardized questionnaire, chart review as well as with the help of ward staff wither by telephonic conversation and also by direct visualization. All these scattered information destroys the quality of the paper making readers apprehensive about the authenticity of the data collected. It may also make the readers think that data is not properly collected as they are not mentioned properly. Another negative impact of the absence of proper data collection paragraph also results in loss of proper information about the instruments used; measurement procedure and therefore the reliability of the factors could not be assessed.

Conclusion

Data analysis:

A primary data analysis was conducted by determining a sample of 174 patients per group who were provided each with a single peripheral intravenous catheter. It was found that the failure rate was found to be higher in the control group (with standard care) in comparison to that of the intervention group (were skin glue was used in attachment of the device) where the rate of failure in 4%. This was measured with 80% power at alpha being .05. The data analysis was done following a complete software based system; this technique is appreciated by lots of researchers as it reduces the rate of errors that can be done by human mind. The data after collection was incorporated into a portable tablet like an ipad that contained the Form Connect software. From here, they were then transferred in to the Stata (version 12.1; StataCorp, College Station, TX). The analysis was done on an intention to treat bass which is indeed a positive aspect of the research paper. The unit of measurement was considered to be the Peripheral intravenous catheter devices. Proper time calculation was also done which ensured that the inputs done in the software were apt and decreased the chances of errors. Proper statistical significance was mentioned along with proper confidence intervals which dismissed the scope of any unauthentic information in the study. Moreover, the outcomes which were complete were only taken in consideration and incomplete outcome information was not incorporated. All these steps shown here can easily depict that the researchers were very particular about the process they wanted to follow (Saldaria, 2015). Blinding could not be done in the case as the skin glue that was provided was colored and hence it resulted in easy recognition of the intervention groups. Therefore lack of proper blinding situation was mentioned by the author, as blinding them would not have resulted in any beneficial effects. The outcomes were clearly depicted and stated that any outcome that resulted in replacement of the device would be considered as the failure of device. Thus outcomes consisted of different infection, occlusion, phlebitis and dislodgement. All these were incorporated in the software in order to conduct analysis and reach any conclusion.

Describing the findings:

The findings however marked the success of the researches. This is said so because the result that it yielded suggested 27% of failure in the control group in comparison to that of the 17% failure in that of the intervention groups.  Sharp decrease by 10% shows that the resources of the hospital will be less wasted and more allocated for other important treatment purposes. A proper table has been provided making it easier and clearer to the reader. It clearly stated that infection was totally absent in both groups but catheter failure by dislodgement was less frequent accounting for about 7% in intervention group in comparison to that of control group which has 14%. Hence it becomes very much easier for the reader to get an overview of the result from the table without making it stressful to find from huge amount of data. From the table, it could be also seen that the number if patients who suffered from phlebitis and occlusion was also less in the intervention group than in the control groups. Therefore one can easily understand that the findings are very much in accordance with the research aim and portrayed that skin glue application to PIC are indeed helpful in overcoming many unfavorable conditions in the patients of the emergency departments (Yakub et al., 2014). Individual results were also provided which showed that in every aspect the control groups have been the higher sufferers than that of the intervention groups. Therefore one can easily find that the results of the findings are indeed expected and the researchers were able to put their claims. Information had been sufficient to support the claim done and are present in clear and completed manner. The researchers have provided the findings in a summarized manner. Limitations were clearly stated that gave the readers an idea about the factors that could have had effected the results and how to avoid them in their own researches. The researchers did not make any suggestion for further research and did not mention any implication either.

Conclusion:

The researchers have not included a paragraph with the heading of conclusion but have given a paragraph of discussion. Within the discussion he had explained how the result of the research would help in overcoming many unfavorable conditions. The conclusion which usually contains a brief form of the conducted research is found within the study. Rather he has explained whether any adverse effect would result if used on skin and has also measured the process as simple and rapid. This cannot be considered as conclusion as new information has been introduced. Therefore absence of conclusion but presence of discussion containing a brief overview as well as new information is seen (Yaqub et al., 2014).

Researchers have seen that application and attachment of the costly devices of the peripheral intravenous catheter is associated with high resource expenditure. This includes the cost of insertion of the catheter which is then followed by the other practices like proper dressing of the site, needless connector as well as dedicated stabilization of the device (Keogh et al., 2016). Extension tubing also is of high price. Therefore failure of the procedure and reinsertion of another tube again accompanies a huge amount of energy expenditure of the nurses and also result in huge loss of resources of healthcare as well. Often a failure of one insertion initiates a negative cycle where several reinsertions also tend to fail and the threat to the patient’s life increases (Helm et al., 2015). Therefore then a very costly procedure accompanies this procedure and call for the need of urgent attention. In an emergency department when a nurse has to spend a lump some amount of time in management of the device, it automatically results in increasing life threatening consequences for the patients as many other important functions of the ailing patient’s needs urgent attention from the nurse (Heinrichs et al., 2013). Moreover other important factors about why this issue is bothering both patients and nurses are that failure often leads to infection, occlusion, phlebitis, infiltration, mechanical failure as well as dislodgement of the catheter. A number of steps have been taken over the years like prevention of the needle sticks which are replaced by the use of the safety needle containment devices (Farris et al., 2015). It often accompanies the use of adhesive film dressings. However, these processes have not become successful and had only helped on the temporary basis in some cases. However the new intervention which have been provided by the nurses are believed to impart positive impacts on the patients and will also help the nurse form work burden and help the patients to be safe from any life threats (Edwards et al., 2014). This would also help in saving resources for use in emergencies.

References:

Edwards, M., Rickard, C. M., Rapchuk, I., Corley, A., Marsh, N., Spooner, A. J., ... & Fraser, J. F. (2014). A pilot trial of bordered polyurethane dressings, tissue adhesive and sutureless devices compared with standard polyurethane dressings for securing short-term arterial catheters. Critical Care and Resuscitation, 16(3), 175.

Eisner, E. W. (2017). The enlightened eye: Qualitative inquiry and the enhancement of educational practice. Teachers College Press.

Elo, S., Kääriäinen, M., Kanste, O., Pölkki, T., Utriainen, K., & Kyngäs, H. (2014). Qualitative content analysis: a focus on trustworthiness. Sage Open, 4(1), 2158244014522633.

Farris, M. K., Petty, M., Hamilton, J., Walters, S. A., & Flynn, M. A. (2015). Medical Adhesive-Related Skin Injury Prevalence Among Adult Acute Care Patients: A Single-Center Observational Study. Journal of Wound Ostomy & Continence Nursing, 42(6), 589-598.

Heinrichs, J., Fritze, Z., Vandermeer, B., Klassen, T., & Curtis, S. (2013). Ultrasonographically guided peripheral intravenous cannulation of children and adults: a systematic review and meta-analysis. Annals of emergency medicine, 61(4), 444-454.

Helm, R. E., Klausner, J. D., Klemperer, J. D., Flint, L. M., & Huang, E. (2015). Accepted but unacceptable: peripheral IV catheter failure. Journal of Infusion Nursing, 38(3), 189-203.

Hyett, N., Kenny, A., & Dickson-Swift, V. (2014). Methodology or method? A critical review of qualitative case study reports. International journal of qualitative studies on health and well-being, 9.

Keogh, S., Flynn, J., Marsh, N., Mihala, G., Davies, K., & Rickard, C. (2016). Varied flushing frequency and volume to prevent peripheral intravenous catheter failure: a pilot, factorial randomised controlled trial in adult medical-surgical hospital patients. Trials, 17(1), 348.

Marshall, C., & Rossman, G. B. (2014). Designing qualitative research. Sage publications.

Morse, J. M. (2015). Critical analysis of strategies for determining rigor in qualitative inquiry. Qualitative health research, 25(9), 1212-1222.

Saldaña, J. (2015). The coding manual for qualitative researchers. Sage.

Tesch, R. (2013). Qualitative Types: Analysis Typ. Routledge.

Yaqub, O., Castle-Clarke, S., Sevdalis, N., & Chataway, J. (2014). Attitudes to vaccination: a critical review. Social Science & Medicine, 112, 1-11.