CRITICAL APPRAISAL OF A SYSTEMATIC REVIEW AND NARRATIVE REVIEW RELATED TO COMPUTERISED PHYSICIAN ORDER ENTRY SYSTEM
The author of this paper is a nurse educator working in an Intensive Care Unit (ICU) within the north-west region of England. For the purpose of this paper, the author has chosen a systematic review (SR) and a narrative review (NR) and aims to critically analyse these reviews using the Critical Appraisal Skills Programme (CASP) tool. The CASP tool has been developed by the Solutions for Public Health (SPH) (formerly known as Public Health Resources Unit), which is controlled by the National Health Service (NHS) (SPH, 2006). The tool is based on the guidelines formed by a group of clinicians at McMaster University, Canada
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The author feels that using two different tools would increase the rigour of the appraisal and its relevance to practice. In the forthcoming sections of this essay, the author will attempt critically analyse the two papers using the CASP tool for SRs.
Formulation of the research question
Formulation of the research question guides the type of data collection for the study and states what the study will ‘hypothesise’ (Polit and Beck, 2010). The CASP tool acknowledges that clearly-focused research question will describe the population studied, the intervention given and the outcomes considered (SPH, 2006). The research question in the SR is clearly formulated. The population of patients studied were general and critically ill hospital patients, the intervention was a SR and outcome to be assessed was about the safety of the CPOE and clinical decision support systems or CDSS (CDSS is a computerised medication prescription system) based on hierarchy of outcome measures (kindly refer to table 2 of SR) within ICU settings. Likewise, in the NR, the population of patients studied were general and critically ill patients, the analysis was done via a NR and the purpose of the study was to assess the results of CPOE on clinical and surrogate outcomes in hospitalised patients in both general and critical care settings.
Based on this, the author acknowledges that the SR has adopted a narrow and more specific research question as
Critical reflection is vital to develop evidence based practice for safe and quality approaches to professional nursing practice. Nursing professionals should critically reflect on events to identify what health professionals might do to improve their practice and reduce the risk of a similar error. Reflective practice can help to learn from their mistakes, be empowered and most importantly to deliver best possible care to patient as nurses must work closely with their patients to develop a therapeutic relationship. Critical reflection is a valuable skill to ensure patient centred care. This practice promotes personal development by enhancing students’ self-awareness, their sense of community, and their sense of their own capacities for
The purpose of this report is to conduct a critical appraisal of a published article.
Once an area of evidence-based practice has been chosen for investigation, the reviewer must locate current evidence sources and, using a structured approach, assess each for applicability to the issue being investigated. The aim of this paper is to use a Rapid Critical Appraisal Checklist (Melnyk and Fineout-Overholt, 2011) to support these sources of evidence into a review that discusses the importance of daily, high-level, multidisciplinary communication and patient safety. The summaries of these evaluations will be provided as an appraisal of each study.
CASP (Critical Appraisal Skills programme 2010) is a tool for one to criticize research paper. The questions provided, make one think and consider whether a research study is convincing and trustworthy. In the following, CASP will be used to criticize 1 quantitative research and 1 qualitative research.
The purpose of this paper is to introduce Computerized Provider Order Entry (CPOE) systems in health care practice, and its impact on patient safety through a comprehensive literature review. The background and current implementation of CPOE were reviewed. The benefits and potential disadvantages of CPOE systems related to patient safety were identified, and the strength and gaps in the literature were discussed to suggest further research and guide evidence based health practice.
Steele, A. M., & DeBrow, M. (2008). Efficiency gains with computerized provider order entry. In: Henriksen K, Battles JB, Keyes MA, Grady ML (eds) Advances in patient safety: new directions and alternative approaches AHRQ publication no 08–0034-4, vol 4. Technology and Medication Safety Agency for Healthcare Research and Quality, Rockville, MD. Retrieved from http://www.ahrq.gov/qual/advances2/
Fairley (2005) gives a consultant nurse’ perspective of a clinical role in critical care unit that has evolved as a central feature of all surgical high dependency units (SDHU) in large teaching hospital trusts. Advanced nursing practice is perceived not as the acquisition and application of technical procedures which are usually undertaken by doctors, but also an integration of medicine and nursing where holistic nursing assessment and symptom focused physical examination go hand in hand. Fairley presents a reflective account of practical problems encountered relating to role integration, professional autonomy, legal and consent issues, non-medical prescribing, and role evaluation (Fairley, 2005). The paper successfully describes a model of nursing applied to high dependency units integrating the role of the advanced nurse practitioner within the medical and clinical team an reflective practice plays an important role by being the main method of evaluation of a consultant nurse’ perspective. In a
The qualitative article being appraised is by Martin and Woods (2012) using the CASP tool qualitative framework (CASP 2013). These tools have been validated to ensure that studies can be assessed in a consistent way assessing the trustworthiness of the research article (Aveyard, 2014)
According to the systematic review covered by Apfel, Turan, Souza, Pergolizzi & Hornuss, 2013 there is a significant reduction in postoperative nausea and vomiting and opioid use when using intravenous acetaminophen. The reviewers used Medline and Cochrane databases to conduct their search along with a hand search of abstracts to identify randomized-controlled trials using intravenous acetaminophen. The review was to determine if the acetaminophen was going to have a significant decline in nausea and vomiting following surgical procedures as
Critically ill patients are at increased risk for pressure ulcers. Hospital -acquired Pressure ulcers are serious clinical complications and that can lead to increased length of stay, pain, infection and potentially death. Nurses have the primary role in the pressure ulcer prevention. The study assessed nurses’ perceptions of the usefulness and impact of a pressure ulcer prevention care bundle intervention on clinical practice. So it is imperative to understanding nurses’ assessments of interventions when interpreting results and translating evidence into practice.
Health-care professionals regularly request systematic evidence-based guidance to facilitate decision-making in the provision of clinical care. For this, adequate support from hospital management is needed to implement changes within sectors of the NHS. An approach to the provision of such guidance is the use of clinical pathways as an implementation tool. Clinical pathways are structured multidisciplinary care plans containing detailed essential steps in the care of patients with specific problems (1). Overall, the degree of impact they have on patient outcomes, length of hospital stay and costs appear to be favourable and are established and
Yes. In the article, the aim of the research was to understand the experience of participants, their knowledge about type 2 diabetes, and the factors of medication adherence in Malaysia. According to Susan (2010), the five components of PICOT are population, issue, context, outcome, and time. According to Al-Qazaz et al (2011), the PICOT was presented by the researcher in the study were,
The authors Elske Ammenwerth , PhD; Petra Schnell-Inderst , PhD; Alexander Hoerbst , PhD have conducted and published a research article on ‘The Impact of Electronic Patient Portals on Patient Care: A Systematic Review of Controlled Trials’. The research paper was published by researchers at UMIT - University for Health Sciences, Medical Informatics and Technology.
Further studies are indicated that create a wider area of focus while addressing the limitations of the
The concept of appraisal highlights the method of assessing the documents. The appraisal should be devoid of any sort of partiality. It should not favour any type of user. The appraisal is not supposed to be objective, not subjected to any sort of personal beliefs or opinions, nor shall it be based on any influenced notion.