Essay on Critical Appraisal

As a student/healthcare worker who is new to critical appraisal I am aware that I do not fully understand some of the calculations involved in reporting of findings, however Greenhalgh (2006) argued, ‘all you really need to know is what the best test is to apply in given circumstances, what it does and what might affect its validity/appropriateness’. When caring for patients it is essential that Healthcare Professionals

With regard to sleepiness, several studies indicated that the average of sleep duration in 1910 to 2002 have decreased from 9 to 6 hours on workdays (National sleep foundation, 2002; Groger et al., 2004). Recently, a survey study of Roger et al. (2004) shows that an American Nurses have an average of 84 minutes more sleep on non workdays. Thus, shift work suggested as a cause of sleeping disorder among nurses where they feel of sleep during the shift. Considering the contributing factors of sleepiness, the literature identified that long working hours and rotating shifts are causing sleeping disorder. In the night and rotating shifts, the nurses are rarely obtained adequate amount of sleep. In fact, the nurses experiencing less sleeping hours (1 to 4 hour) than normal sleeping (Zeisler et al.,1980). Nevertheless, insufficient sleep is a significant reason of damaging planning, decision-making, and integration of information (Krueger, 1994; Harrison and Horne, 2000). More recent studies have revealed that long hour shifts and overtime are strongly linked to the difficulties of being a wake through the shift which leads to increase the risk of making an error (Scott et al., 2006; Roger et al., 2004).

The purpose of this report is to conduct a critical appraisal of a published article.

In a world of increasing competition for health resources economic evaluations are essential to provide evidence to decision makers that allows them to make appropriate decisions regarding the best use of those resources (Cohen and Reynolds, 2008; Williams et al., 2008). Critical appraisal is the means by which the validity of this research is assessed and is essential for true evidence based practice, and decision-making (Burls, 2009; Ciliska, Thomas and Buffett, 2008).

The purpose of this paper is to present an analysis of a quantitative article using Melnyk & Fineout-Overholt’s (2015) rapid critical appraisal (RCA) for a randomized clinical trial. Topics included are the validity of the research, results of the research and how the information can be applied to the clinical care of my own patient population.

For some nurses, mandatory overtime can be an advantage due to financial instability but mostly mandatory overtime can cause fatigue, burnout, injuries, errors, inadequate sleep and deficits in performance. According to research working long hours which consists more than 40 hours a week or over 12 hours a day leads to an increased medication errors and patient mortality. The probability of making medication errors increases tremendously when nurses work longer than 12.5 hours a day. During surveys regarding reasons of overtime, 60 % of nurses stated that overtime was obligatory as part of their job, 29 % of nurses stated that they volunteered and 41% of nurses stated that they were “on call hours” (Bae, 2012)

Dr. Mark Lasser’s book “Healing the Wounds of Sexual Addiction” gives insight to those who suffer from sexual addiction and to the families, friends and other people in their lives. Dr. Mark Lasser has chosen to write this book, to share with others his personal struggle and victory with sexual addiction. Dr. Lasser has written this book from a Christian view, to give other individuals hope in a difficult and growing disease, which is taking control and destroying our families. Lasser defines sexual addiction as “a sickness involving any type of uncontrollable sexual activity, and because the addict cannot control his

Nurse staffing have an effect on a variety of areas within nursing. Quality of care is usually affected. Hospitals with low staffing tend to have higher incidence of poor patient outcomes. Martin, (2015) wrote an article on how insufficient nursing staff increases workload and job dissatisfaction, which in effect decreases total patient care over all. When nurse staffing is inadequate, the ability to practice ethically becomes questionable. Time worked, overtime, and total hours per week have significant effect on errors. When nurses works long hours, the more likely errors will be made. He also argued that inadequate staffing not only affects their patients but also their loved ones, future and current nursing staff, and the hospitals in which they are employed. An unrealistic workload may result in chronic fatigue, poor sleep patterns, and absenteeism thus affecting the patients they take care of.

Within the recent years, hospitals and medical facilities have been experiencing nursing shortages that necessitate more nurses to be present to compensate for the care needed to be given. This requires nurses to be dealt with imperative extended work hours along with their normal shifts with no denial or excuse accepted. Working extra hours are accompanied with negative effects that have an impact on the nurse, coworkers, and patients. A major concern that occurs with overtime is that nurses become fatigued or burnout. Fatigue that is experienced is a result of sleep deprivation from working overtime that is associated with arduousness neurobehavioral functioning

Critical Appraisal skills program (CASP) will be defined and will be later use to critically appraise the research mentioned above. The importance of evidence based (EBP) in healthcare settings would be briefly explained. Lastly validity, strength and weakness of the study would be looked into and to conclude if it’s or not fair enough to be used or modified services to patients and service users in care settings.

“Sleep Quality in Nurses: A Randomized Clinical Trial of Day and Night Shift Workers” is a quantitative study by Nui, Chu Chung, Lin, Chang, and Chou published in the journal of Biological Research for Nursing (2012). The article aims to compare the amount of recovery time needed by nurses that work the night shift in relation to nurses that work the day shift. In order to determine if a study is eligible to use for developing evidence based practice it is important to critique research articles (Lobiondo-Wood & Haber, 2014) for their quality and applicability. This will determine if the study is relevant and can be applied to nursing practice. That is the purpose of this paper.

The boss’s evaluation is not good and fair for Sandy. And it is not helpful for Sandy to improve.

The effects of long work hours, resulting in insufficient sleep have been well documented (Rogers, 2008). Insufficient sleep alone has been noted to cause cognitive problems, mood alterations, reduced job performance, reduced motivation, increased safety risks, and physiological changes (Rogers, 2008). Failure to obtain a sufficient amount of sleep is even an important contributor to medical errors (Rogers, 2008). Now think of the effects of sleep, and add in stressful work environments, short-staffing, pressure from administration, and unexpected events, we can begin to realize how patient outcomes may be greatly compromised.

I am in agreement with your process of critical appraisals; identifying the steps in the research process, determining the strengths and weaknesses in the studies and evaluating the validity and credibility of the studies seem to be the root elements of critical appraisals. I appreciated the scholarly article you chose linking depression and mortality among diabetes mellitus patients, particularly because of the straightforwardness of the article. it seemed the conclusion and points of the article were straight forward and the article was easy to understand. If I could suggest any addition, it would be a way to verify the credibility of the study. maybe in this study in particular there is not much incentive for lack of credibility, but in

“Now We Can Begin” an essay by Crystal Eastman is a very powerful essay. Eastman makes the point know in her essay that an honest and true feminist no matter where she stands in the movement she will see to the woman’s fight with strength and courage and how it  matters in the future and as well as its difference in its approach for the workers fight for industrial freedom. Eastman state “In fighting for the right to vote most women have tried to be either non-committal or thoroughly respectable on every other subject. Now they can say what they are really after; and what they are after, in common with all the rest of the struggling world, is freedom”