Rapid Critical Appraisal Sample

In the UK, reports show that heart failure has been affecting up to 2% of the population, over 900,000 people are living with heart failure, with 63,000 new cases being diagnosed each year (BHF, 2015). It costs the NHS £625 million per year, as a result of the high portion of emergency admissions, readmission and long length of inpatient stay (NHS Improvement, 2010). DH (2000) confirmed that Heart failure accounts for all cardiac admissions and the readmission rate can be as high as 50% within 3 months; also, it further estimated 50% readmission might be preventable. Unfortunately, Heart Failure can’t be cured, but early

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).

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.

8. List the nursing implications and education needs for each of the following categories of medication related to heart failure: See Attached

This study used a descriptive, correlational, comparative and quantitative design to determine the probable causes of heart failure readmissions (Anderson, 2014). Independent t tests were used to the characteristics between those individuals that were readmitted and those that were not. Correlation coefficients were examined using the Pearson product-moment and the Spearman ρ test to determine the indications for readmission. (Anderson, 2014). Once these were established the Hosmer and Lemeshow tests were used in binary logistical regression analysis to determine how well each predictor variable determined the probability of readmission. Using these tests, the results showed that P=0.599, indicating that the model adequately fits the data (Anderson, 2014). To add to this, further proving the study’s validity, a hierarchical approach was preferred because “entry of variables is based upon an evaluation of theoretic, clinical, and statistical considerations” (Anderson, 2014, p. 234). This allowed for the assessment of predictive ability. This study through multiple statistical tests proved strong validity in its data collection, research design, and measurement

Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,

My interview with Ms. Carol Baker Cross took place on March 21st, 2015 around 7 p.m. Ms. Cross is an RN who works at Piedmont Fayette Hospital. She earned her BSN from Troy University and graduated in 2011.The most common health care condition/problem that Ms. Cross encounters is Congestive Heart Failure and she identified this health care condition because she is an RN on the cardiac floor of the hospital. According to Ms. Cross, Congestive Heart Failure is seen when the heart doesn't have a lot of output. The heart is not strong and because the ventricles do not pump blood in a sufficient volume, fluid buildup can be seen

An important aspect involved in critical appraisal of a study involves identifying and evaluating the study framework. This allows the reader to determine whether it is appropriate to apply the study findings to nursing practice. The author of this study identified the specific perspective from which the study was developed. More specifically, the author sought to provide insight into the phenomenon of lay presence during adult CPR specifically from the perspective of ambulance staff and

A resident at the time saw that although there is a hearty amount of evidence that illustrates that adhering to heart failure guidelines decreases the rate of mortality and morbidity, nationally there is modest adherence to heart failure practice guidelines. Doctors have voiced a multitude of reasons to this poor participation including but not limited to time constraints in a visit, inertia of patterns in practice, lack of awareness and lack of acceptance are a few. This new web-based tool, the “Smart” Heart failure sheet is designed to help connect previously compartmentalized information. It seeks to link guidelines to their patients’ clinical and laboratory characteristics and systematize adherence to heart failure guidelines. It accomplishes this by uploading pertinent patient-specific data, including laboratory and imaging results, procedure reports and relevant medications. Additionally it also provides tools, such as a flow chart for diuretic dosage and weights. Overall this tool is useful to help physicians identify patients who may benefit from a treatment. From there it provides support tools that alert the physician to a personalized medical treatment. The “Smart” Heart Failure Sheet acts as a registry for scholarly research and also provides educational resources to expand providers’ knowledge, thereby improving patient care (Battaglia,

Rising health care cost and stricter regulations for insurance reimbursement plans have pushed health care leaders to re-evaluate health care services. One focus is reducing hospital readmission rates for chronic disease process (Bos-Touwen et al, 2015). Congestive heart failure is one of the leading causes of hospital readmission (Cubbon et al, 2014). Fifteen million people worldwide have a diagnosis of CHF. In addition, 15-20% of those with the diagnosis of CHF are hospitalized yearly (Sahebi et al, 2015). In 2010, 40 billion dollars was spent on health care needs for CHF patients. Seventy percent of the resources were for hospital services (Siabani, Driscoll, Davidson, and Leeder, 2014). The need for streamline healthcare for CHF patients is imperative to improve overall patient outcomes and reduce the amount of hospital readmission rates.

Varying patients may present to their clinician or the emergency department for treatment with heart failure. It is important to understand that there is more than one type of heart failure; primarily the focus is placed on diastolic heart failure and systolic heart failure. Depending upon the cause of heart failure and what areas are affected dictates the treatment plan needed. While there are similarities with both kinds of heart failure, there are also differences that can help the clinician distinguish the diagnosis needed to fit the patient. Once a diagnosis is made the clinician can move forward in determining if the patient is at risk for use of diuretics and then look towards prescribing ACEIs, ARBs, and beta-blockers.

Heart failure (HF) is one of the leading causes of hospital admissions and readmissions in the United States (Desai & Stevenson, 2012; Gheorghiade, Vaduganathan, Fonarow, & Bonow, 2013). It is a condition that accounts for a very high morbidity and mortality (Bakal, McAlister, Liu, & Ezekowitz, 2014). Every hospital admission for heart failure patients results in disease progression and poor prognosis. For chronic HF patients, a hospitalization is one of the strongest prognostic predictors for increased mortality (Gheorghiade et al., 2013). Factoring in re-hospitalizations, especially at 30-day to 90-day mark, it is increasingly detrimental to patient prognosis.

Also, physicians need the routine lab testing results as this helps them diagnose and initiate treatment plans for patients with heart failure. The lab tests that are recommended by the American Heart Association and others to evaluate for heart failure are: a complete blood count (CBC), which may indicate anemia and possibly an infection as one of the possible causes of heart failure. A basic metabolic panel (BMP) would show serum electrolytes and may help with diagnosing fluid retention or renal failure. Also, B-type natriuretic peptide levels (BNP) are up in heart failure. A twelve lead electrocardiogram (ECG or EKG), shows the electrical activity of the heart and may help reveal arrhythmias, infarctions, or even heart failure (Petersen, M., Wang, Y., Van der Laang., M. & Guzman, D.

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

As the population ages heart failure is expected to increase exceptionally. About twenty-two percent of men and forty-four percent of women will develop heart failure within six years of having a heart attack. “Thirty years ago patients would have died from their heart attacks!” (Couzens)