Health & Medical Question

Requirements:

Complete a review of the literature and select a minimum of 3 articles that are appropriate research articles related to your question. A research article may be quantitative, qualitative, or integrative. A research article may to related to a Quality Improvement study, an Evidence-Based Practice study, or a Research article that reports new knowledge.

Critique each of the articles using the appropriate Appraisal Form below, either C, E, or F.

If a question included in the form you selected is not applicable to your particular study, select option 3, Not Clear.

An Integrative Review, Appraisal form C, can be used for a meta-analysis or systematic review.

Please Note:

In patients over 65 who are at risk of falling, does the use of measures to avoid falls and tactics to make sure people take their medicines (I) compared to methods for preventing falls that don’t include techniques for sticking to medications or standard care (C) lead to fewer falls and better adherence to medications (O) over a 6-month period (T)?

P:Patients over 65 who are at risk of falling

I:Interventions to avoid falls and methods to make sure people take their medications

C:Interventions to avoid falls that don’t include methods for keeping up with medications or normal care

O:Fewer falls and better drug compliance APPENDIX C
Appraisal Guide:
Findings of a Integrative Review
Citation:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Synopsis
How many persons were involved in conducting the review?
What topic or question did the integrative research review address?
How were potential research reports identified?
What determined if a study was included in the analysis?
How many studies were included in the review?
What research designs were used in the studies?
What were the consistent and important across-studies conclusions?
Clinical Significance
Across studies, is the size of the treatment or the strength of the association found or the
meaningfulness of qualitative findings strong enough to make a difference in patient outcomes
or experiences of care?
Yes
No
Not clear
Are the conclusions relevant to the care the nurse gives?
Yes
No
Not clear
The conclusions clinically significant?
Yes
No
Not clear
Applicability
Does the IRR address a problem, situation, or decision we are addressing in our setting?
Yes
No
Not clear
Are the patients in the studies similar to those we see, either overall or in a subgroup of patients?
Yes
No
Not clear
What changes, additions, training, or purchases would be needed to implement and sustain a
clinical
protocol based on these conclusions?
Yes
No
Not clear
Specify
Is what we will have to do to implement the new protocol realistically achievable by us (resources,
capability, commitment)?
Yes
No
Not clear
How will we know if our patients are benefiting from our new protocol?
Yes
No
Not clear
Specify
Should we proceed to design a protocol incorporating these conclusions?
Yes
No
Not clear
Comments
___________________________________________________________________________
___________________________________________________________________________
APPENDIX E
Appraisal Guide:
Findings of a Qualitative Study
Citation:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Synopsis
What experience, situation, or subculture does the researcher seek to understand?
Does the researcher want to produce a description of an experience, a social process, or an event,
or is the goal to generate a theory?
How was data collected?
How did the researcher control his or her biases and preconceptions?
Are specific pieces of data (e.g., direct quotes) and more generalized statements (themes,
theories) included in the report?
What are the main findings of the study?
Credibility
Is the study published in a source
that required peer review?
Yes
No
Not clear
Were the methods used appropriate
to the study purpose?
Yes
No
Not clear
Was the sampling of observations or
interviews appropriate and varied
enough to serve the purpose of the study?
Yes
No
Not clear
*Were data collection methods
effective in obtaining in-depth data?
Yes
No
Not clear
Did the data collection methods
avoid the possibility of oversight,
underrepresentation, or
overrepresentation from certain
types of sources?
Yes
No
Not clear
Were data collection and analysis
intermingled in a dynamic way?
Yes
No
Not clear
Brown
APP E-1
*Is the data presented in ways that
provide a vivid portrayal of what was
experienced or happened and its
context?
Yes
No
Not clear
*Does the data provided justify
generalized statements, themes,
or theory?
Yes
No
Not clear
ARE THE FINDINGS CREDIBLE?
Yes All
Yes Some
No
Clinical Significance
*Are the findings rich and informative?
Yes
No
Not clear
*Is the perspective provided
potentially useful in providing
insight, support, or guidance
for assessing patient status
or progress?
Yes
Some
No
ARE THE FINDINGS
CLINICALLY SIGNIFICANT?
Yes All
Yes Some
Not clear
No
* = Important criteria
Comments
___________________________________________________________________________
___________________________________________________________________________
APP E-2
Brown
APPENDIX F
Appraisal Guide:
Findings of a Quantitative Review
Citation:
Synopsis
What was the purpose of the study (research questions, purposes, and hypotheses)?
How was the sample obtained?
What inclusion or exclusion criteria were used?
Who from the sample actually participated or contributed data (demographic or
clinical profile and dropout rate)?
What methods were used to collect data (e.g., sequence, timing, types of data, and
measures)?
Was an intervention tested?
Yes
No
1. How was the sample size determined?
2. Were patients randomly assigned to treatment groups? What are the main findings?
Is the study published in a source that required peer review?
Yes
No
Not clear
Was the design used appropriate to the research question?
Yes
No
Not clear
*Did the data obtained and the analysis conducted answer the research question?
Yes
No
Not clear
Were the measuring instruments reliable and valid?
Yes
No
Not clear
*Were important extraneous variables and bias controlled?
Yes
No
Not clear
*Was the study free of extraneous variables introduced by how, when, and where the study was done?
Yes
No
Not clear
*If an intervention was tested, answer the following five questions:
1. Were participants randomly assigned to groups and were the two groups similar at the start
(before the intervention)?
Yes
No
Not clear
2. Were the interventions well defined and consistently delivered?
Yes
No
Not clear
3. Were the groups treated equally other than the difference in the interventions?
Yes
No
Not clear
4. If no difference was found, was the sample size large enough to detect a difference if one
existed?
Yes
No
Not clear
5. If a difference was found, are you confident it was due to the intervention?
Yes
No
Not clear
Are the findings consistent with findings of other studies?
Yes
No
Not clear
Are the findings credible?
Yes
No
Not clear
Clinical Significance
Is the target population clearly described?
Yes
No
Not clear
Is the frequency, association, or treatment effect impressive enough for you to be confident that the finding
would make a clinical difference if used as a basis for care?
Yes
No
Not clear
Are the findings clinically significant?
Yes
No
Comments
Not clear