Critical Appraisal of Research
Critical Appraisal of Research
The Assignment (Evidence-Based Project)
Part 4A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tools document. Be sure to include:
· An evaluation table
· A levels of evidence table
· An outcomes synthesis table
Part 4B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
By Day 7 of Week 7
Submit Part 4A and 4B of your Evidence-Based Project.
Name
Fall 2018
Evidence-Based Project, Part 4: Critical Appraisal of Research
Dr. Instructor
Walden University
1. Evaluation table
2. Level of Evidence Table
3. Outcome Synthesis Table
Author (Year)
Conceptual framework
Design/
Method
Sample/
Setting
Major Variables
Measurement
Data
analysis
Findings
Appraisal
Schultz et al, (2018)
BMJ open, 8(1), e019789
None
Randomized
Controlled
Trial (RCT)
Purpose: effectiveness of Normal Saline instillation (NSI) to determine its feasibility for full efficacy trial.
Searched 4 databases from 2014-2019.
Focussed only on studies with a control group.
Excluded those without controlled trials
N- 825 studies
Setting-respiratory care hospital
Age-(0-16 years) intubated
IV- NSI, Lung Recruitment
DV 1- Oxygen concentration
DV2- Secretion Efficieny
NSI –
0.1 ml/kg of NaCl with ETS event/
Lung Recruitment-increasing PEEP by a factor of two
Oxygen
Concentration
Feasibility for full efficacy.
Feasibility of the entire study through examination of recruitment,
Eligibility,
Protocol,
adherence and missing data
Normal Saline has no potential benefit to tracheostomy process
Weaknesses-
· Does not
Contain full
Body of research
Potential missed
Evidence with
Restriction to
Only controlled
Trials.
Strengths
A large sample
Of study hence
Reliable
Identified the
Exact impact of
NS during
Suctioning of
Respiratory
Patients
Conclusion
Use of NS in tracheostomy is
Feasible with no
Supported
Benefit in
Suctioning.
Feasibility
Benefits
Outweigh
Potential risks
Eliminating NSI
Is cost effective
And EBP
Friendly
Wang et al.,( 2017 )Australian Critical Care, 30(5), 260-265
NSI has
Adverse
Effects on
Respiratory
Patients such
As increased
Hear rate, dyspenia and reduced oxygen
SR-systematic
Review
Purpose:
To evaluate the necessity of NSI to ICU patients.
Data sources.
Cochrane,
Embase and scienceDirect.
Focussed only on studies with a control group
Limited search
To RCT
N-337
Study setting- ICU in respiratory care.
Intubated patients.
IV-NSI
DV-oxygen saturation
DV2-Heart rate
Was a similar amount of NSI involved?
Heart rate- pulses
Blood pressure-
examination
Oxygen saturation-pool mean difference using the random
effect model.
NS
instillation reduces oxygen concentration but has little effect on heart rate and blood pressure
The pooled mean difference between was -1.14%
Weakness
Low
methodology
quality
Missing data
Strengths
Large body
of sources
identified the
pooled mean
difference in
the saturation
of oxygen
as -1.14
conclusion
NSI is harmful
To the health,
By reducing
Oxygen
saturation
Leddy &
Wilkinson
(2015) RCTR, 51(3), 60
Current Evidence does not support the routine NS instilatilation for ETS
Survey, Expert opinion.
Purpose: to determine the practises of therapists and registered nurses in six Hospitals in Ontario
Survey admission to 180 participants
Setting six hospitals in Ontario
IV-NSI
DV-oxygen saturation
DV2-Heart rate
DV3-expert application opinion
Survey administration and response analysis using descriptive statistical analysis, comparative statistics on RN and RRT opinions
Report, statistical analysis using
SPSS software and
Pearson rule
38.6 % of RN’s frequently used NS
42% Rarely used NS for Suctioning.
51.4 % observed patient adverse effects of NS
NS reduces oxygen saturation
NS increases
Patient
agitation
Weakness
Does not
contain full
body of
evidence
Full of bias
because it
mainly
consists of
opinions.
Strengths
Compares
