Rough Draft Quantitative Research Critique and Ethical Considerations

Write a critical appraisal that demonstrates comprehension of two quantitative research studies. Use the “Research Critique Guidelines – Part II” document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the study in your responses.

Use the practice problem and two quantitative, peer-reviewed research articles you identified in the Topic 1 assignment to complete this assignment.

In a 1,000–1,250 word essay, summarize two quantitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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ANSWER

Rough Draft Quantitative Research Critique and Ethical Considerations

Research Critique

Over the years, an increase in the ageing and active population have continued to make total Knee arthroplasty procedures. However, the procedures have been linked with risk factors that lead to readmission. The knee replacement surgery can lead to physical complications that result from swelling and pain to implant infection, rejection and bone fractures. The total costs for hospital readmission after the primary total hip arthroplasty has amounted to about 1.1 billion USD. This has increasingly led to the need for changing care landscape that will lead to transitions of care and decrease the likelihood of readmissions in future. This research critique will focus on two quantitative articles with findings of proposed models to reduce readmission after knee replacement surgery.

Background

Edward et al., (2015) focused on the effectiveness of the patient management support system TAVHealth to lower readmission rates during the episodic of care. Tavhealth has been linked to the quality of care and health outcomes. The study retrospectively reviewed 1874 total joint arthroplasties. There was a great reduction in readmissions from 16% (205) to 9.2% (54) after incorporating the patient management support system in the clinical pathway. The study is significant to nursing since it reveals the relevance of a patient management support system such as Tavhealth to reduce the rate of readmissions linked to postoperative. The research question was whether the patient management support system would reduce the readmission rates at the point of care. The objective of this study was to determine whether readmission rates would reduce after the implementation of patient management support systems.

Andriotti et al., (2019) focused on the effectiveness of optimal length of stay in reducing readmissions. Considerably, the optimal length of stay increases the patient’s commitment to continued care, while a short stay requires aftercare planning. The retrospective study relied on Tricare claims. The study obtained eligible adults between the ages of 18 and 64 who had received a series of common surgical procedures from 2006 to 2014. The study results supported discharging patients after they are clinically feasible after their knee and hip arthroplasty. The study’s objective was to examine the importance of the optimal length of stay in reducing readmissions after knee replacement surgery. The significance of the study to nursing is that it offers significant findings on the need for the optimal length of stay to prevent risk factors linked to readmissions. The research question was whether the optimal length of stay is effective in reducing readmissions after surgery.

PICOT Question

The PICOT question focuses on interventions that reduce readmissions after knee replacement surgery. The two articles have focused on different interventions that can be used to reduce readmission rates for surgical patients. The problem of concern is the postoperative readmission rates due to surgical problems. Andriotti et al., (2019) has indicated that optimal length of stay will support reduced readmission rates. Edward et al., (2015) has revealed that the patient management support system such as Tavhealth can effectively reduce the rate of postoperative readmissions.

Considerably, the PICOT question focuses on education and awareness as interventions to reduce postoperative readmission rates for knee replacement surgery patients. On the other hand, the studies rely on different interventions to reduce postoperative readmissions. Andriotti et al., (2019) relied on the optimal length of stay, while Edward et al., (2015) focused on the patient management support system, Tavhealth. The PICOT question and the two articles focused on the same comparison groups that included individuals that underwent common surgical procedures such as knee replacement surgery.

Method of Study

Andriotti et al., (2019) focused on a retrospective study, an observational study that entails enrolling participants who already have a condition or disease. This is an effective study design that allows the researcher to gain ideas about possible links and examine potential relationships. Edwards et al., (2015) relied on a cross-sectional study, a research design where data is collected from different individuals. This study design allows collecting different findings and outcomes that can be analyzed to obtain observational data. Considerably, the two articles have focused on different observational designs used to examine the effectiveness of the different interventions for readmission of postoperative patients.

The cross-sectional analysis allows the study of multiple exposures and outcomes. It’s also effective for descriptive analysis and measures the prevalence of various factors under investigation. However, it is difficult to measure the incidence, and the associations identified may be challenging to interpret. Retrospective study design effectively identifies and addresses the potential risk factor. However, the study is prone to misclassification or recall bias and is also subject to confounding.

Results of the Study

Andrioti et al., (2019) found out that optimal length of stay is essential in reducing the readmission rates. Ninety-day admission rates varied ranged from 6.03% to 34.69%. Most of the procedures have exhibited a logit linear relationship and indicating a low risk of admission on day -1 of postoperative and increasing thereafter. The results supported discharging patients as after they clinically feasible after the knee replacement surgery. The results suggested that invasive procedures have an exceptional outcome regarding the optimal length of stay.

Edwards et al., (2015) revealed that readmissions could be reduced through support systems needed after discharge to facilitate continuous rapid recovery. The findings indicated a significant reduction in readmission from 205 to 54 after the incorporation of the patient management support system. The utilization of the patient management support system Tavhealth was effective in reducing readmission rates.

Interventions to reduce the rate of readmissions after surgery is essential in lowering the healthcare cost as well as increasing patient satisfaction. Hospital readmissions also affect revenue, staffing and care quality. Therefore, there is a need for various care transitions process to lower readmission in surgical procedures. The various interventions in the nursing practice can be lowered by improving the core transition processes, discharge planning and care coordination to support patient self-management.

Outcome Comparison

The PICOT question anticipated for reduced readmission rates through various interventions that facilitate postoperative services. The PCOT question includes an evaluation of how different interventions can be applied to the postoperative practice to reduce the rate of readmissions. Therefore, the PICOT question focuses on the correlation between interventions and reduced postoperative readmission rates. The findings of the two studies were in line with the anticipated outcomes for the PICOT question since they indicated that various interventions after knee replacement surgery reduce the readmission rates.

References

Andriotti, T., Goralnick, E., Jarman, M., Chaudhary, M. A., Nguyen, L. L., Learn, P. A., … & Schoenfeld, A. J. (2019). The optimal length of stay associated with the lowest readmission risk following surgery. journal of surgical research, 239, 292-299.

Edwards, P. K., Levine, M., Cullinan, K., Newbern, G., & Barnes, C. L. (2015). Avoiding readmissions—support systems required after discharge to continue rapid recovery?. The Journal of arthroplasty, 30(4), 527-530.