Evidence base week 6 assignment 

Assignment: Evidence-Based Project, Part 4: Critical Appraisal of Research

Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

To Prepare:

· Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.

· Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.

· Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.

The Assignment (Evidence-Based Project)

Part 4A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

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.

Required Readings

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

  • Chapter 5, “Critically      Appraising Quantitative Evidence for Clinical Decision Making” (pp.      124–188)
  • Chapter 6, “Critically Appraising Qualitative Evidence      for Clinical Decision Making” (pp. 189–218)

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010a). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. American Journal of Nursing, 110(7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c

Note: You will access this article from the Walden Library databases.

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Critical appraisal of the evidence: Part II: Digging deeper—examining the “keeper” studies. American Journal of Nursing, 110(9), 41–48. doi:10.1097/01.NAJ.0000388264.49427.f9

Note: You will access this article from the Walden Library databases.

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010c). Evidence-based practice, step by step: Critical appraisal of the evidence: Part III: The process of synthesis: Seeing similarities and differences across the body of evidence. American Journal of Nursing, 110(11), 43–51. doi: 10.1097/01.NAJ.0000390523.99066.b5

Note: You will access this article from the Walden Library databases.

Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric Nurses Association, 15(3), 202–207. doi:10.1177/1078390309338733

Note: You will access this article from the Walden Library databases.

Part 3:Advanced Levels of Clinical Inquiry and Systematic Reviews

Evidence-Based Practice and the Quadruple Aim

 Tina Cherry

Walden University

NURS 6052: Essentials of Evidence-Based Practice

Dr. South

July 6, 2020

 

 

Chosen Clinical Issue

Mental health disorders impact the brain’s the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life.

Mental health patients are often given various medications to treat psychotic disorders.

Many of these medications are safe and effective treatment.

An understanding of the appropriate medication therapy improves patient outcomes.

Description of how I developed the PICO(T) question based on the clinical issue

The PICO(T) question identifies the target population (Davies, K. S. 2011). The best intervention to treat clients presenting with psychosis and schizophrenia.

The management strategy needed to be identified (Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. 2010). The safe and effective use of antipsychotic medications to treat mental disorders. The continuum performance of multitude interventions such as administering medication, arouse questions about the evidence supporting their use and effectiveness (Stillwell, Fineout-Overholt, Melnyk, & Williamson, 2010).

Psychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly.

LEVELS OF EVIDENCE OF THE PEER-REVIEWED ARTICLES

Chang, W. C., Chu, A., Kwong, V., Wong, C., Hui, C., Chan, S., Lee, E., & Chen, E.
(2018). Patterns and predictors of trajectories for social and occupational functioning in patients presenting with first-episode non-affective psychosis: A three-year follow-up study. Schizophrenia research, 197, 131–137. https://doi-org.ezp.waldenulibrary.org/10.1016/j.schres.2018.01.021
Systematic review/meta-synthesis of qualitative studies Level V: The level of evidence is from a systematic review of qualitative studies (meta-synthesis)
Endriyani, L., Chien, C., Huang, X., & Chieh, Y. L. (2019). The influence of adherence to
antipsychotics medication on the quality of life among patients with schizophrenia in Indonesia. Perspectives in Psychiatric Care, 55(2), 147–152. https://doi-org.ezp.waldenulibrary.org/10.1111/ppc.12276
Systematic review/meta-analysis of randomized controlled trials (RCTs) Level I: The level of evidence is from a systematic review or meta-analysis of all related RCTs
Potkin, S.G., Kane, J.M., Correll, C.U. et al. The neurobiology of treatment-resistant
schizophrenia:

My study interest is psychiatric mental health. Psychiatric patients are often given various medications to treat psychotic disorders. My PICOT question is what are the risks and benefits of anti-psychotic medications? My clinical inquiry is focused safe and effective treatment for psychotic disorders. The continuum performance of multitude interventions such as administering medication, arouse questions about the evidence supporting their use and effectiveness (Stillwell, Fineout-Overholt, Melnyk, & Williamson, 2010). While delivering care, I am intrigued to learn how medications will affect my patients.

I initiated my search using the key term “psychotic disorders” at the Walden University Library as filtered and unfiltered. I chose a database with strong levels of evidence for intervention questions because they have the best study designs and are generally the most rigorous” (Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M., 2010b). I retrieved unfiltered information from the Cochrane Database of Systematic Reviews from 2014-2018. This resulted in nine articles. These articles pertained to medications and there affects. I retrieved 31,509 unfiltered results by adding two additional databases, PsychINFO, and CINAHL Plus with Full Text. To narrow my search, I added key terms psychotic disorders, mono anti-psychotic medication, and combination therapy in my additional search terms and identifiers.

I then used Boolean phrases with full text peer-reviewed scholarly articles, ranging from 2014-2019, and Cochrane reviews from 2014-2019. I used special limiters for PsychINFO, which were Peer-Review Journals from 2014-2019. My Boolean search with key term “medications” resulted in 783 articles, key term “Safety,” resulted in 35 articles. These articles pertained to specific medications for psychotic disorders.

I found two articles to further study. I will focus on one to answer my PICOT question “The risks and benefits of switching patients with schizophrenia or schizoaffective disorder from two to one antipsychotic medication: A randomized controlled trial”. The article imply changing medications risks exceed benefits for patients on long-term psychiatric therapeutic medications. The article further states, changing medications should be approached with great caution (Constantine et al., 2015). Effective medication management is essential in safe treatment for psychosis. In schizophrenia spectrum disorders antipsychotic medications are routine maintenance treatment (Birur at el., 2020)

References

Birur, B., Kraguljac, N. V., VerHoef, L., Morgan, C. J., Jindal, R. D., Reid, M. A., Luker, A., & Lahti, A. C. (2020). Neurometabolic correlates of 6 and 16 weeks of treatment with risperidone in medication-naive first-episode psychosis patients. Translational Psychiatry10(1), 15. https://doi-org.ezp.waldenulibrary.org/10.1038/s41398-020-07