Critical Evaluation for Case Study Critique - MyAssignmenthelp

Question: Discuss about theCritical Evaluation for Case Study Critique. Answer: Introduction There are a variety of ways or guides for critiquing. All work in similar ways in understanding whether they have followed the correct procedure and principles of research, and key part is always the ability for the results to be generalised in terms of emphasis on accuracy and the ability to apply findings to other situations or generalizability. Models used for critique include the Crombie model; it is an essential tool for both qualitative and quantitative research. Secondly, Critical Appraisal Skills Programme (CASP) is a tool designed by the public health experts and provides key tool for critique. Third tool for critique is the Parhoo model and finally the fourth is the Reel Model, (Wu et al., 2011) which is both used in quantitative and qualitative research. The journal for this article, Annals of Emergency has an impact factor of 5.009. Its publication site is in New York. It is reviewed as largest peer review based circulation journal in medicine, this give the confidence of having high quality data which can be utilised in other research settings. The authors are practising medical practitioners in the health care and have vast experience in utilising the care practice involved. The rich knowledge of the authors gives the confidence to believe in the results and be able to apply them with confidence. Title and abstract review The title of the research, Skin Glue reduces the failure rate of Emergency Department-Inserted Peripheral Intravenous Catheters, is relevant to the research and its form of presentation is clear and concise. It is more specific and direct on its intent. The objective of the research was clearly stated, and the proposed objective is to investigate whether the failure rate of peripheral intravenous catheters could be reduced by addition of skin glue to standard peripheral intravenous catheter care. The abstract of the document contained adequate information with regard to the experimentally methodology. Structure of the Study The literature review cited provides the relevant motivations for conducting this study in that, peripheral device catheters are commonly used in hospitals with approximately 80 % of the patients being applied. Of these, failure reported with its usage is between 33%-69% due to other factors such as phlebitis, occlusion, infection or dislodgement, thus the need for facilitating this study to address the problems arising. The literature review cited in reviewing this study are relevant and recent giving more up to data, reflects the current practices in catheter use thus giving a broader understanding of the topic under review. The gap in literature as outlined in the article is based on a review by Cochrane, which made a conclusion that there were no best practice methods to manage safe use of peripheral intravenous use of catheters. This gap in literature and practices informed the studying trying to come up with an effective method to manage the problem. In conducting this study, i t was hypothesized that addition of skin glue to the insertion site of peripheral intravenous catheters in emergency units reduces the device failure at a rate of 8 hours, this scientific hypothesis. The statement portrays the intent of the researchers to compare the two groups of patients, with key interest on care practice given. One group is given standard care and the other group is provides with intravenous application of peripheral catheter. The intervention indicated in the hypothesis confirms this intent by the researcher, in providing an alternate method for the treatment and application of catheter among patients in emergency care units in reducing the failure of the device within 48 hours of admission in the emergency unit. The Sample Selection The patients were selected from a list of admission who were being admitted in the hospital at the Emergency Unit. The screening process was facilitated by a registered nurse at the facility and patients who were admitted in the unit and above 18 years were recruited in the study. Exclusion criteria were informed by the presence of allergy and infection at the catheter area and that patient who were had intentions of removing the catheter and non English speaking patients were excluded. The participants were recruited through patients attending one health facility referred to as Caboolture Hospital; a community based health care facility. The methodology used was none blinded randomized controlled design in recruiting the participants of the study. Data Collection The data was collected using the use of peripheral intravenous catheters were performed with insertion included treatment with treatment of various solutions. The data of patients was collected at the enrollment and data tabulated in a table. Treatment follow-ups were done after 24 hours. The data were assessed and collected by the research nurses through person or face to face contact and telephone based method. The groups were given different measurement protocols in that the standard care group received standard care management while the skin group received standard care management with Cyanoacrylate skin glue applied at the insertion site as the treatment control. The data used were adequately described in that it quality was preserved. The data was collected with technology based aid, thus tampering of the data was minimised. Collection tools were the use of iPad, Apple, Cupertini, Form Connections, Laguna Niguel and transferred to Stata software and later analysed. This approac h was meant to minimise cofounding factors on the researcher on any tampering with the data which is a factor in its quality adherence. The instrument was adequately described however its validity and reliability were not assessed. There was no reported on the reliability measure of the instruments. The reliability of instruments used in any research to determine the extent t which concepts are accurately measuring the needed data. The analysis method of Assesment was the peripheral intravenous devices used in the process. Ethical consideration is such of research is essential in assuring the safety of the patients is assured. The research sought ethics approval from Caboolture hospital human research ethics committee before commencement of the study and registered with the Australian and New Zealand Clinical Trilas Registry. Data Analysis A total of 380 patients were receiving the peripheral intravenous catheters device were entitled and allocated, in this 11 patients were lost in the following and data for 369 patients were analysed. The rate of loss of the patients was as low as 0.83% per patients and outcome rates was further assessed using 95% confidence level. The follow ups were effective an a marginal number of patients were lost, this did not meet the threshold for affecting the data obtained, thus the data were valid and credible. The assessments of the patients in both groups the control and intervention were not blinded because it was not practical due to the suitable colour of the glue used and its appearances reflected in both groups of the study. The results obtained were statistically significant at p0.05 at a 95% confidence level. The statistics used were correlation in that the two groups were compared and statistical significance obtained to validate the treatment given if it had any impacts. The outcomes of the results was that catheter failure of 17% in the skin glue groups and 27% in the standard care group was reported at a 95% confidence level.. The primary outcome of the study results was that peripheral intravenous catheter failure at 8 hours while the secondary outcomes were the individual modes of peripheral intravenous catheter failure which includes infections, occlusions, dislodgements and phlebitis. The meaning of this outcome is that there was difference in between the groups being treated. Findings The findings were expected in the sense that the literature review had clearly stated that the main problem which often occurs with catheter fixation on the skin was due to inability to fix itself on the skin which was a major factor in dislodgement and loose attachments. The findings presented are well articulated and formulated in the manner in which the research was conducted by the study. The study process gives enough credibility to provide the required information for the judgment of the results. The results obtained are well articulated and easily applicable. The findings obtained by the researcher r were that peripheral catheter failure was reported at 10% lower at a 95 % confidence level with skin glue being 17% while the standard care was 27%. Phlebitis and occlusion was less with the skin glue care however they were not statistically significant to affect the quality of the results obtained. Limitation encountered in this study was that total blinding was not because the s kin glue was visible on the skin surface. Another encountered limitation of the study was the limited period of hospital stay by the patients. Some patients were discharged with an average stay at the hospital being 2.7 days and were discharged before examination by the research nurse. Many left the facility which this could be factor in shorter reflection of time and catheter failure increased rates with hospital stay after the 48 hours by the patients. A suggestion for further research was not suggested by the researcher in that it is termed as a conclusive study. The implications made of the research were that application of skin care glue in the administration of peripheral catheter was beneficial to the patients in the sense that it reduces hospital infections and complications, reduced length of stay in hospital, any related issues with catheter application could be significant reduced with patient benefits and satisfaction improved. The information provided by the reported gi ves room for replication of the study methods and process in other settings. The treatment processes involved are well applicable to replicate in other settings. Conclusion of the Study The study concludes that there no incidence of skin allergy experienced by the patients. The benefits associated with the skin care application are beneficial to the patient and improve the related outcomes. Thus the study concluded that the use of skin care treatment alongside peripheral intravenous catheter care reduced the significant rates in among the emergency department patients admitted at the study site hospital. Other studies done have found out that replacement of peripheral intravenous catheters have no effect on incidence of failure however when this study approach is used of applying skin care treatment to the procedure, reduces infections rate as the underlying factors associated with care. Thus it informs the findings of this study on the use of glue skin care on the peripheral intravenous catheter application. Relevance to Nursing Practice The use of peripheral intravenous catheter among patients has shown to impact negatively on the quality of care among patients, effects have included various complications to the patient which contribute significantly to reduce quality of care, (Arsaln et al., 2014). Associated complication such as phlebitis has admission occurrence of 75% on patients admitted to health care facilities, (Singh, Pun Bhandary, 2008). It has been investigated and shown to cause discomfort, prolong stay at the hospital and increased health care cost hence limit, thus affecting the rights of patients of getting affordable and quality health care. the current rates of 35%-50 % failure rates of catheters is termed as unacceptable practice and this giving unfair treatment to the patients, caregivers and affecting the quality of the overall health care system at large, (Helm et al., 2015). The application and practice of catheter use has been the most invasive procedures in the clinical practice among patients admitted in hospitals, with remedy solution being intravenous therapy, (Di Nisio et al., 2015). It has been found out that majority of the patients develop accompanying complications which include infections to the blood stream, (Maki et al., 2006). This health care issue has prompted the development of various approaches aimed at tackling the problem, which have included new innovative methods of securing the catheter position in patients, (Shah , 2005). Studies by CDC have suggested that catheters should be replaced after every 72-96 hours to reduce the infection rate in patients, (OGrady et al, 2002). However this recommendation is based on limited research conducted to ascertain this. Some of the observational studies have indicated that placing the catheters at safe places for longer periods could have a significant effect on the quality of care provided to the patient, (Van Donk et al., 2009). With this uncertain use of peripheral intravenous catheters on patients, there is need for a safe routine replacement to be utilised in the health care practice, which informs the basis of this study. This study is focused on human health care practice, and more so when it comes to clinical care. The context of the application of the catheter intravenous injection signifies its practise in the health care setting. The use of peripheral intravenous catheter use has been a general practise in health care and has been evidently researched and guidelines outlined. It is common method and approach used in hospitals and utilised in the administration of drugs, fluids or blood products. The procedure involves the intravenous catheter injection, it follows a wide range of experience in the practice which makes it more non ineffective when its failure rate is taken into consideration. The procedure of intravenous catheter administration has been the most invasive procedure applied to the patients admitted in hospitals an estimate about half admitted in hospitals receiving the therapy, (Malyon et al., 2014). Peripheral intravenous catheters have been used in health care and has been termed a time consuming procedure and more so when dealing the younger generation like children due to smaller veins, reduced cooperation and increased adipose tissue of the skin, (Webster et al ., 2008). The practice is relevant fort nursing care, as it is drug administration channel for drugs and medicines. References Arslan, M., Yal?n, S., Kesik, F., Demirci, B., Bal?k, . ?.(2014). Turkish Nurses Knowledge About Application, Care, and Complications of Peripheral and Central Venous Catheters and Port Catheters. Bugden, S., Shean, K., Scott, M., Mihala, G., Clark, S., Johnstone, C., Rickard, C. (2016). Skin glue reduces the failure rate of emergency department-inserted peripheral intravenous catheters: A randomized controlled trial. Annals of Emergency Medicine, 68, 196201. https://dx.doi.org/10.1016/j.annemergmed.2015.11.026 Di Nisio, M., Peinemann, F., Porreca, E., Rutjes, A. W. (2015). Treatment for superficial infusion thrombophlebitis of the upper extremity. The Cochrane Library. Helm, R. E., Klausner, J. D., Klemperer, J. D., Flint, L. M., Huang, E. (2015). Accepted but unacceptable: peripheral IV catheter failure. Journal of Infusion Nursing, 38(3), 189-203. Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc 2006;81:1159-71 Malyon, L., Ullman, A. J., Phillips, N., Young, J., Kleidon, T., Murfield, J., Rickard, C. M. (2014). Peripheral intravenous catheter duration and failure in paediatric acute care: a prospective cohort study. Emergency Medicine Australasia, 26(6), 602-608. OGrady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, et al. Guidelines for the prevention of intravascular catheter-related infections. Infect Control Hosp Epidemiol 2002;23:759-69 Shah PS, Ng E, Sinha AK. Heparin for prolonging peripheral intravenous catheter use in neonates. Cochrane Database Syst Rev 2005:CD002774. Singh, R., Bhandary, S., Pun, K. D. (2008). Peripheral intravenous catheter related phlebitis and its contributing factors among adult population at KU Teaching Hospital. Kathmandu University Medical Journal, 6(4), 443-447. Van Donk, P., Rickard, C. M., McGrail, M. R., Doolan, G. (2009). Routine Replacement versus Clinical Monitoring of Peripheral Intravenous Catheters in a Regional Hospital in the Home Program A Randomized Controlled Trial. Infection Control Hospital Epidemiology, 30(09), 915-917. Webster, J., Clarke, S., Paterson, D., Hutton, A., van Dyk, S., Gale, C., Hopkins, T. (2008). Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial. BMJ?: British Medical Journal, 337(7662), 157160. https://doi.org/10.1136/bmj.a339 Wu, K., Takacs, D., Yao, T., Zhang, J., Yang, H., Wen, J. R., ... Reel, E. A. (2011). U.S. Patent No. 7,979,459. Washington, DC: U.S. Patent and Trademark Office.