Posted: January 12th, 2022

Evidence-Based Project, Part 4: Critical Appraisal

Critical Appraisal
Assignment: Evidence-Based Project, Part 4: Critical Appraisal of Research
DUE DATE: OCT. 10th 2020.

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 Assessment 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

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

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

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

Critical Appraisal

It is vital for nurses or any other medical practitioner to be informed of the best methods and practices that they can use to treat patients suffering from opioid addiction. They would then serve as a resource, educators, and even influence patients based on best evidence. To get informed knowledge in regards to managing opioid addiction, four research journals will be reviewed to identify the quality of research, identify their trustworthiness, and their relevance in managing opioid addiction. Through this, I would enhance my skills, know-how, and also have the capacity of determining if the research evidence is true and also related to patients that I will be treating.
A study conducted by Nyamathi, Nandy, Greengold, Marfisee, Khalilifard, Cohen, and Leake (2010), focused on motivational interviewing(MI) which is a non-conformational process that is designed to help an individual to adjust his/her behavior. A randomized method was carried out to compare three-group to identify which group was effective. This study showed that both MI carried out for individuals and group sessions were effective.
Another study by Kouimtsidis, Reynolds, Coulton, and Drummond (2012) on how behavior therapy works with an opioid dependent client was carried out where 60 clients were randomized. From the study, 29 patients who were offered both standard methadone maintenance therapy(MMT) and CBT showed significant improvement and had a lower emotional discharge compared to the 31 who received only MMT.
Further, a study conducted by Brigham, Slesnick, Winhusen, Lewis, Guo, and Somoza (2014) assessed the effectiveness of using community reinforcement and family training for treatment retention (CRAFT) in the context of buprenorphine treatment. In this study, two individual sessions for identified participants(IPs) and 12 for concerned significant other(CSO) were carried out. IPs that were assigned to the CRAFT group had a reduction of opioid usage as compared to those who were not allocated to the group. Nonetheless, the participants that had parental family CSO had higher treatment retention as compared to those that did not.
Equally important, Prieto, McEwen, Davidson, Al-Tayyib, Gawenus, Sangareddy, and Shlay (2019) carried out a study to identify the factors that are affecting opioid decision making together with the challenges that arise when prescribing opioid in ambulatory settings. This study used an open-ended question and was conducted online and 83 palliative clinicians took part. Some of the challenges that arose from this study included clinicians’ deference in approach to care, medication access, and insurance and managing problem outside the typical palliative care scope.

All the first three studies addressed some of the most effective methods that opioid addiction can be managed. Though possible, some challenges need to be addressed. For instance, lack of information regarding using specific medication in conjunction with a given type of psychosocial intervention to treat different patients of different subpopulation is a great challenge. By developing best practices and clinical guidance in managing opioid patients will be effective for different patient populations. By doing so, it will address issues like differences in approach to care and also managing problem outside the typical palliative care scope

References

Brigham, G. S., Slesnick, N., Winhusen, T. M., Lewis, D. F., Guo, X., & Somoza, E. (2014). A randomized pilot clinical trial to evaluate the efficacy of Community Reinforcement and Family Training for Treatment Retention (CRAFT-T) for improving outcomes for patients completing opioid detoxification. Drug and Alcohol Dependence, 138, 240-243.
Kouimtsidis, C., Reynolds, M., Coulton, S., & Drummond, C. (2012). How does cognitive behaviour therapy work with opioid-dependent clients? Results of the UKCBTMM study. Drugs: education, prevention and policy, 19(3), 253-258.
Nyamathi, A. M., Nandy, K., Greengold, B., Marfisee, M., Khalilifard, F., Cohen, A., & Leake, B. (2010). Effectiveness of intervention on improvement of drug use among methadone maintained adults. Journal of Addictive Diseases, 30(1), 6-16.
Prieto, J. T., McEwen, D., Davidson, A. J., Al-Tayyib, A., Gawenus, L., Sangareddy, S. R. P., … & Shlay, J. C. (2019). Monitoring opioid addiction and treatment: Do you know if your population is engaged?. Drug and alcohol dependence, 202, 56-60.

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