Critical Appraisal of Research
Part 4B: Critical Appraisal of Research
This part systematically examines the four articles addressed in the critical appraisal tool worksheet to determine their “fitness for purpose” in addressing the Covid-19 pandemic in clinical settings. For registered nurses (RNs) to provide high-quality care, they must rely on valid and reliable information. Thus, nurses need to employ the approaches to care that represent good value and minimize the risk of harm to people. Based on the examination, Evidence-Based Practice (EBP) is the best practice. In clinical settings, EBP is vital for it guarantees quality care and treatment to patients. In addressing Covid-19, nurses, with the help of EBP, have been able to make sound decisions in relation to the nursing and care services they give. For example, in prisons.
The study by (Sanders et al., 2020) was a review on the pharmacological treatments for Covid-19 disease by the FDA, WHO, PubMed and other studies. As per the study, no vaccine, therapy, or form of treatment have been proven effective to contain Covid-19 to date. However, based on EBP, the study posits that expanding knowledge by scientists on SARS-COV-2 virology has been reliable in a number of potential drug targets, for example, ramdesivir. Also, the study argues that clinical trials have been launched to come up with a vaccine, which would work better than the already existing measures set to contain the spread of the virus. According to (Sud et al., 2010) article, reviewed in 2020 and published in the EMBASE, MEDLINE, and Cochrane, the randomized clinical trials posits that prone ventilation lowers mortality in patients experiencing acute respiratory failure and severe hypoxemia. Based on this study, prone ventilation, which is an EBP approach, can be reliable in lowering death rates in Covid-19 patients having severe respiratory problems. Thus, the use of ventilators, which has been there since the past, has proved valid and reliable in bringing positive outcomes of Covid-19 patients under critical care.
By examining the study by (Prem et al., 2020), strategies such as physical distancing help combat the spread of Covid-19. The study posits that physical distancing measures prevent the progression of Coronavirus disease. Such measures include the closure of schools, workplaces, and banning visitations to prisons. In the context of EBP, this study proposes the age-structured SEIR physical distancing model as a valid and reliable control strategy to lower social mixing in different settings, such as prisons, schools, and workplaces where Covid-19 spread is reduced significantly. On the last article, Tobaigy et al. (2020) did a systematic review on “Therapeutic management of patients with Covid-19.” The most commonly reported medication was corticosteroids, despite WHO safety alerts. The outcome measures include were patients’ discharge, recovery, continuing hospitalization and rate of mortality. The study recommended that nurses and other health care professionals should provide supportive management depending on patient’ need, for example, oxygen therapy for respiratory failure/distress or antipyretics for fever. The study is valid and reliable in containing Covid-19, particularly if the WHO recommendations are adhered to the latter.
These four studies have sufficiently and appropriately addressed the clinical issue at hand (Covid-19) as per this EBP project. The studies suggest continued clinical trials, the use of prone ventilators, marinating physical distancing, medication/drug therapy, and oxygen therapy for respiratory distress as the most valid and reliable measures to lower the spread of Covid-19 as well as the mortality rate of coronavirus patients in the clinical setting.
Prem, K., Liu, Y., Russell, T. W., Kucharski, A. J., Eggo, R. M., Davies, N., Flasche, S., … Klepac, P. (May 01, 2020). The effect of control strategies to reduce social mixing on
outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study. The Lancet Public Health, 5, 5.)
Sanders, J. M., Monogue, M. L., Jodlowski, T. Z., & Cutrell, J. B. (January 01, 2020). Pharmacologic treatments for coronavirus disease 2019 (COVID-19): A review. Jama, 323, 18, 1824-1836.
Sud, S., Friedrich, J. O., Taccone, P., Polli, F., Adhikari, N. K. J., Latini, R., Pesenti, A & Gattinoni, L. (April 01, 2010). Prone ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia: systematic review and meta-analysis. Intensive Care Medicine, 36, 4, 585-599
Tobaiqy, M., Qashqary, M., Al-Dahery, S., Mujallad, A., Hershan, A. A., Kamal, M. A., & Helmi, N. (September 01, 2020). Therapeutic management of patients with COVID-19: a systematic review. Infection Prevention in Practice, 2, 3, 100061.