Assignment 5.1: Critical Appraisal

Essay Instructions:

My DNP proposed project is about medication safety for adults 50 years old and above. Omit Required Resources for this part of the assignment. That is for a different assignment. Directions Using three selected articles, begin to propose your DNP project and how it can apply to concept measurement, including quality indicators and evaluation methodology. Part 1: Articles Evaluate three research articles related to your DNP project idea. These may be the three used in your matrix assignments, or you may select new ones. Your evaluation will help you determine if the articles are appropriate and useful for your DNP project. Based on your DNP project idea, use the QI and primary research articles you completed a matrix on or replace any that you found unfit for the project with a more appropriate article. Determine what type of article each is, such as case-control, cohort, economic, diagnostic, and so on. Select an appraisal tool from Critical Appraisal ToolsLinks to an external site. that you think best fits your selected articles, and critically evaluate your three articles. Rarely will one tool fit all articles, so you may use two or three. Part 2: Paper Write a six- to eight-page paper (not including the cover and reference pages) in Microsoft Word about your three articles (no more than half the paper) and your proposed project. Write no more than two to three paragraphs about why each article is a good fit for your project and why the selected appraisal tool is appropriate. Create tables for the appraisal areas in the context of the narrative paper, and provide descriptions in the table to support what you checked. Do not submit tables alone nor tables with simple checkmarks and no rationales. Describe which of the measurement-related concepts (structure, process, outcome; see The Healthcare Quality Book Chapter 8, p. 224) best fits your DNP project and defend your position. Propose up to three quality indicators that may capture data on a clinical structure, process, and/or outcome measure related to population health within your DNP project. Explain how you might examine one of the indicators selected using a PDSA cycle. What to Submit Your APA-formatted paper in Microsoft Word that contains all three article reviews, the measurement-related concept, proposed quality indicators, and reference list Your three articles in Adobe PDF If you copy and paste references from the course into your assignment, be sure to confirm APA formatting before submitting. Similarity Score After submitting your assignment, select Submission Details to view your similarity score. Your similarity score will appear as a percentage next to your submitted file. It may take up to 24 hours for your similarity score to appear. Critical Appraisal Rubric Critical Appraisal Rubric Criteria Ratings Pts Article 1: Completes appraisal in a clear manner and completes all relevant fields. Clearly and concisely describes why the article is a good fit for the project. 7 pts Excellently written appraisal, showing deep understanding of the article and how to use the appraisal tool. 6.5 pts Well-written appraisal, showing a strong understanding of the article and how to use the appraisal tool. 6 pts Somewhat well-written appraisal, showing a basic understanding of the article and how to use the appraisal tool. 5.75 pts Poorly written appraisal, showing little understanding of the article and how to use the appraisal tool. 0 pts Missing or very poorly written appraisal, showing no effort in understanding the article and how to use appraisal tool. / 7 pts Article 2: Completes appraisal in a clear manner and completes all relevant fields. Clearly and concisely describes why the article is a good fit for the project. 7 pts Excellently written appraisal, showing deep understanding of the article and how to use the appraisal tool. 6.5 pts Well-written appraisal, showing a strong understanding of the article and how to use the appraisal tool. 6 pts Somewhat well-written appraisal, showing a basic understanding of the article and how to use the appraisal tool. 5.75 pts Poorly written appraisal, showing little understanding of the article and how to use the appraisal tool. 0 pts Missing or very poorly written appraisal, showing no effort in understanding the article and how to use appraisal tool. / 7 pts Article 3: Completes appraisal in a clear manner and completes all relevant fields. Clearly and concisely describes why the article is a good fit for the project. 7 pts Excellently written appraisal, showing deep understanding of the article and how to use the appraisal tool. 6.5 pts Well-written appraisal, showing a strong understanding of the article and how to use the appraisal tool. 6 pts Somewhat well-written appraisal, showing a basic understanding of the article and how to use the appraisal tool. 5.75 pts Poorly written appraisal, showing little understanding of the article and how to use the appraisal tool. 0 pts Missing or very poorly written appraisal, showing no effort in understanding the article and how to use appraisal tool. / 7 pts Clearly and concisely describes why the appraisal tool is a good fit for the articles. 5 pts Excellently written explanation, showing deep understanding of the appraisal tool. 4.75 pts Well-written explanation, showing a strong understanding of the appraisal tool. 4.25 pts Somewhat well-written explanation, showing a basic understanding of the appraisal tool. 4 pts Poorly written explanation, showing little understanding of the appraisal tool. 0 pts Missing or very poorly written explanation, showing no effort in understanding the appraisal tool. / 5 pts Describes best measurement concept (structure, process, outcome fit for project). 9 pts Excellently written description, showing deep understanding of the measurement concept. 8.25 pts Well-written description, showing a strong understanding of the measurement concept. 7.75 pts Somewhat well-written description, showing a basic understanding of the measurement concept. 7.25 pts Poorly written description, showing little understanding of the measurement concept. 0 pts Missing or very poorly written description, showing no effort in understanding the measurement concept. / 9 pts Describes up to three quality indicators and briefly explains how to apply a PDSA cycle to examine one of the selected indicators. 25 pts Excellently written description, showing deep understanding of the indicator(s) and how to apply a PDSA cycle. 22.75 pts Well-written description, showing a strong understanding of the indicator(s) and how to apply a PDSA cycle. 21 pts Somewhat well-written description, showing a basic understanding of the indicator(s) and how to apply a PDSA cycle. 19.75 pts Poorly written description, showing little understanding of the indicator(s) and how to apply a PDSA cycle. 0 pts Missing or very poorly written description, showing no effort in understanding the indicator(s) and how to apply a PDSA cycle. / 25 pts Spelling, Grammar, and Writing 10 pts Excellently written and composed. No errors in spelling and grammar. 9.25 pts Well-written and composed. A few minor errors in spelling and/or grammar. 8.5 pts Somewhat well-written and composed. Many minor errors in spelling and/or grammar. 8 pts Poorly written and composed. Major errors in spelling and/or grammar, but still understandable. 0 pts Very poorly written and composed. Major errors in spelling and/or grammar make it difficult to understand. / 10 pts APA Format 5 pts No errors in format. 4.75 pts A few minor errors in format. 4.25 pts Many minor errors in format. 4 pts Major errors in format. 0 pts APA format not used. / 5 pts Total Points: 0

Essay Sample Content Preview:

Assignment 5.1: Critical Appraisal Student’s Name Institution Course Professor’s Name Date Part 1: Article Evaluation Article 1: A Systematic Review of Potentially Inappropriate Medications Use and Related Costs Among the Elderly This review by Malakouti et al. (2021) incorporates data from multiple studies to explore the prevalence of potentially inappropriate medication among elderly populations and the resulting economic burden. The study shows that Potentially Inappropriate Medications (PIMs) are one of the major causes of disproportionate medication-related harm among older adults, mainly brought about by physiological changes, polypharmacy, and comorbidities that characterize aging. It will also carry out a systematic review of the use of multiple medications listed as PIMs, among them benzodiazepines, nonsteroidal anti-inflammatory drugs (NSAIDs), and some cardiovascular drugs. These drugs have been identified in a number of lists, including the Beers criteria and the Screening Tool of Older Person's Prescriptions (STOPP) criteria, as especially at high risk of adverse events relative to their therapeutic benefits in older persons. The article identifies that PIM use in elderly adults exceeds 30% of the population at costs directly and indirectly related to adverse drug events, increased healthcare use, and extended hospitalization. This prevalence is attributed to factors such as inadequate medication reviews, a high degree of polypharmacy, and limited adherence to evidence-based prescribing guidelines for the elderly. Economic analyses within the review indicate a significant financial burden resulting from PIMs; for example, in Canada, the estimated cost of PIMs among older people was reported to be approximately USD 419 million for a single year. These findings are in line with the objective of this study in quantifying PIM-associated costs and advocating for targeted interventions that mitigate such financial and clinical impacts through improved prescribing practices. Given the broad population focus and the synthesis of data from multiple studies, this article is best described as a systematic review. Systematic reviews especially in healthcare, are truly useful as they provide high-quality evidence through the aggregation of findings from various sources, often leading to more comprehensive insights compared with individual studies. In fact, by synthesizing a large volume of data on PIM prevalence and cost implications, the systematic review by Malakouti et al. serves as an important asset in understanding the extent of inappropriate medication use among older adults. The reason this article chose the Joanna Briggs Institute JBI Critical Appraisal Checklist for Systematic Reviews is because it focuses on methodological quality: for example, whether the search strategy is transparent, data is combined, or possible bias has been treated. Article 2: Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide The systematic review and meta-analysis by Tian et al. (2023) is the second article. This study seeks to quantify the worldwide prevalence of PIM use among elderly patients attending outpatient services and assess the patterns of this prevalence across different regions and income levels. These studies also determined that the prevalence of PIMs was highest in outpatient services in low- and middle-income regions, where health systems are usually not well-regulated and have limited access to healthcare services that focus on the population of older individuals. The prevalence attributed to PIM remains reasonably lower in high-income regions due to the practices of more established safety protocols and guidelines, such as the Beers and STOPP criteria. Synthesizing data obtained from 94 studies, which included over 371 million older adult contributors from 17 countries, this meta-analysis constitutes one of the most comprehensive global analyses of PIM use among outpatients to date. This study, therefore, based on the pooled prevalence estimates, highlights that the most significant geographical inequalities in the use of PIMs were observed to be in Africa and South America. Furthermore, in a period of the last two decades, the results indicate an increasing trend in the use of PIMs, which is partly due to the fact that throughout the world, the population is aging, and polypharmacy is one of the distinctive features of elderly subjects. Of note is that the article discusses the consequences of PIM use in relation to health resource consumption, such as increased hospitalization, utilization of the emergency department, and overall healthcare expenditures. The current article is a systematic review and meta-analysis that contrasts with the prior article but uses statistical methods to combine quantitative data from multiple studies so as to increase the precision of its prevalence estimates. Meta-analyses provide a quantitative synthesis that is especially useful in elucidating trends across diverse populations and settings since they afford greater statistical power than that achievable in individual studies. The PRISMA Checklist is an appropriate appraisal tool for reviewing this meta-analysis. PRISMA is a commonly used reporting guideline that appraises the methodological quality and standard of reporting in systematic reviews and/or meta-analyses, hence emphasizing clarity, transparency, and consistency in data synthesis and selection. Article 3: WHO Report on Medication Safety in Polypharmacy The third article is a technical report published by the World Health Organization (WHO) in 2019. The report converges on the rising prevalence of polypharmacy across, especially among adults, and gives strategic direction on the management of...

Updated on February 10, 2025

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