Critical Appraisal of the Evidence

Evidence Evaluation Table
Student’s Name
Affiliation
Course
Professor
Due Date
Evidence Evaluation Table
Author (Year)

Conceptual Framework

Design

Sample/Setting

Variables

Measurement/Collection

Data analysis

Findings

Appraisal

Dresden et al. (2019)

None

A multicentered prospective cohort study

The setting for the study was Mount Sinai Medical Center, St Joseph Regional Medical Center, and Northwestern Memorial Hospital. 6,838 emergency department readmissions in the three hospitals.

Transitional Nursing Care (TCN); Emergency department (ED) readmission

TCN was measured in medical record notes. ED readmission was measured from the electronic health records, TCN logs, and data warehouse

Entropy balancing was used to balance the data collected. Bivariate analyses and multivariable regression models were used.

608 visits out of the 6838 readmissions involved TCN care. TCN patients reported reduced risk for readmission at MSMC and NMH, but not at SJRMC.

Weaknesses: the study was observational. The potential effect of confounders is not considered. Patients could have visited other medical centers. Strengths: entropy balancing was used to minimize selection bias. Patients were tracked for a long time.

Finlayson et al., (2018)

None

Randomised controlled trial

222 participants in medical wards of two metropolitan hospitals in Australia

Transitional Care Interventions (TCI); unplanned hospital readmissions

Unplanned hospital readmission was measured through an audit of hospital records; Adherence to TCI was measured using hospital records.

Descriptive statistics, chi-square, ANOVA, and Kruskal-Wallis were the statistical analysis used

The participants in the intervention groups had a lower likelihood of hospital readmission compared to the control groups at 28 days and 12 weeks period. The difference was not evident 24 weeks after discharge.

Strength: RCTs establish causality and are highly generalizable. Weaknesses: The participants were not blinded. Hospital records were retrieved before randomization. The study did not achieve desired sample size, with some of the acquired participants unwilling to participate.

Rezapour-Nasrabad (2018)

None

Mini Review Study

10 articles published between 2000 and 2017

Transitional care model.

Variables were retrieved from the included studies.

The study had to be published between 2000 and 2017 and had to cover original research.

The transitional care model can be described using seven core components, is made up of eight main elements, and reduce hospital readmissions.

weaknesses: limited details about the critical appraisal of collected samples. The quality of the included sample was not provided.

Mai-Ba et al. (2020)

None

Integrative Review

25 articles published between January 2000 to December 2019

Components of Transitional care interventions; Effectiveness of TNI on health outcomes

Variables were retrieved from the included studies.

2018 mixed method appraisal tool was used to assess the quality of studies. PRISMA flow diagram was used to analyze the collected studies.

The review showed that transitional care interventions enhance the safe patient transition from hospital to home. To this end, transitional care interventions minimize readmission rates.

Strength: The review cover studies from quantitative studies. Weaknesses: Review only included studies in English and does not include literature such as dissertations or non-peer-reviewed articles.

Kripalani et al. (2019).

None

Quasi-experimental evaluation design

The setting of the study was Nashville's Vanderbilt University Medical Center. 7132 hospitalizations

Transitional care coordinator, Sociodemographic variables, readmission risk, comorbidities, administrative factors

administrative databases and electronic health records were used to collect data.

Generalized estimating equation methods were used.

Hospitals that implement TCI had a low likelihood of readmission at 30 days and 90 days regardless of whether the TCI was partial or full.

The TCC intervention was a quality improvement measure and thus retrospective approach was used to define the samples.

Morkisch et al. (2020)

None

Systematic review

3 studies

Transitional care model; all-cause readmission rate

Variabl...