Critique and Picot

Qualitative Research Studies Critical Appraisal

Grand Canyon University

Prof. Llanos, Cherryl

Introduction to Nursing Research

06/15/2021

Study one: Neale, J., & Strang, J. (2015). Naloxone-does over-antagonism matter? Evidence of iatrogenic harm after emergency treatment of heroin/opioid overdose. Addiction (Abingdon, England), 110(10), 1644–1652. https://doi.org/10.1111/add.13027

Study two: Bessen, S., Metcalf, S. A., Saunders, E. C., Moore, S. K., Meier, A., McLeman, B., ... & Marsch, L. A. (2019). Barriers to naloxone use and acceptance among opioid users, first responders, and emergency department providers in New Hampshire, USA. International Journal of Drug Policy, 74, 144-151.

Background of the Studies

Study one

Ambulance personnel and emergency medical team in emergency departments and accident scenes attending opioid or heroin overdose cases in the community use naloxone to save lives. As a result, naloxone dissemination programs have been established as individual wellbeing treatments and public health initiatives to avert death caused by opioid or heroin overdose. Therefore, the study addresses the problem of opioid and heroin overdose. The study is significant to nursing because its study will help emergency care nurses discover the importance of naloxone in preventing deaths caused by opioid or heroin overdose deaths. Besides, it will enable nurses to understand the harm that can result from administering excessive naloxone dosage. The study objective was to analyze drug users’ experiences and views of naloxone during emergency resuscitation after illicit opiate overdose. The purpose of the study was to assess the implications for naloxone medical administration within the modern emergency settings and to gather evidence about any harm caused by using excessive naloxone dose. The study question was: what are the drug users’ experiences and views of naloxone during emergency resuscitation after an illicit opiate overdose?

Study two

The problem addressed by the study is that opioid overdose and opioid use disorder are major public health concerns in the US. For example, in 2018, opioids caused about 47,500 deaths. The study's purpose was to understand opinions about and experiences with naloxone use and distribution in New Hampshire among opioid users and emergency responders. The study's objective was to examine barriers to naloxone acceptance and use midst opioid users, emergency department providers, and first responders. The study is significant to nursing practice because it will enable nurses to understand what prevents adequate use of naloxone among opioid users and develop strategies to address the issue. Besides, it will help nurses working as emergency responders to identify where to obtain naloxone for their patients by determining its distribution rate. The research question was: what are the barriers to naloxone acceptance and use among opioid users, emergency department providers, and first responders?

How the Articles Support the Nurse Practice Issue, I Chose

The first article evaluates drug users’ experiences and views of naloxone after illicit opiate overuse. Thus, it supports the nursing practice issue that I chose by addressing the use of naloxone to prevent deaths caused by opioid overdose. The interventions in the study compare to those in the PICOT question because they seek to address the issue of effective administration of naloxone to reduce harm. The second article addresses barriers to naloxone acceptance and use among opioid users. Hence, I chose the nursing issue, which is about opioid overdose and deaths resulting from it. The study answers the PICOT question by evaluating the importance of naloxone distribution in reducing fatalities resulting from an opioid overdose. The primary intervention in the study is to ensure adequate distribution of naloxone. Hence, the systems-level intervention approach aims at reducing harm by focusing on drug-related harm context within the risk environment rather than individual-level interventions.

Method of study

In the first study , interviews and non-participant observation were used as data collection tools. The first group of respondents was purposively sampled from emergency departments in hospitals, while the other group was opportunistically sampled via pharmacies and drug agencies. In the second study, semi-structured interviews were used to collect data. The study sample was selected through a multi-pronged recruitment approach, including advertisements on craigslist, fliers posted at public places, and snowball sampling. The main difference between the study methods was the sampling techniques, where sampling in the first study relied on the researcher's judgment. One advantage of purposive sampling is that it is cost and time-effective, while its disadvantage is that it is vulnerable to errors resulting from the researcher's judgment. One advantage of the multi-pronged recruitment technique is broad reach, while its disadvantage is that it is difficult to attain good engagement .

Results of the study

In the first study results, the participants had little knowledge about naloxone, its use, and pharmacology, yet they had negative views and opinions about it. The participants indicated that naloxone administration resulted to severe withdrawal symptoms forcing patients to become aggressive, taking other drugs to counter the effects, discharge themselves from hospitals, and refuse treatment. As a result, the participants opined that healthcare providers should administer naloxone cautiously and selectively and prescribe counter-naloxone drugs if it causes withdrawal symptoms. Besides, the study found that most people who received naloxone medication had no information about what it was. The second study results indicated that naloxone had become more available in the region when the study was conducted. Both responders and users granted that naloxone had become progressively available in New Hampshire. Most responders indicated that naloxone availability encourages more opioid use because individuals feel safer using it at greater intensities. Furthermore, they articulated apprehensions that naloxone is a short-term solution and does not address long-term opioid addiction. Lastly, the study findings indicated that cases of aggressive patients were common when using naloxone on patients. Most patients experienced withdrawal symptoms, with anger being among the main ones. However, the responders suggested that such encounters can be prevented through nuanced naloxone administration and gradual titration to prevent precipitated withdrawal.

Ethical Considerations

Research ethical considerations involve research requirements, including publication of research information and protection of the research subjects' dignity. Nursing research is based on three crucial aspects; the nursing culture founded on the caring ethics, the human rights according to the society and researchers' values about the study inquiry. There are several major ethical issues regarding nursing research. The first ethical consideration is informed consent, which means that research participants must clearly, knowingly, and voluntarily consent. The second primary ethical consideration is beneficence, which means do no harm. The third main ethical consideration is confidentiality or respect for anonymity. The participants' identity should not be linked to their personal responses . The respondents should be allowed to withhold as much information as they wish if they feel that it is private and not worth sharing. The last primary ethical consideration is protection of vulnerable groups. It has become to include vulnerable groups such as minors, the aged, mentally challenged individuals and sedated persons a research participants. In the first study, the researchers used transcribed interviews to ensure privacy and confidentiality of participants’ information. In the second study, the participants selected for the sample were all above 18 years to avoid including minors who are considered as vulnerable.

Hello Eliety,

Several of your ideas came together well for the Module 2 writing assignment. Please note it is important to include and state what type of articles you are critiquing, qualitative or quantitative?

Please remember to introduce the critique to provide overall thesis of the paper. You did a good job overall presenting your findings on each study.

You did a nice job overall summarizing each study’s background. However, it is important to cite the articles throughout in order to clarify your points.

You also presented good rationale on how the two articles support the nurse practices issue you chose. Please also remember to include your specifically developed PICOT question to compare with those in the articles. This is a critical component of the paper.

Your reviews of each study’s research method presented with good efforts. Please remember to also state qualitative method to strengthen points. The specific method used is required.

You also did a good job discussing the research results, and the nursing implications.

The ethical considerations were reviewed. However, please cite the sources of information.

Please remember to include concluding points to help wrap up your key findings in conducting your critique.

Please see above for additional feedback noted in balloon comments throughout.

Also, continue to review APA 7th edition guidelines to assist in formatting. You are presenting good efforts overall. You are also missing your Reference page. Please refer to the GCU APA 7th edition essay template and guidelines to assist you.

I hope the corrections will be of help to you for future writing assignments. Please remember to review the assignment guidelines and rubric to make certain all points are included as you prepare for the Week 3 quantitative critique. Remember to use the additional assignment guidelines presented as an attachment on the assignment criteria page. Nice job overall Eliety! - Cherryl Llanos

�APA is quite specific about the formatting of the document, including titles, page headers etc. You are presenting great efforts here. Review your settings

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�Good efforts; however not required to list your references here, only cite throughout the paper and reference page at the end.

�Please cite the facts. It is critical to cite your facts.

�Please cite the facts. It is critical to cite your facts.

�Overall, nice job presenting the study’s background.

�Please cite the facts. It is critical to cite your facts.

�Please cite the facts. It is critical to cite your facts.

�Here you effectively presented the purpose of the study.

You also did a good job discussing the study's question.

�Citation needed to clarify points.

�What is your specific PICOT question? Please remember to include your specifically developed PICOT question as this is a critical component of your critiques.

�Please remember to avoid using first person in academic writing. Here you can use "the author" or "the writer" when referring to yourself.

�Overall, good point provided on each articles relation to your PICOT and the interventions.

�Please cite your sources throughout the paper in order to clarify points.

�Good start here, what was the specific method used to conduct the study?

Qualitative or quantitative and further supporting details.

� The benefits and limitations have been well noted.

�Citation needed

�Citation needed

�You provided key detail on both research results and their implications!

�Please cite sources of information

�Good job overall discussing the ethical considerations