wk9 assign 6052
Ifeoma12
criticalappraisaltemplate1module4.docCRITICAL APPRAISAL
CRITICAL APPRAISAL
Critical Appraisal
Student’s Name
Institution
Date
Evaluation Table
Part 4A: Critical Appraisal of Research
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APA formatted citation |
Article #1 |
Article #2 |
Article #3 |
Article #4 |
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Abbas, S., Akram, A., Ali Shah, S. H., Iqbal, R., Abbas, B., & Urooj, U. (2020). Patient Safety; Interventions to Reduce Hospital Errors. Pakistan Armed Forces Medical Journal, 70(4), 902–909.
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Akinleye, D. D., McNutt, L.-A., Lazariu, V., & McLaughlin, C. C. (2019). Correlation between hospital finances and quality and safety of patient care. PLoS ONE, 14(8), 1–19. https://doi.org/10.1371/journal.pone.0219124
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Kuriakose, R., Aggarwal, A., Sohi, R. K., Goel, R., N.C., R., & Gambhir, R. S. (2020). Patient safety in primary and outpatient health care. Journal of Family Medicine & Primary Care, 9(1), 7–11. https://doi.org/10.4103/jfmpc.jfmpc_837_19
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Maeng, D. D., & Martsolf, G. R. (2011). Comparing Patient Outcomes across Payer Types: Implications for Using Hospital Discharge Records to Assess Quality. Health Services Research, 46(6pt1), 1720–1740. https://doi.org/10.1111/j.1475-6773.2011.01285.x |
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Evidence Level |
Level I |
Level I |
Level I |
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Conceptual Framework
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The study investigates the factors that compromise patient safety, such as medical errors.
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The study's hypothesis seeks to find out whether the financial status f a healthcare facility and the quality of services/ patient safety are linked. |
The study does not have a conceptual framework. |
The study proposes three potential hypotheses: there may be selective contracting between payer types and providers; there may exist unobserved health status differences among patients with different payers, and payers may reduce the quality and quantity of services resulting from MCO financial incentives. |
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Design/Method
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The study is a cross-sectional study. The study included paper and web-based questionnaires. Medical errors related to anesthesia and surgery were included. |
The study is a cross-sectional study. A financial performance score was developed using a principal composite analysis. The study included data on the standardized inpatient mortality, 30-day readmissions, and mortality. Some of the Acute care centers in New York were excluded as they did not have surgical beds, ancillary facilities, and recent closure. |
The study evaluates secondary data in the determination of patient care in the primary sector. The data used is from the World Health Organization. Only data relevant to patient care in primary healthcare is used. |
The study used five different regression analyses to identify a relationship between payer type and the possibility of experiencing complications. |
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Sample/Setting
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The study used 1470 participants. 814 were anesthesiologists and 656 were surgeons.
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108 State acute care facilities in New York were used in the study. |
Three characteristics are evaluated; the role of patients and caregiver providers, community and health systems, and provider-patient interaction in promoting patient care. |
The study used inpatient discharge records from 250 major Florida hospitals. Only data from 1996 to 2000 was chosen for this study. 50% of the random sample was picked from each hospital. |
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Major Variables Studied
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The independent variable in the study was patient safety. The dependent variables were drug errors, medical errors, and critical incidence reporting.
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The independent variable was hospital finances. The dependent variables were the quality of care and patient safety. |
The independent variable in the study is primary care in the primary healthcare sector. The dependent variables are the role of patients and caregiver providers, community and health systems, and provider-patient interaction. |
The independent variable was the primary payer indicator. The dependent variable was the hospital complication rates among patients who had undergone major surgeries. |
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Measurement
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Questionnaires were used in the study. Data on the reasons for drug errors, never events, and lack of critical incident reporting were evaluated. |
A composite financial performance score and hospital quality/safety performance score were used in the study. The data was collected from the Medicaid and Medicare Services cost report. 46 indicators of patient safety and quality of care were used. |
Evaluation of the research done by WHO was used.
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A regression analysis was used in the study. The test done was the discrete factor approximation method, |
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Data Analysis Statistical or Qualitative findings
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44.2% of participants said drug errors resulted from the heavy workload and long working hours. 44.2% attributed the lack of reporting critical incident reporting to medical-legal issues, 22.3% due to unwillingness to reveal details, 16.7% for fear of judgment from colleagues, and 16.7% due to the lack of clarity regarding reporting channel. |
There was a 0.34 correlation coefficient between the financial performance and the hospital quality/safety performance score. |
70% of the primary healthcare sector does not have patient harm. It was found that 56% of the errors committed are common in the primary healthcare sector. |
The correlation coefficient in 1997 was -0.2037(0.0542), in 1998 it was -0.221(0.0936), in 199 -.02882 (0.1209), and in year 2000 is -0.3075 (0.161) |
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Findings and Recommendations
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According to the study, it was revealed that critical incident reporting and drug errors might reduce patient safety. |
The study determined that hospitals with access to more finances provide better quality care, thus improving patient safety. Therefore, hospitals should seek more funds to improve the quality of their services to promote patient safety. |
The role of patients and caregiver providers, community and health systems, and provider-patient interaction affects patient safety in the primary healthcare sector. The primary healthcare patient safety plays a big role in promoting universal health coverage and sustainability of healthcare. Best practices should be practiced in the primary healthcare sector. |
The study revealed that there might exist complications among patients with different payers. However, the complications are a result of other underlying factors. Healthcare facilities should concentrate on the provision of quality care despite the payer type. |
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Appraisal and Study Quality
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The study's strength is that it used primary data; thus, it has a higher statistical power. The limitation of the study is that the answers of the medical practitioners cannot be verified. There are no risks associated with the suggested practice. The findings of the study are feasible in the nursing practice, as it will improve patient safety. |
The research was instrumental in the healthcare sector as it identified that finances could be used to boost the quality of services. The study used secondary data from a reliable source, thus increasing the statistical power of the study. However, some of the data used may not be accurate, or some gaps might exist in the data. The risk is that there is no surety that if hospitals have access to more funds, they will improve service quality and patient safety. It is quite difficult for the results f the study to be implemented because of the tight budgets in the healthcare industry. |
The research is integral to the promotion of patient care. An advantage of the study is that it uses data from a trustworthy source. Implementing the suggested practice is expensive. Implementing the results of the study is possible, but it will take time. |
The research helped identify the role of payers in the level of complications in hospitals. One limitation of the study is that hospital discharge records may have errors making comparison difficult. Implementing the suggested practices may be time-consuming and expensive for healthcare facilities. The feasibility of the use in my practice is low. |
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Key findings
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Drug errors and critical incident reporting improves patient safety. |
There is a relationship between the finances in a healthcare facility with the quality of care and patient safety. |
The primary healthcare sector is affected by the role of patients and caregiver providers, community and health systems, and provider-patient interaction. |
Unobserved differences in patient health contribute to the differences in complications among patients with different payers. |
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Outcomes )
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Medical practitioners should ensure that patient safety is improved through critical incidence reporting and reducing drug errors. |
The study will increase funding in the healthcare sector to improve the quality of care and patient safety. |
The study will lead to the adoption of best practices in the primary healthcare sector. |
The study will lead to the adoption of best practices in the primary healthcare sector. |
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General Notes/Comments |
The study indicated that communication is one of the basic methods that can be used to improve patient safety. |
From the study, it is evident that hospitals with access to more finances are in a position to ensure the systems are reliable, thus increasing patient safety. |
The problems regarding patient safety should be addressed to ensure that it is improved in the healthcare facilities. |
The study makes it challenging to make conclusions about patient safety and patient outcomes from the hospital records. |
Part 4B: Critical Appraisal of Research
Patient safety is the absence of harm to a patient during receiving healthcare services or the reduction of risk of harm that may occur to a patient during a particular healthcare process. Patient safety is one of the key issues healthcare facilities focus on when providing healthcare services for their patients. The research papers in critical appraisal investigate various variables that may affect patient safety in a healthcare organization. In this section of the assignment, the best practices identified to increase patient safety will be discussed.
To ensure patient safety in a healthcare organization, the first step is to ensure that the healthcare services offered to the patients are of high quality. There is a positive relationship between the quality of healthcare services and patient safety. When a healthcare facility offers high-quality healthcare services to the patients, the level of patient safety will increase significantly.
One of the major causes of reduced patient safety is medical errors. Healthcare practitioners may make medical errors due to heavy workloads, long working hours, and burnouts. Therefore, to improve patient safety, healthcare facilities have to ensure that medical practitioners are enough to handle the workload. Under-staffing medical practitioners increases the workload they have and the number of patients they have to deal with. The exhaustion of the heavy workload and working for long hours may lead to numerous medical errors. Additionally, the shift should be implemented effectively to ensure enough time for medical practitioners to rest.
Finances were also identified as a determinant of patient safety. According to Akinleye et al. (2019), more finances in a healthcare facility positively affect patient safety and the quality of care. That is because a healthcare facility has enough finances to improve their infrastructure and introduce the best methods and systems to help deliver patient-centered care. Therefore, healthcare facilities should seek more funds so that they may promote patient safety. Additionally, people would prefer to go to healthcare facilities with higher rates of patient safety.
Effective communication can also help in improving patient safety. The healthcare practitioners in a healthcare facility should communicate effectively. That will help pass the correct details about a patient (Abbas et al., 2020). Miscommunication of a patient’s details may lead to the wrong diagnosis and wrong treatments, thus contributing to the patient's complications. IN a nutshell, there are several factors that affect patient safety in a healthcare facility. Some of the factors that can be used to improve patient safety include effective communication, access to financial resources, promoting patient-centered care, creating effective working schedules, and hiring enough staff in a healthcare facility.
References
Abbas, S., Akram, A., Ali Shah, S. H., Iqbal, R., Abbas, B., & Urooj, U. (2020). Patient Safety; Interventions to Reduce Hospital Errors. Pakistan Armed Forces Medical Journal, 70(4), 902–909.
Akinleye, D. D., McNutt, L.-A., Lazariu, V., & McLaughlin, C. C. (2019). Correlation between hospital finances and quality and safety of patient care. PLoS ONE, 14(8), 1–19. https://doi.org/10.1371/journal.pone.0219124
Grant, C., & Osanloo, A. (2014). Understanding, Selecting, and Integrating a Theoretical Framework in Dissertation Research: Creating the Blueprint for Your" House". Administrative Issues Journal: Education, Practice, and Research, 4(2), 12-26.
The Johns Hopkins Hospital/Johns Hopkins University (n.d.). Johns Hopkins nursing dvidence-based practice: appendix C: evidence level and quality guide. Retrieved October 23, 2019 from https://www.hopkinsmedicine.org/evidence-based-practice/_docs/appendix_c_evidence_level_quality_guide.pdf
Walden University Academic Guides (n.d.). Conceptual & theoretical frameworks overview. Retrieved October 23, 2019 from https://academicguides.waldenu.edu/library/conceptualframework
Critical Appraisal Tool Worksheet Template
