RESEARCH CRITIQUES AND PICOT STATEMENT FINAL

Running Head: QUANTITATIVE RESEARCH CRITIQUE AND ETHICAL CONSIDERATIONS

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CRITIQUE 2

Quantitative Research Critique and Ethical Considerations

Angelique Christoffel

Grand Canyon University

Nurs 433V

June Helbig

August 30, 2020

Quantitative Research Critique and Ethical Considerations

Article ‘Reducing Behavioral Inpatient Readmissions for People with Substance Use Disorders: Do Follow-up Services Matter’ is written by Reif, S., Acevedo, A., Garnick, D. W., & Fullerton, C. A. (2017) and they have evaluated the effectiveness of the follow-up which extended for the period of fourteen days among the people who had a problem of substance abuse and this follow-up took place after the discharge from the hospital. It has been found out that readmission is common among the patients having the problem of substance abuse which is major because of the lack of any kind of subsequent communication between the patients and doctors after their discharge.

Background of Study

The research question in the article aims at evaluating the effectiveness of the services provided in the follow-up sessions. The article ‘Inpatient Addiction Consultation for Hospitalized Patients Increases Post-Discharge Abstinence and Reduces Addiction Severity’ is written by Wakeman, S. E., Metlay, J. P., Chang, Y., Herman, G. E., & Rigotti, N. A. (2017) in which they assessed the impact of the hospital-based intervention among people who had a problem of drug use and alcohol use during their hospital visits. People suffering from substance abuse a mostly taken care of in the general medical setting. The hospital-based intervention for such patients also included the addiction consultation in the inpatient setting and research has shown that such interventions can improve the outcomes. The interventions which include the consultation and follow-up settings are usually performed by the nurses who significantly increase the value of their profession and they are given more responsibility that becomes beneficial for them. My research question is as follows: 

“In mental health patients with substance use disorders (P), does treatment, (I) as compared to non-treatment, (C), reduce readmissions, (O) within 90 days?”

The effectiveness of the intervention treatment in the patients with substance abuse will be evaluated in my research study and the hypothesis states that such intervention can reduce the chances of readmission back to the hospitals among the patients with the problem of drug and alcohol abuse. Addiction is the worst thing and once people get addicted, it becomes harder for them to leave their dependence and stay clean even when they are given the medical and hospital interventions. It has been found out that lack of medical consultation in the follow-up increases the risk of readmission. Therapies are also found effective in reducing dependence among patients with substance abuse. The selected articles for this assignment had chosen two different interventions and their impact on the readmission among patients. Interventions include hospital-based intervention including therapy and consultation and fourteen days follow-up. These studies will find out the impact of any kind of intervention which will assist in answering the selected research problem. The time periods in which interventions are monitored are different from the one selected in PICOT but that will help the question because the selected time period is more than what is being evaluated in the assignments. The intervention plan includes the follow-up and the consultation in addition to providing the regular services. The comparison groups’ selection is also on point because patients suffering from alcohol and drug use from different age groups are selected in these studies. 

How do these two articles support the nurse practice issue you chose?

The sample selected in the study ‘Reducing Behavioral Inpatient Readmissions for People with Substance Use Disorders: Do Follow-up Services Matter’ includes people from the age of 18 to 64 suffering from the problem of substance abuse and along with that inclusion criteria included their inpatient hospital stay and residential detoxification. The intervention plan includes residential and outpatient treatment, medication-assisted treatment, and intensive outpatient treatment. The intervention was conducted and evaluated in people belonging to ten different states and was given index admission numbers and follow-up prevalence services. Survival analyses were conducted in which time-variant independent variables were analyzed and at the same time connection of follow-up services with the medication-assisted treatment was assessed in relation to the behavioral health readmissions frequency. People from different age groups were added into this study which is a plus point because the impact of different people will be evaluated but it has a negative point of having a different time frame than the research question. 

Method of Study

The prospective quasi-experiment for the thirty days post-discharge is conducted in people having additional consultation from doctors and the ones without any kind of consultation in the article ‘Inpatient Addiction Consultation for Hospitalized Patients Increases Post-Discharge Abstinence and Reduces Addiction Severity’. The people from urban academic hospitals were evaluated and selected which were a total of 399 adults. The intervention used for them had a multidisciplinary approach including pharmacotherapy initiation, motivational counseling, relation with the ongoing addiction treatment, and treatment planning. The calculation was conducted on the basis of the Addiction Severity Index (ASI). The inclusion of people from different age groups was a plus point but the limitation of the time frame poses a negative challenge to the chosen research problem. 

Results of Study

The results of ‘Reducing Behavioral Inpatient Readmissions for People with Substance Use Disorders: Do Follow-up Services Matter’ showed that twenty-nine percent of patients got the follow-up checkup who had behavioral health admission before. However, the combination of residential treatment and medication-assisted treatment improved their overall outcomes and decreased their chances of getting readmission again in three months. At the same time, the ones without outpatient follow-up became more vulnerable to the chances of readmission. The conclusion stated that such medication-assisted treatment and residential treatment after the inpatient treatment and detoxification minimizes the risk of future readmission and hence it is recommended to the Medicaid programs to improve their residential treatment and medication-assisted treatment.

The results of ‘Inpatient Addiction Consultation for Hospitalized Patients Increases Post-Discharge Abstinence and Reduces Addiction Severity’ showed that patients in the intervention group getting the follow-up sessions have decreased ASI composite score. Results remained the same in people belonging to different genders, ages, and severity of diseases but the people without any kind of follow-up were found out to be vulnerable to readmission. Therefore the addiction consultation was found to be effective in reducing the chances of getting addicted to alcohol and substance abuse. The chosen research studies presented that any kind of information including the consultation and follow-up decreases the pressure from the medical profession because fewer people are readmitted again and hence it also helped in signifying the importance of nurse’s intervention. 

Ethical Considerations

Therefore, it is found out that there is a correlation between the reduced readmissions and the intervention treatments in the form of follow-ups. The anticipated outcome of the research suggests that intervention in the form of treatment in people suffering from substance abuse can minimize the chances of readmission in hospitals due to the same reason in ninety days. The selected studies have shown that intervention in form of the addiction consultation and follow-ups decreases the readmission risk in the people suffering from substance use disorders, which is also the same as the anticipated outcome of my research study. 

References

Wakeman, S. E., Metlay, J. P., Chang, Y., Herman, G. E., & Rigotti, N. A. (2017). Inpatient addiction consultation for hospitalized patients increases post-discharge abstinence and reduces addiction severity. Journal of general internal medicine, 32(8), 909-916. https://doi.org/10.1007/s11606-017-4077-z

· Reif, S., Acevedo, A., Garnick, D. W., & Fullerton, C. A. (2017). Reducing behavioral health inpatient readmissions for people with substance use disorders: do follow-up services matter? Psychiatric services, 68(8), 810-818. 10.1176/appi.ps.201600339