Research Critiques and PICOT Statement Final Draft

PICOT Question

Is the implementation of clearly structured training modules for adult with Chronic Kidney Disease (CKD) necessary to narrow the gaps existing in the education and general knowledge of CKD?

Background Study

There is a significant gap in perceived knowledge and education associated with the diagnosis of CKD although detection and treatment of CKD at earlier stages have gained a lot of attention, there is limited evidence that is associated with patients' education to improve management of patients at keys stages of the disease.

An article by Davis and Zuber (2013), reviewed that the medical care improvement for patients and providers Act enhanced education for stage 4 CKD patients through reimbursing educators who are qualified for formal instructions. There are various specifications laid down by the law but much of the content and structure of the instruction are left out to educators. However, educated patients prefer home modalities more often as they start dialysis with permanent vascular access and mostly score better on a test measuring mobility, mood, and anxiety. But there is insufficient research on the impacts of CKD patient education. Implementation of education in clinics with CKD to help in fighting it. The study aims at establishing if structured education programs play any role in the management of CKD patients and if non-medical educators or professionals or staff matter more. The study concluded that education plays an important role in CKD patient's disease management and it is effective on the disease progression. The study is important for nursing purposes because it helps to determine if well-structured programs help in the management of CKD patients and prevention of negative progressions.

In the study by Dixon et. al, (2011), the Nephrology section at Darmouth-Hitchcok Medical center incorporated a new idea of care provision that involved nephrologists and care managers to work together with patients in the introduction of clinical interventions and stage-based educations. The study compares outcomes from two different approaches to providing CKD knowledge to help in improving positive outcomes in dialysis. It involves the establishment of the role of education to CKD patients on multidisciplinary care and traditional nephrology care. The study wanted to evaluate which method worked better between the multidisciplinary care approach and the traditional nephrology care method. The study concluded that the multidisciplinary care approach is better than traditional nephrology care. This study is important for nursing purposes because it provides knowledge on the best approach to use when providing dialysis educations to patients .

The articles determine that all types of educations interventions programs for patients with CKD, mostly when education is specific for a certain disease. However, the use of a multidisciplinary care approach is better than the traditional Nephrology approach. Therapies aimed at the progression of kidney disease or lowering complications related to advanced CKD stages depend mostly on patient-centered care thus specific education provides the best outcome of initiating dialysis, reduction of hospital costs, and admission.

Nursing Practice

The Picot questions identify adult patients living with CKD disease as the population and provision of knowledge and education of CKBD enhances patient's engagement in their healthcare, alteration of personal behaviors which are changeable thus enhancing substantial delay in disease progression, personal management efforts and completion of treatment options. While the articles agree with the picot question because they review that CKD intervention programs and educations are imperious for better patient outcomes. Although there are different approaches, multidimensional is more effective as compared to traditional care.

Both articles used Qualitative research which employs methods that are open to subjectivity and flexible. An article by Davis and Zuber (2013), group interviews, and informal groups were used in answering questions that were brought to them. While On the study by Dixon et. al, (2011), the observation was used to evaluate the outcome of the patients who received multidisciplinary care and traditional nephrology care .

Methods of Study

Group interviews are important because they help to explain and understand better and explore subjects' opinions, experiences, behavior, and phenomenon . The interview questions are usually open-ended so that in-depth information can be collected. Questionnaires are advantageous because a large number of people can answer a large amount of information within a short period in a cost-effective way. While observation methods help the researcher to capture subtle and overt factors in the research setting. The researcher can see and record how the participants act in the environment.

However, these methods can be advantageous. The questionnaire cannot be termed as very valid and reliable. This is because subjects may misinterpret the question thus providing an indefinite and incomplete response, less can be done to connect such response. This because there is no clarification of a particular response. Interviews are more time-consuming this is due to interview preparation, taking interviews, and interpretation of the response needs a lot of time. Time constrain is the main limitation.

Results of Study

The finding in an article by Davis and Zuber (2013), shows that education plays an important role in the management of CKD patients and delays disease progression. This helps to guide patients on delaying disease progression, transplant preparedness, and dialysis. Additionally, health literacy incorporates skills such as directions understanding of prescriptions and instructions enhancing CKD patients to express themselves. However, there is limited data that support the importance of education and its impact on disease progression.

The findings in Dixon et. al, (2011), the study supports the use of a multidisciplinary approach as a method of improving the care of patients with CKD initiating dialysis and reduction of hospital costs and admissions. The patients who were receiving a multidisciplinary approach of education have a 42% less likelihood of being admitted to the hospital for dialysis initiation, fewer admission (p=0.005), fewer hospitalization days(p=0.001), and charges reduction for 90 days (p=0.003) after initiation of dialysis. This approach will help in filling the gap of education and knowledge of CKD

The two studies recommend implementing clear and well-structured training modules for adult CKD patients in nursing practice to enhance CKD management and efficiency .

Ethical Considerations.

Ethical considerations are the most important in research because the research may fail if the parts are missing. The researcher should seek the full consent of the participants should be obtained before the study. It is important to specify which kind of data supposed to be collected and how it will be used. the researcher should completely inform the participants about various aspects of research in a comprehensive manner. Additionally, it is important to protect the confidentiality and privacy of participants. This can be enhanced if data is collected anonymously.

Confidentiality and privacy were enhanced because not much information about the participants were published, no participant's names were used. additionally, the consent of participants was asked before involving them in the research .

References

Davis, J. S., & Zuber, K. (2013). Implementing patient education in the CKD clinic. Advances in chronic kidney disease, 20(4), 320-325.

Dixon, J., Borden, P., Kaneko, T. M., & Schoolwerth, A. C. (2011). Multidisciplinary CKD care enhances outcomes at dialysis initiation. Nephrology Nursing Journal, 38(2).

Several of your ideas came together well for the Module 2 writing assignment. You did a good job overall on your findings on each qualitative study.

You did a nice job summarizing each study’s background.

You also presented good rationale on how the two articles support the nurse practices issue you chose. It would have been helpful to include your developed PICOT question as you discuss how the interventions and comparison groups in the articles compare to those identified in your PICOT question. This will help to strengthen your argument.

Your reviews of each study’s research method start off well. Please review to make certain you include the specific method used to conduct the study. Was it qualitative, quantitative? Experimental, non experimental? etc. Further detail will assist as you prepare for your future research critiques.

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

The ethical considerations were reviewed in good detail.

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

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

Also, continue to review APA 7th edition guidelines to assist in formatting. You are doing a good job overall, minimum issues noted above.

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.

�Running head is not required per APA 7th edition

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

For more help click here: �HYPERLINK "http://owl.english.purdue.edu/owl/resource/560/01/" \o "Click here."��http://owl.english.purdue.edu/owl/resource/560/01/�

�Good job including your developed PICOT question. It would be helpful to include introductory points, presenting an overview of the critique and introducing the qualitative articles you will be critiquing.

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

For more help click here: �HYPERLINK "http://owl.english.purdue.edu/owl/resource/560/01/" \o "Click here."��http://owl.english.purdue.edu/owl/resource/560/01/�

Please review throughout the paper.

�Nice job presenting the study’s background.

�Here you effectively presented the purpose of the study.

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

�Good insight offered here as you summarize each article.

�PICOT

�PICOT

�Remember to include your PICOT in this area of the discussion as well. This will strengthen your argument.

�Please remember to indent at the start of a new paragraph.

�Clear points provided on each articles relation to your PICOT and the interventions.

�Good start here. What was the specific method used to conduct the study? Was it qualitative, quantitative? experimental, non experimental? etc.

Further detail will assist as you prepare for your future research critiques.

�Good points presented overall here regarding the method of research used for both studies.

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

�Good start here, remember to cite key points from each article as you review each study’s ethical considerations.

�Watch for spacing issues