CRITICAL APPRAISAL

CRITICAL APPRAISAL

Introduction

The articles to be analyzed are Powel et al. (2005) and Camps-Font et al. (2015) about nursing interventions to prevent dental surgical infections.

Background of the Studies

Powell et al. (2005)

Powell et al. (2005) conducted a study to investigate the nursing interventions that would benefit patients who had undergone a dental procedure. The significance of this problem was to investigate how nursing would be beneficial in the management of surgical procedures. The major purpose was to identify the disease burden of surgical site infections and its impact on financial resources. The research question posed was, “What are the nursing interventions to prevent surgical site infections in postoperative patients?”

Camps-Font et al. (2015)

The major of Camps-Font et al. (2015) was to conduct a qualitative study on the prevalence and nursing interventions needed to treat and reduce post-surgical infections in dental implant patients. The significance of this study was based on the implication that the mouth is a source of may normal flora that would gain access into the bloodstream following an invasive dental transplant procedure. This study aimed to investigate the prevalence, clinical features, and interventions for postoperative infections found in the procedures. However, for this paper, we will only look at the treatment interventions.

How Articles Support Nursing Practice

Population

In both the studies, the population selected were the patients that had undergone surgical intervention. The patients were subjected to a nursing intervention that included treatment and followed to investigate the prevalence of them developing an infection and if the intervention helped prevent the infection.

Intervention

            The intervention used included putting one group of patients under antibiotic cover and another not on any form of antibiotic cover and following them up. After the surgical procedure, the nurse would administer antibiotics in one group while another group was not subjected to antibiotic intervention.

Comparison

In the Camps-Font et al. (2015), 1273 patients were placed under intervention and studied, while the Powell et al. (2005) totaling 1,053 patients that had undergone surgical intervention were observed retrospectively.

Outcomes

The outcome reported from Camps-Font et al. (2015) was an 8.2% infection rate from the sample population collected. The Powell et al. (2005) showed an increase in infection rates at 2.05%, with 22 patients being reported from the sample of 1,053 patients

Time

According to Ellis, Lin, and Tartar (2018), the wound healing process takes approximately five to six months. Nine months is the approximate period for the wound to gain its original tensile strength. This study used an average of 10 months because of longer time healing in complicated infections. The time taken for both of the studies was different to investigate the interventions. The Camps-Font et al. (2015) used a mean of 42.9 months which translated to a standard deviation of 10.9 months. Powel et al. (2005) used timing of 10 months to compare interventions vested on the patients.

Methods of Study

            Camps-Font et al. (2005) used cohort study, and Powel et al. (2005) used the retrospective study design. In cohort studies, the patients are followed up to see if they develop the desired outcome. The retrospective study entails conducting a study after the desired outcome has occurred, i.e., looking back.

Cohort Study Benefit and Limitation

            The major benefit of cohort studies is the deferment of an expected outcome, and the potential causes of harm are investigated before they occur. The limitation posed by cohort studies is it requires a large sample size because of sampling errors and to observe the desired outcome effectively.

Retrospective Benefit and Limitation

            The retrospective design is easy because the desired outcome has already occurred, and this is good for diseases with longer periods of latency, such as more than six months. The major limitation is there are high chances of loss of follow-up of the patient, which causes difficulties in conducting the study effectively.

Results of the Study

            Powell et al. (2005) demonstrated an increase in infection rates at 2.09% from the total sample of 1,053 patients. The 2.09% translated to 22 patients that developed the infections despite any form of nursing intervention. The antibiotic intervention showed a reduction in infection; from a sample of 281 that received antibiotics by the nurse, only eight developed infections, compared to 14 patients that developed infections and were not on any form of antibiotics, i.e., 14 in 772.

            Camps-Font et al. (2015) showed that treatment interventions improved patient outcomes. Twenty-two patients from a total of 1,273 recorded infections. 6.5% of the patients recorded an increase in infection rates, while 1.7% were associated with implant infection despite the administration of amoxicillin and Clavulanate.

Implications in Nursing

            The above two analyses indicate that nursing intervention by administration of antibiotics postsurgically improves patient outcomes and recovery. The major implication is that nurses should administer prophylactic antibiotics to reduce infection postsurgically.

Ethical Considerations

Two considerations

Reijers et al. (2018) argue that Informed consent forms a key part of any form of research. Without consent, the research is deemed illegal and without the authority of the respondent. Informed consent provided the respondent the ability to self-awareness of the situation they’re getting into and the risk factors. In minors, the parent or guardian may give consent after the research has explained the implications and benefits accrued. Ethical approval is important in research because it builds legal grounds and prevents litigation. Ethical approval involves getting a permit to conduct a study. An ethically approved research is more likely to become acceptable by other researchers.

Ethical Considerations in My Two Research

            The Camps-Font et al. (2005) was conducted in Spain and was ethically approved by the Ethical Committee for Research in Barcelona. The Dental Hospital of Barcelona is also an approved member of the Ethics Committee. Powell et al. (the Review and Ethics Committee support 2005 to conduct research.

References

Camps-Font, O., Figueiredo, R., Valmaseda-Castellón, E., & Gay-Escoda, C. (2015). Postoperative infections after dental implant placement: prevalence, clinical features, and treatment. Implant dentistry, 24(6), 713-719.

Ellis, S., Lin, E. J., & Tartar, D. (2018). Immunology of wound healing. Current dermatology reports, 7(4), 350-358.

Powell, C. A., Mealey, B. L., Deas, D. E., McDonnell, H. T., & Moritz, A. J. (2005). Post‐surgical infections: prevalence associated with various periodontal surgical procedures. Journal of periodontology, 76(3), 329-333.

Reijers, W., Wright, D., Brey, P., Weber, K., Rodrigues, R., O’Sullivan, D., & Gordijn, B. (2018). Methods for practicing ethics in research and innovation: A literature review, critical analysis, and recommendations. Science and engineering ethics, 24(5), 1437-1481.

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Literature Evaluation Table

Summary of Clinical Issue

The corona virus pandemic has killed many people and has led to an economic regression without any parallel in the past. The people living in the rural areas have been majorly been affected by this pandemic and are among the people who are at a very big risk yet there has not been enough information that portrays the danger of this pandemic to this vulnerable group of people. Like all the other viruses, the corona virus is an obligate parasite that cannot produce outside the host. The virus does not have bodies to grow, and thus it can only grow by hijacking the host’s body. The viruses, therefore, cause the infection by invading the cell of the body and then multiplying within the host.  This virus has a short intracellular period before they infect the cells and a long intracellular period during replication. The virus can suppress the host’s immune response and thereby overcome or minimize the defense of the host. The CDC created a social distancing policy with guidelines to be implemented although the United States. This is meant to help in protecting people from contracting COVID-19. Corona Virus is a mild disease that most people will recover from. There are various measures that the government has put in place to put people safe from the disease and reduce the risk of infections. Apart from creating a safe environment, the policy is aimed at informing the public of the dangers that come along with this disease.

PICOT Question:  Will the spread of Covid-19 in Tarrant county, Texas reduce after the Implementation of Early preventive measures of social Distancing, mask-wearing, and Nursing education, compared to Neighboring counties with more cases where such actions were not implemented to reduce the spread of the virus over the next few months?

CriteriaArticle 1Article 2Article 3
APA-Formatted Article Citation with Permalink“Teslya, A., Pham, T. M., Godijk, N. G., Kretzschmar, M. E., Bootsma, M. C., & Rozhnova, G. (2020). Impact of self-imposed prevention measures and short-term government-imposed social distancing on mitigating and delaying a COVID-19 epidemic: A modelling study. PLoS medicine17(7), e1003166. Impact of self-imposed prevention measures and short-term government-imposed social distancing on mitigating and delaying a COVID-19 epidemic: A modelling study (plos.org)”  “Chiu, N. C., Chi, H., Tai, Y. L., Peng, C. C., Tseng, C. Y., Chen, C. C., … & Lin, C. Y. (2020). Impact of wearing masks, hand hygiene, and social distancing on influenza, enterovirus, and all-cause pneumonia during the coronavirus pandemic: Retrospective national epidemiological surveillance study. Journal of Medical Internet Research22(8), e21257.  JMIR – Impact of Wearing Masks, Hand Hygiene, and Social Distancing on Influenza, Enterovirus, and All-Cause Pneumonia During the Coronavirus Pandemic: Retrospective National Epidemiological Surveillance Study | Chiu | Journal of Medical Internet Research“Bundgaard, H., Bundgaard, J. S., Raaschou-Pedersen, D. E. T., von Buchwald, C., Todsen, T., Norsk, J. B., … & Iversen, K. (2020). Effectiveness of adding a mask recommendation to other public health measures to prevent SARS-CoV-2 infection in Danish mask wearers: a randomized controlled trial. Annals of Internal MedicineEffectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers: A Randomized Controlled Trial: Annals of Internal Medicine: Vol 0, No 0 (acpjournals.org)
How Does the Article Relate to the PICOT Question?This article directly supports the PICOT as it highlight measures that can help in reducing COVID 19This study is very significant in supporting my PICOT since it shows the role that the various measures that have been put in place can help not only in reducing the spread of Covid 19 but also other respiratory disease.This article highlight some of the measures that can help in checking the spread of this Virus and therefore it is directly related to my PICOT question.
Quantitative, Qualitative(How do you know?)This is a qualitative study because it uses non numerical data in analyzing the study resultsThis is a qualitative study because it uses non numerical data in analyzing the study resultsThis is a qualitative study
Purpose StatementThe study compared the effectiveness of the various prevention measures and their effects on fighting CovidThis study was aimed at investigating the impact of the implemented infectious control strategiesThis study was aimed at assessing whether surgical mask recommendation use outside home decreases the risk of Covid 19
Research QuestionDo prevention measures imposed by the government and social distancing mitigate or delay covid 19.What is the impact of the infectious control strategies that that have been implemented during this pandemic.Does wearing surgical mask outside the home reduce the risk of the wearer for COVID 19?
OutcomeIt was found that all the measures like hand washing, social distancing and mask wearing have an effect on  the dynamics of COVID 19It was found that the control measures that have been implemented have greatly played a big role in helping control the pandemic.most infections came from outside the home setting
Setting (Where did the study take place?)Hospitals, long term care facilities and nursing homes. home setting  
SampleSample not provided 3030 participants
MethodThe researchers developed a deterministic compartment model to describe SARS-CoV-2. The patients were classified basing of their susceptibility and transmission observedThe study used Taiwan National infectious Disease electronic database statistics.  the authors then extracted COVID 19 incidences and all al- cause pneumonia  and compared these incidencesThe participants were enrolled and data was registered using REDCap software. Patients who were eligible were assigned masks
Key Findings of the StudyThe patients were classified basing of their susceptibility and transmission observedIt was found that the control measures that have been implemented have greatly played a big role in helping control the pandemic.It was observed that most infections came from outside the home setting.
Recommendations of the ResearcherUsing self imposed measures and government imposed measures will help this community to reduce the viruswearing of masks social distancing ad hand hygiene may help a lot in the prevention of covid 19 and also decrease the spread of other respiratory diseaseThis was an indication that wearing mask outside the home setting was very important as it helped in checking the spread of the virus
CriteriaArticle 4Article 5Article 6
APA-Formatted Article Citation with Permalink“Li, T., Liu, Y., Li, M., Qian, X., & Dai, S. Y. (2020). Mask or no mask for COVID-19: A public health and market study. PloS one15(8), e0237691.  Mask or no mask for COVID-19: A public health and market study (plos.org)“Gray, D. J., Kurscheid, J., Mationg, M. L., Williams, G. M., Gordon, C., Kelly, M., … & McManus, D. P. (2020). Health-education to prevent COVID-19 in schoolchildren: a call to action. Infectious diseases of poverty9(1), 1-3. Health-education to prevent COVID-19 in schoolchildren: a call to action | Infectious Diseases of Poverty | Full Text (biomedcentral.com)“Hornik, R., Kikut, A., Jesch, E., Woko, C., Siegel, L., & Kim, K. (2021). Association of COVID-19 misinformation with face mask wearing and social distancing in a nationally representative US sample. Health communication36(1), 6-14. Full article: Association of COVID-19 Misinformation with Face Mask Wearing and Social Distancing in a Nationally Representative US Sample (tandfonline.com)
How Does the Article Relate to the PICOT Question?This article has a direct support in my project since it elaborates the ways that mask wearing as a protective measure can help in mitigating the spread of the Virus.This article is very significant in supporting my PICCOT sine it illustrates the significance o education on trying to decrease the spread of this virus in the society.This study is crucial in supporting my PICCOT question  since it illustrates the significance of offering education to the people regarding the significance of these measures to help fight the pandemic
Quantitative, Qualitative(How do you know?)This is a simulated qualitative study This is a qualitative research since it does not use numerical data in the result analysisThis is qualitative research that uses non numerical statistics
Purpose StatementThis study was aimed at assessing whether the use of face masks is capable of delaying an influenza pandemic.This study was aimed at assessing whether the TV programs such as cartoons can help in passing covid 19 prevention messages among the childrenThe study was aimed at assessing how misinformation on face mask wearing and social distancing affected the adherence of people to the measures put in place
Research QuestionWhat is the likely effect of the  mask utilization in public spaces to combat  COVID 19 pandemicDoes positive  health messages and television programs help in reinforcing positive influence on hand washing procedures and social distancingWhat is the association of misinformation of wearing face mask and social distancing in U.S and adherence  
OutcomeThe research found out that wearing mask since the masks had a considerable promise of containing the pandemic.This study illustrated that cartoon concepts allows the children to identify with characters and this reinforces the need of good hygieneThe study found out that Social distance was observed outside but it was not adhered at homes. There was however an increase in observance of these measures
Setting (Where did the study take place?)Closed settings (household and aircraft)Home environment.   Home environment in the united states
Samplesample not givenSample not given1074 adults
MethodThe study used equation in predicting the basic reproduction number. B is the risk of transmission per contact and k the contact rate ad d the duration of infectivityThe intervention was trying to inform children on the transmission of disease. This was done by using cartoon conceptsAn online survey was conducted where the participants were asked various questions regarding Covid 19 behaviors such as social distancing and faces mask wearing.
Key Findings of the StudyThe key findings illustrated that there was a great significance of wearing masks since the masks had a considerable promise of containing the pandemic.It was found that these cartoon concepts allows the children to identify with characters and they can be able to visualize intestinal parasitic worms and their eggs in people and the environment. this reinforces the need of good hygieneIt was found that the wearing of face masks varied depending on the behavior. Social distance was observed outside but it was not adhered at homes. There was however an increase in observance of these measures
Recommendations of the ResearcherFace masks is one of the most important measures that can play a significant role in cutting the spread of the virus. However, the masks should be properly worn for efficacy. Education is very significant in helping curb the spread of Covid 19. This should be done even to the children so that they are aware of the dangers and how to keep themselves safeIt is important that more education on these measures is done. This study illustrate that although there is an increase in adherence of these measures, there is still a great importance of educating people on why this should also be done in our homes

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`RESEARCH CRITIQUE

Research Critique

Summary of the Two Articles

Background

Chiu et al. (2020) analyze the impact of methods that prevent the spread of infections through nasal drops to prevent respiratory infections. The primary aim of this study was to investigate the effect of national strategies that the government had implemented in the spread of respiratory infections. The respiratory infections covered in this article are entero-virus and influenza. Increased infections are a burden to the nursing fraternity because the nursing care given to patients is reduced when the disease burden is higher. The research question in this study is: What is the impact of infection control measures instituted by different governments on the spread of pneumonia?

Teslya et al. (2020) conducted a study to investigate the effects of self-imposed preventive mentions conjoined with government regulation in preventing COVID-19. The principal aim of this study was to examine and analyze how to prevent the pandemic. The significance of this study to nursing was to investigate if the hygienic and preventive measures would provide relief to nurses that have become overwhelmed by a surge in COVID-19 cases. This study wanted to answer: What is the effectiveness of self-preventive and government measures in preventing COVID-19 spread?

How Do These Articles Support the Nurse Practice Issue You Choose?

How Articles Answer the PICOT Question

            Chiu et al. (2020) answer the PICOT question posed if Tarrant County, Texas, will impact the implementation of the control measures in other counties. Chiu et al. (2020) support the PICOT question because the conclusion from this study was a general decrease in transmissibility of respiratory infections. Also, the aim of this study answers the PICOT question. Tesyla et al. (2020) support the PICOT question from the conclusion of the study. The study concluded that implementing strategies such as wearing masks and social distancing helped prevent COVID-19.

How Interventions and Comparison Group Compare to Those in the PICOT Question

            Teslya et al. (2020) used a compartmentalized transmission model as an intervention to curb the spread of  COVID-19. The compartmentalized model classified both individual and governmental measures as interventions that reduce the spread of COVID-19. The interventions compared attack rate and highest number of diagnoses. Chiu et al. (2020) used the Taiwan Taiwan National Infectious Disease Statistics System to investigate the interventions of wearing a mask, hand washing, and social distance on the spread of respiratory tract infections. The two articles answer the PICOT question posed because they show and support that various measures, if implemented, are crucial in preventing the spread of the virus.

Methods

Methods Used and the Difference

            Teslya et al. (2020) used the compartmental model. The compartmental model is used in the analysis of infectious diseases. The progression of the disease is gradual in individuals, and thus they are classified into particular groups and assigned unique letters. The natural progress of a condition may be assessed through this model. Chiu et al. (2020) used the Taiwan National Infectious Disease Statistics System to study the evolution of COVID-19 in weeks. This statistical model is important because it employs prevalence and incidence rates which are critical factors in spreading the virus.

Limitation and Delimitation of the Methods

            Franco (2020) argues that the compartment model is advantageous because it gives the results of the various compartments at a glance, and a conclusion is withdrawn with the naked eye. A compartmental model is critical in comparison approaches. The delimitation is that different compartments have chances of developing bias because the progression of disease in individuals varies depending on immunological status and drug interventions. Thus, in some individuals, the condition is more likely to progress faster, and regrouping is needed in each compartment.

            The statistical model used by Chiue et al. (2020) has the advantage of using factors such as prevalence rate, incidence rate, attack rate, which are essential in tracing disease occurrences relative to time. The delimitation is that mathematical errors lead to a generalized impact on the final result (Silk et al., 2017).

Results

Key Findings

            The Teslya et al. (2020) results showed that 46 per 1,000 individuals would develop COVID-19 at an attack rate equivalent to 16%. In the absence of preventive measures, the spread of COVID-19 rises to 20%. Fast and efficient spread of awareness dropped the number of infections from 16% to 12%. The total efficacy of preventive measures was 50%. Chiu et al. (2020) found a general decline in transmissibility from analysis in 2017, 2018, 2019, and 2020. In 2020, the reported cases of COVID-19 was 41 in week 21 caused a surge of infections; however, with implementation strategies, actual infections dropped significantly to a regression analysis of 0.098.

Implications

            The two studies are essential in nursing practice and education. The role of nursing education is vital in the prevention of the spread of COVID-19 and other respiratory tract infections. The major implication is the formation of state coalitions such as the California State Coalition that is at the forefront in educating people on the importance of preventing the spread of the virus (San Francisco, 2020). Thus, nursing practices such as hand washing, masks, and social distancing are significant in cubbing spread.

Outcomes Comparison

Anticipated Outcomes for the PICOT Question

            The anticipated outcome is that evidential analysis from the two studies is vital in preventing COVID-19 spread and other respiratory infections. The outcome is masks, hand washing; social distancing is essential in preventing the spread of the virus. Nursing education is also critical in molding the outcome of the disease.

Outcomes of Articles in Comparison to Anticipated Outcomes

            Teslya et al. (2020) concluded that preventive measures help flatten the peak curve of COVID-19. Therefore the preventive measures are aligned to the PICOT question and its anticipated outcome. According to Chiu et al. (2020), the preventive strategies were widely accepted by the population and were considered effective in preventing the spread of the virus. Analysis of the articles reveals an alignment to the anticipated outcome. The expected outcome was a decrease in the spread of the virus and flattening of the COVID-19 curve.

References

Chiu, N. C., Chi, H., Tai, Y. L., Peng, C. C., Tseng, C. Y., Chen, C. C., … & Lin, C. Y. (2020). Impact of wearing masks, hand hygiene, and social distancing on influenza, enterovirus, and all-cause pneumonia during the coronavirus pandemic: Retrospective national epidemiological surveillance study. Journal of Medical Internet Research, 22(8), e21257.

Franco, E. (2020). A feedback SIR (fSIR) model highlights advantages and limitations of infection-based social distancing. arXiv preprint arXiv:2004.13216, 28.

San Francisco, A. I. D. S. (2020). Coalition Effort for ‘Overdose Prevention Programs’ in California Announced. policy.

Silk, M. J., Croft, D. P., Delahay, R. J., Hodgson, D. J., Weber, N., Boots, M., & McDonald, R. A. (2017). The application of statistical network models in disease research. Methods in Ecology and Evolution, 8(9), 1026-1041.

Teslya, A., Pham, T. M., Godijk, N. G., Kretzschmar, M. E., Bootsma, M. C., & Rozhnova, G. (2020). Impact of self-imposed prevention measures and short-term government-imposed social distancing on mitigating and delaying a COVID-19 epidemic: A modelling study. PLoS medicine, 17(7), e1003166.