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Critique of a Systematic Research Review

Critiqueof a Systematic Research Review

Critiqueof a Systematic Research Review

Asystematic research review (SRR) involves an evaluation of theexisting scientific studies. The SRR helps the scholars avoidembarking on a new research since a review of existing studies ischeaper and faster. This paper is a critique of an article “Reducinghospital readmission rates in patients with heart failure”. ThisSRR was authored by several researchers, including Joanne Kathleen,Haley Harrison, Diana Escutia, Amy Moore, and Evelyn Sarpong. Thearticle was published in the Medsurg Nursing in 2016. The purpose ofthe SRR was to review studies that could help the authors determinewhether the post-discharge telephone calls can minimize avoidablereadmission with a period of 30 days of discharge of patientssuffering from the heart failure (HF).

Relevanceof the Research Problem

Themain research problem that is addressed in the article is the issueof the readmission of the patients suffering from the heart attack.The significance of this research problem is confirmed by the largenumber of people who are affected by the HF disease and the highprevalence of cases of readmission that have been reported in thepast. For example, it is estimated that HF affects about 20 millionpeople, where half of them are most likely to die within a period offive years after being diagnosed (Hobbs, Escutia, Harrison, Moore &ampSarpong, 2016). Most importantly, the rate of readmission among thesepatients is estimated to be 40 %, which is quite high. Studies showthat the treating HF will cost about $ 70 billion annually by 2030(Hobbs et al., 2016). This implies that it is important to determinewhether post discharge calls can minimize the rate of readmission inorder to reduce the cost of care, spare hospital beds for otherpatients, and enhance the quality of care.

ResearchRigor

Theanalysis of the type of evidence used in the SRR indicates that themethodological rigor is relatively high. It is clear that six out ofseven studies that were considered in the systematic review werebased on the randomized control trials. One of the studies was basedon the evidence collected through a review of literature. One studywas based on a combination of the randomized control trials andquasi-RCTs. In overall, the authors of the relied on the evidence ofthe articles based on two major designs, namely the randomizedcontrol trials and literature review. The reliance on the evidencegathered using more than one methodology increased the level offlexibility. However, two types of methodology are quite lesscompared to the number of available alternatives. The high level ofmethodological rigor is associated with a limited possibility ofreflecting the truth and an increase in intrinsic error (Abalos,Carroli &amp Bergel, 2011).

TheLevel of Evidence

Thearticles reviews in the SRR were based on studies conducted using acombination of experimental and non-experimental designs. Therandomized controlled trial, which was used in six out of sevenstudies, is a special scientific experiment that is preferred byscholars because it reduces bias. Bias is minimized through therandom sampling of the subjects and their assignment to differentgroups, which increases the reliability of the findings. Moreover,the RCTs methodology enhances objectivity of the research findings byremoving extraneous variables. However, the need to use a sample inexperiments to serve as a representative of a given population limitsthe possibility of generalizing the evidence or the research findingsobtained through RCTs.

Theevidence documented in one of the articles was obtained through thereview of literature. This non-experimental design allows authors tocollect evidence that is based on the perspective of differentresearchers, thus increasing the reliability of the findings.However, it limits the ability of the research to control ordetermine the quality of the data used to make conclusions in thearticles that are being reviewed. In overall, most of the articlesconsidered in the SRR were based on the evidence gathered usingexperimental design that is associated with an increase in the levelsof reliability, objectivity, and credibility of the findings.

Presentationand Critique of the Studies

Thestudies considered in the SRR are presented in a clear way, whichmakes it easy for the readers to follow and understand. Thedescription of each of the studies is provided in a narrative form.The narrative of each study is comprehensive since it explains howthe research was conducted, its findings, and weaknesses. Inaddition, the use of a table to provide the summary of the studiesincreases the clarity with which they are presented. For example, thereader can see the sample, method, treatment, results, and appraisalof each study at a glance by looking at the table. In addition, theauthors critique the studies by determining their weaknesses andstrengths. For example, the authors identify studies that might havecontained skewed results. However, these limitations are not includedin the table. Presentation would have been improved by indicating thelimitation of the studies in the table.

Descriptionof the Findings

Thesuitability as well as the reliability of the findings is determinedby their ability to answer the research question or meet theobjectives of a given study. The suitability of the findings of thearticles considered in the SRR depends on whether they indicate theability of the post-discharge calls to reduce the risk HF patientsbeing readmitted. Most of the studies indicated that an effectivefollow-up made through the telephone calls minimize the risk of HFpatients being readmitted. For example, an article published byMelton etal.(2012) showed that telephone calls minimized the risk of beingreadmitted by 22 %. Similarly, the articles authored by Smith (2013)and Takeda etal.(2013) indicated that the telephone call resulted in a reduction inreadmission rates. However, Smith (2013) stated that the findingswere inconclusive. Inglis etal.(2010) also showed that a well structured follow-up could minimizethe rate of readmission among the HT patients. Although Copeland etal.(2010) found out that there was no significant difference in thelevels of satisfaction between the control and the interventiongroups, the study indicated that the follow-up helped the patientscomply with the self-care programs, which minimized the risk of beingreadmitted. The article published by Domingues etal.(2011) confirmed that the follow-up made through the telephone callsresulted in a decline in the readmission rate by 4 %.

Thefindings of the article published by Mistiaen &amp Poot (2008)indicated that the relationship between a decrease in readmission andpost-discharge telephone calls is not statistically significant. Thisindicates that all the studies that were considered in the SRRresponded to the research problem being addressed. In addition, thefindings reported in all articles, except one, indicated that thetelephone calls were effective in minimizing the readmission rate.One study indicated that the effect of the telephone calls wasinsignificant.

Conclusions

Theauthors conclude with a statement that the financial sequences thatare imposed by ACA indicate the desire to facilitate effectiveinterventions in order to minimize the challenges associated with thereadmission of patients. Although the authors argue that theresponsibility of identifying effective interventions should beassumed by the health care providers, there are other factors (suchas patients’ willingness to comply with medication) that need to beconsidered. This can reduce the risk of blaming the doctors ortelephone calls for readmissions. However, the study has significantimplications for the current practice since it indicates that nursescan play a critical role in reducing the readmission rates by usingtelephone calls to make a follow-up. However, the authors did notmake recommendations for the future research in the conclusion.

References

Abalos,E., Carroli, G. &amp Bergel, E. (2011). Criticalappraisal of systematic review.Rosario:Centro Rosarino de Estudios Perinatales.

Hobbs,J. K., Escutia, D., Harrison, H., Moore, A., &amp Sarpong, E.(2016). Reducing hospital readmission rates in patients with heartfailure. MedsurgNursing,25(3), 145-152. Retrieved fromhttp://search.proquest.com.proxy.chamberlain.edu/docview/1798714013?accountid=147674