Critical Appraisal: Qualitative Study
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Critical Appraisal: Qualitative Study
Introduction
All scientific evidence is crucial to clinical decision-making. As such, it is required that all this evidence is critically appraised to determine their contribution to decision-making. Therefore, clinicians should embrace critical appraisal to gain an understanding of the field of science to the content of a study or research report and how well researchers have answered clinical questions. Hence, this paper will critically appraise Kaiser et al. (2020) qualitative study on best practices in implementing inpatient pediatric asthma pathways by answering the clinical questions.
Qualitative Research Design Used
Kaiser et al. (2020) illustrate that after an initial observational study, the research team identified higher and lower performing children’s hospital-based changes in hospital-level in asthma patient length of stay after implementing a pathway. Then, the researchers used a qualitative study that utilized semi-structured interviews and constant comparative methods to develop a model with the potential of being a best practice in implementation.
Validity and Credibility of the Study
Kaiser et al. (2020) indicate that they used a “purposive” sample of healthcare providers involved in pathway implementation at 42 tertiary academic children’s hospitals in the Pediatric Health Information System database. The study reveals that 40 key personnel from six performing and two lower-performing hospitals were approached for the study. Sixteen participants declined, and 24 participants were interviewed in a range of 2-6 participants per hospital. In regards to accuracy, 58% of the interviewed personnel were physicians, 17% were respiratory therapists, 13% were nurse practitioners, 8 % were nurse, one pharmacist. Researchers further reveal that participants recalled events that occurred in the past, i.e., more significant than 12 years in some cases, and this would be subject to bias in and the qualitative study could not draw conclusions about causality. The study results are believable, given that health professionals who were participants with different professional roles, hence a multi-modal teams. Additionally, the sample only focused on children’s hospitals, which raised generalizability to other hospitals with both children and adult services.
Implications of the Study
Kaiser et al. (2020) reports that the research study findings align with studies from other hospital settings, and the results will be applicable to general hospitals. Additionally, the researchers indicate that there were no prior studies to their knowledge that primarily focused on better understanding pediatric titrate bronchodilator therapy. Also, the study aligns with adult clinical pathway implementation.
Effect on the Reader
As mentioned earlier, the study results are believable, given that they utilized a multi-modal team in healthcare as participants. These are professionals, and they know what they are doing. Second, the reader can be drawn to the experience from the way the journal article has been structured into parts to help the reader understand the step-by-step study regarding best practices in implementing inpatient pediatric pathways.
Fitness of the Results
Yes indeed! The study approach fits the purpose of the research. As such, researchers were focused on identifying potential best practices in pathway implementation, which at that time, there were limited guidelines on how to implement pathways successfully. The results reveal several pathways, such as the use of quality improvement methodology and data-driven approach, getting the team to commit to shared goals, integrating pathways into HER, leveraging multi-disciplinary teams by developing protocols for health professionals, and engaging hospital leaders with pathway implementation teams to aid at securing essential resources. All these are best practices that would ensure success in improving Asthma care quality in children, as stated in the research objective.
Identifying Study Approach
Kaiser et al. (2020) articulates that their study used constructs described in the Consolidated Framework of Implementation Research (CFIR) to develop a semi-structured interview guide utilized by all the research participants. The CFIR is composed of five major domains that influence implementation, and interviews were conducted in person and by phone from October 2016- September 2017. Second, the analysis was done using constant comparative methods; case in point, they used the approach of Charmaz. All these methods are appropriate for a qualitative study.
Significance and Importance of the Study
Kaiser et al. (2020) start the introduction by saying that Asthma is a major leading cause of pediatric hospitalization, and pediatric asthma pathways have been shown to improve care quality for children with Asthma. Therefore, the literature supports the study’s need to identify best practices in pediatric asthma pathways implementation. Second, from the discussion section of the study, the researchers have argues that the potential best practices to support pathway implementation in the study should be considered by hospitals to ensure better success in improving quality care for pediatric asthma patients.
Sampling
The researchers controlled the sample selection because the study itself required professionals from higher-performing hospitals and lower-performing hospitals. The expected sample size and composition did not reflect the study needs since 16 potential participants declined. Last, the phenomenon of human experience is identified. The researchers reveal that the institutional board at the University of California reviewed their research and exempted it as not human subjects research since the research lacks inquiry on sensitive issues or collection of personal identifiers.
Clarity of Data Collection Procedures.
The researchers’ sources and means of data are clearly defined in the data collection segment of the study. They clearly state that the study was the first national multi-centre analysis of pediatric Asthma. Second, researcher roles have been explained fully as they maintained an inductive approach grounded on data. Additionally, the researchers indicate that any disagreements regarding focused codes were solved by reviewing primary data and iterative discussions by all researchers in the study.
Data Analysis Procedures
Data analysis directions are stipulated in the study, and it reveals that when sampling ended, and data management processes are described. For instance, the article reveals the characteristics of the included children’s hospitals in a tabular manner and shows a diagrammatic conceptual model of the potential best practices, which is presented as an interpretation and description.
Specific Findings
Data meaning is clearly described for the data described. The study reveals five potential best practices pathway implementation for pediatric patients and is fully described and illustrated with different barriers addressed. Second, the article’s writing promotes understanding since the language used is not simple and straightforward. Additionally, the researchers have structured their research step-by-step with sub-headings clearly defined.
Reflections, Application to Clinical Practice and Conclusions
The results of the study are relevant to all health care professionals that deal with pediatric Asthma. It provides five potential best practices that will improve the quality of care for children with Asthma. As such, the research acts as a guide to health professionals. At the same time, these results are relevant to patient values in that if health professionals apply these strategies, patients with pediatric Asthma will receive better and quality care. These results apply to clinical practice since it offers the potential best practices for health care professionals in the pediatric sector, an eye-opening of ways to practice quality care. Conclusively, the study answered all clinical questions and can be applied can be classified as evidence-based research critical to clinical practice.
Reference
Kaiser, S. V., Lam, R., Cabana, M. D., Bekmezian, A., Bardach, N. S., Auerbach, A., & Rehm, R. S. (2020). Best Practices in Implementing Inpatient Pediatric Asthma Pathways: A Qualitative Study. Journal of Asthma, 57(7), 744–754. https://doi.org/10.1080/02770903.2019.1606237
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