Critical Appraisal Assignment Paper

Critical Appraisal Assignment Paper

To Prepare: Part A and Part B

The Articles that must be used for the evaluation table within the critical appraisal tool worksheet template are listed below.

Chang, C. D., Saidinejad, M., Atanelov, Z., Dietrich, A. M., Lam, S. H. F., Rose, E., … & ACEP Pediatric Emergency Medicine Committee. (2021). Emergency department strategies to combat the opioid crisis in children and adolescents. Journal of the American College of Emergency Physicians Open, 2(4), e12512. Critical Appraisal Assignment Paper

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Daoust, R., Paquet, J., Cournoyer, A., Piette, É., Morris, J., Gosselin, S., … & Chauny, J. M. (2018). Quantity of opioids consumed following an emergency department visit for acute pain: a Canadian prospective cohort study. BMJ Open, 8(9), e022649.

Kilaru, A. S., Lowenstein, M., & Agarwal, A. K. (2022). Optimizing Opioid Prescriptions for Patients in the Emergency Department—How Much Is Almost Never? JAMA Network Open, 5(1), e2143433-e2143433.

Marco, C. A., Trautman, W., Cook, A., Mann, D., Rasp, J., Perkins, O., & Ballester, M. (2018)Critical Appraisal Assignment Paper.
Naloxone use among emergency department patients with opioid overdose. The Journal of
Emergency Medicine, 55(1), 64–70. Retrieved June 14, 2022, from
https://doi.org/10.1016/j.jemermed.2018.04.022

Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high-level evidence) you selected in Module 3.

Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.

Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer-reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Part 3B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

Critical Appraisal of Research
\Evaluation Table
Full APA formatted citation of the selected article. Article #1 Article #2 Article #3 Article #4
Chang, C. D., Saidinejad, M., Atanelov, Z., Dietrich, A. M., Lam, S. H. F., Rose, E., … & ACEP Pediatric Emergency Medicine Committee. (2021). Emergency department strategies to combat the opioid crisis in children and adolescents. Journal of the American College of Emergency Physicians Open, 2(4), e12512. Daoust, R., Paquet, J., Cournoyer, A., Piette, É., Morris, J., Gosselin, S., … & Chauny, J. M. (2018). Quantity of opioids consumed following an emergency department visit for acute pain: a Canadian prospective cohort study. BMJ open, 8(9), e022649. Kilaru, A. S., Lowenstein, M., & Agarwal, A. K. (2022). Optimizing Opioid Prescriptions for Patients in the Emergency Department—How Much Is Almost Never? JAMA Network Open, 5(1), e2143433-e2143433. Marco, C. A., Trautman, W., Cook, A., Mann, D., Rasp, J., Perkins, O., & Ballester, M. (2018). Naloxone use among emergency department patients with opioid overdose. The Journal of Emergency Medicine, 55(1), 64-70. Critical Appraisal Assignment Paper
Evidence Level *
(I, II, or III)
Conceptual Framework

Describe the theoretical basis for the study (If no one is mentioned in the article, say that here).**
Even though the conceptual framework is not mentioned in the article, the conceptual framework of this article is based on the fact that opioids have both benefits and disadvantages that must be carefully considered. The conceptual framework of the article is based on the fact that the number of opioids dispensed to patients after visiting an emergency department can influence opioid addiction among patients. This study’s conceptual framework emphasizes that the emergency department is a potential source of opioids. The conceptual framework of this study is based on the theoretical fact the emergency department is a source of unintentional opioid overdose. Critical Appraisal Assignment Paper
Design/Method

Describe the design and how the study was carried out (Including inclusion/exclusion criteria). The study involves a descriptive study of the burden of the opioid crisis. The study utilized a prospective cohort study with phone interviews among patients to whom opioids had been prescribed. The study included patients aged 18 years and above who had complained of pain for two weeks and below. In this systematic review and meta-analysis, the researcher wanted to identify interventions to reduce emergency department opioid prescribing. This prospective survey was conducted at an urban level I trauma center, where a survey was administered to eligible emergency department patients after an unintentional opioid overdose.
Sample/Setting Critical Appraisal Assignment Paper

The number and characteristics of
patients, attrition rate, etc. The study focused on children and adolescents in the emergency department. No specific sample population was used in the descriptive study. The study utilized a sample size of r 627 patients discharged from the emergency department at least 18 years old. The study was based in an emergency department and did not use any specified number of participants. The study used a total of 89 emergency department patients with accidental opioid overdose.
Major Variables Studied

List and define dependent and independent variables
The variables include parental opioid abuse and adverse childhood events. The variables in the study were musculoskeletal pain, fracture pain, renal colic, and abdominal pain n/a Some of the variables identified in the study include age, sex, ethnicity, and history of opioid overdose. Critical Appraisal Assignment Paper
Measurement
Identify primary statistics used to answer clinical questions (You need to list the actual tests done). The study used a literature review of previous studies. The study perfumed interviews among patients prescribed opioids. The study used a meta-analysis of research articles from previous studies. They used a prospective survey method to gather information from the participants.
Data Analysis Statistical or
Qualitative findings

(You need to enter the actual numbers determined by the statistical tests or qualitative data). The study identified that the emergence department setting offers a unique opportunity for clinicians to provide multidisciplinary care for children and adults who
are affected by the opioid crisis. The study identified that patients discharged from the emergency department with an acute pain condition consumed only seven tablets of morphine 5 mg but received a median of 30 tablets of morphine 5 mg prescription, leaving two-thirds of the opioids unused and available for misuse. The qualitative findings indicate that clinicians, health systems, and policymakers should seek to optimize opioid prescribing and incorporate patient perspectives. Furthermore, all EDs should be able to prescribe buprenorphine hydrochloride, effective treatment for opioid use disorder, and provide naloxone hydrochloride for overdose prevention 62% of participants using naloxone reported a history of opioid overdose. There was, however, no association between the dose of naloxone administered and sex. Critical Appraisal Assignment Paper
Findings and Recommendations

General findings and recommendations of the research The study recommends that institutions create and implement policies addressing the opioid epidemic in the emergence department while understanding the workplace challenges that emergence department clinicians face. The study recommends that emergency department physicians consider prescribing a smaller quantity of opioids and ask the pharmacist to dispense them in portions to minimize unused opioids. The study recommends that there is a need to optimize opioid prescribing and incorporate patient perspectives. The study’s significant findings were that there is strong evidence from the patient perspective that access to a naloxone kit increases chances to seek treatment and decreases opiate use.

Part B
The best practice that emerges from the critical appraisal of research is the need to implement strategies to combat the opioid crisis that is rising across all ages in the world. The opioid crisis has been a severe issue in healthcare which has affected the lives of many people, young and old, and increased the financial burden on healthcare systems. The opioid crisis is a rapid and exponential increase in the misuse, abuse, or overuse of opiate drugs which has the potential of overdose and even death. The increase in the opioid crisis has partly been blamed on doctors as part of those who contribute to the increase in the menace through faulty prescribing, incentive prescribing as well as poor addiction education, both of which lead patients to addiction and sometimes overdose. Opioids are drugs prescribed to relieve chronic pain among patients to improve their quality of life. Patients with chronic pain who are prescribed opioids for pain relief in most cases, continue using to avoid withdrawal symptoms which lead to addiction.
Some of the common opioids that are prescribed as drugs include heroin, fentanyl, oxycodone, and hydrocodone, among others. The drugs are addictive and, when prescribed in inappropriate doses, cause more harm than good because the effects can include overdose and death. There are several strategies for preventing the opioid crisis, including taking prescribed opioids in the required amounts, reporting side effects and other concerns associated with the opioids, and avoiding using opioids with alcoholic drinks. Doctors can equally prevent opioid overdose by prescribing only the required quantity of opioids in the required quantities only. Also, naloxone is used as an opioid antagonist to help avert the effects of opioid overdose (Marco et al., 2018)Critical Appraisal Assignment Paper.

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References
Marco, C. A., Trautman, W., Cook, A., Mann, D., Rasp, J., Perkins, O., & Ballester, M. (2018). Naloxone uses among emergency department patients with opioid overdose. The Journal of Emergency Medicine, 55(1), 64-70.
The Johns Hopkins Hospital/Johns Hopkins University (n.d.). Johns Hopkins nursing evidence-based practice: appendix C: evidence level and quality guide.

Grant, C., & Osanloo, A. (2014). Understanding, selecting, and integrating a theoretical framework in dissertation research: Creating the blueprint for your house. Administrative Issues Journal: Education, Practice, and Research, 4(2), 12-26.

Walden University Academic Guides (n.d.). Conceptual & theoretical frameworks overview.  Critical Appraisal Assignment Paper