write assessment essay XXXXXXXXXXwords use the subheading to address the assessment objectives. 1. problem and research question 150 words2. critical appraisal 600 words3. casp checklist and appraisal...

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write assessment essay 1200-1500 words use the subheading to address the assessment objectives. 1. problem and research question 150 words2. critical appraisal 600 words3. casp checklist and appraisal summary 150 words4. Application outcome and methodology rigour 300 words. Article- Oral mucosa mouth wash with chlorhexidine doesnot reduce the incidence of ventilator associated pnemonia in critically ill children: A randomised control trial.Articel2. Improving the patients experience of a bone marrowe biopsy - an RCT


CASP Checklist CASP Randomised Controlled Trial Standard Checklist: 11 questions to help you make sense of a randomised controlled trial (RCT) Main issues for consideration: Several aspects need to be considered when appraising a randomised controlled trial: Is the basic study design valid for a randomised controlled trial? (Section A) Was the study methodologically sound? (Section B) What are the results? (Section C) Will the results help locally? (Section D) The 11 questions in the checklist are designed to help you think about these aspects systematically. How to use this appraisal tool: The first three questions (Section A) are screening questions about the validity of the basic study design and can be answered quickly. If, in light of your responses to Section A, you think the study design is valid, continue to Section B to assess whether the study was methodologically sound and if it is worth continuing with the appraisal by answering the remaining questions in Sections C and D. Record ‘Yes’, ‘No’ or ‘Can’t tell’ in response to the questions. Prompts below all but one of the questions highlight the issues it is important to consider. Record the reasons for your answers in the space provided. As CASP checklists were designed to be used as educational/teaching tools in a workshop setting, we do not recommend using a scoring system. About CASP Checklists: The CASP RCT checklist was originally based on JAMA Users’ guides to the medical literature 1994 (adapted from Guyatt GH, Sackett DL and Cook DJ), and piloted with healthcare practitioners. This version has been updated taking into account the CONSORT 2010 guideline (http://www.consort-statement.org/consort-2010, accessed 16 September 2020). Citation: CASP recommends using the Harvard style, i.e., Critical Appraisal Skills Programme (2021). CASP (insert name of checklist i.e. Randomised Controlled Trial) Checklist. [online] Available at: insert URL. Accessed: insert date accessed. ©CASP this work is licensed under the Creative Commons Attribution – Non-Commercial- Share A like. To view a copy of this licence, visit https://creativecommons.org/licenses/by-sa/4.0/ Critical Appraisal Skills Programme (CASP) www.casp-uk.net Part of OAP Ltd Study and citation: ........................................................................................................................ Section A: Is the basic study design valid for a randomised controlled trial? 1. Did the study address a clearly focused research question? CONSIDER: · Was the study designed to assess the outcomes of an intervention? · Is the research question ‘focused’ in terms of: · Population studied · Intervention given · Comparator chosen · Outcomes measured? Yes No Can’t tell  2. Was the assignment of participants to interventions randomised? CONSIDER: · How was randomisation carried out? Was the method appropriate? · Was randomisation sufficient to eliminate systematic bias? · Was the allocation sequence concealed from investigators and participants? Yes No Can’t tell  3. Were all participants who entered the study accounted for at its conclusion? CONSIDER: · Were losses to follow-up and exclusions after randomisation accounted for? · Were participants analysed in the study groups to which they were randomised (intention-to-treat analysis)? · Was the study stopped early? If so, what was the reason? Yes No Can’t tell  ( 2 ) Section B: Was the study methodologically sound? 4. · Were the participants ‘blind’ to intervention they were given? · Were the investigators ‘blind’ to the intervention they were giving to participants? · Were the people assessing/analysing outcome/s ‘blinded’? Yes No Can’t tell    5. Were the study groups similar at the start of the randomised controlled trial? CONSIDER: · Were the baseline characteristics of each study group (e.g. age, sex, socio-economic group) clearly set out? · Were there any differences between the study groups that could affect the outcome/s? Yes No Can’t tell  6. Apart from the experimental intervention, did each study group receive the same level of care (that is, were they treated equally)? CONSIDER: · Was there a clearly defined study protocol? · If any additional interventions were given (e.g. tests or treatments), were they similar between the study groups? · Were the follow-up intervals the same for each study group? Yes No Can’t tell  Section C: What are the results? 7. Were the effects of intervention reported comprehensively? CONSIDER: · Was a power calculation undertaken? · What outcomes were measured, and were they clearly specified? · How were the results expressed? For binary outcomes, were relative and absolute effects reported? · Were the results reported for each outcome in each study group at each follow-up interval? · Was there any missing or incomplete data? · Was there differential drop-out between the study groups that could affect the results? · Were potential sources of bias identified? · Which statistical tests were used? · Were p values reported? Yes No Can’t tell  8. Was the precision of the estimate of the intervention or treatment effect reported? CONSIDER: · Were confidence intervals (CIs) reported? Yes No Can’t tell  9. Do the benefits of the experimental intervention outweigh the harms and costs? CONSIDER: · What was the size of the intervention or treatment effect? · Were harms or unintended effects reported for each study group? · Was a cost-effectiveness analysis undertaken? (Cost-effectiveness analysis allows a comparison to be made between different interventions used in the care of the same condition or problem.) Yes No Can’t tell  Section D: Will the results help locally? 10. Can the results be applied to your local population/in your context? CONSIDER: · Are the study participants similar to the people in your care? · Would any differences between your population and the study participants alter the outcomes reported in the study? · Are the outcomes important to your population? · Are there any outcomes you would have wanted information on that have not been studied or reported? · Are there any limitations of the study that would affect your decision? Yes No Can’t tell  11. Would the experimental intervention provide greater value to the people in your care than any of the existing interventions? CONSIDER: · What resources are needed to introduce this intervention taking into account time, finances, and skills development or training needs? · Are you able to disinvest resources in one or more existing interventions in order to be able to re-invest in the new intervention? Yes No Can’t tell  APPRAISAL SUMMARY: Record key points from your critical appraisal in this box. What is your conclusion about the paper? Would you use it to change your practice or to recommend changes to care/interventions used by your organisation? Could you judiciously implement this intervention without delay?
Answered 1 days AfterJul 13, 2022

Answer To: write assessment essay XXXXXXXXXXwords use the subheading to address the assessment objectives. 1....

Sahiba answered on Jul 15 2022
74 Votes
Article: Improving the patient’s experience of a bone marrow biopsy - an RCT
(1) Problem and Research Question
Problem: In modern health care, cancer pain or postoperative pain. Brown and Fanurik (1996) say procedural discomfort. Craig (1993) says anxiety, anticipation, and emotional distress are the worst effects of pain. It is troublesome for bone marrow biopsies. Any unpleasant intervention should cause the patient little suffering and worry. In many haematology centres, local anaesthesia (LA) alone for this treatment. Since many patients find bone mar
row biopsy unpleasant and disturbing, pain medication may be inadequate (Johnson et al., 2008).
Research Question: The nurse may perform or support the process of bone marrow biopsy. Thus, how nursing can assess and relieve procedure discomfort? How may Nurses detect pain more sensitively and accurately than other health professionals? With a wide range of pain sensation and analgesic responses, by whom?
Potentially necessary nursing intervention is N2O/O2, which, if used effectively, could minimise patient procedural discomfort. How? Does it offer benefits over other strong analgesics, such as sedation with awareness and a stellar safety record? Can nurses instruct and supervise the need for patient monitoring with less than conscious sedation and N2O/O2 self-administration? Can N2O/short O2's half-life, which means patients spend less time in the clinic, affect cost-effectiveness? Do low medical expenses and the lack of anaesthetist insurance help with cost-effectiveness?
(2) Critical appraisal
In this double-blind, randomised, controlled trial, N2O/O2 did not often reduce bone marrow biopsy discomfort. Men who received N2O/O2 experienced mild pain compared to those who received the placebo. For women, there was no difference, though. It might have resulted from the various responses that men and women who had previously had biopsies had.
Given N2O/O2 efficacy results in other painful procedures, it is surprising that there was no overall effect in bone marrow biopsy. The scientists concluded that this may have happened since the women did not react, and those who had never had a biopsy only felt slightly uncomfortable. Men utilised more gas than women, regardless of the volume, which explains why the N2O/O2 group reported more analgesia. It may have an impact on future therapy and research. If more extensive studies confirm that men use analgesics more frequently, it would be interesting to investigate the possible causes of this increased use.
N2O/O2 will be used by women in the same ways as men in the future, thanks to research and medicinal applications. In the inhalation method utilised in the study by Fich et al. (1997), however, patients in the current trial received specific breathing instructions. Also, multiply the depth or duration of inhalations by their number. A finding of more inhalations, if verified in more careful research, would suggest that the variance in consumption among genders was a matter of frequency rather than style, even though the study couldn't address these latter elements. It may only take giving women participants explicit instructions to increase the number of times they inhale for them to get an excellent therapeutic response and allow for further research.
Perneger (1998) claims that we failed to consider various test results. The higher efficacy in men could be a type I error from numerous testing. Without a doubt, doing so would have resulted in an insignificant outcome—however, such an interpretation for two reasons. First, given the stark disparity between male and female scores, we postulated that the women's modest responses were to blame for the group's overall lack of response. Men's answers match the research on how people react to N2O/O2 in procedural pain. The N2O/O2 and placebo groups' mean pain score difference was second-largest. Despite these limitations, replication research may be beneficial.
Curnow et al. 2003 found that previous biopsies increased pain perception regardless of gas dosage. The patients in the recent study presumably had unfavourable expectations about their painful experiences, which enhanced their pain experience even if reports of pain intensity from biopsy varied. Many pain experience models consider this anticipated function in pain modulation. According to the fear-avoidance theory of pain proposed by Lethem et al. in 1983, if experts predict pain based on recent unfavourable occurrences, they would experience more pain during subsequent painful episodes. This discovery may help determine the patients' pain thresholds and select the most effective medications.
(3) CASP checklist and appraisal summary
Bone marrow biopsies are necessary for several haematological disorders. People report experiencing discomfort throughout therapy, despite the LA. N2O/O2 is an excellent substitute for LA to manage pain during invasive diagnostic procedures like sigmoidoscopy. RCT, double-blind, randomly assigned N2O/O2 or oxygen in addition to LA to 48 patients who needed a bone marrow biopsy. N2O/O2 significantly reduced pain for males but not for women, according to participant ratings and comments on the experiment. Independent of gas, previous biopsies made all patients more uncomfortable. Neither group saw significant side effects. More research on the safe, efficient, and simple-to-use analgesic N2O/O2 for painful diagnostic (and other) procedures.
(4) Application - outcome & methodological rigour
Due to these advantages for both nurses and patients, N2O/O2 may be recommended for routine use as a...
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