Answer 4 for NRS 445 Select a research article that uses a randomized controlled trial focusing on a clinical nursing problem of your choice
Finkelstein, A., Zhou, A., Taubman, S., & Doyle, J. (2020). Health care hotspotting—a randomized, controlled trial. New England Journal of Medicine, 382(2), 152-162. https://www.nejm.org/doi/full/10.1056/NEJMsa1906848
In the article Health Care Hotspotting. A Randomized, Controlled Trial (Finkelstein, A. et al., 2020). The research aim was to reduce spending and improve health care quality among “superutilizers,” patients with very high use of health care services.
The randomized trial seeks to check the factors responsible for people to be readmitted back to the hospital. This was also to identify the main problems associated with them and their financial implications, aiming to reduce spending and improve health care quality among the patients and their families.
A total of 800 patients were randomly selected with medically and socially complex conditions, all with at least one additional hospitalization in the preceding 6 months.
The conclusion was not explicit about the total respondents that did not conclude the studies but the details about their recruitment and randomization were accounted for in the details.
This studies focus was on patients with social and medical problems and one additional hospitalization and the hospitals to deliver quality services but not on healthcare worker.
Moreover, all the 800 respondents were recruited with similar characteristics as indicated by the research and later separated into the control and treatment groups using random sampling.
The entire group was treated the same in my opinion because recruitment offered the same cut of age for the trial to be limited to adults 18 to 80 years of age within those settings and randomized the sample and paid the same fees to each participant.
The interventions given to the controlled group had an impact on their health since kept them up to date on all healthy schedules and gave them education about their health condition as well.
The treatment was accurate because there was a composition of treatments for the treatment group to keep them healthy with the 180 days by conducting home visits, scheduled and accompanied patients to initial primary and specialty care visits, coordinated follow-up care and medication management, measured blood pressure and blood sugar levels, coached patients in disease-specific self-care, and helped patients apply for social services and appropriate behavioral health programs.
In terms of the general population, the results were not significant considering the effects after data analysis and could relate to the population because the extraneous variables were controlled through randomization and the study clearly stated all ages of the population that will be used and other characteristics.
However, this study was clinically meaningful because the study was sorted to reduce cost to the patient and organizations through readmission and made patients follow all discharge guidelines.
Benefits
The results were not significantly different between the two groups. Therefore, in my opinion, the aim was to relatively to help control the cost to the patient and to the hospitals and so it was beneficial to evaluate such data to determine how to help patients who are readmitted to the hospital.
Ethical Considerations
The study upheld the ethical considerations by allowing the participants to be approached by an officer and the process explained to them for them to sign a consent form. A Coalition recruiter approached these patients in the hospital, confirmed their eligibility, obtained written informed consent, and conducted a baseline survey.
Reference
Cooper, H., Hedges, L. V., & Valentine, J. C. (Eds.). (2019). The handbook of research synthesis and meta-analysis. Russell Sage Foundation.
Finkelstein, A., Zhou, A., Taubman, S., & Doyle, J. (2020). Health care hotspotting—a randomized, controlled trial. New England Journal of Medicine, 382(2), 152-162.
Peel, K. L. (2020). A beginner’s guide to applied educational research using thematic analysis. Practical Assessment Research and Evaluation, 25(1).
