HLSC122: Critical Appraisal of Evidence-Based Healthcare Report

This report critically appraises the application of evidence-based practice in healthcare, examining its strengths and limitations, potential conflicts of interest, and biases in research. It analyzes a case study involving stroke rehabilitation, evaluating the research design and methods used, including the mixed-methods approach and the selection of participants. The report discusses the barriers to implementing evidence-based practices, such as a lack of skills in critical appraisal and conflicting research results. The analysis emphasizes the importance of considering diverse perspectives and methodologies to enhance the accuracy and applicability of research findings in healthcare settings. Desklib offers a range of resources, including past papers and solved assignments, to support students in understanding and applying these concepts.

Running head: CRITICAL APPRAISAL OF EVIDENCE
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Critical appraisal of evidence
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Critical appraisal of evidence
Introduction
Evidence-based practice implies the use of the current clinical expertise with the best
available medical evidence from research in decision making in the process of offering a quality
healthcare to patients. Medical practitioners have implemented this approach in different units as
much as it has its cons and pros. (Greenhalgh and Trisha, 2017) outlines some of the strengths
and limitations encountered in an evidence-based practice in the expertise of the researchers.
Strengths and limitations of evidence for practice
Some of the benefits which are regarded as strengths of the evidence-based practice
research include; finding means to better procedures where the evidence helps the carers to
remove the possible harm to the patients if not providing total treatment. (Hershenberg and
Rachel, 2015, pp.156-165) outlines that the evidence also helps in preventing or stopping
negative procedures from happening, it provides an opportunity to learn from previously made
mistakes in treatment and caring for the patients. The practice helps to identify unnecessary and
costly procedures that should be dropped and provides recommendations and better options. In
addition, the approach of evidence-based practices promotes integrity in data collection and
interpretation thus facilitating the making of critical medical decisions. The approach is
advantageous in the sense that it can be used across all medical disciplines as its principles of
approach does not change from time to time (Townsend and Mary, 2017).

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For any approach, there comes limitations and weaknesses as for the evidence-based
practice they include; some of the managers in the medical sector view the evidence-based
approach as a means to reduce costs as they end up hiring young, unskilled, and cheap
professionals with an aim to apply the approach as a means to guide the new staff through their
duties. This is professionally wrong as the evidence-based practice is not a cookbook for
management but rather can be comfortable termed as one of the many tools for knowledgeable
medical practitioners. Another weakness of the approach is the limitation of research samples as
there is need to develop facts from the collected information which is not always sufficient to
draw accurate conclusions from the findings in most cases (Dang and Deborah, 2017).
Also, sometimes the best evidence being researched is never available. This has always
called for approximations and interpolation of a set of data which might not be very accurate in
relation to the context of the study. Additionally, the evidence-based practice research requires
new skills and expertise in evaluation, interpretation, and appraisal of the findings as there are
rapid changes that take place in the current management structures unlike in the past as the
practice requires a lot of effort and time-consuming in developing the evidence for future
reference.
Possible conflicts of interest/bias in the research
In the research, there could be a conflict of interest which arises from the relationship
between the researcher and the funding organization. (McCoy and Matthew, 2017, pp.1721-
1722) argues that the research might focus more on the areas that would directly benefit the
organization of interest than the general views and objectives of the research. Another possible
source of bias is the selection of the research topic. The research might fall for the bias in

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choosing from a list of topics or case studies the ones that they are more comfortable pursuing
the research. Moreover, the time taken for conducting the randomized-trials of evidence-based
practices may create a bias towards short-term researchers.
Selection of research question
In the case study, for instance, the research question of how a caregiver may effectively
support a 67-year-old family member with their daily activities following a stroke is a good
choice of a research in relation to the evidence-based research. The topic was a valid choice for
research due to rampantly increasing cases of stroke patients with their rehabilitation needs
which have been reported to be unsatisfied. The aim of the study was to explore the perceptions
of the stroke patients and their carers in relation to rehabilitation services and procedures. Also,
there was the need to explore the daily changes in the everyday lifestyle of these parties and their
strategies, engagement, and cooperation towards handling the one year after stroke cases
(Ekstam et al., 2015).
Research design
The research employed the use of mixed data collection methods while combining
quantitative and qualitative data and analyses. A single participant was selected where the data
collection and recording was done from the participant’s resident.
Strengths and limitations of research methods used
The use of mixed approach method for data collection which was qualitative and
quantitative methods in the study brings out a more comprehensive state of rehabilitation of the
one year after stroke (Palinkas et al., 2015, pp.533-544). The selection of one patient in the case

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study could be both an advantage in the sense that the patient will be given total attention
whereby every detail including the patient needs and preference in the rehabilitation process
could be recorded and put into consideration. The selection of a single participant could also be a
disadvantage as it could not give a conclusive result as the patient behavior, traits, and
adaptability are very dynamic and vary from one patient to another. Moreover, the research could
result in biases due to the researcher’s relationship with the participant with use of open-ended
oral questions. The researcher may not exhaustively conduct a follow up in the collection of data
and the changes that the participant undergoes due to boredom if it is conducted over a long
period of time with one participant (LoBiondo and Geri, 2017).
Results/Conclusions obtained
The results and the findings of the rehabilitation of the stroke patients could be very
effective and accurate to the participant, however, they might not be applicable to other stroke
patients due to a number of reasons. These could be the biases in the outcome of research based
on a single participant. The recommendation from the findings could possibly not be applicable
to other victims rehabilitating from the stroke due to factors such as the environmental setting.
This could lead to the research question being partially unanswered (van, Els, and Hanneke,
2017, pp.1738-1747). Therefore, for future, a wide range of participants should be chosen to
enhance accuracies in the findings.
Barriers to the application of evidence-based practice
Researchers may sometime lack the required skills in critical appraisal of the sources to
find evidence. The lack of knowledge to judge the quality of the evidence and the uncertainty in

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the level of confidence to validate an evidence or its source could turn out to be a hindrance in
the application of this approach. Studies have also pointed out that lack of motivation by the
researchers has greatly contributed to the list of barriers as the researchers have ended up
prioritizing the healthcare and neglecting the evidence-practice aspect as highlighted by (Stavor
et al., 2017, pp.51-61).
In contrary, scientific results have given different results making the practitioners lack
trust and confidence in what to use. This has also been a great setback to the use of evidence-
based as there have been different results from different articles that had the same research
question thus creating a lot of doubt in the use of this approach. Another barrier is due to
competition from non-public entities in the provision of healthcare with a wide range of
approaches has made the participants and researchers reluctant in implementing this approach.

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References
Dang, S. and Deborah, D. (2017). Johns Hopkins Nursing Evidence-Based Practice: Model and
Guidelines. Sigma Theta Tau.
Ekstam, C., Lisa, J., Ulla, G., Susanne, E., and Gunilla, Y. (2015). The combined perceptions of
people with stroke and their carers regarding rehabilitation needs 1 year after stroke: a
mixed methods study. BMJ open, 5(2).
Greenhalgh, M. and Trisha, G. (2017). What seems to be the trouble?: stories in illness and
healthcare. CRC Press.
Hershenberg, M. and Rachel, G. (2015). Implications of RDoC for the research and practice of
psychotherapy. Behavior Therapy, 46(2), 156-165.
LoBiondo, J. and Geri, H. (2017). Nursing Research-E-Book: Methods and Critical Appraisal
for Evidence-Based Practice. Elsevier Health Sciences.
McCoy, E. and Matthew, E. (2017). Why there are no “potential” conflicts of interest. Jama,
317(17), 1721-1722.
Palinkas, K., Lawrence, H., Sarah, G., Carla, W., Jennifer, D., and Naihua, H. (2015).
Purposeful sampling for qualitative data collection and analysis in mixed method
implementation research. Administration and Policy in Mental Health and Mental Health
Services Research, 42(5), 533-544.
Stavor, R., Dawn, Z., and Judith, H. (2017). Improving the use of evidence-based practice and
research utilization through the identification of barriers to implementation in a critical
access hospital. Journal of Nursing Administration, 47(1), 56-61.

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Townsend, K. and Mary, M. (2017). Psychiatric mental health nursing: Concepts of care in
evidence-based practice. FA Davis.
van, K., Els, M., and Hanneke,D. (2017). Researching health care as a meaningful practice:
Toward a nondualistic view on evidence for qualitative research. Qualitative health
research, 27(11), 1738-1747.