Grand Canyon University: Influenza Vaccine Research Critique and PICOT

This assignment presents a comprehensive analysis of two research critiques focused on influenza vaccines. The first critique examines the effectiveness of influenza vaccination in patients with asthma, analyzing the background of influenza, a PICOT question, and comparing the methods, limitations, and benefits of the included articles. It highlights the study results, implications for nursing practice, and outcomes of comparison. The second critique investigates influenza vaccination in vulnerable populations, specifically the elderly and healthcare professionals, following a similar structure to the first. This includes the background of influenza in these groups, a PICOT question, and an evaluation of the methods, limitations, benefits, and results of the studies. The assignment concludes by comparing the outcomes of both studies and their implications for nursing practice, emphasizing the importance of vaccination and the need for further research to optimize influenza prevention strategies.

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Research Critiques and PICOT Statement Final Draft
RESEARCH CRITIQUES AND PICOT STATEMENT FINAL
DRAFT

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Research Critiques and PICOT Statement Final Draft
Table of Contents
Qualitative Analysis Study One.......................................................................................................3
Background......................................................................................................................................3
PICOT Question..............................................................................................................................3
Nursing practice issue and the articles’ purpose..............................................................................4
Comparing the methods of the articles............................................................................................4
Limitation and benefits of the above method..................................................................................4
Results of the study..........................................................................................................................4
Implications of these studies in nursing practice.............................................................................5
Outcomes of Comparison................................................................................................................5
Quantitative Analysis Study two.....................................................................................................5
Background......................................................................................................................................5
PICOT Question..............................................................................................................................6
Nursing practice issue and the articles’ purpose..............................................................................6
Comparing the methods of the articles............................................................................................7
Limitation and benefits of the above method..................................................................................7
Results of the study..........................................................................................................................7
Implications of these studies in nursing practice.............................................................................7
Outcomes of Comparison................................................................................................................8
References........................................................................................................................................9

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Research Critiques and PICOT Statement Final Draft
Qualitative Analysis Study One
Background
Influenza is an acute respiratory disease that affects the upper and/or lower airways and is
caused by the influenza virus, typically A or type B. Influenza is contracted by inhaling the
infected droplets present in the air. It is a seasonal-diseases that is especially prevalent in the
temperate zones and throughout the year in tropical areas. The strains of the virus causing
influenza constantly undergoes mutation and evolves. As this changes the way they respond to
medication and antibodies present in the body, annual changes in vaccine strains need to be
made.
Influenza vaccines are given to people generally above the age of six months. It is either
administered through a shot or through a nasal spray for adults.
Influenza vaccine strains are altered each year (for both the Northern Hemisphere and the
Southern Hemisphere) to match more tightly with presently circulating virus strains due to the
constant change in circulating influenza viruses (Who, 2017). There is a doubt regarding the
efficacy of influenza vaccination in case of asthma patients and their effect on asthma results.
This adds to the suboptimal vaccination rates in asthma patients and makes them more prone to
pulmonary diseases.
PICOT Question
P (Problem or patient
or Population)
The effectiveness of the chosen drug on people diagnosed with
asthma and want to prevent any further influenza-related
complications
I (Intervention /
Indicator)
Effectiveness of Influenza vaccine
C (Comparison) Compared with placebo, no vaccine or other vaccines where like
recombinant influenza vaccines, split vaccines or inactive influenza
vaccines
O (Outcome) The possibility of influenza-related complications

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Research Critiques and PICOT Statement Final Draft
T (Time) Within the time period of a year.
Nursing practice issue and the articles’ purpose
In the context of asthma, there may be some grounds for this concern because a latest
systematic review of Cochrane that assess the effectiveness of influenza vaccination on people
with asthma was inconclusive about the effectiveness of influenza vaccines. It is also of concern
that the safety of live influenza vaccines has not yet been conclusively established in infants with
wheezing disorders or asthma (Bmjopen, 2016). Also, another question is raised regarding the
health and lives of infants who also suffer from asthma. Such individuals have been identified as
high-risk individuals and are the focus of the articles.
Comparing the methods of the articles
In the first article, published by the National Library of Medicine, research literature was
considered which have been published from January 1970 to January 2016. The studies chosen
focused on the effectiveness and results of influenza vaccination among people with asthma. In
the second article, Medline, Embase and other online databases were searched for similar articles
during the same time period. Two reviewers were set in both cases to choose and study each of
the chosen research literature (Bmjopen, 2016). This method was chosen as the through this the
likelihood of meeting with biased analysis can be lessened.
Limitation and benefits of the above method
The benefit of the articles was that high-quality literature was orderly reviewed. The
analysis was performed by individually by two researchers. Their study has then been reviewed,
assessed and then combined. This limits the presence of any bias or subjective views. Both
articles have only included randomised trial studies that further eliminates the risk of biased
information.
Results of the study
The findings indicate that the influenza vaccination is successful in combatting the virus
and is equally effective among people with asthma. Moreover, the influenza vaccination was
successful in decreasing the exacerbations associated with asthma and limits the chances or other
respiratory illnesses. The results indicate that public healthcare organisations should raise

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Research Critiques and PICOT Statement Final Draft
awareness about the influenza vaccine so that the uptake of the vaccines increases among the
people with asthma.
Implications of these studies in nursing practice
The research was conducted as there is not much evidence about how asthma patients
react to the influenza virus. This doubt and uncertainty have caused many patients and their
physicians to neglect the influenza vaccine which has created more complication since the
airways are weakened. The vaccination rates were suboptimal which increased the risk of an
outbreak since the disease is very contagious and can be contracted through inhaling infected air
droplets (Ncbi, 2017). The study has cleared this uncertainty and proved that the influenza
vaccine is effective in case of asthma patients as well.
Outcomes of Comparison
the articles reflect the same results and answer the PICOT question that was raised. The
recruitment method of the studies and the definition and assessment of asthma exacerbations was
different. Only one study had focused on recruiting children and adults, who prove to be more
vulnerable. The results of both the articles show that the people with asthma should rather opt for
the shot and not the nasal spray vaccine.

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Research Critiques and PICOT Statement Final Draft
Quantitative Analysis Study two
Background
Influenza can be a danger to the wellbeing of individuals, particularly for individuals who
are powerless against genuine influenza sickness, as more established grown-ups and individuals
living with certain interminable ailments or are regularly exposed to infectious agents like
healthcare professionals. Individuals matured 65 years and more established are at high hazard
for hospitalization and inconveniences from influenza and record for most of influenza
hospitalizations and deaths in the United States every year (Jamanetwork, 2017). It's evaluated
that between 70 percent and 85 percent of occasional influenza related deaths have happened in
individuals 65 years and more seasoned. It was also recorded that between 50 percent and 70
percent of occasional influenza-related hospitalizations have happened among individuals 65
years and more seasoned.
PICOT Question
P (Problem or patient
or Population)
The effectiveness of the chosen drug on vulnerable people like the
elderly people and health care professionals who are exposed to many
infectious agents
I (Intervention /
Indicator)
Effectiveness of Influenza vaccine
C (Comparison) Compared with placebo, no vaccine or other vaccines where like
recombinant influenza vaccines, split vaccines or inactive influenza
vaccines
O (Outcome) The possibility of influenza-related complications
T (Time) Within the time period of a year.

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Research Critiques and PICOT Statement Final Draft
Nursing practice issue and the articles’ purpose
Among the assumed advantages of the vaccination is a decrease in contamination and
absenteeism among medicinal services experts and a decrease in transmission of influenza from
healthcare experts to susceptible patients (Nejm, 2017). Albeit distributed information bolsters
the theory that contaminated healthcare experts can fill in as a vector to spread influenza among
hospitalized patients, causing an assortment of antagonistic impacts from expanded emergency,
rise in clinic expenses to death. There are clashing information on whether influenza
immunization diminishes the pace of influenza disease or wiped out leave among human services
experts. In the other article, the effectiveness of influenza vaccines on the people above the age
of 65 years is examined in order to provide correct idea of the perceived benefits of the vaccine.
Comparing the methods of the articles
In first article, 18 cohort studies were collected from 1990-2000. Information about more
than 20,000 people. In the other research, patients were studied from two hospitals, two hundred
sixty-four healthcare professionals were selected below the age of 50 who did not have any
chronic diseases (Jamanetwork, 2017).
Limitation and benefits of the above method
It has to be noted that such great number of sample size is necessary in studies dealing
with diseases caused by viruses. Virus strains are able to alter themselves and various strains
becomes infective in a given season. Influenza virus strains alter themselves each year.
Therefore, different strains are available each year, different in different hemispheres which react
differently with the medication (Nejm, 2017). This large sample size enables the articles to
provided results that are closes to the real situation as it is likely to account for a greater number
of virus strains and their response to medication.
Results of the study
Influenza immunization is successful in avoiding disease by influenza An and B in
human services experts and may decrease revealed long stretches of work nonattendance and
febrile respiratory sickness. This information bolsters an arrangement of yearly influenza
vaccination of social insurance experts. An enormous number of subjects in our informational
collection allowed impressive exactness in our evaluations, which demonstrated generous
advantages over numerous subgroups, an outcome proposing that vaccination benefits most
likely reach out to a wide range of older people.

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Research Critiques and PICOT Statement Final Draft
Implications of these studies in nursing practice
Results give valuable data on the advantages that older people may get from vaccination.
How these outcomes may identify with populace level patterns is indistinct. For instance,
influenza-inferable abundance death rates in the United States have not declined to the extent
that may be normal in light of expanding vaccination rates during the 1980s and the mid-1990s
(Nejm, 2017). However, country level information does exclude the hazard profile or vaccination
status of the individuals who have passed on. Basic data is along these lines lacking, making it
hard to evaluate what the normal abundance death rates would be if vaccination rates were 0%,
what advantages have just been acknowledged given current examples of antibody use, and what
extra advantages may be acknowledged with progressively successful immunization conveyance.
Outcomes of Comparison
Making ideal progress in counteracting and controlling influenza among the older may
require increasingly immunogenic antibodies and new systems that initiate more prominent
degrees of crowd resistance and along these lines intrude on influenza transmission in networks.
Increasingly successful immunizations for the old are a work in progress however have not yet
been endorsed for use in the United States. Vaccination of youngsters in the United States has
been related with decreases in sickness in families and in the network. In any case, these
examinations are not conclusive and extra research is expected to characterize the advantages
among the older that may be acknowledged from inoculating youngsters.

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Research Critiques and PICOT Statement Final Draft
References
Bmjopen, (2016), Effectiveness of influenza vaccination for preventing influenza-related
complications in people with asthma: a systematic review protocol [Online], Access date
10 August 2019, Retrieved from
https://bmjopen.bmj.com/content/bmjopen/6/3/e010133.full.pdf
Jamanetwork, (2017), Effectiveness of Influenza Vaccine in Health Care Professionals [Online],
Access date 10 August 2019,Retrieved from
https://jamanetwork.com/journals/jama/fullarticle/189023
Ncbi, (2017),Effectiveness of Influenza Vaccines in Asthma: A Systematic Review and Meta-
Analysis [Online], Access date 10 August 2019,Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5850022/
Nejm, (2017), Effectiveness of Influenza Vaccine in the Community-Dwelling Elderly
[Online], ]Access date 10 August 2019, Retrieved from
https://www.nejm.org/doi/full/10.1056/nejmoa070844
Who, (2017), Influenza vaccines [Online], Access date 10 August 2019, Retrieved from
https://www.who.int/immunization/research/development/influenza/en/index1.html