Quantitative Research Critique and Ethical Considerations ✓ Solved

Critique of two articles: “Reducing Behavioral Inpatient Readmissions for People with Substance Use Disorders: Do Follow-up Services Matter?” and “Inpatient Addiction Consultation for Hospitalized Patients Increases Post-Discharge Abstinence and Reduces Addiction Severity.” Both articles explore interventions aimed at reducing readmissions of patients with substance use disorders following inpatient care.

The study by Reif et al. (2017) evaluates the effectiveness of follow-up services for substance abuse patients post-discharge. It finds that readmissions are common due to inadequate follow-up. Similarly, Wakeman et al. (2017) assess the impact of hospital-based addiction consultations, noting improvements in outcomes associated with these interventions.

Background of Study

Both articles address critical nursing issues related to substance use disorder patients. The primary research question focuses on whether specific interventions reduce hospital readmissions within 90 days. The first article utilizes follow-up services, while the second emphasizes the impact of addiction consultations. This research is significant as it directly contributes to understanding effective nursing practices and interventions that can mitigate the recurrence of inpatient admissions among this vulnerable population.

The interventions described aim to create continuity of care through follow-ups and consultations. These actions are essential for promoting patient understanding and engagement with their treatment plans, reducing the risk of relapse, and subsequent readmissions.

Method of Study

The article by Reif et al. employs a quasi-experimental design with a focus on behavioral health inpatient readmissions. The sample includes individuals aged 18 to 64, analyzing their readmission rates based on follow-up services and medication-assisted treatments. In contrast, Wakeman et al. use a multidisciplinary approach, assessing the outcomes of addiction consultations in a prospective cohort of hospital patients.

A notable benefit of the quasi-experimental design is the practical application of findings, as it mirrors real-world scenarios. A limitation, however, is the challenge of controlling external variables that may impact readmissions. The multidisciplinary approach in Wakeman et al.'s study highlights the effectiveness of collaborative care but may also face limitations related to the applicability of results across diverse patient populations.

Results of Study

The findings from Reif et al. show that only 29% of patients received the recommended follow-up after discharge. This lack of engagement correlated with higher rates of readmission. In contrast, the combination of medication-assisted treatment and residential services was shown to improve long-term patient outcomes significantly.

Wakeman et al. found that patients receiving follow-up consultations exhibited a decrease in addiction severity and increased abstinence rates. The interventions proved effective across various demographic groups, indicating that rightly structured addiction consultations could be beneficial for diverse populations facing similar challenges.

Implications for Nursing Practice

The implications of these studies emphasize the necessity for structured follow-up protocols and addiction consultations in the hospital setting. Nurses play a critical role in implementing these interventions, thus supporting the continuity of care needed to prevent readmission. Increasing awareness of the importance of post-discharge follow-up and intervention can lead to improved patient outcomes and reduced healthcare costs.

Ethical Considerations

Research involving patients with substance use disorders raises various ethical considerations. Informed consent and maintaining confidentiality are paramount. Both studies adhered to ethical standards by obtaining informed consent from participants and ensuring confidentiality throughout the research process.

For instance, Reif et al. provided participants with comprehensive information about the study's purpose and procedures, allowing them to make informed decisions about their participation. Additionally, Wakeman et al. ensured that personal identifiers were removed, maintaining the anonymity of any sensitive health information.

References

• Antony, S. M., Grau, L. E., & Brienza, R. S. (2018). A qualitative study of perspectives concerning recent rehospitalizations among a high-risk cohort of veteran patients in Connecticut, USA. BMJ Open, 8(6), e018200.
• Burke, R. E., Donzé, J., & Schnipper, J. L. (2013). Contribution of psychiatric illness and substance abuse to 30-day readmission risk. Journal of Hospital Medicine, 8(8).
• Reif, S., Acevedo, A., Garnick, D. W., & Fullerton, C. A. (2017). Reducing behavioral health inpatient readmissions for people with substance use disorders: do follow-up services matter? Psychiatric Services, 68(8).
• Wakeman, S. E., Metlay, J. P., Chang, Y., Herman, G. E., & Rigotti, N. A. (2017). Inpatient addiction consultation for hospitalized patients increases post-discharge abstinence and reduces addiction severity. Journal of General Internal Medicine, 32(8).
• National Institute on Drug Abuse. (2020). Principles of Drug Addiction Treatment: A Research-Based Guide. Retrieved from [NIDA URL]
• Substance Abuse and Mental Health Services Administration. (2020). Treatment Improvement Protocols (TIPs). Retrieved from [SAMHSA URL]
• World Health Organization. (2021). Substance Use. Retrieved from [WHO URL]
• National Institute of Mental Health. (2020). Mental Illness. Retrieved from [NIMH URL]
• American Psychological Association. (2020). Ethics Code. Retrieved from [APA URL]
• Agency for Healthcare Research and Quality. (2020). Reducing Hospital Readmissions. Retrieved from [AHRQ URL]