Dec 09, · A Critical Literature Review The review involves investigating the research that has been done on a particular topic and then summarizing and evaluating what you have found. The important task in this kind of assignment is to organize your material clearly and synthesize it for your reader. A good review does not just summarize Jul 13, · A literature review is a type of critical review in which you analyze and evaluate many sources on a specific topic. The purpose is to provide your reader with File Size: KB Oct 29, · A literature review is an essential part of dissertation paper writing: it shows the need for your work in relation to what is already known about your subject. A critical literature review, on the other hand, is analytical, in which the statement of facts are mentioned critically. When writing a critical literature review for a dissertation, it is necessary to collect information from numerous sources of Estimated Reading Time: 5 mins
Sample Essays On Critical Literature Review | WOW Essays
We use cookies to enhance our website for you. Proceed if you agree to this policy or learn more about it. Type of paper: Essay. Topic: NursingAliensStudySurgeryMedicineStayDisasterRecovery. Early ambulation is now recognised as an intervention that confers many positive benefits to patients following cardiac surgery, critical literature review dissertation. However, there is lack of clarity as to the optimum time for the patient to perform early ambulation.
A focused question was developed to ascertain whether early ambulation within 24 hours after extubation is more effective compared to ambulation 24 hours or more following extubation. The clinical question guided the search and retrieval of 6 studies that were subsequently appraised.
There are benefits and many limitations of the chosen studies and do not provide sufficient evidence to answer the clinical question definitively. A more refined question is proposed. The conventional postoperative management of cardiac surgery is to have the patient remain on bedrest for days at a time to ensure rest and healing. However, there is increasing recognition of the benefits of mobilisation early in the postoperative period.
A decline in the risks for complications is associated with shorter hospital stays and maintenance of functional ability without the need for rehabilitation, critical literature review dissertation. Changes have since been made in clinical practice to enable early ambulation so that patients can optimise the benefits.
Extubation is performed earlier, and the patient care involves the performance of progressive mobility exercises. The second postoperative day entails transfers thrice a day, ambulation times a day, incentive spirometer, coughing, and deep breathing. Even patients with mechanical circulatory support devices are supported to mobilise early. However, critical literature review dissertation, there is controversy in relation to how early the early ambulation is.
Evidence-based practice warrants that guidelines or protocols be based on available research evidence, clinical experience, and patient preferences rather than an arbitrary decision Stevens, A focused question was developed to ascertain the state of evidence and what additional research needs to be done.
The chosen population is adult post-cardiac surgery patients, and the intervention is early ambulation at less than 24 hours following extubation. It will be compared to early ambulation 24 hours post-extubation. The selected outcomes are wound status, early recovery, and vascular circulation.
A structured search of the literature was conducted in the following databases: PubMed, Science Direct, CINAHL, Cochrane, and Medline. These key words guided the search: post-cardiac, post-heart, surgery, early, ambulation, mobilisation, less, than, more, critical literature review dissertation, than, 24 hours, after, extubation, recovery, wound, circulation.
The results were critical literature review dissertation according to relevance and limited to peer-reviewed journal articles in the English language published within the last 10 years or beginning in The titles were browsed and if deemed related to the clinical question, the abstract was reviewed to ensure its relevance to each element of the question.
If filtered results exceededonly the first articles were considered for abstract review. The best articles in terms of relevance and research design were retrieved with greater preference placed on systematic reviews, randomised controlled trials RCTsquasi-experimental studies which are typically within a quality improvement framework, critical literature review dissertation, and cohort studies. If lacking, descriptive case studies were also considered.
The combined search of the CINAHL and Medline databases with filters yielded 4, results. A review of the first articles led to the retrieval of 3 articles. The search of PubMed lead to results and the retrieval of 2 articles after duplicates were removed, critical literature review dissertation.
In the Science Direct database were results with the retrieval of one article after duplicate removal, critical literature review dissertation. One article was retrieved from the Cochrane Database bringing the total articles chosen for the review to 6.
One is a systematic review, 3 were QI or non-QI quasi-experimental studies, one was a non-randomised trial, and one was a randomised prospective trial. There remains a paucity of research on the critical literature review dissertation given the turnout of relevant articles.
Camp et al. A description of the new protocol that was implemented was described critical literature review dissertation included weaning the patient from the ventilator and incentive spirometry and early ambulation within the same day as extubation. Prior to this, ambulation was done the day after extubation, critical literature review dissertation.
Critical literature review dissertation adherence to the protocol was ensured through education and training. The defined outcomes were sepsis, pneumonia, length of stay in the ICU, critical literature review dissertation length of stay, reintubation, and ICU readmission.
These outcomes are proxy indicators of patient recovery. A large sample of patients was in the post-intervention group while 1, participants were in the pre-intervention group Camp et al. Critical literature review dissertation included CABG, valve repair, or a combination of both. The results show that the post-intervention group had a lower rate of complications, namely pneumonia and sepsis, and reduced lengths of stay in the ICU and the hospital overall Camp et al.
Furthermore, there was a lower risk of reintubation and ICU readmission. The outcomes reflect speedier recovery when patients are extubated earlier and ambulated within 24 hours compared with delayed extubation and ambulation. Murphy et al. Extubation and mobilization via sitting are performed within postoperative day zero. Again, this outcome is a proxy measure of recovery wherein shorter stays are associated with reduced complications including DVT and pulmonary embolism.
The results also show a reduction in the median length of hospital stay from 9 days before protocol implementation down to 5 days after implementation. Albeit not a QI study, Ahmed et al.
Critical literature review dissertation mobilisation included repositioning the patient in bed, early ambulation through bed-to-chair transfers and walking, and chest physiotherapy.
An even smaller sample was used — 20 patients for the pre-intervention group and 20 patients for the post-intervention group. All underwent open heart surgery. The results demonstrated earlier respiratory recovery in the early ambulation group with lower rates of dysrhythmias and atelectasis, critical literature review dissertation. Also noted in this group is a significantly shorter ICU length of stay implying earlier recovery from a critical status.
However, no differences were found in relation to hemodynamic, oxygenation, and renal parameters. Meanwhile, Kandasamy et al. The outcomes include recovery, ICU length of stay, and length of hospital stay.
The ultra-fast track group was extubated less than 3 hours post-surgery while the conventional treatment group were extubated more than 3 hours post-surgery. Patients who were unstable were excluded from participation. The premedication, extubation, and other postoperative interventions that was standardised to all study participants was described.
Overall, the ultra-fast track group had shorter ICU and hospital lengths of stay with fewer hours on ventilation Kandasamy et al. However, the conventional treatment group had a greater number of patients with pulmonary arterial hypertension PAH which could be a source of bias.
Otherwise, critical literature review dissertation, the 2 groups are statistically similar in terms of demographic attributes. A multifaceted intervention that begins in the intraoperative period is seen to have contributed to the positive results. The use of titrated short-acting anaesthetics, maintenance of normothermia in the postoperative period, administration of appropriate analgaesics, early extubation, early ambulation, and promotion of the return of alimentary functions collectively contribute to early recovery Kandasamy et al.
Hoque et al. Forty adults who underwent cardiac surgery were allocated either to the total intravenous anaesthesia TIVA group or to conventional anaesthesia. Except for the choice of anaesthesia, all other treatment related factors were kept similar to reduce bias between the TIVA and conventional anaesthesia groups.
The depressant effect of TIVA is shorter in duration than more long-acting conventional anaesthesia making it possible to perform early extubation and ambulation within 24 hours on postoperative day zero or day critical literature review dissertation. On the other hand, overnight mechanical ventilation is often necessary when conventional anaesthetics were used. Extubation followed when the patient met the criteria for eye opening, muscle power, respiration, haemodynamic indicators, pain level, and presence or absence of bleeding.
The results demonstrate better respiratory and haemodynamic performance following extubation and ambulation in the TIVA group compared with conventional anaesthesia. The outcome is an indirect indicator critical literature review dissertation recovery as it reduces the risk of reintubation and longer cardiac ICU stay.
In a systematic review, Zhu, Lee and Chee aimed to determine the impact of fast-track interventions in the post-cardiac surgery period on mortality as well as postsurgical complications and length of stay in the ICU and hospital. Comparison interventions were conventional or non-fast track care, critical literature review dissertation. Interventions were early extubation, critical literature review dissertation ambulation, and the use of low-dose opioids for general anaesthesia during the intraoperative period.
Early extubation and ambulation typically occurred within postoperative day zero. Patient surgeries included CABG and valve replacement. Complications included wound infection and major bleeding. The aggregate sample size of the studies was 4, critical literature review dissertation, and most trial samples involved low- to moderate-risk patients.
However, patients on fast-track care were noted to have shorter ICU stays indicative of lower risks for critical illness. The findings also show that fast-track care leads to similar outcomes as conventional care in low- to moderate-risk patients but at a lower cost.
The strength of the evidence is the integration of early ambulation within 24 hours following extubation into a multifaceted intervention such as fast-track protocols. This recognises the complex nature of post-cardiac surgery outcomes in that there are many factors that shape the clinical consequences.
Indeed, if the patient remains heavily sedated then extubation cannot be performed. In addition, Kandasamy et al. The quasi-experimental QI approach of Camp et al.
For instance, critical literature review dissertation, Camp et al. There are limitations to the evidence, however. Therefore, it is difficult to draw conclusions on effectiveness in relation to many of the outcomes when considering the entirety of the evidence. Another limitation of the evidence is the conduct of studies in single centres. It may be difficult to generalise the findings of one hospital in Bangladesh as in the study by Hoque et al. The randomised trial by Hoque et al.
Only the study by Camp et al. These factors reduce the quality of the studies.
INTELLECTUAL LADDER: 3 Steps to Write a [CRITICAL] Literature Review for a Dissertation / Thesis
, time: 14:41How To Write A Critical Literature Review For A Dissertation
Running head: LITERATURE REVIEW 1. a particular topic. It generally follows a discussion of the paper’s thesis. A literature review is a survey of scholarly sources that provides an overview of statement or the study’s goals or purpose. *This sample paper was adapted by the Writing Center from Key, K.L., Rich, C., DeCristofaro Oct 29, · A literature review is an essential part of dissertation paper writing: it shows the need for your work in relation to what is already known about your subject. A critical literature review, on the other hand, is analytical, in which the statement of facts are mentioned critically. When writing a critical literature review for a dissertation, it is necessary to collect information from numerous sources of Estimated Reading Time: 5 mins Feb 22, · Dissertation literature review If you are writing the literature review as part of your dissertation or thesis, reiterate your central problem or research question and give a brief summary of the scholarly context. You can emphasize the timeliness of the topic (“many recent studies have focused on the problem of x”) or highlight a gap in the literature (“while there has been much research on x,
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