This is a group project. As a group, you will critique and critically appraise the quantitative research article sent to you by your faculty member at the beginning of the semester. Students should respond to each criterion and provide an appropriate discussion for the criterion. For example, for the criterion regarding the purpose, do not simply respond yes the purpose was stated. Students should provide a discussion of whether the purpose was specifically stated and where the authors stated the purpose (ie: the end of the introduction portion of the paper). If the purpose was not specifically stated, was it implied? Give a brief but thorough explanation and discussion to support the answer to the critique criterion. Use your textbook to help you formulate answers and provide references as appropriate.
See attached files
Quantitative Research Article Critique
Group Members: Brandie Davis, Dena Lowe, Aja Miller, Aaliyah Scott, Ryley Snell
| Criteria | Possible Points | Points Earned | Group Response to Criteria |
| Part I Problem | |||
| Was the origin of the problem clearly stated? | 3 | This study investigates the use of an interactive teaching approach powered by the Engaging Parents in Education for Discharge (ePED) app to address particular content aspects crucial to family self-management at home following the child’s hospital discharge. The ePED app was designed to give the discharging nurse a tool to facilitate teaching strategies and enhance parent discharge preparedness. In the end, better discharge planning should lead to better post-discharge results, such as a decrease in ER visits and hospital readmissions. | |
| Was the purpose of the study stated? | 2 | The purpose of this study was stated in the article. The purpose of this study was to assess how the iPad software Engaging Parents in Education for Discharge (ePED) affected parents’ perceptions of teaching about hospital discharge and care coordination. The secondary goal looked at differences between groups in the care coordination, discharge teaching, and 30-day readmissions for parents of kids with and without chronic conditions. This study’s objective was to assess the results of ePED use with parents of hospitalized children on two pediatric inpatient units. | |
| Was the population who will benefit from the study identified? | 2 | The population that will benefit from the study identified are nurses, parents, and the patient. The nurse uses the ePED software to concentrate on comprehending the dangers, challenges, and strengths of the family in managing the child’s illness and the transition from the hospital to home. The results of highly involved and structured discharge communication can highlight parental strengths, flag hazards, and activate resources. The ePED app directs the nurse through the five key steps by giving specific open-ended questions to assess, confirm, and encourage parents before they leave for home, eliciting specific goals and potential concerns, knowledge gaps and possibilities for additional education. Parent involvement and feedback should be sought during discharge education and care coordination to determine the requirements of patients and their families. Particular attention must be paid to the distinctiveness and uniqueness of patient and family needs at hospital release for children with complicated medical needs and long-term health issues. | |
| Was the problem significant to nursing? | 3 | The problem in this study is significant to nursing. For the parent experience of discharge to be as positive as possible, nurses need efficient resources to help them engage the parent in the discharge planning process. Due to this, the Engaging Parents in Education for Discharge (ePED) application to close this gap was created. | |
| Was the relationship of the problem to previous research clear? | 3 | ||
| What were the variables under study? | 3 | ||
| What is the research question or hypothesis(es)?—even if not formally addressed in the study | 2 | The following statement is the hypothesis of this study: Compared to parents exposed to standard discharge teaching, parents exposed to discharge teaching via Engaging Parents in Education Discharge (ePED) will experience higher-quality discharge teaching and improved care coordination. | |
| Part II Theory and Review of the Literature | |||
| Was a theoretical framework identified? If so, what was it? | 4 | ||
| What topics did the literature review cover? | 4 | ||
| Part III Methodology | |||
| Did the study show evidence of thorough planning from beginning to end? | 2 | ||
| What was the design of the study? | 2 | ||
| Did the study design ‘fit’ the research problem? | 2 | ||
| Were all steps of the scientific method included so the research can be replicated? | 2 | ||
| What was the setting for the study? | 2 | ||
| Who was the target population? | 2 | ||
| What was the sampling technique? | 3 | ||
| What were the sampling criteria and the sample size? | 2 | ||
| What was the data collection method? | 3 | ||
| What were the details of the instrument(s) used? | 3 | ||
| What was the reliability and validity of the instruments? | 3 | ||
| Was IRB approval obtained? | 2 | ||
| Part IV Outcome of Data Analysis | |||
| Were descriptive statistics reported? | 3 | ||
| What variables were described? | 3 | ||
| Were inferential statistics reported? | 4 | ||
| What statistical method(s) were used? | 4 | ||
| What was the set level of significance? | 2 | ||
| Was the null hypothesis(es) rejected?—address each hypothesis/research question | 4 | ||
| Were the findings clearly and concisely stated? | 3 | ||
| Part V Conclusion and Discussion | |||
| Are the limitations of the study described? | 2 | ||
| Can the study be generalized to the population studied? | 2 | ||
| Are nursing recommendations made? | 2 | ||
| Is future research recommended? | 2 | ||
| What were evident problems with this research? | 3 | ||
| Could this research be used as evidence? | 2 | ||
| References | |||
| One half point will be deducted for each grammar/lack of clarity error—regardless of type—for a maximum of 15 points | |||
| Total | 90 | ||
Quantitative Research Article Critique
Group Members: Brandie Davis, Dena Lowe, Aja Miller, Aaliyah Scott, Ryley Snell
| Criteria | Possible Points | Points Earned | Group Response to Criteria |
| Part I Problem | |||
| Was the origin of the problem clearly stated? | 3 | This study investigates the use of an interactive teaching approach powered by the Engaging Parents in Education for Discharge (ePED) app to address particular content aspects crucial to family self-management at home following the child’s hospital discharge. The ePED app was designed to give the discharging nurse a tool to facilitate teaching strategies and enhance parent discharge preparedness. In the end, better discharge planning should lead to better post-discharge results, such as a decrease in ER visits and hospital readmissions. | |
| Was the purpose of the study stated? | 2 | The purpose of this study was stated in the article. The purpose of this study was to assess how the iPad software Engaging Parents in Education for Discharge (ePED) affected parents’ perceptions of teaching about hospital discharge and care coordination. The secondary goal looked at differences between groups in the care coordination, discharge teaching, and 30-day readmissions for parents of kids with and without chronic conditions. This study’s objective was to assess the results of ePED use with parents of hospitalized children on two pediatric inpatient units. | |
| Was the population who will benefit from the study identified? | 2 | The population that will benefit from the study identified are nurses, parents, and the patient. The nurse uses the ePED software to concentrate on comprehending the dangers, challenges, and strengths of the family in managing the child’s illness and the transition from the hospital to home. The results of highly involved and structured discharge communication can highlight parental strengths, flag hazards, and activate resources. The ePED app directs the nurse through the five key steps by giving specific open-ended questions to assess, confirm, and encourage parents before they leave for home, eliciting specific goals and potential concerns, knowledge gaps and possibilities for additional education. Parent involvement and feedback should be sought during discharge education and care coordination to determine the requirements of patients and their families. Particular attention must be paid to the distinctiveness and uniqueness of patient and family needs at hospital release for children with complicated medical needs and long-term health issues. | |
| Was the problem significant to nursing? | 3 | The problem in this study is significant to nursing. For the parent experience of discharge to be as positive as possible, nurses need efficient resources to help them engage the parent in the discharge planning process. Due to this, the Engaging Parents in Education for Discharge (ePED) application to close this gap was created. | |
| Was the relationship of the problem to previous research clear? | 3 | The study clearly describes the association between the problem to previous research. The researchers used literature to explain how discharge teaching for parents improved patient outcomes post discharge. | |
| What were the variables under study? | 3 | The following are the variables under study;
Independent variable: Interactive patient teaching using the Engaging Parents in Education for Discharge (ePED) iPad application (app).
Dependent variables:
|
|
| What is the research question or hypothesis(es)?—even if not formally addressed in the study | 2 | The following statement is the hypothesis of this study: Compared to parents exposed to standard discharge teaching, parents exposed to discharge teaching via Engaging Parents in Education Discharge (ePED) will experience higher-quality discharge teaching and improved care coordination. | |
| Part II Theory and Review of the Literature | |||
| Was a theoretical framework identified? If so, what was it? | 4 | The researchers used a teaching method and two theoretical frameworks to guide the program of research. The teaching method is the Teach-Back educational tool that utilizes an iterative face-to-face methodology during teaching. The Teach-Back method supports literacy and it is advantageous in that it allows the instructor to deliver content and ask participants to recall or restate whatever they have been taught. The inclusion of the ‘think forward’ approach in the Teach-Back methodology allowed the nurse to identify and address the potential challenges that families might encounter following discharge.
One of the theoretical frameworks used by the researchers is the Tanner’s Reflective Practitioner Theory. This theory assumes that nurses have the capacity to identify problems, interpret behaviors of children and family, take appropriate action to respond to the identified problems, observe how families respond to nursing actions, and make necessary adjustments. In order to perform these roles effectively, the nurse needs to recognize the health-related beliefs and values of individuals and families.
The other theoretical framework that was used in addition to the Tanner’s Reflective Practitioner Theory is the Individual and Family Self-Management Theory (IFSMT). The IFSMT assumes that individuals and families make significant contributions to their daily functioning including how nurses collaborate with them the skills that they need for self-management and health promotion.
|
|
| What topics did the literature review cover? | 4 | The literature explored the unidirectionality of traditional discharge teaching and the increased use of the Teach-Back educational tool in contemporary clinical settings to enhance the understanding of the taught concepts by patients and nurses. In traditional discharge teaching, nurses primarily focused on demonstrating the skills needed for home management without considering whether they understood the taught concepts or not. The literature provides evidence supporting the effectiveness of the Teach-Back method in promoting patient and family engagement during teaching.
Also discussed in the literature is the importance of evaluating discharge teaching. Parents whose children are suffering from chronic diseases need discharge teaching that will enable them to effectively address their children’s needs at home. In this respect, discharge teaching should be designed in a manner that it is able to identify the unique needs of individuals and families.
|
|
| Part III Methodology | |||
| Did the study show evidence of thorough planning from beginning to end? | 2 | There is evidence of thorough planning from the beginning of the study to the end. The study includes a comprehensive description of the study design, the inclusion and exclusion criteria used to select participants, the sampling procedure, outcome measures, participant characteristics, data collection procedures, and data analysis approaches. | |
| What was the design of the study? | 2 | The study follows the quasi-experimental pre-post two group design. The researchers used convenience sampling to recruit 395 parents of hospitalized children preparing for home discharge. Two separate units were used for the intervention and comparison groups. | |
| Did the study design ‘fit’ the research problem? | 2 | The study design is an appropriate ‘fit’ for the research problem. The reason is that the study aims to establish whether there is a cause-and-effect relationship between the independent and dependent variables. Precisely, the aim of the study is to establish whether the use of interactive patient teaching using the Engaging Parents in Education for Discharge (ePED) iPad application (app) affects the quality of discharge teaching, care coordination, and within 30-day readmission of parents of children with a chronic condition. | |
| Were all steps of the scientific method included so the research can be replicated? | 2 | The research can be replicated because all steps of the scientific method were included. For instance, using the inclusion and exclusion criteria described in the study, one can easily follow the same guide to recruit the same types of participants. Additionally, one can use the given tools or instruments to collect data for the three dependent variables. | |
| What was the setting for the study? | 2 | The study was conducted in two separate units within a free-standing pediatric academic medical center with Magnet designation in the Midwestern United States. The units are a 24-bed surgical unit and a 24-bed medical care unit. Subjects from the surgical unit received the ePED intervention while participants from the medical care unit were used as the comparison group. | |
| Who was the target population? | 2 | Parents of hospitalized children were the target population for the study. The parents must have been preparing for discharge from the facility at the time of study. | |
| What was the sampling technique? | 3 | Convenience sampling technique has been applied to recruit participants into the study. This is a non-probability sampling method in which the researchers utilize readily available subjects. | |
| What were the sampling criteria and the sample size? | 2 | The sample size was 395 parents of hospitalized children who were preparing for discharge. 211 subjects were used in the intervention group while 184 subjects were used in the comparison group. The inclusion criteria include parents who were 18 years of age or older, could speak and read English, and agreed to participate in the use of ePED to guide discharge conversations and for data collection for the study’s outcome measures. Parents were excluded if the hospitalized child was older than 18 years of age. | |
| What was the data collection method? | 3 | The researchers used quantitative methodologies to collect the data. | |
| What were the details of the instrument(s) used? | 3 | Two instruments were used to collect the data. These include the Quality of Discharge Teaching Scale-Delivery (QDTS-D) and the Care Transition Measure (CTM) tool. | |
| What was the reliability and validity of the instruments? | 3 | The Cronbach’s alpha reliability for the QDTS-D in a sample of parents of hospitalized children is high at 0.86. The CTM instrument has high Cronbach’s alpha reliability estimates of 0.93 in adult and 0.89 to 0.95 in pediatric populations. | |
| Was IRB approval obtained? | 2 | The researchers obtained the Institutional Review Board (IRB) approval before commencement of the study. | |
| Part IV Outcome of Data Analysis | |||
| Were descriptive statistics reported? | 3 | Descriptive statistics were reported. | |
| What variables were described? | 3 | Outcome variables, and their relationship with the independent variable, were clearly described. The following variables were captured in the data analysis;
Independent variable: Interactive patient teaching using the Engaging Parents in Education for Discharge (ePED) iPad application (app).
Dependent variables:
|
|
| Were inferential statistics reported? | 4 | Inferential statistics were reported. Precisely, the researchers clearly described the mean differences between dependent variables and how they relate to the independent variable. | |
| What statistical method(s) were used? | 4 | T-tests were performed to examine the mead differences between variables and draw conclusions. | |
| What was the set level of significance? | 2 | The level of significance was set at p < 0.05. | |
| Was the null hypothesis(es) rejected?—address each hypothesis/research question | 4 | The null hypothesis was rejected. | |
| Were the findings clearly and concisely stated? | 3 | The findings were clearly and concisely stated. The study found that parents taught using ePED reported higher QDTS-D scores than parents without ePED (p = .002). No differences in CTM were found between groups. Correlations between QDTS-D and CTM were small for ePED (r = 0.14, p 0.03) and non-ePED (r = 0.29, p b .001) parent groups. CTM was weakly associated with 30-day readmissions in the ePED group.
|
|
| Part V Conclusion and Discussion | |||
| Are the limitations of the study described? | 2 | The study includes a comprehensive description of study limitations. | |
| Can the study be generalized to the population studied? | 2 | The study cannot be generalized to the population studied because it only concentrated in one practice setting. | |
| Are nursing recommendations made? | 2 | Nursing recommendations have been made in the study. Nurses can use the study findings to improve discharge teaching for patients. | |
| Is future research recommended? | 2 | Based on study findings, future studies should explore the concept of care coordination on populations with complex chronic diseases. | |
| What were evident problems with this research? | 3 | The fact that the inpatient clinical nurse who completed the intervention was the assigned nurse for the day presents a potential source of bias.
|
|
| Could this research be used as evidence? | 2 | This research could be used as evidence to improve discharge teaching among parents with children who are suffering from conditions that require continuum care at home. | |
| References | |||
| One half point will be deducted for each grammar/lack of clarity error—regardless of type—for a maximum of 15 points | |||
| Total | 90 | ||
Quantitative Research Article Critique
Group Members: Brandie Davis, Dena Lowe, Aja Miller, Aaliyah Scott, Ryley Snell
| Criteria | Possible Points | Points Earned | Group Response to Criteria |
| Part I Problem | |||
| Was the origin of the problem clearly stated? | 3 | This study investigates the use of an interactive teaching approach powered by the Engaging Parents in Education for Discharge (ePED) app to address particular content aspects crucial to family self-management at home following the child’s hospital discharge. The ePED app was designed to give the discharging nurse a tool to facilitate teaching strategies and enhance parent discharge preparedness. In the end, better discharge planning should lead to better post-discharge results, such as a decrease in ER visits and hospital readmissions. | |
| Was the purpose of the study stated? | 2 | The purpose of this study was stated in the article. The purpose of this study was to assess how the iPad software Engaging Parents in Education for Discharge (ePED) affected parents’ perceptions of teaching about hospital discharge and care coordination. The secondary goal looked at differences between groups in the care coordination, discharge teaching, and 30-day readmissions for parents of kids with and without chronic conditions. This study’s objective was to assess the results of ePED use with parents of hospitalized children on two pediatric inpatient units. | |
| Was the population who will benefit from the study identified? | 2 | The population that will benefit from the study identified are nurses, parents, and the patient. The nurse uses the ePED software to concentrate on comprehending the dangers, challenges, and strengths of the family in managing the child’s illness and the transition from the hospital to home. The results of highly involved and structured discharge communication can highlight parental strengths, flag hazards, and activate resources. The ePED app directs the nurse through the five key steps by giving specific open-ended questions to assess, confirm, and encourage parents before they leave for home, eliciting specific goals and potential concerns, knowledge gaps and possibilities for additional education. Parent involvement and feedback should be sought during discharge education and care coordination to determine the requirements of patients and their families. Particular attention must be paid to the distinctiveness and uniqueness of patient and family needs at hospital release for children with complicated medical needs and long-term health issues. | |
| Was the problem significant to nursing? | 3 | The problem in this study is significant to nursing. For the parent experience of discharge to be as positive as possible, nurses need efficient resources to help them engage the parent in the discharge planning process. Due to this, the Engaging Parents in Education for Discharge (ePED) application to close this gap was created. | |
| Was the relationship of the problem to previous research clear? | 3 | The study clearly describes the association between the problem to previous research. The researchers used literature to explain how discharge teaching for parents improved patient outcomes post discharge. | |
| What were the variables under study? | 3 | The following are the variables under study;
Independent variable: Interactive patient teaching using the Engaging Parents in Education for Discharge (ePED) iPad application (app).
Dependent variables:
|
|
| What is the research question or hypothesis(es)?—even if not formally addressed in the study | 2 | The following statement is the hypothesis of this study: Compared to parents exposed to standard discharge teaching, parents exposed to discharge teaching via Engaging Parents in Education Discharge (ePED) will experience higher-quality discharge teaching and improved care coordination. | |
| Part II Theory and Review of the Literature | |||
| Was a theoretical framework identified? If so, what was it? | 4 | The researchers used a teaching method and two theoretical frameworks to guide the program of research. The teaching method is the Teach-Back educational tool that utilizes an iterative face-to-face methodology during teaching. The Teach-Back method supports literacy and it is advantageous in that it allows the instructor to deliver content and ask participants to recall or restate whatever they have been taught. The inclusion of the ‘think forward’ approach in the Teach-Back methodology allowed the nurse to identify and address the potential challenges that families might encounter following discharge.
One of the theoretical frameworks used by the researchers is the Tanner’s Reflective Practitioner Theory. This theory assumes that nurses have the capacity to identify problems, interpret behaviors of children and family, take appropriate action to respond to the identified problems, observe how families respond to nursing actions, and make necessary adjustments. In order to perform these roles effectively, the nurse needs to recognize the health-related beliefs and values of individuals and families.
The other theoretical framework that was used in addition to the Tanner’s Reflective Practitioner Theory is the Individual and Family Self-Management Theory (IFSMT). The IFSMT assumes that individuals and families make significant contributions to their daily functioning including how nurses collaborate with them the skills that they need for self-management and health promotion.
|
|
| What topics did the literature review cover? | 4 | The literature explored the unidirectionality of traditional discharge teaching and the increased use of the Teach-Back educational tool in contemporary clinical settings to enhance the understanding of the taught concepts by patients and nurses. In traditional discharge teaching, nurses primarily focused on demonstrating the skills needed for home management without considering whether they understood the taught concepts or not. The literature provides evidence supporting the effectiveness of the Teach-Back method in promoting patient and family engagement during teaching.
Also discussed in the literature is the importance of evaluating discharge teaching. Parents whose children are suffering from chronic diseases need discharge teaching that will enable them to effectively address their children’s needs at home. In this respect, discharge teaching should be designed in a manner that it is able to identify the unique needs of individuals and families.
|
|
| Part III Methodology | |||
| Did the study show evidence of thorough planning from beginning to end? | 2 | There is evidence of thorough planning from the beginning of the study to the end. The study includes a comprehensive description of the study design, the inclusion and exclusion criteria used to select participants, the sampling procedure, outcome measures, participant characteristics, data collection procedures, and data analysis approaches. | |
| What was the design of the study? | 2 | The study follows the quasi-experimental pre-post two group design. The researchers used convenience sampling to recruit 395 parents of hospitalized children preparing for home discharge. Two separate units were used for the intervention and comparison groups. | |
| Did the study design ‘fit’ the research problem? | 2 | The study design is an appropriate ‘fit’ for the research problem. The reason is that the study aims to establish whether there is a cause-and-effect relationship between the independent and dependent variables. Precisely, the aim of the study is to establish whether the use of interactive patient teaching using the Engaging Parents in Education for Discharge (ePED) iPad application (app) affects the quality of discharge teaching, care coordination, and within 30-day readmission of parents of children with a chronic condition. | |
| Were all steps of the scientific method included so the research can be replicated? | 2 | The research can be replicated because all steps of the scientific method were included. For instance, using the inclusion and exclusion criteria described in the study, one can easily follow the same guide to recruit the same types of participants. Additionally, one can use the given tools or instruments to collect data for the three dependent variables. | |
| What was the setting for the study? | 2 | The study was conducted in two separate units within a free-standing pediatric academic medical center with Magnet designation in the Midwestern United States. The units are a 24-bed surgical unit and a 24-bed medical care unit. Subjects from the surgical unit received the ePED intervention while participants from the medical care unit were used as the comparison group. | |
| Who was the target population? | 2 | Parents of hospitalized children were the target population for the study. The parents must have been preparing for discharge from the facility at the time of study. | |
| What was the sampling technique? | 3 | Convenience sampling technique has been applied to recruit participants into the study. This is a non-probability sampling method in which the researchers utilize readily available subjects. | |
| What were the sampling criteria and the sample size? | 2 | The sample size was 395 parents of hospitalized children who were preparing for discharge. 211 subjects were used in the intervention group while 184 subjects were used in the comparison group. The inclusion criteria include parents who were 18 years of age or older, could speak and read English, and agreed to participate in the use of ePED to guide discharge conversations and for data collection for the study’s outcome measures. Parents were excluded if the hospitalized child was older than 18 years of age. | |
| What was the data collection method? | 3 | The researchers used quantitative methodologies to collect the data. | |
| What were the details of the instrument(s) used? | 3 | Two instruments were used to collect the data. These include the Quality of Discharge Teaching Scale-Delivery (QDTS-D) and the Care Transition Measure (CTM) tool. | |
| What was the reliability and validity of the instruments? | 3 | The Cronbach’s alpha reliability for the QDTS-D in a sample of parents of hospitalized children is high at 0.86. The CTM instrument has high Cronbach’s alpha reliability estimates of 0.93 in adult and 0.89 to 0.95 in pediatric populations. | |
| Was IRB approval obtained? | 2 | The researchers obtained the Institutional Review Board (IRB) approval before commencement of the study. | |
| Part IV Outcome of Data Analysis | |||
| Were descriptive statistics reported? | 3 | Descriptive statistics were reported. | |
| What variables were described? | 3 | Outcome variables, and their relationship with the independent variable, were clearly described. The following variables were captured in the data analysis;
Independent variable: Interactive patient teaching using the Engaging Parents in Education for Discharge (ePED) iPad application (app).
Dependent variables:
|
|
| Were inferential statistics reported? | 4 | Inferential statistics were reported. Precisely, the researchers clearly described the mean differences between dependent variables and how they relate to the independent variable. | |
| What statistical method(s) were used? | 4 | T-tests were performed to examine the mead differences between variables and draw conclusions. | |
| What was the set level of significance? | 2 | The level of significance was set at p < 0.05. | |
| Was the null hypothesis(es) rejected?—address each hypothesis/research question | 4 | The null hypothesis was rejected. | |
| Were the findings clearly and concisely stated? | 3 | The findings were clearly and concisely stated. The study found that parents taught using ePED reported higher QDTS-D scores than parents without ePED (p = .002). No differences in CTM were found between groups. Correlations between QDTS-D and CTM were small for ePED (r = 0.14, p 0.03) and non-ePED (r = 0.29, p b .001) parent groups. CTM was weakly associated with 30-day readmissions in the ePED group.
|
|
| Part V Conclusion and Discussion | |||
| Are the limitations of the study described? | 2 | The study includes a comprehensive description of study limitations. | |
| Can the study be generalized to the population studied? | 2 | The study cannot be generalized to the population studied because it only concentrated in one practice setting. | |
| Are nursing recommendations made? | 2 | Nursing recommendations have been made in the study. Nurses can use the study findings to improve discharge teaching for patients. | |
| Is future research recommended? | 2 | Based on study findings, future studies should explore the concept of care coordination on populations with complex chronic diseases. | |
| What were evident problems with this research? | 3 | The fact that the inpatient clinical nurse who completed the intervention was the assigned nurse for the day presents a potential source of bias.
|
|
| Could this research be used as evidence? | 2 | This research could be used as evidence to improve discharge teaching among parents with children who are suffering from conditions that require continuum care at home. | |
| References | |||
| One half point will be deducted for each grammar/lack of clarity error—regardless of type—for a maximum of 15 points | |||
| Total | 90 | ||