The Practice of Nurses in Hospitals and Long-Term Care Facilities - Essay Example

?Introduction This paper seeks to critically analyse a quantitative research paper written by Christine M. Meade, Amy L. Bursell and Lyn Ketelsen (2006) entitled “Effects of Nursing Rounds on Patients’ Call Light Use, Satisfaction and Safety.” The paper is mainly concerned with analysing the impact of long term rounds in nursing practice and how these may contribute to falls. As such, this critical analysis seeks to explore the extent to which the research paper mentioned above has been successful in achieving its stated objectives. The paper looks at various components of a research paper and it starts by outlining the problem statement and how it relates to the practice of nurses in hospitals as well as long term care facilities. Background to the study The call light is very significant with regards to patient care in hospitals but it can be noted that this same call light can pose a challenge to nurses given that the demand for their time may also be increased. Various studies have revealed that the patients’ frequent use of the call light have unfavourable effects especially on patient care management units which is compounded by issues such as shortages of staff as well as general dissatisfaction among the nursing staff. However, there is little empirical research about rounding which is concerned about conducting bedside rounds among the patients. Therefore, this study has been significantly influenced by mainly two factors: to find out more about the observations made with regards to the amount of time spent by nurses responding to call lights and the impact of this practice on patient care management and measures that can be taken in order to assist nurses as well as hospitals to improve their daily operations as well as the safety of the patients. Research has shown that patients mainly use call lights mainly for other non medical purposes such as the need to use toilets or other aspects related to food. However, there is need to research is needed to determine the best way of reducing call light use and burnout and fatigue among the people involved in this particular task in hospitals as well as increase the safety and satisfaction of the patients. Other studies have observed that an interdisciplinary rounding exercise is effective since it can positively improve patient care as well as operational efficiency while at the same time guaranteeing satisfaction of the health care personnel. Normally, the patients derive their satisfaction from their perceptions about the nurses especially with regards to the care they receive and in most cases, the call light is used for various purposes to determine the level of satisfaction of the patients. Therefore, the crux of this study has been to investigate the effectiveness of the use of the call light on patient satisfaction with regards to falls and its impact on the performance of the nurses. Problem statement In the study above, the problem statement can be summarised as: to what extent is there a correlation between the use of call light in nursing rounds as well as improved satisfaction of the customers and reduced workload on nurses? It has been observed that unscheduled use of call light negatively impacts on the nurses while on the other hand their failure to respond to the patients’ needs often results in reduced satisfaction. Therefore, it can be noted that this research is a twofold process which affects both parties involved in either a positive way or negative manner. In my own view, I think this problem statement is a researchable topic given that it is closely related to the nursing profession. The study also focuses on a population on a population sample collected from different hospitals to show that this problem identified is common in different healthcare centres. Given such a scenario, it can be seen that there is need to address this problem in order to improve the welfare of the nursing professionals as well as satisfaction of the customers from the services they get from the hospitals. It can also be seen that the purpose of the study is to establish the measures that can be taken in order to improve the use of the call light on both the patients as well as the nursing staff involved. Given that research has shown that the use of the call light has an impact on the patients as well as the nurses, concerted efforts are supposed to be put in place in order to ensure that both parties involved are satisfied for the benefit of both parties involved. Review of literature The study drew on some literature from previous studies. For instance, the study looked at literature from the work of Van Handel and Krug who categorized and quantified patients’ reasons for using the call light. For instance, they found that the call light was mainly used at meal as well as medication periods. On the other hand, the study also reviewed literature by Gersh who reported that the use of an unlicensed “patient service partner” decreased call light response time, improved the attitudes of those responding. The major notable problem with the literature reviewed showed that there are no dates showing the year this literature was published. However, there are likely chances of compromising the study given that researches of this magnitude have to strongly draw from previous literature in order to ensure that the study is authentic. Failure to do that as is the case can result in the study losing credibility. This is a weakness in as far as studies of this nature are concerned. The other problem is that the study mainly relies on secondary data but this particular type of study should also focus on primary data given that it is concerned with investigating factors that can affect the nurses as well as the patients in as far as the use of call light is concerned. However, one major notable problem with the study is that the research question is not clearly outlined. The sub questions of the study are also not clearly stated either. This is one major weakness of the study given that it becomes difficult for the readers to grasp the whole concept about what is being investigated. In order for the readers to gain a clear understanding of the research, there is need for the researcher to clearly outline the research question of the study so that it becomes apparent that the study seeks to answer certain questions. The research problem has been generalised and this can pose problems in some instances where some of the readers may fail to clearly understand the concept under investigation. Theoretical framework Unfortunately, the study does not clearly outline the theoretical framework which has been used as its basis. In as far as nursing practice is concerned, I think the theoretical framework underpinning this study falls short of highlighting some major concepts that affect this profession. The researchers assumed that every person is aware of the routines of the nurses such as conducting the rounds. The study lacks a rich background of theory which underpins the nursing profession. The theoretical framework has been just generalised by the researchers assuming that each person is aware of what happens in this particular field. For instance, the study does not utilise some of the theories applicable to this field by renowned scholars. Given that it uses a quasi experimental method in collection of data, this entails that this topic is not very new to the nursing fraternity. Therefore, I think it should have drawn this argument from some of the theories that are commonly used in the nursing field. As noted above, there are no dates for the literature reviewed and I think it was also noble for the researchers to highlight some theories that are commonly used in this field in order to ensure that the study is authentic. Such type of research has to be based on the work of other scholars given that it is not new to the practice of nursing. Hypotheses and research design Struig & Stead (2001) posit to the effect that a hypothesis depicts the relationship between two or more variables. However, in some cases, there is no relationship between the variables in a particular study. In this study, it has been hypothesised that nursing rounds conducted on a regular schedule will result in the following: Reduction of call light use. An increase patient satisfaction. Improved patient safety, as measured by the frequency of patient falls. From the hypothesis above, it has been noted that an independent variable is the use of the call light for nursing rounds since this can be manipulated. The dependent variables include the following: an increase in patient satisfaction, a reduction in the use of the call light as well as improved patient safety witnessed by a decline in the number of their falls. It can be seen that there is a relationship between the variables mentioned in this particular study and to a larger extent, I would like to believe that these hypotheses are empirically testable as shown by the results of the findings of the study. The research method utilised in the study is quasi experimental design which is meant to test the impact of the use of the call light on identified groups in the study. The study was carried on a similar time frame and the same conditions were adhered to during the course of the study. This was meant to ensure that there is consistency in the data collected so as to ensure that the results are reliable and valid. The population for data collection was drawn from 22 different hospitals in USA and the data was collected from different types of hospitals which reflect the general trend of the nature of hospitals in USA. I believe that this measure is effective in as far as ensuring that the data collected is valid as well as reliable. In each research, such measures should be given priority and this is the reason why I would like to believe that the data collected is authentic. Since the research has been designed in a quasi experimental framework, it entails that it heavily relied on secondary sources of date. It is my opinion that this study should have focused more on primary data in order to establish if there has been any change in the variables under investigation. The research design of this study did not take into consideration some of the external factors likely to impact on the outcome of the study as shown by the results. It has been observed that out of the 22 hospitals constituting the population sample, eight of them had to be dropped from the study given that the data collected from them was not consistent. Therefore, it can be seen that the researchers did not seriously take into consideration the external factors that could affect on the reliability and validity of the data used in this particular study. Sampling As discussed above, the sample for the study was drawn from 22 hospitals but the other eight had to be dropped in the study. The study assumed that the subjects of research are similar whilst conveniently forgetting that the internal processes of these hospitals are quite different. To a certain extent, it can be noted that the study is based on the wrong perception that all hospitals are similar of which that is not the case in some cases since this was discovered at a later stage of the research. Indeed, the study utilised the non probability sampling but this was discovered to have its own flaws as well as biases since the population sample selected was not uniform in different respect as explained above. Whilst every measure was taken in order to ensure that the sample was representative of the whole population, it can be seen that the sample size is small for the study of this magnitude. The sample size should have been a bit larger and should also have covered a large geographical area in order for it to be representative of the population at large. Data analysis The study has been designed to establish the extent to which the hypothesis that a rounding intervention could reduce the number of call light uses in hospitals. The first hypothesis has been supported by the study given that the use of the call light has been drastically reduced during the implementation period of the study. Patient satisfaction was also increased during the course of the study given that a 65 % increase in patient satisfaction was witnessed in all hospitals that were studied. It has also been noted that data from eight hospitals was dropped given that there were errors in the information collected. However, the other notable discrepancy in the data collected is that there was no raw data for the study. To a certain extent, this may be problematic given that the information collected was not consistent. This has a negative connotation on the nature of the information collected. Despite these shortcomings of the study, it can be noted that the t tests were conducted using stats software. This particular type of software is ideal for quantitative researches given that the data can be statistically computed to establish the changes in the variables under investigation. The other advantage of this method of data analysis is that the chances of reliability and validity of the data collected are likely to be increased. Discussion of the results/findings There has also been a reduction in the cases of falls among the patients after the implementation of the one hour routine rounding schedule in place of the use of call lights in hospitals. There has been a decrease in the number of falls from 25 to about ten, which entails a 60 % reduction after the study which shows that there are likely chances of improving the welfare of the patients if the strategy is carefully implemented. However, the statistics for falls in the two hour rounding were negligible since the difference was small. Therefore, there is need to carry out further studies on a large scale using the two hour scheduling in order to establish the gap that exists between the different time schedules of rounding in the hospitals. However, despite these weaknesses, it can be seen that the study tried to present the results in a coherent manner. For instance, there has been an increase in the satisfaction of the patients since the study was implemented. It can also be seen that there has been a reduction of patient falls by about 60 %. These results bear testimony that the research has attempted to fulfil its generalised objectives. The limitations of the study were outlined such as the data collection methods utilised since the research mainly depended on data from vendors. There is need to take care of such aspects in the future in order to come up with reliable results for such kind of a research. Weaknesses of the study The study largely depended on data from vendors and this data was assumed to be accurate. However, the problem is that this data may not be accurate given that it was collected for different purposes by the vendors. In order to improve on this particular aspect, it is imperative that measures are put in place in order to ensure that the researchers conduct the actual primary data collection rather than merely depend on secondary data. There are likely chances of changes in the type of data collected hence need to use current methods of data collection when conducting such kind of study. The other weakness of the study is that it does not take into consideration the behavioural aspect of the nurses. It assumed that the behaviour of the nursing staff is uniform but this may not be the case. This has a bearing on the way they perform their duties and tasks. Therefore, in the future there is need for the researchers to ensure that the participants in the study share the same understanding of the study as well as all other relevant aspects expected of them. The study fails to address the impact of routine rounding on the welfare of the nurses since it specifically focused on the needs and interests of the patients. Future studies/recommendations It has been suggested that this study is useful in establishing the extent to which routine rounding can be effective in dealing with issues such as patient as well as nursing satisfaction in hospitals. However, in future there is need to carry out a similar study on a large population sample, probably the whole country in order to establish if the trends are similar in different parts of the country. There is also need to carry out such kind of study over a long period of time so as to be in a position to determine if the rounding schedules are effective. In some cases, the changes can only be short term based hence the need to conduct the study over a long period. It has also been suggested that researchers should attempt to conduct primary research in as far as data collection is concerned in order to ensure that the results are reliable. In this particular case, it can be noted that the study mainly relied on data from vendors and this can be problematic given that it might not be a true reflection of what is actually happening on the ground. It is also important to establish the level of satisfaction among the nurses in order to check if the routine scheduling has been effective. This is so because this study is twofold given that it sought to establish the link between different variables mentioned above. Bibliography Christine M. Meade, Amy L. Bursell and Lyn Ketelsen, “Effects of Nursing Rounds on Patients’ Call Light Use, Satisfaction and Safety ” AJN. September 2006, Vol. 106, No. 9, Viewed 11 June 2012, . Colin, R. (1993). Real world research: A resource for social scientists and practitioner researchers. New Jersey, NJ: Blackwell. Dawson, C. (2007). A practical guide to research methods. London. How to Books. Struwig, F.W. & Stead, G.B. (2004). Planning, Designing and Reporting Research. Cape Town: CT. Pearson Education. Read More