Caring For an Acutely Ill Patient - Essay Example

? Research critique: Caring For an Acutely Ill Patient Introduction The ultimate goal for nursing care is to ensure and improve the quality of care available to patients. Embarking on research is one avenue via which this goal can be achieved. As such, research is increasingly becoming an integral part of the nursing profession. The changes that have been made in nursing care are as a direct effect of research previously and currently being undertaken (SANDELOWSKI 2000). This spate of increasing research has eventuated in numerous nurses being awarded recognition in their endeavors. However, publication of research does not necessarily guarantee its quality. As such, it is imperative to engage in research critique in order to judge on research quality and appropriateness. It is within this context that this paper will endeavor to critique, critically, the article by Siobhan Warne et al.:Non-therapeutic omission of medications in acutely ill patients. Critique The article adheres to the conventional structure of a research article. According to Beauchamp, specification in research is unavoidable (BEAUCHAMP & CHILDRESS 2001). This might be hinged on the effectiveness of the research. This article is in line with this assertion as it has incorporated research specification in the article. As such, the critique will analyze the complete structure of this article coupled with its content. This entails a critical analysis of both its content and structure by sections. This approach will ensure that the critique is objective and is not subject to bias. Title The title of a research is tasked with informing the reader on the subject and content of the research article. An informative research title conveys the concepts, methods and variables associated with the article (POLIT & BECK, 2004). The title of the article by Siobhan Warne et al. gives a brief hint on the variables of the study. However, the title does not mention or hint on the concepts and methods used in the study. As such, it does not the meet the requisite conditions for an appropriate title. Abstract The article expounds on the figures associated with the omission of medication to acutely ill patients. The study principally centers on the drugs prescribed for cardiac and respiratory ailments. This, however, limits the scope within which the results might be deemed representative of the actuality on the ground. The conductors of the research adopted the notion that respiratory and cardiac ailments form the core reason for acutely ill patients. This assumption is rather bias as acutely ill patients may be ailing from a number of different reasons, and not particularly these two. The abstract fails to declare whether or not the research is quantitative or qualitative. As such, the reader is obliged to explore and arrive at the conclusion that this is indeed a quantitative research. This is easily identified since the study is concerned with the measurement of the concerning phenomena (HOSKINS, 2004). Statement of aims Questions set by the researcher are usually identified in the statement of aims of the research (POLIT-O'HARA, POLIT, & HUNGLER, 1999). This informs the reader of the intentions motivating the research. As such, this statement must be inclusive of all the aims that necessitated the research. In the framework of this article, the authors only affirm one aim of the research. This is rather vague as it necessitates the reader to explore, further, into the article to arrive at with the precise aims of the research. However, this error is corrected at the study objectives. There is no conclusive rationale that justifies this setup. Introduction The article neither states the research hypothesis nor the research questions in the introduction; this is in contradiction to the expectations of a research article (CHARMAZ, 2006). In light of this omission, their absence is not justified. It is anticipated that the authors will attempt to specify the key variables and the study population. This is, nonetheless, not the actuality adopted by the research. The introduction neither identifies the key variables nor the study population. Arising from the fact that the literature review is distinctively absent, consistency of the conceptual framework cannot be ascertained (GERRISH & LACEY, 2006). Literature review A core feature that is absent, distinctively, from the abstract is the literature review. The primary function of the literature review is to provide a solid foundation for embarking on the new study (BORDENS, & ABBOTT, 2011). However, the authors of the article chose to ignore this function. This is a substantial flaw on their part and negatively affects the overall quality of the research. This is because, it only when a literature review is provided, will analysis be effectively made since the sources of their conclusions and data is available (BURNS & GROVE 2003). Problem statement In the introduction, the problem statement is easy to identify as it is predominantly in the first paragraph. However, the problem statement is structured into a lengthy elucidation of the problem. As such, before the problem statement is understood, the reader has to withstand this lengthy discussion. However, the problem statement should be kept as short as possible and precise (CORMACK 2000). Irrespective of this flaw, the authors offer a cogent and persuasive argument as the rationale for the new study. Nurses are tasked with ensuring that patients under their care receive the appropriate care they need to guarantee swift recovery. In this effort, numerous measures have been undertaken to enable nurses attain this goal. Thus, any nursing research that is undertaken should fall in line with this guideline (POLIT & HUNGLER, 1987). Research methods The article by Siobhan Warne et al. does, in fact, fall within the confines of this guideline. This translates to mean that the problem the research is tackling is a significant problem for nursing. The researchers were able to arrive at a link between the research problem and the methods used. In a quantitative research of this nature, the methods applied herein are the most applicable (CRESWELL, 2003). Prudence dictates that analysis is made on whether or not a quantitative approach is appropriate (KNAPP, 1998). This study endeavors to investigate the extent to which missed medication doses affects nursing. As such, in order to arrive at the precise extent, figures must be sought. It is only via the analysis of these numbers will the study be, in a position to achieve this goal. Research design / data collection In context to the rationale for the research, the design employed was the best design for this situation. However, appropriate comparisons were not made and subsequently the interpretability of the findings has been impeded. The mode and number of data collection points maximizes the potential of data collection. However, the research does not expound on the measures put in place, to minimize panel attrition. Sample The study identified four different sources of first hand data. The population was thus adequately and sufficiently described. Furthermore, the sample size has been described. In the context of representativeness, the sample design is not sufficient. The study does not categorically state the sampling technique that is being used. As such, the reader must analyze the sampling technique and hopefully arrive at the correct technique. With this regard, it has been established that stratified random sampling has been used. However, this is subject to further analysis since the researchers do not expound on any information pertaining to the sampling technique. Aside from this fact, the researchers minimized the probability of bias in the sample. However, the sample size is sufficiently adequate. The operational definitions given in the study are congruent. The key variables, that is: missed medication doses and length of delay, were operationalized and have been given adequate justification. Proforma questionnaire was the primary instrument employed in data collection. Given the study population and purpose of the study, the instruments selected are appropriate (HEK, 2003). Validity and reliability The article expounds on the validity and reliability measures undertaken by the researchers. Regardless of this inclusion, the article does not elucidate on whether or not the methods employed yielded data that can be classified as highly reliable and valid. Ethical issues The researchers employed the services of the chair of the ethics committee to safeguard the rights of the study participants. Thus, the ethical standards of research were upheld. The study was further designed to minimize the risks to patients. Their action of securing the data collected is commendable. As such, benefits to be sourced, by the participants, were maximized. Data analysis Data analysis in the article expounds on statistical methods employed. In the context of the measurement levels attribute to the variables, SPSS software was the best statistical tool available (WAGNER, 2007). The two key variables were the lengths of stay and omitted medications. As such, the spearman’s rank correlation is best suit for correlating these two variables. The type I error was minimized to 0.05 and so was the type II error. However, in some situations, the data analysis technique employed by the researchers might limited in its approach. The best method entails computing the ANOVAs regression using the R statistical software (HOLLOWAY & WHEELER 2002). Findings With regard to the findings, adequate summary has been made. This has been propagated by the use of tables and figures. Aside from this, the findings are illustrated in such a way that future analysis of the results can be undertaken, that is meta-analysis. The evidence produced by the research team is of a nature that facilitates evidence based practice. The researchers performed an exceptional job at ensuring the findings were discussed within the framework of the conceptual study. The interpretations also fall inline with the results that have been provided. A matter that should be of concern is that fact that article does not address the issue of generality of the results. Nonetheless, it has to be understood that the research does not infer any generalization of its findings. The implications of the study for clinical practice are elucidated broadly and efficiently. The study cites organizational factors and the drug administration process as reasons for Missed Medication Doses. Thus, the implications provided by the study are reasonable within the context of nursing practice. Discussion and Recommendations The mode of data collection, that was employed, minimized the probability of bias in the study. The researchers do not mention the training that was conducted for the staff. As such, this might have created an enabling environment for bias (JOHNS & FRESHWATER, 1998). This is not, however, a guarantee, but this avenue for bias cannot be disregarded. The study neither highlights on its hypothesis nor its research questions. As such, critique has to be based on the research objectives. In light of this, the results address all these expounded objectives. The researchers distinctively use other researches to justify their own conclusions. It significantly relies on other sources. This action goes a long way to ascertain the viability of the findings. Aside from this, the researchers present good facts that convince the reader, beyond doubt, about the need for the study and subsequently the validity, reliability and its relevance to clinical practice. However, the relevance of the study comes into question when the sample size is analyzed. A study of this nature necessitates that a sample of significant size is employed. It is rather doubtful that a sample size of 132 patients can be expected to be representative of the whole population. The study also gives justification for the implementation of the bedside handover procedure. This procedure has been found to increase the ability of the nurses to give holistic care (HUDAK et al., 1994). Though the study is aimed at improving the capabilities of clinical practice in giving holistic care, it does not propose programs that can be implemented to this effect. Conclusion There is a need within the healthcare sector for programs akin to bedside handover to be implemented. This procedure has been instrumental in improving patient satisfaction and healthcare accountability (EVANS et al., 2012). In order for such programs, to be created and subsequently implemented, research akin to this one must be conducted for the nursing practice. The recommendations of this study will aid, in part, patient safety. Nursing care must be based on quality research (Hek, 1996). As such, nurses must engage in research so that evidence based care is plausible. Evidence based care enable the direct implementation of recommendations from nursing research without conducting trial runs. This is hinged on the fact that, trial runs are usually a costly affair. At the same time, the recommendations might not be useful to nursing thus in the end, the whole exercise would have been a waste of valuable resources. The presence of a research in a journal does not necessarily guarantee its reliability and appropriateness in clinical practice. As such, nurses must develop their critical evaluation skills to assure that the standard for evidence based practice is high as possible. References BEAUCHAMP, T. L., & CHILDRESS, J. F., 2001. Principles of biomedical ethics. New York, N.Y., Oxford University Press. BORDENS, K. S., & ABBOTT, B. B., 2011. Research design and methods: a process approach. New York, McGraw-Hill. BURNS, N., & GROVE, S. K., 2003. Understanding nursing research. Philadelphia, Pa, Saunders. CHARMAZ, K., 2006. Constructing grounded theory: a practical guide through qualitative analysis. London, Sage Publications. CORMACK, D., 2000. The research process in nursing. Oxford, BlackwellScience. CRESWELL, J. W., 2003. Research design: qualitative, quantitative, and mixed method approaches. Thousand Oaks, Calif, Sage Publications. EVANS D, GRUNAWALT J, MCCLISH D, WOOD W, & FRIESE CR., 2012. Bedside shift-to-shift nursing report: implementation and outcomes. Medsurg Nursing : Official Journal of the Academy of Medical-Surgical Nurses. 21. GERRISH, K., & LACEY, A., 2006. The research process in nursing. Oxford, Blackwell Pub. HEK, G., JUDD, M., & MOULE, P., 1996. Making sense of research: an introduction for nurses. London, Cassell. HEK, G., JUDD, M., & MOULE, P., 2003. Making sense of research: an introduction for health and social care practitioners. London, Sage Publications. HOLLOWAY, I., WHEELER, S., & HOLLOWAY, I., 2002. Qualitative research in nursing. Oxford, UK, Blackwell Science. HOSKINS, C. N., & MARIANO, C., 2004. Research in nursing and health: understanding and using quantitative and qualitative methods. New York, NY, Springer Pub. Co. HUDAK, C. M., GALLO, B. M., & BENZ, J. J., 1994. Critical care nursing: a holistic approach. Philadelphia, Pa, Lippincott. JOHNS, C., & FRESHWATER, D., 1998. Transforming nursing through reflective practice. Osney Mead, Oxford, Blackwell Science. KNAPP, T. R., 1998. Quantitative nursing research. Thousand Oaks, Calif, Sage Publications. POLIT, D. F., & BECK, C. T., 2004. Nursing research: principles and methods. Philadelphia, Lippincott Williams & Wilkins. POLIT-O'HARA, D., POLIT, D. F., & HUNGLER, B. P., 1999. Instructor's manual to accompany Nursing research: principles and methods. Philadelphia, Lippincott. POLIT, D. F., HUNGLER, B. P., & POLIT, D. F., 1987. Study guide to Nursing research: principles and methods. Philadelphia, Lippincott. SANDELOWSKI, M., 2000. Devices & desires: gender, technology, and American nursing. Chapel Hill, University of North Carolina Press. WAGNER, W. E., 2007. Using SPSS for social statistics and research methods. Thousand Oaks, Calif, Pine Forge Press. Appendix Critiquing tool Citation: Authors: Siobhan Wame, Ruth Endacott, Helen Ryan, Wendy Chamberlain, Julie Hendry, Carole Boulanger and Nicola Donlin Title: Non-therapeutic omission of medications in acutely ill patients Journal: British Association of Critical Care Nurses Year: 2010 Volume: 15 Issue: 3 Pages: 112-117 Type of study: a) Quantitative Location / setting: Four medical wards, four surgical wards and one othorpaedic ward. If Quantitative: Key concepts: Concepts: missed medication Intervention/independent variable: Missed Medication Doses Dependent variable: length of stay Controlled variables: reason for omission Design type: b) Quasi-experimental Specific design: stratified random sampling Description of intervention: N/A Time factors: b) Cross sectional a) Prospective Comparison groups: 1) Missed medication dose and stayed longer and 2) missed medication dose and did not stay longer If Qualitative: Tradition: a) Grounded theory b) Phenomenology c) Ethnography = N/A Sample: Size: Sampling method: N/A Sample characteristics: N/A Data collection: N/A Data Analysis: N/A Findings: N/A Recommendations: N/A Ethical issues: N/A Strengths: N/A Weaknesses: N/A Read More