Published Work in Care of Patients with Tracheostomy - Literature review Example

Critical Analysis and Summary Report of Published Work in Care of Patients with Tracheostomy Author/s and year The first research article was written and refereed by Anne McKillon, a registered nurse with extensive clinical and educational experience. The second published work was written by Zoe Sherlock, Janet Wilson and Catherine Exley who are in the field of medicine and have various published clinical-related articles. Meanwhile, the last journal which was assessed was written by Sandra Zeitoun, Alba de barros and Solange Diccini, who are all registered nurses and affiliated with the academe as professors in nursing. Sandra Zeitoun is currently a doctoral student aside from holding the position of Clinical Nurse Specialist at the ICU of SEPACO Hospital. Journal The first study was published by JBI Reports which is a fully referred journal that publishes original scholarly work from the International Joanna Briggs Institute Collaboration. Its main objective is to advance the understanding and development of evidence-based practice in nursing, midwifery, nutrition an dietetics, physiotherapy, occupational therapy, medical radiation and podiatry. All reports are peer-reviewed by at least two researchers who are expert in the field of evidence-based practice (JBI Reports, 2004). On the other hand, Journal of Critical Care which published the second study provides a forum for publication of original peer-reviewed articles with the goal of improving patient care through integration of critical care system knowledge into practice behavior (Elsevier, 2009). The last research article was published by the Journal of Clinical Nursing. JCN is an international, peer-reviewed, scientific journal that seeks to promote the development and exchange of knowledge encompassing nursing practice and midwifery. It is also the main objective of the journal to set high standards of clinically related scholarship which supports the nursing discipline (Watson, 2008). Credibility of Authors The authors of various published works are commendable and credible for their exemplary records in the field of clinical practice, education and research. The authors of the first and last research articles are very credible in the field of researching the care of patients with tracheostomy because of the relevance of their work experience as registered nurses in critical settings. Title of Publication The first study is entitled Evaluation of the Implementation of a Best Practice Information Sheet: tracheal suctioning of adults with an artificial airway; the second is Tracheostomy in the acute setting: Patient experience and information needs; the last publication is entitled A prospective, randomized study of ventilator-associated pneumonia in patients using a closed vs. open suction system. The three publication titles are clear and precise in describing the aims of each study. This aspect is important to provide easy comprehension and avoid confusion for prospective readers. Aims and Objective of the Study The objective of the first study is to provide an evaluation of the implementation of a Best Practice Information Sheet in connection to tracheal auctioning of adults with artificial airway. Through evidence-based practice, the study aimed at obtaining comprehensive assessment of the newly release Best Practice Information Sheet in order to ensure whether it is effective or not in relation to patient’s assessment. On the other hand, the second study aimed at investigating the patient’s experiences of tracheostomy or the adequacy of the information provided to them. Lastly, the third publication purports to verify the incidence of nosocomial pneumonia in intubated and extended mechanically ventilated patients having endotracheal suctioning by an open versus closed suction method. The main aim is to reduce nosocomial pneumonia. The objectives of the study are all relevant to the topic of caring patients with tracheostomy. All of which are focused on how to improve care for patients with such surgical condition. Study Design The first and second study both used qualitative research design. Accordingly, Qualitative research method is useful in collecting evidences which are not determined in advance (Family Health Int’l, N.d). By using a systematized set of procedures to answer the question, the efficiency of the tool as regards the tracheal suctioning of adults with artificial airway was evaluated as well as the assessment of patient’s experiences that underwent tracheostomy. On the other hand, the last study applied a quantitative approach as it gauged on the incidences of acquiring nosocomial pneumonia between patients with open versus closed suction method. Adopting quantitative method entails objective, rigorous, and systematic strategies for generating and refining knowledge (Burns and Grove, 2005). By verifying the incidence of nosocomial pneumonia and comparing the results between two groups of patients, it is apt that a quantitative method was used as it warrants statistical analysis (Sousa et al, 2007). Method The method used in the first study and second study were survey interview whilst the last study employed an experimental research design. Analyzing the first two studies, the method used was somewhat weak because they solely depend on the interview of the respondent. Thus, subjectivity of the participant may likely affect the results. Unlike if they used a mixed method research, the findings of qualitative interview may be supported by quantifications to derive a stronger conclusion. Study Setting The setting of the first study is good for it is more diversified in form as it conducted its research in two different countries; whilst, the setting of the second and third studies are limited when research has been concentrated only on one large teaching hospital and ICU of general hospital in Siao Paulo, Brazil, respectively. Sampling Method The most common sampling method in nursing studies is non-probability sampling (Burns et al, 2002, p. 248). This type of sampling technique has been applied in the first and second studies; nonetheless, the third publication gauged on using a randomized selection of sample to ensure more bias-free representatives. Appropriateness of Sample Size The first study conducted its research on 105 nurses across two different countries. The second study gauged to assessed 8 participants whilst 47 patients were derived by the third study. The second study seemed to be weak in its sampling size especially that it has conducted its research on a large teaching hospital. Inclusion Criteria for Sample Selection The sample for the first study includes only those nurses who have been involved in the implementation of best practice in the suctioning procedures. In the second study, the inclusion criteria focus only on adult patient who had a tracheostomy during an acute admission to hospital and whom healthcare professional felt were able to participate fully in 45 – minute interview and had a recordable voice. The last study opted to group the patients into two; those intubated on even dates received open endotracheal suction while those intubated on odd dates had closed suction. Additional data were gathered as part of the inclusion criteria such as Acute Physiology and chronic Health Evaluation II. The second study seemed to be weak in its inclusion criteria for participants because selection process also depends on subjective assumption of the healthcare professionals. Exclusion criteria for sample selection The first study entails to exclude those who have not participated or involved in the implementation of best practice information sheet; whilst the second study excluded patients with critical illness, significant cognitive and/or communication difficulties; the third study opt to exclude those patients who had been intubated or had a tracheostomy performed at another hospital; those with pulmonary infection at the time of admission, those diagnosed with AIDS or severe neutropenia and early reintubation. Results The results obtained in the first study varied across different settings. Nonetheless, a modest trend was observed in lieu of recommendations given. Most of the answers derived suggest an uptake of the Best Practice Information Sheet. The differences in the results were caused by varying strategies implemented by the respondents in relation to Best Practice Information Sheet. In this regard, the study suggests a trend toward modest uptake of best practice recommendations into nursing practice as evidence of change in behavior has been obtained; the second research study obtained four themes based on the result of interview, physical sensations, understanding, information, and experiences after removal of the tracheostomy tube, therefore suggesting that the experience of having a tracheostomy is a complex mixture of physical sensations and emotions. It is also derived that information provided to patients may be inadequate and incoherent to patient’s needs; the result of the last study entails that a closed suction system did not decrease the incidence of nosocomial pneumonia when compared to open system. It has been found that exogenous factors were most important factor in the acquisition of the infection. Ethical consideration All three publications applied ethical considerations such as asking permission and guidelines from ethic committee to conduct research among groups of patients where treatment variable will be provided (3rd study). Relative Strengths of Each Publication All three publications are strong in regards the journals where they have published their material; credibility of the authors are also commended; and the aim and objectives of their research are all relative to the topic of patient care with tracheostomy. Relative Weaknesses of Each Publication Relative weaknesses of the publications are evident in the type of study design and sampling method used in their researches especially for the first two studies. Nonetheless, the third study is considered stronger in validity and reliability compared to other two studies. Conclusion The critical analysis of the three publications provided an in-depth understanding of their weaknesses and strengths which allows the identification of areas needing further improvement. However, based on the results of the studies, it is likewise concluded that evidence-based practice is important in the enhancement of clinical practice particularly in nursing. Nurses are the primary care provider of patients and their role in the critical setting is very important. References Burns N, Grove SK. The practice of nursing research: Conduct, critique, and utilization. 5th ed. St Louis: Elsevier; 2005. Burns, N., Burns, N, and Grove, SK. (1999). Understanding nursing research. (3rd Ed.). Elsevier Health Sciences. JBI Reports (2004). http://library.georgetown.edu/newjour/j/msg03707.html Journal of Critical Care. (2009). Elsevier. Available [Online] at http://www.jccjournal.org/authorinfo Module 1 Qualitative Research Methods Overview. (N.d). Qualittaive Research Methods: A Data Collector’s Field Guide. Family Health International. [Online] Available at http://www.fhi.org/NR/rdonlyres/etl7vogszehu5s4stpzb3tyqlpp7rojv4waq37elpbyei3tgmc4ty6dunbccfzxtaj2rvbaubzmz4f/overview1.pdf Sousa, VD., Driessnack, M. and Mendes, IAC. (2007). An overview of research relevant to nursing: Part 1: Quantitative Research Designs. Rev Latino-am Enfermagem. Maio-junho, 15(3), pp. 502-7 Watson, R. (2008). Journal of Clinical Nursing. WILEY-BLACKWELL. Available [Online] at http://www.wiley.com/bw/journal.asp?ref=0962-1067 Read More