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Nurse Initiated Reinsertion of Nasogastric Tubes in the Emergency Department - Essay Example

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The article Nurse initiated reinsertion of nasogastric tubes in the EmergencyDepartment: A randomised controlled trial authored by Ho, Rainer and Graham involved…
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Nurse Initiated Reinsertion of Nasogastric Tubes in the Emergency Department
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Quantitative Article Critique A quantitative research basically involves the collection, analysis, and interpretation of numerical data. The article Nurse initiated reinsertion of nasogastric tubes in the EmergencyDepartment: A randomised controlled trial authored by Ho, Rainer and Graham involved quantitative research. The article included all the main sections of a research article including the abstract, introduction, literature review, methods, and conclusion. The article meets the standards required of a professional study although it has a few lapses which reasonably do not have a major impact on its credibility. Quantitative Article Critique Analysis of the Article’s Abstract A structured abstract basically is a summary of the main sections of an article and has distinct and labeled sections as noted by Polit and Beck (2013). On the other hand, the traditional abstract is merely descriptive and only serves to tell the audience what will be covered in the text. This article has a structured abstract. In the abstract, the sections presented are distinct and are well labeled. In this respect, the sections labeled are background, methods, results, and conclusion (Ho, Rainer and Graham, 2013). The abstract is not limited to providing a description of what the article covers but goes deeper to summarize the main sections of the research, which qualifies it as a structured abstract. The information presented in the abstract is adequate to make a person know what the study is all about; the background to the problem, the research method(s), the results and the conclusion. The evidence used in this study was a prospective randomised controlled clinical trial (Ho, Rainer and Graham, 2013). Based on the evidence hierarchy pyramid, the first level applies. This is the case given that the control group and intervention group trials were both randomized trials. Research Purpose/Problem Statement In the article, the problem statement is clearly stated in the introduction. The problem statement in this article relates to the long waiting times and associated risks that patients have to contend with for the reinsertion of nasogastric tubes (NGT) (Ho, Rainer and Graham, 2013). The researchers postulate that the waiting times that patients have to endure as they wait for doctors to assess their situations before nurses reinsert NG tubes can be reduced significantly through nurse initiated reinsertion. This argument is worthwhile and significant since it can go a long way in making emergency care more efficient, improve nurse autonomy, and improve the overall outcome of emergency care (Ho, Rainer and Graham, 2013). The problem is significant going by the fact that patients face greater risks and emergency care outcomes are impacted negatively by long waiting times. Research Questions/Hypothesis The article has no research questions but instead features hypotheses. In the article, the author hypothesizes that by allowing nurse initiated reinsertion of nasogastric tubes, patient waiting time will be shortened and Emergency Department (ED) service will become more effective. The author also hypothesizes that nurse initiated reinsertion will increase the autonomy of nurses. The study has no research and null hypotheses. Rather, the hypotheses are directional. This is the case given that they predict the direction of the difference between the relationship between variables. Literature Review/Background This article has a short literature review that can be easily identified. The information contained in the literature review relates to the procedure of NGT insertion (Ho, Rainer and Graham, 2013). The information presented in the literature review is that which is drawn from different journal articles related to emergency care. While the literature review is short and therefore seems insufficient at first look, it is actually sufficient considering the information presented in the introduction. In other words, the literature review is well complemented by the introduction so that it does not seem to lack anything. The article was authored sometime in June 2013. The articles that are cited in the literature review were authored between 2003 and 2007. As is evident, some of the articles used in the literature review were more than five years old and may be considered to be outdated. Variables under study There are several variables under examination in the study. The dependent variables include door-to-treatment time, total LoS, and the satisfaction levels of nurses, patients, or patients’ relatives. The operational definitions for door-to-treatment time and total LoS were adequately provided. The definition for total LoS was given as “from the time of registration to the time of leaving the ED” (Ho, Rainer and Graham, 2013, p. 139). The two independent variables are: nurse initiated reinsertion of NGT and traditional NG tube reinsertion. While the definitions of the two variables were not presented in the methods section, their operational definitions are well discussed in the introduction and literature review sections. Ethical Considerations A number of ethical considerations were applied in the study. For one, the researchers obtained ethical approval from the relevant ethical committee before conducting their study (Ho, Rainer and Graham, 2013). This went a long way in minimizing potential risks to participants in the study, especially patients. This was the case since the review board would not have approved a study that would cause more harm to the patients than good or that would expose them to grave risks. The researchers also sought consent from participants and/or their relatives and provided contact details so that any questions or concerns that they had could be adequately attended to. Participation in the study was voluntary which means that participant autonomy was preserved (Ho, Rainer and Graham, 2013). Also, the anonymity of participants in the study was preserved given that they were no required to provide their personal information on the questionnaires. This also went a long way in ensuring the confidentiality of participants and their personal information. The study was subject to review by an ethics review board (the joint university and local institutional ethical committee) (Ho, Rainer and Graham, 2013). As previously stated, it was most appropriate that the study be subject to review by a competent and authoritative body so as to minimize potential risks to participants and ensure that the study was conducted within ethical limits. The main vulnerable group included in the study was patients who needed NG reinsertion. The patients were also vulnerable by virtue of being elderly (mean age of 82.8 and 81.5 years for the control group and intervention group respectively) (Ho, Rainer and Graham, 2013). To protect the vulnerable groups, the researchers took measures to preserve their anonymity and seek their consent, which went a long way in preventing them from experiencing psychological distress. Theoretical and Conceptual Framework/Conceptual Underpinnings The article had no theoretical framework. One theoretical framework that could be applied to this study is Beckers Belief Health Model (HBM). This theoretical framework is relevant to the study given that it focuses on individuals’ health related behavior as noted by Polit and Beck (2013). In this case, the nurse is concerned about saving lives and yet has to comply with medical procedures and protocols which may lower or grossly impact on the outcomes of emergency response. Conclusion In conclusion, the article features a structured article. The study sought to establish whether or not nurse initiated NG reinsertion could improve emergency department outcomes. Although the study had a short literature review, relied on sources that seemed outdated, and had no theoretical framework, it fulfilled most of the requirements that are demanded of a scientific study. The study involved systematic randomized clinical trials to prove that nurse initiated NG reinsertion is the way to go. References Ho, C. H. Y., Rainer H.R. & Graham,C. A. (2013). Nurse initiated reinsertion of nasogastric tubes in the EmergencyDepartment: A randomised controlled trial. Australasian Emergency. Nursin Journal 2013(16):136-143. Polit, D. F. & Beck, C. T. (eds) (2013). Essentials of Nursing Research Appraising Evidence for Nursing Practice, Edition 8. Lippincott Williams & Wilkins. Read More
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