Graduate Nurses' Communication with Health Professionals When Managing Patients' Medications - Assignment Example

Critique of a qualitative research paper titled: Graduate nurses' communication with health professionals when managing patients' medications. Authors: Manias, E., Aitken, R., & Dunning. 2004. 1. Identify and describe the research problems/questions. The statement which is used to identify issues to be studied in a research is referred to as the research question (Thorne et al 2004). For one to be able to formulate a research question which is strong he or she should be familiar with the field of research. In addition, he or she should be familiar with vital research questions in his or her area of study (Propp et al 2010). The researcher should also be able to identify fields which require more research to be able to formulate a research question. The research question should be aimed at bringing more understanding to the field of study or filling a knowledge gap (Turner et al 2004). The researchers also need to know what has already been done in the field of study and what needs to be improved to be able to formulate a research question. The relevance of the study also is vital in the formulation of the research question. Finally, the significance of the knowledge gained in the proposed study should be considered to be able to formulate a research question. In our case study the first research question was: how do graduate nurses interact with doctors, pharmacists and other nurses during their service delivery? The second research question was: during these interactions, what kind of information about the treatment of the patient is communicated and how is it passed to fellow healthcare workers? The first question is relevant to nursing profession and it addresses an area not yet covered since it is stated in the paper that little if any research has been carried out concerning information exchange between graduate nurses and other professionals in Medicare sector (Propp et al 2010). The question addresses a very important issue since this exchange of information is essential for other health care workers such as doctors to make informed decision in the treatment of the patients. The second question addresses a vital issue concerning the efficiency of information exchange. This determines how the recipients who are other professionals in healthcare perceive the information received which they rely on making medication decisions. 2. Identify and describe the research design employed in the study. The research employed a qualitative research design. A qualitative research design involves answering research questions related to experiences of human beings. The data obtained is mainly in terms of text or words (Propp et al 2010). These texts and words usually elucidate what is experienced by the people. The experiences form the basis of the study. The qualitative research design covers various concepts including grounded theory, phenomenology, ethnography and case studies (Hasselbladh & Bejerot, 2007). In this study the data obtained will mainly be in terms of words since interviews will be carried out and observations made. The observations will be recorded as text hence it qualifies to be a qualitative study. The concept covered in this study is grounded theory. This is because the study involves observation and interviewing of nurses on how they exchange information between themselves and related health professionals. The study uses these interviews and observations to make conclusion on communication among health workers. Since communication is a social process, the method is in line with grounded theory. Thus using this theory the study tries to answer how the nurses exchange information with pharmacists, doctors and other nurses. 3. Identify and outline the justification of using such a design The design was used to allow exploration of the way graduate nurses pass information to other healthcare workers during their management of medication to patients (Barbour & Lammers, 2007). It is near impossible to address this research question using other research designs such as quantitative design (Heslo et al 2003). Thus qualitative method was the only method which could answer this question conclusively. Thus it was used to provide new direction and insight on the necessity and of better communication between graduate nurses and the related healthcare workers for efficiency provision of medical services to patients. 4. Describe the method of recruiting samples/participants & allocation of samples/participants. Prior to recruitment, participants were required to sign an informed consent form. Recruitment of graduate nurses and the patients was undertaken using stratified random sampling. The method allowed recruitment of graduate nurses from various practice setting (Barbour & Lammers, 2007). Stratified random sampling tries to restrict sampling to those with medium characteristics avoiding the more extreme and ensures representation across the population allowing increased efficiency (Christensen & Remler, 2009). Thus the error of estimation is reduced. This was very vital in coming up with a reliable conclusion in this study. In stratified random sampling the population is divided into different strata with similar characteristics. An independent sample is then selected using simple random sampling from each of the stratum. Stratification increases the precision of the estimates obtained in each stratum, provides convenience in the administration of the stratum, can allow different procedures of sampling and increases precision of the estimated characteristic in the stratum. Thus this method of sampling increased the precision of the results obtained in this study concerning communication between the graduate nurses and doctors, pharmacists or other nurses. 5. Describe in detail how data is collected. Observations and interviews were used to collect data in the study (Christensen & Remler, 2009). When using observations to collect data, video recorder may be used. While making observations you need to be invisible to be able to get reliable data. Interviews usually use structured and unstructured questions which in most cases are unambiguous. Tape recording is essential in such method of data collection. In this study observations were undertaken in the morning, mid day and afternoon. The observation was randomly done with each nurse being observed for two hours. Interviewing of the nurses was done to clarify observed activities on the same day for approximately one hour. The observation and interview was recorded using an audio tape (portable) through which the researcher described verbally the observations. 6. Describe in detail how data is analyzed. Framework method was used to analyze the data. This is a manual method of data analysis mainly for qualitative data analysis. The method is versatile and thus is not for specific qualitative analysis. Thus its application may be in analysis of any qualitative data (Thorne et al 2004). Data collected and recorded by audio tapes need to be transcribed prior to analysis using this method of data analysis (Hasselbladh & Bejerot, 2007). Framework method of data analysis enables the investigator to organize his data from transcripts in structured way. The method has five stages which are easily followed and analyzed. In this study, the data obtained from both interviews and observations was transcribed verbatim prior to analysis using the framework method. Analysis was carried out independently by two team members and an agreement 95% was obtained. This analysis was essential in describing the variations, relationships, experiences and norms of communicating during medical management activities between graduate nurses and pharmacists, doctors and other nurses. 7. Discuss the credibility, auditability and fittingness (qualitative) Credibility is truth of the conclusions made on the findings (Propp et al 2010). This is usually dependent on the judgments by the participants and any other persons related to the discipline (Marcell et al 2007). The conclusions of this study were largely credible because the observed activities were augmented by the interviews which were used to confirm what had taken place during observation. In addition the conclusion which were made were not biased since it points out all the shortcomings which were experienced and outlines some of the strengths of some graduate nurses in the process of communication (Perloff, 2006). The authors of the study also note the shortcomings of their research as being based on a small sample and the need to have a larger sample to improve credibility. Thus the team which was involved in the study is reliable and hence we can say that the research was credible. The credibility of the study is further strengthened by the fact that data analysis was done by two individuals independently and their results had an agreement of about 95%. Auditability is the accountability of the information relayed in the report. It is dependent on the availability of information guiding the reader through the report from formulation of the research question, collection of data and its analysis and the subsequent interpretation of the results (Barbour & Lammers, 2007). This research is auditable because it clearly outlines the research question. The research question as seen before is about communication between graduate nurses and other related healthcare givers (Christensen & Remler, 2009). This is the guiding theme throughout the data collection and analysis. The conclusions made are also related to this research question and thus the research is credible. Fittingness involves faithfulness of the subjects in relation to daily realities. There is faithfulness in this study since the conclusion of the study identifies some problems in the process of information exchange among some graduate nurses. This has some reality in it since not all people can be effective in communication so we expect some deviations. In addition, the fact that communication is instrumental in quality medication and management, calls on the need of other graduate nurses to improve their communication and those involved in their training need to insist the importance of effective communication. This is vital for medical management and the development of the nursing practice. 8. Describe and discuss any ethical issues arising from the study, and how these issues are dealt with. Participants’ well being is very essential when carrying out a study involving human subjects. The research should not cause any harm or if any it should be minimized as much as possible (Marcell et al 2007). In qualitative research, three research ethics need to be observed, namely; persons participating in the research need to be respected, minimization of risk to the participants and being just (Thorne et al 2004). Respecting participants ensures that participation is voluntary and autonomous. It also ensures that research subjects are handled with dignity. Thus this ensures that persons are not misused in studies as study objects to realize the study objectives. This study observed this principle by allowing participants to voluntarily participate and those who accepted signed informed consent (Perloff, 2006). Minimization of risk to the participants is vital for the credibility of the research. The risk minimization need to both social and psychological risk minimization. It is upon the investigators to ensure that this takes place and if possible the benefits of the participants should out way the risks of participating. In this research no risks were involved. Being just ensures that risks and benefits resulting from the study are fairly distributed. This implies that any knowledge resulting from the research need to benefit the participants of the study. In this study the information regarding communication of medication management activities is bound to benefit the graduate nurses who participated in the study. 9. Discuss the relevancy and contribution to your professional work. This was relevancy to my professional work as a nurse because it addresses the most important part of my service delivery to my patients (Heslo et al 2003). That is, it emphasizes on the need for effective communication while carrying out my duties as a nurse (Thorne et al 2004). The study gives insights on the need for some order in the wards to improve communication. From observation in the study prior preparation are essential in effective communication. The study points out that this is enhanced by order in the wards. Thus, if management of various hospitals takes in this recommendation it can improve communication of the nurses involved and the healthcare team involved. This can enhance the medication of patients. Furthermore, the study recommends the need for provision of peer support and the need to have role models. Thus, as I develop into a nurse this recommendation will helpful in assisting those who are not competent in the process of communication and I will also need a role model to make my process of information exchange more efficient. References Barbour, J. & Lammers, J. (2007). Health care institutions, communication, and physicians’ experience of managed care: A multilevel analysis. Management Communication Quarterly, 21(2): 201-231. Christensen, M. & Remler, D. (2009). Information and communications technology in US Health Care: Why is adoption so slow and is slower better? Journal of Health Politics Policy and Law, 34(6): 1011-1034 Hasselbladh, H. & Bejerot, E. (2007). Webs of knowledge and circuits of communication: Cnstructing rationalized agency in Swedish Health Care. Organization, 14(2): 175-200 Heslo, L., Howard, A., Fernado, J., Rothfield A. & Wallance, L. (2003). 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Willingness to try a new communication technology: Perceptual factors and task situation in a health care context. Journal of Business Communication, 41(1): 5-26. Read More