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Research Critique

Describe about the Evidence Based Nursing Research for Business Research Study.

A research critique is a professional analysis of the strengths and weaknesses of a research study. It is the unbiased, systematic and careful examination of all the aspects of a research study for judging its significance, meaning, limitations and merits based on the previous knowledge and experience of the topic (Polit & Beck, 2013). There may be several purposes for carrying out a research critique. It can act as an expert reviewer for the assessment of the research paper regarding its publication, it helps to provide helpful comments regarding the research work prior to its submission for publication and it can act as a learning experience for the emerging scholars for the development of their research skills (Parahoo, 2014). The analytical and methodological skills of the student are assessed by a research critique and broaden the understanding of its application in practice. The critique is done by emphasizing the similar elements as the part of research design followed by the evaluation of the research work by the author (Borbasi &  Jackson, 2012). Complete critique includes the data analysis and comments on its appropriate interpretation and implementation (LoBiondo-Wood & Haber, 2014). In this essay, two research articles will be critiqued one of which is a qualitative study and the other is a quantitative study considering the research framework.

The first article is a research study by Jeffery & Pickler (2014) titled ‘Barriers to nurses’ adherence to central venous catheter guidelines’. The research study is a qualitative study that included a descriptive phenomenological method that involved ten participants. Data collection was done by interviewing and the data analysis was done by Colaizzi’s method. The aim of the research was the exploration of the perceived barriers of the nurses for adherence to the standard care practices of CVC (Central Venous Catheter). Key finding of the study suggested that adherence barriers have the potential for producing errors and limits the nurses from providing care of high quality.

The research process employed by the researchers and the general credibility explored the perceived barriers of the nurses in an explicit manner. The researchers have carried out the interview process for data collection as it would give the best description of the perception of the nurses and what made them deviate from the accepted norms. Any other tool for data collection would not have provided a better way to understand the perceived barriers (Dougherty & Lister, 2015). It has been reflected in the study findings as well where various factors emerged in the form of cognitive barriers and contextual factors that were later connected with the major theme of the study. From the study findings, it can be stated that the authors could have emphasized a bit more on the role of the institutions in facilitating the barriers faced by the nurses and that would have provided a clearer picture of the problem. Apart from this, the study has been well linked and coherent in its research process. The introduction of the study exhibits a statistics that states the number of patients dying every year in the hospitals due to errors is itself a clear demonstration of the fact why nurses should adhere to the guidelines of the standard care practices and their role in the reduction of errors. The authors have also mentioned the interventions that have been implemented to reduce the errors and how they have been ineffective in reducing errors states the rationale of the study or the necessity to understand the perceived barriers of the nurses. Perceiving the barriers can certainly help in advancing the knowledge in reducing errors and increasing patient safety (Sandrucci & Mussa, 2014). The background of the research provided statistical information on the infections occurring annually in the US hospitals and estimated the cost range. A thorough review of the cited articles has been carried by the researchers with the logical development of the rationale and understanding of the study. There has been an integrated review of each of the articles and the researchers identified the gap between the practice and knowledge of the nursing profession and the individual nurses. It was explored from the literature review that the researchers have not only nurtured the study findings, but also the research methods in the articles to determine how effective they have been to find out the perceived barriers by the nurses and identify the existing gaps in the current knowledge and understanding. The discussion of the study analyzed the results of the study along with their implications and limitations. The results of the study have been linked with the other studies reviewed in the background section that helped to identify the variables like staffing, resource availability, documentation and time demands. With the analysis of the results, the authors have identified that the nurses are aware of the barriers to standard care and have rationalized their non-adherence through cognitive strategies. Apart from the strength, the found weakness was the limitation of the study that has been acknowledged appropriately with recommendations for further research. Implications of the study have also been discussed which increased the study validity and the implications have been proposed considering the complex healthcare environments for their practical implementation. The improvement efforts proposed by the researchers are focused on the individual and the system and how they can be addressed in the future research that widened the scope of the study and made it more practice oriented.

Qualitative Study: Adherence Barriers of Nurses in Central Venous Catheter Guidelines


The second study is a research article by Storey et al. (2016) titled ‘A comparative evaluation of antimicrobial-coated versus non-antimicrobial coated peripherally inserted central catheters on associated outcomes: A randomized controlled trial’. It is a quantitative study that involved the 167 patients from three high-risk units who were randomly assigned for receiving either a non-CHG PICC or a CHG impregnated line. Data collection was done in the form of laboratory data with daily reviewing for all the study patients. The study aimed at comparing the outcomes of the CHG and non-CHG lines on the development of VTE and CLABSI and the study findings revealed that no significant differences were observed in the development of VTE and CLABSI with the use of both the lines.

The general credibility of the research process can be stated by saying that the research process clearly investigated the research aim of the study. This is evident from the fact that the researchers established a clear and consistent link between the research aim and study findings as the study aimed to explore the impact of both the PICC lines on the development of complications and the findings suggested no significant differences between the both the lines for the development of the complications. These indicate the coherence that the researchers maintained throughout the study for providing a credible understanding of the research aim with the application of the interventions for the establishment of the research hypothesis. The researchers discussed the post-insertion bleeding as a side effect however, no intervention was suggested for avoiding or lessening this bleeding which could have made the study more realistic and safety oriented. Introduction of the study gives a clear demonstration of the infections related to catheters and the importance of CVC in the management of the patients who are acutely ill. The researchers have provided statistical evidence for the occurrence of CLABSIs in the hospitals of US annually and the need for reduction of CLABSIs for the improvement of patient safety and reduction of healthcare costs. This clearly explains the problem outline and the purpose of the study that the researchers investigated as a randomized controlled trial. In addition, the rationale for taking up the study has also been specified by the researchers considering the widespread severity and expenditure of the infections due to the catheters which are peripherally inserted. Comparison of the impact of the PICC lines on the outcomes stated the role of the CHG PICC lines in the development of infections and this contributes towards the advancing knowledge for the prevention of infections with the applied lines by adopting the necessary precautions (Diggery, 2012). The literature review thoroughly reviewed the articles for demonstrating the risk factors for the development of the infection and identification of the patients who are susceptible to the development of infection. A logical development of the understanding of the topic in accordance with the current knowledge has been developed by the researchers and this is evident from the fact that PICC lines present challenge in the clinical practice due to the development of complications (Lapp & Krakau, 2014). Therefore, it is essential to identify the impact of non-CHG and CHG groups on the development of complications and their subsequent prevention. This directly relates the review to the research problem and from the review, gaps have been identified by summarizing the research publications. The discussion carried out by the researchers included the development of CLABSI, VTE and post-insertion bleeding. This provided a detailed examination of the study findings and related them with the findings from another study for the development of knowledge. The strengths and limitations of the study have also been discussed with the identification of the study variables which provided the scope of prevention of infections due to PICC lines in future. On comparing the study design with other studies, the researchers found that this study had a lesser susceptibility to bias as it is more rigorous and therefore, this study extended the present knowledge with the rationale for lesser variation.

Quantitative Study: Comparison of Antimicrobial-Coated and Non-Antimicrobial Coated PICC on Associated Outcomes

Both the articles dealt with CVC (Central Venous Catheter), while one dealt with the adherence to the guidelines by the nurses and development of complications like CLABSI and VTE due to the use of PICC lines. According to the Health Quality and Safety Commission of New Zealand, substantial international experiences have been employed to reduce the infections that are healthcare acquired (Hqsc.govt.nz, 2016). The Commission has provided information for assisting the healthcare staff members for preventing the CVC-related infections. It is evident that the evidence-based guidelines are not followed in New Zealand that brings about diversity in the clinical practice (Holland & Rees, 2010). Therefore, it is essential that the nursing and senior medical staff members review the guidelines for ensuring that the best evidence is made available (Cdhb.health.nz, 2016). The perceived barriers of the nurses have to be diminished for enabling them to adhere to the standard care practices for reducing the blood-related complications of CVC. The knowledge of the nurses can be improved by the betterment of the reliability with the development of a model for ensuring that the patients receive evidenced based interventions (Kidshealth.org.nz, 2016).

From the two research articles, it is evident that safe care delivery is a priority in healthcare and the role of the nurses is of paramount importance. Any carelessness can lead to the development of infection in the bloodstream (Schmidt & Brown, 2012). For preventing this from happening, organizational orientation and formal academic preparation will play a major role in providing with the tools required for safe practice (Polit & Tatano Beck, 2014). Identification of the barriers and eliminating or reducing them can ensure the patient safety of the highest level.

References

Borbasi, S., & Jackson, D. (2012). Navigating the maze of nursing research: Enhancing nursing and midwifery practice (3rd ed.). Sydney, Australia: Mosby Elsevier.

Canterbury District Health Board - Home. (2016). Cdhb.health.nz. Retrieved 31 August 2016, from https://www.cdhb.health.nz/

Central venous catheters. (2016). kidshealth. Retrieved 31 August 2016, from https://www.kidshealth.org.nz/central-venous-catheters

Diggery, R. C. (2012). Catheters: Types, applications and potential complications Nova Science Publishers, Inc.

Dougherty, L., & Lister, S. (2015). The Royal Marsden manual of clinical nursing procedures. John Wiley & Sons.

Health Quality & Safety Commission | Home. (2016). Hqsc.govt.nz. Retrieved 31 August 2016, from https://www.hqsc.govt.nz

Holland, K., & Rees, C. (2010). Nursing: Evidence‐based practice skills. New York, NY: Oxford.

Jeffery, A. D., & Pickler, R. H. (2014). Barriers to nurses’ adherence to central venous catheter guidelines. Journal of Nursing Administration,44(7/8), 429-435.

Lapp, H., & Krakau, I. (2014). Cardiac catheter book (1st ed.). New York: Thieme.

LoBiondo-Wood, G., & Haber, J. (2014). Nursing research: Methods and critical appraisal for evidence-based practice. Elsevier Health Sciences.

Parahoo, K. (2014). Nursing research: principles, process and issues. Palgrave Macmillan.

Polit, D. F., & Beck, C. T. (2013). Essentials of nursing research: Appraising evidence for nursing practice. Lippincott Williams & Wilkins.

Polit, D.F., & Tatano Beck, C. (2014). Nursing research: Appraising evidence for nursing practice. (8th ed.). Sydney, Australia: Lippincott Williams & Wilkins.

Sandrucci, S., & Mussa, B. (Eds.). (2014). Peripherally Inserted Central Venous Catheters. Springer Milan.

Schmidt, N., & Brown, J. (2012). Evidence‐based practice for nurses: Appraisal and application of research (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.

Storey, S., Brown, J., Foley, A., Newkirk, E., Powers, J., Barger, J., & Paige, K. (2016). A comparative evaluation of antimicrobial coated versus nonantimicrobial coated peripherally inserted central catheters on associated outcomes: A randomized controlled trial. American journal of infection control, 44(6), 636-641.

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