This assessment provides a guided review of nominated literature on qualitative and quantitative studies. It explores the aim and significance of the studies, the methods used, data collection and analysis, and the findings and limitations of the studies.
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Assessment 2 Assessment 2 Guided Review of nominated literature Guided QuestionQualitative StudyQuantitative Study 1.Aim and Significance a. What was the aim and significance of the study? The objectives are the specific actions to be accomplished to achieve the study problem (Polit,2016).Inthis study,theresearchers have stated an achievable aim as ‘to explore the experiences and perspectives of nurses on controlling/preventingtheerrorsrelatedto medicationadministration’whichisclear, highlyrelevantandacceptabletoresearch question (Iverson, 2014). AccordingtoGill(2012),thenurse’s adherencetomedicationsafetypractices seemstobeagreatproblem(Raban& Westbrook, 2013), while only a little evidence is available regarding the experiences as well In this study, Sahay (2015) has identified theaim as‘to investigate the association between the work-placesupports&relationshipsandsafe medication practices among Graduate nurses’, which can help to solve the study-problem as advisedbyBoswell.(2017).Thegivenaimis clear, concise, not too long or short,appropriate and is based on purpose. Thestudy’ssignificanceincludein-spiteof advancingawarenessaboutthebenefitsof positiveworkareasupportsaswellas relationships, un-supportive and highly-disruptive work area behaviors are wide-spread in health organizations. Specifically, the Graduate nurses 1
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Assessment 2 as perspectives of nurses in preventing the medicationadministrationerrors(MAEs)& applyingsafetypractices.Moreover, knowledgeoftheseexperiences& perspectivesishighlyessentialfortailoring medication-safetypracticestoexperienced barriers as well as facilitators & realizing an appropriate level of implementation. This has motivated the researchers to learn more about the nurses’ experiences and perspectives on preventing MAEs. whoarenewjoinerstoworkareaaremore vulnerableinun-supportivework-environments andwithincreasedriskformedicationerror. Hence, they have proposed this study with an aim as to investigate the effect of work-place supportsaswellasrelationshipsonsafe medication practices.. 2.Methods a. Identify the research design used in the study and was it appropriate for the Smeulers (2014)has utilizedexploratory research design under qualitative type to obtain in-depth perspectives in controlling/preventing MAEs.Qualitative They have adoptedsurvey based exploratory as well as descriptive study- designto investigate the effect of work area supports with relations on safe medication practices. Sahay (2015) has 2
Assessment 2 issue discussed?research is a systematic, interactive and subjective design that is used to describe life experiences that include disabilities, discomfort and difficulties and give them a meaning (Polii, 2016). It promotes the understanding of ideas, facts, opinions, motivations and explores the human experiences (Yin, 2015,Merriam, 2016). Moreover, qualitative design seems to be highly effective method than quantitative design for studies that investigate the emotional responses of individuals. According toGrossoehme (2013), it focuses on discovery and understanding of the subject as a whole and is consistent with the holistic philosophy of nursing.Qualitative research usually associate conducteddescriptive study under quantitative type of a larger sequential mixed methods study. The text suggests that little information known about effect of work area supports and relationships & safe medication errors and many variables requiring newly framed measures has motivated them to utilize survey-based exploratory with descriptive design which is acceptable(Curtis, 2013). This design has given the chance to revise new measures and promote understandings of the variables, as given byHenly(2016). Quantitative research is a formal, systematic and objective process in which numerical data are used to obtain information (Polit, 2016). This method is considered as superior to other methods as it aid 3
Assessment 2 with naturalistic way of inquiry that intends to analyse the problems of human complexities by deeply exploring it This exploratory approach enables investigating the selected personal experience in a holistic and in-depth way by using a rich narrative data. In this study, the researchers have employed the qualitative exploratory design through semi- structured interview technique to explore the experiences and perspectives of nurses on preventing MAEs (Smeulers, 2014). This indicates that the givenqualitative exploratorydesign is adequate to achieve their objective and findsolutions. to obtain information, describe variable, examine relationship between variable and determine cause and effect interactions between variables. Therefore, this particular design can address the medication-based errors and can investigate the influence of work area supports & relationships on safe medication practices. b. Discuss the samplingThe researchers have employedpurposiveAccording toGrossoehme (2013), the selection 4
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Assessment 2 technique, inclusion and exclusion criteria used for the selection of sample in the study sampling technique to obtain a broad perspective on the subject (medication safety practices) from both the management as well as the operational level nurses. Grove (2015) has given that purposive technique is a judgmental non- probability sampling technique that aids in the voluntary selection of samples through personal judgment. In this study, the researchers have purposely selected the subjects by carefully judging them as the representative of the target population with knowledge about the research problem, which is highly adequate as advised by Polit (2016).Smeulers (2014) indicate that 2 researchers have contacted thenursing managers, quality- and safety- innovators, and of appropriate target population and sample is highlycrucial for a good research study.The researchershaveusedconveniencesampling technique to select the aggregate of subjects from target population with 58 graduate nurses in two selected Australian States.The use of conveniencesamplingmethodthatinvolves selecting the most readily available samples for the study, whichis appropriatefor this study (LoBiondo-Wood,2014).Thiscancreate sampling bias as it intends to select only those subjects who are interested to participate. It is highlyimportanttoselectparticipantswithin inclusion and exclusion criteria.According to Polit (2016), eligibility criteria has to be identified before commencementasproper selectionof 5
Assessment 2 nursing ward managers through e-mail with a request to participate in this study on effective practices to enhance medication safety.They have also adoptedSnowball sampling technique to obtain the names of nurses from other departments, representatives of training & seniority levels and other differing attitudes on practices of medication safety. Eligibility criteria are the criteria that designate particular attributes of the target population by which samples are selected to involve in the study (Polit, 2016). According to Grove (2015), inclusion criteria are the characteristics that the participants should possess while the exclusion criteria are the characteristics that the samples should never possess. It is inclusion and exclusion criteriacan promote the validity (external and internal) of the findings, enhanceitsfeasibilityandcontrolsbias(Yin, 2016).LoBiondo-Wood,(2014)statedthat appropriaterecruitmentcanimprovethe homogeneityoftherecruitedsamplesby effective control of confounding variables. The researchers have included the recent Graduate nurses who were registered within the first 18– 24 months of practice which is adequate based ontheirobjectiveastostudyonlythenew graduates. 6
Assessment 2 evidenced in this study with one eligibility criteria that is kept by the researcher as to be a registered nurse. It seems to be highly adequate for this study that aid in achieving their objective. c.Explore the data collection method and its appropriateness to the research design of the study Smeulers (2014)have collected narrative data to address their research problem by utilizing semi-structured individualized interview technique from the month ofMarch till December 2011, The interview lasted for 60 to 90 minutes(n= 20). Grove (2015) has given that semi-structured interviews are conducted to motivate the samples to express their views within the given pre-structured guidance along with a list of topics. In this study, the researchers have adopted this interview The researchers have gathered numerical data by appropriate data collection process (Grove, 2015).The authors have selected the subjects through the databases of newly joined nursing graduates duates graduates from 3 selected Australian universities with 1425 fresh nursing graduates; 30% having active university e-mail accounts. At- first, they have opened the survey link in e-mails of administrative-staffs at each university; without direct involvement in which 58 has only completed the survey and with large 7
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Assessment 2 technique with a topic list that contains the plan of revisions in medication practice, potential barriers with facilitators, involved professional’s characteristics as well as the social with organizational context. It is effective than un-structured type as it goes un-planned while structured with a strict interview schedule, which may not allow the interviewer to obtain appropriate results and too may not suit this exploratory study and hence semi- structured technique is adequateIn addition to that, qualitative studies intend to study the relevant issues more naturally by in-depth exploration (Poli,2016). These studies strive to elicit a detailed, complete and in-depth description about the selected issues, non-responders. Though online survey method is acceptable, a large number of non- responders, shows that they could have improved their data collection method.. 8
Assessment 2 particularly the core of the problems and the evolved circumstances.The study-researchers have employedsemi-structured interview methodto trace the nurse’s perspectives on preventing MAEs. 3.Data analysis and results a.How was the data analysed and was it appropriate for the study? According to Polit (2016), qualitative-data analysis involves organizing and interpreting the gathered data to obtain results. The researchers have coded interviews independentlyafter each interviewusing MAXQDA10- software and has compared codes and too discussed the results until consensus was achieved on coding tree. Smeulers (2014) has developed most relevant themes about the experiences & perspectives In this study, Sahay (2015).has downloaded the survey data from the Qualtrics online platform that was posted on the University’s website and analyzed through SPSS version-20. They have run the descriptive statistics on the complete set of information to note logical graduate-responses and identify the extent of missed data. They adopted frequency distributions (mean and standard deviations) and Spearman's correlation as given byGerrish(2015), which is highly 9
Assessment 2 of nurses in preventing MAEs and has sorted well & analyzed. Meanwhile 2 co-authors have peer-reviewed the findings to get appropriate results. They used aappropriate data analytical methods to organize and structure data, elicit meaning to frame themes as advised by Polit (2016). . appropriate for a quantitative study. b.What were the findings/results of the study? They have identified three themes as: (1) the roles & responsibilities of nurses in medication safety: despite safe preparation & administration, the clinical reasoning is vital for medication safety; (2) Ability of nurses to work safely: knowledge regarding risks & nurse’s working area influence their ability to work safely; & (3) Acceptance of safety practices by nurses: feasibility, appropriateness and The adopted Spearman's correlations suggested that un-supportive workplace relationships were inversely related-to graduate-nurse-caused medication errors and destruction of safe medication practices, conversely supportive Nurse Unit-Manager & work-team relationships have positively influenced the graduate-nurse’s safe medication practice 10
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Assessment 2 advantages, are crucial for acceptance of safe practice. c.Discuss the limitations and recommendations of the study? They have carried-out this study in a single University setting alone which questions teh reliability of study findings. They have recommended the nurses to conduct future study on further exploration of the extensive nurse’s roles with powerful incentives. The studies can be conducted for physicians and pharmacists as they may provide a broad perspective on the role of nurses in medication safety. They have used online survey method through University e-mails to access the recent graduate accounts which is a major limitation as a considerable period of time had elapsed since graduation. Additionally, use of convenience sampling technique, self-reporting technique, and lack of information on non-responders can introduce major bias that may alter the study findings. They could have increased the sample size to generalize the results but has given smaller samples. It is supported by Johanson and Brooks (2010) that the samples greater than 50 is enough to avoid bias in standard error estimates and 30 samples from a representative 11
Assessment 2 population of interest is a minimal recommendation for an exploratory survey. The authors recommend that these findings can be tested through hypotheses by adopting a large scale study which could inform the development of undergraduate and continuing education programmes. 12
Assessment 2 References Boswell,C&Cannon.(2017).Introductiontonursingresearch-IncorporatingevidencebasedpracticeRetrievedfrom https://books.google.co.in/books?id=nsQwCwAAQBAJ&pg= PA312&dq=Polit+tools+in+research&hl=en&sa=X&ved=0ahUKEwj6xdOJmpHbAhUBKJQKHYLMBKQQ6AEIXzAJ#v=onepa ge&q=Polit%20tools%20in%20research&f=fal Curtis, E. A., & Drennan, J. (Eds.). (2013).Quantitative health research: Issues and methods.Maidenhead, United Kingdom: Open University Press. Gerrish, K., & Lathlean, J. (2015).The research process in nursing(7th ed.). Malden, MA: John Wiley & Sons. Gill, F., Corkish, V., Robertson, J., Samson J., Simmons B. &Stewart D. (2012). An exploration of pediatric nurses’ compliance with a medication checking and administration protocol.Journal for Specialists in Pediatric Nursing,17 (2), 136–146. Grossoehme, D.H et al. (2013). "I honestly believe God keeps me healthy so I can take care of my child: Parental use of faith related to treatment adherence:Journal of Health Care Chaplaincy.19(2):66–78.doi: 10.1080/08854726.2013.779540 Grove, S. K., Grey, J. R., & Burns, N. (2015).Understanding nursing research: Building an evidence-based practice(6th ed.). London, United Kingdom: Elsevier Henly, S. J. (2016).Routledge international handbook of advanced quantitative methods in nursing research. New York, NY: Taylor & Francis. 13
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Assessment 2 Iverson, K.M. (2014). Women veterans’ preferences for intimate partner violence screening and response procedures within the Veterans Health Administration.Research in Nursing and Health,37, 302-311 Johanson, A.G & Brooks, P.G. (2010). Initial scale development: sample size for pilot studies,Educ. Psychol,70 (3), 394–400. LoBiondo-Wood, G & Haber, J. (2014).Nursing Research: Methods and Critical Appraisal for Evidence-Based.Retrieved from https://books.google.co.in/books?isbn=0323100864 Merriam, S. B., &Tisdell, E. J. (2016).Qualitative research: A guide to design and implementation(4th ed.). San Francisco, CA: Jossey-Bass. Polit, D.F & Beck, C.T. (2016).Nursing Research: Generating and assessing evidence for nursing practice. Lippincott Williams & Wilkins: New Delhi. Raban M.Z. & Westbrook J.I. (2013) Are interventions to reduce interruptions and errors during medication administration effective?: a systematic review. BMJ Quality & Safety. doi:10.1136/bmjqs-2013-002118. Sahay, A., Hutchinson, M., & East, L. (2016).Exploring the influence of workplace supports and relationships on safe medication practice: A pilot study of Australian graduate nurses,Nurse EducationToday,35, e21-e26 Smeulers, M., Onderwater, A. T., Zwieten, M. C. B., & Vermeulen, H. (2014).Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study,Journal of NursingManagement, 22, 276-285 Yin, R.K. (2015).Qualitative Research from Start to Finish. Retrieved from https://books.google.co.in/books?isbn=1462521347 14