1 CRITICAL APPRAISAL OF THE ARTICLE Introduction: Nursing research has emerged as a contributing factor for the development as well as the renewal of patient care. Nursing research is also contributed to the development of nursing education and leadership in clinical practice (Christmals and Gross 2017). Nursing research is the most suitable source of beneficial evidence for patients and communities for involving resolving complex diseases that are intrinsic in nursing and health care (Brooke, Hvalič-Touzery and Skela 2015). In this context, in order to understand the experience of nurses regarding the involvement in nursing research, the article “An ethnographic study of nurses’ experience with nursing research and its integration in practice” by Dupin et al. (2014), has been chosen for critical analysis. After a critical analysis, research findings and the implications for clinical practice will be elaborated in the research.Caldwell framework would be used to critically appraise the article. The rationale behind choosing this tool as a critical appraisal tool is that it enables individuals to develop skills for research evidence and apply them in professional practice (Caldwell, Henshaw and Taylor 2011). Hence, individuals will develop skills of critically appraise diverse evidence. Discussion: Title of the content: Yes. The title of the article reflect the content of the article. The article title, “An ethnographic study of nurses’ experience with nursing research and its integration in practice” suggested that this research will explore the experience of nurses in research and its integration in practice.
2 CRITICAL APPRAISAL OF THE ARTICLE Author credibility: Yes. The researchers are credible because majority of the authors Research Fellow & PhD Student or professor of Human and Social Science Department, Department of Epidemiology, Information Systems, and Modellin , indicating authors were credible. Abstract: Yes. Abstract summarize key points since the article summarize each segment such as Aim, background, design, method, results , implication for practice(Downeset al.2016). The abstract also provide key words for the study. Clarity of the rationale: Yes. It is valuable in the research practice. The majority of nurses are unable to apply critical thinking and innovative intervention for treating the patients due to the lack of evidence-based knowledge and lack of involvement in the research. In this context, this research will provide nursing professionals to involve in the research work in between the nursing practice and alter their professional values so that they can serve the professionals better. Aim: The clear statement regarding the aim of the study was clearly mentioned in the article along with the abstract of the article. The aim of the study conducted by Dupin et al. (2014) was to report the experience of French registered nurses regarding the involved nursing research in their clinical practice.
3 CRITICAL APPRAISAL OF THE ARTICLE Literature review: Yes. The literature review is up to date since researchers consider approximately 10 years of peer reviewed journal to conduct literature review (1995-2013). Ethical consideration: The researchers mentioned the ethical consideration in the article for conducting the research. The study was performed according to the ethical guideline of the Declaration Helsinki. The research work was approved by the oncology hospital’s head of nursing care (Dupinet al. 2014). The verbal, as well as written informed consent, was obtained from all the participants who were participating in the research. Methodology and research design: The qualitative research design was considered in this case for underpinning the experience of French nurses regarding the involvement in nursing research in clinical practice. Gelling(2015),suggestedthatforexploringpersonalvalues,beliefs,andeventsofthe population, the qualitative research design is appropriate that enable researchers to look deeper into the attitude and feelings. It also encourages participants to expand on their responses that can address the area which was not previously considered (Melendez‐Torres, Grant and Bonell 2015). Hence, qualitative methodology is appropriate for conducting this research. Hypothesis: No.
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4 CRITICAL APPRAISAL OF THE ARTICLE No Hypothesis was proposed in the research.The researchers explored how French Registered Nurses experience and engage in nursing research in clinical practice, indicating thatthe researchers explored nursing experience rather than hypothesized system. Variables: Yes. Since no hypothesized were proposed research, no key variable is present in the research. Population: Yes. The researcher’s undertaken ethnographic approach for underpinning the experience of the French registered nurse in involving in the nursing research. Christmals and Gross (2017), highlighted that in order to gain an understanding of the real-life experience of the study participants in their real-life setting, the ethnographic approach is the most suitable approach. Hence,atthisjuncture,theethnographicapproachisthemostsuitableapproachfor understanding the experience of the French nurse (Knauft 2019). In this study, Hammersley and Atkinson’s (1994) description of ethnography was used which was grounded in the field of social research and intended to explore the social events through interpretation and description (Leeet al.2015). Sample and inclusion criteria for selection: Yes. The setting of having registered nurses working in the teaching hospital situated in France was considered for the study participants (Voldbjerget al.2016). The requirement for recruiting the nurses was registered nurses associated with anesthesia, pain control, intensive care unit, the surgery, radiotherapy and medical imaging. The researchers also considered their
5 CRITICAL APPRAISAL OF THE ARTICLE clinical activities for recruiting the participants such as working hours 9 am to 6 pm from Monday to Friday and the schedule of the involved in the research during their clinical practice and consent to participate in the study (Dupinet al.2014). Lastly, four registered nurses were also recruited from the recommendation of the gatekeeper. The researchers suggested that one registered nurse played the role of the gatekeeper in order to recruit the nurses and she became essential in enhancing the RNs engagement in research activities outside the wound care team (Dupinet al.2014). Data collection: Yes. Theinterview,fieldnotesandparticipatory,theobservationwasdonefor collecting the experience of the nurses. The data was collected from the registered nurses of the wound care treatment and daily participatory observation of the wound care team was done for three weeks in between July to August 2012. The researchers used a selective intermittent time model by Jeffrey and Troman to observation the activities.Conroy (2017), suggested that it is the most suitable method since it enabled a flexible approach for the number of field visits along withthetimeduringclinicalactivities.Allactivitieswereconsideredinthiscasefor participatoryobservation.Thesystematicfieldnoteswererecordedonadailybasisby underpinning certain factors such as time, space and verbal exchanges of the registered nurse (Dupinet al.2014). The theoretical notes, methodological notes along with personal notes were also considered where perception and thoughts throughout the filed (Dupinet al.2014). The additional data were collected through interviews for gaining a deeper understanding of the experience of the registered nurses.
6 CRITICAL APPRAISAL OF THE ARTICLE Method of analysis: Yes. Theoneregisterednurseplayedtheroleofthegatekeeperwhofacilitatedirect communication with the registered nurse. While researchers did not mention any additional information regarding the relationship between researchers and participants, the potential bias is present since the gatekeeper recommended the registered nurse and take part in the research activities for participatory observation (Dupinet al.2014). In this case, it might be the case that the values and beliefs of the nurse influence the observation of the participants (Dupinet al. 2014). Moreover, the collected data were assessed after every observation and discussed with researchers, indicating that the researchers may influence the result of the study (Dupinet al. 2014). The presentation of findings: Yes. The researchers mentioned in depth rigour of the research in the article. Reflection was used to handle preconceptions (Cahillet al.2018). The reflection also allowed the researches to distance her from the first impression such as a consideration of probable observer effect along with a break from preconceptions. In order to obtain results that are free from biases and erroneous interpretation, the personal notes were taken in this case as a self-correction of the fieldwork (Dupinet al.2014). The researchers also mentioned that restriction from the constant writing of the field notes allowed the first author to distance from the collection of the information along with diverse feelings and emotions of the participants which can be evoked (Dupinet al.2014). Findings:
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7 CRITICAL APPRAISAL OF THE ARTICLE In the result section and the discussion section, the thematic analysis of the collected data reflected the findings. The result of the study suggested that the experiences of the participants reflected three beliefs such as belong to the unified team along with being an integrated part of crosswise activities supported their role as intermediaries while occupied on connecting the gap between clinical activities and research. On the other hand, other participants suggested that specialist nurses can play an essential role in implementing the research evidence into clinical practice (Dupinet al.2014). They also suggested that the role of nurses as a practitioner and role of nurses as researchers are interchangeable part of their practitioners and it has a strong impact on the patients as well as patent care since it will improve the patient care. In this context, the priority of the health care sector is to support the research work of the registered nurses along with their clinical practice. The researchers also suggested that teams captivating on the role of leaders in the nursing practice are effectively facilitate knowledge transfer along with promoting Evidence-Based Practice directly at the bedside (Dupinet al.2014). The research knowledge and fieldwork, facilitate the connection of the registered nurse with their practice. In this context, in order to nurture the connection between research practice and clinical practice, leaderships from the senior nurses and intensive support are required which can engage the population in an evidence-based practice since nurses consider leadership roles as a positive contribution to the clinical practice. Indeed, the nursing professionals with the higher degree such as doctorate or Ph.D. degree can serve the society better and can involve in the clinical practice as a research educator for empowering other nurses to involve in practice and research (Dupinet al.2014). Connecting the academic programmers with research can be an effective initiative to strengthen the development of the nursing profession (Dupinet al.2014).
8 CRITICAL APPRAISAL OF THE ARTICLE Generalizable of the research: Yes. Since research was conducted onFrench nurses, it is difficult to apply on other population. Other population have diverse experience which is required to explore for implementation of the research findings. Conclusion: The conclusion is comprehensive since researchers summarize the findings such asthe beliefs and culture of these registered nurses hindered them from the shared experience of both activities such as involve in the research experiment and relate it to the situation of the patient. It further enhances its commitment to the research. The providing scholarship to the professionals during their curriculum and to the nurses who are interested in the research work will alter their values, beliefs profession and support nurses to more readily implement EBP. However, the limitation of the research is that the registered nurse who was the researchers and health professionals along with the first author influence the result of the study and they were aware of it. In this context, personal values and beliefs of the professionals influence the result obtained from the themes or collected data. Critical analysis of the findings and implication: The main purpose of nurses, as the frontline professionals, is to serve the need of the society irrespective of gender, race, and ethnicity. The nurses in the clinical setting usually do not have an interest as well as time for involving in the research. Feo et al. (2017), suggested that
9 CRITICAL APPRAISAL OF THE ARTICLE 30–40% of patients in the clinical setting do not receive scientific evidence-based practice and approximately 20–25% of the patients receive unnecessary care. Consequently, the rate of medication errors, neglect, and wrong interventions are very common in the clinical practice which was conducted by the nursing practice and it subject patients in great harm. Hence, this research findings such as involving in the nursing research will empower nurses to involve in the research activities in between their clinical practice (McCaffrey and McConnell 2015). The use of evidence of the research from the research findings can facilitate the efficient as well as effective patient care. The implementation of the research into the practice can reduce deliberate errors such as wrong intervention,negligenceand also can makenursesresponsiblefor individual performance (Mackey and Bassendowski 2017). Using the research findings in the practice not only will improve the excellence and ethics of nursing care, but also can lead to the professional’s development. Similar kind of research result was obtained from the research conducted by Bahadori et al. (2016), where researchers suggested that involve in the research findings facilitate their critical thinking and bring innovation for addressing the unique need of the professionals. However, time is considered as one of the most frequent barriers to involve in the research and implement in the clinical practice. Curtis et al. (2017), also suggested that while heavy workload and shortage of nurses hinders involvement in the research, the involvement in the research develop leadership and the ability to work autonomously. Hence, the research findings are useful in improving the quality of care. The research implies that after gaining an in-depth understanding of the benefit of the research, the professionals will be interested to involve in research (Barker and Linsley 2016). This research will provide a road map to the management and leaders of the health care sector to develop academic programs and educational curriculum that facilitate involvement (Uny, France
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10 CRITICAL APPRAISAL OF THE ARTICLE and Noblit 2017). It will also enable the recruitment of nurses for the distribution of workload so that they can involve in the research for a long time.
11 CRITICAL APPRAISAL OF THE ARTICLE References: Bahadori, M., Raadabadi, M., Ravangard, R., and Mahaki, B. 2016.The barriers to the application of the research findings from the nurses' perspective: A case study in a teaching hospital.Journal of education and health promotion,5, 14. Barker, J. and Linsley, P., 2016. Critical Appraisal and Qualitative Research.Evidence‐based practice for nurses and healthcare professionals, pp.110-125. Brooke,J.,Hvalič-Touzery,S.andSkela-Savič,B.,2015.Studentnurseperceptionson evidence-based practice and research: An exploratory research study involving students from the University of Greenwich, England and the Faculty of Health Care Jesenice, Slovenia.Nurse education today,35(7), pp.e6-e11. Cahill, M., Robinson, K., Pettigrew, J., Galvin, R. and Stanley, M., 2018. Qualitative synthesis: a guide to conducting a meta-ethnography.British journal of occupational therapy,81(3), pp.129-137. Caldwell, K., Henshaw, L. and Taylor, G., 2011. Developing a framework for critiquing health research: an early evaluation.Nurse education today,31(8), pp.e1-e7. Christmals,C.D.andGross,J.J.,2017.Anintegrativeliteraturereviewframeworkfor postgraduate nursing research reviews.European Journal of Research in Medical Sciences Vol,5(1). Christmals,C.D.andGross,J.J.,2017.Anintegrativeliteraturereviewframeworkfor postgraduate nursing research reviews.European Journal of Research in Medical Sciences Vol,5(1).
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13 CRITICAL APPRAISAL OF THE ARTICLE McCaffrey, G. and McConnell, S., 2015. Compassion: a critical review of peer‐reviewed nursing literature.Journal of Clinical Nursing,24(19-20), pp.3006-3015. Melendez‐Torres, G.J., Grant, S. and Bonell, C., 2015. A systematic review and critical appraisal of qualitative metasynthetic practice in public health to develop a taxonomy of operations of reciprocal translation.Research synthesis methods,6(4), pp.357-371. Uny, I., France, E.F. and Noblit, G.W., 2017. Steady and delayed: explaining the different developmentofmeta-ethnographyinhealthcareandeducation.Ethnographyand Education,12(2), pp.243-257. Voldbjerg, S.L., Grønkjær, M., Sørensen, E.E. and Hall, E.O., 2016. Newly graduated nurses’ use of knowledge sources: a meta‐ethnography.Journal of advanced nursing,72(8), pp.1751- 1765.