(PDF) Improving the quality of nursing documentation

CRITICAL EVALUATION
OF A RESEARCH ARTICLE

Research is one of the most important part of nursing as it helps in defining nursing
interventions and decision-making. Research also helps in improving current nursing practises,
regularly update knowledge and skills of the nurses through updated clinical practise guidelines.
A practise that relies on decision-making and evidence is known as Evidence based practise.
Today in nursing most of the time deviance based nursing is only used (Salomé & Ferreira,
2018). This research paper helps in solving obstacles in order to deliver patient centred care and
clinical practises. It has also focused on highlighting strengths and weakness of the study.
Critical Evaluation also helps in determining the credibility of the study. The main
purpose of this essay is to evaluate an article "Effects of a home care mobile app on the
outcomes of discharged patients with a stoma: A randomised controlled trial" (Wang & et.al.
2018). Critical evaluation of this research article will help in evaluation of article by evaluating
its main strengths, weaknesses and limitations.
According to Yang & et.al., (2016) article title specifies the topic clearly which is
required to be studied. Not only this article title should be specific and detailed in nature. The
above mentioned research article well-structured as it is a quantitative evidence based research
article which helps the reader to understand what has been researched.
In order to understand the research topic it is important to understand the trsearch title
and abstract of the research. It also helps the search engine to easily identify the research article.
According to Soffer, (2016) abstract provides a quick overview of an article. It helps in outlining
complete article, introduce the subject, targeted research etc. Patients with stoma might face
various kinds of difficulties especially after surgery. Use of home care mobile application can
make it much more easier for patients to adjust into their new life, accept all the changes and
adjust as well as manage with their diseases. It is one of the most efficient way to ensure
continuity of care. But there are many effects of these home care mobile applications in both
positive and negative manner upon discharged patients with stoma. Abstract of this article
represents journal article itself.
Introduction
As per the view of Salomé & Ferreira, (2018) introduction helps in makinf the reasers
understand what the article is about and what kind of details will it lay emphasis on. All the
authors of this research article were well qualified and experts in their own fields. The main
purpose of this research paper is to find effects of a home care mobile application on the

outcomes of discharged patients with a stoma. This research paper was not at all factual in fact a
proper study was carried out on various patients of different stoma types and cancer patient r
(Wang, et al. 2018). This research paper provides evidence that helps in supporting nurse led
follow-ups using mobile applications i.e. whether mobile apps are effective and efficient enough
to improve stoma related outcomes, self efficiency and psychosocial adjustments of discharged
patients. This research paper also helped in understanding that mobile phone technologies are a
part of transitional care which helps in delivering psychosocial interventions to stoma patients.
Background of the research paper helps in relating significance of research paper to the
study topic. It helps in studying the latest proposal and former work. According to Wand & et.al.,
2018, no study had been conducted on permanent stoma patients that can be compared. In this
study all the complications faced by stoma patients had been discussed and how with the help of
mobile app it can be solved.
Demirci & et.al., (2018) says that aim of a research study helps in relating the results of
the study with its title or desired outcome. The main aim of this study is to check the e ffects of a
home care mobile app on the outcomes of discharged patients with a stoma: A randomised
controlled trial (Wang & et.al. 2018).
Literature review of a research article helps in justifying all the research questions,
identifying research paper importance as well as provides a general background description of
research topic (Salomé & Ferreira, 2018). This chosen article does not have a literature review
article as it does not have any kind of research questions.
Soffer, (2016) explains that methodology of a research paper helps the readers to
understand what all methods have been used within the study in order to achieve all the desired
aims and objectives of the study. It also helps the readers to understand methods used within
research paper clearly. Wang, et al. (2018) in this research paper used single-blind, randomised
controlled trial research design i.e. all the participants were randomly assigned with routine
discharge care which was provided to them either through home care mobile app or through
outpatient follow-ups. All the participants who participated within the study were randomly
assigned into two groups i.e. control group and intervention group. The two intervention groups
i.e. control group and home care mobile application intervention group patients were observed in
a detail manner for accurate results. Out of these 203 patients 103 patients received routine
discharge care and other 100 patients received home care via mobile application which was

completely based on routine care. Data collected done by the researcher for this study was
completed even before completion of discharge baseline and after completion of discharge after
1, 3 or 6 months. For main outcomes of patients were measured i.e. clinical and demographic
characteristics, stoma self efficiency, psychosocial adjustments and stoma related complications.
All the data collected from the participants was analysed using quantitative data analysis method
using SPSS statistics. Data was collected from two interventions of people explained above. All
the control group patients of all 10 hospitals were given similar routine care. After getting
discharged all the patients were given teaching information and support such as drug
instructions, proper use of appliances, health education and continuous follow-ups with the
nurses. At each follow ups needs of patients and stoma were accessed. Other than this, such
patients were also provided with practical information related to stoma self care. After discharge
all the control group patients clinical and demographic characteristics, stoma self efficiency,
psychosocial adjustments and stoma related complications were recorded after getting
discharged. All the participants in intervention groups were given same routine care like control
group. But other than this those patients and their family members were taught ways to use home
care mobile application before getting discharged.
All the patients who met the study criteria were invited to participate within the research
study. All the participants were provided with both oral and written study explanations. All the
participants were explained all the requirements of the study and were also explained that their
decisions didn't affect the routine care they would be provided with. All the voluntary
participations of the study were asked to provide their standard demographic information. All the
patients in intervention groups were asked to access their mobile phones and install home care
mobile application.
Using SPSS statistics within windows all the data collected were analysed by the
researcher. SPSS version used for this analysis was 22.0 (Symer & et.al. 2017). All the data were
tested using Cronbach’s alpha coefficients so that reliability of the scales can be tested. In order
to describe all the variable outcomes descriptive statistics were used. Clinical and demographics
of intervention patients were compared and controlled using Student’s t test, Mann– Whitney U
test, chi-square test, or Fisher’s exact test as per their appropriateness. in order to examine the
data, whether it provided normal distribution or not Kolmogorov–Smirnov test was used.
Student’s t test or Mann–Whitney U test had been used to check the differences between

normally distributed continuous variables of two groups. These test were based on the results of
homogeneity variance test. Chi-square/Fisher’s exact test were used to compare results of
Categorical variables of both the groups. ANOVA variance analysis was used to explore
between-group, within-group and interaction effect.
Result section of a research paper helps in analysing found outcomes of the study
(Salomé & Ferreira, 2018). It is discussed in theoretical form by referring key findings. From the
analysis done within the research study it was observed that there was no significant differences
in the baseline characteristics between the two groups. From the analysis, it was observed that
there is no significant difference in ostomy psychosocial adjustment scores between the
intervention and control groups. As per the research study it was also observed that there is no
significant difference between both the groups at baselines. Outcomes of the research study was
mainly focused on demographics of the study. All the characteristics of participants baseline was
mainly related to their age.
Discussion is one of the most important part of any research study. It helps in giving
meaning to the research article as it help in explaining results, discuss them, compare them and
then based on those results finds out all the limitations of the research. It should be clear and
should support all the research questions and hypothesis of the research paper (Wang & et.al.,
2018). Discussion part of any research paper also helps the researcher to compare other
researchers research papers and if they have any kind of suggestions related to the research.
Study explains that stoma patients with weekly planned group meetings with nurses had better
ostomy adjustment and received psychological support effectively. As per the previous studies it
was observed that patients with planned meetings with nurses received better psychosocial
support effectively (Ling & et.al. 2017). According to the semi structured interview, stoma care
problem was solved and time period was shortened by continuous telephone follow-ups. Other
than this it was also observed the stoma complication within mobile application intervention
group was also lower as compared to control group. As per this study it was also observed that
patients who were constantly in touch with nurses through telephones received less stoma
complications. This results shows that intervention group using mobile application received
better and timely transitional care rather than control group. This was mainly because of the
mobile application used by the patients as they were able to access the app easily, upload their
photographs and required information through mobile app which was received by the nurses.

Ethics of a research paper includes approvals which helps in conducting the research. In
order to peruse and complete the research study, researcher took ethical approval from Jiangsu
Province Hospital Ethics Committee (Yang & et.al. 2016). Researcher also protected privacy of
all the participants with the help of non identifiable information. Other than this all the
participants who participated with the study provided with informed consent.
All the limitations of the research article should be pointed out clearly and should be
defined in a clear and specific manner for the readers. There were various kinds of limitations
within the research paper study that were described below. One of the main challenge faced by
the patients who lacked knowledge and experience with mobile applications or smart phones.
There were many issues that were faced by nurses in terms of privacy of personal information of
patients. Other than this there was a probability that patients might ask to change the type of
intervention they were receiving as they were made aware about the type of intervention they
were receiving.
Conclusion of a study helps in discussing the implications and results of the study but
does not introduce any new things. Wang, et al. (2018) concluded that home care follow-up with
the help of mobile app can efficiently and effectively improving self efficiency scale, psycho
social adjustment level and various others' outcome results of stoma patients. Wang, et al. (2018)
has also derived some notations, limitations and clinical practise in this. He strongly supports use
of mobile applications post discharge of stoma patients. It was also observed that as the
application was easy to use, it was easily performed by the caregiver as well as by the patients
themselves. As compared to the treatment given to control group, this treatment was quite
convenient, lower in cost and also supported the patients even after their treatment. It was also
analysed that confidence of intervention group patients was quite good, their self care ability was
getting improved.

REFERENCES
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Ling, W. U., & et.al. (2017). Application of home care mobile app in discharged patients with
permanent enterostomy in Jiangsu Province. Chinese Journal of Nursing. 52(10). 1192-
1194.
Salomé, G. M., & Ferreira, L. M. (2018). Developing a Mobile App for Prevention and
Treatment of Pressure Injuries. Advances in skin & wound care. 31(2). 1-6.
Symer, M. M., & et.al. (2017). A mobile health application to track patients after gastrointestinal
surgery: results from a pilot study. Journal of Gastrointestinal Surgery. 21(9). 1500-
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Wang, Q. Q., & et.al. (2018). Effects of a home care mobile app on the outcomes of discharged
patients with a stoma: A randomised controlled trial. Journal of clinical nursing. 27(19-
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Yang, F., & et.al. (2016). The Development and Evaluation of Delirium Assessment and Nursing
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Soffer, A. K. B. (2016). Situating beyond the social: understanding the role of materiality in
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