Activities to Manage Aggressive Patients in the Emergency Department

Activities of registered nurses managing aggressive service users within the emergency department were studied to understand their perception regarding this issue. It is crucial for nurses to effectively manage aggressive behavior, as it directly impacts their activities and patient care. The study aimed to attain this understanding by assessing the perception of registered nurses towards managing aggressive service users in the emergency department.

The use of models and
theories in nursing practice
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The nursing theory is defined as the set of concept as well as disciplinary actions that
determine when the nursing is needed as well as what are the goals and objectives of the nursing
therapeutic activities. The present essay focuses on performing critique of the two different
articles that are based on the practices of nursing in the different region. Along with this, both the
articles focuses on qualitative and qualitative study in the field area of nursing. It focuses on
critique both the research articles on the basis of different research aspects.
Article 1- Prevalence of overweight and obesity among the nurses in Scotland: A cross-
sectional study using Scottish Health Survey
It focuses on critiquing framework aspects that is best used in conducting the quantitative
research articles. The different aspects are enumerated as follows-
Focus
Through reviewing the quantitative study it been focuses that topic of the article focuses
on understanding the key ratio of the nurses within the Scotland that are diagnosed with the
obesity and overweight problem. The key measurable variables within the article is ratio of
obesity and overweight among the individual. It has been also assessed that topic is significant
for the researcher as it assists in gaining the adequate information regarding the overweight
nurses so that they can engage in the activities and practices that support in lowering their ratio
in the Scotland.
Background
The key background of the article include increasing ratio of overweight and obesity is
consider as global epidemic that need to be addressed properly so that they can overcome this
ratio. As per the view of () in the present context there is increase in the ratio of individual that
possess the obesity and overweight therefore, it is required by the occupation groups existing in
the international healthcare system to engage in the activities so that they can minimize the ratio.
Furthermore, it is also stated that it is significant for the researcher to estimate the prevalence of
obesity and overweight among the nurses. Furthermore, it has been also evaluated that form the
previous studies reinforcing this topic is essential for the researcher as it support them in gaining
the adequate knowledge and information regarding the topic.
Aim
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The key aim of the study is to estimate or examine the ratio of obesity and overweight
among the nurses within Scotland and it also compare different healthcare professionals and
those individual rendering services in the non-health related occupations. Moreover, it is also
assessed that the aim of the quantitative study is to estimate the ratio of obesity and overweight
situation among the general working population and nurses so that researcher may contribute in
delivering the healthcare education and knowledge to the individual so that they can easily
address the pandemic of obesity and overweight.
Methodology
The present study is cross sectional study that is comparing the ratio of nurses and other
general population therefore, it engage in using methodology related with quantitative methods
that is applying different mathematical tests as well as SPSS technique so that they can acquire
the reliable and accurate results within minimum standard error. As per the view of Bernard
(2011) researcher while conducting the quantitative study uses figures to test the devised
hypothesis. In the situation if the devised hypothesis is accepted then in such situation the study
will be carried properly.
Tools of data collection
In order to collect the data regarding the prevalence of obesity and overweight among the
nurses within Scottish research uses the Scottish Health survey. It is considered as an effective
method for collecting the data within the Scotland (Creswell, 2013). Along with this the survey
is also used to collect the relevant data related with ratio of health condition, diseases risk
factors, track health trends etc. along with this, it has been also evaluated that face to face
interview method is used by the researcher for collecting the data from the residential adults (age
group of 16 and above). Furthermore, it has also critique that to ensure proper analysis five round
of Scottish Health Survey has been aggregated. In which the participant from the age group 17-
65 years were included. On the contrary to this Andrews and Herzberg (2012) has stated there
was no pilot study was conducted for collecting the data as for the large sample it was the better
option that support in gaining accurate results.
Data analysis
For the quantitative research paper researcher has focused on the descriptive statistics for
the socio demographic variables. As the selected variables mainly focuses on the gender, age,
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parental class etc. along with this for analysing the data researcher also engaged in the logistic
regression model that focuses on comparing the odds of being overweight with not being
overweight nurses in the occupational courses (Pleis, Ward and Lucas, 2010). Furthermore,
through reviewing the article it was also found that data were also analysed through using SAS
9.1.3. that is Statistical Analysis System software. It has been also critically evaluated that the
chosen technique is appropriate for the study as it allows proper analysis as well as
categorization of quantitative data.
Sample
Through analysing the article it was measured that selected sample size for conducting
the research the selected participants or the sample unit were 13,483 adults of the age group 17-
65. it was indicated that all the participants were properly classified into the four different
occupational groups that mainly include nurses (411), other healthcare professionals (320),
unqualified care staff (685) and the last category of the participants include general participants
who are employed in other occupation other than health care (12,067). therefore, the selected
sample size is too large and using quantitative tools and technique assists the researcher in
gaining accurate and reliable resultant. Along with this, purposive sampling is been used by the
researcher for successfully conducting the study in which the researcher relies on their own
decisions and judgement. On the other hand, Hasan, Chandrasekaran and Hansen (2010) has
critically evaluated that there were several other survey technique that is successfully within the
study that is cluster sampling as well as cross sectional survey etc. in addition to this, the key
strength of the sample is that is is convenient for the researcher as well as also less costly that
results in gaining the accurate result (Lin, Liu and Zhu, 2010).
Ethical considerations
Analysing the whole article it was studied that researcher has engaged in considering the
ethical consideration that support them in attaining the valid and reliable information (Houser,
2013). It has been also assessed that for the conducting the study research has taken approval
from the research ethics committee in the school of health sciences, University of Stirling UK.
Along with this, aspect of ethical consideration also ensure that researcher has not been engaged
in any sort of bias activities and assists in attaining the most accurate and reliable information.
Whereas, engaging in the ethical consideration activities also support the individual in
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overcoming the ethical issues and thus pursue in the informed consent, fairness among the
activities as well as anonymity (Fain, 2013). Moreover, ethical consideration also assists in
ensuring the validity and reliability of the collected data from the large sample size but in the
present article it has not mention anything regarding the validity and reliability of the collected
data and information.
Main findings
With the key aim to estimate the prevalence of obesity and overweight nurses in the
Scotland it may result in finding the different ways for the welfare of nurses so that they may
overcome the situation. On the other hand, the findings also focuses on stating the question
regarding the importance of health to the individual. It has been critically evaluated that all the
research questions of the study has been answered and ensure that prevalence of obesity and
overweight is higher in the area of Scotland as compare to the area of UK and US.
Conclusion and recommendations
Through critically evaluating the quantitative article it has been concluded that with
assessing the participants over two third of the nurses were having the overweight and obesity.
Along with this it was also evaluated that ratio of obesity and overweight was higher in the
healthcare professionals as compare to the non healthcare professionals. Moreover, the observed
or determined prevalences was higher in the previous studies that were conducted in the region
of UK, Australia as well as New Zealand etc. whereas, it was also recommended that
development of supportive workplace interventions is being consider as effective value that
support in overcoming the prevalence rate. In addition to this, engaging in the health promotions
campaigns and activities is also consider as effective activity that assists in overcoming the
increasing situation of obesity and overweight in the Scotland.
Overall strengths and limitations
Through conducting the quantitative research paper it was assessed that author or
researcher has identified the proper limitation of the study that is researcher might conduct the
more deeply study for estimating the prevalence of obesity and overweight situation. Along with
this, it was also stated that there were certain limitations to the study that is analysing using cross
sectional survey results in changing their health. Moreover, the strength of the study was that in
the past different dataset were used for the study but in the present comparison is made among
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the different occupational groups. Along with this another strength of the study is that engaging
in the survey interview rather than using the self report raises the level of accuracy of gathered
data and information.
Application to practice
With the help of reviewing the article it was stated that key findings as well as
recommendations has been applied to the practice as it support in providing proper awareness
and education among the residential individual as well as nurses regarding the prevalence of
obesity and overweight so that they can engage in the activities that support in overcoming the
issue. Along with this, changes and recommendations must be considered in order to avoid or
increases their ratio in the Scotland.
Article 2- Nursing management of aggression in a Singapore emergency department: A
qualitative study
Another article is based on the qualitative study that concerned about the nursing
management aggression within the Singapore emergency department as the level of incidence is
increasing at the constant rate.
Focus
The key focus of the study was on the nursing management of aggression level of the
patients in the Singapore emergency department. Along with this, the key aim of the study was to
understand the perception of registered nurses regarding managing the aggressive service users
within the emergency department. It has been critique that the focus emphasis on aggressive
behaviour of patient that directly impact the activities of the nurses within the premises.
Background
The key aspect for conducting the research was to explore the perspective of the nurses
related with caring the people or patients with the aggressive behaviour. Therefore, the
background of the study only focuses on the Singaporean nurses and their activities in managing
the activities of their patients. Along with this, there are several studies that focuses on
measuring the impact of patients aggressive behaviour on the nurses but the research was
conducted first on the Singaporean nurses presenting to the Emergency Department.
Methodology
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In order to successfully carries out the research the selected methodology was
phenomenological approach that mainly focuses on describing the lived experiences of the
respondent. It has been critically evaluated that benefit of this methodology to the study is that it
support in accumulating the reliable and accurate information and data. On the contrary to this
Taylor, Bogdan and DeVault (2015) has also stated that using this research methodology is
difficult to observe and prevent research worker induced bias.
Tools of data collection
For the present study the selected technique for collecting the data include pilot survey
technique in which the interview guide was adopted from the previous study. Pilot survey is
defined as preliminary survey that is used by the researcher to accumulate relevant information
before conducting the actual study or survey (Rogers, 2010). The strength of using this method is
that it focuses on selecting the small groups that help them in conducting the main study or
research work. Along with this, it has also evaluated that interview method was also chosen for
collecting the data. The interview were conducted in English and structured questions were
followed to the respondents. The conducted interviews were recorded and all were lasts from 30
to 60 minutes. From the collected data it was indicated that nurses who were engaged in the
intoxication contribute to their aggressive behaviours (Brinkmann, 2014).
Methods of data analysis and presentation
The methodology used for the qualitative study was interpretivism as the data is collected
through survey as well as interview that ensure their proper interpretation and analysing that
assist in gaining the adequate results (Smith, 2015). For the present study data was in the form of
observation as well as verbal statement with the help of conducting interview. Thus, interview
assists the researcher in framing the different themes for the study. Along with this, for analysing
the collected data research had also chosen the thematic analysis four different themes has been
designed that support in gaining the adequate information related with impact of aggressive
behaviour on the nurses, assessment of nurses, proper management of individual behaviour as
well as support and response of the organization.
Sample
It has been evaluated that for conducting the qualitative research, scholar focuses on the
small number of sample that is mainly range from 10 to 20. In order conduct the adequate
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research and explore the ideas researcher focuses on taking the perception of the registered
nurses that manages the aggressive patients within the Emergency Department (ED). The
selected sample for the study was 10 registered nurses were selected from the public hospital
within the Singapore. The selected sample was feasible for the qualitative study as it gain the
suitable results from the respondents (Nielsen and Cleal, 2011). Along with this purposive
sampling technique is been used by the researcher in which he relies on their own judgement and
decisions when they are selecting the sample. It has been critically evaluated that this sampling
method is ineffective as it ensure judgemental activities in selecting the sample from the
population.
Ethical consideration
The ethical consideration is must within the study that support in accessing the validity
and reliability of the collected data (Holloway and Wheeler, 2013). Therefore, in the present
study the ethical consideration has been taken into the account. For enabling the protection of the
participants or respondents researcher has taken approval from the National Healthcare Group
Domain Specific Review Board. Along with this, advertisement flyers and staff briefing were
also utilized to enlist the possible respondents (Munhall, 2012). It has been critique that in the
situation when the researcher is unable to engage in the ethical consideration then in such case
researcher is exposed to attain legal ramification.
Main findings
From the present qualitative study it was find out that researcher is effective in
understanding the nursing management of aggressive behaviour of the patients within the
Singapore emergency department. Along with this it has been successfully found out in attaining
the aim of measuring the impact of aggressive behaviour of patients on the activities of nurses.
Along with this, it has been also found that effective support to the nurses for delivering the
optimal care for the aggressive patients and accomplish in attaining the positive and negative
outcomes.
Conclusion and recommendations
With the help of reviewing the qualitative research paper it has been critically evaluated
that researcher has positively assisted in understanding the experience of nurses rendering
services in the emergency department and impact of their care activities for the aggressive
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patients. On the other hand, it has also reviewed that support from the colleagues as well as
debriefing of the formal workplace is lacking that impact the activities of the nurses. From the
reviewed research paper work it has been assessed that nurses has been recommended with
attending the aggression management training program that would support in raising and
enhancing the confidence level of nurses. Further, from the study it has been also recommended
that usage of legislation, protocol as well as policies would also direct the care activities of
nurses related with the aggressive patients within the study.
Overall strength and limitations
Through analysing the qualitative paper work it has been assessed that there are certain
strength as well as limitation of the conducted study. Thus, measuring the limitation of study will
support the other investigator in overcoming the limitation gap so that adequate results can be
achieved. The overall strength of the study is that it support in measuring the level of aggression
in the which the patient threatened and assault the Singaporean nurses rendering services within
the emergence department. The several limitation for this qualitative study is that it only focuses
on the single site that is Singapore with the small sample size of emergency department nurses.
Whereas, it is also critically evaluated that findings also explore the experience of the
Singaporean registered nurses while it restrict the experience of western country nurses
(Csikszentmihalyi and Larson, 2014).
Application to practice
It has been assessed that findings of the conducted study can be relate to the practice as
the behaviour of patient varies from individual to individual that directly impact the activities of
the nurses within the Singaporean hospital. Along with this, it is also assessed that findings is
applicable to the practice as it support in understanding the behaviour of each and every patients
within the emergency department so that they can provide the required activities to their patients.
Therefore, it is assessed in attaining the aim of the study that was to understand the perception of
registered nurses regarding managing the aggressive service users within the emergency
department. It has been critique that the focus emphasis on aggressive behaviour of patient that
directly impact the activities of the nurses within the premises.
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