Research Foundations for Health Practice

Research Foundations for Health Practice
Research Foundations for Health Practice
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Research Foundations for Health Practice
Purpose of the Study: Identifying the Research Question using the PICO format.
A research question that is well formulated needs extreme preciseness and specificity that guides
the implementation of the project. The PICO (Population, Intervention, Control and Outcomes)
format provides a strategy for framing a ‘foreground’ research question (Leung, et al., 2016).
Population or problem: seeks to address a specific population, demographic information and its
key characteristics. From the case, I can identify the nursing population in medical and
administrative capacities.
Intervention: In this case, the intervention is explaining ways of managing interruptions on
medical errors in hospitals.
Comparator or control: an existing therapy is compared to a new one.
Outcome: The outcome in this case is averting interruptions. Therefore, the research question
can be formulated as follows;
Among nurses (P), is managed interruptions (I) effective in addressing medical errors (O) as
compared to risking its impacts (C)?
Discussion of the Research Design
Research design is the overall strategy that is used to integrate the various study components in a
coherent and logical manner (Desborough, et al., 2016). The study adopted a non-participant
observational method for nurses conducting rounds of medication to collect data. However, this
method is more of being passive than actively being involved in the exercise. It therefore means
that the information obtained is unlikely to be reliable owing to this shortcoming of the non-
participant observational method. The comparison of data collection methods with other works
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Research Foundations for Health Practice
on a theoretical basis is also questionable. This is because such methods are likely to be outdated.
Choosing only two clinical units for the study presents a limited scope for obtaining the relevant
information. The methods used to measure the outcomes of the study do not have a completely
quantifiable approach. In analyzing the numeric data, the researchers used IBM SPSS statistics.
Sampling and Recruitment Procedures used in the Research.
Sampling is defined as the process of selecting units; representative portion from a population of
interest in a research context (Lane, et al., 2016). The study used a non-participant method of
observational study and convenience sample. It was made up of two clinical units and five units
of medical surgery. Their recruitment was done within a vast metropolitan teaching hospital. A
total of 56 medication events were observed. The patient rooms used in the study were single and
four-bed oriented. I am dissatisfied that more relevant and wide data were left out by the fact that
only two units were involved in the study research. The study was also conducted in only one
hospital setting that would probably not reflect the actual picture of the interruptions witnessed in
the administration of medication by nurses. Expansive and more relevant information would
have enabled the reader of the article to form an objective opinion regarding the impact of
interruptions on medication errors and viable ways of managing them. For a good research, there
is need to use the most viable sampling and recruitment procedures as dictated by the context of
the study.
Discussion of the Ethical Considerations
Ethical considerations are perceived as critical in every research study (Oad, et al., 2018). These
are the standards or norms that define conduct and distinguishes between wrong and right. The
ethical standards seek to prevent falsifying or fabrication of data in an effort to promote the
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Research Foundations for Health Practice
pursuit of truth and knowledge which forms the primary goal of a study. The researcher sought
for the consent of the participants before engaging them in the observational study. I found this
move to be that of goodwill because it promotes the willingness of the participants to provide the
relevant information for the research. Explaining the motive of the study at a forum by unit
managers is also recommendable. It ensured that the rights of the observed nurses are being
respected in the context of their working environment. Before the observation, consent in written
form is always obtained (Coggins, et al., 2018). However, I found it interesting that the research
nurse was given instructions to intervene in case of a potentially harmful incident was witnessed
in the course of the study. I am concerned that the benefits and risks associated with this
particular study were not explained to the participants.
Discussion of Data Collection and Analysis
Data collection refers to the process of assembling information and measuring it based on
variables of interests. It is done in defined systematic manner that enables the researcher to
answer research questions, test hypothesis and evaluate the findings. According to the article, the
data was collected through a non-participant prospective observational study that involved a
convenience sample. A standard observation tool that included nurse identifier, ward details,
administered medications, clinical history of patients and interruptions’ data during medication
events was developed. I noted that primary and secondary tasks were presented in a brief written
description. I found this move recommendable because it supplements the data collection
framework in the research. Analysis of data involves summarizing and interpreting obtained
information through logical and analytical reasoning to establish trends, patterns or relationships.
The data in numeric form was analyzed using IBM SPSS statistics. I found it more reliable in
interpreting statistical data. For instance, the frequency of interruptions and other characteristics
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Research Foundations for Health Practice
were described using proportions and descriptive statistics. Re-categorizing of written
descriptions into quantifiable categories, further refines the data analysis (Amaral, et al., 2017).
Discussion of the Summary of the Study.
The primary diagnosis of patients comprised musculoskeletal, gastrointestinal conditions (30%),
cardiovascular conditions (15%), skin and spinal conditions (21%), renal, urinary, hepatic and
endocrine conditions (9%) and other conditions (25%) (n=47). The information was drawn from
Nursing Handover Summary documents. However, I feel dissatisfied that the patient
characteristics were insufficiently captured because no demographic data like patient gender or
age were collected during the study. In such a study, demographic data is critical because it
contributes to enhancing the reliability of the findings. One-third of the recorded interruptions
emanated from other nurses seeking to share information about workflow and patients. However,
the authors of the article do not tell the reader what the other two-thirds represent in these results.
I feel the untold remaining proportion should have been mentioned to facilitate an objective
understanding by the reader about the sources of interruptions. The authors of the article found it
relevant to also identify the importance of the tasks that made nurses to adjourn attending to
medical administration. (Kunac, et al., 2014) I found this to be an important ingredient in
devising a framework to manage these interruptions. The findings also detail the nature of the
secondary tasks.
Discussion of Implications for Health Professional Practice
The article presents a variety of implications for the practice of health professional. It may not be
easy to completely alleviate clinical interruptions, but it is possible to reduce these interruptions.
According to the article, one way of achieving this is by minimizing non-patient related
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Research Foundations for Health Practice
interruptions as well as nurse-to-nurse interactions (Westbrook, et al., 2018). However, I feel that
pre-assessment should be done before such implementing it to avoid any form of resistance from
the nursing staff. It would also compromise their service delivery to patients. It is recommended
that consultations be done involving the management and clinicians. The authors note that
interruptions emanating from medication preparation and administration result to a significant
workload for nurses (Raban & Westbrook, 2014). They suggest the existence of potential for
nurse managers to increase the available hours of nursing per patient. However, I doubt the
effectiveness of such a move because it would only serve the interests of the nurse manager and
make the work of the nurses tedious. There is the need to design a framework that incorporates
the clinicians with an aim of identifying the sources together with volumes of interruptions
(Manias, et al., 2018). It could be utilized as a strategy of quality improvement in any context in
our hospitals across the world. The article’s main focus was to prepare an educational
intervention and this may not be applicable in majority of situations experienced in the hospitals
as far as interruptions are concerned (Johnson, et al., 2017). Therefore, I found the applicability
of the suggested control measures for interruptions somehow challenging and unrealistic.
Considering the diverse and unique working environments in the context of health care, realistic
methods of managing such interruptions should not be overlooked. The authors have at some
point acknowledged that some witnessed interruptions are worth as dictated by the situations
which cause them (Hayes, et al., 2015). Such interruptions should be categorized as necessary
interruptions which should be widely acceptable in medication preparation and administration.
However, there needs to be a clear set out mechanism that seeks to harmonize these interruptions
such that the accruing benefits can be realized by both parties; the nurses and patients (Hayes, et
al., 2014). This would contribute in enhancing service delivery amidst of the acceptable and
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Research Foundations for Health Practice
harmonized interruptions owing to the common understanding between the hospital management
and clinical staff in their respective health care centers (Hayes, et al., 2015). The potential that
exists in minimizing the socialization among nurses which result to interruptions is eminent
(MareeJohnson, et al., 2018). However, great care should be observed when adopting such
measures.
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Research Foundations for Health Practice
References
Amaral, L., Martins, C. & Coimbra, . A., 2017. Use of the Control of Allergic Rhinitis and Asthma Test and
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Coggins, A. et al., 2018. A prospective evaluation of the ‘C.O.A.C.H.E.D.’ cognitive aid for emergency
defibrillation. Australasian Emergency Care, 21(3), pp. 81-86.
Desborough, J. et al., 2016. The impact of general practice nursing care on patient satisfaction and
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Hayes, C., Jackson, . D., Davidson, . P. M. & Power, T., 2015. Medication errors in hospitals: a literature
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Hayes, C., Power, T., Davidson, P. M. & Jackson, D., 2014. Interruptions and medication: Is ‘Do not
disturb’ the answer?. Contemporary Nurse, 47(1-2), pp. 3-6.
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Raban, M. Z. & Westbrook, . J. I., 2014. Are interventions to reduce interruptions and errors during
medication administration effective?: a systematic review. BMJ Qual Saf , 23(5), pp. 414-421.
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