Critical Appraisal of Evidence-Based Practice in Adult Nursing

This report provides a critical analysis of a research paper titled "Patient perceptions and experiences with falls during hospitalization and after discharge." It evaluates the believability and robustness of the study, examining aspects such as the title, abstract, writing style, research problem, and literature review. The report scrutinizes the study design, methods, philosophical underpinnings, sampling techniques, ethical considerations, data collection, and data analysis. It highlights the importance of aligning the research aim with the title, suggests improvements in the literature review by including more diverse studies and critical analysis of risk factors. The report also discusses the choice of qualitative research design and sampling methods, and emphasizes the significance of ethical considerations in data collection and analysis. The report provides a thorough overview of the strengths and weaknesses of the research paper and provides insights into areas that could be improved upon.

Appraising evidence based
practice in adult nursing

Table of Contents
INTRODUCTION...........................................................................................................................1
Believability.....................................................................................................................................1
Writing style, credentials of authors, title and abstract................................................................1
Robustness.......................................................................................................................................2
Research problem and significance of the study..........................................................................2
Literature review..........................................................................................................................3
Critical analysis of Study design, methods, philosophical underpinnings, theoretical
framework, aim and hypothesis...................................................................................................3
Sampling......................................................................................................................................4
Ethical considerations..................................................................................................................5
Data collection.............................................................................................................................5
Data analysis................................................................................................................................6
Finding.........................................................................................................................................7
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................8

INTRODUCTION
Critical analysis helps in analysing that whether the all the important aspect related to the
research have been prudently or not. It can be related to formation of aim and objective, chosen
researcher methodology, data collection and analysis method, chosen sample size etc. It also
helps in providing that choice whose adoption could have helped in better formation of results.
Critical analysis of the paper, with the title “Patient perceptions and experiences with falls during
hospitalization and after discharge” has been initiated in the below report. It helps in identifying
the loopholes that has significantly affected the overall results of the research. The report
discuses regarding the formation of aims and objectives which is the overall base of present
research conducted by the researchers of this research paper. It also helps in understanding
believability and robustness of the research paper based on study design, sampling, ethical
consideration, data collection and analysis methods, abstract and title (Berger, 2015). Their direct
alignment to the overall aim and objectives will be assessed for an effective critical review.
Believability
Writing style, credentials of authors, title and abstract
The title of the study conducted by clayton Suman and various other writers is “Patient
perceptions and experiences with falls during hospitalization and after discharge”. The title itself
is the clear indicator of what the research conducted by the scholar will be all about. It can be
stated from the meaning derived from title that research is all about the perceptions and
experiences that is faced by the patients with respect to falls during the period of hospitalization
and after discharge (Shuman and et.al., 2016).
The writers belong to University of Michigan, School of nursing. Hence, it can be stated
that the writers belong to the same subject and must be carrying adequate amount of knowledge
regarding subject matter that has been chosen for research. The writing style adopted by the
researcher is quite lucid which is understandable enough to gather information regarding subject
matter (Brinkmann, 2014). Moreover, explanation regarding each and every aspect of the
statement has been given to ensure that reader can gather adequate amount of knowledge
regarding the same.
Another important aspect to be critically analyzed is abstract presented by the researcher.
An abstract plays an important role in the overall research which helps in identifying core
aspects of the study that are being discussed by the researcher in the whole researcher paper. The
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abstract of present paper of nursing clearly states aim, background of the study, methods used to
conduct the research, results based upon the study and practiced methods and conclusion based
on the results (O’Brien and et.al., 2014). It helps in giving a clear-cut review of the whole
research paper in such a manner that the reader can gather the information regarding the whole
research by reading abstract only. However, critically analyzing the same, background of the
study has not been adequately mentioned which lacks information regarding chosen subject
matter. It also lacks to identify all the methods that are actually used by the researcher in
conducting research (Morse, 2015). It generates the requirement to go through the whole
research paper to gather more effective and prominent research.
Robustness
Research problem and significance of the study
The main aim of research is to describe hospitalized older adults which are above the age
of 60, there perception regarding
 Fall risk while hospitalized
 Fall prevention interventions received while hospitalized
 Fall prevention discharge instructions
Hence, it can be stated that the research paper makes an assessment of all the three factors
mentioned above. There is no theme created regarding experiences of fall of adults after
discharge. It can be stated that the aim framed for the researcher does not exactly match with the
title framed for the study. It becomes important for the researcher to bring changes in one of the
two aspects (Corbin, Strauss and Strauss, 2014). Either there must be certain modifications in the
title or changes in aim can also be initiated by the scholar, whichever is suitable for the team.
The research issue discussed in the paper is that falls is the significant problems that is faced
by old adults, particularly with the people who are being hospitalized (Ritchie and et.al., 2013). It
is the most frequent episode reported which directly questions the patient’s safety in the hospital
and after discharge as well. It generally results in various issues, such as, fracture, trauma and in
the extreme cases, it can also lead to death of the individual. It also results in anxiety, loss of
confidence and social isolation. It is important to provide prolonged set of instruction that can
help the adult from any fall during the hospitalization tenure and after the discharge as well.
Hence, it becomes important to study various aspects related to it and conduct a research on the
same. However, the research is qualitative in nature which makes it difficult to statistically
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present certain data in statistical or graphical format. Another important aspect that has not been
covered in the research is related to analysis of episodes of fall faced by adults. An interview
format could have helped in gathering their view regarding the subject matter.
Literature review
Literature review considered to be an important aspect of any research. It helps in
gathering the opinions of the researcher who have already conducted a research with respect to
subject matter. It also helps in ensuring that each and every aspect of the research are already
being gathered in a well defined manner that it can help in reaching to the specific conclusion
aligned to the aim being framed for the research (Potter, 2013).
The present research is related to Patient perceptions and experiences with falls during
hospitalization and after discharge. Hence, it important to analyze the views that has already
been shared by people with respect to the subject matter earlier. Hence the researcher has made
adequate efforts to gather information related to it. The research paper discusses regarding results
collected by various scholars related to falling and conclusion that has been drawn by them.
However, critically analyzing the same, efforts have not been made to analyze the importance of
preventing older generation from falling (Corbin, Strauss and Strauss, 2014). Moreover,
researcher have not critically analyzed the factor stated by one researcher effectively.
The researcher has not able to rigorously analyse the view points of various author. Hence,
a handful studies have been collected and analysed. All the studies that have been considered are
quantitative in nature and hence, it is difficult to gather in-depth knowledge base regarding the
subject matter (Lewis, 2015). The risk factors associated to falling are also not mentioned in the
research paper, which make it an overall ineffective analysis of the collected data. It is important
to understand various aspects rather than having answer in a closed ended format. If the journals
having interview have been chosen, it could have helped in concreting the understanding
regarding subject matter. Their direct alignment to the overall aim and objectives will be
assessed for an effective critical review
Critical analysis of Study design, methods, philosophical underpinnings, theoretical framework,
aim and hypothesis
Exploratory research design has been chosen by the researcher to explore the chosen topic
in an effective manner. Ion order to solicit the requirements of research aim, a face to face
interview was conducted by the researcher and elicit the information regarding it. However, the
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main issue that can be stated regarding choice is that, the individual may not be comfortable in
disclosing all the episodes of falling. Moreover, some of the stories told by the patient may not
accurate enough and can be made up. Hence, in such cases, questionnaire could have gathered
specific results that could have helped in gathering better data. A qualitative study has been
initiated by the researcher for the present research paper. It shows that results have been
performed based upon the interview conducted. There are no specific results rendered by the
researcher through the research paper (Hyett, Kenny and Dickson-Swift, 2014). Questionnaire
format could have gathered rather more specific results which could have been presented in a
statistical format. Specific questions could have rendered specific results regarding the subject
matter and framed aim for the research.
The research methodology however is directly linked to the aim framed for the research.
Adoption of better methods could have been able to gather rather more specific data in
comparison to the present one. Hence, critically analysing the same, it can be stated that
researcher could have used questionnaire format to collect the information. It would have been
less time taking and larger sample could have been used for the research. It could have helped in
giving better results in the end. Another aspect is related to usage of statistical data to reach to
the result.it could have represented in graphical format, where use of SPSS or any other data
analysis tool could have been initiated (Tufford and Newman, 2012).
Sampling
Most important part of research which is analysed as a statistical tool used for selection
of appropriate sample size from the target population. It is also important measure that aids the
management in accomplishment of effective research through analysis of various populations
and measure to select the sample size from the population. Sampling is best tool that
involvement mathematical and statistical applications which is implemented to get accurate
results outcomes (Potter, 2013). There are mainly tow type of sampling methods such as
probabilistic and non probabilistic sampling. Probabilistic sampling methods is used for
quantitative analysis of population in order to achieve the correct sample size from population. It
mainly involves the method like simple random, systematic sampling, stratified sampling etc.
Further, non probabilistic sampling is used for qualitative analysis because it is theoretical
sampling methods does not involve mathematical analysis of data. It usually involves methods
like convenience , purposive and snowball sampling methods (Ritchie and et.al., 2013). In this
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research, simple random sampling methods is used to select the sample size from the
populations. It is effective methods because does not involve a lot of calculation and easily used
to undertake research. It also provides supports in effective analysis of information which is
required to accomplish the project. Thus, simple random sampling is effective method through
which the research has been conducted and achieved the valid outcomes.
Ethical considerations
There are several ethical principles have been taken in to consideration by researcher
while undertaking study and collection of data. For making the research reliable and effective, it
is essential for the scholar to apply all the methods ethically so that no further restrictions are
required to be faced. In this report, it is clear that data are collected from the respondents on the
basis of questionnaire (Morse, 2015). This questionnaire was prepared by scholar on the basis of
aims and objectives which was developed earlier. At initial stages, respondents have not
provided proper response but taking permission of their supervisors in organisation. They have
started supports us and provided relevant answers of the questions. Moreover, personal
information about the users was not disclosed to any other person. Data are used to accomplish
research and after completion of research, it will be destroyed. Secondary analysis was also
conducted on the basis of information which is collected from the journals, articles and E books
which are cited properly. Thus, it can be said that these practices has provided supports in
accomplishment of research effectively.
Data collection
The type of perception that is carried out by individuals differs. It is important to make
sure that appropriate steps are taken so that they are able to consider that aspects that has to be
included (Manary, Boulding and Glickman, 2013). With this respect, there is various type of
health related problems faced by people and individuals who stay longer time period are able to
develop negative perception. When patient comes to a hospital for some kind of health related
issues especially among individuals who are able the age of 60 years are scared. Article that
selected has made use of both primary and secondary methods for collection of information.
Information is required to be gathered by using effective sources and this article has selected the
most reliable tool that has helped in gathering information in relation with the research topic.
Complete list of potential informants was given by clinical nurse specialist and nurse manager.
Then use of inclusion criteria was done so that most reliable sources of data can be selected.
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Apart from this, two type of research assistance was conducted which were in-hospital and post
discharge interviews. All the data related with inn hospital were gathered rooms of patients at the
time when professionals were not present. At the time of hospital interviews, all the informants
were asked regarding the perspective concerning risk that is involved in falling while they are at
hospitals (Kalisch, Tschannen and Lee, 2012). It took almost less than 45 minutes time to
complete the interview and majority of the respondents also provided their home telephone
number as per their following discharge. In addition to this, post discharge interview was
conducted as 8 days after their discharge. Telephonic interview was conducted and audio
recording were done.
Data analysis
There are different types of methods that can be used for the data analysed. In accordance
with the analysis made, the researcher has made use of transcripts. Each of the responses
provided by patients was transcript and then analyses were made for each of them. The type of
method that is used the constant comparative methods. In order to make sure appropriate, robust
data analysis and rigorous. Coding is done so that all the responses provided by patients can be
analyses and interpreted in effective manner (Schoen, Osborn and Applebaum, 2011). As per the
analysis made, there are themes developed and these are done so that the research aim and
objective set by the researcher can be identified. The type of method used by the researcher is not
effective enough as the total time that will be taken to interpret and analyse the information will
take up lot of time. As there are many people taken as sample size. However, the total time take
has helped in identifying the perception that is carried out by patients towards risk of falling.
Further, all the patients are scared in condition of fall and so that prefer to make sure that all the
problems that are faced by them are properly analysed and effective steps are taken so that they
are able to overcome them in effective manner. Further, there were in total three different type of
investigators organized towards minor themes towards major themes (Kalisch, Tschannen and
Lee, 2012). This was done so that all the findings made are presented in effective manner and
these can be relied on. In addition to this, it can be stated that overall the findings made were
highly effective and reliable and made to come up with the attaining the goals and objectives that
were set by the researcher.
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Finding
In accordance with the findings, it can be stated that all the patients are highly conscious
and careful that they many not fall. For this respect, they also convey to patients to be more
careful while they carry or place them to other positions. Further, it can be stated that care
providers should be provided with proper training so that all the areas in which they lack can be
identified and steps are taken so that they can improve them. Apart from this, there are certain
roles and responsibilities that have be played by them. When these are not known to them, then it
has negative impact on the perception of patients (Manary, Boulding and Glickman, 2013). In
this context, seniors should have proper monitoring done so that their performance level can be
measured. Further, there are in total 8 themes that are presented. All these are mainly focused on
which the perceptions that are carried out by individuals are different and majority of the
respondents are scared of falling and they prefer to get a care provider who understands them and
proper care is delivered to them. There are majority of the patients who have experiences one or
two falls. From this, it can be stated that care providers are not so conscious regarding the care
that is delivered to them. Use of new or updated technology should be done so that all the
problems that are faced by them can be considered in appropriate manner. The findings
presented in the current article is highly effective and this is helped enough to make sure that all
the objectives are determined and are presented in effective manner.
CONCLUSION
In accordance with the findings, it can be stated that to develop an article, it is important
for the researcher to finding out the main area that has to be focused on. Further, a systematic
plan is required to be developed so that steps by the steps findings can be made and it can be
presented. In addition to this, there are two main ways that are provide the opportunity to gather
information, these are primary and secondary. The researcher has made use of both these
methods for collection and the method for data analysis is used that makes the viewers to
understand the main findings that are made and presenting the perception that is carried out by
patients towards falling that has faced by them.
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REFERENCES
Books and Journals
Berger, R., 2015. Now I see it, now I don’t: Researcher’s position and reflexivity in qualitative
research. Qualitative research. 15(2). pp.219-234.
Brinkmann, S., 2014. Interview. In Encyclopedia of critical psychology (pp. 1008-1010).
Springer New York.
Corbin, J., Strauss, A. and Strauss, A. L., 2014. Basics of qualitative research. Sage.
Hyett, N., Kenny, A. and Dickson-Swift, V., 2014. Methodology or method? A critical review of
qualitative case study reports. International journal of qualitative studies on health and
well-being. 9(1). p.23606.
Kalisch, B. J., Tschannen, D. and Lee, K. H., 2012. Missed nursing care, staffing, and patient
falls. Journal of nursing care quality. 27(1). pp.6-12.
Lewis, S., 2015. Qualitative inquiry and research design: Choosing among five
approaches. Health promotion practice. 16(4). pp.473-475.
Manary, M. P., Boulding, W. and Glickman, S. W., 2013. The patient experience and health
outcomes. New England Journal of Medicine. 368(3). pp.201-203.
Morse, J. M., 2015. Critical analysis of strategies for determining rigor in qualitative
inquiry. Qualitative health research. 25(9). pp.1212-1222.
O’Brien, B. C. and et.al., 2014. Standards for reporting qualitative research: a synthesis of
recommendations. Academic Medicine. 89(9). pp.1245-1251.
Potter, W. J., 2013. An analysis of thinking and research about qualitative methods. Routledge.
Ritchie, J. and et.al., 2013. Qualitative research practice: A guide for social science students and
researchers. Sage.
Schoen, C., Osborn, R. and Applebaum, S., 2011. New 2011 survey of patients with complex
care needs in eleven countries finds that care is often poorly coordinated. Health Affairs.
30(12). pp.2437-2448.
Shuman, C. and et.al., 2016. Patient perceptions and experiences with falls during hospitalization
and after discharge. Applied nursing research. 31. pp.79-85.
Tufford, L. and Newman, P., 2012. Bracketing in qualitative research. Qualitative social
work. 11(1). pp.80-96.
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