Qualitative Research Critique: Healthcare Research Analysis

This report presents a critical appraisal of a qualitative research article exploring the relationship between hospital ward design and healthcare-associated infection (HAI) rates, specifically focusing on the impact of accessible hand sanitizer dispensers. The analysis, based on a systematic review and meta-analysis, examines the research design, sampling plan, and data collection methods. The report identifies the inferred grounded theory approach, assesses the congruency of the research question with the qualitative method, and evaluates the data sources and research methods. It critiques the description of the research design, reflexivity, and ideological perspective. The sampling plan is evaluated for its appropriateness, the use of nonprobability purposive sampling, and the defined eligibility criteria. The report also discusses limitations, such as the lack of data saturation and the absence of participant baseline characteristics. References to relevant literature are included to support the analysis.

Running head: QUALITATIVE RESEARCH CRITICAL APPRAISAL
QUALITATIVE RESEARCH CRITICAL APPRAISAL
Name of the Student:
Name of the University:
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Running head: QUALITATIVE RESEARCH CRITICAL APPRAISAL
For the critical appraisal, the systematic review and meta-analysis Stiller et al., (2016),
was considered, which explored the association between the ward design of a hospital and the
reported rates of healthcare associated infections, in which, the presence of accessible hand
sanitizer dispensers in patient rooms yield significant effect on reduced rates of healthcare
association infections and bacteremia.
Qualitative Design Critique
Upon close examination, the researchers have not mentioned the adherence to any
research tradition prior to implementing this study. However, from the review of literature and
background of the study, it can be inferred that the research was based upon a research tradition
of grounded theory – since it aimed to expound upon the theory of effective hand washing
practices and their effect on healthcare acquire infections (HAIs) by exploring a possible theory
on the effect of a ward design comprising of hand sanitizer dispenser upon HAI rates (Polit &
Beck, 2009). While the congruency of the research question to a qualitative method is evident
since it already mentions the usage of a systematic review, the presence of a grounded theory
was better observed from the background of the research which theorized the importance of
infection control practices and HAI incidence (Stiller et al., 2016). The evidence based sources
of data coupled with systematic review research methods are congruent to a grounded research
tradition since the latter relies on inductive reasoning – which can only be performed using
multiple theories explored by multiple research studies as evidence in systematic reviews
(Cypress, 2017). While researchers expounded upon the direct association between three
multiple components of ward design (hand dispenser accessibility, patient room size, and single
patient room) and reduced HAI incidences, there was no statement on effectiveness on any of
these three options thus demonstrating and absence of early theorization (Polit & Beck, 2009).

Running head: QUALITATIVE RESEARCH CRITICAL APPRAISAL
Further, the research methodology justified the correct adherence to systematic review protocols
as evident in clear mentioning of databases, keywords and article selection process by the
researchers (Kite & Whitley, 2018). The usage of systematic reviews as well as meta-analysis
for exploring the risk ratios of HAIs and ward design is reflective of a thorough, unbiased
examination of research. However, there was no mention of reflexivity by the researchers and
inclusion of additional phenomenological methods like healthcare worker interviews could have
paved the way for inclusion of multiple views other than that of the authors (Polit & Beck,
2009). The full research was however conducted with an ideological perspective since the
selected articles reviewed by the researchers were evaluated was based on the infection
prevention control theories for HAI prevention in healthcare organizations (Huebschmann,
Leavitt & Glasgow, 2019).
Qualitative Sampling Plan Critique
The inclusion of multiple researches exploring ward design components’ effect on HAI
was appropriate to the research question and was described using a comprehensive search
strategy and article screening process by the researchers. Nonprobability purposive sampling was
used since the articles selected for the review focused only upon adult patients and health
workers via case control, observational and intervention based methodologies (Leung, 2016).
The eligibility criteria was clearly defined in the form of an inclusion and exclusion criteria
where only studies examining size of patient’s room, single rooms and hand dispenser
accessibility and HAI rates were included for the study (Polit & Beck, 2009). Given that the
research aimed to explore multiple components of ward design and effect on HAI rates, inclusion
of a qualitative research tradition using systematic reviews and grounded was effective due to
their ability to explore multiple studied and theories. The inclusion of only three studies and lack

Running head: QUALITATIVE RESEARCH CRITICAL APPRAISAL
of data saturation raises doubts on internal validity. Further, inclusion of randomized controlled
trials could have further correct presence of any bias or research invalidity. Further, the lack of
information on participant’s baseline characteristics hinders data transferability and applicability
(Noble & Smith, 2015).

Running head: QUALITATIVE RESEARCH CRITICAL APPRAISAL
References
Cypress, B. S. (2017). Rigor or reliability and validity in qualitative research: Perspectives,
strategies, reconceptualization, and recommendations. Dimensions of Critical Care
Nursing, 36(4), 253-263.
Huebschmann, A. G., Leavitt, I. M., & Glasgow, R. E. (2019). Making health research matter: a
call to increase attention to external validity. Annual review of public health, 40, 45-63.
Kite, M. E., & Whitley, B. E. (2018). The internal validity of research. In Principles of Research
in Behavioral Science (pp. 277-309). Routledge.
Leung, L. (2015). Validity, reliability, and generalizability in qualitative research. Journal of
family medicine and primary care, 4(3), 324.
Noble, H., & Smith, J. (2015). Issues of validity and reliability in qualitative research. Evidence-
based nursing, 18(2), 34-35.
Polit, D. F., & Beck, C. T. (2009). Essentials of nursing research: Appraising evidence for
nursing practice. Lippincott Williams & Wilkins.
Stiller, A., Salm, F., Bischoff, P., & Gastmeier, P. (2016). Relationship between hospital ward
design and healthcare-associated infection rates: a systematic review and meta-
analysis. Antimicrobial Resistance & Infection Control, 5(1), 51.