NRS 433V: Research Critique on Newborn Care and Ethical Issues

This report presents a comprehensive critique of a research article focusing on immediate newborn care practices, specifically early skin-to-skin contact and delayed cord clamping. The critique includes a background of the study, a critical analysis of the methods and results, and a discussion of ethical considerations. The original study aimed to assess current practices among healthcare professionals in a North Indian tertiary care hospital. The critique evaluates the study's observational approach, ethical clearances, data collection methods, and statistical analysis. The results of the original study indicated a lack of adequate practice in delayed cord clamping and early skin-to-skin contact, highlighting the need for standardized protocols and improved healthcare professional education. Additional research is referenced to emphasize the importance of skin-to-skin contact in promoting mother-child bonding and humanized care.

Running header: RESEARCH CRITIQUE & ETHICAL CONSIDERATIONS
Nursing
Quantitative Research Critique and Ethical Considerations - Draft
Student Name
NRS 433V Introduction to Nursing Research
Grand Canyon University
Due Date

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RESEARCH CRITIQUE & ETHICAL CONSIDERATIONS
Introduction
According to Kardefelt-Winther (2014), a research critique is a systematic way of
reviewing a piece of scientific research. Systematic review is done in order to highlight the
strengths and weakness of the study design and the applicability of the research into practice.
The following assignment aims to undertaken research critique of the paper named “A pilot
study to assess the current practices of immediate newborn care for term newborns in
relation to early skin-to-skin contact and delayed cord clamping among health personnel of
Labour Room” published by Khyriem, Venkadalakshmi and Rana in Nursing and Midwifery
Research in the year 2017. The assignment will initiate with background of the study
followed by the critical analysis of the methods and the results of the study along with the
ethical consideration.
Background of the study
The clinical or the research problem that was highlighted in the study of Khyriem and
his fellow authors (2017) was: there are difference in the recommendation or regulations of
practice in the domain of immediate newborn care. The World Health Organization (2013)
highlighted all routine procedure like assessment of the mother and the new born is not
mandatory to undertaken through immediate skin-to-skin contact. On the other hand, the
regulation of World Health Organization (WHO) highlighted that cord clamping can be
delayed but skin-to-skin contact during the initial hours of birth helps to prevent hypothermia
and promotes breastfeeding. Thus, the main objective of the study was to assess the current
practices associated with immediate newborn care in relation to early skin-to-skin contact and
delayed cord clamping among the health care professionals in the labor room. They selected
tertiary care hospital in North India as the main center for the conduction of the study. The
main research question was to analyze relation between cord clamping and skin-to-skin

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contact. The rationale of the objective selected by the authors is assessment of the current
practices by the healthcare professionals will help to ascertain the relation to early skin-to
skin contact and delayed cord clamping in immediate newborn care. Knowing the relation
will guide the future research prospects of standardization of practice. The purpose of the
research question is related to the problem of the study as it mainly aims to establish the
importance of skin-to-skin contact in the immediate newborn care.
Methods of the study
The authors here used the observational approach in order to access the present
practice in immediate newborn care. The main benefits of the observational study is provides
access under real life situations and provides strong validity of immediate understanding
(Holloway & Galvin, 2016). The present study took permission through Ethical clearance for
the conducting the study from the Institute Ethics committee PGIMER Chandigarh.
According to Holloway and Galvin (2016) taking permission from the concerned ethical
committee is important in order to conduct the research in an organized manner. The authors
mainly observed the delivery process undertaken by the 45 healthcare professionals of the
obstetrics and gynecology department. They used questionnaire tools in order to record the
demographic and experience profile of the physicians and the observational checklist of 13
full term deliveries (during the month of July) include sequence to steps undertaken after the
birth of the new-born (gestational age of 37 to 42 weeks) in relation of delayed cord clamping
and early skin-to-skin contact. They excluded new-born born to mother will cardiac
problems, severe bleeding and eclampsia. This exclusion helps to reduce the chances of
selection bias. There were no significant risks of the subjects participated in the study as the
authors mainly observed the process of delivery and did not conduct any trails over them.
This is also the reason that there is no definite time-period of the study. They only observed

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the delivery process and did not conduct any follow-up. There are no direct benefits
associated with the study but the results elucidated in this study will help proper
standardization of the new-born care protocols and will also help to access the level of
knowledge and nature of practice followed by the healthcare professionals. The dependent
variable of the research that remained constant through the progress of the research is
immediate newborn care and the independent variable is the time-span and the degree or
preference of early skin-to-skin contact and delayed cord clamping (this is not constant as
there is change in preference between the two process). The rigor of this quantitative study is
statistical analysis of the collected data based on mean standard deviation (SD). The use of
mean SD used to provide detailed quantitative perspective of data to extract the average
outcome.
Results of the study
The analysis of the results highlighted that warm and dry linens were kept ready at the
time of birth and the mother was provided with clear gowns during all the 13 deliveries.
Breastfeeding was started with one hour of the birth of birth in 92.31% of cases and delayed
cord clamping was used in 30.76% of the cases while early skin-to-skin contact was not
executed with any of the deliveries. The main limitation of the study is its poor sample size.
The ratio of the healthcare professionals demographic signifies only 4 males and 41 females.
This disparity in the ration of male, female, and poor sample size might lead to biased
outcome (Kaufman, 2017). The implications of the study are, it highlighted that there is lack
of adequate practice of the process of delayed cord clamping and early skin-to skin contact.
The study highlighted an immediate need to proper newborn practices in relation to early
skin-to-skin contact and delayed cord clamping via designing proper protocol and educating
healthcare professionals to bring further improvement in the newborn care. The future

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implication of the study must be designed in such a way that it increases the importance of
skin-to-skin contact under nursing care. According to Koller Kologeski et al. (2017) increase
in the skin-to-skin contact in nursing care helps to promote mother and child bonding and
promotes humanized care approach. In relation to skin-to-skin contact, Nahidi et al. (2014)
conducted a questionnaire based development and psychometric evaluation. The results
highlighted that numerous and irrelevant responsibilities which are imparted on the midwives
has caused decreased in the interest in undertaking the care of newborn of the through skin-
to-skin contact. Thus, in future care planning o new norms, the responsibilities of the nursing
professionals must be devised in a strict manner so that they might provide adequate time in
delivering skin-to-skin contact.
Ethical consideration
Before initiating the study, the authors took permission from Institute Ethics
committee PGIMER Chandigarh. The mane of the healthcare professionals who conducted
the delivery in the Labor room and the name of the mothers over whom the observational
study were conducted were not disclosed as per the data protection act. The revealed data
only included the demographics of the selected group of the healthcare professionals.
Conclusion
The analysis of the article highlighted that the healthcare professionals who are
providing care in the Labor room displayed inadequate practice in delayed cord clamping and
early skin-to-skin contact. Thus main thesis statement, which evolved from the study, is
proper standardization protocol are required to be undertaken in order to educate the
healthcare professionals and subsequently bring change in the newborn practice protocol.
Moreover, the analysis of the additional articles in relation to the newborn care highlighted
that effective importance must be given to the skin-to-skin contact between the mother and

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the newborn. Emphasis over the skin-to-skin contact helps in developing proper bonding
among the mother and child and helps to increase an humanized approach in the care plan.

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References
Holloway, I., & Galvin, K. (2016). Qualitative research in nursing and healthcare. John
Wiley & Sons.
Kardefelt-Winther, D. (2014). A conceptual and methodological critique of internet addiction
research: Towards a model of compensatory internet use. Computers in Human
Behavior, 31, 351-354. https://doi.org/10.1016/j.chb.2013.10.059
Kaufman, J. S. (2017). Methods in social epidemiology (Vol. 16). John Wiley & Sons.
Khyriem, B., Venkadalakshmi, V., & Rana., A. (2017). A pilot study to assess the current
practices of immediate newborn care for term newborns in relation to early skin-to-
skin contact and delayed cord clamping among health personnel of Labour Room.
Nursing and Midwifery Research Journal. 13(3). 2017.
Koller Kologeski, T., Strapasson, M. R., Schneider, V., & Renosto, J. M. (2017). Skin To
Skin Contact Of The Newborn With Its Mother In The Perspective Of The
Multiprofessional Team. Journal of Nursing UFPE/Revista de Enfermagem
UFPE, 11(1). Retrieved from: https://web.a.ebscohost.com/abstract?
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Nahidi, F., Tavafian, S. S., Heidarzadeh, M., Hajizadeh, E., & Montazeri, A. (2014). The
Mother-Newborn Skin-to-Skin Contact Questionnaire (MSSCQ): development and
psychometric evaluation among Iranian midwives. BMC pregnancy and
childbirth, 14(1), 85. http://www.biomedcentral.com/1471-2393/14/85
World Health Organisation. (2013). Maternal, newborn, child and adolescent health. Access
date: 28th September 2017. Retrieved from:
http://www.who.int/maternal_child_adolescent/en/