NRS 433 Rough Draft Quantitative Research Critique and Ethical Considerations Patience
Quantitative Research Critique
The inadequacy of nurses is a serious issue in the US, as it is in many other nations regarding healthcare. This issue is brought on by the steadily growing patient population and the rising nurse turnover rates. According to several authorities, a heavy workload in nursing in the US is causing stress and eventually significant nurse turnover. The issue poses serious difficulties for everyone involved in healthcare, including patients, nurses, and their relatives. Therefore, patients experience subpar care due to the high nurse attrition rate. Numerous research has been undertaken to comprehend and address this issue. This paper assesses the outcomes of two quantitative investigations on the effects of staffing levels on patient safety, infection control, and nurse and patient stress especially in the intensive care unit departments
In the ICU departments, do sufficient nurse workers (I) prevent the occurrence of medical errors, infections, and stress among patients and nurses themselves (O) within one year (T) compared to inadequate nurse workers (C)?
Population (P) – The target population is the patients in the ICU.
Intervention (I) – Sufficient nurse workers
Comparison (C) – Inadequate nurse workers.
Outcome (O) -Prevents infections, stress, and medical errors among the patients and nurses
Time (T) – The duration is one year.
Background of Studies
Fagerström et al. (2018) studied how nurses’ daily workloads relate to patients’ safety in 36 units from four hospitals in Finland, one of which was a tertiary acute care hospital while the other three were secondary acute care hospitals. The researchers used the studying of safety incidents through observation. Also, they based their investigation on collecting information from the reporting system in healthcare institutions. To compare the findings with regressions using the common patients/nurse measure, researchers employed the RAFAELA system to correlate various patient safety issues and patient mortality. Patient safety events and deaths served as the investigation’s preliminary result indicators. It reveals that the nurses’ workload increases the health risks among patients. However, a reduced workload reduces the health risks.
Intensive Care Unit (ICU) patient average nursing care hours are correlated with nursing care metrics in Nogueira et al. (2017). Between 2011 and 2013, the researchers carried out a transversal, descriptive study to gather information from the nursing staff’s daily schedule and the electronic records system. The data was then analysed using Generalized Linear Models. According to the study, providing patients more daily hours reduced the risk of pneumonia and phlebitis, two conditions linked to ventilator use. As a result, it is clear from the study that the number of nursing care hours directly influences patient outcomes, necessitating modification of nurse staffing levels.
The relationship between nurses’ daily workloads and patients’ safety is described in Fagerström et al. (2018). It demonstrates that the workload of nurses raises patient health concerns. But a lighter burden lessens the health dangers. Similarly, Nogueira et al. (2017) examine the proportion of nurse care hours supplied to patient demands. The research also establishes that the length of nursing care impacts patients’ health outcomes. As a result, both studies support the PICOT question since they show a connection between the quality of nursing care and patient outcomes.
Method of Studies
Fagerström et al. (2018) used observational analysis of safety occurrences. Additionally, the researchers base their work on gathering data from the reporting system in healthcare facilities. They collected information from 36 units across four Finnish hospitals, including one that provided acute tertiary care and three others that provided secondary acute care. The RAFAELA system was used daily per standards, valid nursing severity inclusion criteria were measured using the PAONCIL method, and reliable nursing intensity data were expressed in terms of an annual reliability test conducted by parallel classifications. Units that had undergone significant organizational shifts over the preceding year were excluded from the procedure. The same goes for sensitive health information about patients and any information about the qualities of the nurses. In this instance, researchers conducted logistic regression analyses to assess the data and predict correlations between each kind of result and the daily level of nursing intensity per nurse concerning the presumed optimal level. The number of nurses employed in the surveyed ICU on a daily and monthly basis was reported by the researchers in Nogueira et al. (2017) based on the nursing staff’s daily schedule and the electronic records system. After that, the researchers used generalized linear models to examine it. Therefore, the two investigations were different in that Nogueira et al. (2017) used descriptive research to collect information from the electronic records system and the daily schedule of the nursing staff. In contrast, Fagerström et al. (2018) used observation.
Since the researcher may check the validity of the data collected, the observation approach is often accurate. Based on data collected daily, researchers in Fagerström et al. (2018) successfully analyzed the association between nurse workload and patient outcomes. They could apply tools that consider patient variables, including sex, age, and diagnosis. In addition, the study offers some data that suggests the classic nurse staffing indicator, the patients to nurses’ ratio, may partly fall short of adequately controlling for patient severity and casemix.
Additionally, researchers can rely on various tools to verify the phenomena in the observation method. Researchers in Fagerström et al. (2018) gathered nursing resources, patients’ nursing intensity, patient mortality, and patient safety issues daily, totalling 12 475 data points. Additionally, using uncorrected logistic regression models and models that took into account the impacts of the day of the week, holiday, and season, they were able to predict relationships between OPC/nurse and patient safety events or death. However, when utilizing the observational method, researchers might miss some instances that are being examined. Fagerström et al. (2018) study neglect to consider the potential impact of the experts’ patient-related direct time, skill mix, competency level, or job experience.
Using transverse, descriptive studies, researchers can describe, analyse, and record people’s behaviors such as emotions, responses, and attitudes. Researchers found that giving patients more daily hours reduced pneumonia and phlebitis, which are linked to ventilator use (Nogueira et al. (2017). However, this method is subject to biases. For instance, they could base conclusions about a person on the analysis of a larger group or conclude about a group of people based on one person. Nogueira et al. (2017) aim to circumvent this issue by focusing on a particular audience, 1,717 patients.
Results of Studies
According to Fagerström et al. (2018), the risk of patient mortality and other safety issues is enhanced by hospital nurses’ increased workload. The researchers found that if OPC/nurse was below the limit, a medical error mortality chance was nearly 25% lower. A workforce metric based on daily assessments of specific patient care needs and the necessary NWL (OPC/nurse) performed marginally better in predicting incidents and mortality rates than the conventional patient-to-nurse measure.
Nursing care hours affected patients’ health outcomes, according to Nogueira et al. (2017). Researchers found that extending the day for patients reduced their risk of developing pneumonia and phlebitis, two conditions linked to ventilator use.
Fagerström et al. (2018) ensured that the study adheres to ethical standards and protects participants’ rights. It is necessary to obtain approval from the pertinent authorities. Hence, they sought approval from the chief administrative physicians of all four hospitals involved. However, it did not necessitate any additional ethical clearance, which complies with Finland’s regulatory framework for health research. Similarly, Nogueira et al. (2017) had approval from various organizations, including the University of São Paulo (EERP/USP) and the Research Ethics Committee of Ribeirão Preto College of Nurse. Consequently, the two studies were following the necessary laws and regulations.
Before starting their study, researchers must also get participants’ informed consent. Participants are told of the study’s goals, rights, potential advantages and dangers, and the methodology. The participants must next indicate their agreement to participate in the study by signing a consent form. However, informed consent was not used in either study because of the scope of the investigations. The type of approval used by Nogueira et al. (2017) did not require participant agreement. Fagerström et al. (2018) did not require patient agreement because their study incorporated observation and data collection from the reporting process in healthcare facilities.
Both Fagerström et al. (2018) and Nogueira et al. (2017) examine the relationship between the nature of nursing care and patient safety. Specifically, Fagerström et al. (2018) investigate the relationship between patient safety concerns and fatalities and the workload of each nurse. On the other hand, Nogueira et al. (2017) compare nurse care indicators with the number of nursing hours spent caring for patients in intensive care units. While Nogueira et al. (2017) utilized a transverse, descriptive study to gather data, researchers in Fagerström et al. (2018) used observation. Both investigations adhere to ethical norms because they have received the necessary authority’s approval. The two approaches were useful since they supported the study’s conclusions that staffing levels affect nurses’ and patients’ outcomes. However, they had some limitations that probably compromised the findings.
Fagerström, L., Kinnunen, M., & Saarela, J. (2018). Nursing workload, patient safety incidents and mortality: an observational study from Finland. BMJ Open, 8(4), e016367.
Nogueira, T. D. A., Menegueti, M. G., Perdoná, G. D. S. C., Auxiliadora-Martins, M., Fugulin, F. M. T., & Laus, A. M. (2017). Effect of nursing care hours on the outcomes of Intensive Care assistance. PloS one, 12(11), e0188241. https://doi.org/10.1371/journal.pone.0188241
Write a critical appraisal that demonstrates comprehension of two quantitative research studies. Use the “Research Critique Guidelines – Part II” document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the study in your responses.
Use the practice problem and two quantitative, peer-reviewed research articles you identified in the Topic 1 assignment to complete this assignment.
In a 1,000–1,250 word essay, summarize two quantitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
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As noted above, nursing shortage is a critical issue that affects the safety and quality of care given to patients (Bittner & Bechtel, 2017). Nursing shortage is an issue that affects most of the healthcare organizations in America in the modern world. The American Association of Colleges of Nursing (AACN) reports that the shortage of nurses in the US is anticipated to rise in the next decade due to the aging of the Baby Boomers. The aging of the Baby Boomers will also imply the increased need for care demands, hence, overburdening the already burden healthcare system due to nursing shortage (Marć et al., 2019). Shortage of nurses in the US is also attributed to the low capacity of nursing schools that do not produce new nurses to meet the increasing demands (Sokhanvar et al., 2018).
Authors have explored the issue of shortage of nurses in their studies. One of the studies that examined the issue of nursing shortage is the one conducted by (Halter, Boiko, et al., 2017). Halter et al., (2017) identified in their study that nursing turnover is a critical factor contributing to the shortage of nurses being experienced in America today. As a result, the aim of their research was to investigate the determinants as well as consequences of staff turnover among adult nurses. The research question that guided their investigation was; what are the determinants and consequences of adult nursing staff turnover? Halter, Pelone et al., (2017) conducted another study to examine evidence-based interventions that can be used to address the issue of nursing shortage by reducing adult nursing turnover. The authors recognized the fact that nursing shortage is preventable by implementing practical interventions that aim at its contributing factors. Therefore, the research question that guided the authors was; what interventions can be embraced to reduce adult nursing turnover?
How do these two articles support the nurse practice issue you chose?
The articles by Halter, Pelone, et al. (2017) and Halter, Boiko, et al. (2017) answers the PICOT question for my project in a number of ways. Firstly, the article by Halter, Boiko, et al., (2017) answers the PICOT question by providing insights into the determinants of factors that contribute to shortage of nurses and its consequences. The information obtained from the article provides information about the severity and magnitude of the problem of nursing shortage, hence, increasing the need for the exploration of interventions to address the problem. The article by Halter, Pelone, et al., (2017) answers the PICOT question by providing evidence-based interventions that can be adopted to address the issue of nursing shortage. The article examines broad interventions that are applicable to health organizations in addressing the issue of nursing shortage. The article by Halter, Pelone, et al., (2017) provided interventions that are similar to those proposed in my PICOT question. The interventions include the adoption of teamwork approaches in nursing, effective leadership styles, preceptor-based programs, needs-based orientation programs, use of residency programs and expanding the training capacity of nursing education institutions. The two articles used previous studies with a mix of comparison groups comprising of nurses, nursing students, and healthcare leaders and managers. As a result, the comparison groups vary from those in my PICOT question.
Method of Study:
The studies by Halter, Pelone, et al., (2017) and Halter, Boiko, et al., (2017) were quantitative systematic reviews. The authors reviewed evidences from previous quantitative studies that examined the factors contributing to nursing shortage, including turnover by adult nurses. The quantitative systematic reviews that the authors performed are associated with a number of benefits as well as limitations. The benefits include the fact that they provide highly reliable and accurate data, addresses specific questions or hypothesis, and guides the identification of best practices in nursing. The method is however associated with limitations such as the lack of use of human subjects, using studies with bias, and presenting findings that may not be generalizable to a larger population.
Rough Draft Quantitative Research Critique and Ethical Considerations – Rubri
Provide examples of experimental and nonexperimental research design. Contrast the levels of control applied to each.Experimental research design is defined as “a type of quantitative research design that in highly controlled to study cause and effect with independent and dependent variables” (Helbig, 2018). Experimental research is very common in healthcare and helps lead evidence-based practice. An example of experimental research is the prevalence and prevention of central line associated blood stream infections (CLABSI). Experimental research design in the case of CLABSI focuses on the time frame from central line insertion to time of infection, factors that could have added to the risk for infection such as nonsterile insertion, loose dressing, lack of chlorhexidine gluconate patch, and other factors (Baier, et al., 2020). Many other examples of experimental research design are present within the healthcare field. Each day, another example of a potential research project comes to mind in order to increase the positivity of patient outcomes.
Non-experimental research “involves data collection of the study participants in their natural or real-world environments” (Chew, 2019). Non-experimental research uses observation skills and does not have controls like experimental research. In nonexperimental research, variables such as the independent variable are not present, and the researcher is unable to manipulate any part of the study. An example of non-experimental research design would be a survey related to which IV catheter is preferred by nurses. It is non-experimental because there is no control, and the study cannot be manipulated with in independent variable. The nurses simply give their answer and then the researcher can come to conclusions based on the answers. Non-experimental research is not as reliable as experimental research due to the lack of controls and quantitative backing behind the findings. Other examples of non-experimental research exist in the psychology field where researchers can observe correlations between factors but cannot manipulate any variables. For example, if the researcher is observing the presence of diagnosed white coat syndrome in a patient, they will simply observe how the patient reacts around medical professionals but will not be able to adjust any of the variables in the research.
Baier, C., Linke, L., Eder, M., Schwab, F., Chaberny, I.F., & Vonberg, R.P. (2020) Incidence,risk factors and healthcare costs of central line associated nosocomial bloodstream infections in hematologic and oncologic patients. PLoS ONE 15 (1). https://doi.org/10.1371/journal.pone.0227772Chew B. H. (2019). Planning and Conducting Clinical Research: The Whole Process. Cureus, 11(2), e4112. https://doi.org/10.7759/cureus.4112
Helbig, J. (2018). History and process of nursing research, evidence-based nursing practice, and quantitative and qualitative research process. In GCU’s nursing research: Understanding methods for best practice. https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/1
The two main types of quantitative research studies are experimental and non-experimental. For an effective investigation and high-quality data discoveries, the study design and technique the researcher should employ depends on the kind of research questions that the researcher aims to address. A scientific method is applied in experimental investigations to manipulate one or more control variables and assess the impact of the modification on the dependent variables (McNiff & Petrick, 2018). Non-experimental investigations, on the other hand, do not entail the manipulation of control variables.
Cross-sectional, correlational, and observational studies are examples of non-experimental research, whereas pre-experimental, quasi-experimental, and randomized control trials are experimental studies (Andrade, 2019). For example, a study on the prevalence and determinants of childhood obesity is a non-experimental study. An example of an experimental study would be determining the impact of an exercise program in preventing childhood obesity and applying the intervention in one group against a control group.
When manipulating the research variables is difficult or impossible, non-experimental research investigations must determine the causal relationship between two variables. Non-experimental studies are essential when the researchers cannot assign subjects at random to groups or conditions when the research is broad and exploratory, when there is little information available on research studies, when the research is on the non-causal relationship between variables, and when the study is about a causal relationship. Still, the researcher cannot manipulate an independent variable (Andrade, 2019). The control variables in the research do not change, and non-random selection is prominent.
To maintain high validity, experimental studies apply strict manipulation and control within the research design. Therefore, experimental studies are usually labor-intensive in comparison to non-experimental studies. As a result, the cost of conducting experimental studies is higher in most cases (McNiff & Petrick, 2018). In non-experimental studies, the researcher neither manipulates the control variables nor the environment or conditions. The researchers study the variables on the subjects as they naturally occur in their environment without manipulation.
Andrade, C. (2019). Describing research design. Indian journal of psychological medicine, 41(2), 201-202. https://doi.org/10.4103%2FIJPSYM.IJPSYM_66_19
McNiff P. & Petrick M. (2018). Nursing research: Understanding methods for best practice. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/3
Rough Draft Qualitative Research Critique and Ethical Considerations – Rubric
1. 1: Unsatisfactory
2. 2: Less Than Satisfactory
3. 3: Satisfactory
4. 4: Good
5. 5: Excellent
Discussion of ethical considerations when conducting nursing research is incomplete. A discussion on ethical considerations of the two articles presented in the essay is incomplete.
Discussion of ethical considerations when conducting nursing research is included but lacks relevant details and explanation. A discussion on ethical considerations of the two articles used in the essay is summarized but there are significant inaccuracies or omissions.
Discussion of ethical considerations when conducting nursing research is partially complete and includes some relevant details and explanation. A discussion on ethical considerations of the two articles used in the essay is discussed but there are some inaccuracies, or some information is needed.
Discussion of ethical considerations when conducting nursing research is complete and includes relevant details and explanation. A discussion on ethical considerations of the two articles used in the essay is presented; some detail in needed for accuracy or clarity.
Discussion of ethical considerations associated with the conduct of nursing research is thorough with substantial relevant details and extensive explanation. A detailed discussion on ethical considerations of the two articles used in the essay is presented.
Results of Study
Results of Study
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