Quantitative Research Critique Essay

In a 1000-1,250 word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.
Refer to the resource \”Research Critique Guidelines\” for suggested headings and content for your paper.
Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is not required.
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PICOT Statement:
For hospitalized adult patients (P), does use of the CAUTI Bundle/Guide (I) compared with CAUTI without use of Bundle/Guide (C) reduce the rate of CAUTI (O) within 180 days of process improvement implementation (T)?

Quantitative research critique

This paper presents a critique of a study that was published in the American Journal of Infection Control in 2012. The study applied a quantitative research approach. In the article “Nurse-directed interventions to reduce catheter-associated urinary tract infections” by Oman et al. (2012), the results are presented to show how nursing personnel can meaningfully contribute towards reducing catheter-associated urinary tract infection (CAUTI) incidence among hospitalized patients.

Background of Study

Oman et al. (2012) notes that CAUTI incidences are common among hospital patients, and they have serious consequences to include both the cost and associated morbidity. It further adds that the available statistics paint a grim picture since approximately 25% of hospitalized patients use catheters and 10% of them acquire urinary tract infection (UTI) during their hospital stay. The implication is that 25% of hospitalized patients have high potential for developing CAUTI. However, this is not a new concern and has been extensively evaluated and resulted in the development of evidence-based guidelines for indwelling catheter management. Still, the study notes that the guidelines are not consistently applied so that their effectiveness is actually reduced.  To address this concern, the study proposes that nursing personnel can take on a leadership position in directing the guidelines application thus being responsible for consistent application. The underlying intention is to identify the value of nurse-directed interventions in reducing CAUTI. In this respect, Oman et al. (2012) explores the contributions that nursing personnel can make to reduce central line-associated bloodstream infection (CLABSI) incidence when they direct interventions as leaders.

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Method of Study

Oman et al. (2012) applies a quantitative research approach to collect primary data that directs the research conclusions. In this case, the focus is on collecting numerical data that is then subjected to statistical analysis to determine data trends and themes. The study applies a pre-post intervention design to evaluate the effects of evidence-based nurse-led interventions as quality improvement approaches. The participants were recruited from among patients and multidisciplinary care teams in two medical/surgical units. The study setting was two adjacent medical/surgical nursing units in the University of Colorado Hospital. Each one of the two units had a capacity of 18 beds. A review of their records revealed that every month, 150 patients in the surgery unit and 125 patients in the pulmonary unit used indwelling urinary catheters. All the patients using indwelling urinary catheters in the two units were recruited for the study, except for those having urologic surgery. The study protocol was applied in three phases. The first phase was conducted over three months and it entailed collecting baseline data from the two units. The second phase involved applying house-wide intervention that entailed integrating the efforts of nursing personnel, patients and family members to apply evidence-based practice in reducing CAUTI incidence among hospitalized patients to be accompanied by data collection. The final phase involved applying focused intervention that included educational sessions, competency training and journal clubs to be accompanied by data collection. Data collection focused on demographic data (age, gender, surgical procedure and length of stay in the hospital), CAUTI rates (number of infections for every 1,000 catheter days for the participating patients), IUC duration, and bladder scanner log. The collected data was subjected to statistical analysis that presented the appropriate descriptive statistics and student t-test with the confidence interval set at 95% (Oman et al., 2012).  Quantitative Research Critique Essay

The method applied in the study is appropriate for the research intentions. Through applying a quantitative research approach that collected numerical data, the study was able to carry out a direct comparison to evaluate the effects of the intervention. In addition, the study methodology was comprehensively described thereby facilitating research replication efforts. As such, the methodology is appropriate to meet the research intentions.

Results of Study

The first phase of the study recruited 80 patients in the pulmonary unit and 139 patients in the surgery unit. The second phase recruited 97 patients in the pulmonary unit and 141 patients in the surgery unit. The final phase recruited 96 patients in the pulmonary unit and 142 patients in the surgery unit. 947 medical personnel were subjected to the health stream module while 96% of them completed the module. 100% of the nursing personnel in the operating room completed the competency-based IUC insertion training while the nursing personnel in the emergency department did not undertake the training. 95% of the medical personnel attended journal club discussions on intervention unit in-services and bladder scanner training. An evaluation of catheter duration over the three phases showed a reduction for both the pulmonary unit (p=0.076) and general surgery unit (p=0.018) with an average decrease from 400 days to 305 days. CAUTI incidence was maintained at 0.0 in the pulmonary unit but it increased for the surgical unit from 1.9 in phase one to 3.4 in phase two before settling at 2.2 in phase three. Length of stay in the pulmonary unit progressively decreased from 7.39 in phase one, to 7.21 in phase two before settling at 6.72 in phase three. For the surgical unit, the length of stay initially increased from 6.91 in phase one to 8.03 in phase two before reducing to 6.55 in the phase three. The study determined that the program allowed the facility to save $52,000 every year. Although the study did not produce definite results for changes in CAUTI rates, a reduction in catheter-days was achieved to imply that nurse-led interventions can improve nursing care outcomes (Oman et al., 2012).

Ethical Considerations

The article reports that the study was exempted from oversight by the institutional review board since the study focused on quality improvement and would not expose the participants to any harm. Given that it used medical records as a primary source of information, there was an assurance of the patient data being kept confidential and stored in password-protected locations. Also, information that could identify the participants was not included in the study thus ensuring that they remained anonymous as required by the law. The project was financially supported by a quality improvement small grant from the University of Colorado Hospital and the University of Colorado Denver School of Medicine thus showing that there was no conflict of interest that could unduly influence the results (Oman et al., 2012).

Conclusion

Oman et al. (2012) explored the potential for nurse directed interventions to reduce CAUTI incidence in surgical and pulmonary units. The study was galvanized by the commonality, morbidity and costliness associated with CAUTI. The study applied a quantitative approach that entail using a pre-post intervention design. The results noted that catheter days and costs reduced following the intervention. Still, it noted that CAUTI rates were too low to present statistically significant result although a reduction was equally reported. Based on the study results, the article determined that nurse-led interventions guided by evidence should be applied to reduce CAUTI infections, catheter days and facility costs.

Research Critique Guidelines

Quantitative Study

Background of Study:

• Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem.
• How did the author establish the significance of the study? In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem.
• Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims.
• List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers.
• Were the purpose and research questions related to the problem?

 Methods of Study

• Identify the benefits and risks of participation addressed by the authors. Were there benefits or risks the authors do not identify?
• Was informed consent obtained from the subjects or participants?
• Did it seem that the subjects participated voluntarily in the study?
• Was institutional review board approval obtained from the agency in which the study was conducted?
• Are the major variables (independent and dependent variables) identified and defined? What were these variables?
• How were data collected in this study?
• What rationale did the author provide for using this data collection method?
• Identify the time period for data collection of the study.
• Describe the sequence of data collection events for a participant.
• Describe the data management and analysis methods used in the study.
• Did the author discuss how the rigor of the process was assured? For example, does the author describe maintaining a paper trail of critical decisions that were made during the analysis of the data? Was statistical software used to ensure accuracy of the analysis?
• What measures were used to minimize the effects of researcher bias (their experiences and perspectives)? For example, did two researchers independently analyze the data and compare their analyses?

Results of Study

• What is the researcher’s interpretation of findings?
• Are the findings valid or an accurate reflection of reality? Do you have confidence in the findings?
• What limitations of the study were identified by researchers?
• Was there a coherent logic to the presentation of findings?
• What implications do the findings have for nursing practice? For example, can the findings of the study be applied to general nursing practice, to a specific population, or to a specific area of nursing?
• What suggestions are made for further studies?

Ethical Considerations

• Was the study approved by an Institutional Review Board?
• Was patient privacy protected?
• Were there ethical considerations regarding the treatment or lack of?

Conclusion

• Emphasize the importance and congruity of the thesis statement.
• Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice.
• Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice.
• Integrate a summary of the knowledge learned.

Reference

Burns, N., & Grove, S. (2011). Understanding nursing research (5th ed.). St. Louis, MO: Elsevier.

Quantitative Research Critique Essay