HNB2007 - Research and Evidence Based Practice Assignment

Assignment Task

1. Screening

The purpose of the screening questions is to consider if the paper is worth reading. You need to answer questions 1 and 2 of the CASP tool here. There is no need for references in this short section.

2. The research problem and its significance

The task here is to describe the research problem (the reason the researcher is interested in the study) and its significance (why it is important).

3. The research design

The task here is to identify the research approach, which refers to how the study was conducted. What was done? To whom? For what reason?

Is the study qualitative or quantitative? What type of study (e.g Phenomenology; ethnography, descriptive study)? Describe the study characteristics (e.g. sample size; inclusion criteria, who was excluded, why?). You also need to discuss the appropriateness of the design for the study. For example, in qualitative studies- subjective, experience, understanding. You need to answer questions 3-5,7 of the CASP tool here. Make sure you have included- recruitment, ethics, data collection.

4. Data analysis

In this section, the analysis of the study recordings/ transcripts needs to be described and evaluated, using question 8 of the CASP guide. This means providing a step by step overview of the analysis.

6. The findings/results of the study need to be discussed

Taking into consideration the clarity of the findings, what they mean and the value of the study. You need to answer questions 9-10 of the CASP tool here. Comparison with other research evidence (journal articles) is important.

7. Relevance to contemporary nursing policy and practice

Finally, you are required to discuss the relevance of the study to contemporary nursing policy and practice; is this a problem in Australia? In the local area (Western Suburbs of Melbourne). This includes the impact the findings may have for nurses.

Sample critical appraisal information to include:

This is a sample for a Quantitative research critical appraisal for the article by Bridges, Griffiths, Oliver and Pickering (2019) report the findings of a study that sought to describe how nurse staffing relates to staff-patient interactions. A critical appraisal of any article focuses on the research problem, its significance, design, methods, as well as its findings and relevance for policy and nursing practice.

The Research Problem and its Significance

This article which provided background information about the nursing staffing topic by first highlighting how nurse shortages impair the ability to deliver quality and safe care. Notably, the research problem is presented in the form of an aim statement: to explore the link between nurse skill mix, staffing levels and quality and quantity of interactions with hospitalized patients. However, Bridges et al. (2019) noted a gap that no studies had examined the impact of substituting nursing staff with assistant personnel on patient interaction. The authors, therefore, considered the study as significant because understanding the quality of nurse-patient interactions is an important determinant of care quality and patient experience mostly among older patients. This is the first study to describe the relationship between the nursing staff and staff patient interactions.

The Research Design

The selected study was based on an observational design. Observational prospective studies involve non-experimental methods whereby ongoing behavior is observed by the researcher (reference). This was the case in the selected study where participants were observed in their daily practice. Notably, observational study designs have benefits including, helping gather data on a sequence of events, examining multiple outcomes and investigating rare exposures (Gilmartin-Thomas, Liew & Hopper, 2018). However, observational studies have limitations including, the significant risk of selection bias, the need for long follow-up durations, and their expensive nature (Gilmartin-Thomas et al., 2018). Nevertheless, the observational design in the chosen study is appropriate as it helped the researchers gather data that helped answer the research question

The Research Methods

Methods and procedures used in the study are an important consideration and these relate to sampling, data collection, and data analysis. A study's sample is considered critical. In the selected article, the sample was made up of nurses and patients in 6 wards in two NHS hospital Trusts. The wards had an average of 44 full time staff, and the patients were aged at least 65 years. Overall 270 patients were observed. Notably, the article does not provide details about the sampling method, but it appears that a convenience sample was used. Convenience sampling involves a non-probabilistic selection of subjects due to proximity and accessibility and may lead to biased findings (Melnyk & Fineout-Overholt, 2014). Additionally, the study sample should be represented by reflecting the population from which it was drawn (Melnyk & Fineout-Overholt, 2014). Accordingly, the study sample can be considered representative as it was made up of nurses and elderly patients in the wards, and this was the specific population that the researchers were interested in.

The sample size is another important consideration (Abell & Garrett Wright, 2016). Considering this was an observational study, which may benefit from huge sample sizes, the fact that only 270 patients were observed may indicate insufficient sample size. Data analysis is another consideration when critiquing a study. Data analysis in the selected study involved statistical analysis. The statistical tests used and their rationale should be identified (Melnyk & Fineout-Overholt, 2014). Similarly, the authors noted that descriptive and inferential statistics were employed. The descriptive statistics included means and standard deviation. Concerning inferential statistics, Stata V.11.0 was used to conduct multiple regression analysis and the inferential statistics involved included Wald tests at 5% two-sided level to determine the significance of staffing levels.

The confidence interval was set at 95%. P values for each finding were also provided Regarding data collection, the procedures used should allow for the collection of appropriate data to answer the question. In the selected study, data on observed staff-patient interactions were collected using the Quality of Interaction Schedule (QuIS), an instrument that helps measure the quality and length of staff-patient interactions. Melnyk and Fineout-Overholt (2014) highlighted the need for researchers to include information regarding the instrument used, including its appropriateness, validity, and reliability. Concerning appropriateness, the QuIS tool was appropriate as it allowed for the collection of relevant data. The instrument's reliability and validity were also ascertained with the authors reporting its previous use in several studies. Notably, data collection procedures must be detailed (Abell & Garrett Wright, 2016). Accordingly, a clear description of how observations were made and recorded is evident in the methods section. Regarding data collection, the procedures used should allow for the collection of appropriate data to answer the question. In the selected study, data on observed staff-patient interactions were collected using the Quality of Interaction Schedule (QuIS), an instrument that helps measure the quality and length of staff-patient interactions.

Melnyk and Fineout-Overholt (2014) highlighted the need for researchers to include information regarding the instrument used, including its appropriateness, validity, and reliability. Concerning appropriateness, the QuIS tool was appropriate as it allowed for the collection of relevant data. The instrument's reliability and validity were also ascertained with the authors reporting its previous use in several studies. Notably, data collection procedures must be detailed (Abell & Garrett Wright, 2016). Accordingly, a clear description of how observations were made and recorded is evident in the methods section.

Contemporary nursing policy and practice

Regarding policy relevance, the findings point towards a policy initiative that would ensure that all hospitals have reasonable nurse-to-patient ratios. In relation to nursing policy and practices, when hospitals have staff shortages these policies and practices should focus on improving the supply and preservation of RNs, rather than substituting the RNs with HCA workers, this may be less detrimental to the quality and care of the patient (Bridges, Griffiths, Oliver & Pickering, 2019). Nursing staff metrics that treat RN and HCA hours as equivalent, can provide a significantly misleading picture of the ability of the nursing workforce to deliver high-quality care to patients and their families (Bridges, Griffiths, Oliver & Pickering, 2019). This should try and limit the pressure on RNs due to the nurse-to-patient ratio or taking on extra patients because the HCA doesn’t have the skills to handle the patient.

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