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Running head: QUALITATIVE STUDIES 1

QUALITATIVE STUDIES 4

Qualitative Research Critique and Ethical Considerations

Daniel Nweke

Grand Canyon University

NRS-433V Introduction to Nursing Research

Professor Tijana Zelenovic

Qualitative Research Critique and Ethical Considerations

Study 1: Dukes, K., Bunch, J., Chan, P., Guetterman, T., Lehrich, J., & Trumpower, B. et al. (2019). Assessment of Rapid Response Teams at Top-Performing Hospitals for In-Hospital Cardiac Arrest. JAMA Internal Medicine, 179(10), 1398. https://doi.org/10.1001/jamainternmed.2019.2420

Background of the Study

The study gap that is recognized is that there are multiple patients that encounter the in-hospital cardiac arrest annually and most of them die because of the poor efforts that are in place in terms of timelines and time for resuscitation. The study highlights the rapid response team (RRT) as an important strategy that works towards the prevention of in-hospital cardiac arrest (Dukes et al., 2019). Having the RRT in place is important in the process of conducting an evaluation on the patient health deterioration and consider an immediate start of life-saving interventions including transferring the patient for specialized and emergency care in higher level care areas as the intensive care unit (ICU) (Dukes et al., 2019). There is also an aspect that maintaining the operations of the RRT in the hospital facility is quite expensive and demands for more revenue like a medium-size hospital spending around 1$ million in a 5-year period plan. The research question for the study is that: “how do rapid teams differ between top-performing and non-top performing hospital resuscitation care?” The problem statement of the study is that hospitals are considered non-performing if they have no RRTs team that offer an immediate response to in-hospital cardiac arrest that require an immediate intervention to save life. There is the challenge of preventing deaths associated with cardiac arrest in the hospitals. The purpose of the study is to conduct an evaluation about the differences in the design and implementation of RRT between top-performing and non-performing hospitals in handling deteriorating patient health due to cardiac arrest. Nurses are relevant in this RRT team because they are the people that are close to patient and are there for monitoring and their feedback is much needed to achieve an early intervention in case of cardiac arrest.

The article answers the PICOT question based on how the nurses play an important role in handling the cardiac arrest of in-hospital patients as part of the RRT team. The intervention group in the article that is the RRT works effectively since it is a multi-disciplinary team that monitor and evaluate patient in the hospital and offer an immediate treatment or intervention by taking them to higher specialized care wards like the ICU.

Method of Study

A qualitative analysis was conducted where semi structured interview was done where about 158 hospitals were involved engaging on the healthcare providers that included the nurses, physicians, and administrators. The benefit of the method is that a detailed insight was collected from the population of interest. The challenge is that the results collected is difficult to replicate.

Results of the Study

Most of the participants in the study are nurses and this demonstrated that nurses play an important role as the members of the RRT response team. Top-performing sites had significantly different RRTs in four areas: team design and composition, RRT involvement in patient monitoring for high-risk patients, bedside nurse empowerment to activate the RRT, as well as collaborative work with bedside nurses before during and after an RRT response (Dukes et al., 2019). RRTs at high-performing hospitals were often staffed by dedicated team members without competing clinical responsibilities, who provided expertise to bedside nurses in managing patients at risk of deterioration and collaborated with nurses during and after a rapid response. Bedside nurses have the freedom to use RRTs on their own, without fear of retaliation from doctors or hospital personnel.

Ethical Consideration

The study was conducted in an ethical manner where the participants were requested for their consent to participate and taking part was a voluntary process.

Conclusion

The qualitative study has indicated that hospitals that are operating and performing well would have the RRT in place that consists of the dedicated staff and led by the nurses in implementing the clinical roles and work collaboratively as a multi-disciplinary team and ensure that patients interests are prioritized.

Ethical Consideration

The participants in the study participated in approving consent of participation and also, they were requested to participate voluntary. The participant’s data was protected and assured that their data is secured.

Study 2: Bunkenborg, G., Barfod O'Connell, M., Jensen, H., & Bucknall, T. (2022). Balancing responsibilities, rewards, and challenges: A qualitative study illuminating the complexity of being a rapid response team nurse. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.16183

Background of the Study

The nurses have been working as the frontline staff in the rapid response team (RRT) in the process of handling critical situations that are experienced in the acute care hospitals. The literature has indicated that nurses feel that their collaboration to the handling of acute care in hospitals is successful due to their collaboration with the general ward nurses and the physicians. There was the need that the RRT is adjusted to benefit the patient benefit and also the team member’s job satisfaction (Bunkenborg et al., 2022). The purpose and objective of the study is that understanding the nurse perception about being in the RRT and the way they consider collaboration with other healthcare providers in handling acute care experienced with the patients (Dukes et al., 2019). The research question is: What perception does the nurses have as being part of the RRT team in hospital? The problem is that nurses have different perceptions about their role in the RRT team in serving critical care. The research is much critical in answering the PICOT question concerning the role nurses play as part of the RRT team and their contribution in the critical care especially in the cardiac arrest in hospital.

Method used

Qualitative research was used and this was intentionally done in order to source more information about the role nurses play in RRT and their perception about their contribution (Bunkenborg et al., 2022). The qualitative method is beneficial that data collected has more insight as compared to using the quantitative method. The disadvantage is that the data may not be replicated.

Results of the Study

The themes that emerged from the study include balancing the responsibilities as nurses towards handling RRT assignment well especially when attending to cardiac arrest cases that happen within the hospital facility. The issue of rewards and challenges was also the outcome of the study and it stated that the desired outcome is to help the patients using the RRT as the core function to ensure that they receive the best care.

Conclusion

Working as an RRT nurse is a challenging task but having the training and experience in the RRT field results to a satisfaction assisting the patients especially those experiencing deteriorating health and restore it back. There is the need to have resources for training staff for interdisciplinary collaboration to minimize stress transferred to nurses during implementation.

Ethical Consideration

According to the study only collected data that was already available and took patient and nurse data privacy into account, it did not raise any ethical red flags.

References

Bunkenborg, G., Barfod O'Connell, M., Jensen, H., & Bucknall, T. (2022). Balancing responsibilities, rewards and challenges: A qualitative study illuminating the complexity of being a rapid response team nurse. Journal Of Clinical Nursing. https://doi.org/10.1111/jocn.16183

Dukes, K., Bunch, J., Chan, P., Guetterman, T., Lehrich, J., & Trumpower, B. et al. (2019). Assessment of Rapid Response Teams at Top-Performing Hospitals for In-Hospital Cardiac Arrest. JAMA Internal Medicine, 179(10), 1398. https://doi.org/10.1001/jamainternmed.2019.2420