Rough Draft Qualitative Research Critique and Ethical Considerations
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QualitativeResearchCritiqueandEthicalConsiderations.docxRunning head: Qualitative Research Critique and Ethical Considerations 1
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Qualitative Research Critique and Ethical Considerations
Salice Acha Njei
Grand Canyon University: (NRS-428VN)
06/16/2020
PICOT Question:
For hospitalized patients age 65 and older (P), does the use of bed alarms (I), compared to current practice (C), reduce the number of fall incidents (O), within 4 weeks (T)?
Majkusová et al. (2016) describes a fall as an event that results in an individual coming to rest inadvertently on the ground, floor or other lower level. Older people are at a greater risk of fall and this has significant consequences to their quality of life and that of their families. With the population of people who are 65 years and above set to more than double in the next decade, it is undoubtedly important that risk factors are established and an effective prevention program established to mitigate these falls. This way, hospitals are implementing bed alarms to improve patient safety and quality of care delivery. Therefore, this discussion will critique these two qualitative studies that support the proposed evidence-based practice initiative to support the central question in this research paper which is “can the use of alarm sensors or bed alarms reduce fall incidents with the elderly in a hospital setting?”.
Qualitative Studies
According to Majkusová et al. (2016) qualitative study is a research method conducted in natural settings, and the used data are words or text, rather than numerical, in order to describe the experiences that were being studied. There are a variety of methods of data collection in qualitative research, including observations, textual or visual analysis (example from books or videos) and interviews (individual or group).The first qualitative study is Enema, D. M., Skinner, A. M., Nailon, R., Conley, D., High, R., & Jones, K. J. (2019). Patient and system factors associated with unassisted and injurious falls in hospitals: an observational study. BMC Geriatrics, 19(1), 1. Retrieved from:
https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/detail/detail?vid=0&sid=bedb2bb0-ec00-4d86-abcf 092c57247ca2%40sessionmgr4008&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=140312571&db=edb. The second one is Majkusová, K., Jarošová, D., Zeleníková, R., & Kozáková, R. (2016). Assessing the methodological quality of clinical guidelines for preventing falls of patients. Central European Journal of Nursing & Midwifery, 7(4), 549. Retrieved from:
https://eds-b-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=0&sid=da9cb59c-18bc-4aec-899b-72423a431e61%40pdc-v-sessmgr02. These two qualitative studies support the fact that implementing bed alarms in hospital settings helps to reduce the number of falls incidents with the elderly population.
Background of Study
Older people are more susceptible to falls than young people because of a few factors. These factors may include, however not limited to; chronic health conditions such as dementia, hypotension, and heart disease which cause dizziness, poor vision, muscle weakness, and labyrinthitis. All the factors above cause a loss of balance, dropping, or a sudden feeling of unsteadiness, which are all supporters of falls. External factors that may cause falls among the older people are; recently polished floors, dim light, rugs or carpets that are not adequately safeguarded, trying to reach high storage places like cupboards, tripping on the stairs. The risk of falls additionally significantly increases with the increase in age.
How these two articles support the nurse practice issue chosen
For hospitals to measure how well they succeed in making patients safer related to falls, the number and fall-related injuries in the hospital must reduce to zero. If falls and fall-related injuries continue to decline, the hospital is implementing proper measures to mitigate the issue. Conversely, hospitals formulate new ways and methods to improve their care delivery standards if the number of falls and fall-related injuries continues to get worse. According to Enema et al. (2019), as one gets older, the higher the risk of falling. Implying that fall-related accidents for hospitalized older patients continues to increase. Understanding the negative impacts falls have on the aging population, healthcare facilities need to improve on quality improvement efforts and patient safety to reduce falls and fall-related injuries. Therefore, he posits that hospitals in pursuit of reducing or eliminating falls need to consider other strategies like installing bed alarms. This argument is central to my PICOT question. It intends to find out whether the use of bed alarms compared to existing practice will reduce the occurrence of fall incidents in hospitalized patients age 65 and older. Based on the research, it is evident that the beds' alarms are meant to aid nurses in monitoring their patients, to be precise, those at risk of falling.
Conversely, the research by Majkusová et al. (2016) was done by evaluating articles on how to prevent the risk of falling in older patients employing a methodological quality investigation with clinical practice guidelines (CPG's). This examination would be positioned in the seventh level of the evidence hierarchy because of it being a data reduction, gathering data, and listing different studies without a test trial or interviewing individuals. This therefore means, health care providers should be responsible for creating and maintaining a safety culture to residents who are at high risk of falling through constant and communal vigilance. Nurses should reinforce preventive care as they act as patients advocates in the hospital. This research source is very crucial to me as it is arguing on similar bases as to my PICOT question, where I want to find out how hospitals operate with an implemented fall prevention technology to reduce the number of falls incidents. Nevertheless, my study used a different research intervention as compared to both researchers.
Method of Study
Enema et al. (2019) conducted an observational analysis to investigate the occurrence of patient falls recorded in Nebraska hospitals by analyzing 353 reported fall events. The strength of this article had multiple interventions in fall prevention for the elderly patients. It is clear, concise, and has ways to support study without being biased. Nevertheless, as compared to other studies that researched factors associated with falling in-assisted and experiencing a fall-related injury, this article used a small sample size. On the contrary, Majkusová et al. (2016) planned to survey the methodological quality of chosen CPGs for preventing the risk of fall in older patients in acute setting with the AGREE II generic instrument. The article's strength is having strong evidence of relationships (from the credible resources and having the information surveyed by four independent specialists) alongside offering no noteworthy risks to validity.
Results of Study
The results of the exploration by Enema et al. (2019) direct the path toward further examination to evaluate the pervasiveness of alert alarms in every state, alongside related fall rates at a representative sample of hospital. First, an organized correspondence structure was required to promote effective fall prevention alert response. And, second, hospital safety culture is firmly connected with the adopted technological system. Implementing a fall prevention program with an assessment tool and specific guidelines such as bed alarms in the nursing field will help healthcare professionals decrease inpatient falls.
The research performed by Majkusová et al. (2016) was situated in Australian medical clinics to survey the methodological quality of clinical practice guidelines using the AGREE instrument. It was found that the AGREE instrument is central strides for their further adjustment – adaptation to various socio-cultural and hospital settings. The research inferred that many older adults took risks during the recovery stage to improve or be well to establish independence at home. Therefore, healthcare facilities should adopt proper risk mitigation measures that offer assistance during falls and fall-related injuries and to discover how a fall is supported. Even though the use of these alarms does not necessarily mean that falls will not occur, hospitals must use fall prevention programs to yield significant results. Nursing leadership can be a driving force to implement change on an extensive systematic level by tracking, trending, reporting, and analyzing factors to prevent further patient harm.
Ethical Considerations
Firstly, researchers acquired approval before conducting their research. This is a considerable ethical concern that any researcher should consider before starting any study. Secondly, researchers effectively cited secondary materials they used in their research. This is an essential ethical consideration because it avoids plagiarism in the survey. Secondary sources were adequately cited by both researchers, which showed they are acknowledging and giving credit to other researchers. Lastly, they have supported their findings using a considerable amount of literature. This means both researchers have played within the standards highlighted by the University Committee and greatly supports that implementing bed alarms in hospital settings reduces fall incidents with the elderly population.
References
https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/detail/detail?vid=0&sid=bedb2bb0-ec00-4d86-abcf 092c57247ca2%40sessionmgr4008&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=140312571&db=edb
https://eds-b-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=0&sid=da9cb59c-18bc-4aec-899b-72423a431e61%40pdc-v-sessmgr02
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