Rough Draft Qualitative Research Critique and Ethical Considerations

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Salice Njei

Qualitative Research Critique and Ethical Considerations.docx

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Running 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)?

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. 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-a-ebscohost-com.lopes.idm.oclc.org/eds/detail/detail?vid=0&sid=bedb2bb0-ec00-

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. 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.

https://eds-b-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=0&sid=da9cb59c-

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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

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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:

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

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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

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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,

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 Student: Submitted to Grand Canyon University

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

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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.

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References

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=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2

l0ZQ%3d%3d#AN=140312571&db=edb

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