Quantitative and Qualitative Research Critique Part 3

Critique of Research Part

Quantitative article Critique

• Results

o Data analysis

Of the fifty- seven patients undergoing hemodialysis through the use of central venous catheter (CVC), three- quarters were men aged 20 - 59 years; fifty- seven percent of subjects belonged to the Christian Catholic church and sixty-four percent were married. With regard to their educational qualification, forty- six percent of subjects had completed primary education while one in five patients was uneducated. With respect to CVC implant, seven out of ten implants were noted to have been installed within patients’ internal right jugular veins, whereas twelve percent were within their right femoral veins. Concerning causes for removal of implants, seventy percent were on account of maturation of AVF, while twenty percent were account of infection. Concerning hemodialysis dosage (gauged in terms of Kt/ V), eighty- two percent depicted > 250 ml/ min blood flow while seventy percent showed values ranging from 1.1 - 1.2 (Guimarães et al, 2017).

o Reliability and validity

Drawing from NANDA I’s Nursing Diagnosis of Taxonomy II, nursing professionals confirmed a couple of diagnoses associated with VA (vascular access) among individuals being hemo- dialyzed through the use of CVC and picked a couple of nursing intervention titles: vascular device- based care and maintenance of dialytic access. The link between interventional activities allows for listing actions to formulate the following 8 nurse prescriptions for CVC- employing hemodialysis patients: (1) Measurement of axillary temperature before and after treatment; (2) Keeping an eye on indications of systemic and local infections; (3) Maintenance of occlusive dressing; (4) Maintenance of aseptic practice when manipulating CVC; (5) Maintenance of standard precautions; (6) Replacement of protective CVC covering following every hemodialysis; (7) Patients’ and their families’ guidance with regard to CVC maintenance; and (8) Maintenance of access permeability using heparin following culmination of hemodialysis session (Guimarães et al, 2017).

• Discussion

· Interpretation of findings

A couple of nurse initiatives associated with CVC- employing hemodialytic patients’ care were established and debated on, based on the NIC: vascular device- based care and maintenance of dialytic access. These facilitated the identification and discussion of the following 8 nurse activities: Measurement of axillary temperature before and after treatment; Keeping an eye on indications of systemic and local infections; Maintenance of occlusive dressing; Maintenance of aseptic practice when manipulating CVC; Maintenance of standard precautions; Replacement of protective CVC covering following every hemodialysis; Patients’ and their families’ guidance with regard to CVC maintenance; and Maintenance of access permeability using heparin following culmination of hemodialysis session (Guimarães et al, 2017).

• Implications/Recommendations

On account of hemodialytic technical specificity, nursing staff dynamically and plastically linked elements of the initiative for devising an appropriate, current patient safety-connected nurse prescription. The outlined activities are substantiated by a sound scientific base within literature, validating their application towards maintaining CVC utilization in combatting and controlling thrombotic, infectious, or traumatic complications. Hence, nursing professionals need to take on CVC- based hemodialytic patients’ care as a key role, since this represents a multifaceted process (Guimarães et al, 2017).

• Global Issues

· Presentation

De Lima Guimarães and colleagues’ (2017) research is characterized by ineffective organization. Rational thought development proves pivotal to proper relay of scientific facts. The research fails to adequately situate the research issue within a wider theoretical context. Not much attention has been paid to the enhancement of study value by linking the problem under study with a theoretical foundation. An accurately- formulated study problem typically contributes particularly significantly to the nursing profession (Loiselle, 2011). With respect to this research, the paper is not easy to comprehend and might prove ineffective in providing valuable inputs to the clinical nursing domain.

o Researcher credibility

De Lima Guimarães and coworkers (2017) accept the fact that heparin quantities utilized have been debated by scholars. Research works suggest that utilizing 1000 IU/mL of heparin poses reduced systemic heparinization risks as compared to the typically administered 5000 IU/mL dosage, without adversely impacting CVC utilization conditions.

· Summary assessment

Normally, quantitative study reports have an objective and formal design with passive voice or third person employed for indicating its unbiased nature. However, de Lima Guimarães and colleagues’ (2017) research report has been prepared in first person. A review of the paper indicates one area of concern: the report’s discussion heading doesn’t outline any limitation at all. After all, generally, it is the individual(s) conducting research who is (are) ideally equipped to identify and evaluate the effects sampling deficits, issues with information quality and practical limitations have. Furthermore, if the author of the study records methodological or any other kind of shortfall, the reader and peers will understand that the author has taken those deficits into account during outcome interpretation. Naturally, every single inadequacy will likely noted be outlined and this is where including comments on research limitations under the discussion heading comes into the picture (Loiselle, 2011).

Qualitative article critique

• Results

· Data analysis

The assessment generated the following 4 themes: observation, advocacy, healthcare system navigation, and active provision of patient care (Jeffs et al, 2017).

· Theoretical integrations

The theme of observation indicates active engagement of caregivers through the supervision of their patients’ care. This covers their actual presence within the care setting, normally at acute care as well as rehab units. The theme of advocacy indicates how caregiver subjects engaged dynamically in their patient’s advocacy. Healthcare system navigation was closely in line with the advocate’s function, since familial caregivers were required to circumvent the clinical system, including follow- up patient care coordination and posing relevant follow- up related queries. The common queries raised were linked to the next stage of the therapeutic process, follow- up visits, where the patient would be directed for rehab, and service coordination following the patient’s discharge from rehab. The theme of active provision of patient care indicates that a few caregivers assumed the task of delivering specific care aspects usually delivered by healthcare professionals. (Jeffs et al, 2017).

Discussion

· Interpretation of the findings

Caregivers’ active engagement in their patients’ care was an independent decision; physicians and other members of the care team did not engage them actively and urge them to participate in their patients’ care. Another research on the active participation of familial caregivers in patient care, though striving to exert some amount of influence, has discussed the aforementioned provider-caregiver tension, but this research adequately explains its nature. Additionally, providers, patients, and caregivers recognized caregiver function and significance in the course of care transition (Jeffs et al, 2017).

o Implications/Recommendations

The research findings indicate the necessity of reconciling the tension existing between familial caregiver participation in their patients’ care and participation levels all through the course of care transition. Direct patient care delivery by certain caregiver subjects of the research to substitute for suitable staffing necessitates additional focus. Studies in the long run need to give emphasis to tension reconciliation and offer explanations of the ideal means of dynamically and meaningfully engaging caregivers within the process of planning family patient care transition (Jeffs et al, 2017).

• Global Issues

· Presentation

This research report has been effectively organized and composed and adequately thorough, thereby facilitating its critical assessment. It was easily understandable and penned such that outcomes become accessible to nurse practitioners (Loiselle, 2011). Jeffs and coworkers’ (2017) research reveals the significance of active caregiver participation and supervision of their patient for ensuring their health and safety in the course of care transition. Family caregivers reported their experiences with making sure their patient received proper medicines at proper times, with a few providers expressing gratitude for family caregivers’ presence and their capacity of identifying potential mistakes which may have, if not for their attentiveness, been overlooked. Additionally, family caregivers’ presence incorporated provision of patent-related information to providers, and the successive interpretation of health and treatment connected information conveyed by practitioners to the patient. This finding resembles other studies in which patients and their families believed the provider-family caregiver interaction was inefficient, while awaiting details relating to, and explaining the need for, transition (Jeffs et al, 2017).