'Critiquing nursing research Essay\r'

'Through the breast feeding and Midwifery Council (NMC) code of headmaster conduct (NMC, 2004) nurses supply high standards of c atomic number 18 to patients and clients. single code nurses adhere to is clause 6 which pronounces nurses must(prenominal) maintain professional knowledge and competence, endure a responsibility to deliver c are base on current evidence, go around serve and validated interrogation (NMC, 2004). Validated enquiry involves critiquing and acquiring the skills of synthesis and vituperative compend, this changes nurses to distinguish the descent between theory and practice in care for (Hendry & adenosine monophosphate; Farley 1998).\r\nThis assignment forget critique the re look for report â€Å"Patients’ upshot †nones: vista only when don’t touch” indite by Bebbington, Parkin, James, Chichester and Kubiak (2003) (Appendix 1) using Benton and Comack’s (2000) manikin (Appendix 2). This was selected because of the promotional material that surrounds infirmary acquired infection (Barrett, 2005).\r\nTitleThe fabric suggests the ennoble should be concise, informative, distinctly specify the content and level the query advent. The title of the paper is concise; and it gives no information of content or re wait subject. moreover the rehunt progress is un determine thus the ratifier is unsure what kind of interrogation has been performed, perhaps an flip title could bring forth been â€Å"Case nones, do they carry infection: A quantitative study”. This whitethorn indicate that the authors ache non apply a standard format which Benton (2000) pleads wrap ups should follow; except the title captured the imagination of the referee and warrants win fileing.\r\nAuthorsAccording to the manakin, the author(s) should possess portion academic and professional qualifications and experience; this according to Carter & antiophthalmic factor; Porter (2000) establishes integ rity. The qualifications and experiences of the authors are non documented. This could indicate the authors incur no applicable qualifications or experiences in this field. in time further reading identifies where the authors work which could be relevant to their subject, although thither is no indication of their occupation. up to now the indorser performed an online search and found the authors pitch had previous document published suggesting look for experience, which gives confidence in their abilities.\r\nAbstractThe framework realms an bunco should be included, should put the question job, bring up the hypotheses, outline the methodological abbreviation, give details of the smack subjects and report major findings. The abstract is included and is outlined which makes it classifiable and captures the attention. Burns and woodlet (2003) utters this helps to influence the fall overer to read the remainder of the report. Additionally a distinctive abstract is ben eficial for a rapid summary (Parahoo, 1997). The search headspring is included and is noticed immediately on the first line. Also holdd are the methodology, take subjects and major findings. Yet they do not state the hypothesis. The abstract is clear and precise which gives the lecturer depression in the capability of the searches.\r\n launchingThe framework indicates the introduction should clearly identify the enigma, include a rationale and state whatsoever(prenominal) limitations. The problem is identifiable and the rational is included, nevertheless the reader would have liked to see these presented to begin with in the introduction. Dempsey & adenylic acid; Dempsey (2000) concur and states the research problem should be identified early and Polit & adenine; Beck (2004) put up that readers profit from learning the problem immediately. The authors did not indicate any limitations which could suggest inexperience or could question their professional responsibility (P olit & adenylic acid; Beck, 2004), nevertheless the reader perceives a limitation as being precisely unmatched study of infirmary inpatients notes have been describe thus altogether one study to discriminate findings.\r\nLiterature reviewThe, framework indicates the books review should be current, identify the underlying theoretical framework, produce a balanced evaluation of material and to look for wanting elongations. The authors’ literature reviews produce twelve parts which range from 1967 to 2002, cardinal were classed as outdated (Burns & axerophthol; Grove, 2003) and nine were classed current. Although the reference from 1967 is outdated it is reasonable the authors included it since it is the scarce research paper found on their particular subject. even this causes the reader to speculate the reason this subject was studied. Because the authors and the reader did not discover any opposite literature concerned with the subject this, could indicate that the authors’ literature search was comprehensive which could prove validity of the study. til now it is wondered if other researches deliberated miscue notes were irrelevant compared to other objects in the hospital or if this is ground breaking research. Improvement could have been made by the authors including the search engines they had used as this would allow replication and evaluation of the paper.\r\nThe literature the authors cited used a quantitative approach as did the authors themselves thus identifying and employing the underlying theoretical framework and bragging(a) credibleness to the paper. Cutlcliff & group A; Ward (2003) suggests the literature review consorts the detective in discussing the results of the study in terms of commensurateness or non agreement with other studies, even on that point is no evidence of evaluation of material that supports or challenges the position being proposed .This suggests the researches appear to have nevertheles s reported the finding of other studies and not examined the material, which, Peat (2001) states is requirement for making decisions about whether or not to diverseness practice on the basis of published report.\r\nThe issuing is a research paper without critical analysis which Beyea & adenosine monophosphate; Nicoll (1998) states is central to the deli really of evidence based patient care. Following duplication of the researches literature search using their key quarrel the reader could find no of the essence(p) references omitted which leads to the belief that they performed the search methodically. However it was discovered that one main(prenominal) reference in the text (Semmelweis) had been omitted in the reference list. This leads the reader to question if other things whitethorn also have been omitted resulting in an unsound paper.\r\nThe hypothesisThe framework asks if the hypothesis is capable of testing and if the hypothesis is unambiguous. in that respect is no hyp othesis in the paper only a research question. Cormack (2000) states that hypothesis female genitals only be stated for studies which predict a relationship between two variables. Polic & Becks (2004) concur and believe hypotheses are predictions of expected outcomes. Since the authors do not state an expectation of the outcome they did not need to incorporate a hypothesis. This could suggest an collar of research big the reader faith in their capabilities.\r\nOperational definitionsThe framework suggests the terms used in the research problem should be clearly defined. The terms that the author’s employ are clearly defined and tail assembly be found effortlessly. Nevertheless they are precise limited in respect of the paper and the reader speculated how they found eleven of the twelve references using the keywords since they relate to other objects. This could indicate that they decided upon key words prior to performing the literature research, thus restrict thei r search (Tarling & Crofts, 2002) which questions the validity of the paper. The reader searched Blackwell synergy using own keywords such as hospital equipment, contamination and bacteria. Many more members were discovered indicating the authors did not perform an adequate literature search.\r\nMethodologyThe framework indicates that the methodology should clearly state the research approach, appropriate to the research problem and if strengths and weaknesses are noted. Although the authors do not identify the study as quantitative the reader understands that it is since it uses findings that skunk be measured and deals with quantity of results as inappropriate to interpretation (Munhall, 2001). Additionally the reader believed it is a deductive study since the authors looked at muff infection and objects in the hospital setting and narrowed it down to plunder infection and nerve notes. No strengths or weaknesses were acknowledged, which, Byrne (1998) states is needful s o the reader can ascertain if the research is valid.\r\nFurthermore the authors state they sampled the spine of the case notes because this is where well-nigh hand contact occurs while reading them, however perhaps it could have been suggested sampling the inside since in, my experience, this is where most hand contact occurs. The researches also stated they did not wash their hands until the last set of notes had been tried and true because it simulates the typical daily handling of notes by HCW’s. However the Department of health (2000) state originally and afterwards patient contact hands should be washed, consequently the validity of their approach is questionable. Finally the reader would have liked the researches to explain why the notes were incubated at 37 degrees since an assumption could be made that they are simulating a hospital environment.\r\nSubjectsThe framework suggests the subjects should be clearly identified in the title abstract and methodology. In th is paper on that point are no subjects only case notes. However the reader would have liked there to be a rationale why the authors chose case notes as this according Polit & Beck (2004) gives the reader an understanding of the strengths and weaknesses of the sampling plan.\r\nSample selectionThe framework suggests the selection approach is congruent to the methodology, clearly stated and if sample sizing is clearly stated. It appears that convenience sampling was utilised though this is not clear; Burns & Grove (2003) suggest this approach should be avoided however as it provides the opportunity for bias. Since the sample selection method is ill-defined, it may have been inappropriate, denoting further flaws which affect the remainder of the paper. The sample size is clearly stated however but should have been included in the methodology giving the reader a reference when reading it.\r\n info collectionThe framework asks if the selective information collection procedure s are adequately described. The authors describe the data collection procedure as recorded and analysed. This gives the reader no understanding of how the data was collected, who document it, who interpreted it and where it was stored. This could have implications on the results since there may have been weaknesses in these areas such as the reliability of the collection tools, if the people who recorded and analysis it had training and if there could there be any contamination to the notes.\r\nEthical considerationsThe framework asks if the study involves humanity has the study received ethics committee adulation, if sensible consent was sought, if confidentiality was assured and anonymity guaranteed. Although the study does not directly involve human subject’s research involving personal information relating to human subjects requires the approval of the local ethics committee. (Cormack, 2000)(Royal college of physicians, 1998) The authors make no reference these three good codes so it is unknown if the patients hold to their case notes being tested. This implies no consideration of ethical issues from the authors and questions what other considerations they have overlooked.\r\nResultsAccording to the framework the results should be clearly presented, internally consistent, have satisfactory detail to enable the reader to judge, and asks how much confidence can be placed in the finding. The results that the authors present are unclear and misleading since the first two lines state 227/228 case notes contained bacteria; however it continues to inform that most were â€Å"environmental”. The authors use a circumvent to portray their results which Crooks & Davis (1998) suggests is all that is needed to convey information. However the table appears complex, confusing and impossible to understand; therefore the reader would question the internal consistency. In addition since the results are difficult to interpret the reader can not judge the reliability of the findings.\r\nData analysisThe framework states the approach should be appropriate to the type of data collected, statistical analysis should be correctly performed, should be sufficient analysis to decide whether significant differences are not caused by differences in other relevant variables and if the substitute information is reported. The authors approach was appropriate to the type of data collected since no other approach would be suitable. Nevertheless the researches do not state how they analysed the statistics so the reader can not judge any limitations.\r\nDiscussionThe framework states the handling should be balanced, drawn on previous research, weaknesses of the study acknowledged and clinical implications discussed. The discussion is not balanced since it focus upon the findings of pathogenic bacteria on case notes and subsequently formulates assumptions about MRSA hold out on case notes without research to back this up. It mistily draws upon the only previous research and mentions the result, which contradicts their own findings. No failings or limitations of the study or literature review are recognized implying no review or evaluation of the literature, which, according to Benton & Cormack (2000) is central to the research process. One clinical implication is discussed briefly however the reader should re constituent that the authors have not proved the transmission of bacteria on case notes to HCW’s hands only the potential.\r\nConclusionThe framework asks if the conclusions are back up by the results obtained. The conclusion the authors established was the possibility of transferring bacteria, however since the results are indecipherable it is impossible to determine if the conclusions are supported by the results.\r\nRecommendationThe framework states the recommendations should suggest further areas for research, and identify how any weaknesses in the study formulate could be avoided in future resear ch. There is no suggestion for further research; no weaknesses in the study design mentioned and no recommendations on how issues can be avoided. Therefore the reader believes this paper does not establish contamination from case notes, so is fallible and lacks validity.\r\nApplication to practiceThe Department of Health (2005) states Clinical constitution is the system through which National Health serve up organisations are accountable for continuously improving the forest of their services and safeguarding high standards of care. Elcoat (2000) adds evidence-based practice and evidence-based care for have very strong positions in the Clinical organisation agenda of quality improvement. Evidence-based practice can be defined as using contemporaneous best evidence ensuring actions are clinically appropriate exist effective and result in positive outcomes for patients (Trinder & Reynolds, 2000). Therefore every healthcare team member has to critique evidence, assess its re liability and application before combining it with their own clinical expertise (DePoy & Gitlin, 1998).\r\nBefore knowing how to critique I did not understand why nurses had to review articles and I would have taken them on face value, however since critiquing this article I have realized it is a very important part of my practice and taking articles on face value is unsafe practice. The authors discussed some important issues concerning cross infection and as a termination I have reflected more on cross infection in my clinical area. This leads me to believe that every research paper is of value and has something to give to the reader. However the article will have little opposition on my practice since the recommendation of hand lavation before and after patient contact is already integrated in my breast feeding practice.\r\nReferences\r\nBarrett , S. P. (2005). What’s in the buff in infection control? Medicine print Company,33(3), i-iii. Retrieved July 5, 2006, fr om http://www.atyponlink.com/MPC/doi/abs/10.1383/medc.2005.33.3.iBebbington, A., Parkin, P.A., Chichester, L. J., & Kubiak, E. M. (2003). Patients’case notes: look but don’t touch. Journal of Hospital Infection. 55, (4).\r\nBenton, D., & Cormack, D. (2000). Reviewing and evaluating the literature. In D.\r\nCormack (Ed.). The research process in nursing (4th ed.). Oxford, UK:Blackwell Science.\r\nBeyea. S, Nicoll, L. (1998). Writing an integrative review. Association ofpreoperative Registered Nurses Journal. 67, 4, 877-880.\r\nBurns, N., & Grove, S. (2003). misgiving nursing research (3rd ed.). Philadelphia:SaundersByrne, D. W. (1998). Publishing medical research. Philadelphia: Lippincott Williams &Wilkins.\r\nCarter, D. & Porter, S. (2000). Validity and reliability. In D. Cormack (Ed.), Theresearch process in nursing (4th ed.). Oxford, UK: Blackwell Science.\r\nCormack , D. (Ed.). (2000). The research process in nursing (4th ed.). Oxford: Blackwell Publishing.\r\nCrookes, P. A., & Davies, S. (Eds.). (2004). Research into practice: essential skills forreading and applying research in nursing and health care. Edinburgh: BaillièreTindall.\r\nCutcliffe, J. R., & Ward, M. (Eds.). (2003). Critiquing nursing research. Wiltshire: M A Healthcare Limited.\r\nDempsey, P., & Dempsey, A. (2000). reasonableness nursing research; process,\r\ncritical appraisal & utilization (5th ed.). Philadelphia: Lippincott Williams & Wilkins.\r\nDepartment of health. (2001). The Epic come across: developing national evidence-basedguidelines for preventing healthcare associated infections, phase 1: guidelines forpreventing hospital-acquired infections .Journal of Hospital Infections 47 (suppl): S1-82Department of Health. (2005). Clinical government. Retrieved July 12, 2006,fromhttp://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/ClinicalGovernance/fs/enDePoy, E., & Gitlin, L. N. (1998). Introduction to research: un derstanding and applying multiple strategies. Philadelphia: MosbyElcoat, D. (2000). Clinical Governance in action: key issues in clinical effectiveness.\r\nProfessional Nurse.18 (10).\r\nHendry, C., & Farley, A. (1998). Reviewing the literature: a guide for students.\r\n nursing Standard. 12(44).\r\nMunhall, P. L. (2001). Nursing research: a soft perspective (3rd ed.). Boston: Jones and Bartlett Publishers.\r\nNursing & Midwifery council. (2004). Code of professional conduct. London: Nursing & Midwifery council.\r\nPeat, J. (2001). Health science research; a handbook of quantitative methods. London: Sage.\r\nParahoo, K. (1997). Nursing research: principles, process and issues. Basingstoke: Macmillan.\r\nTrinder, L., & Reynolds, S. (2000). Evidence-based Practice. A exact Appraisal.\r\n'