Critical Analysis of a Quantitative Study

RESEARCH CRITIQUE

Max Points: 150

Details:
Prepare a critical analysis of a quantitative study focusing on protection of human participants, data collection, data management and analysis, problem statement, and interpretation of findings. The quantitative research article can be from your previous literature review or a new peer-reviewed article.
Each study analysis will be 1,000-1,250 words and submitted in one document. As with the assignments in Topics 1-3, this should connect to your identified practice problem of interest.
Refer to the resource entitled “Research Critique Part 2.” Questions under each heading should be addressed as a narrative, in the structure of a formal paper. You are also required to include an Introduction and Conclusion.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to Turnitin.
Submit the assignment along with an electronic version of the article used for the analysis. If an electronic version is not available, submit a clean unmarked copy of the article.
NRS433V.v10R.ResearchCritiquePart2Guidelines_student.docx

Research Critique, Part 2
To write a critical appraisal that demonstrates comprehension of the research study conducted, and respond to each of the action items listed under the headings below. Successful completion of this assignment requires that you provide a rationale, include examples, or reference content from the study in your response.

CRITICAL APPRAISAL GUIDELINES: QUANTITATIVE STUDY ON TYPE 2 DIABETES FOCUSING ON PROTECTION OF HUMAN PARTICIPANTS, DATA COLLECTION, DATA MANAGEMENT AND ANALYSIS PROBLEM.
Introduction
• Develop a topic sentence in which you will define the purpose of the Research Critique, Part 2
• Formulate a thesis statement which briefly provides a broad indication of your point of view in composing this assignment.
• Include a summary outline to describe the organization and main topics you will include in the body paragraphs of the assignments (see below sections).
Protection of Human Participants
• Identify the benefits and risks of participation addressed by the authors. Were there benefits or risks the authors do not identify?
• Was informed consent obtained from the subjects or participants?
• Did it seem that the subjects participated voluntarily in the study?
• Was institutional review board approval obtained from the agency in which the study was conducted?

Data Collection
• Are the major variables (independent and dependent variables) identified and defined? What were these variables?
• How were data collected in this study?
• What rationale did the author provide for using this data collection method?
• Identify the time period for data collection of the study.
• Describe the sequence of data collection events for a participant.

Data Management and Analysis
• Describe the data management and analysis methods used in the study.
• Did the author discuss how the rigor of the process was assured? For example, does the author describe maintaining a paper trail of critical decisions that were made during the analysis of the data? Was statistical software used to ensure accuracy of the analysis?
• What measures were used to minimize the effects of researcher bias (their experiences and perspectives)? For example, did two researchers independently analyze the data and compare their analyses?

Findings / Interpretation of Findings: Implications for Practice and Future Research
• What is the researcher’s interpretation of findings?
• Are the findings valid or an accurate reflection of reality? Do you have confidence in the findings?
• What limitations of the study were identified by researchers?
• Was there a coherent logic to the presentation of findings?
• What implications do the findings have for nursing practice? For example, can the study findings be applied to general nursing practice, to a specific population, to a specific area of nursing?
• What suggestions are made for further studies?

Conclusion
• Emphasize the importance and congruity of the thesis statement
• Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice.
• Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice.
• Integrate a summary of the knowledge learned.

Reference
Burns, N., & Grove, S. (2011). Understanding Nursing Research (5th ed.). Elsevier. ISBN-13: 9781437707502

 

Solution

A CRITICAL ANALYSIS OF A QUANTITATIVE STUDY

A CRITICAL ANALYSIS OF A QUANTITATIVE STUDY

Introduction

            Urinary tract infection (UTI) accounts for 40 percent of all nosocomial infections in the health care facilities. It is estimated that 80 percent of all urinary tract infection is attributed to the use of urinary catheter. These kind of urinary infections are defined as catheter-associated urinary tract infections or CAUTI (Blanck, Donahue, Brentlinger, Stinger, & Polito, 2014). This article indicated that catheter-associated tract infection is undeniable increasing the burden on the healthcare system due to increased cost of care, length of hospital stay, morbidity and mortality. The review shown that estimated 15 to 25 percent of patients hospitalized at some point have a urinary catheter during their stay, which is clear indication that the scale of problem is extensive. Further analysis indicated that the cost of treatment and management of catheter-associated urinary tract in United Kingdom stand at 1,968 sterling pounds, which translates to financial burden of 99 million pounds annually. Critical analysis on these development heightened the interest of the research to develop strategies of reducing the occurrence of catheter-associated urinary.

Purpose statement

            The purpose of this study was to quasi-experimentally test the use of a bundled approach of catheter care practices to reduce the cases of catheter-associated urinary tract infections. The experiment was conducted in a period of three months. The objectives of the study was to create a valuable source of information for healthcare professional especially nursing staff involves in the care and insertion of urinary catheters as well as providing with the best practice guidelines and advice (Blanck, et al., 2014). The research questions that guided the study was to identify the kind of nursing intervention that could help in reducing urinary tract infections associated with the use of catheters. As a result, critical appraisal of numerous literature review was conducted to identify those that were eligible and of high quality.

            The summary of the main topics that were presented in the study included: Protection of Human participants, Data collection, Data management and analysis, Findings/Interpretation of the findings and the implications of the findings to the practice and future research.

Protection of human participants

            Critical analysis indicated that legal and ethical principles were adhered to throughout the experimental process. In order to ensure that human participation was protected, the study was approved by study hospital Institutional Review Board (IRB). The author ensured that anonymity and confidentiality of the patients that participated in the study was maintained by not collecting the identification numbers and names (Burns, & Grove, 2011). Before each participant was enrolled to study, informed consent later was obtained. Review indicated that eligible candidates were briefed about the purpose and intentions of the study before submitting the informed consent letter. Agreeing to participate in the study was voluntarily and the patients were ready to withdraw from the study at any stage at their own will.

Data collection

            The major variables in the study was the catheter day number, which was the independent variables and CAUTI, which was dependent variable. Catheter day number represent the number of day a patient was using a catheter and the CAUTI represented the urinary tract infections caused by the prolonged use of catheter. At the beginning of the day shift, the unit clerk collected the catheter day number from patients’ log that was maintained in the critical care unit (CCU). The number of patients who had urinary catheter inserted was recorded each day by the unit clerk. The catheter day information was collected by infection control coordinator on daily basis. Urine culture for patients with symptomatic for a CAUTI was ordered. The hospital laboratory notified the infection control department about the all positive urine culture and urinalyses. The results obtained from laboratory tests were independently reviewed by two infection control coordinators to identify the patients’ records showing evidence of CAUTIs.

Once the independent reviews were completed, the infection control coordinator conferred with the director of the coordination department and each infections was reviewed against the NHSN surveillance definition. The rationale for adopting and using this collection was to obtain a group consensus on the determination of presence of a CAUTI. The data was collected for a period of three months. Catheter days were counted by recording the number of patients who had urinary catheters inserted in each day of the week at the same time of day; and then each day’s number were added for a monthly total. This sampling method was used to account for variation in population sizes each month in the critical care unit (CCU) when comparing the number of CAUTUs over time.

Data management and analysis

            The study used NHSN formula to calculate the occurrence rate for CAUTIs. The formula stated that the number of new CAUTIs divided by the total number of catheter days multiplied by 1000 for each of the pre-and post-study time periods (Rate = CAUTIs/Cath Days x 100) (Burns, & Grove, 2011). The study used SPSS software to generate Wilcoxin signed rank test for comparing CAUTI rate between the pre- and post-intervention time period. Selection bias was avoided by ensuring that all participants were with indwelling catheters and did not have a urinary tract infection when recruited into the study. This ensured that data collected was exclusively from patients that contracted urinary tract infection after catheters was inserted.

Findings/interpretation of findings: Implications for practice and future research

            The researcher interpreted the findings to indicate that there was an overall reduction of 50 percent of CAUTI occurrence after the interventions as compared to the pre-interventions. Although, the findings indicated that results were not statistically significant, with p = 0.285, they were clinically significant at confidence level of p < 0.05 (Blanck, et al., 2014). There was confidence that the findings accurately reflected the reality because earlier studies indicated that proper management catheters as well as avoiding unnecessary use of catheter significantly reduce the incidences of urinary tract infection associated with catheter. Review indicated that the limitations of this study was the lack of randomization for group assignments. The possibility of a true control group could not be achieved since the standard catheter care was possible to be withheld from critical care unit. In addition, the study indicated that it was not possible to effectively sort critical care unit patients’ assignment into bundled and non-bundled catheter care to form a control group due to nursing work-flow perspective. Finally, the findings are not generalizable to pediatric patients since the data was collected from adult patients in critical care unit.

            There was no logical presentation of the findings since the researcher presented the results in table format without comprehensive interpretation. However, the findings can be applied in the nursing practice to reduce the incidence of urinary tract infection associated with catheter. The researcher suggested the findings could assist the nurses by ensuring that high standard of hygiene is maintained and catheters are only used when necessary in order to alleviate the incidence of urinary tract infection among the patients with catheters in place. The researcher also suggested that more studies should be conducted in the future since catheter care is considered to be completed by the nursing staff and there is little information that support specific nursing care to eliminate the occurrence of CAUTIs for patients with indwelling catheters.

Conclusion

            From the findings it can be concluded that nursing intervention and comprehensive research helps to reduce the incidence of CAUTI in patients with catheter in place. Nurse requires education on evidence-based practices that helps in minimizing the occurrence of urinary tract infections among the patients with catheters in place. Critical appraisal indicated that the study used eligible and appropriate literature that met almost all the standards in the research field. This was supported by the fact that the findings was clinically significant in minimizing the CAUTI occurrence by 50 percent.

References

Blanck, W. A., Donahue, M., Brentlinger, L., Stinger, D. K. & Polito, C. (2014). A Quasi-Experimental Study to Test a Prevention Bundle for Catheter-Associated Urinary Tract Infections. Journal of Hospital Administration, 3(4): 101-108.

Burns, N. & Grove, S. (2011). Understanding Nursing Research. Elsevier.