Quantitative and Quantitative StudiesBackground
1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question.
How do these two articles support the nurse practice issue you chose?
1. Discuss how these articles will be used to answer your PICOT question.
2. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question.(Qualitative Research Critique and Ethical Considerations)
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Qualitative Research Critique and Ethical Considerations
Introduction
Healthcare brings together professions ranging from medical doctors, nurses, social workers, technicians, and many others. It requires all these professions to engage with the clients and with one another to improve patient outcomes. Interprofessional communication and collaboration involve the efficient sharing of data and communication among the various professions in a health facility. Ordinarily, inadequate communication leads to loss of critical data, misinterpretation, lack of clarity in telephone orders, and sometimes-inappropriate drug prescriptions. Enabling teamwork and collaboration among various professions creates an atmosphere that precludes fair and open interactions essential in our healthcare delivery. The paper examines qualitative and quantitative research to determine how different researchers analyze interventions, measures and factors related to implementation of interprofessional communication and collaboration in clinical settings.(Qualitative Research Critique and Ethical Considerations)
Background of Study
In the first, Matziou, Vlahioti, Perdikaris, Matziou, Megapanou, & Petsios (2014) use quantitative approaches to examine the various views and perspectives of health practitioners on communication in clinical settings. The study aimed to investigate the physician and nursing perceptions regarding communication and collaboration as well as the factors that may influence these activities. The research question examined the perceptions of physicians and nursing concerning interprofessional communication and collaboration. The study is significant to nursing because it explores the concept of interpersonal communication to understand its impact on patient care by affecting the quality and safety of care.(Qualitative Research Critique and Ethical Considerations)
In the second quantitative study, Keshmiri et al. (2017) examine the importance of having interprofessional communication education as part of nursing education. The purpose of the paper is to assess the effectiveness of an interprofessional education model (IPE) based on the transtheoretical model to improve the participants’ interprofessional collaborative practice. The research question focused on the efficiency of IPE in improving patient outcomes. The study contributes to the body of knowledge that focuses on improving nursing education to meet the needs of contemporary clinical settings.
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The third article takes a qualitative approach to examine interprofessional collaboration in nursing homes by assessing the outcomes of measures of improving communication and collaboration (Müller, Fleischmann, Cavazzini, Heim, Seide, Geister, & Scherer, 2018). The purpose of the paper is to develop and teste measures to improve collaboration and communication between nurses and general practitioners (GPs) in this setting. The research question focuses on the steps to improve interprofessional collaboration and communication between GPs and nurses in nursing homes. The study is significant because it examines the implementation of interprofessional collaboration measures in a clinical environment, and provides insights on the measures that enhance collaboration and communication.(Qualitative Research Critique and Ethical Considerations)
The fourth article is a qualitative study by Busari, Moll, & Duits (2017) uses the metric, quality of care, to explore the impact of interprofessional communication. The article contributes to nursing by assessing the effect of communication in a small-scale health care facility. The purpose of the study is to assess nurse-physician communication perception in patient care in the clinical setting. The research question explores whether the local culture’s high power index and masculinity had any influence on the quality of collaboration between the different health care providers, e.g., nurses and physicians within the organization.
Support to PICOT question
In the first article Matziou et al. (2014) examine various perceptions of health practitioners on communication in clinical settings. Matziou et al. (2014) find that improving the knowledge of nurses and physicians regarding their different approaches and perceptions about nurse-physician communication and collaboration may lead to a better mutual understanding and a more effective collaborative relationship. Similar to the PICOT, the focus on nurse-physician helps understand the frameworks for attaining effective interprofessional communication and collaboration in clinical settings. The article focuses on nurses and physicians in a large facility while the PICOT focus on nurses and the interactions they have with other healthcare practitioners.(Qualitative Research Critique and Ethical Considerations)
In the second article, Keshmiri et al. (2017) focus on IPE informs the PICOT on the avenues of improving collaborative practice among both practicing nurses and nursing students. The IPE model used in the study will help improve the competence of nurses in interprofessional communication and collaboration. The model teaches collaborative practice and communication, while the intervention used in the PICOT implements the practice and competencies.(Qualitative Research Critique and Ethical Considerations)
In the third article, Muller et al. (2018) offer a unique discussion on measures to improve communication in clinical settings. The research question and proposal for this study had been developed based on the national and international literature about the topic. The study intended to capture hidden, implicit assumptions of the participants, helping understand the best practices in the implementation of collaborative practice. The measures used in the article will be implemented in the PICOT to ensure the effective implementation of collaborative practice. In the fourth article, Busari, Moll, & Duits (2017) also focus on nurse-physician and inform on the impact of collaborative practice and communication, factoring in cultural aspects as well as power dynamics. The article helps the PICOT anticipate potential challenges in the implementation of the interprofessional communication and collaboration framework. Differentially, the intervention used in the article offers a better understanding of external factors such as culture and gender that affect interprofessional communication.(Qualitative Research Critique and Ethical Considerations)
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Methods of Study
Article 1 is a descriptive study designed to investigate nurses’ and physicians’ perceptions of their collaboration and the factors that influence it. The study was conducted on a convenience sample of nurses and physicians from two public hospitals in Greece, and data were collected with the ‘‘Communication and Collaboration among physicians and nurses’’ questionnaire. While questionnaires are easy to administer and analyze, they are limited by potential differences in understanding and interpretation by the respondents as well as lack of personalization. On the other hand, article two by Keshmiri et al. (2017) is a quantitative study that involves an empirical investigation of data collected through statistical, mathematical, and computational techniques. The article used a controlled before-and-after study design and ANOVA. The method is highly effective in studies where randomization is not possible such as the study. However, the method is limited by confounding bias.(Qualitative Research Critique and Ethical Considerations)
Article three, comparatively from article 1, this article measures were developed iteratively in a continuous process, which is the focus of this article. In part 1, “exploration of the situation,” interviews were conducted with GPs, nurses, nursing home residents, and their relatives focusing on interprofessional interactions and medical care. The combination of methods included interviews, interprofessional focus groups, expert workshops, and an exploratory qualitative evaluation. The study benefited from the focus study approach as it can be used to obtain detailed comprehension of the measures implemented. However, the method is limited by the fact that some people may find it challenging their views openly.
Similarly, in the fourth article, Busari, Moll, & Duits (2017) use focus groups to collect data that was iteratively read and analyzed by the thematic synthesis method. The focus group structure helped the qualitative study collected perspectives and perceptions of nurses and physicians comprehensively. In both cases, the articles were limited by moderator bias, which guides the direction of the focus group’s discussions.(Qualitative Research Critique and Ethical Considerations)
Results of Study
Article 1: Effective and active communication is extremely required by all professionals, especially while working as a team because the component is crucial for conflict resolution. Professionals with good interprofessional communication, therefore, tend to enhance competence and confidence to respond to conflict arise. However, not everybody committed. Among all professions, physicians have less interprofessional communication skills, and not surprisingly, they have less positive attitudes towards IPC compared to other professions. Physicians did not recognize other professionals’ roles around them (Matziou et al., 2014). While improving collaborative practice and communication is essential in clinical settings, it is also vital to address the perceptions of practitioners towards IPC. Besides, the second article offers an avenue to support interprofessional communication and collaboration in clinical settings by underlining that IPE education can help improve IPC competency in the clinical settings (Keshmiri et al. (2017). The article underlines that it is imperative to incorporate IPE in nursing education, and as a part of continuous learning.(Qualitative Research Critique and Ethical Considerations)
In the third article, Muller et al. (2018) six measures were generated: meetings to establish common goals, main contact person, standardized medication, and the introduction of name badges, improved availability of nurse/GP, and standardized scheduling / procedure for nursing home visits. In the pilot study, the measures were implemented in four nursing homes. GPs and nurses reviewed five measures as feasible and acceptable; only the designation of a “main contact person” was not considered as an improvement. Implementing these measures can immensely improve collaborative practice in clinical settings. In the fourth article, Busari, Moll, & Duits (2017) find that having systematic procedures can improve interprofessional communication and the quality of patient care. The article highlights the need for continuous improvement in interprofessional communication and collaborative practice, with the input of organizational leadership being critical in the cultural shift.(Qualitative Research Critique and Ethical Considerations)
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Ethical Considerations
Informed consent is a critical ethical consideration that ensures that the participants of a study are aware of the evaluation being conducted. The participants have to understand the implications of the evaluation, potential impacts, and their ability to cease participation. Confidentiality entails taking steps to ensure any identifying information is not made available to or accessed by anyone but the researcher. Confidentiality ensures that the participants are not targeted for their participation in the study. The researchers in the four articles ensured that they included the informed consent of all the participants. The reporting also did not including any identifying information.(Qualitative Research Critique and Ethical Considerations)
Outcome Comparison
The PICOT question intends to improve patient outcomes during diagnosis and recovery time by implementing interprofessional communication and collaboration measures. The outcomes would help improve the coordination of care for chronic patients in clinical settings by setting up a collaborative practice from diagnosis to the development of care plans. Matziou, et al. (2014) provides a rationale for implementing IPC by underlining the potential impacts it has on patient care while Keshmiri et al. (2017) provides a model for teaching IPE in nursing education and to existing nurses to facilitate the transition to better collaboration and communication. Muller et al. (2018) provide measures for enhancing IPC in a nursing home and offer insights of implementation, such as coordinating interviews to understand potential points of breakdown. Busari, Moll, & Duits (2017) also support the implementation of IPC by improving the competence of health practitioners in collaboration and communication and addressing potential cultural barriers and attitudes that might limit effective implementation.(Qualitative Research Critique and Ethical Considerations)
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Conclusion
Medical errors are among the leading causes of death in the United States. Most of the mistakes are attributed to communication failures that are also the primary causes of sentinel events. These medical errors can be reduced by increasing the effectiveness of interprofessional education (IPE) in nurses’ school. The inclusion of IPE in the curriculum would significantly strengthen students’ interpersonal skills vital to nursing practice. Enabling teamwork and collaboration among various professions creates an atmosphere that precludes fair and open interactions essential in our healthcare delivery.(Qualitative Research Critique and Ethical Considerations)
References
Busari, J. O., Moll, F. M., & Duits, A. J. (2017). Understanding the impact of interprofessional collaboration on the quality of care: a case report from a small-scale resource-limited health care environment. Journal of multidisciplinary healthcare, 10, 227.(Qualitative Research Critique and Ethical Considerations)
Keshmiri, F., Rezai, M., Mosaddegh, R., Moradi, K., Hafezimoghadam, P., Zare, M. A., & Shirazi, M. (2017). Effectiveness of an interprofessional education model based on the transtheoretical model of behavior change to improve interprofessional collaboration. Journal of Interprofessional Care, 31(3), 307-316(Qualitative Research Critique and Ethical Considerations)
Matziou, V., Vlahioti, E., Perdikaris, P., Matziou, T., Megapanou, E., & Petsios, K. (2014). Physician and nursing perceptions concerning interprofessional communication and collaboration. Journal of interprofessional care, 28(6), 526-533.
Müller, C. A., Fleischmann, N., Cavazzini, C., Heim, S., Seide, S., Geister, C., & Scherer, M. (2018). Interprofessional collaboration in nursing homes (interprof): development and piloting of measures to improve interprofessional collaboration and communication: a qualitative multicentre study. BMC family practice, 19(1), 14.(Qualitative Research Critique and Ethical Considerations)
Question
Quantitative and Quantitative StudiesBackground
1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question.
How do these two articles support the nurse practice issue you chose?
1. Discuss how these articles will be used to answer your PICOT question.
2. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question.
Method of Study:
1. State the methods of the articles you are comparing and describe how they are different.(Qualitative Research Critique and Ethical Considerations)
2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method.
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Qualitative Research Critique and Ethical ConsiderationsResults of Study
1. Summarize the key findings of each of the studies into a comprehensive summary.
2. What are the implications of the four studies you chose in nursing practice?
Ethical Considerations
1. Discuss two ethical consideration in conducting research.(Qualitative Research Critique and Ethical Considerations)
2. Describe how the researchers in the four articles you choose took these ethical considerations into account while performing their research.
Outcomes Comparison
1. What are the anticipated outcomes for your PICOT question?
2. How do the outcomes of the four articles you chose compare to your anticipated outcomes?