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Article Critique Sample Paper

Critiquing a research article permits healthcare providers to gather the necessary evidence-based knowledge to utilize in clinical practice to improve the general quality of patient care. This comprehensive process necessitates a nurse to carefully go through the article and intensively analyze it. The purpose of this piece of paper is to critically appraise the Effect of Intentional Nursing Rounds Based on the Care Model on Patient’s Perceived Nursing Quality and their Satisfaction with Nursing Services’ report.

Introduction and Identification of the Problem

After extensive review of The Effect of Intentional Nursing Rounds Based on the Care Model on Patient’s Perceived Nursing Quality and their Satisfaction with Nursing Services’ report, the report was well written with minimal grammatical errors. The well-structured introductory section attains the attention of the reader or rather makes the subject area interesting. It further explains the key concepts of the research and the background of the study (Cathala & Moorley, 2018).

The introduction further elaborates on the details mentioned in the abstract and what to foresee in the manuscript. The purpose of this study is well outlined. For instance, this study examined the effects of intentional nursing rounds based on the care model on patients’ perceived nursing quality and their satisfaction with nursing services (Shin & Park, 2018). This problem statement purposefully introduces and orients the reader to the significance of the topic under study.

Aside from the purpose of the study, the researchers in this report also highlight two alternative hypotheses that were subjected to validation. The first hypothesis stated that the interventional group under intentional nursing rounds would demonstrate a significant level of perceived nursing quality when compared to the control group without rounding services (Shin & Park, 2018). Secondly, the interventional cohort under intentional nursing rounds would demonstrate a higher level of satisfaction with nursing services than the control group without rounding service (Shin & Park, 2018). The roles of hypotheses in research are overwhelming.

They describe the exploration in concrete terms, provide the backbone of evidence to ascertain the validity of research as well as assisting in data analysis to assess the reliability and validity of the study (Vance et al., 2013).  Likewise, hypotheses emphasize the validity and scientific attribute of research methodologies by linking the underlying theoretical basis and the specific research problem in addition to furnishing the researchers with distinct clarifications and restatements of the research problem.

Literature Review Analysis

The logical flow of any research must include the literature review part. A literature review serves multiple functions. To begin, it is ordinarily the initial step of clarifying the intention of any research. This part further facilitates the development of clear comprehension of the research topic by both the researchers and the readers (Cathala & Moorley, 2018). Additionally, discerning existing conceptual framework approaches to the study topic and refining the research topic can only be practical via the literature review. Lastly, the literature review mitigates the burden of readers unfamiliar with the topic experience striving to understand the rationale of the study.

Consequently, this section of the research must be well written to fulfill its purpose. Looking at the literature review section of this study, several key deductions can be outlined. Firstly, the articles referenced in this article are not current since principally most of them are older than five years probably due to the time the study was conducted. Nevertheless, most of the references used are peer-reviewed journal articles that are relevant to the topic under investigation. The articles summarize what is already known about the research topic and highlight the available gaps such as few pieces of research on intentional rounding reported in the literature in Korea as well as the need to view patients’ satisfaction from the patients’ angle (Shin & Park, 2018). Finally, the report’s literature review outlines the critical contribution to new knowledge that this study will add. For instance, the study will emphasize intentional rounds that would draw patient-oriented nursing care with the identification of the patients’ needs.

Participants, Sampling Issues, and Study Setting Analysis

Participants utilized in the study were patients from two general surgical wards in a large metropolitan teaching hospital in Korea. To qualify as a participant, one had to understand the survey questions without any difficulty in communication. Similarly, the participant had to be an adult Korean-speaking patient admitted to the surgical unit. However, the exclusion criteria included those patients transferred during research duration, those who were discharged as well as those who lost their lives during the research period (Shin & Park, 2018). The sampling was non-probability sampling as it followed the admission register. Ratelle et al. (2019) describe this type of sampling as non-random as not all members of the population have an equal chance of being selected as participants. This type of sampling is mostly utilized by researchers where it is difficult to procure a random sample due to time and cost considerations. The sample is therefore not a true representation of the general population.

Out of the 155 participants assessed for eligibility, 152 were recruited. Initially, there was an equivalent allocation of participants across the experimental and the control group. Subsequently, six from the experimental group discontinued intervention while one from the control group discontinued the intervention leaving a total analyzable sample of 145. The study setting where data collection took place was in two orthopedic wards of a metropolitan teaching hospital in Korea. Data from this setting was collected at different times. The data for the control group that was under conventional rounding was collected from subjects admitted between November 1, 2015, and March 25, 2016. The data from the experimental group under intentional nursing was collected from subjects admitted between April 1, 2016, and October 25, 2016.

Ethical Considerations

Ethical issues in medical explorations involving human subjects have been in existence since taking roots in 1964 through the Declaration of Helsinki issued by the World Medical Association. This particular declaration outlined two fundamental ethical issues; informed consent and ethical approval (Wu et al., 2019). Informed consent is an interactive process by which the researchers educate the participants about the research, benefits, and risks of the study before asking the participants to voluntarily and willingly consent to the study. On the other hand, ethical approval out to be done by the ethics approval committee after a detailed and careful viewing of the appropriateness of the study design (Wu et al., 2019). Besides, it is stipulated that all research articles involving human subjects should essentially submit their report on ethical approval and informed consent prior to their publication.

Following an in-depth review of the research. It is crystal clear that the researchers of the article abided by the elements of ethical considerations in research. For instance, the study was undertaken after receiving approval from the Institutional Review Board of Bundang CHA Hospital (Approval No. 2015-11-198-002). In addition, all participants signed a written consent form after being enlightened about study goals, data collection, and confidentiality of the procedures as well as the freedom to walk out of the research process (Shin & Park, 2018). Subsequently, the rights of the participants were safeguarded in this exploration.

Research Design, variables, and Methodology Analysis

Study design refers to the methodology utilized to investigate the research problem in question (Ratelle et al., 2019). Study variables on the other hand refer to a person, thing, place, or phenomenon that the research attempts to measure (Ratelle et al., 2019). The two types of variables greatly deployed in research are dependent and independent variables.  The dependent variable just as the name suggests is contemplated to change on manipulation of the independent variable. It is the presumed effect (Ratelle et al., 2019). Meanwhile, the independent variable is the presumed cause and is the stable variable that the investigators navigate.

With that background in mind, in-depth scanning of this article reveals an experimental research design. This quasi-experimental included a non-equivalent and non-synchronized control group. According to Ratelle et al. (2019), quasi-experimental study designs feature both control and intervention groups but do not provide for random assignment of the treatment group. Similarly, in this research, the control and treatment groups were assigned according to the admission register. A quasi-experimental design is best suitable when a cause-effect relationship is desired to be established with a feasible introduction of experimental stimuli but randomization is impractical or unethical.

The dependent variables in this study were patient’s perceived quality of nursing and patient’s satisfaction with nursing services. According to Shin and Park (2018), these variables referred to how patients felt about the nursing care they received and the degree of subjectively perceived satisfaction between patients’ expectation of nursing service and actual service provided respectively. Nonetheless, the independent variables were the conventional nursing rounds and intentional nursing rounds given to the control and treatment groups respectively.

Data Analysis and Results

Data analysis entailed an initial identification of homogeneity of participants’ baseline variables and characteristics between control and experimental groups using descriptive statistics, chi-square tests, Fisher’s exact test, and independent T-test. This was followed by the assessment of the impact of intentional rounding utilizing the difference-in-indifference method to analyze alterations in patients’ perceived nursing quality and their satisfaction with nursing service. Finally, the mean and the standard deviation of the intervention group were used as measures of the effect size of this study.

The results of this study supported both hypotheses. For instance, in testing the first hypothesis, it was discovered that the experimental group’s perceived nursing quality level was 0.85 points higher than that of the control group (p =.041) while in the second, it revealed that the level of satisfaction with nursing services from the experimental group was 8.28 points higher than that of the control group (p < .001). In terms of the hierarchy of evidence, this study is at level III (Drisko & Grady, 2019). The nursing theory used in this study is Swanson’s caring model.

The Swanson theory of caring is based on the five fundamental principles including maintaining belief, knowing, being with, doing for, and empowering (Shin & Park, 2018). The study limitations for this study included lack of representation of the patients’ perceived nursing quality and their satisfaction of general patients and at the general level because the study was conducted for patients at a metropolitan teaching hospital to ensure homogeneity. Similarly, the effect of intentional rounding cannot be fully generalized in the clinical setting since the study was conducted in only two surgical units.

Implications for Nursing Practice

As the nursing practice shifts focus to patient-centered care, patients’ experiences become key. The findings of this result influence the nursing practice by advocating for the establishment of intentional rounding to replace conventional rounding. According to this study, this structured nursing system looks after patients at fixed time intervals to assess and manage patients’ basic needs. The nurses are always available to be with and take care of their patients. Subsequently, this type of nursing is perceived as high quality with increased levels of patients satisfaction. It is therefore imperative that nurse leaders should try to adopt such kind of nursing care.

Arguably, this type of care requires manpower in terms of the nursing staff to be available at patients’ disposal. Nurse leaders in their policy making, should advocate for enough staff in healthcare facilities to spearhead the shifting of nursing care from conventional rounding to intentional rounds. Shin and Park (2018) further outline that the findings of their research should form the backbone for further research to systematically improve future nursing practice to eventually increase patients’ safety, nursing needs, nurses’ performance ability, and communication ability, as well as patients’ satisfaction.

Conclusion

Appraising a research article is an elemental skill that all nurses should have to guide their clinical practice. Likewise, nurses should synthesize evidence-based knowledge as well as areas that require future research to help shape and shift the future nursing practice to align with the ever-growing and dynamic healthcare needs.

References

• Cathala, X., & Moorley, C. (2018). How to appraise quantitative research. Evidence-Based Nursing, 21(4), 99–101. https://doi.org/10.1136/eb-2018-102996
• Drisko, J. W., & Grady, M. D. (2019). Step 3 of EBP: Part 1—evaluating research designs. In Essential Clinical Social Work Series (pp. 107–122). Springer International Publishing. https://doi.org/10.1007/978-3-030-15224-6_6
• Ratelle, J. T., Sawatsky, A. P., & Beckman, T. J. (2019). Quantitative research methods in medical education. Anesthesiology, 131(1), 23–35. https://doi.org/10.1097/ALN.0000000000002727
• Shin, N., & Park, J. (2018). The effect of intentional nursing rounds based on the care model on patients’ perceived nursing quality and their satisfaction with nursing services. Asian Nursing Research, 12(3), 203–208. https://doi.org/10.1016/j.anr.2018.08.003
• Wu, Y., Howarth, M., Zhou, C., Hu, M., & Cong, W. (2019). Reporting of ethical approval and informed consent in clinical research published in leading nursing journals: a retrospective observational study. BMC Medical Ethics, 20(1), 94. https://doi.org/10.1186/s12910-019-0431-5

Article Critique Pay for Performance Sample Paper

Article Critique: Pay for Performance

Healthcare providers utilize research for a variety of health reasons including but not limited to making clinical decisions, improving the quality of patient care, and formulation of healthcare policies. This evidence-based practice is highly recommended because of its overwhelming value in improving the quality of patient care. Consequently, it is elemental for nurses to develop skills for filtering and determining which research articles to deploy best hence critiquing a research article is a crucial skill to gather evidence-based research. The purpose of this piece of writing is to appraise the Challenges of Implementing Pay for Performance Plan in the Views of Nurses Working in Hospitals Affiliated to Mashhad University of Medical Sciences, a Qualitative Study Report by Rasi et al. (2018).

After going through the Challenges of Implementing the Pay for Performance (PFP) Plan in the Views of Nurses Working in Hospitals Affiliated to Mashhad University of Medical Sciences, a Qualitative Study Report, it is crystal clear that the exploration was well written with the slightest grammatical errors. To begin with, the title is a correct description of the research and informative as it gives a glance at the key concepts as well as stating the variables and methods of the research. The author of the article has further logically organized the research by describing the abstract exhaustively. The abstract is a mirror image of the report and clearly outlines the background, purpose of the study, methods, results, and conclusions (Moorley & Cathala, 2019). After reviewing the report, it is evident that the research is logical as it has followed all the steps of research. For example, the authors provided a comprehensive introduction, significant literature review, sound data collection, and an in-depth discussion.

Similarly, the introduction section of the article was well structured as it gains the attention of the reader or rather makes the subject area interesting. Additionally, it defines the key concepts of the research such as nurse, hospital, human resource, and pay for performance (Rasi et al., 2018). The introduction also makes the purpose of the article clear. However, this being a qualitative study, it didn’t seek to test a hypothesis. Moorley and Cathala (2019) recommend a statement of the purpose of the study that incorporates the research statement. For instance, in this article, Rasi and associates (2018) aimed at exploring the challenges of the PFP plan in the views of nurses working in hospitals affiliated to Mashhad University of Medical Sciences, Iran.

The theoretical framework of this research was effectively structured. The authors begin by reviewing the challenges facing the human resource department and the impact of the value-based payment systems and comparing them to the results of various studies globally. The theoretical framework subsequently narrows down to a specific variable and defines this variable based on the distinct standpoint of nurses.

After a deep review of the research, the literature review is comprehensive and extensive. The authors have incorporated evidence and important findings from previous studies that relate to the topic of interest. The references used are a concoction of both current and old sources. Similarly, the lion’s share of these references is primary hence show a wide range of discrepancies. Nevertheless, the literature review elaborates the context of the study by expounding on value-based payment systems through the integration of both old and recent studies.

The methodology section was sound. The authors used a qualitative research approach to address the research objectives. The study setting is well highlighted and the type of sampling technique, as well as the sample size, are clearly indicated. Rasi et al. (2018) set forth an apparent inclusion criterion which consisted of nurses with at least 10 years of working experience. The methods of data collection were also pinpointed and data were collected until saturation as recommended (Moorley & Cathala, 2019). Additionally, ethical issues such as informed consent and data confidentiality were confronted in this report. The data collected was analyzed using content analysis which is one of the recommended styles of analyzing qualitative data. The issues concerning reliability, accuracy, precision, and consolidation of data were taken care of via the triangulation method. This methodology is therefore sound and replicable.

The findings of this report were well presented in tables and figures. The themes analyzed were clearly linked to the data that was collected and the information found in the literature review. The discussion section was comprehensive. The authors contextualize their study by relating the research findings to findings of other studies across the globe. The findings of this research strongly connect with research objectives and aims and are supported with literature. However, the research fails to indicate the limitations encountered in the study. The study recommends proper planning before the implementation of pay for performance plan to avoid the challenges associated with this payment system.

Level of Evidence

The level of evidence is based on the methodological quality of design, validity, and applicability to patient care. In terms of the hierarchy of evidence, qualitative studies usually fall short of quantitative studies. For instance, this being a single qualitative study, it can be ranked at level VI in terms of evidence (Astroth, 2018). However, Astroth (2018) proposes a critical analysis and scoring of individual qualitative study across five parameters namely; descriptive vividness, methodological congruence, analytical preciseness, theoretical connectedness, and heuristic relevance. The legend for this scoring scale is designated QI to QIII based on the percentage criteria score. This report can be ranked QII and it meets 50% to 74% of all the criteria (Astroth, 2018).

Decide if the Study is Applicable to your Practice

Value-based payment systems such as pay for performance are beginning to take roots in human resource management. The benefits of these payment mechanisms are overwhelming. Hermer et al. (2018), in their work, discovered that resident and nursing homes that adopted pay for performance plans had significant improvement in patient care quality as it became safe and patient centered. Similarly, Mathes et al. (2019) in their exploration concluded that pay for performance in hospitals was associated with efficiency in the running of the hospital facilities and equity in the allocation of healthcare resources. In terms of cost and staffing, pay for performance is associated with an overall reduction in healthcare costs and increased job satisfaction respectively.

These overwhelming benefits of the PFP plan can only be achieved with solid planning and execution of the program. This entire study applies to my practice as the findings of this research give a glimpse of future nursing practice. That as current and future nursing leaders along with the stakeholders and policymakers, we should be able to critically evaluate a program such as PFP, taking into account the advantages and the challenges of its execution. Consequently, such in-depth reviews will result in the development of laws and guidelines that will aim at controlling the challenges while enjoying the benefits of the program.

Conclusion

Appraisal of research is vital for shaping the future of the nursing practice. Policymakers and stakeholders should extensively evaluate available information to guide their decision-making. Value-based payment systems such as pay for performance significantly improves the quality of patient care, job satisfaction and reduces overall healthcare costs. Nonetheless, careful planning and implementation are central to relish these benefits.

References

• Astroth, K. S. (2018). Focusing on the fundamentals: Reading qualitative research with a critical eye. Nephrology Nursing Journal: Journal of the American Nephrology Nurses Association, 45(4), 381–348.
• Hermer, L., Cornelison, L., Kaup, M. L., Poey, J. L., Drake, P. N., Stone, R. I., & Doll, G. A. (2018). Person-centered care as facilitated by Kansas’ PEAK 2.0 Medicaid pay-for-performance program and nursing home resident clinical outcomes. Innovation in Aging, 2(3), igy033. https://doi.org/10.1093/geroni/igy033
• Mathes, T., Pieper, D., Morche, J., Polus, S., Jaschinski, T., & Eikermann, M. (2019). Pay for performance for hospitals. Cochrane Database of Systematic Reviews, 7, CD011156. https://doi.org/10.1002/14651858.CD011156.pub2
• Moorley, C., & Cathala, X. (2019). How to appraise qualitative research. Evidence-Based Nursing, 22(1), 10–13. https://doi.org/10.1136/ebnurs-2018-103044
• Rasi, V., Maleki, M. R., Yarmohammadian, M. H., Reyhani Yasavoli, A., & Doosty, F. (2018). Challenges of implementing pay-for-performance plan in the views of nurses working in hospitals affiliated to Mashhad university of medical sciences: A qualitative study. Modern Care Journal, 15(4), e87007. https://dx.doi.org/10.5812/modernc.87007

When emergency situations arise, first responders rush to provide critical aid. But in the complex landscape of healthcare roles, there is debate about whether registered nurses should be categorized among these frontline heroes.

This article will examine what constitutes a first responder, how nurses fit into the picture, their authorized roles in mass casualty incidents, and other critical considerations around categorizing these healthcare professionals.

Who Are Considered First Responders?

First responders are specially trained personnel who are among the first to arrive and assist at the scene of an emergency. They must stabilize dangerous situations, triage patients, and provide pre-hospital care to victims before they can receive definitive treatment at a hospital.

The Department of Homeland Security officially designates the following groups as first responders:

• Firefighters
• Police Officers
• EMTs
• Paramedics

These professions all undergo rigorous training to prepare them for diverse emergencies. Whether a cardiac arrest, car accident, or crime is unfolding – first responders must take command of chaotic scenes using their expertise.

Characteristics of First Responders

While titles may vary, some universal characteristics apply to certified first responders across fields:

Immediate Response

First responders are dispatched to crisis sites via 9-1-1 calls through public safety access points. First responders are equipped for the fastest possible response times for critical injuries where minutes make the difference between life and death.

Specialized Training

To qualify, extensive education in emergency medicine, assessment, and field treatment is required. Ongoing skills training and evaluations keep first responders sharp and ready to intervene across heterogeneous incidents.

Scene Assessment

A huge part of a first responder’s duties includes quick analysis of emergency scenes to determine the mechanism of injury or nature of the illness. This allows them to accurately triage patients and determine transport priorities if multiple victims are involved.

Pre-Hospital Care

Whether through CPR, bandaging wounds, administering oxygen, or even helping deliver babies – first responders initiate urgent care using specialized techniques and equipment at the scene. This aims to stabilize and improve outcomes before the patient arrives at the ER.

What Is a Frontline Worker in Healthcare?

Frontline workers in healthcare refer to the staff who engage directly with patients to provide care. They assume higher physical and psychological risk as the first point of contact with those seeking treatment.

Common frontline healthcare worker roles include:

• Nurses
• Emergency Medical Technicians
• Medical Assistants
• Physicians
• Home Health Aides
• Phlebotomists

These jobs usually require and exceed varying levels of medical education and credentials to practice. But what they share is working face-to-face with the injured, the sick, and the vulnerable day in and day out – especially when crises like pandemics transpire.

Comparing Key Duties: Nurses vs EMTs

Both nurses and EMTs undisputedly function as indispensable frontline healthcare workers. But there are also roles and capabilities worth contrasting:

TABLE

While both dispatcher roles involve urgent facets of medicine, EMTs focus on emergency response and stabilization until the patient can receive comprehensive hospital care from nurses and physicians. Both demonstrate selflessness and compassion that make them indispensable frontline healthcare heroes.

When are Nurses First Responders?

Clearly, an ability to make rapid, lifesaving decisions under pressure in many situations defines first responders. But where exactly do nurses fit in?

Nurses are essential healthcare professionals who provide around-the-clock patient care in medical settings after hospital transport. They assist physicians in developing treatment plans, communicating with families, operating complex equipment, and much more.

With advanced education in anatomy, pathophysiology, pharmacology, and disease management, there is no doubt nurses have expertise that allows them to function in crises. However, pre-hospital emergency care in the field is not a standard or defining duty of registered nurses.

Compare this to EMTs who specifically train in and are certified to diagnose, treat, and transport critical patients under fire-department or ambulance jurisdiction before they ever reach the ER doors.

Are Nurses First Responders in a Mass Casualty Incident?

While the nurse’s role is typically after the emergency phase, things get more complex in special situations:

Mass Casualty Events

In the case of a disastrous mass casualty scenario where the victims far outnumber existing first responders, emergency operation plans tap into expanded medical resources. Off-duty EMTs may be called in, while on-site nurses at nearby hospitals may deploy to the field as reinforcements.

In such dire scenarios, nurses serve as emergency triage volunteers functioning in a first responder capacity. It becomes all hands on deck. So, context matters when distinguishing nurses as first responders.

Good Samaritan Aid

Another example where ER nurses potentially act as first responders involves sudden emergencies unfolding in public places. If a nurse witnesses a person collapse nearby due to sudden cardiac arrest or choking, for example – legal and ethical codes require they render reasonable emergency aid within their qualifications.

This is no different than if an off-duty doctor or firefighter notices a traumatic health crisis arise away from their professional jurisdiction. Any medically qualified individual is bound to vital good Samaritan laws.

Can Nurses Help in an Emergency Situation?

Absolutely. Apart from specific on-site disasters where emergency agencies require all qualified backup, nurses can still provide essential aid without identifying as first responders. Here are some examples:

• Calling 9-11 at accidents when people are injured or in medical distress.
• Volunteering and maintaining certification in CPR/AED administration to help resuscitate cardiac arrest sufferers.
• Applying pressure on heavily bleeding wounds or using tourniquets before paramedics arrive.
• Assisting choking victims at restaurants using abdominal thrusts if trained.
• Offering overdose victims basic help if opioid reversal agents like Narcan are available.
• Sharing critical medical history with paramedics reaching emergencies.

During catastrophes like the COVID-19 pandemic, nurses undoubtedly served at the frontlines right alongside first responders. And they will continue filling such desperate societal needs as they arise.

But nursing fundamentally deals with patient care, communication, critical thinking, and education – not emergency response. This helps delineate nurses from emergency medical technicians under normal non-disaster circumstances.

First Responder and Healthcare Worker Discounts

The distinction gets muddled around first responder discounts and recognition. For example, the American Nurses Association successfully lobbied for the Emergency Responder Act to include registered nurses for benefits like federal retirement credit during COVID-19.

And many businesses extend discounts broadly to all hospital staff or frontline workers – whether emergency responders or not. Appreciating nurses for their sacrifice makes sense generally.

But most formal first responder acknowledgment initiatives strictly define the term to honor only personnel operating under those crisis-response roles day-to-day. Blurring professional boundaries too much can undermine nurses’ specialized expertise and scope.

Why is precise language important here? Beyond mere titles or discounts, appropriate professional boundaries in medicine impact:

• Public understanding in emergencies.
• Workplace laws, pay, insurance considerations.
• Operating authority in crises.
• Safety and capabilities around skills/training.

For these reasons and more, correctly distinguishing nurses from emergency medical services (EMS) personnel as first responders carries real relevance.

Summary: Are Nurses First Responders?

First responders assume specialized duties to respond urgently to medical crises in the field using autonomous judgment. Though absolutely essential healthcare professionals, nurses are not trained or necessarily certified first responders under normal circumstances.

However, standard emergency services may incorporate registered nurses to help fill the gaps. Good Samaritan laws ethically obligate any healthcare practitioner to assist in public medical emergencies, too. In the end, roles around emergency response versus ongoing care, are important to differentiate – even if we equally honor all those who sacrifice to save lives.