How Nurses and Their Work Environment Affect Patient Experiences of the Quality of Care

Critical Appraisal: A Qualitative Article
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Critical Appraisal: A Qualitative Article
This critical appraisal paper is critiquing a qualitative study entitled: How nurses and their work environment affect patient experiences of the quality of care: a qualitative study by Kieft et al. (2014).
Statement of the Phenomenon of Interest
Kieft et al. (2014) has incorporated the statement of the phenomenon of interest in the background of their qualitative article. The researchers` phenomenon of interest is to understand from the perspectives of Dutch nurses their own role in providing positive patients experiences (p.3). Hence, the phenomenon of interest is clearly provided by the researchers. Moreover, this statement is presented together with a short literature review entitled: Relation between nursing work environment and patient experiences of the quality of care but this review was not comprehensively done since the researchers have only discussed briefly few studies in the United States and in some European countries (Kieft et al., 2014, p. 1). According to Burns and Grove (2005), a comprehensive literature review, should have the three main section; the introduction, the body/discussion, and the summary. Moreover, Burns and Groove (2009) stated that a comprehensive review of literature also presents a conclusion that have been drawn from the literature reviewed.
Purpose
In this qualitative research study, the researchers (Kieft et al., 2014) purpose is clear: to comprehend from the views of the nurses how their work environment is affecting the patients` positive experiences (p.3). The study focuses on trying to understand the main research question: According to nurses, which elements of nurses’ work and work environment influence patients’ experiences with the quality of nursing care? Moreover, there are two sub questions to help in answering the main question:
1. Are these elements related to the eight essentials of magnetism? and
2. What is the mechanism by which these elements lead to better patients experiences?
Methods
Following the background and the short literature review, the researchers listed the methods of the study. The methods included 5 sub sections: aim of the study, research question, research design, sample size, composition and data collection and ethical considerations.
Kieft et al., 2014 employed a phenomenological approach, in order to explore to know or to gain an understanding of the views of the nurses, on their role on how their work environment and their role is affecting the patients` experiences with the quality of nursing care (p.4). As a research method, the Phenomenological approach studies the nurses` experiences, behaviors, and feelings (Kieft et al., 2014, p.3). The methods is not clearly discussed since it did not include the study variables, the dependent and the independent. The researchers did not elaborate on their study`s variables, in fact no discussion was appropriated for this purpose.
Data Collection
For data collection, the researchers employed purposeful sampling, using three criteria:
Participants must be employed as registered nurses or certified nursing assistants.
 Participants must have worked as nurses for at least two years.
Participants must be operative in mental health care, hospital care, home care or nursing
home care (p.5). The nurses in their study was from an organisation called, Dutch program ‘Excellent
Care’ on which 26 nurses were recruited and divided into 4 focus groups, with 6 or 7 registered nurses for each group (Kieft et al., 2014, p.5).
To collect the views of the 26 nurses on how their work environment is affecting their patient`s experiences, whether positive or not, each focus group performed some discussion led by two of the researchers, one the facilitator, the other, the monitor. After the discussion, the researchers critically evaluated the quality of the nurses` views, thus a triangulation occurred for the correct dissection of their perspectives. Kieft et al. (2014) has included a table listing the questions and the corresponding topics in order to organize the flow of the...