Research Critiques and PICOT Statement Final Draft

Quantitative Research Critique and Ethical Considerations
Harmandeep Kaur
Grand Canyon University: NRS-433V
March 11, 2017.
PICOT statement
Population: Patients in an acute care setting
Intervention: Does hourly rounding
Comparison: Compared to responding to call lights
Outcome: Reduce the rate of patient fall incidents
Timeline: During patient stay at hospital
Question: Does hourly rounding reduce the rate of patient fall incidents and consequential injuries?
Patients in an acute care setting (P), does hourly rounding (I), compared to responding to call lights (C), reduce the rate of patient fall incidents (O), during patient stay at hospital (T)?
Introduction
Patient falls are a common occurrence within the hospitals especially within the critical care unit. Patient fall can be described as a situation in which a patient falls from a resting bed or falls as he or she attempts to walk within the unit. Patient fall may be caused by many factors such as polypharmacy, failure in diagnosis and failure in assessment of the patient by the care giver. All the same, there have been tireless efforts by the hospital administrators, nurses as well as researchers to try and get a lasting solution to minimize patient fall. There have been technological introductions such as the call lights which are fixed at the patient bed so that the patient may use them to seek for help from care givers or the nurses when they are feeling uncomfortable and need immediate attention. However, due to scarcity of nursing personnel in our hospitals, some call lights takes longer to be responded to. Another way boosting the hourly rounding is by increasing the number of staffs to increase the rate of rounding per day to ensure there is enough surveillance within the unit. These include monitoring and occasional assessment of the patient. However, there is no single most effective method of preventing patient fall and a combination of technology based methods as well as hourly rounding paramount in reducing patient fall.
Quantitative Research Critique and Ethical Considerations
The author sought to establish if the call light use rate and the average time to call light can affect the rate of falls and consequential injuries in an acute care setting. The author used archived data from the hospital to find out if the rate at which the call light was used and the average response time would contribute to patient falls and serious injuries as a result. The researchers were able to establish that high rate of patient calls resulted in less patient fall and prevented injuries (Tzeng & Yin, 2009). They also found that high rate of call light use led to longer response times, although the longer response to call light was lesser the fall rate and injuries. The authors were clear in the statement of the problem as well as the research questions (Tzeng & Yin, 2009). The methods used adequately adhered to the ethics of medical practice. The findings presented by the authors are meaningful and highly applicable in the acute care setting to prevent high patient fall and consequential injuries by responding to call lights as signaled by the patients.
This paper will conduct an appraisal of the study Tzeng & Yin (2009) so as to determine its findings and how they can be applied in nursing practice. It shall also establish the methods of study and determine whether the researchers considered ethical issues while conducting the study.
Background of Study
The researchers were elaborate enough in outlining the quantitative research problem which is clearly defined. The authors predict that if the patient caregivers or the nurses patrolled on an hourly basis or after every two hours, they would reduce patient call rates and at the same time prevent more falls. They also explain that if the nurses or the patient caregivers maintained the patient call rates above average, they would achieve low patient fall rates as well as minimal injuries. By outlining this information, the authors state why it was necessary to carry out this study. The implication of the study is the quicker response to the call lights by the nurses, which will reduce the patient fall rate and the injuries. A study by Cullen (2014) compared two care units, one with call lights and another one without. It established that there were high patient fall rates in the one without call lights while there were few cases in the one with call lights. The author concluded that call lights were effective in preventing patient falls as the patients would easily and quickly seek for attention. These findings support the argument of this study that stipulates the higher call lights and quicker the response relates to lower patient falls. Through the purpose of the study, the author outlines the use of the call lights and response by patient caregivers as well as the nurses in the past which offer a foundation of the study as it drives towards the problem that exists and how it will be fulfilled by the research initiated.
The researchers were prompted to conduct this study due to the fact that in as much as the patients have been equipped with call lights through which they would seek response from the nurses when they need assistance, there has been know studies that have examined the data collected in the call lights tracking system. The researchers argue that examining the data would generate meaningful findings that would help in determining whether quick response to call lights would reduce patient fall and the consequent injuries from fall.
Methods
The study used archived data from which the data contained in the call light tracking system was retrieved and used to calculate the rate of call light use per day. The tracking system provided the average response time in seconds which was used in the calculation of the call light rate. The patient fall and injury rates were determined using the fall incident data available in the hospital reports. This method was appropriate as it used data obtained from a practical environment and a workable machine which guaranteed the credibility of the study's results. However, the use of the reports that had been recorded cannot guarantee the exclusion of bias from the data since the researcher could not ascertain the circumstances in which that data was collected and filed. Moreover, the authors vividly described the call light data and the fall data that was used in the study providing a detailed background of the sources of data for the consumers of the report to understand the parameters. Data was collected in a period of one week. Data from each participant was collected from the call light tracking system.
The authors of the study sought patient consent before collecting their data as a way of considering ethics of the study. However, there is a possibility that the patients did not participate voluntarily in the study because the data collected at some point already existed from previous patients. The study obtained an approval from the Michigan hospital approval board to conduct the study. Moreover, the study did not have variables.
Results
The researchers relayed their results in a clear manner. They used tables which explain the various variables and show the differences that occurred among the values generated from different units that were involved in the quantitative research such as surgical and medical units. The study tackles the various relationships among call lights rate, response time and the rate of injuries and the correlations are established which relate with the findings and the conclusion.
The results show that when the average call light was higher, corresponding patient fall rate was lower (r=-0.16, p<0.01. n=288). N was the number of patients and r represents the response time while p is patient fall. It shows that when r is high, the p is lower.
The findings are a reflection of the reality because a patient will always seek help well he or she is feeling uncomfortable and predicts something bad might happen. Thus, if a nurse response to the call, the patient would be saved from fall. The study identified two limitations. One is that the call light tracking system did not indicate whether the call light was responded to or cancelled by the patient. Two is that the tracking system failed to show if the call light response came when the patient was in need or after the patient concern had been attended to. Also, the study had a coherent flow as the authors present the results in a logical order.
The findings are vital to the nursing field. The quicker response to the call lights means reduced patient fall and reduction in injuries from patient fall. The results are valuable as they encourage the nurses or patient caregivers to be highly responsive to the call lights so as to reduce patient falls and injuries within a critical care unit. The author suggests that future research should focus on establishing the differences between unit types through employing unit level indicators such as scheduling patterns and patient mobility levels.
Ethical Considerations
The study was not approved by any Institute Review board but got the permission from Michigan’s Hospital committee. The patient privacy was protected through the anonymity of the results which ensured that patient names were not disclosed anywhere. Further, patient consent was sought before the patient’s data was collected. The study lacked ethical considerations regarding to the treatment.
Implications for Practice
The findings of this study imply that call light use per patient is a predictor of the fall rate and injuries. It therefore suggests that routine managers should be keen on call lights as signaled by the patients and respond to them accordingly to prevent patient fall and consequential injuries.
Conclusion
The researchers came up with vital findings to guide nursing practice. The significance of quantitative study is based on solving the high c...