Nursing Research and Evidence Based practiceHello
I need to post 6 comments to my peers. Responses to peers or faculty should be 150 min words and include one reference.
Comment 1:
In current times, research is becoming more complex and dynamic and therefore, several researchers are complementing one method with another. For instance, researchers are utilizing a mixed methodology that includes using qualitative and quantitative methods. Of course, there are advantages or disadvantages to the mixed methodology. As advantages, the mixed methodology offers more validity and reliability to the findings of a research that includes qualitative data that is derived from open ended sources, often without predesigned replies, and in contrast, quantitative data is from close ended data sources such as tests, questionnaires, or psychological instruments (Hafsa, 2019). As disadvantages, mixed methodology is more labor-intensive and time-consuming that requires more resources (Hafsa, 2019).
Indeed, the article by Escrivá Gracia, et al. (2019) utilized a mixed methodology study to determine medication errors and drug knowledge gaps among critical-care nurses. In particular, a mixed study that included an analysis of medical records, a discussion group, as well as a questionnaire, were utilized and as result, it was discovered that several medication errors occurred in ICUs and ICU nurses have a low level of knowledge of the drugs they use the most. As result of utilizing a mixed study in this article, all areas of the deficiencies were specifically identified in a detailed manner, and therefore, corrective measures may be implemented to eliminate such deficiencies in the future.
Comment 2:
Using both qualitative and quantitative methods for research may complicate studies but also improve them as well. A benefit of using mixed methods as stated by (Doorenbos, 2014) is that quantitative data can be used to identify representative patients or outlying cases. Meaning, it can be used to collect hard data on a specific subject. Qualitative data can reveal aspects of quantitative components in research by assisting in development of conceptual models or instruments. As previously mentioned, while using a mixed method approach to research may result in more data, it also adds complexity, demanding more of the researchers. In (Wasti et al., 2022), they state that it increases cost and resources. Researchers must also be well versed in both types of research methods and have a clear understanding of the qualitative subject as there can be differences in understanding between researchers themselves. Using mixed methods isn’t always the best choice for every research study, it must be applied to the topic, or it will be more work for works sake. A great example of a mixed approach would be the topic my research critique paper, is NPO after midnight best practice? The research articles take mixed method approach. In (He et al., 2021), patient’s signs and symptoms of nausea, vomiting, thirst and hunger were measured on a 1-10 scale and blood samples were taken to measure blood glucose and insulin resistances. They wanted to see if there was a benefit to giving a carb rich drink 2 hours before a procedure and if it was safe versus NPO after midnight. The study concluded with the patients who had the carb loaded drink to have higher satisfaction rates due to lower reported numbers of S/S and no adverse outcomes came from the beverage, proving it to be safe.
Comment 3:
Mixed method research uses both qualitative and quantitative research in the same study. Using both types of research in the same study allows for more detailed data covering a broader degree of uses and purpose. Bressan, 2017 discusses the early use of mixed method research, and how many studies using this technique lack rigor. Bresson also discusses that many researchers using mixed methods lack one or both research means.
Both single and mixed method research has advantages and disadvantages. Bressan cautions new and novice researchers; “This has implications for providing limited direction for novice researchers. There is also potential for application of evidence in healthcare practice that limited validity.” The primary advantage of mixed method research would be more thorough research and data set.
Mixed method research can be used for many nursing problems. Quantitative research can provide rigorous data supporting the alternative hypothesis. Qualitative research can investigate how and why the alternative hypothesis is implemented at the clinical level. An example of mixed method technique in use would be investigating a newly implemented sacral dressing for bedbound patients. The quantitative research investigates the efficacy and bedside implementation. Qualitative research can further investigate why, when and how there are compliance fallouts, and what measures can be taken to improve compliance and patient care.
Comment 4:
We as nurses have the unique position of providing 24-hour care to patients. In real time, we can see how treatment affects patients and advocate for their needs. As stated by (American Nurses Association, 2024), the use of evidence-based practice (EBP) uses research based data to improve patient outcomes, reduce healthcare costs, allows for well-informed decisions and critical thinking. EBP is being used every day when providing patient care. Turning patients every two hours, providing 02 when patient is short of breath, ambulating after a procedure. All of this is done to prevent harm and improve outcomes in patient care. There is no research-based data on a “gut” feeling that will improve a patient’s condition. With the popularity and data rich EBP articles, applying the right one is a hurdle in itself. Internal stakeholders are the ones who can make implementations of EBP happen. In (Tsistinas, n.d.), they recommend having a PICO with substantial evidence ready to present to a stakeholder. Identification and engagement of the stakeholders is paramount. One must also place themselves in the shoes of the stakeholder and identify any potential rebuttals with cost, implementation, and staff push back being common topics. One must be patient as it can takes weeks and several meetings with adjustments and compromises on both parties.
Comment 5:
Nurses are the forefront of improving healthcare quality and safety through the use of evidence-based practices. By integrating the best available evidence with clinical expertise and patient preferences, nurses can deliver high-quality, patient-centered care that is both effective and most importantly, safe. To to implement best practices in patient care, nurses ensure that treatments and interventions are based on the most current and reliable evidence before application of the order. Evidenced based practice encourages nurses to stay updated with the latest research and innovations in healthcare, promoting a culture of continuous learning and improvement. This is important because medicine and practices are forever changing. Staying up to date with the latest information and research before implementation of a standard intervention, emphasizes patient safety, helping nurses identify and mitigate risks, prevent errors, and improve the overall safety of care delivery.
While working at a level 1 trauma hospital, I observe, and practice myself, nurses improving the quality and safety of patient care every shift. An example including, being involved in a project to implement better protocols, documentation, and education for patient’s needing peritoneal dialysis. By identifying a specific practice issue or area for improvement, this will benefit the patients from the application of evidenced based protocols and interdisciplinary action with the Nephrology team. It is also important to note that involvement from the patient and the family in the sessions and evidenced based practice will help ensure that values and preferences are integrated when implementing such change. Considering these perspectives and gaining support from key stakeholders, such as the nurses, interdisciplinary action, and involvement from patient/family members, this can increase the likelihood of successfully implementing projects driven by evidenced based practice in the workplace, leading to improved healthcare quality and safety.
Comment 6:
Although there are differences in qualitative and quantitative research methods, both offer ample advantages. Combining both methods allows researchers to gain a comprehensive understanding of a nursing practice problem. Quantitative data can provide statistical trends and associations, while qualitative data can provide rich descriptions and insights into the experiences and perspectives of individuals involved. (Streefkerk, 2019 ). Nursing practice problems are often complex and multifaceted. Using both qualitative and quantitative methods can help researchers better understand these complexities by capturing both the quantitative measurements and the qualitative nuances of the issue.
However, there are also some disadvantages to using both methods. Conducting a mixed methods study can be resource-intensive, requiring expertise in both qualitative and quantitative research methods, as well as additional time and resources for data collection, analysis, and integration. It’s common to encounter challenges and limitations when using mixed-methods research, as integrating two distinct approaches can be complex (Bressan, et al. 2017). Researchers must carefully consider the strengths and weaknesses of each method and how they can complement each other to address the research question effectively. Inconsistencies in application and reporting highlight the importance of clear methodology and transparent reporting to ensure the rigor and validity of mixed-methods studies. In addition, mixing qualitative and quantitative data could introduce bias if not done carefully.
An example of a nursing practice problem that could be studied using a mixed methods approach is the implementation of a new pain management protocol in a hospital. Quantitative methods could be used to measure the effectiveness of the protocol in reducing pain scores and opioid use, while qualitative methods could be used to explore patients’ and healthcare providers’ experiences and perceptions of the protocol. Integrating these findings could provide a more comprehensive understanding of the protocol’s impact and inform future practice improvements. Pain for hospitalized patients is an ongoing problem. By using both qualitative and quantitative data, this information could reduce hospital stays, provide better patient outcomes, and drive increased patient satisfaction survey scores.
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