A1. Quantitative Study
Articles Bucknall, T. K., Forbes, H., Phillips, N. M., Hewitt, N. A., Cooper, S., & Bogossian, F. (2016). An analysis of nursing students' decision-making in teams during simulations of acute patient deterioration. Journal of advanced nursing, 72(10), 2482-2494.
Bach, V., Ploeg, J., & Black, M. (2015). Nursing roles in end-of-life decision making in critical care settings. Western Journal of Nursing Research, 31(4), 496-512.
The statement of purpose of the authors (Bach, Ploeg & Black, 2015) entails a quantitative study on the attitude and knowledge the nurses have towards the provision of palliative care to the terminally ill and their services. However, the attention has expanded to include a scope whereby the patients may live for long but with an end-stage failure of organs or chronic illness like cancer. The account has a lot of sense because all patients demand proper services from well knowledgeable nurses. The research has aimed at assessing the attitudes and knowledge of nurses towards palliative care in selective hospitals. In case the prognosis for a patient is much critical to the extent of imminent death, hospice care is always available to provide a quality life to the patient. Therefore, it tends to reduce the severity of the disease instead of making an effort of treating the disease itself. To adequately address such situations for the patients in acute hospitals, there was a need for an Irish hospital foundation to develop hospice friendly hospital.
Review of the literature
The existing international literature was examined to identify a global perspective for patients under palliative care. The aspect entails the employment of essential themes for analysing the dying phase and symptoms to cater for the sick patients. In the event, there was a conclusion that there was a considerable difference on the approaches that nurses and medical staff applied to take care of palliative patients (Bucknall et al., 2016) As a result of the above challenge, there was a suggestion for education concerning the patients in question. However, the training the only solution to the rising problems appropriate care although the research does not cover the status quo in education.
Discussion of Methodology
The research involved the use of descriptive study design. Majority of the participants included the family members as well as the society residents. However, there was a selection of about 200 staff nurses from CRCU and ICU who joined the entire community members as fellow participants. In the event, there was the use of questionnaires to facilitate the collection of data. For instance, 50 individuals treated for pneumonia were interviewed in-depth to give their accounts of the care they underwent while under medication. Participants had a feeling that both attention and caring are the main aspects that are readily available in nursing homes. However, they also felt that doctors should decide on whether to hospitalise them in case the family members were to get consulted (Bach, Ploeg & Black, 2015).
In our case study, the appropriate descriptive analysis gets done concerning the data obtained from the field. Coefficients briefly summarizing the data were broken down into measures of variability. It got found that the number of dying patients received almost 75% of inadequate symptom control in addition to 40% of insufficient pain relief. Besides, the study asserts that 60% of the dying patients were suffering from terrible conditions such as insomnia. Although uncontrolled symptoms got presented, nurses ranked the overall management of patients as being excellent (88%) (Bach, Ploeg & Black, 2015).
In conclusion (Bach, Ploeg & Black, 2015) stated that there is a necessity to attain knowledge as well as having a positive attitude towards the nursing provision. The research has a significant impact on me as a clinician in the sense that I can learn different ways of handling the dying patients in all instances. On the other hand, the research is quite encouraging since it expands my mind to have a better perception of the health of the citizens.
A2: Researcher's Conclusion
The researchers (Bach, Ploeg & Black, 2015) have concluded that there exist some disagreements between the doctors and nurses concerning when patients enter into dying phase. However, several studies highlight that some patients are dying before the initiation of appropriate health care. Even after the patient was seen to be extremely sick, doctors continued to press on therapeutic interventions which later frustrated the nurses. Furthermore, assessment of the application of Liverpool Care Pathway (LCP) found that active preparedness and training assisted much to the catering of patients.
A3: Protection and Considerations
All findings that involve human beings should observe ethical issues. For instance, there will be a necessity for a moral approval in writing before interacting with hospital committees that are involved in research. However, the main ethical issues to take into considerations affect personal respects, beneficence and confidentiality (Ellershaw et al., 2016).
Confidentiality entails that there should be the protection of anonymity and high levels of privacy of respondent who is providing the information. Therefore, in case the method used questionnaires, none of them should get numbered for more confidentiality. On the other hand, respect for the person involves maintaining high levels of consent. In fact, before doing any research, it is always advisable to seek permission from the participants. However, before making the approval, the researcher should provide all his details as well as the purpose of the research. After filling the questionnaires, the participant is said to have taken consent for participating in the case study (Ellershaw et al., 2016).
A4: Strengths and limitations
According to the previous researchers, the size of the sample should be evaluated appropriately (Ellershaw et al., 2016). The results help the researchers to select the most prominent example possible so that he/she can represent the specific population. On the other hand, it is true that the sample size can easily lose some subjects due to the poor participation of the participants. However, there is an expectation of lower representation of data whenever there is a slower response in a collection of data. Also, the selection of data is associated with high levels of biases. In such situation, the researcher is unable to acquire competent results (Ellershaw et al., 2016).
On the other hand, research design gives the basic approach that helps the researcher to answer their research questions. Therefore, to meet the objective of the research, the researcher should choose the most appropriate design. From different perceptions, a quantitative method may arise from a belief that the behaviours of human can be learned objectively. As a result, the above idea makes the plan to emerge as being the best method for research methods. Also, quantitative research method uses the non-flexible approach that I advance organises the entire process of collecting the data. Also, it is assumed that the descriptive approach is likely to obtain current attitude and experiences of the nurses. Besides, the written questionnaires used to collect data can accommodate significant samples with little expenses (Ellershaw et al., 2016).
A5: Evidence application
The results from the above research are more significant impacts on the nursing practice. For instance, they give a better indication of attitudes and experiences that nurses should have towards caring for the dying patients. In fact, the results highlight clear signs concerning when the doctors should intervene in taking care of the patients. More so, it is true that the results play a prominent role in recommending the future practice as a nurse. As a result, they will later on move the palliative care higher as far as the nursing profession is concerned. Sharing of the finding with the nursing management is hoped to highlight the importance of proper planning for the available education for nurses.
B1. Qualitative study
Articles Pouralizadeh, M. (2017). Factors Influencing Nursing Students' Clinical Judgment: A Qualitative Directed Content Analysis in an Iranian Context. journal of clinical and diagnostic research. doi:10.7860/jcdr/2017/25753.9822
Bussard, M. (2015). The nature of clinical judgment development in reflective journals. Journal of Nursing Education. 2015;54(8):451-54.
Pourvakhshoori, N., Norouzi, K., Ahmadi, F., Hosseini, M., & Khankeh, H. (2017). Nurse in limbo: A qualitative study of nursing in disasters in Iranian context. plos one, 12(7), e0181314.doi:10.1371/journal.pone.0181314
Nursing as a practice lays its basis on discipline, and clinical judgement is one of the objectives a nurse must pose in nursing education. The statement of purpose in a study by (Pouralizadeh, 2017) entails qualitative research of nurses in different disasters. The researcher in the article states that a shortage of qualified nurses has led to the early confrontation of newly graduated nurses with decision making and judgement challenges which lead to an increment of the probability of causing harm to the patients. However, the nursing g education systems have been encouraged to equip students with skills to develop clinical judgement. Therefore, the study aims to evaluate and explore perceptions of disasters that nurses have regarding their effort in providing sufficient health care to the patients, focusing mostly on the palliative patients.
Review of the Literature
The study entails an exploration of the five categories that involve clinical judgment challenges that result when providing health care services. Clinical judgment is inseparable whenever high-quality nursing care gets expected. Such impeccable sense and other relative skill are capabilities expected of a nurse at graduation level (Bussard, 2015). Comprehending whatever the nurses experience in areas with disasters, could help in the identification of their problems in that given area (Pourvakhshoori et al., 2017). As a result, due to challenges, a majority of the nurses possesses a lot of negative attitudes towards their jobs. They end up growing emotional, and this affects their clinical judgment.
Discussion of Methodology
A qualitative study was used in data collection under which, the researcher applied the direct analysis approach. Here, the participants involved 15 nurses, with an age bracket of between 34-51 years with an approximate mean of 40.87, who previously had an experience on health care provision disasters (Pouralizadeh, 2017). Also, data would get collected through semi-structured interviews. The data got analyzed concerning the principle of inductive content study or occasional grounded theory in facilitating qualitative research.
From the perception, the duration of each interview was between 30 to 61 minutes in as much as the interviewer was the same. All texts, like interview guide that included brief notes on short questions, concerning the interview like the keywords and the facts were read during the opening of coding phase. Besides, there was an extraction of primary code which facilitated comparison of systems and data regarding differences and similarities (Pourvakhshoori et al., 2017). After completing the aspect of comparing the two, there was a need to develop both categories and subcategories which were evidence that there was the creation of a preliminary set of codes from the first interview. As a result, the existing systems were finally well thought-out to be the results.
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