The Nursing Methods in Patient Care

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Table of Contents

Abstract
Introduction
Select of research interest area
Overview of research design
Foundation for the study
Conduct of the research
Analysis and reporting of the research
Usefulness of the research
Conclusion
References

Abstract

Nursing often involves safeguarding the lives of people and sometimes it requires innovative methods in order to actualize this role. This paper analyzes two articles that present two interesting perspectives on different methods that nurses can use in patient care, especially for special needs patients. Both articles contain findings on research that forms the basis of this scholarly paper.

Introduction

The main aim for this scholarly paper is to create awareness and spark actionable interest regarding the various concepts that the articles of research in this paper present. The paper explores elements relating to the care of acute and chronic care of patients, application of the hope experience, and prevention of patient falls in health institutions as part of the methods of safeguarding the health of patients in the nursing profession.

Select of research interest area

For my research, I chose two articles. The first article, Evaluating the Use of a Targeted Intervention Strategy in Reducing Patient Falls in an Acute Care Hospital, focuses on the issue of patient falls and the effects of a multiple intervention strategy in reducing such cases. My interest in this article stems from the view that researchers in the medical field often fail to give the matter the amount of seriousness it deserves (Mol, 2006). Additionally, in most cases, researchers that recognize the importance of discussing the topic usually overlook possible strategic solutions for the problem (Sochan, 2011). In my opinion, focusing on a solution rather than the problem of patient falls makes more sense and it creates a new outlook on the alleviation of the problem. The second article of my choice, Hope, older adults and chronic illnesses, focuses on the concept of hope and its effect on older adults in the recovery process with regard to chronic illnesses. The article presents a uniquely interesting perspective on how a psychosocial concept can affect the physical recovery of a patient suffering a chronic illness (McCready, 2010). The paper’s point of focus presents a multifaceted perspective on nursing and it inspires an out-of-the-box approach on various issues that most nursing professionals consider as obvious. The articles’ similarities and conformity to uniqueness make them ideal for my paper.

Overview of research design

Article 1 takes the quantitative analysis approach. The article is a report on the results of a randomized controlled trial consisting of two groups of patients in an acute care hospital. The first group received targeted multiple interventions while the second group, which is the control group, did not receive the same. The authors state that the design aims at establishing the effectiveness of targeted multiple intervention strategies as a measure of reducing patient falls, thus making the design mainly experimental in nature. The authors explain that the prevention of patient falls is often a challenge in many institutions and although the idea of targeted multiple intervention has been around for a few years, previous studies do not indicate its effectiveness (Ang et al., 2011).

The second article, Hope, Older Adults and Chronic Illness, is a qualitative analysis of previous research on the subject from different authors. The authors of the article explore comprehensive databases regarding the hope experience from different countries all over the world. The authors state that they concentrated on patients of all genders whose minimum ages averaged sixty years and above. They also state that the patient reports they used from various articles include patients with varying diagnoses (Duggleby et al., 2012). This aspect of the research has helped the authors in attaining some objectivity in their research and overall conclusions (Holzemer, 2007).

The two articles are different as they take different approaches regarding research material. The authors of Article 1 take a quantitative analysis approach and base their conclusion on a randomized controlled trial where they consider the number of patients on whom the trial proves effective against those that show no change. In contrast, the authors of Article 2 base their research on previous research by different authors regarding their topic and analyze the information in their formation of a conclusion. The second difference between the two articles is that Article 1 is practical in its research, while Article 2 remains theoretical. Therefore, even though the findings in Article 2 may make sense, there is no way of ascertaining the practicality of the findings yet (Santos, 2005). Although the research methods in the two articles vary, the procedures used in both articles ensure that the research is extensive and they exhibit objectivity. Additionally, both methods address the subject matter appropriately by taking into account aspects such as limitations.

Foundation for the study

The authors of Article 1 present the theory that a targeted multiple intervention strategy works effectively in reducing the number of patient falls and subsequent injuries on patients. Patient falls are a real issue in most health institutions, especially at acute care hospitals where patients require assistance regarding mobility. Although a large number of such institutions formulate certain measures to aid in prevention, singular application of specific measures often offers shorter solutions and it fails to address patients’ needs in terms of numbers (Ang et al., 2011). Given that nurses often bear the task of ensuring the continued care for patients, it is important to establish long-term methods of prevention (Weinberg, 2006). Patient falls pose various implications socially, financially, and medically.

The medical aspect of the issue concerns aggravation of pre-existing conditions in patients and the risk of occurrence of new conditions such as physical injuries. The financial element of this consideration concerns the need for institutions to procure medication to treat conditions that emerge from such falls, sometimes resulting in costly procedures such as surgeries. Socially, hospitals should ensure safe environments for all patients, regardless of their medical conditions and this task often falls within the job description of nurses. Therefore, formulation of long-term strategies benefits patients, health practitioners, and the reputation of health facilities regarding their ability to safeguard the health of their patients (Ang et al., 2011). The authors note that even though research regarding the possibility of effective prevention of patient falls is not theoretically new, the practical aspect of the research is new, and thus it presents uncertainty in the results.

In Article 2, the content essentially aims at giving a holistic approach to understanding the concept of hope with regard to patients suffering chronic diseases and older adults. Although the authors note that there is no universally acceptable definition and explanation of the concept of hope, they present common characteristics in most research material that they use for the metasynthesis. They elaborate some of the most crucial components that the concept exhibits in terms of differences between hope experiences for young adults and those of older adults (Duggleby et al., 2012). The authors state that although various scholars have explored the involvement of hope as a factor in the recovery of patients, the definition of the concept of hope and the explanation of the experience varies depending on the method of research, diversity of the illness experience, and age of the patients. The authors state, “Theories and conceptual models of hope vary significantly with respect to how hope is conceptualized” (Duggleby, et al., 2012, p. 1212), and give examples of two theories, viz., Synder’s theory and the grounded theory by Duggleby and Wright. The former theory focuses on the cognitive setting while the later incorporates elements such as finding meaning and purpose in the hope process.

The organization of both articles in a progressive manner gives a concise understanding of the concepts that the authors present. For instance, in both articles, the authors indicate the background of the problem and reasons that make their research essential and elaborate the various methods of data collection they applied, data analysis, and points of consideration before arriving at their conclusion. The articles also indicate the presence of objectivity despite the use of varying research designs (Risjord, 2010). For instance, the authors support their arguments using medical facts and literature on nursing. Although Duggleby, one of the authors in Article 2 supports the grounded theory in explaining the hope experience, he does not omit Synder’s theory, which provides contrast and reasons for the applicability of his own theory in the paper over that of Synder. The authors indicate their hypothesis in the abstract and dedicate their research to proving their theory, without leaving out explanations on counter arguments.

Conduct of the research

In article 1, the population of interest for the research was patients who had “scored five and above on the Heinrich II Fall Risk Model in recruitment that took place in 2006” (Ang et al., 2011, p.1988). The trial took place at a Singapore hospital where nurses gave the control group as well as the target group standard fall prevention measures. The nurses reported rates of falls for both groups with “95% CI, which was calculated using the Wilson method and compared using the Chi-Square method and they estimated the relative risk and reported hazard ratio at 95% CI and made comparison using the log-rank test” (Ang et al., 2011, p. 1989). Although the authors did not indicate any particular disease as part of the characteristics for the study, they indicated that the target patients were those in acute care. The participant patients did not have access to the data constituting the findings, but they had prior notice of the research, and thus they participated willingly. Throughout the trial, nurses participating in the process ensured that they maintained integrity, dignity, and privacy of the participating patients in accordance with the hospital’s code of ethics. The trial remained non-intrusive throughout (Ang et al., 2011; Mill & Oglivie, 2002).

Article 2 mainly constituted a study of various reports targeting patients with a minimum of sixty years and above, with an inclusion of those suffering from non-chronic illnesses within the age bracket to provide results for a comparative study. The research material, which comprised twenty independent studies in total from around the world, included patients with varying diagnoses with regard to chronic illnesses in order to maintain objectivity. Although the researchers did not directly interact with the patients, any personal information regarding patients remained confidential in compliance with nursing code of ethics (Duggleby et al., 2012).

Analysis and reporting of the research

In Article 1, once the data collection process was complete, the researchers conducted a comparative analysis with consideration of information previously available about acute care patients. The researchers compared the hazard ratio reported against the log-rank test to ascertain the viability of the results. The authors noted that although the research provided a margin of error, the information they obtained was reliable. For Article 2, the researchers applied a qualitative method of analysis involving comparison of research on the subject matter and ascertainment of common facts in most reports. By comparing the findings from different reports, the authors noted that the hope experience for older adults and patients under chronic care varied with the level of illness. They also noted that hope contained both internal and external resources, involved choice, was future-focused, and dynamic in nature.

Usefulness of the research

The findings in both reports are of great help to the nursing practice and they create a basis for further research in the future. For instance, the practical element of research in Article 1 makes it possible for nurses to prevent patients’ falls in hospitals using the same procedure. The extensive nature of research in Article 2 generates enlightenment on the application of hope experiences in the treatment process. The articles contain contact information on the authors in case the reader wants to contact them for further clarification or research material.

Conclusion

The overall content in the two research articles helps in creating new perspectives on the role of nurses in safeguarding patient health as well as sparking interest in further research on patient care issues. The uniqueness of the points of focus in both articles allows the reader to go beyond the orthodox textbook readings and explore the practicability of various concepts for the benefit of patients.

References

Ang, E., Mordiffi, S., & Wong, H. (2011). Evaluating the use of a targeted multiple intervention strategy in reducing patient falls in an acute care hospital; a randomized controlled trial. Journal of Advanced Nursing, 67(9), 1984-1992.

Duggleby, W., Hicks, D., Nekolaichuk, C., Holtslander, L., Williams, A., Chambers, T., & Eby, J. (2012). Hope, older adults, and chronic illness: a metasynthesis of qualitative research. Journal of Advanced Nursing, 68(6), 1211–1223.

Holzemer, W. (2007). Towards understanding nursing science. Japan Journal of Nursing Science, 4(1), 57-59.

McCready, J. (2010). Jamesian pragmatism: A framework for working towards unified diversity in nursing knowledge development. Nursing Philosophy 11(3), 191-203.

Mill, E., & Oglivie, L. (2002). Ethical decision making in international nursing research. Qualitative Health Research, 12(6), 807-815.

Mol, A. (2006). Proving or Improving: On Health Care Research as a Form of Self-Reflection. Qualitative Health Research, 16, 405-414.

Risjord, M. (2010). Nursing Knowledge: Science, Practice and Philosophy. Oxford, UK: Wiley-Blackwell.

Santos, A. (2005). Toward a north-south dialogue: Revisiting nursing theory (from the south). Advances in Nursing Science, 28(1), 17-24.

Sochan, A. (2011). Stance and strategy: post-structural perspective and post-colonial engagement to develop nursing knowledge. Nursing Philosophy, 12(3): 177-190.

Weinberg, D. (2006). When little things are big things: The importance of relationship for nurses’ professional practice. In S. Nelson & S. Gordon (Eds.), The Complexities of Care: Nursing Reconsidered (pp. 30-43). Ithaca, NY: University of Cornell Press.

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