Reducing Restrictive Side Rail Use in Nursing Homes

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Table of Contents

Research Problem and Purpose
Theoretical Framework
Literature Review
Research Design
Study Sample
Data Collection
Data Analysis
Results
Recommendations
Reference List

Research Problem and Purpose

The scientific article analyzed in this paper is called “Consequences of an Intervention to Reduce Restrictive Side Rail Use in Nursing Homes.” The study is dedicated to the problem of the restrictive side rail usage. It is aimed at exploring the influence of an advanced practice nursing on the restrictive side rail usage in different establishments. The other purpose of the study is to determine whether the bed-related falls are dependent on the restrictive side rail use. The purposes were clearly identified by the researchers in the objectives’ section; however, the problem of the study was not expressed as a separate idea. Interestingly, this fact caused no confusion as the problem of the study can be derived from its content. It seems that there is a need for this study these days because the restrictive side rails are currently widely used in nursing homes, which makes the subject of the article vital. Knowing how to provide patients with proper consultations will reduce their use and help nurses to improve their professional skills of working with patients who have special needs. The previous research on this topic was stated to be less successful with respect to the restrictive side rail use reduction. The article under consideration is expected to improve the nursing practice since the introduced technique proved to be quite beneficial for the patients.

Theoretical Framework

In order to guide the study, the authors used a conceptual framework. The cases (patients and nursing homes) and their variables (quantity, setting, and special features) are thoroughly discussed in the article. The concepts have a clear organization as each of them is explained in a separate section; they are thoroughly discussed and articulated in a manner accessible to any reader.

Literature Review

The literature review is well-organized; it includes an introduction, a body section, and a conclusion. In addition, it was easy to follow the ideas and relate them to the references since the literature was mentioned in the same order as in the reference list. This section is also rather critical as it contains both the achievements and the flaws of the previous studies. The researchers identify and discuss gaps in knowledge emphasizing that the significance of their research for the area of studies in question. The chosen sources were relevant and significant for the study. They are numerous and all of them refer to the chosen topic. Moreover, most of the sources were published after year 2000, which points to the fact that they are contemporary. The literature review was comprehensive, because the researchers not only mentioned the sources they used in the study, but critically evaluated most of them.

Research Design

This study can be considered quasi-experimental; to be more exact, it is a nonequivalent groups design, because the researchers used pretests and posttests for the comparison of the groups chosen by them. Among the variables, the dependent one is the reduction in the restrictive side rail usage; the independent variable is the advanced practice nurse intervention. However, the hypotheses are not stated as separate sentences, which can cause confusion in the process of understanding the study. The design chosen by the researchers is appropriate for the problem under consideration, because the study with such a design is easy to implement.

Study Sample

The sample size can be considered adequate, because such quantity of people can guarantee reliable results. It was determined by the need to observe a large number of patients in order to get enough data for analysis. The sample is representative of the defined population because the participants are the patients of a definite nursing home. The study utilizes a stratified sampling method; this can be explained by the necessity to explore the way the patients are treated in the nursing homes. It is possible that the chosen method contains sampling bias due to the diversity of the patients, but this has hardly influence the results of the study. The including and excluding criteria were clearly identified by the researchers. The including criterion was based on the minimum three- months presence of the participants in the nursing home after the APN intervention and during the side rail rounds. The excluding criterion was the unwillingness of the patients to participate in the research due to their personal reasons.

Data Collection

No definite steps of collecting the data can be identified in the study. Despite the fact that the general scheme is given, a more detailed description of the process is needed. In general, data collection methods, though not clearly organized, are possible to understand from the researchers’ description. The researchers did not mention any problems regarding data collection. The research assistant collected, studied, and analyzed the healthcare records of the patients and evaluated them later by means of APNs. Such a method is reliable enough as the assistant is stated to be trained to work in this field.

Data Analysis

The collected data concerns different tendencies in restrictive side rail usage. Various aspects of the issue were taken into consideration; those were the residents’ mental and physical health, mobility, different time of the day, etc. Therefore, the measurement level can be considered high. The measurements are presented in statistical percentage. The statistics used is appropriate for the chosen data collection method because it is the most convenient way of working with a big sample size. The statistics were also supported with three tables and a diagram which served as a visual illustration of the information. The tables and a figure are quite clear and detailed; thus, they are comprehensive for the readers.

Results

The research question is fully answered in the results’ section. The results are valid both internally and externally as they show the statistical changes in restrictive side rail prevalence. On the whole, the results are widely generalizable because they can be applicable to any nursing home. They are also highly reliable because they were derived by trained professionals from a precise observation of a limited number of people; thus, the results of the study have strong reliability. The researchers name the absence of the control group a major limitation of their study. However, there is another one which has not been mentioned; for instance, the sample size, as well as the period of study, is limited. Significantly, the author fails to mention these limitations. The results of the study were discussed in relation to the previous studies with some concrete examples given. No unexpected findings have been identified by the researchers.

Recommendations

The researchers do not clearly state their recommendations focusing instead on the need for the future research. They believe that a further research can improve the achieved results and exclude the restrictive side rail use at all. The logical structure and comprehensive form of the article makes it accessible for BSN nurses. The results of the study can be used in practice. Moreover, there is one thing which I personally would use in everyday practice. This is the preference of nurse consultation instead of the traditional clinical nurse practice. This technique proved to be few times more effective and therefore should be developed and applied more often.

Reference List

Capezuti, E., Wagner, L., Brush, B., Boltz, M., Renz, S. & Talerico, K. (2007). Consequences of an Intervention to Reduce Restrictive Side Rail Use in Nursing Homes. Journal of the American Geriatrics Society, 55, 334–341.

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