Quantitative and Qualitative Research Reviews
Part A: Quantitative Article Review
A quantitative research study conducted by Gunningberg, Sedin, Andersson, and Pingel (2017) provides evidence-based information on the use of pressure mapping to control pressure ulcers within a hospital setting. The study clearly describes the context within which its objective is pursued, alongside past study findings and gaps in extant literature. From a review of the article, it appears that various sections of the paper were well articulated. The introduction section provides an overview of what other studies have presented concerning pressure units and how the present study will change the information or contribute to future studies on pressure units within a healthcare setting. It also concludes with a clear statement of the main and secondary objectives of the study namely, to evaluate what impacts pressure mapping can have on pressure units in a hospital setting, and describing the preventive actions by nurses and the interface measures respectively.
The literature review is embedded within the introduction section of the paper. The section satisfies the conventional objective of a literature review, which is to help develop a background to a theoretical or pragmatic study. In this article, Gunningberg et al. (2017) clearly draw information on aspects such as multidisciplinary team involvement and pressure unit-specific interventions in hospital settings. Other pieces of information presented include the need for and prevalence of pressure units in hospitals. This information is crucial for developing a framework for the study on pressure unit applicability in controlling pressure ulcers. It is thus deductible that the literature review, while not explicit, is quite thorough and informative. The introduction in which the literature review is embedded is also quite comprehensive.
The data analysis section is also clearly presented. The data collected about patients was mainly of demographic nature and the analysis was performed with the use of various statistical tools including the chi-square, student t-test, and the Mann-Whitney U-test. The analysis was completed with a pictorial breakdown indicating the populations of patients participating in the study and the control group and the outcomes of the trial according to the respective participant groups. The data analysis draws from the detailed methodological descriptions and is in accordance with the conventional approaches to data analysis for randomized controlled trials such as the one described in the study. The authors provide a detailed description of the study method, including its design, sample selection procedures (participants were considered eligible if they were 50 years and above besides other criteria), the process of participant randomization, concealment, and coding is also clearly described. The methodology is thus describable as repeatable by any willing party as it should be for a randomized controlled trial.
Evidence and Outcomes
From the different sections of the study, various forms of evidence are presented, which can be helpful for future research as well as for practical clinical application. In the introduction the authors provide detailed background information, with clear information about already existing knowledge on pressure ulcers and the application of pressure mapping. The evidence provided from past pieces of literature on pressure mapping helped to structure the study, design a good study methodology and select corresponding data analysis approaches. The introduction provides sufficient evidence for the researchers and the readers to answer the question as to why there is need for that study. From the data analysis and the methodology sections, sufficient evidence has also been provided that can be used for a repeat study with the same objectives. The implications of the evidence from the study are far reaching in clinical applications.
The authors’ conclusions are that a pressure mapping system would have insignificant benefits in managing pressure ulcers in a hospital setting. This is in congruence with the evidence from the other sections of the paper. For instance, while the reviewed literatures provide information about various interventions for pressure ulcers within hospital settings, there is no clear evidence that pressure mapping is one of the most beneficial approaches. However, the evidence from the other sections of the paper help to identify areas that can be addressed in future studies to ensure the results obtained are transferrable to a clinical setting.
With human subjects, Gunningberg et al. (2017) followed an ethical research plan, which is also described in the article. The trails were conducted following the ethical research guidelines provided by the national environment. Additionally, the research methodology was approved by the ethical review board in Uppsala, Sweden. Some of the key ethical considerations made by the authors included maintenance of confidentiality, informed consent in participation, continuation and/ or withdrawal at will and respect for human subjects. The choice of subjects was itself guided by ethical research principles, resulting in informed and willing participants. Such research ethics help to ensure respect for human subjects and are in accordance with the general principles of ethical research which include beneficence, anonymity, confidentiality, avoidance of deception, and informed consent. The only other concern that was not addressed by the authors relates to how they would manage and store data collected from the participants. By adhering to these ethical research practices, the authors ensured that respect to participants’ beliefs and cultural values was maintained as the participants were at liberty to choose whether to be involved or not.
Strengths, Limitations and Practical Application of Evidence
While the study achieves its intended objective, it fails to provide a solution to pressure ulcers management in a hospital setting. However, it adds to the volume of information available on current nursing practices, and can be used as a guideline both to the effective use of pressure unit systems and as a source of information on other systems that can be used instead of pressure mapping. Its constraints can however be attributed to the limited awareness of healthcare providers on pressure ulcers and its prevention. As such, any study conducted as a trial for a given intervention measure should take into consideration all factors that may affect the performance of the intervention measure and begin with a sensitization process for intended users.
Evidence collected from the article can nonetheless inform current nursing practices in various ways. For instance, the data analysis section provides details of the CBPM – system, which has been associated with various limitations in the management of pressure ulcers. The article provides a new perspective and guidelines into why the system should not be dismissed and instead nursing staff should be educated more about the systems, possibly once every day. Such outcomes cut across all sections and provide direct clinical implications for current nursing practice. Other seemingly obvious suggestions have also been given, which can be instrumental in reducing the average hospital stay duration for each patient as this could also increase the risks of pressure ulcers. Nurses induced repositioning is recommended, which can be initiated even by present day nurses.
Part B: Qualitative Study Review
Gunningberg, Baath, and Sving (2018) conducted a qualitative study in a bid to understand the perceptions of hospital staffs on the use of a continuous pressure mapping system in preventing pressure injury on a hospital bed. The study begins from the background that pressure injuries are still common in hospitals despite efforts made to increase awareness about pressure injury and the intervention measures against them. Through the different sections, the authors not only provide a strong background to the study, but also ensure that the research methodologies and data analysis procedures are founded on the existing gaps in the subject of pressure injury and the available interventions. The introduction section particularly provides a detailed background on the subject of pressure injury, its prevalence rates in hospital settings and the reasons why repositioning provides a suitable relief to pressure injury. It goes further to provide a detailed background on continuous pressure mapping systems, and why they would be a good tool for nurses to use to improve the well-being of patients in hospitals. From this background information therefore, one clearly understands what the authors intend to achieve and why achieving that objective would be important both to them and to the general public healthcare system.
Just like in the article by Gunningberg et al. (2017), this article does not have an explicit literature review section. On the contrary, the literature review is integrated within the entire body of the research paper, in that every section is well researched and cited. The introduction through the discussion sections continuously present synthesized literatures that are quite informative on the subject being addressed. For instance, the section on clinical implications of the research describes details from various theoretical frameworks such as the theory of diffusion of innovation, which clearly explains the principle of spread of the continuous pressure management system and how it could be beneficial when combined with effective information distribution and other forms of motivation for assistant nurses.
The data analysis and the methodology sections similarly reflect thorough research and implementation of the research findings in study. The study methodology considered by Gunningberg et al. (2018) was the descriptive approach to qualitative research. In most cases, the descriptive approach is used in qualitative research where the study objective is to explore a particular phenomenon within a given context. The descriptive approach answers the questions why and what, which studies such as this one by Gunningberg et al. (2018) aimed at answering. As such, it can be deduced that the methodology of choice was effective at achieving the study objective. While conducting the study, the authors also randomly collected using focus group interviews consisting of assistant nurses and assistant nurse managers. The objective of the focus groups was to use unstructured interview formats to guide information sharing by the nurses. The data analysis also goes hand in hand with the methodology stipulated for a descriptive study. In the article, an abstractive approach to data analysis has been used. This approach involves going back and forth between thematic classification of data and data breakdown into smaller pieces. The objective was divided into five different themes in which the research findings were expected to fit. From the qualitative analysis conducted therefore, it is evident that the research findings were in accordance with the theoretical information obtained from past studies.
Evidence and Outcomes
The evidence availed in each of the four areas discussed above provide information that corresponds to the study outcomes. Research from the past literatures show that CBPM systems are effective towards preventing pressure injuries and that self or assisted repositioning can also be one of the ways for reducing the impacts pressure injuries. Similarly, the data collected through the focus group interviews, theme-based data analysis, and the results presented all conform to the outcomes of the study. The authors conclude that nurses recognized the effectiveness of CBPM systems in preventing pressure injuries and also appreciated the immediate feedback provided by the patients when subjected to those systems. These findings not only reflect the messages extracted from the focus group participants’ responses, but are also parallel to other studies such as that by Gunningberg et al. (2017), which suggests that creation of awareness about such systems is one of the approaches towards more effective and successful implementation. From the conclusion, it is also notable that the study findings reflect the objective of the study, and can thus be considered a positive outcome.
While working on the study, the researchers worked with human subjects, who had to be protected against unethical research conduct. There are various basic research principles that originate from the requirement for researchers to uphold human dignity when working with subjects. For instance, the researchers have to protect participants’ identities and confidentiality. This was accomplished by protecting all information given by participants from exposure to unauthorized groups. Moreover, all the information given by participants was considered to be given out of willingness since all participation was based on informed consent. Participants were informed of the voluntary participation requirement and were allowed to leave the study at will. They were also given all the information about the study in both oral and written formats. To ensure compliance to ethical principles, the researchers obtained the approval of the ethical review board and followed the scientific research ethical standards presented in the Helsinki declaration.
Strength, Limitations, and Practical Application of Evidence
The study by Gunningberg et al. (2018) achieves its intended objective, which was to establish the perceptions of the nurses about the use of continuous pressure management systems in managing pressure injuries. The involvement of healthcare workers within a hospital setting as participants, and the provision of a methodology that would result in real-time feedback, are some of the strengths that can be associated with the study. On the other hand, the visible limitation that could be linked to this study is its focus on a convenience sample. The nurses understand the hospital environment more than any other professionals in healthcare due to their continuous interactions with patients. However, implementing certain interventions requires a multidisciplinary approach, which can only be tested by having a multi-disciplinary team in the sample population. The evidence obtained from the study can nonetheless be very essential in a practical nursing environment. For instance, some of the results obtained include: a confirmation of the effectiveness of CBPM systems in managing pressure injuries, confirmation of the need for training and coaching of healthcare workers (nurses) in the use of CBPM systems, and the need to find strategies for spreading the innovation around CBPM to several nursing leaders. These pieces of information are beneficial to the nursing environment as they can be adopted by nursing leaders who formulate training curricular for nurses, and also implemented for better patient safety.
Gunningberg, L., Baath, C., & Sving, E. (2018). Staff’s perceptions of a pressure mapping system to prevent pressure injuries in a hospital ward: A qualitative study. Journal of Nursing Management, 26, 140-147.
Gunningberg, L., Sedin, I.M., Andersson, S. & Pingel, R. (2017). Pressure mapping to prevent pressure ulcers in a hospital setting: A pragmatic randomized controlled trial. International Journal of Nursing Studies, 72, 53-59.