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NUR3643 Research and Theory Competency: Compare research methodologies Review the article that you selected and complete the following analysis

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NUR3643 Research and Theory Competency: Compare research methodologies Review the article that you selected and complete the following analysis. Be sure to include the permalink for the article you selected. What is the identified research problem? Does the author include the significance and background of the problem? Heart disease is the number one killer in men and women. With many people being diagnosed with heart failure, the researchers want to explore managing patients with heart failure and challenges that they face. Yes, the author does include the significant and background of the problem. Did the author clearly articulate the research purpose? What was the purpose of the research? The purpose of this study was to explore the perceptions and experiences of health care clinicians working in multidisciplinary teams including specialist in heart failure nurses when caring for the management of heart failure patients. Identify the study methodology. A qualitative in-depth interview using ethnographic study of random admissions in heart failure patients was used to conduct the research. There were only 24 clinicians that were interviewed during the process. NUR3643 Research and Theory Did the article include a relevant review of the literature? Explain. Yes, the article did include relevant review of the literature by providing example and statements to help strength the research paper. Describe the theoretical framework for the research study? The theoretical framework that was used for this research was grounded theory. Grounded theory uses repeating themes by thoroughly reviewing the information and emerging themes. What are the research objectives, questions, hypotheses, and procedures identified in the article? The objective to explore how to manage patients with heart failure and challenges that clinicians face. Some of the questions that raised were if language barriers or the patient not being able to process the information was a problem. The procedure that was used for this research paper was interview style. They interviewed 24 clinicians across primary, secondary, and community care. Describe the results of the study along with identified strengths and limitations. Include appropriate terms for rigor in qualitative research The toughest challenges that clinicals faced were communication with patients. The complications were mostly in explaining the diagnosis and helping patients to understand the NUR3643 Research and Theory condition. They found that communication was better if the clinicians created a long-term relationship with the patient and their family. Another challenge that they faced was communication with their team members. Strength that the article had was personally interviewing clinicians form different levels as their share their experiences. It seems like most workers agreed on the same challenged. Limitations that the article has was that it was only done in Midlands, South Central, and South West of England also only 24 interviews were conducted. Discuss the findings including relevancy to clinical practice. With heart failure being a big issue in the United States, it is important that we understand how to handle these challenges. Being able to effectively communicate with patient about their diagnosis and procedures are crucial. It is important that both parties understand what is taking place. It also is important to know how to communicate with your team members. If healthcare workers are not able to fix these challenges, it puts everyone at risk. For language barriers it is important that translators are there at all times, and it is important for multidisciplinary team to listen to each other. Permalink for the article selected. https://www.annfammed.org/content/13/5/466 NUR3643 Research and Theory References Glogowska, M., Simmonds, R., McLachlan, S., & Cramer, H. (2015, September). Managing Patients With Heart Failure: A Qualitative Study of Multidisciplinary Teams With Specialist Heart Failure Nurses. Annals of Family Medicine. https://www.annfammed.org/content/13/5/466. DOI: https://doi.org/10.1370/afm.1845 NUR3643 Research and Theory Amber Anthony Competency: Qualitative Research Methodology Review the article that you selected and complete the following analysis. Be sure to include the permalink for the article you selected. What is the identified research problem? Does the author include the significance and background of the problem? The identified research problem is understanding the barriers to nursing errors in intensive care units in Iranian hospitals. A vital factor of the study is understanding that everyone makes errors regardless of their knowledge and level of expertise. However, errors need to be reported and learned from so that individuals do not make the same mistakes again. Nursing errors can be subtle to severe during nursing activities and procedures. Research has found that nursing errors are more common in intensive care units (ICUs) related to the client’s high-risk nature and complex care. These critically ill clients receive medications and interventions approximately twice as often as other clients, exposing them to more significant opportunities for error. The author found that there were four barriers to reporting nursing errors in Iranian critical care units. The first barrier was preventing stigma and saving professional reputation. The fear of punishment, legal problems, and organizational misconduct lead to some staff failing to report incident reports. Even feelings of insecurity where a nurse felt a lack of managerial support with finger-pointing is considered barriers. Finally, a common barrier is the leadership not investigating the root cause of the error, which ingrates the feeling of hopelessness and the system never changing. The author described the background of nursing errors adequately and why not reporting them could lead to even deadlier consequences. The article explained the statistics, which stated that patients in ICUs experience an average of 1.7 errors per day. Almost all of them suffer from a potentially life-threatening error at some point during their stay in the ICU (Peyrovi et al., 2016). Did the author clearly articulate the research purpose? What was the purpose of the research? The purpose of this study was to explore the barriers to why nurses would fail to report errors in ICUs. The author articulated the research purpose in the abstract paragraph by explaining why nurses would hide their mistakes. The article found that about 50–96% of adverse events are never reported, while half of those hidden events could have been prevented. This research is needed to understand the type and causes of nursing errors. It even talks about how to deal with and manage nursing errors as a necessary prevention skill. The author found that nursing will not report their mistakes due to embarrassment and fear of punishment. These actions can highlight a lack of attention, motivation, and sufficient education, increasing the nurse’s reason to hide them. The author describes the need to prevent nursing errors for the client's benefit and provide the best care possible. This article explains that by understanding the type and causes of errors in ICUs, the leadership will be able to learn how to deal with and manage them as necessary for future prevention. Preventing medical errors depends on a vigorous process of error reporting (Peyrovi et al., 2016). Identify the study methodology. The study of methodology was a qualitative approach of in-depth semi-structured interviews with a randomized sample of 16 nurses working in four general intensive care units in Kurdistan province, Iran. The data gathered was collected through interviews that were transcribed and analyzed through conventional content analysis. This study was approved by the Ethics Committee of Tehran University of Medical Sciences with written consent of the 16 randomized nurses. The methodology of the study was to collect systematic data and interpretation of the experiences of the participants. The nurses who were interview were randomly selected from four general ICUs of four teaching hospitals in NUR3643 Research and Theory Kurdistan and Tehran provinces, Iran. The participants were picked from different undergraduate and graduate programs with a variety of ages, gender, work experience but with a minimum of one year of working experience. This allowed a greater selection of different backgrounds and reasons why nurses failed to report medical errors. The study found that most of the newer nurses were embarrassed and feared reporting their errors as they felt that they did not have a proper footing to keep their job. Fear of new education and being “stuck in the old ways” were why the older nurses failed to report their medical errors. The in-depth semi-structured interviews were conducted in areas where the nurses could feel comfortable speaking about their errors. The interviews were completed in the school of nursing, clinical governance offices, and the ward’s breakrooms. The interviewer began by asking each nurse general questions about their experiences with error in their ward. Afterward, the nurse was asked probing questions to acquire an in-depth understanding of their involvement. Each nurse was asked to discuss their nursing errors and how they could have prevented them (Peyrovi et al., 2016). Did the article include a relevant review of the literature? Explain. A total of 42 references were included in this research article. The oldest article was written in 2000, with the most current information obtained from research conducted in 2014. The article gave a paragraph about the current practices and the trustworthiness of the data gained. The author explained that a qualitative study supports the argument that the research findings are considering. The relevant review of literature is achieved through data confirmability, credibility, transferability, and dependability. The data is only trustworthy when the following points were considered: allocation of a proper place and adequate time for data collection, using the complementary views of the colleagues, establishing a cooperative relationship with the interviewers, examining the data by all researchers for increasing the acceptability of the coded data, and reviewing the handwritten materials for the participants. These factors allowed the study to be considered more impartial and research worthy than being an area to complain and gripe. The author used the qualitative content analysis process as a basis to remain neutral and without judgment. Its guidelines helped the author develop the evidence-based questions to ask to report a wide array of systematic reviews and metaanalyses that assesses the benefits and harms of identified health care errors. An example of this method allowed the author to refrained from using pre-defined categories and instead allowed the subjects to come out of the data. One of the advantages of such an approach is that the results are directly achieved by the data taken from the participants in the research without imposing any ideas. Instead of asking if the nurse ever gave the wrong dose of medication to a patient, asking open-ended questions to describe nursing errors opened the floor to unknown issues (Peyrovi et al., 2016). Describe the theoretical framework for the research study? This article does not state that it uses any theoretical framework for the research study, but Kurt Lewin’s Change Theory of Nursing would be the best fit for this article. The model explains that only through prior learning can information and training be rejected and replaced. This would fall in line with the understanding that learning from nurse errors would allow others to learn from these mistakes. The driving force, restraining force, and equilibrium are the three major concepts of The Change Theory. The driving force is the push in a direction that causes change to occur. This force allows change because the nursing staff will be able to push the patient in the desired direction. Understanding errors and mistakes can cause a shift in the equilibrium towards change. The restraining force counters the driving force. A nurse should be able to identify the restraining force as it hinders change because these actions can push the client in the opposite direction. In the article, the barriers are the restraining force that stops nurses from reporting medical errors. These actions cause a shift in the equilibrium that opposes change. The last major concept is equilibrium, a state of being where both forces are equal, and no change occurs. This is considered the stalemate as change can be raised or lowered by the other two powers, but this is neither good nor bad. Nurses should NUR3643 Research and Theory strive to be the driving force to improve patient outcomes and hospital care by reporting nursing errors so they can be studied and learned from (Mehrolhassani & Emami, 2013). What are the research objectives, questions, hypotheses, and procedures identified in the article? The research objective was to identify the barriers that nurses faced due to nursing errors through interviews. Some of the questions identified known barriers like addressing stigmas and retaliation that nurses faced from their peers and coworkers if they reported their medical errors. Another factor was how the nurses developed trust, relationships, and credibility in the professional setting that could be taken away instantly with an accidental error. Some nurses felt that there was no reason to report some nursing errors as they did not poorly affect the client and felt justified in hiding their secrets. One of the hypotheses was that nurses would not report nursing errors due to fear of punishment. Legal consequences in clinical practice have been a leading barrier to fixing known problems. Another hypothesis was that these barriers could be eliminated from hospitals with simple communication between the nursing staff and the leadership to understand that reporting is not a form of punishment but an area where people should learn. The procedures identified in the article were the data given by the interviews and the development of open-door policies to stop the barriers. All information found in the discussions helped the leadership understand the obstacles and ways to combat them (Peyrovi et al., 2016). Describe the results of the study along with identified strengths and limitations. The results of the study identified that most nurses experience barriers to error reporting due to fear of its consequences, feelings of insecurity, and to preserve personal and professional reputations. Hospitals could overcome these barriers by creating an atmosphere based on mutual trust between nurses and nursing supervisors in which transparency and impartiality prevail. The interviews were anonymous to preserve the nurses from fear of retribution and judgment, but with an understanding that only by being truthful and honest could the answers help how leadership viewed nursing errors. However, these types of interviews had limitations as the translation was one as all the nurses were interviewed in Persian. Therefore, some information may have been mistranslated or not pertinent to how medicine is conducted in the United States. Culture and religious views play an essential role in many Iranian hospitals, so what is considered a nursing error involving failing to incorporate religion into the nursing plan is not what we might consider a mistake. An example is a belief that family members must stay for long and extended periods in a client's hospital room. The nursing error could be failing to allow this, wherein the United States medical care comes before family interaction. This could be seen as disrespectful of the nurse to remind the client that they have procedures or medications to take. Another limitation was that the nurses only answered errors that were absent of patient harm because they feared the repercussions of a potential lawsuit or having someone find out they accidentally caused severe or fatal damage to a client. An example is when a nurse wants to never speak of how they almost killed a client by giving them the wrong medication. This fear of anyone finding out and the nurse losing the respect of their peers leads them to bury this secret. The nurse may think that they will always be careful from now on and they will never be found out, especially if nothing happened to the client. The final limitation of this study was nurses feared being labeled; this could be defined as either a "whistleblower" or someone not to be trusted. Even though the nurses were randomly selected and sent emails to volunteer to be interviewed, some staff members felt threatened that they were being "told" on and that the study was not anonymous enough to hide the identities of the 16 nurses who were interviewed. The article explained how many nurses responded negatively and refused to sign consent forms as they had the attitude that nothing would ever change no matter what was said. But with all limitations, the study was able to create some advantages such as creating open-door policies, identifying the stigmas seen in the ICU wards, and helping nurses understand the consequences of medical errors. The study helped create a strength where hospitals could create confidential environments like open-door policies to report NUR3643 Research and Theory anonymous nursing errors. These safe areas helped increase reporting and learning without undermining the individual's reputation. An example is identifying how many beds were left in high positions rather than the lowest possible level to reduce the risk of falls. The study helped show the leadership what stigmas are still happening in the ICU between the nurses and other staff. One example was a nurse being shunned by the doctor as they only thought negatively about them. The last strength of this study was helping the nurses understand the consequences of not reporting nursing errors. Even though they did not see a reaction within their shift, the error could have caused complications for other staff members or changed the client’s way of living. One of the nurses explained that if they had reported their error, it would have stopped another nurse from doing the same thing to another client who had a fatal reaction (Peyrovi et al., 2016). Discuss the findings including relevancy to clinical practice. The findings of these interviews provided helpful information about the barriers to reporting nursing errors in ICUs. The researcher found that the barriers consisted of saving reputation, fear of consequences, feelings of insecurity, and not investigating the root cause of the error. Nurses explained that an open-door system allowed the convenience of communication with risk managers and leaders by providing e-reporting compared to paper-based systems, writing emails, and oral reporting. If a known error is reported, the leadership can develop training and new policies to prevent others from making the same mistake. An example is putting similar sounding medications in the medicine room and the nurse reporting the wrong drug's error. If a nurse accidentally gave Lyrica instead of Lamictal, there could be dangerous complications. Lyrica is used to treat nerve and muscle pain like fibromyalgia, while Lamictal is an anticonvulsant used to treat seizures and bipolar disorder. If the nurse does not report their error, then other staff members could make the same mistake and cause complications in their patients. All interviews showed that each nurse could have an easily preventable barrier that could be minimized with leadership involvement and communication. One of the most extraordinary leadership measures is just being there for the nurse and holding no judgment on making a mistake. Everyone is human, and errors are common flaws that happen all the time. Only by understanding and recognizing a mistake can a person grow and learn from it (Peyrovi et al., 2016). Permalink for the article selected. The permalink for the article selected: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606520/. References Mehrolhassani, M. H., & Emami, M. (2013). Change theory for accounting system reform in health sector: A case study of Kerman university of medical sciences in Iran. International journal of health policy and management, 1(4), 279–285. https://doi.org/10.15171/ijhpm.2013.57. Peyrovi, H., Nikbakht Nasrabadi, A., & Valiee, S. (2016). Exploration of the barriers of reporting nursing errors in intensive care units: A qualitative study. Journal of the intensive care society, 17(3), 215–221.