Table of Contents
Overall Presentation and Final Summary
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The current study critique analyzes the presented article to answer several questions. It shows that the report follows a consistent flow, although the study’s abstract does not summarize the article. The authors took a sample of 4923 nurses from America and Canada to determine how the outcomes of the Essential Professional Nursing Practices (EPNP) tool relate to clinical nurse jobs, nurse-measured client satisfaction, and practice. In addition to consistency noted throughout the report, the authors present ideas and information logically. Generally, the findings could have implications for nursing in the future.
Although the research problem is not clearly described in the article, it appears like it is associated with the ever-increasing number of patients, the complexity of healthcare systems, as well as the need to assess the extent to which clinical nurses (CNs) engage in their professional practices. All these necessitate the development of an effective instrument that can go a long way in evaluating nursing practices. The problem is critical to nursing since it helps researchers and other stakeholders learn about dynamic issues in the contemporary that can be handled to achieve better outcomes for clients. There is no doubt that these trends in the healthcare sector can either lead to better or worse performances among CNs.
The justification for the investigation is that nursing outcomes should be assessed using appropriate tools. Previous studies have claimed to evaluate practices of nurses, but have only measured structures within which nurses perform their duties. This implies that they have not remained focused on their initial goals. The current investigation concentrates on assessing nursing professional practice within complex systems.
If stakeholders in healthcare facilities know that the professional practice of nurses within these systems is not associated with the set organizational and individual objectives, they can institute changes that can enable nurse professionals to achieve better outcomes. In addition, identification of performance problems within these settings can help management teams to prevent major issues that may arise in the future. In other words, the development of an appropriate instrument for measuring nursing practices can help to mitigate problems in healthcare facilities.
The study authors have stated three objectives. First, they aimed at critiquing and weighing items. Second, they purposed to evaluate the value as well as psychometric of the newly developed Essential Professional Nursing Practices (EPNP) tool. Finally, the investigators wanted to create relationships between the created instrument and clinical nurse tasks, professional practice, and nurse-measured client satisfaction.
One of the strengths of the study article is a theoretical framework, which is implied rather than identified. Scientific studies around the world should be founded on theoretical frameworks, which act as guiding principles. In cases where they are not identified or implied, consumers of the investigations assume that the authors did not consider any theoretical framework to guide their studies.
The theoretical framework in the article is based on a complex adaptive system (CAS) and Newtonian science. These conceptual frameworks can go a long way in helping nursing executives to manage quality in healthcare settings. In this context, it is critical to underscore that the research purposes are linked to the theories in the framework since they support a holistic approach to handling nursing issues.
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The literature is an important component of studies since they are used by research authors to learn and report what has been done in the past concerning topics of interest. It is reviewed to know research gaps that can be filled with scientific evidence in the future. Notably, it is essential for the literature reviewed in a study to be current because science is ever-changing. Reviewing outdated sources implies that an author can identify issues that are not experienced in current settings. In the context of the current research article, the authors have used both current and outdated sources of literature. In particular, these sources were published in the 1970s, 1980s, 1990s, 2000s, and 2010s.
The researchers should have considered the literature published in the last five years (from 2017) to ensure that the information was current. That notwithstanding, the literature has been organized logically in the article by citing sources where they support statements that are relevant to the publications’ areas of interest. In addition, the information that the authors have reviewed adequately supports the need for the investigation. All the sources reviewed are associated with the areas of investigation on which the researchers have focused. It is from the review that the investigators have identified the gaps in research that need attention from the scientific community.
The study uses a cross-sectional design that incorporates both qualitative and quantitative methods to collect data. This type of design utilizes observational approaches to collecting and analyzing data associated with a particular population at a given point in time. This design is not interested in knowing how research phenomena looked like at other times rather than that particular point in time. The study’s design fits the purposes of the investigation since they would be determined at a given time as specified. In other words, the critiquing and weighting, assessment of the value and psychometric attributes of the EPNP tool, and the creation of the relationships between the phenomena in the targeted population could be achieved at a given point in time.
The design aligns with the sampling as well as statistical analysis in the article because the authors have demonstrated that they utilized a sample drawn from a cross-section of the U.S.A regions as well as Canadian provinces. Therefore, the cross-sectional data from the sample were analyzed using the identified statistical methods. The authors have adequately described the sample that was taken from both American regions and Canadian provinces.
The eventual sample had eight hospitals from Alaska and Hawaii, seven from the north-central, seven from the northeast, and nine from the southeast and south-central regions of the U.S.A. Since only healthcare facilities from two Canadian provinces took part in the study, their data were combined with that collected in America. The final number of clinical nurses who were surveyed was 4923. This number was drawn from twenty-two Magnet and nine non-magnet hospitals that were highly recommended by boards of directors, investigators, and nursing organization management teams. The sampling procedure is described in detail, but the ages of the proportions of the gender of the surveyed nurses are not given.
Notably, female and male nurses could have different performance outcomes as well as satisfaction levels. In addition, the authors do not justify the sample size and, consequently, one cannot conclude whether it was a fair representation of the entire population.
The study was conducted using the study protocol or procedures that were described by previous investigations. These procedures involved refinement of the EPNP instrument, identification of the population, and subsequent sampling, data collection, analysis. The EPNP instrument was developed to gather data that could be analyzed to answer the study questions. However, before it was tested, a refinement was done by requesting registered nursing executives as well as educators to evaluate the wording and the importance of the proposed items to the clinical nurse practice. This refinement process resulted in the reduction of the number of items from 51 to 43.
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The EPNP instrument measures the intended variables since the concept definition aligns with the operational characterization. However, the items in the measurement tool were weighted according to relative importance described by more than 59% of the respondents.
The authors do not present any information on the validity and reliability of the outcome measurement tools described in the article. It appears like they assume they are valid and reliable since they were utilized in previous investigations. Moreover, they do not address threats to validity from both internal and external sources in the study design. They could have proposed ways of handling these issues to increase the study’s validity level. The publication does not have evidence of subjects’ review and approval by an independent body. Ethical issues could arise from the study because the participating nurses were not given a chance to consent. However, the authors have described the investigation in detail that can go a long way in supporting replication.
Characteristics of the sample are described in detail; these include the levels of education (80% had a BSN or higher degrees, 14% had MSN, 5% had diplomas, and 155 had associate degrees), registered nursing experience (50.1% had between one to ten years, while 49.9% had more than ten years of experience), and inpatient clinical units of practice (14% on critical care, 14% on medical, 13.9% on surgical/medical, and 11.9% on surgical units).
The research questions are answered separated by analyzing the quantitative type of data gathered from the survey. The procedures used to manipulate the data statistically helped to answer the questions in the study include the Bartlett test of sphericity and Kaiser-Meyer-Olkin measure that assessed the appropriateness of the data and sampling adequacy, respectively. These procedures were relevant to analyze the quantitative data as contained in the EPNP items. The authors have used seven tables to present data for the study. Notably, the text supplements data in the tabular presentations. In other words, the article’s paragraphs do not repeat the information that the tablets contain.
Briefly, the findings show nurses with BSN scored lower than those with other educational qualifications. There was no positive correlation between education and experience in clinical nursing settings. In addition, variations among clinical units or services were determined to exist. Analysis of the results shows that accreditation and curriculum standards should be reviewed since the BSN holders scored lowest.
Moreover, nurse resiliency, professional coaching, and other forms of educational programs could be important in increasing EPNP for nurses with experiences of one to ten years. Finally, quality structures in nursing units support how professionals engage in quality practice. This finding suggests that nursing management teams should institute the best quality management approaches to achieving exemplary outcomes in the short and long run.
The authors relate the findings to the objectives of the study. The items in the measurement instrument have been critiqued and weighted. There is evidence that the newly developed tool (EPNP) has a reliable structure. In addition, the findings have demonstrated the relationships between EPNPs and nurse tasks, practice, and well as professional-measured patient satisfaction. If one compares the study with previous investigations, a few things can be noted. The research findings that nurses with BSN score lower than those with other educational qualifications contradict what has been determined by other investigations.
However, a lack of correlation between education and experience supports the outcomes of other studies. Moreover, the current study findings on the variations between different clinical settings support the results of other investigations. The authors discuss the findings that conflict with past works. The article does not document limitations concerning practice and future research. However, the study has potential use in nursing because it provides an effective tool to assess how clinical nurses engage in their profession. The new research that emerged from the current one would determine how adequately nursing education programs prepare learns for future practice.
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Overall Presentation and Final Summary
The title describes the variables that are nursing practice and patient/client outcomes, but it does not imply the design study and the targeted study population. In addition, the abstract does not represent the investigation since it provides background and objectives, but it does not give any information on the methods, results/discussion, and conclusion. However, the overall report is logically consistent, and the writing is clear as well as concise. Consumers of the research cannot have problems reading and synthesizing the findings of the study.