An Interventional Approach for Patient and Nurse Safety, Article Critique Example

Abstract

Patient and Nurse Safety are of utmost importance in the medical field. This paper will provide a critique of the quantitative study, “An Interventional Approach for Patient and Nurse Safety,” published in Nursing Research in 2010. Within this critique, the reader will begin to understand the research methods and conclusion of Scott, Hofmeister, Rogness, and Rogers as they take us through the quantitative study of nurses and the safety of the patients. Within this critique we will discuss the study, the literature review, the methods which include the research design, the variables, the sampling method, the ethical consideration if any, the data collection methods, data analysis, recommendations and discussions as well as the conclusion and overall critique of the study.

Quantitative Critique

It is important for professionals in the medical field to understand how important sleep is in reference to performing their duties at a level that is higher than any other person’s expectations. This quantitative critique gives the audience an idea of just how important it is for nurses to have the proper amount of sleep coupled with the proper amount of breaks within a given shift. Quantitative research throughout this article shows us that nurses work better and do not make as many errors during their shift if they have had the proper amount of sleep between their shifts.

Overview of Study

This paper will provide a critique of the quantitative study, “An Interventional Approach for Patient and Nurse Safety,” published in Nursing Research in 2010. The authors, Linda Scott, Nancee Hofmeister, Neal Rogness, and Ann Rogers are professors in the health fields and have credentials as nurses, doctors, and/or both.

The study indicates that extended shifts worked by hospital staff are actually associated with higher risk factors of errors during their shift. Long work hours and insufficient sleep are risky for the nurses as well as the patients. “The objective of the study was to evaluate the feasibility of an FCMPN for improving sleep duration and quality while reducing daytime sleepiness and patient care errors” (Scott, Hofmeister, Rogness, Rogers, 2010, p.250). The study works to show the reader the importance of sleep and rest for nurses. The authors are credible in the fields and the research description contains all of the proper elements for studying such a pivotal role of a nurse.

The title, the abstract and the authors all show credible evidence that helps explain why and how nurses make errors while they are on duty. The remainder of this paper will discuss the study, the participants, research methods, and conclusions based on the authors who are listed above.

Introduction

This research was done in order to provide professionals in the medical field with information on the importance of adequate sleep, depravity of sleep and its consequences for the patients, the nurses, and the hospitals in general. The research attempts to show us, through means of tests and logbooks, exactly how important it is for nurses to obtain enough sleep before their required shift. It is obvious to state that if nurses do not have enough sleep and are falling asleep on the job, they are not alert and cannot perform their duties and take care of the patients as needed. There has to be something put into place in order for these nurses to get the attention they need just as the patients get the attention they need. The research question is answered fully throughout the study and, in the end, shows the reader that the amount of sleep a nurse gets between shifts is extremely important to the care of their patients.

Literature Review

The literature review is brief and explains the obvious implications for nurses. It states that nurses must remain alert in order to care for their patients, to recognize changes in their patients, and to complete their work error-free. However, they are still working 12 hour shifts and they tend to encounter difficulties staying awake, reduced or loss of sleep time, and significant risks of error. The literature review explains that many nurses are continuously fighting to stay awake during their shifts and that this can be harmful to them and to the patients in which they are giving care. Finally, the literature review informs us of the negative affects that lack of sleep can do to an individual including physical health risks (obesity, cardiovascular disease, diabetes, and depression) as well as psychiatric disorders. The researchers provide us with a conceptual framework that informs us that sleep loss and sleep disruption may have further consequences for nurses and their patients.

Methods

Research Design

The research question is defined properly throughout the study. The authors performed a one-group pretest and posttest on a number of Michigan nurses in order to distinguish how effective the fatigue countermeasures program for nurses (FCMPN) is in reference to nurses who are working long hours and who are not retaining enough sleep in the process. This design is a quantitative research design that describes the relationship between nurses, their long work hours, and their lack of sleep due to their careers.

Variables

Nurse sleep patterns and margin of error for patients are the selected variables of the study. Further variable breakdown for the nurses included their age, the number of hours on their feet, time in between shifts, sleep quality, sleep depravity, and alertness. The margin of error was also broken down into sub-groups in relation to administering medicine, patient care procedures, transcription issues, and physician order processing (Scott et al, 2010, p. 256).

Sampling Method

In order for nurses to be eligible to participate in the study, these nurses had to be full-time staff nurses working at least 36 hours per week. The sampling frame was of 147 medical-surgical nurses. The researchers used a mailing list that was obtained from the human resources departments of each of the medical sites. A cover letter was mailed to the nurses explaining the study. After receiving the completed demographic forms, nurses who agreed to participate, sent the forms back to the principal investigator. This created the study. There was 62 full-time hospital staff nurses included in the study as these were the ones that were interested and met the qualifications.

Ethical Considerations

Though ethical considerations were not specifically discussed in the study, it is important to discuss what may be ethical and what may not be in a situation such as this. The authors do not use specific names of the nurses, hospital staff or patients in order to provide a clear picture. They are able to keep this confidential as they should. They also do not specifically put any confidential information in their studies. This could be confidential information of the participants, the hospital directors, or the patients.

Data Collection Methods

Data collection methods for this research included a pretest and posttest repeated-measures approach in order to explore the feasibility of the FCMPN in reference to how it helps reduce fatigue related errors among full-time hospital staff. Baseline data were collected for 2 weeks with subsequent data collection during a 4 week period after the intervention, and a final collection period at the 12 week mark. Other instruments include the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and log books. The PSQI “consists of 19 items that can be used to compute a global sleep quality score, with higher scores indicative of poor sleep quality” (Scott et al., 2010, p. 253). “The ESS was used to evaluate the severity of daytime sleepiness” (Scott et al, 2010, p. 253). Participants were asked to rate their sleepiness during the day by using a scale of 0-3. 0 meaning they never doze, 1 meaning they have a slight chance of dozing, 2 meaning they have a moderate chance of dozing, and 3 meaning they have a high chance of dozing. Finally, logbooks were used by the participants to log their “schedule and actual work hours, breaks, difficulties remaining awake while on duty, and sleep and wake patterns were similar to those used in previous staff nurse fatigue and patient safety studies” (Scott et al, 2010, p. 254).

Data Analysis

According to the authors, it was hypothesized that the FCMPN would actually improve sleep quality, increase total sleep duration, and decrease the severity of sleepiness on duty. Most of nurses in the study experienced poor sleep quality, severe daytime sleepiness, and decreased alertness before the use of the FCMPN. However, after the FCMPN, there were significant improvements in the nurse’s sleep duration, sleep quality, alertness, and error prevention. According to the researchers, “initial findings support the feasibility of using an FCMPN for mitigating fatigue, improving sleep, and reducing errors among hospital staff nurses. In relation to sleep duration, sleep quality, and daytime sleepiness tests, such as the McNemar and paired t tests were used. Error reduction was examined by using generalized estimating equations after the use of the FCMPN.

Discussion/Recommendations

We have seen, throughout this study that nurses can perform their job duties and care for their patients much better if they are not fatigued and they are getting the proper sleep. It is important that more hospitals use the FCMPN model in order to help their nurses stay alert, awake, and less fatigued during their shifts. The short term naps and caffeine are important for nurses to be able to work effectively. The FCMPN provides nurses and hospital staff, especially those in power, the opportunity to understand fatigue and sleepiness and what it may do to individuals who are working longer shifts than normal. It also provides them with recommendations on how to proceed if nurses are fatigued and tired during their shift. Hospital personnel need to be alert and need to understand when it is time for them to rest. Individuals in power at these hospitals need to allow their nurses to take the time needed in order to provide the best care for the patient.

Conclusions

The safety of patients is of utmost importance when they are being cared for by nurses. This study shows that, without proper sleep, nurses are not able to do their jobs properly and many mistakes can be made when dealing with patients. Medications and other hospital related procedures can be full of errors if these nurses, specifically ones that work overtime or more than 12 hour shifts, do not get the proper amount of sleep. The FCMPN shows us that the practices used in this program can benefit nurses, hospital staff, and patients since the nurses are finally getting the sleep they need in order to perform their duties on a daily basis. It is important to use the measures in the FCMPN so that each patient can receive the care they need and nurses who tend to work long shifts can function properly during their shifts.

Overall Critique Summary

In this research report, the researchers have explored the importance of sleep between a nurse’s shifts in relation to their ability to work effectively. This research sets the stage for other researchers as it makes use of the fatigue countermeasures program for nurses (FCMPN), the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS). It helps researchers as well as the public understand the consequences of lack of sleep for nurses as well as how lack of sleep affects their alertness. Using this research model helps other researchers do more extensive research on the subject in order for them to understand what sleep deprived nurses actually experience on a day to day basis.

References

Scott, L. D., Hofmeister, N., Rogness, N., & Rogers, A. E. (2010). An interventional approach for patient and nurse safety. Nursing Research, 59(4), 250-258.