Effectiveness of an Aspiration Risk-Reduction Protocol, Research Paper Example

Overview of the Study

A study by Metheny, Davis-Jackson, & Stewart (2010) in Nursing Research addresses the significance of aspirating gastric contents in patients who are critically ill and who require mechanical ventilation. For this patient population, the risk of aspiration is quite high and may contribute to symptoms of pneumonia and extending hospitalizations (Metheny et.al, 2010). In order to reduce the risk of aspirations in this population, prior evidence regarding interventions was evaluated and an Aspiration Risk-Reduction Protocol (ARRP) involving three steps was considered (Metheny et.al, 2010).

A quasi-experimental design was utilized for the study across two groups and implemented the ARRP protocol in order to determine if this protocol was effective in preventing the risk of aspirations (Metheny et.al, 2010). The use of descriptive statistics to evaluate the primary dependent variable of aspiration and pneumonia and a secondary dependent variable of hospital resource utilization was employed, and it was determined that ARRP was an effective means of reducing aspirations and pneumonia risk for this patient population (Metheny et.al, 2010).

Strengths of the Study

The study strengths included a quasi-experimental design in order to enforce a greater understanding of causality and the overall impact of experimental and control groups in addressing the research hypothesis (Grove, Burns, & Gray, 2013). Furthermore, the use of the t-test for statistical evaluation was effective due to the nature of the sample size and the overall ability to obtain more accurate results at this level (Polit, 2010).

Weaknesses of the Study

The study was not efficient in identifying sufficient data that was essential for the GRV algorithm, as only three patients qualified and were not evaluated in this context (Metheny et.al, 2010). Therefore, a lack of knowledge was evident in regards to the overall impact of the GRP protocol, and in addition, the number of patients who qualified for the algorithm was statistically insignificant (Metheny et.al, 2010). Finally, there is a limitation related to the quasi-experimental design, thereby creating a lack of control in the ICU environment that would have a lasting impact on the surrounding outcomes for these patients.

Changes to Improve Quality of the Study

In order to improve the impact of this study, it is necessary to determine how to improve the GRV component of the ARRP protocol and to evaluate the distal small bowel feeding component of this method. In this context, additional evidence might be considered that would have an improved impact on outcomes and that would provide additional evidence regarding the risk of aspiration and subsequent pneumonia in this patient population. This is also necessary to demonstrate the importance of understanding how the ARRP protocol might impact a location that does not currently implement it in order to determine its true efficacy and impact on these patients over time, using an additional set of data to determine if this protocol is likely to have a lasting influence on this population group.

Summary of the Implications for Nursing Practice

This study demonstrates the importance of current healthcare practice methods and the overall need to improve upon the 2012 National Patient Safety Goals through best practice implementation for patients at risk of ventilator-acquired pneumonia (VAP) during hospitalization (The Joint Commission, 2011). Furthermore, an examination of the Centers for Medicare and Medicaid Services (CMS) protocols must also be considered in regards to reimbursement for patients with VAP (Stone et.al, 2010). These considerations require healthcare providers to address potential protocols that will benefit patients in the ICU in order to prevent the risk of aspiration and subsequent pneumonia in patients across this population group (Stone et.al, 2010).

References

Grove, S.K., Burns, N., and Gray, Jennifer R.  (2013).  The practice of nursing research: appraisal, synthesis and generation of evidence.  (7^th ed.). St. Louis, MO: Elsevier Saunders.

Metheny, N.A., Davis-Jackson, J., and Stewart B.J. (2010).  Effectiveness of an aspiration risk-reduction protocol.  Nursing Research,  59(1), 18-24.

Polit, D.F.  (2010).  Statistics and data analysis for nursing research. (2^nd ed.).  Upper Saddle River, NJ:  Pearson Education Inc.

Stone, P.W., Glied, S.A., McNair, P.D., Mathhes, N., Cohen, B., Landers, T.F.,  and Larsen E.L.  (2010).  CMS changes in reimbursement for HAIS: setting a research agenda. Med Care, 48(5), 433-439.

The Joint Commission. (2011). 2012 national patient safety goals. Retrieved October 25^th, 2014, from http://www.jointcommission.org/assets/1/6/NPSGs_CAUTI-VAP_HAP_20101119.pdf.