Qualitative Research Critique, Research Paper Example

Study Summary

An article by Bolster and Manias (2010) addresses the significance of interactions between nurses and patients that occur during medication administration and related activities.

To be specific, person-centered care is an important phenomenon that supports the interaction between nurses and patients as a critical component of effective nursing practice (Bolster and Manias, 2013). It is necessary for nurse-patient interactions to be effective and instrumental in order to ensure that patient safety is maximized at all times (Bolster and Manias, 2013). It is known that person-centered strategies are effective because they provide a framework for achieving effective patient outcomes and satisfaction (Bolster and Manias, 2013). This process is particularly instrumental in the process of medication administration, as patients might experience difficulties or ask important questions regarding these medications at the time they are administered (Bolster and Manias, 2013). Although this topic has been evaluated in different ways, it reflects the importance of nurses and their ability to communicate effectively to patients to promote their wellbeing (Bolster and Manias, 2013).

In administering medication to patients, it is important to identify the resources that are required to ensure that patient outcomes are met and that support patient needs effectively (Bolster and Manias, 2013). Nonetheless, person-centered care is not viewed across nursing practice in the same context, with some nurses preferring to limit these activities, while others put much effort into this process (Bolster and Manias, 2013). These factors play a role in determining how nurses might approach different perspectives in the work environment in order to provide optimal care to patients, particularly when medication administration is required (Bolster and Manias, 2013). When nurses provide adequate support and guidance to patients, they will likely respond favorably to these actions and will comply with care and treatment requirements accordingly (Bolster and Manias, 2013). However, there is not a significant body of research in place that supports the objectives of patient-centered care as it relates to medication administration (Bolster and Manias, 2013). Therefore, it is necessary to examine this framework more closely and to evaluate the conditions that are essential to improve this practice between nurses and patients (Bolster and Manias, 2013). Unfortunately, one of the outcomes associated with limited patient-centered care in medication administration is a variety of assessments, many of which do not align with patient needs effectively (Bolster and Manias, 2013).

One of the critical areas of person-centered care is the respect shown by nurses to their patients; therefore, this process must encompass the development of new strategies that will ensure that patients are given the respect and guidance that they deserve (Bolster and Manias, 2013). However, some specialty areas of nursing possess a stronger person-centered focus than others, particularly those that emphasize holistic approaches to care and treatment, such as rehabilitation and mental health (Bolster and Manias, 2013). These factors are critical in supporting outcomes and in providing a framework for achieving greater nurse-patient interactions that will improve patient wellbeing, such as those necessary during medication administration (Bolster and Manias, 2013). In some cases, creative approaches must be considered to facilitate these interactions and to improve upon existing frameworks to promote person-centered care more effectively and with the patient’s best interests in mind at all times (Bolster and Manias, 2013).

The primary purpose of this study is to explore the different types of interaction that nurses have with their patients when medication administration is required in an acute care setting (Bolster and Manias, 2013). The primary research question is as follows: “How do nurses and patients interact with each other during medication activities in an acute care environment with an underlying philosophy of person-centered care?” (Bolster and Manias, 2013, p. 156). This is an important question to ask in order to understand the current dynamic of patient-centered interactions between nurses and patients (Bolster and Manias, 2013). Medication administration activities include discussions regarding medications, as well as education and problem-solving related to these medications as necessary (Bolster and Manias, 2013).

The study design encompassed a naturalistic observational research design to obtain real-time data that is relevant to the research question and study focus (Bolster and Manias, 2013).

Furthermore, the study incorporated a set of semi-structured interviews that were conducted with participants after they were observed to evaluate person-centered approaches and beliefs (Bolster and Manias, 2013). The study was conducted in an acute care setting, and nurses were sought to participate if they were responsible for medication administration as part of their duties on the unit (Bolster and Manias, 2013). Using stratified sampling, nurses were chosen with varied levels of experience, and patients were also recruited who met the established criteria (Bolster and Manias, 2013). With the participant observation portion of the study, interactions between nurses and patients were evaluated over a two-hour period, which included medication administration and other activities (Bolster and Manias, 2013). Furthermore, semi-structured interviews took place in order to determine perspectives regarding patient-centered care during medication administration activities (Bolster and Manias, 2013).  The study participants included 11 nurses and 16 patients who chose to be interviewed, with a wide age range of patients (Bolster and Manias, 2013). The majority of patients were prescribed an increased number of medications that required administration, thereby increasing the need for person-centered care in these instances (Bolster and Manias, 2013). Nurses and patients expressed their views regarding person-centered care during the interviews, most of which was favorable in this area, including the ability to be flexible in these situations as necessary (Bolster and Manias, 2013).

The study results indicated that there were a number of common themes in support of patient-centered care for both nurses and patients (Bolster and Manias, 2013).It was important to patients that nurses communicated regarding medication administration activities and supported patients by educating them regarding these medications as best as possible (Bolster and Manias, 2013). This also supported the development of empowerment within these relationships to ensure that patient satisfaction was achieved and that they had some control over their medications and their overall health (Bolster and Manias, 2013). These factors were essential to the person-centered relationship and provided a basis for improving patient care throughout hospitalization (Bolster and Manias, 2013). The interviews also shed some light regarding past patient control over their medications and whether or not they have had much ability to contribute in this area by sharing their views and communicating with nurses regarding any confusion or questions they might have (Bolster and Manias, 2013). At the same time, the results indicate that there are weaknesses with this model when patients are not able to participate in their medication administration activities at a sufficient level (Bolster and Manias, 2013). Perhaps most relevant to the study is the determination that patient-centered interactions are critical in enabling patients to have a voice in their care and treatment and in understanding why certain decisions are made on their behalf, particularly where medications are concerned (Bolster and Manias, 2013). This also demonstrates the importance of other critical factors that indicate an ever-growing need for person-centered care in managing medication administration on a comprehensive basis in order to achieve effective outcomes and greater wellbeing for patients in need of assistance (Bolster and Manias, 2013). Person-centered care has been proven effective in other areas, particularly since it emphasizes the person’s need above all else (Entwistle and Watt, 2013) and supports a shift in the cultural dynamic in healthcare organizations to address the needs of the patient above all else (Jones, 2011). Furthermore, this concept also supports an ethical framework that encompasses the care and treatment of patients without neglect and with ethical responsibility in mind (Davis, 2013).

Critique

This qualitative research study provides a strong case for observational techniques and interviews. The study conveys the importance of person-centered interaction as a means of improving the medication administration process for many patients. This study is truly qualitative in nature because it supports a greater understanding of an important issue in nursing practice that is directly related to healthcare quality, known as person-centered care. The ability to provide care and to focus on the patient and his or needs first is a key contributor to successful nursing practice because it provides patients with the ability to communicate and to share their views regarding the care that they are receiving. When patients serve as the primary focus of these interactions, they are likely to experience a greater sense of comfort and acceptance. In medication administration, communication and interaction is essential to the successful delivery of medication to patients, and this includes allowing patients to ask questions regarding their medications and if they have any concerns regarding their purpose. Patients should be able to voice their concerns and to express their views regarding the medications that they have been prescribed, and nurses are the most appropriate group of professionals to manage these interactions effectively.

From a qualitative perspective, the research study is important because it addresses a critical issue in nursing practice that is a key contributor to quality of care. Person-centered care is a challenging phenomenon and provides a unique opportunity for patients to interact with their nurses on a more humanistic level. This is particularly relevant for interactions involving medication administration, which is often frightening, confusing, and frustrating for many patients. By observing these interactions in person, the researchers were able to capture some of the significance of these interactions in regards to how nurses and patients communicate regarding medication administration as it takes place. These observations also provide a basis for conducting the interviews with nurses and patients in order to identify patterns in the responses that are similar and that demonstrate the importance of person-centered care while administering medications. These contributions are critical in understanding why nurses should administer medications while interacting with their patients in different ways. This is critical in improving medication administration and subsequent compliance with the required medications. The interviews also provided greater insight into the person-centered experience and how it impacts both sides in order to improve quality of care. The perspectives provided were insightful and supported the need for person-centered care during medication administration to ease patient fears and improve quality of care.

Conclusion

This qualitative study provides a strong and meaningful framework for expanding knowledge regarding patient-centered care and its impact on medication administration. These efforts are critical because they reflect the importance of other aspects of the nursing role, such as communication with patients, compassion, understanding, and education. Each of these factors is critical in supporting positive patient outcomes and in enabling medication administration to occur more effectively. The study supports the belief that patients should interact with their nurses, ask questions as necessary, and express their concerns regarding medication administration on a continuous basis. Nurses must be able to express themselves with these interactions and support their patients by demonstrating compassion and understanding while communicating regarding medication administration. The study conveys the importance of these interactions and their value to nursing practice as a whole and to patients in their time of need.

References

Bolster, D., & Manias, E. (2010). Person-centred interactions between nurses and patients during medication activities in an acute hospital setting: Qualitative observation and interview study. International journal of nursing studies, 47(2), 154-165.

Davis, J.B. (2013). Person-centered health care: capabilities and identity. The American Journal of Bioethics, 13(8), 61-62.

Entwistle, V.A., and Watt, I.S. (2013). Treating patients as persons: a capabilities approach to support delivery of person-centered care. The American Journal of Bioethics, 13(8), 29-39.

Jones, C.S. (2011). Person-centered care. The heart of culture change. Journal of Gerontological Nursing, 37(6), 18-23.