Recovery Room Warming Methods for Hypothermia Patients, Research Paper Example

Background and Literature Review

The abstract is sufficient in indicating the variables, design of study, and population being studied. Specifically, the variables were treatment by radiant warmer or by warm cotton blankets. The study was a quasi-experimental design that focused on hypothermia patients in northern Taiwan. The abstract provides potential readers with enough information to determine whether it would be relevant to their research interests. It indicates that the purpose of the study was to “compare the time needed to reach a specified temperature and the efficiency of two warming methods-warm cotton blankets and a radiant warmer-for hypothermia patients in a postanesthetic care unit (PACU) after spinal surgery (Yan et al., 2014). It specifies the methodology used, which includes a temperature comparison before and after the application of two interventions.

The major findings are included in addition to the analysis and implications. However, the references are not recent; many of these articles were published in 2006, and some included were published prior to 2000 and therefore may be outdates. A majority of these articles are from primary sources, but several appear to be review articles. All articles cited are directly related to the research problem. The literature is critically analyzed for gaps in knowledge and limitation of studies, which the author uses to demonstrate to the reader why this particular research project was necessary. However, the article does not include the both sides of this issue, as there are many other potential interventions for hypothermia that are not considered. The literature review appears to be sufficient based on the number and the quality of the resources used. There is a summary of current knowledge in the introduction section of the article, which provides readers with a basic understanding of the information needed to understand the experimental work that was performed. The article provides a rationale for this study, which is that there is a need to understand more about which hypothermia interventions are the most effective. The study discusses a high level of evidence based on the culmination of a variety of prior studies that were used to design this current undertaking. Ultimately, the literature review was effective.

Theoretical Framework Purpose, Research Questions, Hypotheses

Conceptual framework is discussed. There is a logical link between the theory and the research problem because the two devices tested are readily available in hospitals and it is therefore plausible to question which would be the most effective. The aims and research questions stem from this theory due to current knowledge of hypothermia treatment. The theory can be defined as prior knowledge regarding commonly used heating equipment for hypothermia, and therefore interpreting research findings within the context of a theory does not apply to this study. Thus, the study is mostly based on evidence-based practice. The purpose of the study is to determine whether warm blankets or radiant warmers are more effective in treating hypothermia. The hypothesis is not stated. The research question flows logically from the purpose of the study because the purpose is to determine how to improve hypothermia treatment and the study compares two specific hypothermia interventions. An inferred hypothesis is that the radiant blankets will be more effective. The independent variables are the two hypothermia interventions, while the dependent variable is the change in patient body temperature. The target patients are those in north Taiwan that have undergone operations that resulted in hypothermia. Additional variables can include the demographics of the patients in addition to their overall health and reason for visiting the clinic. No operational definition of the variables are provided.

Design

This is a quasi-experimental study. It is cross-sectional because the patients are only being examined at one point in time. This makes sense given the research question because the temperature change in patients with hypothermia is immediately relevant only after treatment. Baseline comparisons were made, as the temperature of the patients was measured before the intervention was applied. There are no significant differences between the two interventions groups at baseline. Data is collected once prior to the intervention and once following the intervention for all 130 patients. The number of data points collected were appropriate given the purpose of the research. In this study, confounding variables were not identified nor were they controlled. This could have been done by utilizing participants with similar demographics (ex. males of a certain age). There are many threats to the internal validity of this study as a consequence. For example, the illness of patients (history) could impact their body temperatures. Statistical regression and selection bias are considerations as well. However, it is likely that subject maturation, testing, and instrumentation did not play a role. The threats identified above can be acknowledged as limitations of the study.

Sample

The sample utilized in this study was hypothermic patients in north Taiwan who had undergone spine surgery and are being housed in the hospital’s postanesthetic care unit (PACU). Subjects were recruited while in the PACU. All patients that fit within this definition were included in the study and there were no other exclusion criteria. This was a convenience sample due to the number of the patients that were typically seen in the research institution. The sample is representative of the target population because individuals of diverse demographic and health backgrounds have a relatively equal likelihood of becoming hypothermic after surgery. Subjects were randomized to each treatment group. The sample culture is not considered culturally diverse, as a majority of participants were Taiwanese. However, this population is representative of the target setting. The threats to external validity is the small sample size and the potential that other hospitals do not have the same hypothermia intervention equipment available. Response rate and attrition are not discussed because all data was collected; all patients were studied in the hospital during their stay as a part of normal treatment and there was no need for follow up due to the nature of this study. There is no evidence of a power analysis and it is likely that 130 patients were studied because this is the number of patients that could reasonably be recruited. This study received IRB approval. The low sample size has a slight impact on the credibility of the findings.

Methods

The two interventions were use of warm blankets and radiant warmers. The protocol for the intervention (warmer option) and data collection (net patient temperature) is clearly defined. All measurement instruments are clearly described as well. The measures are appropriate and all are direct. Reliability is addressed and the same instruments were used to measure all of the patients.However reliability data and instrument validity is not available. It is unlikely that measurement issues threatened the validity of the study due to the simplicity of the measurements.

Results/Findings

An F-test was used to calculate the equality of variance between the two intervention groups. In addition, the Chi square test was used to test for independence. This was appropriate for the type of data collected because it was necessary to determine whether there was a significant difference in temperature change between the two intervention groups. There is evidence that the assumptions of the statistical tests were met because the p-value demonstrated that both tests were statistically significant. The research question was therefore addressed during the analysis. It was found that the group with the radiant warmer needed a shorter time for rewarming than the group with the blankets  (F [1, 125]= 58.17, p <.001). The Chi square test showed that the radiant warmer was also more efficient (?2 = 37.44, p <.001). Tables and figures were not used to summarize the findings and it was therefore difficult to determine the meaning of the results immediately. It appears however, that the analysis was interpreted correctly. It is better to use radiant warmers in treating hypothermia compared to warm blankets.

Discussion/Implications for Practice

There was only one question, which was whether the radiant warmer or warm blankets would treat hypothermia more efficiently. As a consequence, the findings are discussed in relation to each purpose, question, and hypothesis, as there is only one focus in this study. Findings are not discussed in relation to the theoretical framework, because this study is not based on theory. However, the discussion is based on evidence-based practice and previous research in the field. All results are statistically significant. However, they were not explained in detail. It appears that detail is not necessary due to the simplicity of the study and its accommodating results. Clinical significance is addressed, and it is expected that this study will influence practice by causing more health care professionals to choose radiant warmers to treat patients with hypothermia in the future. Findings are related to literature reviewed in both the introduction and in the discussion section. Some limitations are acknowledged, although discussions of threats to validity in the design were brief. All conclusions are consistent with the results of the study. For further research, it would be necessary to determine whether this information applies to additional patient populations. Furthermore, the study should be repeated using other intervention methods for hypothermia to determine which is the best at raising body temperature quickly. The findings of this study are applicable to practice because it is important to quickly restore the body temperature of patients who have hypothermia. Therefore, this study demonstrated that it would be preferable to use radiant heaters to achieve this cause. When situations are less urgent, it may be acceptable to utilize warm blankets instead of the alternative, but these decisions must be made case by case for each unique situation. Of particular interest, it would also be necessary to determine whether implementing the results of the study would be cost effective or realistic providing the resources that are available at my own health care institution. It is possible that the hospital prefers to use a different treatment method, and it would therefore be difficult to utilize these findings in practice.

References

Yan, Hsiu-Ling; Lee, Hsiu-Fang; Chu, Tsung-Lane; Su, Yu-Yun; Ho, Lun-Hui; Fan, Jun-Yu. (2014). The Comparison of Two Recovery Room Warming Methods for Hypothermia Patients Who Had Undergone Spinal Surgery. ProQuest. Retrieved from http://search.proquest.com/docview/940915755?accountid=147674