Methodology
This article should be considered as evidence-based nursing practice because in this article important aspects of evidence-based nursing practice are being incorporated. These aspects include knowledge from research evidence, knowledge from clinical experience and knowledge from carers. In literature review knowledge from research evidence is incorporated. In results section knowledge from clinical experience and knowledge from carers is incorporated (Nunan et al., 2017).
Review of this research article starts with stating importance of this research in nursing. Review of this article will be carried out using a set framework. This frame work consists of research problem and significance of this research, literature review, methodology, aim of the study, sampling, ethical consideration, data collection, data analysis and findings (Aveyard and Sharp, 2013; Melnyk and Fineout-Overholt, 2015).
Literature review is not clearly mentioned in this article. It is mentioned as the part of introduction. Less amount of literature is mentioned in this article. In literature, more articles related to the assessment and management of UC need to be given. However, in this research article, very less articles are given for UC. Literature review should align with the objective of the of the research article. Articles in the review should reflect important themes and concepts of the subject. From the literature review it is evident that, it is not fulfilling objective of the research. In literature review, for most relevant articles details about the methodology and relevant outcome need to be given. However, in this article these details about the previous research not mentioned. For UC, different assessment and management methods are available. In literature review, most effective assessment and management methods for UC should have been mentioned. However, most effective methods were not mentioned in the literature review (Aveyard, 2014; Brown, 2014).
Exploring urinary continence (UC) assessment and management practices in Australian nursing homes. There is little information is available for the UC assessment and management; hence, it is necessary to collect this information. This information can be collected through views and experiences of the care staff. Assessment performance according to the guidelines. To provide training on toileting time and frequency of changing continence aids.
In this research article, quantitative and qualitative research process is used. Quantitative data collected by conducting interview and by providing questionnaire (Magnusson and Marecek, 2015). These questionnaires were provided to each individual participants and quantitative data in the form of number of checking for wetness in older person, number pf participants replaced continence aids and prompting for older person for and frequency of toileting. Qualitative data also collected in the form of perceptions of caregivers in implementing assessment and management plan to older people. Provided data by the participants can be considered as evidence-based data because this data is collected directly from the patients. This data can be used as future direction for deciding on the nursing practice in the clinical setting.
Results
Personal care assistants (PCAs) (63 %), Enrolled Nurses (ENs) (11 %), registered Nurses (RNs) (20 %) and managers (4 %) were incorporated in this study from five different care homes. In this study, 121 staff were incorporated. Out of this 91 % were female. Sampling is described in detail in abstract part of the article. However, in methodology section sampling is not described in detail. In sampling inclusion and exclusion criteria is not mentioned (Parahoo, 2014).
In this study, cross sectional study is used. Cross sectional study is specifically useful for analysis of data from the specific population. Cross sectional studies are descriptive studies. In these studies, experiment is not required. These type studies can analyse prevalence of disease, cause and effect in the disease. In these types of studies individual level data need to be collected. In this study also, individual data was collected. In these types of studies, secondary data also can be collected; however, in this study secondary data was not collected (Salkind, 2010).
In this study data was collected by providing questionnaire to the participants and asked them to fill these questionnaires. These questionnaires were prepared after consultation with continence nurse and two RNs. Validity of these questionnaires were confirmed after conducting three stakeholder consultation meetings. Data collected through questionnaires consist of demographic details, descriptions of UC assessment and management practices and the opinions of care staff about the effectiveness of UC practices. Data related to opinion of the care staff was collected by using seven point Likert scale. Questionnaires were distributed to care staff by visiting each care home and filled forms were collected on the same day. Views and experiences of care staff about assessment and management practices were collected through semi-structured interview. This method of data collection in most suitable for this research because data necessary to meet objective of this study can be collected through questionnaires and interview method. Objective of this study was to explore urinary continence (UC) assessment and management practices in Australian nursing homes. This data can be collected through collecting information related to experience and opinion of the staff (Schmidt and Brown, 2015).
Research which is being carried on human beings, informed consent need to be taken from the patients. However, in this study it was not mentioned whether informed consent was taken from the patients on UC intervention. Studies related to human beings need to get approved from the institutional Human Research Ethics Committee. In this study also this approval was taken. Moreover, agreement was made with all five nursing homes. Identity of the participants should not be revealed to the researchers. It might lead biasness in the outcome. Interviews and observations are prone to ethical dilemma. However, in this article it was not mentioned what were the efforts made to eliminate these dilemmas. In human based studies, patients have right to reject. However, in this study it was not mentioned whether patients were given opportunity to reject participation in the study. Ethical committee and institutional review board approval need to be taken prior to start of the study. However, in the methodology section ethical approval was mentioned at the end of section. However, it was not clear whether approval was taken prior to start of the study.
Literature Review
Prior to data analysis, data need to be arranged and compiled in proper manner. However, compilation of data was not mentioned in this article. However, data was presented systematically in the article. Data was presented in terms of number participants and percentage of participants. IBM SPSS Statistics 19 was for the statistical data analysis. Comprehensive data analysis was conducted by incorporating different methods like ANOVA using posthoc Tukey’s test for data comprising of normal distribution. This method of analysis is descriptive analysis and for this analysis data were presented in the aggregated form. If there is no normal data distribution Kruskal-Wallis test and MannWhitney U Test was performed. These methods are non-parametric methods of analysis and data was presented in the form of median and interquartile range (IQ). Pearson’s Chi-square test was used for find statistical difference between the yes and no questions. Data collected during interviews were analysed by using transcripts collected during interview. Data was analysed in the detailed manner. Analysis for each sub-group was also performed. Frequency of checking wetness was again segregated like 0, 1 -2, 3 – 4 etc. Data for each care home could have been analysed separately. However, in this study, for few parameters, data was analysed collectedly for more than one care home (Taylor, 2013).
There was no significant difference observed among all the five nursing homes in terms of participants’ gender, age, job role, working hours and shifts. 66 % care staff checked wetness for 3-4 times while only 10 % of care staff checked it for more than 5 times. It is evident that care staff in the care home 5 checked wetness more significantly as compared to other care homes. Replacement of continence aids was significantly more in care home 3 as compared to other care homes 1 and 2. Toileting assistance was more in care home 2 as compared to the care home 1. The care staff of care home 4 were less satisfied with accuracy of information they received as compared to the other care homes. Care staff of care home 2 and 4 mentioned that UC assessment was easy as compared to care homes 1 and 3. Eight participants agreed that checking UC accurately is not feasible. Information collected during UC doesn’t include information about fluid intake and urine output. Hence, overall UC assessment is difficult. Comparative data of different parameters among all care homes was not mentioned in this research article. In few of the parameters only 2 or 3 care homes were compared among themselves. Moreover, reason for not comparing these parameters was also not mentioned. Number of participants from each of the homes was not mentioned; hence validity of comparison among different care homes is questionable.
Results of this study provided insight into the UC assessments and management practices in Australian clinical setting. Authors are satisfied with the outcome in terms of data collection because they felt effective communication facilitated among outside and in-house healthcare workers. They are confident that they can develop care plans based on collected data. Authors are confident that their findings are superior as compared to the USS study. For the justification of the collected data, authors gave few references. However, results of this data is not matching with the outcome of this study.
Results obtained about UC assessment and management practices in this study were based on the self-reports of care staff. Hence, there might be possibility of biasness in the results and these results might not be actual results. There was less response from some of the care homes, hence it was difficult to get results all the planned parameters from each home. In few of the instances nursing practice was not performed by qualified personal because UC assessment and management was conducted by PCAs. Parameters other than UC parameters were not collected.
References:
Aveyard, H. (2014) Doing a Literature Review in Health and Social Care: A Practical Guide. Maidenhead. Open University Press.
Aveyard, H. and Sharp, P. (2013) Beginner’s Guide to Evidence-Based Practice in Health and Social Care. 2nd ed. Maidenhead: Open University Press.
Brown, S.J. (2014) Evidence-Based Nursing: the Research-Practice Connection. 3rd ed. Burlington: Jones and Bartlett Learning.
Melnyk, B. and Fineout-Overholt, E. (2015) Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice. 3rd ed. Philadelphia: Wolters Kluwer.
Magnusson, E., and Marecek, J. (2015). Doing Interview-based Qualitative Research: A Learner’s Guide. Cambridge University Press.
Nunan, D., O’Sullivan, J., Heneghan, C., Pluddemann, A., Aronson, J., and Mahtani, K. (2017). Ten essential papers for the practice of evidence-based medicine. Evidence-based medicine, 22(6), 202-204.
Parahoo, K. (2014) Nursing Research: Principles, Process and Issues. 3rd ed. London: Palgrave.
Salkind, N. J. (2010). Encyclopedia of Research Design. SAGE.
Schmidt, N.A., and Brown, J.M. (2015) Evidence-based practice for nurses; appraisal and application of research. 3rd Ed. Burlington: Jones and Bartlett Learning.
Taylor, R. (2013). The essentials of nursing and healthcare research. Sage Publications.
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