Research Critique of Quantitative Studies on VAP in ICUs - Research Paper

Introduction

This research critique aims at critiquing quantitative studies used in the study. The study will follow the guidelines provided in the Final-RS-Research document. The sections to be tackled include background of the study, methods of the study, results of the study, ethical considerations, as well as the conclusion.

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Background of the Study

The clinical problem that led to the studies was a high prevalence and incidences of VAP among patients admitted in the ICU. The information gap that the studied sought to fill was the accurate signs of VAP that distinguish it from other respiratory diseases (Rajan et al., 2018). VAP diagnosis criterion is challenging as multidrug-resistant bacteria base on traditional risk factors that are not sufficient. Knowing the distinctive signs of VAP will improve healthcare delivery as well as patient outcome through the choice of the most appropriate prevention and treatment interventions. The study has some significance on both the patient and the healthcare system. First, the assessments are of relevance because the patient outcomes of the critically ill patient in ICUs deteriorate, and in some cases, it can lead to death because of the development of VAP. The infection leads to complications in the treatment of patients in the ICU, a situation that leads to increased medical costs which creates a financial burden to the healthcare system (Timsit et al., 2017). The investigations are also of significance because it will increase the job satisfaction of nurses due to improved patient outcome because of a reduction in the deaths that occur due to VAP development.

The studies had the well-stated purpose of research. The goal of the survey by Rajan et al. (2018) was to assess the level of knowledge and practice of nurses concerning oral care hygiene among critically ill patients admitted in the ICU. The study by Timsit et al. (2017), on the other hand, had the purpose of updating information on VAT focusing on its signs, diagnosis, treatment, as well as prevention. In achieving their objectives, the researchers had well-stated objectives and research questions. The research question by Rajan et al. (2018) was what are the occurrences and rates of VAP in the ICU and do nurse have the required knowledge to prevent the illness? The study question for Timsit et al. (2017) was what the existing information for the signs, diagnosis, treatment, and prevention of VAP is? In both studies, research questions had a relationship with the purpose.

Methods of Study

The subjects used in the study have both risks and benefits. As identified by the author, the benefit received by the participants was oral care hygiene for patients and knowledge of oral care by nurses. The participants were assigned to antimicrobials, leading to having access to oral care. Concerning the risks, the subjects encountered is physical harm because of exposure to harm and minor pain during drug administration (Burns & Grove, 2011). Obtaining informed consent was effective by respecting the autonomy of participants. The involvement of the participants was also voluntarily. The researcher had approval from an institutional review board from Myusuru University. The studies also had well-defined independent and dependent variables. The data collection used in the research by Rajan et al. (2018) was descriptive design while the survey by Timsit et al. (2017) employed the case study method. Descriptive design was appropriate for the investigation by Rajan et al. (2018) because it described the phenomenon without influencing or influencing the variable. Case study, on the other hand, was also appropriate for the investigation by Timsit et al. (2017) because it provides in-depth information through the collection of data from various populations and setting.

The time frame in the study Rajan et al. (2018) was three weeks while the one for Timsit et al. (2017) took six weeks. The data collection process began by obtaining approval from the institutional review board followed by the selection of suitable participants in a healthcare facility. Respondents were informed about both the risks of participating in the study. Informed consent forms were given to allow subjects to decide whether to take parts in the survey or not. Data analysis was statistical where the collected data underwent analysis using arithmetic assessment and presented using tables and graphs (Burns & Grove, 2011) . The minimization of researcher bias was through independent researcher data analysis and comparing results with other researchers' analyses.

Results of the Study

The researchers' interpretation of the findings had a basis from the established hypothesis. The researchers had a grounded theory that determined the interpretation of results. The interpretation of results in the survey by Rajan et al. (2018) had a basis on the assumption that nurses do not have the required knowledge for oral care hygiene. The findings by Timsit et al. (2017, on the other hand, had interpretation based on the fact that there is little utilization and availability of information on VAP signs, diagnosis, treatment, or prevention. The findings by Rajan et al. (2018) are valid because of minimal manipulation of variables thus reflecting the reality within the clinical settings. Results obtained by Timsit et al. (2017 were also correct due to the comparison of the phenomenon across populations that indicated the real clinical situation. Since the results are accurate and represent the real clinical situations regarding VAP, I have confidence in the results.

The study had some limitations that affected the findings. The survey by Rajan et al. (2018) had the limitation of failure of indicating inferences that predict or illustrates the causal relationships between the variables. The study by Timsit et al. (2017, on the other hand, had the limitation of complex analysis and interpretation of results because of having multiple study settings. Though the findings had analysis and interpretation complexities, there was a coherent logic during results presentation (Burns & Grove, 2011). The studies' results also have implications for nursing practice by improving the quality of healthcare to critically ill patients admitted in the ICU through improved oral care hygiene that prevents VAP. Further studies for Rajan et al. (2018) survey is carrying out a study that compares the knowledge of oral care hygiene for nurses and other practitioners. The Timsit et al. (2017) study, on the other hand, can have further research that focuses on providing other treatment procedures for VAP apart from the use of antimicrobials.

Ethical Considerations

The studies had approval from the Institutional Review Board of Mysuru University. The patients' privacy occurred by not including the participants' official names on the data collection sheets or the informed consent forms. Researchers also ensured patient privacy by having one surveyor to assess a single patient at a time. Ethical consideration concerning the treatment or lack was informed consent and voluntary participation (Burns & Grove, 2011). Subjects had their own free will to participate in the research as well as having full information about the study procedure and the benefits and risks involved.

Conclusion

Conclusively, oral care hygiene is essential among critically ill patients admitted in the ICU who require ventilation. Quality and safe healthcare call for nurses to have the needed knowledge and technologies for oral care patient to improve the patient outcome for patients in need of ventilation to prevent VAP infection. The increasing incidences and prevalence of VAP among patients admitted in the ICU require the establishment of oral care protocols. Also, nurses should acquire the knowledge and skills needed for the prevention, diagnosis, and treatment of VAP to patients in the ICU. Therefore, reducing the incidences and prevalence of VAP will lead to reduced deaths caused by the infection, improved patient recovery, low medical costs, as well as nurses' job satisfaction.

References

Burns, N., & Grove, S. (2011).Understanding nursing research (5thed.).St. Louis, MO: Elsevier.

Rajan, T., MK, A. D., Thomas, U. M., G, M., & Williams, S. (2018). Knowledge and Practice of Staff Nurses Regarding Oral Hygiene in Critically Ill Patients Admitted in Critical Care Units of Selected Hospital at Mysuru, with a View to Develop an Oral Care Protocol. International Journal of Nursing Education, 10(1), 125-131. https://doi-org.lopes.idm.oclc.org/10.5958/0974-9357.2018.00025.9

Timsit, J. F., Esaied, W., Neuville, M., Bouadma, L., & Mourvillier, B. (2017). Update on ventilator-associated pneumonia. F1000Research, 6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710313/.