Critical appraisal

Prepare a critical analysis of a quantitative study focusing on protection of human
participants, data collection, data management and analysis, problem statement, and
interpretation of findings. The quantitative research article can be from your previous
literature review or a new peer-reviewed article.

Benchmark – Research critique 2

Critical appraisal refers to in depth analysis of a quantitative study for various reasons. In
nursing, critical appraisal is normally done for three major reasons including a) improve
nursing practice, b) broaden nursing knowledge and understanding and c) give a baseline for
conducting a study (Shimoinaba, O’Connor, & Lee, 2010). To ensure that these three reasons
are achieved, the following special considerations to the article being critically appraised
must be put into considerations. These include issues such as research findings are
appropriate to the study situation and study setting. The study must identify the further study
research and what pilot studies that need to be conducted before the study findings and
intervention are incorporated into practice, in order to ensure that patient safety and
effectiveness is maintained. Additionally, the article must indicate the clinical implications
of the study finding (O’Shea, 2014).

Thesis statement for composing this assignment is that critical appraisal of this quantitative
article will broaden my nursing knowledge and understanding of nursing care, which will
improve my nursing practice. The article that is critically appraised is “Mc Donell, S.,
&Timmins, F. (2012). A quantitative exploration of the subjective burden experienced by
nurses when caring for patients with delirium. Journal of clinical nursing 21, 2488-2498.”


The nursing main topics that will be included in this critical analysis includes protection of
the human subjects participating in the study, methods of data collection, data management,
the study’s problem statement, findings and the nursing implications (Mc Donell, &
Timmins, 2012).

Protection of Human Participants

Research study is the best approach in advancing treatment and quality care in healthcare.
The author does not mention the risks and benefits that participants received. However from
evidence based practice, some of the benefits that the participants could have achieved
include receiving more attention and oversight as there were frequent designated evaluation
points during the evaluation processes. Additionally, it would have helped in combating
participants feelings of helplessness as they undertook active role in the healthcare, thus
improving the quality of life and general well-being of the patient. The main risk identified in
the study is psychological harms associated with undesired changes in the participant’s
emotions. However, these risks are transitory and thus had minimal potential for causing
serious psychological harm (Mc Donell, & Timmins, 2012).
To ensure that the human participants are protected, the researchers sought permission from
the various ethical authorities, including the University ethical review board. Additionally,
the participants were required to fill in and sign informed consent. The study indicates that
the participants were not forced or coerced in to participating (Mc Donell, & Timmins, 2012).

Data Collection


The data collection design for the study is quantitative descriptive design. The study design
was chosen because of its flexibility attribute which is important particularly during data
collection as it enhances multifaceted data collection strategy. The study population
consisted of 800 registered nurses from the Republic of Ireland. To ensure that study
population was not biased, the population conducted a random sampling (Mc Donell, &
Timmins, 2012).
The participants were required to fill in their questionnaires was collected using the Strain
Of Care for Delirium Index (SCDI), derived from Clinical Assessment of confusion (CAC-
A) tool. The independent variables collected included the psychological behaviours such as
depression, physical injuries, anxiety, and burnouts. The dependent variables collected
included gender, age, area of work and participants qualifications as well as number of
professional training that the participants had attended (Mc Donell, & Timmins, 2012).
This method of data collection was chosen because enabled the researcher to ensure wider
participation of researchers. Additionally, the method ensured that it offered a non-
threatening as well as non-intrusive method, and simultaneously maintaining patient’s
anonymity. This ensured that the inherent biases are reduced, and most importantly, it
allowed a wide range of responses from the nurses who worked in various areas of healthcare
practice. The time frame that was used to collect the data was approximately six months (Mc
Donell, & Timmins, 2012).
Once the data was collected, it was entered into thematic charts, which aimed at improving
the analysis as well as the interpretation of the data. This was done according to the policies
and regulations of the ABA policies. The data in the thematic charts was coded to ensure easy
data analysis using the statistical tools and parameters (Mc Donell, & Timmins, 2012).

Data Management and Analysis


The data management instruments used was the Strain of Care for Delirium Index (SCDI).
Once the data had been gathered from the questionnaires and grouped into thematic charts, it
was subjected to data analysis done using SPSS Version 16 Inc., Chicago, IL, USA. The
statistical analysis conducted included measures of deviation, and means of variances. These
measures were used to ensure that the distribution of pattern could be understood effectively.
The analysis of question was done in a manner that it ensured that each of the study
questions was analysed effectively (Mc Donell, & Timmins, 2012).
Additionally, the appropriateness of the statistical measures that were applied included the
Cramer’s V association measures, which was used to determine the correlation that existed
between variables. To ensure that the statistics analysis was conducted the triangulation
techniques, which was done to ensure that type I & II errors were minimised. Describe the
data management and analysis methods used in the study (Mc Donell, & Timmins, 2012).

Findings / Interpretation and Implications for clinical practice
The study findings in this articles are reported in percentages and in rations. The study also
included the study statistical significance. The study findings summaries are done adequately
and in presentations of graphs and figures. From the study findings, it was evident that the
RN experienced suffered from subjective burden when delivering care to patients diagnosed
with delirium. The study indicated that the main challenging aspect of the disease included
hyper activity as well as hyper alertness, recorded at M=3.41, which were followed by
uncooperativeness which was reported as M=3.58. There were no accidental findings that are
reported, but the study conclusion that RN lack knowledge on ways to manage patients
suffering from delirium, and that the nurses suffered subjective burden when delivering these
care can be generalized. The findings are valid and also an accurate reflection on what is



shown in reality. The main limitation of the study was the poor response from the
questionnaire, which could have introduced bias due to confounding effects (Mc Donell, &
Timmins, 2012).
The implications of the study in clinical practice are derived from the interpretation of the
study findings. This indicated that the RN suffers from subjective burden especially when
delivering care to patients diagnosed with delirium. The study indicated that there is need to
enrol the healthcare providers and the nurse staff to education programs that focus on
effective delivery of care for patients diagnosed with delirium (Wu et al., 2014). The study
recommended that future studies in research should focus on strategies that they facilitate in
understanding the aspects of delirium, its risk factors, pathophysiology, indicators and
preventive measures in order to facilitate early identification of the disease, and early
establishment of strategies that will lower the burden of care (Mc Donell, & Timmins, 2012).
This study and the critical appraisal activity provide substantial implication for nursing
practices, particularly when delivering care for patients. This is important because nurses
spends most of their time in providing direct care, which creates a prolonged intimate
relationship with the patients, which could lead to burden to nurses when delivering care. In
some situations, the challenging behaviours that are exhibited by patient can lead to
significant nurse distress, and potentially impact negatively on the patient care.
This activity has helped me understand the perceptions and challenges experienced by the
nurses, which is a good step in helping me broaden my nursing knowledge and understanding
of nursing care, which will improve my nursing practice. Additionally, this will facilitate
smooth transition from nurse student into nurse practitioner.



Mc Donell, S., &Timmins, F. (2012). A quantitative exploration of the subjective burden
experienced by nurses when caring for patients with delirium. Journal of clinical nursing
21, 2488-2498
O’Shea, M. (2014). CE. AJN, American Journal Of Nursing, 114(11), 26-34.

Shimoinaba, K., O’Connor, M., & Lee, S. (2010). Japanese head nurses’ perspectives
regarding issues of nurses working in palliative care units and current support systems.
Progress In Palliative Care, 18(6), 358-363.

Wu, X., Gao, Y., Yang, J., Xu, M., & Sun, D. (2014). Quantitative measurement to evaluate
morphological changes of the corpus callosum in patients with subcortical ischemic
vascular dementia. Acta Radiologica, 56(2), 214-218.

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