Answer

Research Critique Guidelines – Part I

Flowers, K., Wright, K., Langdon, R., McIlwrath, M., Wainwright, C., & Johnson, M. (2016). Intentional rounding: facilitators, benefits and barriers. Journal of clinical nursing, 25(9-10), 1346-1355.

Toole, N., Meluskey, T., & Hall, N. (2016). A systematic review: barriers to hourly rounding. Journal of nursing management, 24(3), 283-290. 

Qualitative Studies

Background of Study

The article by Toole, Meluskey and Hall (2016) systematically reviews barriers to hourly rounding in healthcare and how they affect the practice’s implementation. Mainly, the research goal was to analyze a comprehensive list of barriers impacting effective sustainment of hourly rounding in adult inpatient medical and surgical units. The findings are significant to nursing. They inform on critical practice issues such as workload, patient acuity levels, inadequate staff training, burdensome rounding logs, missing staff buy-in, and lack of sustainability. Such healthcare barriers inhibit hourly rounding in organizations.

1. Research Question:

Which hospital barriers influence effective implementation of purposeful hourly rounding?

The study by Flowers and colleagues (2016) assesses the facilitators, benefits, and barriers of intentional hourly rounding in healthcare. The goal was to evaluate the execution, practice, and sustainability of purposeful rounding in aged care and maternity units. The article details are significant to nursing because they inform the need to stay consistent and effective with hourly rounding programs. The goal is to reduce patient falls, call lights for increased nurse proficiency, and overall patient experience scores.

1. Research Question

What are the key facilitators, barriers, and benefits of incorporating hourly rounding practice in healthcare settings?

How do these two articles support the nurse practice issue you chose?

These two articles address the PICOT question across all levels. Introducing hourly rounding as an evidence-based practice in healthcare can be challenging to implement in hospital settings. Different researchers have conducted studies to evaluate issues connected to hourly rounding in other care units in hospitals. Effective functioning and successful implementation of the practice require careful planning, implementation, communication, and evaluation. These two articles will be used to address the PICOT question because they highlight deeper on the inefficiencies impeding the effective execution and functioning of the clinical nursing practice. It suggests effective measures for addressing hourly rounding gaps and embracing a systematic, proactive, and nurse-driven-evidence-based intervention. The details also help care institutions understand how to anticipate and address the growing care demands among hospitalized patients. The goal is to streamline operations behind hourly rounding, enhance patient safety, enhance team communication, and improve staff capability to deliver efficient patient care.

The interventions and comparison groups identified in the articles compare to those identified in the PICOT question in various ways. The articles focus on critical interventions such as adequate education and staff training about implementing patient care units. The team needs to understand why they are requested to undertake the task, how to go about it, and why the new venture is vital for quality patient care. The comparison groups in both articles are the care staff and patients. They both compare because they suggest the need for extensive assessment for adopters, who should champion the procedures for unit staff. The recommendations insist on including unit-level staff across all redesign phases by establishing a practically effective communication and education plan. The PICOT question also highlights that nurses are the main subjects to care-based barriers that might inhibit the effective delivery of quality care to patients in specific units where the program applies.

Method of Study:

Toole, Meluskey and Hall (2016) conducted a qualitative study by searching four databases based on the inclusion/exclusion criteria, with a study sample of four searched and 20 articles reviewed. The exercise based on literature reviews as a study method as researchers focused on previous reports on key inhibitors of hourly rounding in healthcare practice. On the other hand, Flowers and colleagues (2016) conducted a qualitative research study using the descriptive method for data collection and analysis, with a study sample of 15 nurses categorized in three focus groups.

The key benefit of using literature reviews in qualitative studies is that it clarifies whether a project fulfills a need or not. Underlying knowledge may reduce the need to re-invent the wheel. Researchers get to compare their understanding with that of different scholars and assess their points of weaknesses in judgment. However, using such an approach as a study method may not be considered practical and realistic by management, inhibiting the implementation of study findings. The descriptive process in data analysis helps assess non-quantified topics and healthcare issues, which helped the researchers analyze the phenomenon in a natural and unchanged study environment. However, the main trick was that it only allows summations on objects and people that researchers had measured practically.

Results of Study

Toole, Meluskey and  Hall (2016) found that workload issues, patient acuity levels, inadequate staff training, burdensome rounding logs, missing staff buy-in, and lack of sustainability are key healthcare barriers inhibiting hourly rounding. Intentional rounding and its fit with the execution setting remains as essential as the care intervention. Care institutions should engage their frontline staff and remove any existing barriers that would impede the program’s efficacy.  Flower and colleagues (2016) found that the working culture, context of the environment, and legal issues present critical barriers in implementing hourly rounding programs in healthcare.

The two studies present significant implications in nursing practice. Healthcare leaders should utilize this information to assess and implement successful options to overcome the listed barriers before, during, and after the execution process and strategize to alleviate them entirely. Care institutions should consider incorporating intentional rounding into daily practices as a management tool. Besides enhancing accountability, it offers support essential for sustainability. Leaders should embrace hourly rounding as a strategy for improving the quality and safe care. Administrators should improve the implementation process by analyzing likely barriers that can inhibit the efficacy of the practice.

Ethical Considerations

Research ethics involve requirement on a day-to-day procedure, protecting the dignity and privacy of involved participants or subjects, and publication of the research’s data. The analysis considered informed consent and beneficence as the two ethical concerns. All study participants were informed about the part they are playing the data collection, and whether they want some personal details published in the final project. Also, literature reviews acknowledged the contribution of vast researchers to the article’s body of knowledge.