Purpose: Comment the Discussion (Class 504 Unit 6 Comment 1) Lucila

Thing to Remember:

Answer this discussion with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.

1 References, find resources that are 5 years or less

No errors with APA format 6 Edition

To Comment:

Qualitative research is a collection of data in a non-numeric form with an intent to describe a phenomenon through personal interviews, focus groups, observations and field notes. It requires judgement on the clinicians to interpret the data for best practice in the clinical environment (Melnyk et al ,2015). Narrative research is capturing the life experiences of a single or group of individuals in a biographical or autobiographical form. In support of this design, I found this systematic review for my PICOT project as an example for the narrative approach in qualitative research. Collins et al (2014) had used this narrative design to review the effectiveness of surgical checklists in correcting and preventing wrong site surgeries and other medical/surgical errors. In conclusion, Collins et al recommended not to solely rely on a checklist but a proliferation of “Just Culture” that encourages a vision of shared goal of patient safety. Another Qualitative research worth looking at for my PICOT project is the study conducted by Panesar et al (2011) which investigated the surgical checklist that was patterned from the aviation industry. This is an example of Grounded Theory Research where the researcher compared data analysis regarding the use of checklist from the aviation industry to that of the surgical environment (Yates &Leggett, 2016). In summary, Panesar et al concluded that technical precision in surgery like Orthopedics must be aligned with patient safety. The implementation of the use of a surgical checklist is one of the recommendations to adapt in clinical practice.

In my PICOT project, I intend to use triangulation of the qualitative and quantitative researches that I could find and explore throughout the length of this course and maybe beyond as I discover some improvement in patient safety that is applicable in my work environment.I believe that triangulation of both types of researches will capture the best evidence based practice in preventing wrong site surgery and other related surgical errors. It will also highlight other initiatives that will enhance the safety measures like organizational and leadership support through implementation and clear understanding of a “Just Culture” concept. Data mining “patient safety” measures in the operating room opened other interesting fields that require equally protective measures like dentistry, dermatology and anesthesia regional blocks.

Reflection: Qualitative research deals with non-numeric data which makes it weak to stand by itself. It encourages collaboration with other specialties (social worker, psychologists, physical therapists, etc) through synthesis of systematic data to make it to Level I in the Hierarchy of Evidence which is the very essence of Advanced Practice Nursing (APN) (Hamric et al ,2014). The qualitative researcher is aware of the socially constructed nature of reality and is embedded intimately in the context of the study that includes the setting, participants and the data being collected. It also summarizes the different nursing theories and paradigms of Watson (Human Caring Theory), Sullivan (The theory of Interpersonal Relations) Rogers (Humanistic Theory) and Parse (Human Becoming Theory) to name a few. More than ever nursing research is paramount in elevating the new role as APNs with that of a primary care giver through Licensing, Accreditation, Credentialing and Education (LACE). One of the crucial tasks ahead of APNs could be the evidence based practice on concepts of health continuum where preservation of healthy habits and lifestyle is crucial in the prevention of illness. Nursing research in our present healthcare system must consider the Quality of life versus Health because the 2 phenomena is shifting, changing and “in the moment” stage as per Parse (Butts et al, 2015). The Health Care Policy environment is rapidly changing and comprehensive reform will be implemented in the next decade and beyond where APNs must take an active role as perceived by the Future of Nursing Report and by the Institute of Medicine Recommendations (2010).

References:

Butts J.B., Rich,K.L.(2015)Philosophies and Theories for Advanced Nursing Practice. 2nd Edition,Burlington,MA: Jones and Barlett Learning

Collins, S. J., Newhouse, R., Porter, J., & Talsma, A. (2014). Effectiveness of the Surgical Safety Checklist in Correcting Errors: ALiterature Review Applying Reason’s Swiss Cheese Model. AORN Journal, 100(1), 65-79. doi:10.1016/j.aorn.2013.07.024

Hamric, A.,Hanson,C.,Tracy,M.,O’Grady,E.,(2014) Advanced Practice Nursing: An Integrative Approach(5th Edition) St Louis MN: Elsevier

Institute of Medicine (2011) Future of Nursing; Leading change, advancing health.Washington DC: Academies Press. Melnyk, B., Fineout-Overholt, E., Stillwell, S., & Williamson, K. (2009). Igniting a spirit of inquiry: An essential foundation for evidence-based practice. American Journal of Nursing, 109(11), 49–52

Panesar, S. S., Noble, D. J., Mirza, S. B., Patel, B., Mann, B., Emerton, M., & Bhandari, M. (2011). Can the surgical checklist reduce the risk of wrong site surgery in orthopaedics? – can the checklist help? Supporting evidence from analysis of a national patient incident reporting system. Journal Of Orthopaedic Surgery & Research, 6(1), 18-24. doi:10.1186/1749-799X-6-18

Parse, R. R. (1999). Nursing science: the transformation of practice. Journal Of Advanced Nursing, 30(6), 1383. doi:10.1046/j.1365-2648.1999.01234.x