research article critique part one uta 2019

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NURS 4325 Nursing Research Syllabus

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Appraisal part one 11-11-2020

Principles of research in nursing (nurs 5366), the university of texas at arlington.

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Research Article Appraisal, Part One Assignment

First Name Last Name University of Texas at Arlington College of Nursing NURS 5366 Dr. Nov 14, 2020

In this paper, the research article which is titled as “Effect of a Scheduled Nurse Intervention on Thirst and Dry Mouth in Intensive Care Patients” will be evaluated (VonStein et al., 2019). This paper will include the evaluations of the identification and explanation of the research problem, research purpose, research questions, the hypothesis, theoretical framework, variables, and research design of the research article. Additionally, the paper will also include a literature review of the research article. The authors of the study are Michelle VonStein, Barbara L. Buchko, Cristina Millen, Deborah Lampo, Theodore Bell, and Anne B. Woods (VonStein et al., 2019). Educational preparation of the authors is included in this research article. The authors hold the credentials of Bachelor of Science in nursing (BSN), Master of Science (MS), Doctor of Nurse Practice (DNP) or Doctor of Physiology (PhD) degree. All the authors hold adequate scientific and clinical background to conduct this research study. Michelle VonStein and Cristina Millen are clinical nurses, and Deborah Lampo is a nurse manager (VonStein et al., 2019). Buchko is director of Evidence-Based Practice and Nursing Research, and Theodore Bell is a research program manager (VonStein et al., 2019). Anne B. Woods is adjunct faculty of Messiah College (VonStein et al., 2019). The title of this article was presented as “Effect of a Scheduled Nurse Intervention on Thirst and Dry Mouth in Intensive Care Patients” will be evaluated (VonStein et al., 2019). The title clearly clarified the study population as the patients in intensive care unit (ICU) setting. The title also stated the key variables of the research study as scheduled nurse intervention and patients in ICU. However, the title did not indicate the general type of study though the type of the study was stated in the abstract of the research article.

There were a proper amount of background information and several topics discussed in the literature review. One major topic discussed was the prevalence of symptoms in ICU patients related to thirst and dry mouth. The common thirst symptoms that affected patients in the ICU were thirst intensity, thirst distress and dry mouth. Another major topics discussed in the literature review are what the nonpharmacological interventions included and nonpharmacological interventions relieve in thirst and dry mouth. Nonpharmacological interventions include cold water, menthol and a menthol lip moisturizer. The relevant previous studies were described in the literature review of this research article appropriately. There are total 12 references in this research article. Most of the references were primary and empirical. About 70% of the references are current in the last 10 years. Both primary sources and secondary sources were cited to support cold water was the most common approaches and thirst intervention bundle significantly relieve in thirst intensity, thirst stress and dry mouth (VonStein et al., 2019). For example, one of the primary studies cited by the research article concluded that thirst intervention bundle significantly decreased the thirst intensity, thirst distress and dry mouth. However the thirst intervention buddle used in this reference was not scheduled one. All the references of the research article were well described, critically appraised, and synthesized to provide a clear summary of the current knowledge about the research problem. The references cited in the review of the literature were summarized by including the design of the study, the patient population, interventions performed, and a brief conclusion of the study. The gap of the research knowledge was discussed in literature review. It described the current knowledge by citing the research that has previously been done. For example, the literature review of the article stated nonpharmacological interventions were identified by previous studies. And nonpharmacological interventions decreased the thirst and dry mouth.

Then the authors identified that no studies indicated frequency of use of nonpharmacological interventions to ameliorate thirst and dry mouth. Research Problem, Purpose, Research Questions/Hypotheses The research problem of the study is explicitly stated in the article. It is that nonpharmacological interventions to manage and minimize thirst and dry mouth in hospitalized adults (especially ICU patients) was lack of solid evidence for practice and no evidence-based recommendations for a standardized frequency of use were reported (VonStein et al., 2019). The purpose of the research article was clearly implied. It is to compare the effectiveness of scheduled use of ice water oral swabs and lip moisturizer with menthol with the effectiveness of unscheduled, as-needed use of the same interventions (usual care) at relieving thirst intensity, thirst distress, and dry mouth in ICU patients (VonStein et al., 2019). The study is attempting to gain more knowledge of nonpharmacological intervention to manage and minimize thirst and dry mouth of ICU patients. The purpose clearly and precisely addressed the gap in nursing knowledge (research problem) identified in this research article. The purpose was supported by previous studies cited in the literature review. Nonpharmacological interventions were identified as ice water spray, oral swab wipes and menthol lip moisturizer. These interventions were reported significantly decrease in thirst and dry mouth in the literature review of the research article. The hypothesis of this study followed from the research problem and purpose was clearly implied in this research article. The hypothesis is that providing patients with regularly scheduled applications of ice water oral swabs and lip moisturizer with menthol would decrease the patients’ perception of thirst intensity, thirst distress, and dry mouth more than would providing these interventions upon patients’ request (VonStein et al., 2019). Theoretical Framework

thirst distress and dry mouth were reported as substantial symptoms. Operationally defined, thirst intensity, thirst distress and dry mouth were measured by using 0 to 10 NRS. The conceptual definitions of thirst and dry mouth were consistent with the operational definitions. The theoretical framework of the study was not identified or stated in the research article. It could not tell the variable definitions were reflective of concepts from the theoretical framework or not. Demographic variables measured in the study were sex, age, ventilator status and nothing by mouth status (VonStein et al., 2019). The patients in the two groups of the study did not differ significantly in sex, ventilator status, nothing by mouth status, or age. The study identified history of dementia, open lesions or desquamation on mouth or lips or a medical condition as extraneous variables. The study set these extraneous variables as exclusion criteria when screening for eligibility. Research Design The study used a quasi-experimental study design. The design provided a means to answer research hypotheses. A quasi-experimental design could establish a cause-and-effect relationship between an independent and dependent variable and could show the impact of an intervention on a certain population. The hypothesis of this study was that providing patients with regularly scheduled applications of ice water oral swabs and lip moisturizer with menthol would decrease the patients’ perception of thirst intensity, thirst distress, and dry mouth more than would providing these interventions upon patients’ request (VonStein et al., 2019). The quasi-experimental study design perfectly matched the study’s hypothesis. The study design had two groups. It verified the hypothesis through comparing the data of the two groups. The description of the study procedures was clear enough to be replicated. One of the two ICUs provided the scheduled use intervention as intervention group and the other unit provided

usual care to patients as control group. A total of 296 patients were evaluated for eligibility. Of these patients, 219 met eligibility criteria, and 134 (61%) were enrolled in the study. Final samples had 103 patients who completed the study with 62 in the intervention group and 41 in the control group. The available of the study subjects is feasible because there are always ICU patients in need of oral care. The patients were monitored for 12 hours or more. This is a relatively short time commitment and therefore makes for a significantly more feasible study. The location needed to conduct the research was ICU setting and instrument NRS was established though factor analysis. The demographic variables were collected by research nurses using a research-developed data collection tool to ensure precision in collection. Researcher expertise is feasible because the knowledge base required for obtaining the data and results is minimal. Key variables (thirst intensity, thirst distress and dry mouth) were measured by using 0 to 10 NRS. The study used IBM SPSS to maintain and analyze data. The intervention group received hourly ice water sabs and lip moisturizer with menthol. The study identified history of dementia, open lesions or desquamation on mouth or lips or a medical condition as extraneous variables identified. Extraneous variables identified and controlled by setting these extraneous variables as exclusion criteria when screening for eligibility. The authors identified threats to design validity. For example, the author identified selection bias as threats to design validity. Subject randomization to different groups did not be done. Participants in one ICU may be different with participants in the other ICU. Possible system differences between the two ICUs could threat to the design validity. Because the study was limited to two ICUs in a single hospital, the author stated the findings of this study could not be generalized to other types of acute inpatient unites. The study had less mechanical ventilation so the findings of this study could not generalize for other population of patients.

References VonStein, M., Buchko, B. L., Millen, C., Lampo, D., Bell, T., & Woods, A. B. (2019). Effect of a scheduled nurse intervention on thirst and dry mouth in intensive care patients. American Journal of Critical Care , 28 (1), 41-46.

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Course : PRINCIPLES OF RESEARCH IN NURSING (NURS 5366)

University : the university of texas at arlington.

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