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Write a critical appraisal that demonstrates comprehension of two qualitative research studies.

Summarize two qualitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Background of Study

Qualitative study 1

Summary and problem

Poor and improper hand hygiene-related practices have been remarkablynoted among nurses that aggravate hospital-borne problems such as infections (Marques et al., 2017). This study focused on inculcating the said practice of hand-hygiene (HH) taking into account particular focus group discussions to explore the healthcare workers' wide-ranging barriers pertaining to HH in Vietnam (Salmon & McLaws, 2015). They mentioned their work overload due to understaffing and mostly insufficient time neglect the areas of HH. Secondly, their difficulties to access sinks and inadequate hand-sanitizing systems and above complicated hospital guidelines pertaining to hygiene further increased the intricacies (Salmon & McLaws, 2015).Due to the unavailability of adequate and proper compliance, visitors never performed HH thereby increasing the infection risks remarkably. The study also revealed the occupancy of dual bed in addition to the limited hygiene resources in Vietnam.

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Significance to nursing

Staff nurses, ingeneral, have better compliances as compared to the doctors (Wetzker et al., 2016). Hence, this study would be of some relevance because their personal hygiene impactsthe hospitalized patient's health. Also, this study will provide other hospitals and nurses with an utmost opportunity to implement the recommended practices of education programs to obtain better HH-related compliances in the near future (Marques et al., 2017).

Objective

The primary aim of this shred of the study was to ascertain the varied perceptions of nurses pertaining to their reasons behind the notable low rates of HH-related compliances along with providing the most probable recommendations to ameliorate the same. In this regard, the implementation of proper guideline accompanied by appropriate education programs for the healthcare workers was highly recommended.

Purpose statement

The critical consequences created by improper nursing compliance on HH might cause detrimental infections and also injuries with the potential of taking a toll on hospitalized patients' lives.

Research question

I.How do nursing practices lead to critical outcomes and how do effective andproper guidelinesregarding such poor rating in the HH compliances?

II. How nursing practices ameliorate following strict adherence to hygiene compliances and how do tailored training and education programs help in achieving the same?

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Qualitative study 2

Summary and problem

The second study dealt with the various safety-based challenges regarding the usage of certain medical equipment in Haiti based on exploratory observation (Santos et al., 2016). It was done to identify certain performance obstacles which provided insight to latent determinants and risk hazards by using Human Factors & Ergonomics (HFE). Performance obstacles correspond to the behavioural pattern of healthcare practitioners including nurse anaesthetists are linked either with system shortcomingsor staff and infrastructure incompatibilities. Existing gaps in Haiti's hospital processes including unhygienic services impact anaesthesia procedure significantly. Their unavailability of concise hygiene policies was also notable.

Significance to nursing

This study is of utmost significance as the personal hygiene of anaesthetist nurses and strict adherence to predefined compliances show their effects on the hospitalized patient's safety.

Objective

This study aims to comprehend the safety aspects with the medical devices and personal hygiene of low-resource based sectors from a typical HFE perspective (Santos et al., 2016). The chief objective of the study is to impeccably assess the varied hospital gapsand performance obstacles during the training period of anaesthetist nurses. Secondly, the training programs emphasized in training multiple registered nurses to transform into nurse anaesthetists and can practice autonomous anaesthesia without the supervision of regular anesthesiologists.

Purpose statement

This study can substantially create nursing awareness and implant certain concrete safety aspects to minimize health hazards in hospitals.

Research question

I. How donursing practices affect safety measures pertaining to human interaction with certain medical equipment?

Discussion on how these two articles will be used to answer the PICOT question

The first study will be most useful to answer the mentioned PICOT question because it concisely mentions about the fact that hygiene needs to be the topmost priority and the prime focus for the nursing-related practices. And pertaining to this, their perceptions of hand-hygiene provides significant awareness among one and all.

The second study aids other healthcare and nursing communities to ameliorate system in anaesthesia service with proper hygiene to enormously ensure patient safety.

Description of how the interventions and comparison groups in the articles are compared to those identified in the PICOT question.
The given PICOT question will be thoroughly addressed following the interventions and comparison groups from both the articles. Both the studies intervention and the prime focus havehygiene based approaches in commonality. Interventions to ameliorate HH practices must inevitably include easy access to HH solutions in spite of infrastructure challenges (Alp and Damani, 2015), proper training on anaesthesia and associated hospital infections.

Study method

Brief description of how they are different

The first study is solely based on the voluntary participation of certain focus groups and thereafter a thematic analysis was categorically conducted (Salmon & McLaws, 2015). The discussion included the usage of masks and HH-related issues separately. To entice participation, minor incentives were also provided. Per focus group-related discussion lasted for nearly one hour.
The second study is a follow-up study in a hospital in Haiti with remote and inadequate ICU and nurse anaesthetists wherein through diligent comparable training the desired skill could be inculcated in them to compensate for their staff shortage.The pieces of training consisted of both theoretical as well as practical sessions. To point the obstacles the SEIPS tool was selected thereafter.
Therefore, the study methods are concrete and different; both implying different uses to the PICOT question.

Stating one benefit and one limitation of each method

The first study used a convenience sample of 12 focus group-based discussionsas conducted with certain healthcare professionals from six public healthcares across Vietnam (Salmon & McLaws, 2015). Such discussions were based on their experiences and above all their perceptions towards hand-hygiene practices. Thematic analysis was performed by two associated investigators and the tape recordings were subsequently translated into English.

Benefit:Focus group-discussions provide the core opportunity to obtain concerned individuals' own perceptions and group feeling. This saves both time and money invested in personal interviews.The benefit of conducting thematic analysis especially in qualitative researches is that impeccably aids to emphasize and examine varied themes within data helping researchers to obtain a detailed description of certain phenomenon pertaining to the research questions.

Limitation:The biggest limitation of focus group discussion is that moderators might inject their own biases leading to inaccurate results (O Nyumba et al., 2018). The thematic analysisfails to provide a researcher with the ground on which he can potentially claim about the usage of the transcribed language.

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Study 2 method

Benefit: The SEIPS model has remarkable flexibility because of its thorough validation and also discrete visual simplicity (Blijleven et al., 2016).

Limitation: This model has vast utility but it does not provide deep insight into the intricacies of a specific work system design. Therefore, patient safety-related information might often get ambiguous (Gray et al., 2015).

Study results

Key findings of study 1

The main finding of the above-mentioned study is the wide-ranging critical medical outcomes as caused by the health care sectors in Vietnam. The major findings were that most of the participants categorically expressed their frustration due to work overload, very poor access to HH-based resource and intricate guidelines that are very complicated to interpret. They mentioned these issues to the sole determinants of non-compliance.

No single participating member acknowledged HH practices to be routinely performed for the admitted patients. In addition, the visitors were not noted performing HH practices as a result of which their non-compliance was appreciably justified.

Key findings of study 2

The key finding is that certain human factors are strongly related to the available equipment that might lead to life-threatening hospital incidents due to delay, inaccuracies or distractions. Also, such errors put safety and hygiene at stake.

Implications of the two studies in nursing practice

Both the studies have the potential to contribute enormously to ameliorate the existing hygiene practices and refining medical equipmentamong the nursing community so that the probable risks of infection and other injuries could be mitigated. Although the second study focuses majorly on ameliorating medical equipment, lack of cleanliness of the equipment again corresponds to unhygienic issues pertaining to patient health.

Ethical Considerations

The researchers of the first study received an ethical license from the National Institute of Hygiene and Epidemiology based in Vietnam and also the New South Wales University from Australia.

The NIHE's ethical sanction was categorically accepted by all the chosen hospitals.

The researchers of study 1, ensured to abide by the ethical considerations by having the consent forms chronologically signed by each participating candidate. Also, to maintain confidentiality, none of the participants' identity was revealed by any means.

Ethical approval from MSF & Health Partners was obtained for the second study.

The researchers of study 2 adhered to the ethics by keeping the patient's identity anonymous. Also, consent was taken from inquired nurses for their observations.

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