Introduction
Nursing research conduction is considered to be a scientific process refining and validating existing knowledge and generating new knowledge which provides an impact on nursing practice. The paper “Developing a Research base for Intravenous Peripheral cannula re-sites (DRIP trial). A randomized controlled trial of hospital in-patients” by Joan Webster is devoted to the analysis of intravenous cannulation spreading in modern medicine. The article is complicated research providing nursing findings and practices related to the topic of investigation.
The paper is focused on the investigation of intravenous therapy and its advantages provided to hospitalized patients and medical specialists. The work analysis is conducted through several research methods and nursing approaches reflecting the study of statistical and financial aspects of the issues; it should be noted that the paper is aimed at disclosure of effectiveness intravenous peripheral cannulas used in nursin (Webster, 2007).
Context of the Paper
The title of the paper under analysis identifies the area of the research underlining the centralization of intravenous peripheral cannula re-sites. The authors of the research paper tried to reflect the significance of intravenous therapy practice and its impact on modern nursing development.
The article is aimed at answering the principle question: What are the changes of peripheral venous cannulas in case of being clinically indicated? Are they safe? The article is concentrated on the investigation of frequency in intravenous cannula re-sites. It should be noted that the authors strived to make use of evidence-based practice involving the knowledge of general intravenous statistics expressing it through particular measures.
Research Method
The researchers managed to use such design as a randomized controlled trial which is frequently used in health technologies testing and analysis of healthcare service effectiveness (Davies & Logan, 2008). It is necessary to underline the fact that the trial appeared to be controversial due to its contravention to established guidelines; as a result, the research covered some restrictions; patients with bloodstream infections and those being treated through immunosuppressive methods were completely excluded. The chosen design allowed standardization of insertion methods and close monitoring of sites.
In the process of study, the control intervention group had re-located peripheral venous catheter every 3 days. There was the person of IV Unit who bore responsibility for insertion of initial and replaced catheters. Various risk factors, as well as demographic ones, were thoroughly collected; besides, the researchers used an irritability scale that contained the information about the patients receiving medications. It is necessary to stress that the members of the control group were monitored for the whole infusion period.
The collection of the data for the research was based upon the following factors: statistical nursing studies conducted in Brisbane, Australia; scores being received from patients’ additive; results from monitoring the participants; risk factors of the particular set of investigation. In the formation of research findings the authors managed to stick to the following hypothesis:
- The control group will have greater IV cannulation cost than the intervention group;
- Control group will experience more unplanned cannula re-sites than the intervention members.
External Validity
The participants of the study appeared to be 206 hospitalized patients being related to medical, orthopedic and surgical wards. All of them were treated in Brisbane referral hospital.
The sample size was focused on 40% rate within unplanned cannula removals; the calculations have shown that 105-sample size is to undergo 50% reduction as to primary outcome measures.
The control group consisted of 103 patients; the same number of patients was in the intervention group. The difference between control and intervention groups lied in the fact that control group members had relocated venous catheters every 3 days to a different site, while the patients of the intervention group had re-sited peripheral venous catheters in case of where clinically indicated. The allocation of the group members can be considered as an appropriate one; it was conducted taking into account medical findings of every individual for the researchers to form necessary groups for indication of exact results of the study. Initial outcomes of the study have shown that about 44,6% of members of the intervention group experienced unplanned cannula removal, while in control group this number was about 39,8%.
It should be noted that the results received from the study being conducted in Brisbane, Australia can be generalized for its usage in other settings. The research appeared to reflect standard practice and methods in comparison of intravenous peripheral cannulas’ effects through the involvement of prospective randomized design. Outcomes appeared to be similar in both groups though indicated various effects of the patients because of such factors as cannula leakage, infiltration, pain, occlusion, local infection and accidental removal being referred to unplanned cannula removal.
Internal Validity
The concept of validity can be characterized by premises relationship to conclusion within deductive argument; it should be noted that in medical research practice this method is determined by the following aspects: general knowledge of assessment topic, substantive aspect, structure scoring models, external factors involvement, consequential aspects and usage of generalizability assessments. The research conducted reflects the concept of validity through construct-related validity evidence demonstrating inter-related factors analysis (Borbasi & Langford, 2007).
The article does not demonstrate the concept of reliability which is based upon the description of failure probability. It should be noted that this concept is widely used in industrial assessments and social science reflecting the aspect of products quality. The paper under analysis is based on valid data and tested results; the concept of probability is excluded. (Burns, & Grove, 2004)
The participants and the researchers were blinded into the study process as was shown through study methodologies used in practice.
Results
The analysis of control and intervention groups study has shown differences in their outcomes and effects. The intervention group showed the results of 46 patients having unplanned removals; in the control group, this number was about 41 patients. Nevertheless the secondary outcomes concerning cannula replacements cost analysis completely differed between the groups:
- Intervention group – AUD $3,183,62
- Control group – AUD $3,837,56
The article is concentrated on the method of qualitative research; the authors preserved the systematic collection of the information and demonstrated analysis of subjective narrative materials involving the practices of researcher-imposed control. Besides, the usage of randomized controlled trials allowed stabilizing and standardizing methods and issues selected for the research conduction.
The research article devoted to the intravenous peripheral cannula re-sites called “Developing a Research base for Intravenous Peripheral cannula re-sites (DRIP trial). A randomized controlled trial of hospital in-patients” can become an integral part of clinical practices and should be used in true statistics. Even though several patients could not participate in the study, the outcomes received from the testament appeared to be effective.
Conclusion
Researchers used appropriate methods and designs which allowed them to stick to standard nursing approaches which are widely promoted in research making. It was found out that frequent re-sites contain a majestic cost component leading to possible venous access difficulties. The paper managed to reflect the adverse outcome risk being unaffected in case re-sited cannulas by clinical parameters; it showed the possibility of increased cost savings under the circumstances of re-sited cannulas when clinically indicated.
References
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- Webster, J., Hopkins, T. & Lloyd, S. (2007). Developing a Research base for Intravenous Peripheral cannula re-sites (DRIP trial). A randomized controlled trial of hospital in-patients. International Journal of Nursing Studies.