The article of Carey, Courtenay, James, Hills, and Roland discusses the influence of a diabetes specialist nurse (DSN) prescriber on the duration of a patient’s stay and their general state. The study’s importance is proved by its background, which suggests that “drug errors in diabetes care are a common cause of significant morbidity and complications” (Carey, 2007). Thus, the authors suggest that nurse prescribing be a solution for the problem. Analyzing the elaborated literature, the authors defined the major problems in the sphere of diabetes patients’ care, such as inefficient procedures, lack of information about the patients, wrong dosage, etc. (Carey, 2007). An evident need to find a way to avoid the mentioned errors served as the motivation for the research. In addition, at the beginning of the research, the authors explain the theoretical grounds related to the topic, which means that the study was oriented toward the general reading public. Specifically, the authors defined and explained the notion of medication errors and their classification, and supported it with relevant statistical data. Therefore, the study can be considered as theoretically contending.
The objective of the study was to define, whether OHA MEs, insulin, and LOS are reduced in case of DSN treatment. The research question is presented at the very beginning of the article and serves as a solid basis for the study. The author’s thesis enables the reader to understand the authors’ position right away. Namely, it states that “nurse prescribing […] creates a new opportunity for nurses to provide care designed to have a positive effect on the system for prescribing and administering insulin and or insulin and oral hypoglycemic agent” (Carey, 2007). In addition, the authors acknowledge, that there are other points of view, which may contradict their argument. This proves the objective nature of their approach to the study. Moreover, the authors present a logical connection between their motivation for the study, the research questions, the theory, the data collected and the findings of the study. Indeed, the mentioned motivation corresponds to the research questions, which are intended to get to know if they use of DSN reduces the level of LOS and insulin inpatients (Carey, 2007). Similarly, the findings answer the research questions.
The flow of the study
The research design suggests that the study was made on the basis of quasi-experiment, based on the quantitative research method. The form of quasi-experiment allowed the researchers to gather the information in the long run, which meant the reliability of results. The authors used six surgical and medical wards in a UK hospital for eight months for their study. A quantitative approach is the most suitable for the topic of the research, as it allows deriving statistical data, which can answer the research questions. This proves that the authors achieved methodological congruence. The sampling was made appropriate, as the studied subjects were united by one problem (diabetes) and were undergoing the same treatment, which consisted of a pre-intervention and intervention phase. However, despite the fact that the sampling was well-prepared, the quantity of 56 patients can be considered as not enough for accurate results. Therefore, one of the drawbacks of the study is the small number of studied subjects. Indeed, analyzing the widespread problem, it is important to study a greater sample, as well as medication errors, which happen rather often. Thus, the results of the study cannot be considered as ultimately reliable.
The findings of the study are not formulated clearly enough. In the “results” section the experiment flow is briefly discussed, but the influence of a diabetes specialist nurse prescriber on patients is not mentioned. This is a considerable drawback, as the readers are likely to lose the track of thought. The perfect variant would be to place the statistical data in this section. The statistics, however, is given in the “main outcome measures” section. The conclusion of the study is clear and unambiguous. All in all, the authors managed to prove the positive effect of the DSN prescriber, showing that in all the cases the level of insulin, as well as the level of LOS, was reduced with the DSN implementation (Carey, 2007). Specifically, the use of the mentioned medication delivery system proved to considerably reduce the level of insulin and OHA MEs in patients. This, in turn, reduced the LOS, which helped the intervention group patients save money. These results validate the author’s initial thesis. Thus, the findings flow logically from the data presented in the research.
It can be stated, that the findings of the study reflect the real situation, as the interdependence of the DSN prescriber and the system of medication delivery had been proved by different scientists. The literature review proves the constituency of the results with those derived from previous studies. However, it should also be noted, that the sampling group had a lot of limitations, such as demographic factor, general health state, etc, which proves that the results of the study can be treated as reliable for this particular group of subjects; however, it cannot be taken as a universal rule, until the other patient groups are studied.
One of the article’s drawbacks is the fact that the authors do not give any directions for further research. This leaves no opportunity for other researchers to continue the study and use the research outcomes in further works. As an ideal option, the pre-conclusive part of the study would address the other researchers, showing them how the presented study can be continued or used in further researches. However, in the analyzed article there is no mentioning of a part of the study that can be developed; the authors also do not give any links to the other research questions that flow from the presented study. In fact, the results of the study can be used by other researchers in the future, as far as the outcomes are valid; however, it is not mentioned in the article.
What is more, the authors failed to define the points of their study’s results, which can be argued by other researchers. Indeed, they did not discuss any option for contradiction or disagreement with their work. This is a negative feature, as it puts under question the authors’ ability to assess their own work objectively. As it is known, similar studies need to define gaps in their own studies or point to their weaknesses, in order to predict the possible confrontation in the future. This is done with the purpose of proving the objectivity of the author. However, in the analyzed research, the weak points were not defined. This disadvantage makes the merit of the study in the research world, namely its applicability by nurses, doubtful.
All in all, the critical analysis of the research article proved that the study has its advantages and drawbacks. For instance, among the work’s strengths are its importance, clearly defined research questions and authors’ thesis, proper research method, logical organization of the study as a whole, analytical preciseness, and valid results. In contrast, among the study’s weaknesses are the absence of directions for further research and a rather limited sampling group. It can be stated that the study’s advantages outweigh its weak points, as far as most of the requirements for the study were met. Indeed, despite minor disadvantages, the research gives an opportunity for the readers to track the author’s flow of thoughts, their motivation, research questions, study design and results. In a conclusion, it can be said, that the study definitely has an academic value, but its presence could have been improved.
American Psychological Association (2001). Publication manual of the American Psychological Association (5th ed). Washington DC: Author.
Burns, N. & Grove, S. (2007) Understanding Nursing Research: Building an evidence- based practice. Philadelphia: Saunders.