Nursing Roles and Strategies in End-of-Life Decision-Making in Acute Care

Research Design

The problem is clinically significant and relevant to the nursing profession. The main focus of the study is to determine the strategies required to improve end-of-Life decision making strategies. Thus, it is an important research question that requires immediate answers. Nevertheless, the purpose of the research was not narrowed down and simplified for easier verification. As a result, there was no establishment of clear protocols in order to efficiently measure the variables. On the other hand, the results of the literature review provided a clear direction for the study. At this point, it has been made clear that the main purpose of the study was to find out the evolution of the roles of nurses when it comes to EOL decision making processes.

The article did not provide a clear discussion of the objectives, questions, and hypotheses that are relevant to the study. At the end, the article seemed like a preliminary investigation as to the role of nurses when it comes to EOL decision making processes. There was no hypothesis with regards to the current role of nurses, especially in the context of EOL decisions.

Since there was no clear set of objectives, and the hypothesis of the study was not made clear, there were no specific directives with regards to data collection strategies. The proponents of the study failed to identify the sample population and setting. The proponents of the study attempted to find answers based on the review of literature alone.

Measurements and Observation

The proponents of the study failed to describe the measurement method. In order to find out the role that nurses play in EOL decision making strategies, they were expected to observe nurses interacting with patients and other health care professionals. They were expected to conduct interviews. They were expected to collate information by interviewing family members, hospital administrators, nurses, and physicians. They were expected to find out how different stakeholders perceive the role of nurses in EOL decision making processes. There was no evidence to show that these actions were undertaken.

In this particular case, the proponents of the study did not identify their target group, and they did not interview people. Thus, there was no information given when it comes to scales and questionnaires. As a result, there was no discussion on how the measurement techniques were developed. However, the proponents of the study made comments on the questionnaires that were used in another study. The comments made were based on information that was gleaned from the analysis of selected literature.

There was no discussion when it comes to the techniques for recording observation. Thus, there was no discussion when it comes to the reliability of the data gathered through this method. There was also no evidence to show that the proponents of the study examined the accuracy, precision, and error of the physiological instruments. Nevertheless, the proponent of the study made a commentary regarding the weakness of one particular research design. In that particular study, the researchers generated information by interviewing the nursing staff. The strategy was flawed, because the researchers were supposed to interview family members to corroborate the statements made by the nurses.

There was no discussion with regards to the training of the data collectors, because the researchers were never sent to the field to gather pertinent information. They did not observe nurses in a real-life setting. They did not interview family members going through an EOL type of dilemma. As a result, it was impossible to determine if the data collection methods were ethical or not.

Analysis and Interpretation

The analysis of the data was done in an indirect manner. In the first place, there was no raw data that the researchers were able to collect and interpret. They relied on the research findings of other research teams. Thus, the second hand information gleaned from different sources became the framework for the analysis of data about the role of nurses in the context of EOL decision making strategies. Since the data came from a literature review, it can be argued that the data analysis procedures were appropriate. In this particular case, the proponents of the study utilized the table format and a flow diagram to highlight the significance of the information that was collected. In the flow diagram, the proponents of the study were able to point out how they filtered out unnecessary or inappropriate sources of information. They also utilized the table format to identify the three major roles that nurses have to play when it comes to EOL decision-making processes. The three major roles they play are listed as follows: 1) Information brokers; 2) Supporters; and 3) Engaged advocates in EOL decision making (Adams, Bailey, Anderson, & Docherty, 2011).

The proponents of the study were able to determine the significant findings of the research process. They also pointed out the limitations of the research design, because it was not clear if the family members welcome the participation of the nurses. They needed to examine other sources of data in order to confirm the assumption that family members need the help of nurses. At this point in time, nurses are seen as unreliable sources of information when it comes to EOL decision-making processes. Nevertheless, the review of literature highlighted the fact that nurses can help facilitate the flow of information.

Reference

Adams, J., Bailey, D., Anderson, R., & Docherty, S. (2011). Nursing roles and strategies in end-of-life decision making in acute care: A systematic review of the literature. Nursing Research and Practice, 1(2), 1-15.