The following assignment will review a chosen piece of nursing research and reflect on how it could have an impact on practice. According to Polit & Beck (2004), the aim of critically appraising an article is ‘an attempt to determine its strengths and limitations.’ The chosen article is titled ‘Effects of changing needles prior to administering heparin subcutaneously.’ The reason for the choice of this particular article was the belief that it would enhance the knowledge of heparin and the administration of this medication, which is of an area of interest to the reader.
It can be seen in the self-assessment and action plan (appendix 1) that the administration of subcutaneous injections is an area that was felt needed to be looked at due to not using this particular skill for some time. The article was also felt to be relevant to practice as it was of a recent nature and was also based on a skill that is used daily in nursing. The Oxford Dictionary of Nursing defines heparin as ‘a prevention of blood coagulation, and a ‘prevention of deep-vein thrombosis following surgery.’
The article is of a quantitative approach, this is described by Burns & Grove (1997) as ‘a formal, objective, systemic process in which numerical data are utilised to obtain information.’ In order to effectively critique, guidelines produced by Bennett (2001) will be followed (appendices 2). This will assist in producing an organised sub headed piece of work. Background The research was published in the Journal of Acute and Critical Care, volume 29(1), January/February 2000.
This illustrates that it is relevantly recent and is not dated which could have posed questions regarding validity and the reliability. The study was carried out in Pittsburgh, Pennsylvania and was carried out by Lori Klingman who is a registered nurse. This suggests that the researcher does have a relevant and necessary academical background. The purpose of the study is to determine if changing needles before administering subcutaneous heparin would cause less ecchymosis at the injection site.
Medterms.com defines ecchymosis as ‘the skin discoloration caused by the escape of blood into the tissues from ruptured blood vessels.’ The researcher hypothesized that changing the needle before injecting heparin into a patient’s abdominal skin would produce fewer and smaller ecchymotic areas when observed 48 hours after the procedure. Literature review Clifford (1997), states that there are two main purposes of a literature review, ‘Firstly, to identify the need to undertake the research in the first instance ad secondly to inform the researcher about potential designs that could be adopted.’
It was difficult to identify where the literature review was included as it was not given a designated section. On reading through the research it can be seen that it is contained within different sections of the research, the majority of it being within the introduction. Abbot & Sapsford (1998) recognise that ‘the introduction may include the literature review.’ Due to the article being published in 2000, it is expected that the literature used will be relevantly recent.
From reading the reference list of the article, it can be seen that this is the case and only one reference before 1990 has been used. It was also felt that the references used were relevant to the subject of the research. The literature did appear accurate and when necessary, the reader found easy access to the references using the information provided by the researcher. The researcher does state that there are only a few published studies that have evaluated the various techniques for the subcutaneous administration of heparin, therefore the objective was to validate the practice of changing needles before this procedure.
The researcher has included published recommendations for the administration of subcutaneous heparin with various literature being referred to throughout. This provided valuable knowledge regarding the administration of heparin. Study aim According to Clifford (1997) ‘the starting point for correlational and experimental research is to formulate an hypothesis.’ The researcher has clearly formed an hypothesis which is included at the beginning of the article.
In addition to the hypothesis, the aim of the study is also clearly stated in the abstract. The aim of the stud is described as ‘determining if changing needles before administering subcutaneous heparin would cause less ecchymosis at the injection site.’ Robertson (1994) suggests that ‘the research problem is normally expressed as a formal question using either the present or future tense.’ On reading this article this feature was noted, the question posed was ‘is changing needles before the subcutaneous administration of low-dose heparin a valid nursing. action that decreases ecchymoses at the injection site?’
Overall, the aim of the study was easy to understand which provided the reader with an expectation of what the research would contain. However, it was felt that a definition of ecchymosis could have been given so as to eliminate any confusion of this term. Study design The design of the study is clearly pointed out as being quantitative. According to Polit & Beck (2004), ‘the research design of a study spells out the basic strategies that researchers adopt to develop evidence that is accurate and interpretable.’