Pin Care Critique Paper

Research Article Critique Paper Vincent J Ramirez University of Phoenix Evidence-Based Nursing Research and Practice NUR/443 Lois Ramer DNSc, FNP February 15, 2009 Research Article Critique Paper The purpose of this paper is to critique a research article; “an intellectual research critique is a careful, complete examination of a study to judge its strengths, weaknesses, logical links, meaning, and significance,” (Burns & Grove, 2007, p. 445). The selected article may be a qualitative or quantitative study from a peer- reviewed nursing journal. This article was selected by this writer earlier in the course.

The critique process for this article will cover steps learned during this course. A Quantitative Research The research article “Multicenter Pin Care Study,” is a quantitative research study, “quantitative research is a formal, objective, systematic process in which numerical data are used to obtain information about the world,”(Burns & Grove, 2007, p. 17). In this study it was determined that using half-strength peroxide cleansing and Xeroform wraps were the best methods of treatment reducing the risk of infections associated with external fixation devices .

Comprehension phase The major sections of the article were clearly identified throughout the report. The literature review, framework, methods, results, and discussion were in bold heading making that section easy to find. The terms and word usage are understandable and therefore, kept my interest throughout my reading. Abstract The abstract was clear and concise; it gave an overview of the study. In the abstract the background, methods, results, and conclusion were short and informative. It enabled me to gain knowledge before reviewing the research study. Problem and purpose

The problem identified in the study is the “lack of evidence for one protocol as the most efficacious for preventing pin-site reaction/infection,” (Patterson, 2005, ¶ 10). The information read stated that no set guidelines have been established and that many doctors and nurses have their own ideal way of managing external fixation devices . The purpose of the study was to determine the incidence of pin-site infection according to cleansing protocol. This information was stated in the abstract and re-established in the review of literature. Literature review

The study presented a moderate amount of relevant studies the author addresses in the literature. Of the previous studies mentioned the references and cites are peers who have conducted similar researches within a five to 10 year range of this article. Models or theories are not included in the literature review and throughout the article. The summary indicates that the need for further evaluation is still an ongoing process. With the current data collected the author is striving to create a form that can be used and therefore, initiate a long-term research on effective pin-care studies.

Framework of study In this article the framework needed to be extracted from the literature review it was not explicitly expressed. Theories or models are not so defined in the study, but the concept of mechanisms of infection control in patients with external fixations was conceptualized because the study directed the reader what was being researched to prevent infections in patients with external pins. Ojectives, questions, hypothesis The objectives were clearly not biased, real, and reachable.

The question, what are the best methods currently used to decrease pin-care infections is congruent with the hypothesis, half strength peroxide and Xeroform dressing are more effective than soap and water cleansing. The research studied all methods and compared the results of all seven treatments being tested and showed no bias for one treatment over another. Variables The independent variables in the study were identified as the pin-care protocols the varied cleansing agent and the type of dressing used. The dependent variable is identified as the infection rate in the study.

Infections rates were tallied for each treatment methods. Demographic variables The study was conducted at two hospitals, a children’s hospital in central U. S. an orthopedic/trauma unit and a pediatric unit at a trauma hospital in New England. The demographics were diverse, adults and children made up the population however, the sample had twice as many men as women. Each of the participants had an average of six pins. The study did exam the locations for environmental contributions regarding infections. Research design “The study randomly assigned patients to seven groups,” (Patterson, 2005, p. 1).

Each of the groups received one out of the seven treatments for managing pin-care wounds. The treatments were defined by the use of half strength peroxide and Xeroform dressing wraps, saline cleansing and gauze wraps, and anti-bacterial soap and water cleansing and gauze. Sample description Approval for this study was obtained from each of the study settings institutional review board. Out of 108 participants, only 101 consented, participation rate of 90%. The study took place at two hospitals as earlier described in this paper. All patients had pin placements within one week before the study began.

Measurement strategies The author of the article labeled the conductors of each measurement as the primary investigator (PI) or site coordinator (SI) who was responsible for each measured step. The type of measurement strategy used was a visual analogue scale, questionnaire, observation. “The rating scale was adapted with permission from a tool used at Children’s Mercy Hospital, Kansas City, MO,” (Patterson, 2005, p. 357). A nominal measurement tool was used in the study. The form used in Children’s Mercy Hospital previous studies was reviewed by a five certified nurse expert group and demonstrated content alidity. Data collection A randomized packet containing the type of treatments to be used for post operative care, protocol one through seven were kept in the post recovery surgical unit and the face sheet of the protocol placed in the patient’s chart. Each member of the study team was assigned to gather the data for each step of the process. A member was also assigned to collect data from patients who had been discharged home. A one way ANOVA using a Tukey HSD post-hoc test presented a significant decrease infection rate using half strength peroxide and Xeroform group (p> . 05). Findings

The study did reveal that half strength peroxide and Xeroform dressing did reduce infections in pin-site care. The findings were consistent with previous studies mentioned in the literature. The limitations were stated that because of financial restrictions the group study could have been larger than this study’s’ group. The researcher gave a general conclusion of the results and what could have been better in the study. He also stated that this work has laid the ground for future studies. Comparison and Analysis The problem, infections in external fixation devices is relevant to nursing.

Nurses are at the bedside and manage the treatments that are rendered to the patients. Infections signs and symptoms are also monitored in wound care. Nurse’s implement evidence based protocols throughout their practice. The problem is focused and remains realistic throughout the study. Literature review The literature review is organized; it promotes the progression of new ideas throughout the study. The theory, that no true protocol for pin care has been established at the beginning of the research laying ground for the problem and purpose of the study.

It also provided good reasons for this study to be conducted. Study framework The overall framework was organized and clear, it linked itself to the nursing body of knowledge and it clearly demonstrated that nurses are a strong source of knowledge for this study. This framework worked well for this research and I do not think another approach would be better. Variables, design, population The variables are clearly defined and are concise based from previous research studies. The variables reflect the concept of the study as well. The design for the study met all standards and I believe it directed the study.

No real threat was defined in this study except for the financial restrictions discussed earlier in the article. The population was a randomized selected group with excellent inclusion and exclusions to create a focused study. The participants were divided into seven groups and treated with one of the seven protocols. Measurements The tools designed for the study were clear and organized. No signs of bias are noticed with the tools used. Questionnaires, pin care forms, and observational methods is what the author of this study used to determine the rate of infections.

Data collection The data collectors were assigned to certain steps in the study; no training data for the observers was mentioned prior to the study. All data was collected in an ethical manner. The participant’s privacy was respected. Data analysis The article had adequate tables and charts to make data analysis more visible and clear. The data analysis addressed the question, hypothesis, and objective clearly. When the study was completed the data analysis was considerably clear, the results were presented in an organized fashion. Interpretation of findings

It was clear that the protocol of half strength peroxide and Xeroform dressings decreased the infection rate of pin sites. The findings support the objective, question, and hypothesis related to infections in pin care. Evaluation The pin-care study demonstrated the need for a set protocol in treating patients with these external fixation devices. It demonstrated the need for nurses to be part of the treatment and testing process. I believe this study has significant potential for nurses to perform studies in the management of pin-care.

This study was linked very well to previous studies performed in the past. The findings prove that half strength peroxide and Xeroform dressing wraps are an effective treatment in the reduction of infections in pin care. Theses findings may be beneficial to patients requiring external fixation devices. References Burns, N. , & Grove, S. K. (2007). Understanding nursing research (4th. ed. ). Philadelphia, PA: Elsevier Saunders. Patterson, M. M. (2005). Multicenter Pin Care Study. Retrieved January 28, 2009, from http://swtuop. museglobal. com/muse/servlet/MusePeer