Infection Prevention as a Show - a Qualitative Study of Nurses Infection Prevention Behaviors - Article Example

Leadership within the Workplace Leadership within the Workplace Study Identification The article, d Infection prevention as “a show”: A qualitative study of nurses’ infection prevention behaviors is by Carole Jackson, Karen Lowton, and Peter Griffiths. It was published in 2013 in the International Journal of Nursing Studies, and can be located using the DOI http://dx.doi.org/10.1016/j.ijnurstu.2013.07.002. Aims of the Research The aims and objectives of the research are clearly stated in the background section of the paper. The authors argue that while inclination toward forecasting infection prevention concepts and behaviors related to guideline compliance has contributed valuable insight, a study targeted at comprehending and clarifying behaviors that exist in routine practice from the point of view of the participants themselves could hold the key to the obstacles of actualizing behavior change (Jackson, Lowton, & Griffiths, 2013). The authors also state that the article investigated how the infection prevention behaviors of nurses can be described. A qualitative research is suitable for this study because it explores a phenomenon. It is descriptive and explorative in nature, so quantitative research involving data collection and analysis to derive patterns would be inappropriate. Study Design The research question has been clearly defined and focused. In the background section of the paper, the authors state that the research investigated “How can nurses’ infection prevention behavior be explained?” The methods used are suited to the research question because they facilitate dissection and exploration, which lead to attainment of the objectives of the paper. The authors clearly state that the study is “interpretative qualitative” in nature, which justifies the use of vignettes designed from nurses’ views on practice (Jackson, Lowton, & Griffiths, 2013). The vignettes enable investigation of the alleged infection prevention behaviors employed by nurses. Besides the vignettes, the authors developed 20 semi-structured interviews and administered them using vignettes and a subject framework. All the interviews were administered directly (face-to-face) and assessed using the framework technique (Jackson, Lowton, & Griffiths, 2013). The use of interviews is highly appropriate for this research because most of the analyses and conclusions are informed by nurses’ perspectives on practice. Considering the context and aims of this research, interviews are the best technique for data collection (Parahoo, 2014). They can be administered directly to the nurses with a high degree of accuracy and the data analyzed to formulate inferences. In this study, the interviews are structured so that the researchers obtain detailed and accurate information from nurses. Recruitment and Data Collection The researchers have not indicated whether or not they have used sampling to select the participants. However, they have explicitly explained how the participants were selected. The researchers focused on registered nurses practicing in an acute hospital environment and who have been practicing for more than one year (Jackson, Lowton, & Griffiths, 2013). They were selected while undertaking part-time studies at an unnamed London University. The following criteria were used to recruit the participants: a) Practiced for not less than one year. b) Practicing in an acute environment. c) Not registered in a discipline that was, in any way, focused on infection prevention. d) Aged between 24 and 53 years. The researchers indicated that the sample selected was not only convenient but also objective. The researchers have not justified the rationale used to select the participants, although the move to avoid participants studying disciplines that are focused on infection prevention could be explained as a strategy of avoiding bias (Jackson, Lowton, & Griffiths, 2013). In addition, the researchers have not compared the criteria used to select participants with other strategies. This is one of the shortcomings of this paper, because the average reader would not understand why the methods used are more appropriate than other available ones (Cutcliffe & Ward, 2014). Other strategies could be more suited to the context of the study than the ones used, and this could cast doubt on the validity and credibility of the paper, because in any research, the aim should be to use methods that guarantee the greatest accuracy, validity, and credibility. Failure to this may dilute the authority of the study and make it irrelevant. The researchers have not clarified why some respondents were not selected for the study, or whether or not some respondents refused to participate. The researchers selected only registered nurses who had worked for not less than one year in an acute hospital setting (Jackson, Lowton, & Griffiths, 2013). This is justified because the research focused on nurses’ infection prevention behaviors. Registered nurses are qualified to provide care in a variety of healthcare settings, so they have a better theoretical and practical understanding of infection prevention and can make a greater contribution to the research (Maltby, Williams, Day, & McGarry, 2014). In addition, the researchers’ decision to limit the nurses’ experience to at least a year in acute hospital settings is strategic for two reasons. First, the study is on infection prevention, which often falls in acute settings. Secondly, an experience of at least one year means the selected nurses have a good comprehension of the subject matter and the dynamics involved in the research. A sample size of 20 participants may have been sufficient in the researchers’ view, but it is not adequate from an external perspective (Haber & LoBiondo-Wood, 2014). At least 50 participants should have been selected to increase the validity, reliability, and credibility of the study. In addition, the 20 participants were selected from one University. It would have been more practical and rational to select respondents from different institutions in order to lend uniformity to the research. From a strictly professional view, 20 participants from one locale is not enough to lead to inferences on a topic as variegated as the one selected by the researchers. Data was collected using 20 semi-structured interviews that were directly administered to each of the 20 respondents selected for the study (Jackson, Lowton, & Griffiths, 2013). It is important to clarify that semi-structured interviews were the only data collection method used in this study. The researchers have not justified the use of semi-structured interviews in the study. They have simply stated that they will use this method and then proceeded to explain the procedures used to administer and then analyze the data collected using the interviews. The researchers have been explicit in explaining the processes involved in administering the interviews (Jackson, Lowton, & Griffiths, 2013). For example, they have explained that interviews were done over a period of 14 months. Each interview lasted between 30 and 45 minutes, and the 20 interviews were divided into 2 phases. The first phase involved interviewing 8 respondents using a topic guide designed from academic sources. The topic guide involved revolved around 3 concepts: perception of exposure and contagion in the hospital environment; issues associated with transmission of diseases to friends and family with measures adopted to avoid this; and whether measures were relevant and effective (Jackson, Lowton, & Griffiths, 2013). In the first phase, participants were asked questions and two vignettes were designed to symbolize observed routines. The researchers audio taped and administered in written form. In the second phase, the 2 vignettes designed in the first stage were used alongside the topic guides to develop justifications for the behaviors from the other 12 respondents. Methods were not modified during the study, so the researchers did not have to clarify how and why any modifications to the methods were done (Jackson, Lowton, & Griffiths, 2013). The study does not clearly explain the roles of the researchers. In fact, only one researcher is revealed to have carried out the administration of interviews; the other two researchers’ responsibilities are not indicated. The research was conducted by Carole Jackson, Karen Lowton, and Peter Griffiths. However, it is not indicated how they were selected to carry out the study (Jackson, Lowton, & Griffiths, 2013). The only attribute associated with the researchers’ skills is their professional/academic qualifications and affiliations. The first researcher (Carole Jackson) is a DHC (doctor of health care) with affiliation to King’s College London. The second researcher (Karen Lowton) is a PhD holder who is also affiliated to King’s College London. The third researcher (Peter Griffiths) is also a PhD holder with affiliation to the University of Southampton (Jackson, Lowton, & Griffiths, 2013). The researchers have not discussed their own responsibilities, likely partiality and influence during the construction of the research question, data collection, and selection of respondents. Interestingly, the study addresses ethical issues in a very minimalist and inadequate manner. For a study of this magnitude and nature, failure to comprehensively address ethical concerns represents a major flaw that affects the credibility and reliability of the study (Gordon, 2014). The only ethical subject mentioned is the fact that the researchers were given ethical approval by King’s College London to recruit participants and conduct the study within the institution (Jackson, Lowton, & Griffiths, 2013). There is no mention of how the study was explained to respondents, no details of the type of consent procedures employed and how consent was acquired, and no indication of how privacy and confidentiality were guaranteed. Data Analysis Since this is a qualitative research and the nature of the paper is strictly exploratory and descriptive, data analysis is virtually nonexistent. The researchers focused on collecting the views of respondents rather than going into statistical aspects like frequencies, means, and standard deviations (Jackson, Lowton, & Griffiths, 2013). The analysis section is inclined toward evaluation of the opinions collected from participants. However, the researchers have identified the analytical theme (rationalizing dirt-related behavior) in advance; they have not waited to derive them from the findings (Jackson, Lowton, & Griffiths, 2013). All the responses are considered during the analysis and compared and contrasted across various contexts. The researchers have not discussed their own responsibilities, likely partiality and influence during evaluation and selection of data for presentation. Findings/Interpretation The findings/interpretation section is the most compelling, comprehensive, and influential part of this study. The researchers cover all the angles expected of this section, from analysis to reflection. The findings are obtained from assessment of gather data instead of the researcher’s assumptions. The findings are discussed and evaluated in great detail, making it extremely convenient for the average reader to understand the results and their interpretations (Jackson, Lowton, & Griffiths, 2013). The one shortcoming in this section is that the researchers have not critically assessed the quality of the responses obtained and the skills of the researchers to a satisfactory level. The findings are relevant to the aims of the study, and the researchers have included an explanation of how the study contributes new perspectives and knowledge in the discipline. Implications of the Research The study includes a short but relevant and precise discussion of the implications it could have on current and future investigations. The researchers state that the future studies should consider that nurses’ behaviors must first be acknowledged and by those exhibiting it (nurses) before they can be altered (Jackson, Lowton, & Griffiths, 2013). The behaviors also demand multifaceted remedies which current strategies and guidance do not comprehensively provide. Finally, the study shows that reflection on the practices developed by healthcare workers to reduce self-risk could be a progressive way of deriving self-awareness and knowledge from ordeals. Reflective activities or clinical oversight initiatives would enable healthcare professionals to, firstly, voice their fears concerning infection and poor sanitation before contemplating whether their own conduct fulfils the strategic requirements or is actually not informed by the scientific rationale (Jackson, Lowton, & Griffiths, 2013). The findings are situated in both local and wider contexts and have been availed to key stakeholders, including respondents. The final aspect of this section is limitations issue. The researchers have discussed all the relevant constraints faced during the study by highlighting and then explaining how exactly they affected the study. The researchers have discussed the weaknesses of the study as part of the limitations, especially the aspect of self-report. Overall Assessment of the Study ++ All or majority of the criteria have been satisfied. Where they have not been satisfied, the inferences of the conclusion are thought very unlikely to change. Conclusion This research is comprehensive, relevant, and precise in various aspects. First, the researchers have shown that they are qualified, capable, and knowledgeable enough in the subject matter to conduct sound research. Second, the researchers have covered all or most of the topics pertaining to the subject, making it very easy for readers to understand the subject and relate to it. Finally, the interpretation/analysis section of the study is very detailed and critical enough to compensate for other deficiencies in the paper. The main flaw of this study is the limited way in which ethics aspect has been covered, which has an adverse impact on the overall credibility of the research. References Cutcliffe, J., & Ward, M. (2014). Critiquing nursing research (4th ed.). London: Andrews UK Limited. Gordon, P. (Ed.). (2014). A guide to educational research (Illustrated ed.). London: Routledge. Haber, J., & LoBiondo-Wood, G. (2014). Nursing research in Canada: Methods and critical appraisal for evidence-based practice (8th ed.). Toronto: Elsevier Health Sciences. Jackson, C., Lowton, K., & Griffiths, P. (2013). Infection prevention as “a show”: A qualitative study of nurses’ infection prevention behaviors. International Journal of Nursing Studies, 51(3), 400-408. Maltby, J., Williams, G., Day, L., & McGarry, J. (2014). Research methods for nursing and healthcare. Harlow, England: Routledge. Parahoo, K. (2014). Nursing research: Principles, process, and issues (Revised ed.). Basingstoke: Palgrave Macmillan. Read More