Research Problem and Purpose
The study problem and purpose can be easily identified in the article by Briscoe et al. simply by looking at the title of their work. Researchers are raising the issue of the high cost and frequency of hospital post-discharge readmissions of patients with kidney failure that entities within the healthcare industry are currently experiencing (Briscoe et al., 2018). The problem that the authors identified and formulated is relevant as it relates directly to nephrology nursing and the basic working procedures of Registered Nurses. They hope that their unique nursing procedure will reduce readmissions, improve the quality of post-discharge care, and lower hospital costs.
Literature Review
Unfortunately, Briscoe et al. do not provide readers with a literature review. Zero information is given in the body of the article about the sources whose data were used. However, Briscoe et al. (2018) describe the nursing-related medical concepts and theoretical models they applied in designing and implementing their interventions, such as the Chronic Care Model, chronic care management, disease, and case management. More than half of all references to their articles are outdated, even for 2018. Only one is current, and two were written during the last decade (Briscoe et al., 2018). These sources were used to develop a unique questionnaire and follow-up protocol. As noted above, there is no literature review, but the order in which papers were incorporated into this work supports academics’ flow of ideas.
Study Framework
At the beginning of the framework section, writers explicitly present their theoretical model, the Chronic Care Model. According to the authors, this conceptual framework was chosen because it covers topics such as chronically ill patients, their relationships with health care providers, and the quality of techniques of nursing care (Briscoe et al., 2018). Briscoe et al. (2018) also note that it provides tools for upgrading healthcare workers’ work practices and developing self-management behavior in patients. The researchers do not give any visual data regarding the Chronic Care Model but devote three paragraphs detailing the linkage between the central concepts in their paper.
Research Objectives, Questions, or Hypotheses
Although there is no separate section for a hypothesis in the article, researchers present it at the very beginning of their paper. Briscoe et al. (2018) argue that “evidence-based quality initiatives that enhance coaching, provide education, and provide support for patient self-management may improve the health-related quality of life (HRQOL) for patients with chronic illnesses like ESRD” (p. 243). Their main objective is to test one such initiative to see if it positively impacts patients and nursing practices (Briscoe et al., 2018). Good patient outcomes mean less need for additional care and lower costs for healthcare organizations. As one can see, the logical connection and consistency between the objective and the purpose of the study are observed.
Variables
After-discharge telephone follow-up procedure is the independent variable in this study, and the percentages of emergency department admissions and readmissions within 30 days are dependent ones (Briscoe et al., 2018). These variables were formulated based on data from Boutwell et al., mentioned in the references section.
Design
It can be said that Briscoe et al. (2018) used a quasi-experimental research design because the authors focus on investigating the causal links between caring practice and medical indicators. This design is the most fitting one because the authors needed to conduct an experimental intervention in a specific population, and this design model provides a framework for doing so. They wanted results from a real-world setting that experimental research design couldn’t offer.
Sample, Population, and Setting
Researchers devote two separate paragraphs to describe the inclusion and exclusion criteria. Briscoe et al. (2018) clarify that they used the convenience sample. This sampling method fits their paper ideally since the researchers needed to quickly gather respondents with whom it would be easy to contact in the future. The lack of variety in hospital settings is the paper’s single bias. The researchers argue that their intervention’s theoretical and practical parts were evaluated and approved several times by different medical professionals (Briscoe et al., 2018). Moreover, each patient received instructions before conducting telephone follow-up calls (Briscoe et al., 2018). They also note that they did not have access to the personal data of their target population, so their privacy and anonymity are respected.
Scales and Questionnaires
Briscoe et al. (2018) have noted on several occasions that their main unique measuring instrument is “the Post-Discharge Questionnaire” (p. 245). Others include “Offering Discharge Support Handout,” “Renal Unit Discharge Follow-up Questionnaire,” and “Renal Unit Patient Triage Algorithm” (p. 245). Unfortunately, researchers only provide tables with results but not sample forms. They establish the validity of their instruments by claiming that they were created with the input of experts in nephrology (Briscoe et al., 2018). The authors also mention that medical experts have carefully analyzed these measurement instruments. Therefore, their use for collecting and interpreting data is acceptable.
Data Collection
Briscoe et al. (2018) argue that the information was collected with the help of nephrology nurses who made phone calls to the target population. This way of data gathering is ideally suited to their research, as it is also part of the intervention and their future unique nursing practice.
Data Analyses
A retrospective group analysis is the researchers’ analytical approach in this academic paper (Briscoe et al., 2018). This method is effective for analyzing causal relationships. Therefore, it suits the research design of this work. Descriptive statistics are the way Briscoe et al. (2018) have approached the interpretation of the collected information. They chose this technique to identify and measure variation, which was one of their primary goals.
Interpretation of Findings
Briscoe et al. successfully proved their hypothesis regarding the benefits of quality after-discharge care and achieved the expected positive results. Nothing abnormal was found in the results, and every major and minor finding was described. After the limitations paragraph, Briscoe et al. (2018) discuss that findings and promising but broader research are needed on this topic.
Evaluation
Briscoe et al. (2018) do not mention any of their previous research. The reliability of their data raises doubts since not enough information was presented about the questionnaire itself and its development process. Although their research has confirmed that quality after-discharge care reduces readmissions, a larger sample and more settings are needed to apply their method in practice.
Reference
Briscoe, G. T., Heerschap, A., Kane, C. F., & Quatrara, B. D. (2018). Using post-discharge telephone follow-up by nephrology nurses to reduce 30-day readmissions and post-discharge complications for adult patients on hemodialysis. Nephrology Nursing Journal, 45(3), 243-267.