Hea00092M Health Research In Practice Assessment Answers

Answer:

Senior nurse practitioners play a significant role in healthcare services across communities since they are dedicated to improving the quality of life of patients. Such professionals work at different care settings that have been put in place to serve the patient population at varying places and at different times of the day as per the convenience of the patients, one of which is  OOH GP services (DiCenso et al., 2014). The NHS, United Kingdom, pledges to serve the community through Out of Hour (OOH) GP Services that is outside the normal time frame of GP practices. The exact time of such services might vary between different healthcare settings, but the common link between such services is that they all aim at providing services in case of an emergency situation threatening the life of the patient. Such a service would include a team of proficient health care professionals working in urgent care centres, primary care centres and other such facilities. The access to such services is easy with options such as telephonic service (Warren et al., 2015).

I work as a senior nurse practitioner for a reputed Out Of Hour (OOH) General Practitioners (GP) service that can be accessed through the 111 telephone service number. The individuals from the community can ring the number for seeking medical attention when the usual GP services are closed at the odd hours of the day. These timings include the evening, bank holidays, night weekends. My role as a nurse practitioner comes into play in this regard in the triage of these patients after they have been put in queues by the individuals handling the call. I am accountable for providing services urgently that includes directing them for emergency cases and booking appointments. In addition, I am also responsible for advising patients to visit local GP depending on the needs after assessing the present problems. As a nurse practitioner involved in an OOH GP service, I am supposed to address different health needs of the patients. One such health concern that I need to address repeatedly is viral illness suffered by children. Viral infections are common among individuals of all ages but are more concentrated among infants and children. The common illnesses that children present include soar throat, viral fever, bronchiolitis, tonsillitis and diarrhoea. These might be mild or severe depending on the immunity of the child. However, there are some serious virus illnesses that need urgent care for avoiding fatal consequences which include measles and pox (Kool et al., 2016). Though most of the viral illness can be treated and managed with appropriate treatment, a number of them are very distinctive and needs a crucial diagnosis before setting up the treatment plan (Forster & Fraser, 2017). Management of viral illness for children is a difficult task since children are more vulnerable to suffer adverse health complications after viral infection. Moreover, children take a longer time to get cured completely. Nurse, therefore, have additional responsibility to care for children presenting with viral illnesses. Previous studies throw light on how children with viral illness are to be managed and treated wherein data have been collected through different methodologies (Hockenberry et al., 2016). As a nurse professional, I perceive it is my duty to research on the best practices that when applied in my practice would help me to care for children gaining help from the OOH services for their viral illnesses. An appropriate research would only ensure that I am able to gather the best evidence and comprehend them appropriately in alignment with my professional goals.  

The present paper aims at developing a relevant and coherent research question that considers the chosen health issue of management of viral illness for child patients attending the OOH GP services. The objective is to highlight the best means by which the selected issue can be best researchered for answering the question.

For gaining valuable information on a research topic, it is necessary to frame a proper research question. Such a question needs to be concise and clear and must have a definite focus which is answerable. The question also needs to be relevant to the practice of the nurse professional in light of the services that are provided in the concerned healthcare setting (Nieswiadomy & Bailey, 2017). The research question that is to be considered for the present research is “How can viral illnesses of children attending OOH GP Services be best managed?” The research question has been crafted for the researcher to learn more about the subject of caring for children suffering from viral illness. The research question has been formed as a fundamental element of the research process and clarity has been maintained while framing it (Parahoo, 2014).

After outlining the research question, one must take the initiative to understand the process by which the research is to be conducted in a stepwise fashion. Looking at the different research paradigms and methodologies and critically analysing each for understanding the applicability of each in the present context is a vital step (Houser, 2016). As opined by Fain (2017) the research methodology is to act as the systematic plan for carrying out a research that might be based on diverse research principles. I must, therefore, choose the appropriate research paradigm that would enable me to organise the available information in a condensed manner into one conceptual and cohesive structure. Research is the best tool for increasing existing knowledge, and there are two basic ways of conducting  research, that is quantitative research and qualitative research. A researcher must critically analyse the two research methods for understanding which one is aligned with the selected research question (LoBiondo-Wood & Haber, 2017). In a qualitative research, the focus is on an exploratory investigation that helps in gaining knowledge of the underlying reasons and real-life conditions for the research question. In contrast, in a quantitative research, the emphasis is on quantifying the manner in which a certain issue is treated using suitable statistics (Houser, 2016). In the present case, it would be necessary to analyse which method among the two would be appropriate for the present research question.

Qualitative research is the form of research in which the researcher can gain valuable insight and understanding of the problem setting (Alligood, 2014). As per the authors, it is the exploratory and unstructured research method studying the highly complex phenomena impossible to be elucidated with quantitative research. Qualitative research further highlights the intentions, motivations, attitudes, experiences and impact related to the event. Quantitative research, on the other hand, relies on the production of numerical data and facts. The aim is to establish the cause and effect relationship between two variables. Statistical, computational and mathematical methods are used for such cases. It is a form of empirical research that can be measured in a precise and accurate manner. In the present context, the aim of the research would be to understand the best practices for managing viral illnesses in child patients which is a phenomenon integrated into care practices. For finding out how patients feel and think after implementation of a treatment plan one must employ qualitative research methodology. In here the qualitative research would enable the researcher to give the complete focus on views and perceptions of the patients after they have been treated (Cope, 2014).

As highlighted by Holloway and Galvin (2016) qualitative research is holistic at its core while quantitative research is fundamentally particularistic. It must be stated that since the aim of the present research is to highlight the holistic consequences of care processes delivered for children with viral illnesses, qualitative research is justified. Moreover, a qualitative research is known to be following a subjective approach instead of the objective approach to quantitative research. The researcher is also actively involved in qualitative research due to the subjective approach. Therefore a qualitative research approach would be appropriate in the present case since this would not enable uninvolevement of a researcher into the study and analysis would be appropriate. This is noteworthy since the involvement of the researcher is crucial for understanding how children with viral illnesses can be best managed. Further, with qualitative research verbal data can be collected, recorded and analysed. The inquiry is also process-oriented. Elements of such research would be based on discovering and exploring ideas as an ongoing process for the care of the targeted patient population.

The design of a particular research study initiates wth the appropriate selection of a topic and the paradigm. Scienticts define a research paradigm as the worldview and framework of values, methods and values within which the proposed research is to take place. It is perception guiding the work of the researchers (Moule et al., 2016). A qualitative study is the inquiry process with the paradigms used for understanding the human problem selected on the basis of building a complex, holistic viewpoint with detailed views of the natural setting. It would be pivotal to analyse the different research paradigms available for qualitative research to understand their applicability in the present context.

DiCenso et al., (2014) clarified the different paradigms that are the theoretical basis of the research studies. These are positivist, constructivist, interpretivist, transformative, emancipatory, critical, pragmatism. In light of the fact that interpretivist researchers are focused on discovering reality through literature search and understanding views and experiences of participants, it would be the suitable research paradigm in the present context. According to Alligood (2014), interpretivism is helpful in understanding the particular context and the underlying belief is that reality is to be perceived as being socially constructed. The researchers suggest that Interpretive research is more subjective than objective. The argument is that interpretivists disdain the inspiration and idea that objective research on human behaviour can be undertaken. On the positive side of the research, paradigm is that research areas such as issues of ethics, analysis of factors influencing patient outcomes can be studied in details. Primary data collected with the help of Interpretivism studies are linked with a high level of validity since the study data is reliable and trustworthy.

Interpretivism paradigm is further classified into philosophies that shape up the study in how the research question is being addressed. These are ethnography, grounded theory and phenomenology. Ethnography is the direct description of the community wherein narrative accounts of respondents are considered. The method would not be suitable in the present context since the aim would be to find the best ways in which child viral illness can be managed. The research is to be carried out in the present setting in which I work (Parahoo, 2014). Grounded theory is a particular approach to research wherein theories and hypothesis emerge for being grounded in the collected data. At the core of grounded theory lies te utilisation of interviews and focus groups as the data collection method. Data analysis is done by substantive coding wherein the empirical data are summarised. The comprehensive literature review is also a part of this certain philosophy that holds prime importance for being an inductive methodology.

Phenomenology has the focus on the interpretation of the experiences of the individuals who are included in the study. It would be interesting to know what other nurses senior to me have to say about the management of viral illnesses for child patients. This particular research philosophy would enable me to gather information on how nurse professionals look into the research topic and act in similar situations. The methodology has appealed to me since I would be bee able to understand how other nurses manage the same conditions that I face. As stated by Fain (2017) descriptive phenomenology would bring into focus the everyday experience for understanding the essential structures of managing health issues. It is an in-detailed explanation of how individuals address situations and how they enact accordingly.

Based on the chosen research paradigms the research methodologies are to be decided upon. It is necessary to critically analyse each of the possible research methodologies before commencing on the research (Cope, 2014). For the present research, it would be pivotal to consider literature review, interviews, focus group discussions and observations as the data collection tools to find which are suitable for alignment with the research question.

Aligned with the research question and selected research paradigm, a comprehensive and precise literature review is to be conducted for the proposed research. The review is to be conducted for bringing into limelight the present set of knowledge inclusive of substantive findings. Methodological and theoretical findings contributing to the selected research topic are to be included in the literature review. Peer-reviewed journal articles are to be searched for retrieving reliable articles discussing management of viral illnesses for children. The literature review needs to be a systematic one in which the objective would be to identify, appraise and synthesise high quality evidence relevant to the question. The search is to be done with a wide range of databases such as PubMed, CINHAL, Scopus and Science Direct. (Houer, 2016). Nieswiadomy and Bailey (2017) highlight the benefit of conducting a litertaure review for finding the answer to a research question. Firstly, the researcher can assess the present state of the research topic. This is the most obvious importance of the review. Secondly, new angles might be found about the research topic that needs further exploration and review. Gaps identified in existing research can be considered for studies in future adding important information in the same context.

In-depth interviews is another data collection method for qualitative study. Since the objective would be to find the perceptions of healthcare professionals as they care for children suffering from viral illnesses, it would be beneficial to carry out interviews with the senior nurse practitioners. Interviews with open-ended questionnaire would be appropriate to generate maximal responses that clearly outline the expressions and viewpoints of the respondents. An open-ended question encourages a complete, meaningful response with the help of the subject's own feelings and knowledge. The advantages of such a method include high response rate, clarification of ambiguities in responses and absence of bias by other respondents. However, interviews can be time-consuming and costly. In addition, different interviewers might transcribe the interviews in a different manner (Parahoo, 2014). Focus group discussions would not be appropriate for the proposed research. Though focus groups are helpful for investigating complex questions, there is a number of disadvantages of focus group discussions. Primarily, there are high chances of irrelevant discussion and disagreements distracting the respondents. The focus might shift from the main research topic. It can be extremely challenging to take control of the discussion. Further, analysis of data might be difficult. Participants might be feeling pressurised to agree with the dominant view (Houser, 2016). Observations are also not suitable for the present research since observational research are too subjective and in the present case is of negligible value. There are also ethical dilemmas associated with observations in real life scenarios.

At this juncture it would be necessary to discuss the ethical, professional and practical factors that would influence the proposed research. Ethics is considered as the main standard mentioned din the research governance framework for healthcare. It is defined as the maintenance of right, dignity, safety and well being of the respondents while conducting a research (Heale & Shorten, 2017). The authors explain that research ethics involving human participants reflect on informed consent, patient autonomy and patient confidentiality. Before commencing on the research it is necessary to gain informed consent from the respondents. This implies gaining consent in written form, with signature in the document, after explaining the aims and objectives of the research. The respondents are to be informed about the implications of the research and how the data is to be managed and stored. The potential respondents are to be given an option to back out from the research in case of any inconvenience. It is also required to maintain the autonomy of the respondents. The respondents are to be respected, and their dignity is to be upheld. They are to be encouraged to make an informed, independent nd free choice of being involved in the study. Confidentiality of respondent data is also crucial and the data collected it to store is a secured manner. As per the Data Protection Act 1989, the data is to not to be shared with any external party (Grace, 2017).  

Conducting literature review also involves chief ethical practices. A systematic literature review is carried out for identifying and processing information from published material in a transparent and clear manner which is reproducible. The main goal is to pledge comprehensiveness in the processing of relevant information. It is, therefore, necessary to have a conducive literature review for permitting proper evidence-based decision making. All literary sources are to be cited aptly, and the authors are to be acknowledged duely. Data reporting also demands maintenance of ethics. Systematic reviews might be containing research studies that have ethical insufficiencies. It would not be suitable to consider unethical research for the present research. Further, those having a conflict of interest would also not be appropriate. Finally, informed consent given for the original study might not be unavoidably valid at the systematic review level (Houser, 2016).

At the end of the paper, it can be stated that senior nurse practitioners are a major part of healthcare professional group who are to offer patient care due to greater knowledge and enhanced skills suitable for addressing the diverse needs of the patients. The paper highlighted that a qualitative research methodology would be ideal for the concerned research question. Interpretivism would be the chosen paradigm acting as a trend of research approach preferring literature review and interview with an open-ended questionnaire for data collection. Through this research key information would be gathered that would answer the question of best management processes for child patients suffering from viral illnesses. The information gathered would be used in practice in future to bring improvement in how children are managed and taken care of. Development in professional practice would be beneficial for taking my career as a senior nurse practitioner to the next level. I would further engage in research on diverse topics that are closely related to my practice area.

References:

Alligood, M. R. (2014). Nursing theorists and their work. Elsevier Health Sciences.

Cope, D. G. (2014, January). Methods and meanings: credibility and trustworthiness of qualitative research. In Oncology nursing forum (Vol. 41, No. 1).

DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-Based Nursing-E-Book: A Guide to Clinical Practice. Elsevier Health Sciences.

Fain, J. A. (2017). Reading, understanding, and applying nursing research. FA Davis.

Forster, E., & Fraser, J. (2017). Paediatric Nursing Skills for Australian Nurses. Cambridge University Press.

Grace, P. J. (2017). Nursing ethics and professional responsibility in advanced practice. Jones & Bartlett Learning.

Heale, R., & Shorten, A. (2017). Ethical context of nursing research. Evidence-based nursing, 20(1), 7-7.

Hockenberry, M. J., Wilson, D., & Rodgers, C. C. (2016). Wong's Essentials of Pediatric Nursing-E-Book. Elsevier Health Sciences.

Holloway, I., & Galvin, K. (2016). Qualitative research in nursing and healthcare. John Wiley & Sons.

Houser, J. (2016). Nursing research: Reading, using and creating evidence. Jones & Bartlett Learning.

Kool, M., Elshout, G., Koes, B. W., Bohnen, A. M., & Berger, M. Y. (2016). C-reactive protein level as diagnostic marker in young febrile children presenting in a general practice out-of-hours service. The Journal of the American Board of Family Medicine, 29(4), 460-468.

LoBiondo-Wood, G., & Haber, J. (2017). Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.

Moule, P., Aveyard, H., & Goodman, M. (2016). Nursing Research: An Introduction. Sage.

Nieswiadomy, R. M., & Bailey, C. (2017). Foundations of nursing research. Pearson.

Parahoo, K. (2014). Nursing research: principles, process and issues. Palgrave Macmillan.

Warren, F. C., Abel, G., Lyratzopoulos, G., Elliott, M. N., Richards, S., Barry, H. E., ... & Campbell, J. L. (2015). Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey. bmj, 350, h2040.