Analyze and critique a quantitative nursing research article from a nursing research journal published within the past five years. Include 3 scholarly references—the article, the text, and one outside source. Use the Guidelines for Quantitative Nursing Research Critique to complete the following steps:
1. State the purpose of the study and identify the problem. Patients in the intensive care unit (ICU) often require enteral feeding due to their inability to consume nutrition naturally. Nutrition in the critically ill patient remains a controversial topic. Most clinicians have viewed nutrition as part of patient care but not as a therapeutic intervention (Fermont & Rice, 2014). The usual questions are when to start feeding and how much should be fed. This study attempts to identify the barriers to enteral feeding, adequacy of nutrition, and prevalence of under-feeding in relationship to caloric intake and meeting needs of nutritional guidelines.
2. Analyze the literature review.
Previous research literature on the subject of enteral feeding points out that most patients in the ICU do not receive adequate caloric intake, therefore, are often underfed rather than overfed. Some of the reasons for underfeeding are barriers based on patient diagnosis and elective discontinuation or delay in feeding. Previous studies also show that the best markers for assessing nutritional status include physical and laboratory values such as prealbumin levels and transferrin. These lab results were also taken into consideration for this study (Kim, Shin, Cho, & Shin, 2010).
3. Analyze the study framework or theoretical perspective.
This quantitative study does not use a particular framework or nursing theory to guide the researchers.
4. Identify, describe, and critique for appropriateness any research
objectives, questions, or hypothesis. The objective of the study was to find the prevalence of enteral feeding adequacy in an ICU. Also, the changes in nutritional indicators would be followed to show additional indicators for adequacy. These objectives were appropriate due to their direct correlation with the problem. The objectives provided a clear and concise determination of the problem which would be an underfed patient.
5. Identify, describe, and critique—conceptually and operationally—the major study variables. The major study variables were the amount of tube feeding prescribed and the number of interruptions in tube feeding. Although these are major variables, these fluctuations in study were adequate due to their presence in prior studies. The descriptive and prevalence research methods account for the variables that are prominent in studies such as these by using the snapshot method. The snapshot method takes into account that at some point during the study certain variables will affect the outcomes. 6. Identify and critique the attributes and demographic variables. This study mentions specific demographics such as gender, diagnosis, and the age which was a mean of 56 years old. The patients all had some neurologic injury which likely rendered them in the same condition neurologically. The demographic variables in this study likely would not affect outcome due to the fact they can all be cohort based on diagnosis. 7. Describe and critique the research design.
The research design of this study is a descriptive prevalence study. The purpose of descriptive studies is to observe, describe, and document aspects of a situation as it naturally occurs. In this case, the prevalence of malnutrition was for patients in the neurosurgical ICU. This was taken into account for the grouping aspect of the research design and literature review prior to conducting the study. This overview or snapshot of previous information helps the researchers find a starting point for theory development and hypothesis generation in descriptive studies such as this (Polit & Beck, 2012).
8. Describe and critique the sample and setting.
The sample for this study was 52 neurosurgical ICU patients. This sample represents the accessible population to the researchers which was adequate for the purpose of this study. The setting was unpredictable in this study due to the nature of the underlying disease processes of the patients.
9. Describe and critique the measurement instrument used in the study. The measurements used for this study were the amount of caloric intake, administration amount of enteral feeding, interruptions and lab values representing measurement of nutrition. These measurements were adequate instruments for determining over and under feeding based on their correlation with the study objective.
10. Describe and critique the procedures for data collection The procedures for data collection in this study were regimented and followed prescribed formula doses divided into three or four daily administrations. The researchers then took into account interruptions and total volumes received to determine the adequate intake based on caloric needs. Biochemical values then followed. These procedures gave the researchers ranges and specific values to use for data analysis. The methods for data collection showed numerical values that were statically viable for this type of study.
11. Describe and critique the statistical analysis.
The data was analyzed using the SPSS 15.0, student t test, and Pearsons correlation. These types of analysis were conducted due to the nature of the variables. The researchers used the analytical tools that best fit each source of data which helps find the best measure of outcome for each group of information.
12. Describe and critique the researcher’s interpretation.
The researcher showed strong data which supported the need for adequate ordering and administration of enteral feeding to reach optimal caloric intake. Also, the researcher highlighted that interruptions in feedings play a factor in the adequacy of feeding warranting closer attention by nurses in the ICU. The researcher lost some credibility of the research due to its need for longer data collection in relation to biochemical markers, a greater sample size for use of the t-test, and the use of biochemical markers due to the patient’s lack of homeostatic state. In the end, this research did provide evidence for nurses to be more aggressive with enteral feeding in ICU patients, which can improve outcomes.
Friedman, R. D., & Rice, T. (2014). How soon should we start interventional feeding in the ICU?
Current Opinion in Gastroenterology, 30(2), 178-181.
Kim, H., Shin, J. A., Shin, J. Y., & Cho, O. M. (2010). Adequacy of Nutritional Support and
Reasons for Underfeeding in Neurosurgical Intensive Care Unit Patients. Asian Nursing
Polit, D., & Beck, C. (2012). Nursing research: generating and assessing evidence for nursing
practice (9th ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.