Critical appraisal of a research study demonstrates an understanding of the research study being conducted. This paper will review a qualitative research study designed to explore the lived experience of lay presence during adult cardiopulmonary resuscitation (CPR) in primary and secondary environments of care from a healthcare provider’s (HCP) perspective. The in-depth critical appraisal will include the problem statement, purpose, research questions, literature review and conceptual framework. Problem Statement
A research problem is an area of interest in which there is deficient knowledge. As a result, research is required to develop an essential understanding of the problem with the ultimate goal of providing evidence based-nursing care (Burns & Grove, 2011). The research problem that led to this study evolved from public support favoring family presence during adult CPR attempts and the contention this causes among emergency HCP’s. Previous research consisted mainly of attitudinal surveys, which neglect the real life experiences of those who encountered these events.
Family member presence during CPR attempts, commonly referred to as witnessed resuscitation is an area of healthcare practice that is yet to be fully accepted and implemented by emergency HCP’s. Lack of written policy provides an option for reluctant HCP’s to refuse presence and an opportunity for supportive HCP’s to implement the practice. National guidelines and professional organizations currently recommend family presence during CPR and bedside invasive procedures (Basol, R., Ohman, K., Simones, J., & Skillings, K., 2009). The qualitative study discussed throughout this paper is significant because it provides insight into the anomaly of lay presence during adult CPR from a HCP’s perspective. The study explores life-world experiences of HCP’s and identifies barriers to the practice in effort to provide evidence based nursing care. Purpose and Research Questions
The purpose of a qualitative study indicates the focus of the study (Burns & Grove, 2011). The purpose of the study discussed throughout this paper was to explore the lived experience of HCP’s resulting from lay presence during adult CPR attempts in primary and secondary environments. The design of the study was a hermeneutical phenomenological study. Phenomenological studies seek to promote a deeper understanding of complex human experiences as they have been lived by study participants (Munhall, 2007).
The research study was semi-structured with face-to-face interviews. Participants included eight ambulance staff who experienced witnessed resuscitation in a pre-hospital settings and twelve registered nurses (RN’s) who experienced witnessed resuscitation in an emergency department setting. The researcher did not explicitly provide a list of research questions but rather examples of participant responses and the overall conclusion. Questions inferred from these conclusions include asking participants to explain lay involvement in resuscitation efforts and if they were resourceful. Participants were asked to describe incidents of interference by laypersons and how they felt by expressions of disquiet. Further participants were asked how they prepare for lay presence and how laypersons were affected by the exposure to CPR. The purpose and research questions effectively addressed the research problem by eliciting participant’s experiences with witnessed resuscitation.
Qualitative methods were appropriate in answering the research questions because of the nature of the study. More specifically, the study sought to address lived experience of research participants. Quantitative methods would not have been appropriate because this study sought lived world experiences rather than numerical data regarding the phenomenon of witnessed resuscitation. Literature Review
Assessing the literature review of a published study involves exploring the quality of the content and sources utilized. Sources cited must be relevant, comprehensive and current as to provide evidence that the study conducted was necessary (Burns & Grove, 2011). Walker cited both quantitative and qualitative studies to describe current knowledge of the problem and need for additional research. The literature was effective and relevant to the focus of the research study. The author used literature to build a logical argument in the introduction and complement the findings of the study in the discussion. Available studies were not evaluated nor were weaknesses indicated.
Literature ranged in publication date from 1997 to 2010. This extends beyond the recommended timeframe of five years. Articles that were older than five years were noted to be qualitative and according to Burns & Grove (2011) this is an appropriate exception to the recommended timeframe. The literature effectively identified the gaps in knowledge that provided a basis for the study. Conceptual and Theoretical Framework
An important aspect involved in critical appraisal of a study involves identifying and evaluating the study framework. This allows the reader to determine whether it is appropriate to apply the study findings to nursing practice. The author of this study identified the specific perspective from which the study was developed. More specifically, the author sought to provide insight into the phenomenon of lay presence during adult CPR specifically from the perspective of ambulance staff and registered nurses. The author used a phenomenological approach and did not develop a framework or diagram from study findings. Conclusion
Critical appraisal is helpful to identify the purpose and quality of research studies. It is also helpful in demonstrating the reviewer’s understanding of the research study being conducted. This paper reviewed a phenomenological study of lay presence during adult CPR in primary and secondary environments from a HCP’s perspective. The in-depth critical appraisal offered in this paper analyzes the research study in an effort to determine its reliability and usefulness for application in nursing care.
Burns, N. & Grove, S. (2011). Understanding nursing research: Building an evidence based practice (5th ed). Maryland Heights, MO: Elsevier Basol, R., Ohman, K., Simones, J. & Skillings, K. (2009). Using research to determine support for a policy on family presence during resuscitation. Dimensions of Critical Care Nursing 28(5), 237-247. doi: 10.1097/DCC.0b013e3181ac4bf4 Munhall, P.L. (2007). Nursing research: A qualitative perspective (4th ed). Sudbury, MA: Jones & Bartlett. Walker, W. M. (2014). Emergency care staff experiences of lay presence during adult cardiopulmonary resuscitation: A phenomenological study. Emergency Medicine Journal, 31(6), 453-458. doi:10.1136/emermed-2012-201984