A literature search was conducted to identify articles that will be most relevant for the study. Both quantitative and qualitative articles were selected. In this paper, a critical appraisal of one of the quantitative studies that was located is done. The article being critiqued is titled, Handover in the Emergency Department: Deficiencies and Adverse Effects by Ye et al. The research was conducted in Australia to help in establishing the deficiencies in the handover process as well as the adverse effects that arise from those deficiencies. This paper will conduct a critical appraisal of the paper by identifying the type of research, why the study was done, sample size, variables, data analysis, and the significance of the research to nursing practices.
Type of Research
The research design is a cohort study. The study involved identifying the deficiencies in the handover process and investigation of their link to adverse effects. The researchers conducted a multisite study where handover process was observed in three emergency departments in different hospitals (Ye et al., 2007). The study lasted a period of three months.
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The Level of Hierarchy of Evidence
Hierarchy of evidence helps in establishing the strength of evidence collected through ranking (Houser, 2016). The study falls within level II in the hierarchy of evidence. The strength of the results obtained from the cohort study is high due to the scientific methods used in the collection and analysis of data. It implies that the findings have a high reliability hence can be generalized to a larger population.
Problem and Purpose of the Study
The transition of care from the paramedics in emergency medical services to nurses in emergency department is supposed to be effective and efficient due to the condition of patients handled under the system. However, deficiencies have been report in the process thus necessitating a study to establish the problems encountered by healthcare professionals. Therefore, the study was aimed at identifying the deficiencies that are encountered in the handover process as well as the effect that they have on the patients as well as the nurses in the emergency department.
Steps of the Study
The researchers have clearly identified the steps of the study in the research article. They have clearly outlined the problem and purpose of the study. The authors conducted a literature review of previous sources to establish the extent of the problem and the views of other scholars on the issue. The researchers have outlined the methodology that was used to conduct the study. It involved a multisite study that was conducted between the months of January and April 2006. It was a multifaceted study that involved observation of patient handovers from paramedics to nurses, a post-handover survey of the emergency department doctors. The results collected were then analyzed and the findings recorded.
Sample Size
The research was conducted in three emergency departments in Melbourne, Australia. The population of the study is thus taken from three emergency departments that have a capacity to handle 55,000, 50,000 and 40,000 patients annually (Ye et al., 2007). The sample size is approximated to be at least 500 patient handovers because the research is an observational study. As for the post-handover survey, the sample size was at 168 interviews (Ye et al., 2007).
Reliability and Validity of the Measurements
The major variables in the study were handover, deficiencies and adverse effects. The measurements used in the research are reliable and valid. The checklist for conducting the observations was trialed extensively to ensure that they capture all the important information. The interview questions used in the post-handover survey were evaluated for content and face-validity. There were also trialed using sample respondents and revised before being used in the actual research. The questionnaire used in the general handover survey was also evaluated for content and face-validity. There were also trialed and revised before administration.
Data Analysis
The data gathered were mainly analyzed descriptively. Others were analyzed using statistical methods that included Mann–Whitney U -test, Spearman’s Correlation test as well as Fisher’s Exact test. SPSS software was also utilized to conduct analysis.
Untoward Events
There were no untoward events that were encountered during the research. All the steps and process were conducted as they had been planned.
Match with Previous Research
Communication errors during the handover process have been identified as the main deficiencies that are encountered in the handover process. Lack of proper information transmission is caused by the chaotic nature of the transition (Ye et al., 2007). Other researchers have also identified information transmission as the main deficiency that results in adverse effects that are encountered in the handover process. The receiving staff has to be sufficiently informed of the patient’s status in a handover process for them to effective and efficient. Poor communication in the process leads to passage of inappropriate information to the receiving staff thus leading to medication errors (Perry, 2006). Therefore, there needs to be a transformation of handling of communication in the transition process to help in the reduction of adverse effects.
Significance of the Research to Clinical Practice
The emergency department need to streamline the communication structure in emergency department so that there are standard practices hence the reduction of errors that are encountered in the process. It will help in enhancing both patient and health care professionals’ experiences.
References
Houser, J. (2016). Nursing research: Reading, using and creating evidence . Jones & Bartlett Learning.
Perry, S. (2006). Transitions in care: studying safety in emergency department signovers. Focus Patient Safety. 2004; 7: 1-3.
Ye, K., McD Taylor, D., Knott, J. C., Dent, A., & MacBean, C. E. (2007). Handover in the emergency department: deficiencies and adverse effects. Emergency Medicine Australasia , 19 (5), 433-441.
