NR 439 Week 3 Discussion – Research Problems, Designs, and Sample

This week’s lesson instructs that the purpose of a literature review is for the researcher to “carefully explore published research findings” about a problem or topic they are studying (CCN, 2018). Reviewing the Baker et al. (2015) assigned reading, I found that the authors performed a comprehensive review of literature that was published between 2001-2014. The review performed by Hare, Dianne et al. (2008) was based on a questionnaire that was sent to hospital 1097 nurses to assess their knowledge of delirium and its associated risk factors. Baker et al. (2015) found that the outcome of the questionnaires showed that 64% of the respondents scored 50% or better overall on the questionnaire in its entirety. Further breakdown showed that only 36.3% attained 50% or more on the risk factors of delirium questions. Conversely, 81.9% scored 50% or better on their general knowledge of delirium. In particular, orthopedic nurses who completed the survey and had attended a delirium education forum prior to filling out the questionnaire scored better on the general knowledge portion than their peers that had not received in-service training, but there was no improvement in their knowledge of the risk factors (Baker et al., 2015).

Baker et al. (2015) sought to research nurses’ general knowledge of delirium, their knowledge of risk factors for it, whether there was a correlation between nurses’ years of experience and years of education, and whether nurses deemed themselves competent regarding delirium. Only one of the studies they reviewed cited information on the educational levels of nurses in the Dahlke and Phinney (2008) study. After reading the literature review, the one thing I found interesting is that across all the literature, it appeared that nurses had a general idea of what delirium was but that most did not have the skill to recognize risk factors. I found it concerning that in the Voyer study, as cited by Baker et al. (2015) that nurses in an LTC setting that had previously received 15 hours of training were only successful in identifying delirium in interview subjects 13% of the time! That is truly alarming to me! All the literature review articles that Baker et al. (2015) supported their research questions.

Dovetailing on last week’s lesson and reading, I feel that the most important thing in being able to conduct a literature review is the development of a strong PICOT question. Utilizing that, it is easier to pick keywords to use to search for literature, according to our lesson (CCN, 2018). Creating strong search terms “expedites and streamlines the search and location of relevant articles” (CCN, 2018). Houser (2018) states that a thorough review of literature can be a time-saver for the researcher; it can “help refine the research question, develop the study design details and put the study in a larger context” (p. 128). Leite, Auxiliadora, Padilha, and Cecatti (2019) state that students need to be trained in information literacy skills and how to effectively conduct searches for literature and how to “evaluate and use the information” (p. 3) and use a librarian to assist them can be invaluable. Of further importance in the literature review is that the literature is current (within the past five years), that it is peer-reviewed, and that the reviewer critically appraises the design of the studies reviewed and their findings. One question I was left with after reading the Baker et al. (2015) study is what was missing in the education of delirium to the nurses. I’m especially shocked by the Voyer study and how poorly the nurses performed after 15 hours of training! I think the quality of education needs to be examined, and ways to improve it. I think it needs to be more interactive so that the signs and symptoms really “stick” with the students afterward.

References

Baker, N., Taggart, H., Nivens, A. & Tillman, P. (2015). Delirium: Why are nurses confused? MedSurg Nursing, 24(1), 15-22. Retrieved from https://chamberlainuniversity.idm.oclc.org/login? url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=100882827&site=eds- live&scope=site

Chamberlain College of Nursing (CCN). (2018). NR-439 Week 3 Lesson: The Literature Review and Scanning for Evidence [Online lesson]. Downers Grove, IL: DeVry Education Group.

Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Burlington, MA: Jones & Bartlett Learning, 128.

Leite, D.F.B., Auxiliadora, M., Padilha, S., and Cecatti, J.G. (2019). Approaching literature review for academic purposes: The Literature Review Checklist. Clinics (Sao Paulo), 74, 1-8. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx? direct=true&db=mdc&AN=31778435&site=eds-live&scope=site

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