Three sets of quality appraisal tools for hospital practices study
The four selected articles that were considered for the analysis will be appraised using the Critical Appraisal Skills Programme (CASP). Three sets of quality appraisal tools are applicable for the selected studies: the Qualitative Appraisal and Review Instrument (QARI) (Joanna Briggs Institute, 2014), the quantitative CASP checklist, and the Mixed Method Appraisal Tool (MMAT) (Hong et al., 2018). The tools used for the analyses are summarized in Table 1, Table 2, and Table 3 in the Appendices. The results of the CASP tools are as depicted in Table 4, Table 5, and Table 6. “Y,” as seen in the tables, has been used to indicate an affirmative answer to the respective question while “N” shows a negative answer.
A quantitative study by Whitty et al. (2017) addresses the disagreements between patients and nurses on their preferences for bedside handover as a clear issue that needs to be assessed for the improvement of patients’ hospital experience. The researchers used the discrete choice experiment (DCE), which provides a random combination of multiple attributes and attribute levels to determine individual preferences for each attribute, hence the possibility to consider several criteria simultaneously (Mandeville, Lagarde & Hanson, 2014). Whitty et al. (2017) used an appropriate research procedure as they sought ethical approval and considered patients and nurses who had experienced bedside handover. Moreover, the researchers used suitable measures to select the study controls, that is, the participation of patients’ families and friends and the handover of sensitive information. Based on the findings, both patients and nurses agree on the effectiveness of the two-way communication process during bedside handover in promoting patient engagement and patient-centered care. However, the participants disagreed on the communication of sensitive information as the nurses felt that sensitive information should be handed over in private rather than by the patient’s bedside. Also, unlike the patients involved in the study, the nurses regarded the presence of the patients’ friends or families as irrelevant to the quality of care. Although the patients and nurses differed on the characteristics of bedside handover, they agreed on its significance in improving communication and the quality of care. Whitty et al. (2017) conclude that hospitals should tailor bedside handover based on the choices due to their diverse preferences. Although the study is useful to any hospital that intends to implement bedside handover, focusing on the adult unit only limits the generalizability of the findings.
Hada, Coyer and Jack (2018) concur with Whitty et al. (2017) on the significance of effective communication in bedside handover to patient safety and quality care. The quantitative study focuses on the need for improved handover communication through a pilot study. The researchers followed an appropriate recruiting procedure by informing the participants about the study, seeking their consent before gathering data, and seeking ethical approval. However, there was no proper procedure for the selection of study controls. The survey involved patients from geriatric and rehabilitation wards whereby they, their families, and the nurses were required to describe their experiences with bedside handover. The study findings associated bedside handover with effective communication improved compliance with the shift-to-shift handover and increased patient and nurse satisfaction. The patients also agreed on the positive impact of bedside handover on the decision-making process and control of pain, hence an improved patient safety and quality of care. Hada, Coyer & Jack (2018) mention that the study results were obtained after considering confounding factors such as concurrent prevention strategies that may minimize risk, shift nursing skill mix, patient complexity and understanding, and participation in risk-mitigation strategies. The main strength of the study is that involved individuals who directly experienced bedside handover such as the patients, their families and nursing staff. However, the study was based on an adult patient unit, thus limiting its applicability to the children’s department and the present topic.
Mannix, Parry and Roderick (2017) used a mixed method approach to examine the steps used to improve the conduct of clinical handover. However, unlike Whitty et al. (2017) and Hada, Coyer & Jack (2018), the study is based on a paediatric unit, making it relevant to the present topic. The researchers suggested that using ISBAR (Identify, Situation, Background, Assessment and recommendation) during handover reduces the risk caused by poor communication among children as it prevents vital information from being missed. As a result, the oncoming nurses at every shift have a shared assessment and better understanding of the patient, leading to improved care. Moreover, using the ISBAR tool also motivated the nurses to involve the children’s parents in the discussion, leading to improved patient outcomes and cost savings on health care. Although Mannix, Parry and Roderick (2017) do not provide a clear rationale for their decision to use the mixed method approach, they provide a clear interpretation of the qualitative and quantitative outcomes by analyzing the results separately then merging the outcomes towards the end of the study. The research methods also adequately addressed the inconsistencies in the results as they filled the gap in each component’s weaknesses. The study contributes to the findings by Whitty et al. (2017) and Hada, Coyer & Jack (2018) by providing evidence that the significant part of improving the patients’ health in the pediatric ward involves the inclusion of their parents in handover.
In addition to the previous studies, Bigani and Correia (2018) use the qualitative approach to study nurses’ patients’ and families’ perception on change-of-shift bedside report. The qualitative method is suitable for the study as it provides a detailed description of the participants’ experiences, feelings and perceptions of diverse issues through semi-structured interviews (Rahman, 2017). The researchers took their relationship with the study participants into consideration during the study, as evident in the recruitment process, which took over six months. The study is conducted in a paediatric setting, hence its relevance to the present topic. Unlike Whitty et al. (2017), Hada, Coyer & Jack (2018) and Mannix, Parry and Roderick (2017), Bigani & Correia (2018) regard time consumption, friends’ and families’ presence and the need for too much information as barriers to bedside handover. However, the researchers agree that the contribution by the patients’ families during handover helped in correcting errors to the medical histories, diagnoses and medication, resulting in increased patient safety, nurses’ accountability and quality of care. Despite the disadvantages, all the participants agreed that they preferred bedside report to the traditional handover process. Overall, the study provides a clear statement of findings as it focuses on the perceptions of individuals groups, that is, the nurses, patients and their families regarding the influence of bedside report on patient care. However, the researchers neither made any ethical considerations nor have a rigorous data analysis process, making it unclear how they arrived at the results.