Evidence Table.

A1. Quantitative Article:

Shah, J., Maharjan, S., Gurung, R., (2018). Oral Rehydration Solution Clear Liquid up to Two Hours before Elective Major Surgery in Adults. Journal of the College of Physicians and Surgeons Pakistan, 28 (5): 348-351

Background or Introduction. The statedapurpose*of this article was to gain evidence for acceptance,icompliance, andafeasability of shortened preoperative fasting to allow patients to have clear liquids at least two hours before elective surgery. Based on the experimental results of the tests carried out, the feasibility to the shortened preoperative fasting before elective surgery was quantified on a safety basis.

Review of the Literature. The author of this article conducted quantitative research from a wide range of peer-reviewed nursing journals to quantify the experimental results for this study. These articles published within the last 10 years provided the experimental outcomes of previous studies carried out by professionals in the field of nursing to establish the implications of randomized clinical trials on the safety and efficacy of oral dehydration therapy for preoperative surgery in adults. The author substantively used 26 peer reviewed nursing journals to quantify and provide a solid information background for a research-based conclusion.

Discussion of Methodology. The author applied a quantitative research methodology in the collection of data for this study. The sample size composed of 100 randomly selected elective surgery patients subjected to the experiment. The researcher followed all the required protocols in the preparation off the patients to ensure maximum validity of the data collected. The experiment was designed such that it allowed for the observation of all relevant and desired conclusions to justify the objectives of this study. Observations regarding to the preoperative procedures were made and recorded for analysis and conclusions. The choice of health facility in which the study was conducted strategically provided the necessary facilities and conducive environment for a cross-sectional observation of the patients. However, there were disparities in the nature of surgeries and gender representation during the study. This minimized the likelihood of identifying the observational variations depending on how the nature of surgery and the gender affects the outcomes. Thus, the research methodology did not ensure gender balance by having a 1:3 male to female patients ratio. Additionally, there is a likelihood that the responses of patients undergoing oral dehydration is not similar in all types of surgeries. The selection of 69.4% of the patients having a similar condition of cholecystectomy in the methodology is was not sufficient to address the issue of diversity.

Data Analysis. The data analysis for this particular study was based on the observational findings on the participants. The cases of nausea, vomiting, and compliance were analyzed and used as the basis for the conclusions. There were no special observations regarding the gender variations and type of surgery. The data was not however substantive but generalized since it did not include statistical analysis to make conclusions based on actual numerical data.

Researcher’s Conclusion. Based on the study results, the researcher concluded that the use of preoperative oral rehydration solution in a period of up to 2 hours before the surgery is meets the feasibility and safety requirements for adults based on the international standards.

A2. Researcher’s Conclusion

The use of preoperative oral dehydration solution in a period of up to 2 hours before elective surgery is safe and feasible for use on adults to minimize the fasting time according to the international standards (Shah et al., 2018).

A3. Protection of Human Subjects and Cultural

Considerations. The human subjects used in the experiment were protected by ensuring that they are subjected to the required processes and cultural practices used in the process of elective surgery. They were informed about the study and the role they would play in the study. All the human subjects used for the study were adults of sound mind who signed consent forms that were further approved by the institutional review committee to ensure that that the study remains within the international standards.

A4. Strengths and Limitations

Strengths

• This study involved extensive research from nursing journals to ensure that the experiment was substantively and quantitively backed up by evidence-based research.
• The sample size selected in the methodology was sufficient to address the research needs.
• The experiment was conducted in a well-equipped facility to guarantee patient safety and the validity of data.
• The entire research was structurally carried out and presented facts in a concise and clear manner.

Limitations

• The analysis of data did not involve statistical methods to produce results based on numerical data.
• The research did not ensure gender representation and diversity of elective surgery types to collect information from a wider perspective.

A5. Evidence Application to Nursing Practice

B1. Qualitative Article:

MacKusick, C. I., & Minick, P. (2010). Why are nurses leaving? Findings from an initial qualitative study on nursing attrition. Medsurg Nursing, 19(6), 335.

Background or Introduction. The primary focus of this study was to identify and evaluate the various factors influencing the decisions of registered nurses to quit the practice of nursing. These factors were evaluated on the basis of personal reasons provided by the nurses who were interviewed. The objectives of this research were to inform the process of developing and implementing effective strategies to ensure retention of nurses in the healthcare system.

Review of the Literature. There was limited data on the people who had left the practice of nursing thus there was no sufficient literature for review concerning the structures used for decision-making by the registered nurses who were no longer practicing. Few journals for various studies that were concluded from the year 2007 backwards cited some of the reasons provided by the practicing nurses who wished to leave the clinical practice. A total of 24 nursing journals were used to back up the research findings.

Discussion of Methodology. This study used the qualitative research methodology to investigate the factors that contributed to the decisions by registered nurses to leave the practice. Focusing on the research question, the methodology applied purposive sampling to select registered nurses who had at least 1 year of experience in the practice. The nurses were subjected to interviews to answer various questions regarding the decision of practicing nurses to quit practice.

Data Analysis. The application of methodology revealed three major factors upon which the analysis was conducted. The records on the responses of each of the 10 participants was recorded for the qualitative analysis of the similarities in responses. According to the analysis of research results, 7 of the participants were employed outside home while 3 were employed at home.

Researcher’s Conclusion. The researcher concluded that three main factors contributed to the decision of the registered nurses to leave the practice. These include emotional distress, unsuitable working environment, and exhaustion due to rigid working schedules.

B2. Researcher’s Conclusion

The researcher concluded that the decision of the registered nurses to leave clinical practice was fueled by emotional distress at the workplace, exhaustion and fatigue, and unfriendly working environment (MacKusick & Minick, 2010).

B3. Protection of Human Subjects and Cultural

Considerations. Participants in the study were made to understand the need of getting involved in the study to facilitate the development of correction measures to improve the retention of nurses. The researcher avoided asking the participants questions on personal issues or using cultural factors as the basis of their decisions. The identity of the nurse’ participants was concealed to protect them against victimization.

B4. Strengths and Limitations

Strengths

• Applied the most appropriate research methodology to ensure the relevance and validity of the data is maintained.
• The study focused on providing a solution to common problems in the practice of nursing.
• The study focused on the analysis of each factor to determine the extent of its contribution on the decision of the nurses to leave practice.

Limitations

• The sample size was relatively small to substantively represent the entire population of the nurses in clinical practice.
• The study results did not reflect the applicability of the findings in the entire nursing practice.

B5. Evidence Application to Nursing Practice

The advancement in medical technology and patient acuity due to the acute shortage of professional nurses is the primary concern for this research to ensure maximum retention of registered nurses. This research would help the organizations engaging in the employment of professional nurses to recognize the identified factors among the workers on time to allow for the design and implementation of mitigation strategies to ensure optimal retention of nurses. Additionally, this research is important in the initiative of applying strategic nursing programs that seek to facilitate the career transition of the nurses from professional and social perspectives.