Quality Research Article Critique Factors Influencing Emergency Use of Nurse Practitioners: A Critique
Problem and Purpose
This is critique of a Qualitative Nursing article, the article is: Factors Influencing the Decision to Use Nurse Practitioners in the Emergency Department by Laurie A. McGee, MN, ARNP and Louise Kaplan, PhD, ARNP, published in Journal of Emergency Nursing, Volume 33, Number 5, October 2007. The problem that is stated in the article is there is a growing and serious problem facing the overcrowding of emergency rooms within the United States. There is a current epidemic of the population that relies on emergency room care as primary care. “The 2004 National Hospital ...view middle of the document...
The purpose of the study is clearly stated and is to “determine factors that influence the decision to use nurse practitioners in the emergency department.”
Emergency rooms cannot turn away non-emergent patients. Facilities that only use physicians will need to evaluate all emergent and non-emergent patients. The non-emergent patients can be seen by nurse practitioners. The research question is broad enough for a qualitative approach of the reasons and factors regarding hospital view of hiring nurse practitioners. “One national survey of hospitals, however, found that only 17% of respondents employed nurse practitioners in the emergency department and only an additional 9% were planning to hire new nurse practitioners. This low level of employment of nurse practitioners in emergency departments occurs despite nurse practitioners having a proven record of professional performance and effectiveness in their ED roles.”
Methods, Design and Approach
Qualitative studies facilitate exploration to a research approach that allows for an issue or phenomenon that is no readily understood, to be explored through a holistic or multi-faceted view. Using the design study a qualitative exploratory study, this investigated factors influencing the decision to use nurse practitioners in the emergency department. Exploratory studies are describes as descriptive studies even if they describe relationships and associations Survey and mixed methods are most commonly used in qualitative studies as well as an initial study into a issue and this was a pilot study. The setting of emergency departments is appropriate to the study. The study used a convenience study of five emergency department managers, four of which participated. The study was approved by the internal review board and all the rights of the participants were protected, even the right to not participate which one of the five requested to participate had the right to not participate. The study was conducted using an interview process which is appropriate for qualitative exploratory studies. The four emergency room participants were scheduled for interviews, at their convenience, and informed consents were obtained before interview to protect the rights of the participants. The research team used audio tapes and conducted semi-structured interviews. The audio tapes were then copied verbatim into transcripts then the transcripts were analyzed using content analysis. Qualitative studies do not typically use a detailed procedure upfront, so the researchers allowed for all for participants to share other data such as the number of emergency department visits per year and how many were for primary care problems or non-emergent problems, all four shared information.
This was a pilot study conducted in one state, so the sample was small and may not reflect all hospitals. Because all four of the participants were managers of emergency rooms, are nurses and all had similar points to add to the...