Running head: QUANTITATIVE RESEARCH CRITIQUE: EVALUATING THE
Quantitative Research Critique: Evaluating the Impact of a Nurse-Driven Mobility Protocol on
Functional Decline in Hospitalized Older Adults – A Nonequivalent Control Group Design
Tonya Allendorfer, Melissa Hayes, Chelsea Melrose, Kathleen Michalak
Ferris State University
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Abstract
The purpose of this assignment is to demonstrate how to critique a nursing research study. The
study to be critiqued was conducted at The Miriam Hospital which is a 247-bed private, not-forprofit, acute care teaching hospital in Providence, Rhode Island. The aim of the study was to
determine the impact of a nurse-driven mobility protocol on maintaining functional status. At
the conclusion of the study, it was determined that early and ongoing ambulation may be an
important contributor to shortening length of stay and preventing functional decline. This
critique will include an evaluation of the study’s objectives, significance, sources, theoretical
framework, hypothesis, data collection methods, and instrumental validity and reliability. Study
data, results and conclusions along with limitations to recommendations from researchers, will
also be analyzed throughout this critique.
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Quantitative Research Critique: Evaluating the Impact of a Nurse-Driven Mobility Protocol on
Functional Decline in Hospitalized Older Adults – A Nonequivalent Control Group Design
Purpose and Problem Statement
Identifying the purpose and problem statement is the first step of the critique process.
The problem statement should be evaluated for clarity. It should be written as a single
declarative or interrogatory sentence (Nieswiadomy, 2012). Study variables and the population
to be studied should be described in this statement. Study feasibility, ethical aspects, and the
significance of the study to nursing should also be reflected in this statement.
Purpose
Evidence. In reviewing the article, Impact of a Nurse-Driven Mobility Protocol on
Functional Decline in Hospitalized Older Adults, there was a definite purpose. The purpose was
stated right away in the abstract of the article.
“The purpose of the study was to determine the impact of a nurse-driven mobility
protocol on functional decline. A nonequivalent control group design was used; the
independent variable was mobility protocol and dependent variables were functional
status and length of stay. Older adults who participated in a mobility protocol maintained
or improved functional status and had a reduced length of stay. Practice implications
include an emphasis on ambulation in hospitalized older adults” (Padula, Hughes &
Baumhover, 2009, p. 325).
This is a relevant area of study because older adults often become debilitated in the hospital.
Support. A good purpose statement clearly sets up the problem of the study. According
to Burns & Groves, “The purpose also includes the variables, the population, and often the
setting for the study” (p. 146). You can often get a sense of the purpose from the title of the
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article. The purpose statement is stated in the abstract of the article most of the time and at the
very least on the first page. It should also be reiterated after the literature review (Burns &
Groves). Niewsiadomy’s critique guidelines are a little more specific. These guidelines suggest
the purpose statement be in one sentence. In this one sentence, it wants to know the significance,
feasibility, data, and if the study is ethical. The purpose statement contains a lot of information
regarding the content of the study that a potential reader would need to know.
Analysis. In the article, Impact of a Nurse-Driven Mobility Protocol on Functional
Decline in Hospitalized Older Adults, purpose is strongly supported. Although it was not in a
single sentence it did clearly state the problem, which was to “determine the impact of a nursedriven mobility protocol on functional decline” (Padula, Hughes & Baumhover, 2009, p. 325).
The variables in this study included the mobility protocol, functional status, and length of stay.
The hospitalized older adult is the population and setting. The article did give a sense of the data
that would be learned by stating the participants stayed the same or improved, but did not
provide specifics. It was an ethical study to improve the lives of hospitalized patients and no
treatment was withheld. The significance and feasibility were not evident in the purpose
statement, but were provided later in the article. The article was directed at nurses and might be
difficult for people without a medical background to understand. Overall, the purpose statement
was supported.
Problem Statement
Evidence. After reviewing the study written by Padula, Hughes & Baumhover the
problem statement was discussed within the first two paragraphs of the article. The authors
presented it by starting out discussing what functional status is and why it is important.
Functional status is the ability to perform basic self-care activities and is a significant component
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in the health and quality of life of older adults. Functional status must be maintained in order for
older adults to continue to be independent and healthy (Padula, Hughes & Baumhover, 2009). A
component of functional status is mobility. Maintaining mobility is vital in preserving
independence in activities of daily living such as bathing, getting dressed and feeding ones’ self.
After the authors defined what functional status is and established its importance in the older
adult population, the problem was defined. Maintaining functional status is important; however
research has demonstrated that low mobility and bed rest are common during acute
hospitalization. Research shows that older adults who have an acute hospital stay often result in
complications that lead to a decline in their functional status.
Support. According to Burns and Groves, a problem statement in a study should include
the following:
1. Identifies an area of concern for a particular population
2. Indicates the significance of a problem
3. Provides background for the problem
4. Outlines the need for additional study in a problem statement (Burns & Groves, 2011).
According to Burns & Groves, the study in review has a problem statement that
incorporates all of these components. However, the example in the book shows that a problem
statement is just that…a statement. The problem in the study being reviewed clearly defines a
problem; however it is over two paragraphs. It is not easily picked out as in the text examples
given by Burns & Groves.
Analysis. The evidence in the research article clearly defines a strong problem area in
the decline in functional status of older adults during an acute hospitalization. The problem is
feasible and ethical and pertains to the nursing and health professions. The problem is mixed in
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throughout the study, not clearly defined in one problem statement. By not having a clear
problem statement, it is hard for the reader to note why the authors felt this problem was or is
important. If someone without a background in healthcare were to read this article the problem
would not easily be picked up on until reaching the purpose section, which is several paragraphs
into the article.
Review of Literature
Evidence. Evidence as provided by the mobility article written by Padula, Hughes &
Baumhover indicates that older adults experiencing an acute hospital stay often times suffer a
functional decline (Brown, Friedkin, & Inouye, 2004; Covinsky, Palmer, & Fortinsky, 2003;
Inouye, Wagner, Acampora, Horwitz, Cooney, & Tinetti, 1993; Brown, Roth, Peel, & Allman,
2006).
Support. A prospective multi-center study was used to examine the effects of low
mobility and bed rest in patients older than 70 years of age. The results of this study determined
that functional decline may be a result of iatrogenic events (Brown et al., 2004). A worsening of
ADL function at discharge as compared with preadmission activity levels was determined in a
descriptive study of 2,293 older adults. This happening resulted in thirty-five percent of patients
studied during an acute hospital stay (Covinsky et al., 2003). Patients experiencing functional
deficits as a result of hospitalization are less likely to recover lost function. This finding was a
result of a study involving 1,270 older adults who were hospitalized for acute illnesses (Inouye et
al., 1993). Mobility was found to be related to recovery of ambulatory ability in a study of 285
patients who were expected to be limited in mobility for the first five days of hospitalization
(Brown et al., 2006).
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Analysis. The mobility article as written by Padula, Hughes & Baumhover provides little
in the way of a literature review. The sources of information used for this study appear to be
secondary sources. The sources were published in years prior to the study and were not
developed as a part of the study. Some of the studies discussed were greater than five years old
and were summarized rather than critiqued. The references appear to be free of citation errors,
but are not necessarily in APA format. As a nurse, the reader may be able to determine the
importance and relevance of the study findings discussed. However, all disciplines in practice
may not be able to gain insight from this article.
Theoretical/Conceptual Framework
Evidence. Evidence as provided by the mobility article written by Padula, Hughes &
Baumhover indicates that the healing process can be improved by getting patients out of bed and
moving around earlier than usual (2009). The Geriatric Friendly Environment through Nursing
Evaluation and Specific Interventions is implementing this theory for Successful Healing
(GENESIS) (Burns & Grove, 2011). The whole mobility article is based off the Self-Care
Deficit Theory of Nursing provided in the Understanding Nursing Research book written by
Burns & Grove.
Support. The GENESIS program was used in this mobility article as a way to
implement the whole theory of the paper. The GENESIS program was used as a model of
nursing care delivery in everyday operations. The program included an extensive three-day
continuing education for all geriatric nurses in all units. This program includes the nurse-driven
mobility protocol which served as the intervention for this research. As part of this program, all
registered nurses were required to question all orders for bed rest and estimate needs and hurdles
to mobility. It is the priority of all nurses to get patients up and out of bed, who are a part of the
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GENESIS program and walk with them three to four times a day. Nurses are also required to
assist patients to a chair for meals and help patients to the bathroom (Burns & Grove, 2011).
This mobility article was based on the Self-Care Deficit Theory of Nursing found in
Understanding Nursing Research by Burns & Grove, 2011. The goal of this theory is to have
patients/individuals perform and start self-care activities in order to maintain activities of daily
living and increase personal growth (Padula, Hughes & Baumhover, 2009).
Analysis. The mobility article written by Padula, Hughes & Baumhover makes it
difficult to find the conceptual framework (CF). This is a weak section in the article. A clearly
defined CF was not found. The article talks about GENESIS, but does not provide a clear
definition of what this program is about. There were no clearly defined terms, assumptions, or
propositions as defined in the Nieswiadomy critique guidelines. The Self-Deficit Theory of
Nursing provides a good description of what the definition is. It is clear to any reader that this
mobility study is based on this theory.
Hypothesis
Evidence. The first hypothesis states that older adults who participate in a mobility
protocol will maintain or improve functional status from admission to discharge. The second
hypothesis states older adults who participate in a mobility protocol will have a reduced length of
stay.
Support. A hypothesis is a formal statement of the expected relationship(s) between two
or more variables in a specified population (Burns & Groves, 2011). The hypothesis translates
the research problem and purpose into a clear explanation or prediction of the expected results or
outcomes of selected quantitative and outcome studies (Burns & Grove, 2011). Hypotheses are
broken into different types:
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Simple hypothesis: states the relationship (associate or causal) between two variables.
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Complex hypothesis: states the relationships (associate or causal) among three or more
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variables.
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Nondirectional hypothesis: states that a relationship exists but does not predict the nature
of the relationship.
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Directional hypothesis: states the nature (positive or negative) of the interaction between
two or more variables.
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Null hypothesis: is used for statistical testing and for interpreting statistical outcomes. It
is used when the researcher believes there is no relationship between two variables and
when theoretical or empirical information is inadequate to state a research hypothesis.
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Research hypothesis: is the alternative hypothesis to the null hypothesis and states that a
relationship exists between two or more variables.
Analysis. In the mobility article the two hypotheses analyzed are clearly stated, early in
the article and also in the discussion section at the end. The authors of the article do not state the
null hypothesis in the article, however it is implied because the null hypothesis is opposite of the
research hypotheses stated. One can assume the null hypotheses for this article would be that
there would be no difference in the functional status of patients involved in the mobility protocol
and those not involved, nor will there be a difference in length of stay between those in the
mobility protocol and those who are not involved.
This study clearly states the hypotheses and it is clearly worded and concise. The
hypothesis is clearly tied to the study problem, which is the functional decline of elderly patients
admitted to the hospital.
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Research Design
Evidence. In the article, Impact of a Nurse-Driven Mobility Protocol on Functional
Decline in Hospitalized Older Adults, the study was stated as using a nonequivalent control
group research design.
Support. According to Burns & Grove (2011), experimental research has a tight control
of the study by random assignment of subjects to groups and the researcher’s ability to
manipulate the independent variables. When complete control is not possible, researchers use
quasi experimental designs with comparison groups. In nonequivalent control group designs,
there is only one group. Only having one group weakens the validity. To strengthen the validity
of a study, two groups would be needed that could be tested pre intervention and post
intervention.
Analysis. In the article, Impact of a Nurse-Driven Mobility Protocol on Functional
Decline in Hospitalized Older Adults, research design is weak. There are too many uncontrolled
variables that interfere with the validity. The treatment group had 5.43 RN hours per day, while
the control group only had 5.32. There are many studies showing that increased RN hours
directly correlates with better patient outcomes. Another element that weakens the study is that
they choose medical patients. That is very broad. It could have narrowed by choosing only
pneumonia patients that were being treated with the same protocol. The fact that the control
group was the only unit left in the hospital that had not gone to the GENESIS protocol, leads the
reader to think that the researcher might have some knowledge of what was being done with the
treatment group.
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Population, Sample & Sampling Plan
Evidence. In the article, Impact of a Nurse-Driven Mobility Protocol on Functional
Decline in Hospitalized Older Adults, a convenience sample of adults aged 60 years or older;
who were admitted with medical diagnoses to one of two nursing units was used for this study.
In order to meet study criteria, the patients must have had a length of stay of three or more days
and an ability to understand English. They must also have been without a physical impairment
that would significantly limit ability to mobilize and must have been cognitively intact or with a
significant other who was able to participate. A Mini Mental Status Exam was used to determine
cognitive status. A score of 24 or more was required to be included in the study. Because there
are potential limitations in mobilization associated with the surgical experience, medical patients
were used. A total of 453 patient records were screened for eligibility. 84 eligible subjects were
enrolled. 34 subjects were withdrawn from the study based on criteria requirements. Study data
were collected within 48 hours of admission. Sample size statistics determined adequate power
and supported a total number equal to 50 (Padula et al., 2009, p. 327).
Support. The researcher randomly selects and assigns members to groups through
probability sampling. “In probability sampling, every member has a probability higher than zero
of being selected for the sample. To achieve this probability, the sample is obtained randomly”
(Burns & Grove, 2011, pp. 298-299). Four sampling designs are used in probability sampling:
simple random sampling, stratified random sampling, cluster sampling, and systematic sampling.
An example of simple random sampling is taking the names of individuals meeting
criteria and placing them in a hat. After the names are in the hat, each one is randomly selected
until the desired number of participants is achieved. Stratified random sampling occurs when the
researcher uses the variables of the sample to stratify those who are represented. For example,
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the researcher may include a certain number of individuals from each ethnic background or in
differing age ranges meeting criteria. Variables used for stratification must be defined in the
research report. Cluster sampling occurs when “a researcher develops a sampling frame that
includes a list of all the states, cities, institutions, or organizations with which elements of the
identified population can be linked” (Burns & Grove, 2011, p. 302). A randomized sample of
these elements can then be used in the study. When an ordered list of all members of the
population is available, systematic sampling may be used. Systematic sampling “involves
selecting every kth individual on the list, using a starting point selected randomly” (Burns &
Grove, 2011, p. 303).
Without randomly selected samples, internal validity or accuracy of the results may be
compromised. The researcher must be able to generalize findings to the entire population in
order for external validity to occur. That is, the represented sample must not be closed to a
certain ethnicity or age group, but rather reflective of all age ranges and ethnicities meeting
criteria.
Analysis. In order to ensure internal validity, the researcher must identify the population
from which the sample will be taken and then randomly select the sample to be included in the
study. Those included in the population which will be randomly selected must be similar in
characteristics or variables which make them eligible for study. A written study report must
outline these variables and must include how the sample was selected and by whom. Without
each of these areas being clearly defined, there is question as to whether the results are due to our
treatment or due to variables between groups.
There are many issues with the sampling from this article. It does identify the patients
that are targeted, but this could be more specific. The study uses patients from two separate units
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in a magnet status hospital. It is not discussed what would happen if the facility was not already
magnet status or what the differences in the units are. This affects external validity. The study
would have more validity if the researchers would have chosen only pneumonia patients. This
was a small sample of fifty patients from one hospital in which the rest of the hospital had
already gone to this particular protocol that was being tested. The researchers discuss bias as
being similar in units, but the treatment group had 7.18% nursing hours versus a control group
with 6.91% nursing hours. It is assumed that those nurses not getting patients up would state that
this was due to a lack of help or time as the top reason for not doing so. This small percentage
makes a huge difference. The researchers do a good job discussing why patients dropped out of
the study. Most patients that were removed either moved or were discharged before the three
day mark.
Levels of Measurement and Data Collection
Evidence. In the article, Impact of a Nurse-Driven Mobility Protocol on Functional
Decline in Hospitalized Older Adults, the only level of measurement found included the
measurement of cognitive statuses by the completion of a Mini-Mental Status Examination with
a score of 24 or more. The data was collected within 48 hours of admission for eligible subjects.
For the GENESIS program, nurses were the main source of data collection through a series of
questions. All data was collected at the Miriam Hospital in Providence, Rhode Island.
Support. Levels of measurement are rules which were developed in 1946 for assigning
numbers to objects in order for a hierarchy in measurement to be established. There are four
measurement categories. Nominal-scale measurement is the lowest of the categories. It is used
when data can be organized into categories of a defined property but the categories cannot be
order ranked. Ordinal-scale measurement is data that is assigned to categories that can be
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ranked. Interval-scale measurement uses scales which have equal numerical distances between
intervals. Ratio-scale measurement is the highest form of measurement and meets all of the rules
for other forms of measurement. According to Burns & Grove (2011), there are five tasks to be
completed when collecting data. These tasks include: selecting subjects, collecting data in a
consistent way, maintaining research controls as indicated in the study design, protecting the
integrity of the study, and solving problems that threaten to disrupt the study.
Analysis. This section of the study is weak. The authors do a poor job in explaining
who, what, when, where, and why of data collection. The instruments and the levels of
measurement for the data being collected are unclear. The article states that SigmaStat,
descriptive statistics and inferential statistics were used, but it does not discuss how this affected
the study. It simply talks of ensuring adequate power and variables. There is no discussion of
what the variables are or what the differences between the groups are. Without this discussion,
one can not assume that the statistical tests which were used were correct for this study.
Instruments
Evidence. This study utilized a demographic data collection sheet which was developed
specifically for the research in the article. This included the following information:
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Age
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Gender
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Primary diagnosis
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Use of assistive devices
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Fall-risk assessment
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Presence of any restrictions to mobility
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Use of PT/OT
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Type of out-of-bed activity
Functional status was configured by using the following:
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The modified Barthel Index (BI): a subjective measure that measures the capacity of an
individual to perform identified Activities of Daily Living (ADL) such as personal
hygiene, bathing, feeding, toileting, etc.). The modified version used 10 items and
included a 5 point rating scale for each item. A quantitative estimate of the level of
dependence was obtained, ranging from 0 (totally dependent) to 100 (totally
independent). The BI was used to assess self-perceived level of function at the time of
admission, for two weeks prior to admission and at discharge.
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Up and Go Test: objective assessment that measures subjects’ ability to stand from an
armchair, walk three meters, turn around, return and sit down in the chair again.
Researchers also used a “mini-mental state exam” to evaluate cognitive status.
Researchers proposed that the BI was the standard of care for clinical and research purposes.
The researchers also state that the Get Up and Go test has been shown to be “reliable and valid”
and is reported to correlate with the BI at r = -0.78.
Support. In research, it is very important to have trustworthy data; especially if a study
is to produce useful findings to guide nursing practice. Quality measurement methods are used
in a study to help improve the accuracy or validity of study outcomes or findings.
Validity:
The validity of an instrument is a determination of how well the instrument reflects the
abstract concept being examined. Validity is not an all-or-nothing phenomenon; it is measured
on a continuum. No instrument is completely valid. Validity varies from one sample to another.
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Construct validity: a single broad method of measurement evaluation which includes
content and predictive validity.
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Content-related validity: examines the extent to which the measurement includes all the
major elements relevant to the construct being measured.
Three common types of validity presented in published studies include evidence of validity from:
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Contrasting groups: indentifying groups that are expected (or known) to have contrasting
scores on the instrument.
-
Convergence: determined when a relatively new instrument is compared with an existing
instrument that measures the same construct.
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Divergence: study participants complete both of these scales to examine evidence of
validity from divergence.
Reliability is concerned with the consistency of the measurement method. Reliability testing is a
measure of the amount of random error in the measurement technique.
Analysis. When discussing the instruments used in this research article, the researchers
do a good job of explaining the tests that were used to examine functional status of the
participants. However, when it comes to discussing the validity of these tests, it appears to be
somewhat lacking. The researchers included how the instruments correlated with each other, but
did not present the internal or external validity of their instruments. No pilot study was done
prior to this study.
Descriptive Statistics
Evidence. The article Impact of a Nurse-Driven Mobility Protocol on Functional
Decline in Hospitalized Older Adults states in the data analysis section “Descriptive statistics
were completed for study variables and comparisons between the groups on baseline
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characteristics were examined” (p. 329). The results section of the article describes the sample
as being 23 men and 27 women between the ages of 62 and 97. The study states 40 patients
lived at home, 7 in assisted living, and 3 were admitted from a nursing home with 31 of them
having to use some sort of assistive device. Out of the 50 people, 20 had a physical therapy
consult and 8 had an occupational therapy consult. The study does mention that there were no
significant differences in demographic variables.
Support. Understanding Nursing Research by Burns & Grove states descriptive statistics
“includes frequency distributions, measures of central tendency, measures of dispersion, and
standardized scores” (p. 383). Frequency distributions are a way to organize measures of a
variable and are either grouped or ungrouped. A measure of central tendency is the average of
the collected data. Measures of dispersion are used with measures of central tendency.
Dispersion is how the individual sample compared with the average. Standardized scores are
sometimes used to do this. Some things are difficult to compare so they “transform raw scores
into standardized scores” (p. 388). These are specific to each study.
Analysis. Impact of a Nurse-Driven Mobility Protocol used a table to represent nursing
staff characteristics to compare the two units of the study. The text states that these units are
similar and comparable, but this author disagrees. The treatment group received more RN and
unlicensed assistive personnel hours than the control group. The treatment group received
7.18% total nursing hours, while the control group only received 6.91% (p. 327). The only other
table the study listed was comparing the Barthel scores. The Barthel score was the patient’s
perceived level of functioning. Again, the treatment group was at an advantage because their
scores were higher to begin the study with. The study did use some central tendency stating the
mean age was 80.4 years. A mean number of diagnoses of 6.7 were also used, which is
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interesting because the only other mention of diagnosis is the fact that the subjects had to be
medical patients. The article did not state if the previously mentioned physical and occupational
therapy consults were included in the treatment or control group or if they made a difference in
the study. Overall, this was not a really strong portion of the study. Details were lacking.
Inferential Statistics
Evidence. According to Baumhover, Hughes & Padula, both of the hypotheses were
supported by descriptive and inferential statistics. “Hypothesis 1, that older adults who
participate in a mobility protocol will maintain or improve functional status from admission to
discharge was supported (P=0.05). Hypothesis 2, older adults who participate in a mobility
protocol will have a reduced LOS, was also supported (P<.001)” (p. 330).
Support. Inferential statistics are for taking a broad view of your results to a bigger
group. That your findings will apply to different scenarios with the same outcome. Degrees of
freedom help the reader to understand the results. It is a math equation of “a scores value to
vary, given the values of other existing scores and the established sum of these scores” (Burns &
Grove, p. 536). The level of significance helps the reader to understand the probability in which
there is a difference between groups.
Analysis. The article uses many tests such as a mini mental state exam, Barthel scores,
and the Up and Go test to support its hypotheses. On each of theses tests a level of significance
is noted, but not the degrees of freedom. The testing is appropriate, but the size of the study is
limited. The article discusses its results in a clear manner, but usage of more visual aids would
have been beneficial. More research is needed, but this author feels that the concept that earlier
and more frequent mobility for patients in order to reduce length of stay and improve the elderly
population’s overall health can be applied.
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Study Findings
Evidence. The SigmaStat statistical program was used in this mobility protocol study.
The study results were from a sample consisting of 23 men and 27 women. The mean age of this
population was 80.4 years, with an actual range of 62 to 97 years. No significant differences
between the groups were found regarding demographic variables. Subjects in the treatment
group had a lower fall-risk score on admission than the control group. This difference was not
significant. Barthel scores which are used to reflect a subject’s perceptions of functioning two
weeks prior to admission were used to represent each group. Scores for the Up and Go test
improved slightly for both groups. However, this improvement was not significant. Subjects in
the treatment group were out of bed to the chair less often than the control group. The treatment
group had a significantly shorter length of stay.
Support. Results in a study are translated and interpreted to become study findings.
Study findings are a consequence of evaluating evidence from a study. The significance of a
study is associated with its importance in contributing to nursing’s body of knowledge.
Significance may be associated with the amount of variance explained, the degree of control in
the study design to eliminate unexplained variance, or the ability to detect statistically significant
differences. A very significant study has implications for one or more disciplines in addition to
nursing.
Analysis. The researchers presented a good overview of the findings but did not
elaborate on how the information could be used. The information from the study could have
been expanded. The study findings should have been written separately from the discussion.
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Discussion & Limitations
Evidence. In the first paragraph of the discussion section, the researchers restate the
purpose of the study. Next, the researchers presented their hypotheses stating that each was
supported by the findings of their research. The paragraph that followed summarized
information that was found in the literature review that demonstrates the researchers’ point that
prolonged immobility is an important factor leading to functional decline. The researchers also
discussed in this paragraph how interventions contributed to make this statement true. The third
paragraph discussed limitations of the study. The researchers found that the lower functional
level of the control group could have contributed to increased length of stay and/or later
ambulation. The lower functional level of the participants could have been caused by other
factors such as acuity and disease burden, which was not discussed in the study. The researchers
subtly recommend that further studies on the impact of disease are warranted. At the end of this
paragraph, the researchers briefly mention that though they found no issue with the instruments
used to measure functional ability, further investigation of these instruments are warranted. The
final paragraph discusses limitations of the environment in which the study was based. The unit
that was utilized employed advance practice nurses and the researchers feel that this may have
affected the mobility outcomes.
Support. The discussion section is used to tie the other sections of the research report
together as well as give them meaning (Burns & Grove, 2011). In the discussion section, the
researchers should include the following: major findings, limitations of the study, conclusions
drawn from the findings, implications of the findings for nursing, and recommendations for
further research (Burns & Grove, 2011). The discussion section is one of the most important
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parts of a research article because it demonstrates the researchers’ ability to critically think about
an issue. An important part of the discussion section is the identification of limitations.
Limitations are restrictions in a study that may decrease the credibility and generalizability of the
findings (Burns & Grove, 2011). Researchers should always identify and acknowledge
limitations of their study as this provides an opportunity to make suggestions for further
research. To identify limitations is not enough. The limitations should be discussed and
evaluated and compared to the conceptual framework. Otherwise, the validity of the research is
questioned.
Analysis. The researchers provide a weak discussion section in this article. The
researchers present limitations of their study. However, they fail to discuss how research would
contribute to the topic they are discussing. The researchers briefly mention finding more
information with further studies but provided limited examples of what they hope to accomplish.
The population sample used in this study is weak and therefore cannot be used in a general
patient population. The researchers used populations from two separate units in magnet status
hospitals. These units provided more mobility opportunities than many floors in other hospitals
that are not magnet status. The researchers recognize this. However, they leave us with no
recommendations on further studies that would help to further validate the purpose of their
research study.
Conclusion
Evidence. The conclusion which was written at the end of the Nurse-Driven Mobility
Protocol article stated that ambulation for patients that are hospitalized should be viewed as a
priority. It further states that a patient’s length of stay may be shortened as a result of early and
QUANTITATIVE RESEARCH CRITIQUE: EVALUATING THE
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ongoing ambulation. The conclusion states that research supports existing literature, but the
author does not elaborate on this point.
Support. According to Burns & Grove (2011), “In forming conclusions, the researcher
uses logical reasoning, creates a meaningful whole from pieces of information obtained through
data analysis and findings from previous studies, remains receptive to subtle clues in the data,
and considers alternative explanations of the data” (p. 412).
Analysis. The conclusion which was written for the Nurse-Driven Mobility Protocol
article is without in depth explanations and simply states what is already known by the reader.
The research which was completed used a very small sample. A clearly defined conceptual
framework could not be found. The instruments for this study were also lacking. Functional
status for this research study was based on a self perceived level of function at the time of
admission and a test which included an objective assessment of a patient’s level of functioning.
The researchers state that the testing was “reliable and valid” but do not elaborate as to how this
is so.
Overall, the Nurse-Driven Mobility Protocol article contains some very useful
information with insight into the importance of early and ongoing ambulation for hospitalized
older adults. However, many portions of this article are weak and a lot of searching is necessary
to pick out the pieces, so to speak. The authors who worked to compile this research paper and
who are medical professionals were able to understand the findings of this research study.
However, the average reader without a medical background may have difficulty understanding
the relevance of these research findings.
QUANTITATIVE RESEARCH CRITIQUE: EVALUATING THE
References
Burns, N. & Grove, S. (2011). Understanding nursing research (5th ed.). Maryland Heights,
MO: Elsevier
Padula, C. P., Hughes, C. & Baumhover, L. (2009). Impact of a nurse-driven mobility protocol
on functional decline in hospitalized older adults. J Nurs Care Qual, 24(4), 325-331.
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