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PNR400: Journal Article Appraisal—Evidence Informed Practice 10%This Journal Article Appraisal support CNO ETP 11, 39, 40
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It is important you complete your readings prior to completing the assignment.
Submit your answers on a word document.
APA referencing required
Briefly answer in point form the questions below:
1. Decide if the study is applicable to your nursing practice and why? Can you use the results
and recommendations in your practice?
2. Think about ‘evidence informed’. Explain why it is critical for nurses to read research papers?
3. What is the purpose/goal of a systematic review?
4. Review your article and answer the following questions.
Journal Article Appraisal- Evidence Informed Practice: Rubic
Title
Is the article clear and accurate i.e. does it describe the
research?
Author
What are the author’s qualifications and current position?
Date
When was the research undertaken?
When was it published?
Is it a recent piece of work?
Is it relevant to present practice?
NB: This is not always easy to establish with online articles.
Journal
Does the journal deal in nursing research?
Who is the target audience for the journal? Broad or
specific?
Abstract/Summary
Does the abstract clearly outline the problem, the
hypothesis/research question, aims and objectives,
methodology, results, conclusions, and recommendations
Identifying the problem
Is the problem and/or purpose of the study clearly
identified?
If yes, what is the purpose of the study in the paper?
Is there a rationale for the study?
Formulation of research
questions
(qualitative design or
hypotheses)(experimental design)
Are the aims and objectives clearly stated?
What issue/problem has led to the development of these
hypotheses?
Is there equipoise? (look this up)
Literature search
Is there an unbiased discussion of related research?
Does the researcher demonstrate insight into the subject
under study?
Are cited references timely and relevant?
Is the search a collection of quotes or does it critically
appraise previous studies?
Omotayo
Methodology design
Is the study described adequately? Can you identify what
type of study is used, e.g. descriptive, experimental,
quasi-experimental?
Methodology Sample
Is the sample representative of the population under
study?
Have the characteristics of the sample been considered
e.g. size, culture, gender?
How appropriate is the method of sample selection?
Methodology Ethics
Has informed consent been given?
Is confidentiality and anonymity assured?
Was the right not to participate explained?
Was dignity upheld?
Were the subjects free from harm?
Was ethics committee approval sought?
Methodology Reliability & validity
Does the study consider the issue of reliability and
validity?
Is the research methodology biased?
Main study results
Are the raw figures and percentages or dialogue provided
in the text?
Are they visually presented e.g. graphs, bar charts,
scatter-grams, extracts of dialogue?
Is the rationale provided for the inclusion or omission of
statistical testing?
Do the results support the objective of the study?
Discussion/Recommendations
Is the discussion of the results understandable?
Are the recommendations linked to the purpose of the
study?
Are the recommendations able to be implemented?
Has the researcher acknowledged their limitations?
Are these suggestions for further research?
Conclusions
Do the conclusions relate logically to the results?
Are there any distortions attempted to ‘fit’ preconceived
ideas?
Are the aims, questions or hypothesis posed earlier
addressed?
What omissions have been made and has the researcher
referred to these?
Reference: Adaptation from article:
Ingham-Broomfield, R., (2007). A nurses’ guide to the critical reading of research. Australian Journal of
Advanced Nursing, 26(1), 534-544
Original Quantitative Research Report
Single Room Maternity Care Versus
Traditional Maternity Care: A CrossSectional Study Examining Differences
in Mothers’ Perceptions of Readiness
for Discharge and Satisfaction and
Health Outcomes
Marc Hall1
Canadian Journal of Nursing
Research
1–9
© The Author(s) 2023
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/08445621231165233
journals.sagepub.com/home/cjn
, Arfan Afzal1 and Deborah E. White2
Abstract
Background: Single room maternity care (SRMC) includes all aspects of the birth process (labour, delivery, postpartum) in a
single room with a consistent team of healthcare providers. Traditional maternity care (TMC) involves having mothers labouring and delivering their baby in one room and then transferring to a room on another unit, which also means a transition in
providers. Although many hospitals have transitioned to SRMC, there has been limited evidence to support their development.
Methods: This study was conducted in two large hospitals (one offering SRMC, the other TMC) in Western Canada. A crosssectional between-subjects design was used to compare differences between SRMC and TMC. New mothers were asked to
complete validated questionnaires. Health information was collected from administrative and health databases. The main outcomes included readiness for hospital discharge, mothers’ satisfaction, newborn length of stay, and mother length of stay.
Several covariates were examined.
Results: In total, 506 (292 SRMC; 214 TMC) mothers participated. Readiness for discharge and maternal satisfaction were
significantly higher in SRMC. Although newborn and mother length of stay were significantly reduced in SRMC compared to
TMC for univariate tests, mother length of stay was not significantly different when adjusting for other variables.
Conclusions: There are positive health and psychosocial outcomes for mothers and newborns in the SRMC model of care
compared to TMC. Since readiness for discharge and satisfaction are associated with positive maternal-infant interactions and
transitions to community, SRMC could be the better approach. Further research should examine healthcare provider outcomes and implementation costs.
Keywords
pregnancy, maternity nursing, hospitals, mothers, delivery rooms
Background and purpose
There has been a shift of viewing childbirth from a medicalized process to a normal family event in Western societies
such as Canada, the United States, and parts of Europe
(Waller-Wise, 2012). This approach goes beyond just
caring about the physical needs of the mother and
newborn, and incorporates the psychosocial aspects of care,
as well as more fulsome integration of the family in care processes and decision-making. In Canada, it has been recommended to implement a single-room maternity care
(SRMC) approach (Health Canada, 2000). As such, there
has been a rise in the number of hospitals offering SRMC
(Public Health Agency of Canada, 2012).
The change to family-centered approaches has roots from
the 1970s feminist movement (Waller-Wise, 2012). This led
to the conceptualization and implementation of SRMC
1
2
Faculty of Nursing, University of Calgary, Calgary, Canada
University of Calgary, Doha, Qatar
Corresponding Author:
Marc Hall, Faculty of Nursing, University of Calgary, Calgary, AB, Canada.
Email: hallm@ucalgary.ca
2
starting in the 1980s (Phillips & Fenwick, 2000; Zwelling &
Phillips, 2001). In SRMC, families remain in a single room
for the duration of their stay. They labour, deliver, and
recover all within the same room. They have the same
team of healthcare providers (e.g., registered nurses, etc.)
over the course of their stay (Gerrits et al., 2013; Phillips
& Fenwick, 2000). In SRMC, nurses are cross-trained in
all facets of care involved from when women are admitted
to when they are discharged (Phillips & Fenwick, 2000). In
traditional maternity care (TMC), families are transferred
from an intrapartum unit for labour and delivery to a postpartum unit for recovery. The intrapartum and postpartum
units have their own separate staff since nurses specialize
in one type of maternity care (Stolte et al., 1994). One
study of SRMC found that nurses described practices as relational and patient-centered where teaching, care, and support
of families was apparent in every stage of the childbirth
process (Ali et al., 2019). In contrast, in a study comparing
SRMC and TMC units, providers described TMC as
having a fragmentation of care and breakdown in communication and discharge planning (Hall et al., 2019). To note,
other research demonstrates that quality of teaching influences mothers’ readiness for discharge (Ş enol et al., 2017;
Weiss & Lokken, 2009)
Although there is a shift towards SRMC units, there is
limited evidence to support their development. A systematic
review examining empirical studies of SRMC and TMC
only yielded 13 studies, 3 of which were from the
same hospital. The methodological quality of quantitative
studies was weak, and few studies used inferential statistics
to assess differences between maternity models (Ali et al.,
2020).
In terms of satisfaction, a cross-sectional survey study
found that mothers delivering in a new SRMC unit indicated
they were satisfied with the care (Olson & Smith, 1992). A
comparative study found that SRMC participants scored significantly higher (positively) compared to TMC participants
in terms of adequacy of information and support received,
privacy needs, physical environment, nursing care, teaching,
infant feeding, and discharge planning (Janssen et al., 2000).
In another study, scores for confidence in newborn care, postpartum nursing care, provision of choice, physical environment, respect for privacy, and labour and delivery nursing
care were significantly higher in SRMC compared to TMC
(Janssen et al., 2006). The former of these studies was
descriptive and the two latter were conducted at the same
hospital (Janssen et al., 2006; Janssen et al., 2000; Olson &
Smith, 1992). None of these studies controlled for possible
confounding health outcomes.
Studies examining clinical outcomes are few. One study
examined clinical outcomes pre- and post-opening of a new
SRMC unit (Harris et al., 2004). With the exception of
lower rates of electronic fetal monitoring and intravenous
therapy in SRMC, rates of intrapartum interventions and
adverse outcomes were not significantly different. Length
Canadian Journal of Nursing Research 0(0)
of stay was shorter in SRMC. Infant outcomes did not
differ between groups, except for fewer 1-min Apgar
scores =35 years at delivery,
hypertension >=140/90, other medical disorders, previous
small for dates, diagnosis of small for dates, previous large
for dates, diagnosis of large for dates, malpresentation, membranes ruptured before 37 weeks, pregnancy-induced hypertension, and substance use disorder. Intrapartum risk
assessment covariates included meconium in labour,
pregnancy-induced hypertension, fever, fetal heart rate
abnormality, ruptured membranes >24 h, birth weight
