Susan is a neonatal ICU nurse in a large, inner-city hospital. A fair percentage of their patients are substance-exposed babies born to drug-dependent moms. In spite of her personal beliefs about drug-dependent women parenting, she is committed to providing optimal care to both moms and their babies to try to optimize outcomes. One day, as Susan and her colleague were talking about their particularly challenging shift in the break room, they start to wonder how care providers’ own attitudes and beliefs impact care. They decide to engage in an EBP project to see whether there is a body of literature around this topic. They start with creating a PICOT question to provide key words to search the databases with.
Using the Meaning PICOT question template, they form the following PICOT question: How do neonatal ICU nurses (P) caring for substance-exposed babies and their moms (I) perceive the impact of their attitudes on quality of care (O) (no T [time] needed for this question)?
Upon searching the literature using the key words from their PICOT question, the nurses discover a handful of articles that address their clinical inquiry. In order to decide whether the articles should be included in their body of evidence, they must critically appraise them. The first article they choose to appraise is Fraser, J. A., Barnes, M., Biggs, H.C., & Kain, V. J. (2007). Caring, chaos and the vulnerable family: Experiences in caring for newborns of drug-dependent parents. International Journal of Nursing Studies, 44(8), 1363-1370. In the abstract, the authors state, “This study used interpretive methods by conducting group interviews with eight neonatal nurses in each of four Special Care Nursery Units in South-East Queensland, Australia.”
- Looking at the article title and the quote from the abstract, what type of study do you believe the Frasier et al. (2007) study is? What brought you to that idea?
- When critically appraising a qualitative study, we are appraising to see if the study is trustworthy (Lincoln and Guba, 1985). What does it mean when a study is “trustworthy”? What criteria are used to assess trustworthiness?
- Qualitative studies are listed below all the types of quantitative studies on the levels of evidence hierarchy: qualitative studies are either at a Level V, for a systematic analysis of group of qualitative studies, or Level VI, for a singular qualitative study, versus quantitative methodologies ranked at Levels I-IV. This can sometimes give the impression that qualitative evidence is of lesser value. What value does qualitative evidence bring to a body of evidence?