Grand Canyon University Research Critiques and PICOT Guidelines paper Prepare this assignment as a 1,500-1,750 word paper using from the the guidelines bel

Grand Canyon University Research Critiques and PICOT Guidelines paper Prepare this assignment as a 1,500-1,750 word paper using from the the guidelines below.

PICOT Question

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

General Requirements

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. Literature Evaluation Table
Student Name: Scan
Summary of Clinical Issue (200-250 words):
The healthcare sector has been identified to have one of the violent working environment. The emergency departments are
particularly the most affected and they are ranked as the areas where one is at the highest risk for such violence. The most common
features in this department and the healthcare sector, in general, is violence and aggression. However, violence comprises of a wide
array of behaviors from physical assault to non-physical forms of violence including sexual harassment and verbal abuse. The nurses
have been identified as healthcare professionals at most risk of patient-related violence. They are often highly exposed to a disparate
amount of violence with threatening behavior and a high level of verbal abuse being the most common. It has also been reported by
various studies that physical violence has been experienced by about 90% of emergency department nurses in the course of their
career with verbal abuse being experienced by almost all the nurses. The most common source of violence is the patients with other
sources of violence being relatives and friends that accompany the patient when they are receiving care. Nurses, in most case, feel
unsupported by their healthcare organizations with regards to workplace violence. It is, therefore, important to ensure that appropriate
measures are put in place to create a safe working environment particularly for nurses working in the emergency department.
PICOT Question:
In the emergency department, will a establishing as Zero-tolerance code of conduct on violence, as compared to lack of a
violence prevention program, minimize the high rate of violence towards nurses in 6 months?
P- Patients, relatives and friends visiting the emergency department
Intervention- Establishing as Zero-tolerance code of conduct on violence towards nurses
Comparison- Lack of a violence prevention program
© 2019. Grand Canyon University. All Rights Reserved.
Outcome- Minimizing the high rate of violence towards nurses
Time- 6 months
Criteria
APAFormatted
Article
Citation
with
Permalink
How Does
the Article
Relate to
the PICOT
Question?
Quantitativ
e,
Qualitative
(How do
you know?)
Article 1
Article 2
Article 3
Shafran-Tikva, S., Zelker, R., Stern,
Z., & Chinitz, D. (2017).
Workplace violence in a
tertiary care Israeli hospital a systematic analysis of the
types of violence, the
perpetrators and hospital
departments. Israel Journal
Of Health Policy Research,
6(1). doi: 10.1186/s13584017-0168-x
https://ijhpr.biomedcentral.com/artic
les/10.1186/s13584-017-0168-x
Heshmati-Nabavi, F., HematiEsmaeili, M., Pouresmail, Z.,
Mazlom, S., & Reihani, H.
(2018). Educational and
managerial policy making to
reduce workplace violence
against nurses: An action
research study. Iranian
Journal of Nursing and
Midwifery Research, 23(6),
478. doi:
10.4103/ijnmr.ijnmr_77_17
https://www.ncbi.nlm.nih.gov/pmc/ar
ticles/PMC6178581/
Niu, S., Kuo, S., Tsai, H., Kao, C.,
Traynor, V., & Chou, K.
(2019). Prevalence of
workplace violent episodes
experienced by nurses in
acute psychiatric settings.
PLOS ONE, 14(1), e0211183.
doi:
10.1371/journal.pone.021118
3
https://www.ncbi.nlm.nih.gov/pmc/ar
ticles/PMC6345477/
The article conducts a systematic
analysis on the various forms of
violence and the perpetrators of the
violence.
The study focused on the creation of
a program that provides a safe
environment for nurses in emergency
departments.
The study focused on the prevalence
of workplace violence, and the
strategies adopted to reduce violence
towards nurses.
The study used a quantitative
research design where a quantitative
questionnaire was administered to
evaluate the incidence of violence.
This was a quantitative study, where
a participatory action research design
was used.
It was quantitative study, where a
cross-sectional study design was
implemented
2
Purpose
Statement
It was to examine the different forms
of violence that nurses and
physicians experience as well as the
types of perpetrators.
What are the different forms of
violence that nurses and physicians
experience as well as the different
types of perpetrators?
The results of the study indicated
that nurses as twice much more
exposed to violence as compared to
physicians.
The purpose of the study was to
establish a workplace violence
prevention program to reduce
violence towards nurses.
What is the level of patient and their
family violence against nurses and
the major sources of violence in the
emergency departments?
The findings indicated that a
workplace violence prevention
program was able to significantly
reduce the frequency of verbal
violence.
Setting
(Where did
the study
take
place?)
Sample
The study was conduct at a
university-affiliated medical center
in Jerusalem
The study was conducted in a
hospital in Iran.
The study population consisted of
729 nurses and physicians
Method
Key
Findings of
the Study
Quantitative research method
Nurses were more exposed to
violence in all the departments as
compared to physicians.
A positive association between rank
and exposure to violence was
established.
Nurses in the emergency department
participated in the participatory
action research between October
2012 and May 2014
Quantitative research method
A workplace violence prevention
program was able to significantly
reduce the frequency of verbal
violence as well as other forms of
violence.
Research
Question
Outcome
3
The purpose of the study was to
establish the prevalence of workplace
violence, and the strategies adopted
to reduce violence towards nurses.
What is the prevalence of workplace
violence?
What are the strategies adopted to
reduce violence towards nurses?
The study results indicated high rates
of both physical and psychological
violence, with both being at over
50%
Patient protocols, security measures
and training were the main strategies
adopted by workplaces to reduce
prevalence of violence.
The study was conducted in various
healthcare settings in Northern
Taiwan
A total of 429 nurses participated in
the study
Quantitative research method
High rates rates of both physical and
psychological violence were
reported.
Patient protocols, security measures
and training were the main strategies
adopted by workplaces to reduce
prevalence of violence.
Recommen
dations of
the
Researcher
Criteria
The researchers recommended
policy interventions at all levels to
promote violence prevention in
healthcare facilities.
The implementation of workplace
violence prevention program
particularly for nurses in the
emergency department.
Article 4
The study recommended training of
healthcare professionals to handle
violence, provision of a therapeutic
environment and making the
reporting process easy.
Article 5
Article 6
APAFormatted
Article
Citation with
Permalink
Hassankhani, H., Parizad, N., GackiNajafi, F., Fallahi-Khoshknab, M., Ahmadi, F.,
Smith, J., Rahmani, A., &
Dalvandi, A., & Rahgozar, M. (2017).
Mohammadi, E. (2018). The
Antecedents and consequences of
consequences of violence
workplace violence against nurses: A
against nurses working in the
qualitative study. Journal of Clinical
emergency department: A
Nursing, 27(1-2), e116-e128. doi:
qualitative study. International
10.1111/jocn.13884
Emergency Nursing, 39, 20-25.
https://onlinelibrary.wiley.com/doi/abs/10.1111
doi: 10.1016/j.ienj.2017.07.007
/jocn.13884
https://www.ncbi.nlm.nih.gov/pubmed/
28882749
Gillespie, G., Gates,
D., & Berry,
P. (2015).
Stressful
Incidents of
Physical
Violence
against
Emergency
Nurses. The
Online
Journal of
Issues In
Nursing,
18(1).
http://ojin.nursingwor
ld.org
How Does the
Article Relate
to the PICOT
Question?
The study relates to the PICOT question as it
explores the experience and perceptions of
nurses towards workplace violence perpetrated
by patients
The study relates to
the PICOT question
as it tries to establish
some of physical acts
of violence that are
The study addresses on the effects on
violence against nurses particularly in
the emergency department and how this
could consequently affect the quality of
care.
4
Quantitative,
Qualitative
(How do you
know?)
Purpose
Statement
The study design was qualitative descriptive
design where unstructured in-depth interviews
were used to collect data.
The study use a qualitative exploratory
design, where semi-structured
interviews were used.
The study aimed at providing an understanding
of the factors that leads to violence and the
consequences of the violence on the nursing
staff.
The study aimed at providing more
knowledge on the underlying
consequences of workplace violence
for emergency nurses.
Research
Question
What are the experiences and perceptions of
nurses towards workplace violence perpetrated
by patients, and consequences the violence has
on their performance?
What are the consequences of
workplace violence for emergency
nurses?
Outcome
The study was able to establish inappropriate
professional communication, unmet patient’s
expectations and inefficient organizational
management as the main predisposing factors
of workplace violence.
The study established that nurses
predisposed to mental health issues,
physical health issues, and issues of
professional integrity as consequences
of workplace violence.
Setting
(Where did
the study take
place?)
Sample
The study was conducted in nine hospitals
The study was conducted in the
emergency departments of five
hospitals.
22 registered nurses participated in the study
16 nurses working in the in the
emergency departments of five
hospitals participated in the study
5
considered stressful
by nurses.
A qualitative
descriptive research
design was used for
the study.
The purpose of the
study was described
violent acts against
emergency nurses
that they consider
stressful.
What are the violent
acts against
emergency nurses do
they consider
stressful?
The study was able to
establish that physical
violence was a major
issue for emergency
nurses during their
routine nursing
practice.
The study was
conducted
countrywide
A random sample of
3000 nurses who
members of the
Emergency Nurses
Association. A
Method
Qualitative research method
Key Findings
of the Study
The findings of the study indicated that
inappropriate professional communication,
unmet patient’s expectations and inefficient
organizational management as the main
predisposing factors of workplace violence.
Recommendat
ions of the
Researcher
Qualitative research method
The study findings indicated that
nurses predisposed to mental health
issues, physical health issues, and
issues of professional integrity as
consequences of workplace violence
and this affected their overall
productivity.
The study recommended the identification of
The study recommended the provision
the factors leading to workplace violence and
of support for the nurses and ensure
use them to develop appropriate interventions
they have a safe working environment
to reduce the violence.
as this would improve their overall
The study also recommended the development well-being and the quality of care
of native instruments that can be used to predict provided.
and monitor violence.
6
response rate of 5.9%
was recorded from
the random sample
which was about 177
study participants.
Qualitative research
method
The study findings
indicated that
physical violence was
a major issue for
emergency nurses
during their routine
nursing practice.
The recommendations
from the study
included the
development of quick
exists for nurses away
from violence
patients, as well as
the developing and
consistently enforcing
policy interventions
that are aimed at
preventing violence
against nurses at the
workplace.
Running head: VIOLENCE AND NURSING
1
Critique of Quantitative Studies: Violence and Nursing
Scan
Grand Canyon University
Violence and Nursing
2
Critique of Quantitative Studies: Violence and Nursing
When it comes to the immediate needs of healthcare workers, a workplace that is free of
violence is bound to be the last item on an individual’s mind. After all, it is not generally
expected that healthcare workers, including nurses, to be facing constant violence. However,
though healthcare settings are perceived as relatively safe spaces, violence is a concerningly
predominant within these spaces. To effectively tackle this problem, it is imperative to make the
issue overt and explicit. It is also important to understand why this problem manifests, who it
affects, and what are the effects that it can have on the individual. In this paper, two quantitative
studies will be evaluated for the insight that they can provide regarding these questions.
Specifically, “Workplace Violence in a Tertiary Care Israeli Hospital – A Systematic Analysis of
The Types of Violence, The Perpetrators and Hospital Departments” and “Prevalence Of
Workplace Violent Episodes Experienced by Nurses in Acute Psychiatric Settings”, two peerreviewed articles that tackle this issue, carried out by different and independent teams, some of
the nuances of this matter are explored. These studies show that violence is a recurring issue in
healthcare setting, that targets nurses, and that the systems in place to mitigate its prevalence are
not always functional. As such, it is imperative to ensure that healthcare facilities have the proper
processes in place to fight against this problem.
Background of Studies
The two studies that were chosen for this analysis respond to the same need – the
prevalence of violence within healthcare facilities, targeted particularly at healthcare workers,
especially nurses. Offering a general exploration of this paradigm, the literature review that
precedes the study by (Shafran-Tikva, et al.), for instance, it is made clear that the problem of
Violence and Nursing
3
violence directed at healthcare workers has been so pervasive to warrant studies in overt 60
countries. Furthermore, they recognize that the violence can change depending on the setting,
with some individuals being at higher risk than others. The work of (Niu, et al), which is more
directly targeted at the violence affects nurses, offers a bit more depth to this particular
manifestation of violence. In their literature review, as well, they include information that is
more specifically tailored towards nurses, as their own distinct category. In their exploration of
this background, they include three vital components for their paper: the source of the violence
that nurses face (from colleagues and patients), the possible reasons for this violence (the direct
and constant interactions that nurses have with their patients), and the different factors that can
lead to their occurrence. One of the factors outlined is environment, as the researchers chose to
focus on one particular type of medical facility – psychiatric hospitals. The authors also make it
evident that the reason was also motivated by the lack of existent research into that kind of
specialized facility.
Methods
Quantitative Study
The specifics in the methodologies of the two texts will be discussed further. In (Niu, et
al.)’s article, “a cross-sectional study was performed to determine the prevalence of workplace
violence, the reaction of victims, and workplace strategies of acute psychiatric settings in
Northern Taiwan” (2019). The study features a sample size of 430 full-time registered nurses
who work full-time in one of the acute psychiatric facilities available in the region. The selected
participants would take a standardize questionnaire, the Workplace Violence Survey
Questionnaire, with the aid of an expert would ensure that the information reach the researchers
Violence and Nursing
4
in the appropriate ethical conditions. The results of the questionnaire would be then analyzed by
the team of researchers. In (Shafran-Tikva, et al.) a questionnaire is also utilized for the
collection of data. Their sample did not just include nurses, but physicians, as well; the
healthcare professionals selected were “from the departments of internal medicine, surgery,
oncology, intensive care, ambulatory care and clinics, and the department of emergency
medicine” (2017). The questionnaire was anonymous.
Results of Studies
Quantitative Results
The two studies showed that violence against healthcare practitioners is a problem within
their selected areas. Starting with (Shafran-Tikva, et al.), which explores more broadly the
subject of violence in healthcare by its shared focus on nurses and physicians, the results of the
study showed that, as in other locations, the hospital selected demonstrated to have a problem
with violence. Out of all their respondents, at least 58% claimed to have experienced some form
of violence within the last six months (2017). The study also showed, though, that the rates of
violence that one can experience as a healthcare practitioner might depend on various different
variables. For instance, the researchers found that the higher in rank a physician was, the less
likely it was for them to encounter violence in the workplace. Interns, on the other hand, were
much more likely to witness this violence. Likewise, the rates of violence changed depending on
the area of work. In the oncology department, for example, healthcare workers were less likely to
be at the receiving end of violence, while violence became more common in the Emergency
Room. The aggressor, though, would remain the same even when accounting for these changes –
in cases of workplace violence, the healthcare workers were more likely to be at the receiving
Violence and Nursing
5
end of it from a patient’s family member, than from the patient themselves. Finally, the
researchers also noticed that there was a difference in the rates of violence faced by doctors and
nurses, with nurses being more likely to be victims of violence. This part, specifically, serves t
add further foundation to the study by (Niu, et al.) which focuses on the violence faced by
nurses, partly because of the existence of this trend.
(Niu, et al., 2019)’s study, which focused on the violence that is faced by nurses at
psychiatric facilities, the researchers found that 88.3% of all nurses had experienced some form
of violence, whether psychological or physical, while at work. The study also showed that most
of the attackers “were patients (97.4%), followed by patient’s family members”. One particularly
shocking revelation showed that, despite the violence being reported, the perpetrators would not
receive mitigating consequences. On the contrary, the perpetrators would either be given a light
warning, or no action would be taken at all. As a result, many nurses choose not to report the
incidents, as they believe that doing so would be futile. Despite this poor record with the
handling of violence in the workplace setting, the facilities did have in place the different
measures that are meant to minimize its occurrence, like encouragement to report and proper
training.
Outcomes Comparison
The results of these two studies are in-line with my previous expectations and the
consensus that is found on the literature. Violence is prevalent enough in healthcare facilities for
majorities to admit to having faced it at some point in their careers. Likewise, the violence that
nurses receive is heighted across different departments because of their relationship to the
patient, which is more frontal than that of the physician. The studies do differ on the perpetrator
Violence and Nursing
6
of the violence, though. With (Niu, et al., 2019) crediting patients as being more likely to be
aggressors, while (Shafran-Tikva, et al., 2016) claims that it is their relatives who are more likely
to offend. Though, this could be credited to the difference in the facilities and the patients.
Shafran-Tikva, et al.’s study does not include the psychiatric department, either. One point of
convergence that the tw…
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