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Melissa Diebel

Article Critique
Quinn, B., Baker, D., Cohen, S., Stewart, J., Lima, C., and Parise, C. (2013). Basic Nursing Care
to Prevent Nonventilator Hospital-Acquired Pneumonia, Journal of Nursing Scholarship
46 (1), 11-19. Doi 10.1111/jnu.12050

This critique on Basic Nursing Care to Prevent Nonventilator Hospital-Acquired

Pneumonia (NV-HAP) is viewed as nursing research. The authors are advanced practice
registered nurses (APRN) and master of science in nursing (MSN) performing this study that was
funded partially by a grant for nursing research. This research was completed by the authors and
did not reflect any governmental agencies such as the Institutional review board (IRB).
The problem of nonventilator hospital-acquired pneumonia (NV-HAP) was clearly stated
in the purpose statement from the abstract. The purpose should have been followed up with a
PICOT question in the opening paragraphs to re-identify the purpose of this study. The addition
of a PICOT question would have reinforced the comparison of NV-HAPs recorded without oral
care, from a sample study utilizing a select few hospitals for comparing the effectiveness with
increased nursing oral care.
The authors did provide appropriate review of the literature as (Davis & Finley, 2012)
stated NV-HAP was present at multiple hospitals at higher rates which contributed to increased
costs and patient loss of life.
The theoretical framework known as the Influencer Model, did provide the study with the
foundation of complex changes of quality improvement in evidence-based programs. This study
was comparing recorded historical trends of NV-HAP obtained after a patient was admitted to the
hospital with, the effectiveness of the nursing staff treating patients with oral care as a determent
for obtaining NV-HAP. The utilization of the international statistical classification of diseases

Melissa Diebel
and related problem (ICD-9) codes for determining previous cases of NV-HAP were not present
during the admissions process to the hospital. The nursing staff was trained to provide basic oral
care to patients for the same hospitals selected for comparison from varying demographics,
comparing the resulting NV-HAP cases to the data history.
The sample was appropriate for this study by pulling the patient history data and
comparing it to the new study while providing the added nursing oral care for NV-HAP patients.
This resulted in a significant difference determining that the results do improve the overall
outcome from this intervention. The data is collected using records maintained by the hospitals
on past history of similar cases. The data for the Veterans Affairs Medical Centers went back ten
years and was substantial enough to allow the study a basis for measuring the data to new results.
This measurement used for comparison purposes only. The reduced amount of patients
obtaining NV-HAP was significantly lower which showed the study was viable for further
research. The overall reduction of patients obtaining NV-HAP was 37% after nurses
administered oral care treatments during a twelve month time frame. This study has shown that
utilizing the NV-HAP in the hospital setting will reduce the amount of time patients spend in the
hospital. It is the nursing staff that needs to implement this into daily nursing practice that will
reinforce oral care in the prevention of obtaining pneumonia. The clinical significance of these
statistical methods have shown an improvement of costs by $1.72 million which was the intent of
the study.