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Healthcare research

N514 Part VII Part VII Focus on evidence has increased rapidly in the healthcare community. In doing that there is a great need to haveresearch methods that are not only efficient but produce evidence that is important and functional for affecting practice guidelines. Meta-synthesis and grounded theory both lend themselves well to the development of best practice guidelines though the methodology is much different between them
Meta-synthesis is a technique that can help establish qualitative research as a viable source of evidence. In this approach multiple qualitative research studies on the same topic are combined and synthesized into a best evidence paper providing what would be best practice at the time of review (Hughes & Davies, 2009). Summation of the finding of multiple qualitative studies with a focus on a particular evidence produces new interpretations of the qualitative research finding yet remains faithful to the philosophical, theoretical, or conceptual frameworks associated with the original research design (Kent & Overholt, 2008).
There is growing acceptance of the value of this type of study and its contribution to qualitative research. Qualitative research itself can make great contributions to improving health care though evidence based information. With the evolving nature of research at this time, meta-synthesis shows major generalisable reality which a single study cannot.
In contrast, grounded theory is done the opposite of the usual kind of research. Grounded theory starts with the problem, and in healthcare, this may likely be the method of use (Waldrop, & Kirkendall, 2009). An example might be that a particular ICU is having trouble with ventilator pneumonia. In grounded theory, that is the problem, increased numbers of ventilator pneumonia in the ICU. The next thing to do is to research what the evidence shows should be done to solve the problem. In this case there are many articles out there on proven mouth care techniques as well as suction techniques that have decreased the numbers of ventilator pneumonias that occur in the ICU. A thorough search would be done and that information would be correlated to find best practice. Once best practice is found, a theory is formulated. If this mouth care and suction technique is used ventilator pneumonia will be decreased in the ICU and this is supported by….
Once a new theory of solving the problem is determined and the practice is changed, it must be monitored and data compared to previous data. Did we find the correct answer which is well supported by background and theory This particular research type works especially well in nursing as there is not always time to go out into the research and find all of the research done on a particular issue such as a meta-synthesis, unless your job is actually research. However, the manager or director for a unit will have problems that need to be solved in the quality of care and grounded theory would be less cumbersome and more appropriate for the time available.
Whichever approach is chosen, nursing and healthcare research will continue to increase the amount of research done, providing better practice guidelines for better quality and safer care. Both meta-synthesis and grounded theory lend themselves well to this need, under different circumstances. The important thing is to come away with research that will give us evidence based medicine.
References
Hughes, A & Davies, B. (2009). Metasynthesis a goldmine for evidence based practice. AORN 90(5). 701-2.
Kent, B., Overhold, E. (2008). Using meta-synthesis to facilitate evidence based practice. Worldviews of Evidence Based Nursing. 5(3) 160-2.
Waldrop, D., Kirkendall, A., (2009). Comfort measures: a qualitative study of nursing home-based-end-of-life-care. Journal of Palliative Medicine. 12(8). 719-724.

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