Research Paper Example: Addressing High Maternal Mortality & Morbidity in Developing Countries

Introduction

Portela et al. (2018) aimed at addressing the issue of high mortality cases in the maternal department. According to the researchers, the rate of maternal mortality and morbidity has been increasing in Brazil, reflecting the situation in other developing countries. The researchers explained that accessibility to healthcare facilities, lack of quality equipment, and reduced number of qualified staff are the main factors identified to cause the increase in morbidity. Therefore, since much is known about maternal care, the researcher's main objective was to identify the factors that could affect the implementation of quality improvement measures in obstetric departments. They targeted to achieve the objectives through semi-structured interviews. The information obtained from the study is essential for all nurses to understand the challenges faced by other healthcare providers and the approach to solving the challenges.

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On the other hand, Bradley et al. (2015) addressed a similar issue of the challenges faced by various healthcare providers in obstetric departments. Unlike the first study that majored mostly on the general issues affecting quality improvement in the department, the researchers in these studies focused on one phenomenon, which is the impact of staff shortage in maternal care. Based on this factor, the researchers carried out a qualitative study to assess healthcare perceptions on the impact of staff shortages in the maternal ward. The research question was mostly focused on the effect of staff shortage. The data obtained was analyzed to draw conclusions. The information obtained from the study is essential in nursing practice as it equips nurses and other healthcare providers with skills on how to deal with the impact of staff shortage.

Studies and the Nursing Practice

The formulated PICOT question targeted the identification of the challenges faced by healthcare providers in the obstetric department. More specifically, the question addressed the impact of staff shortage. The first research revealed that staff shortage is among the major factors that affect the delivery of services in obstetric departments. In addition, the shortage was identified as the major hindrance to quality improvement. QI is essential in all healthcare facilities regardless of the rank and the nature of services offered. It aims at improving the client's experiences and improving outcomes (Portela et al., 2018). The information provided by the researchers can help in answering the questions by revealing that increasing the number of staff can help in improving the standards of services offered in the department and thus reducing the number of deaths within the department.

Furthermore, the impact of a shortage of staff was echoed in the second research. The finding from the study revealed that shortage of staff is the major factor contributing to work overload, workplace stress, and reduced efficiency. The research also revealed that a shortage of other healthcare staff (apart from nurses) working in the same department also contributed to reduced efficiency (Bradley et al., 2015). The PICOT question seed to determine whether increasing the number of staff (mostly nurses) could reduce mortality in the department. According to the evidence, increasing the number of staff can help increase their efficiency and improve outcomes.

Methodology

The methodology used in any research is essential in determining how efficient the results are in answering the PICOT question. Several methods are available that can be used to gather the required information from the participants. In the first study, the researchers used a semi-structured questionnaire to gather information from the participants. The questionnaire addressed the aspects of teamwork, collaboration, leadership, communication, and other elements that are likely to affect the quality of care offered in clinical facilities (Portela et al., 2018). The data was recorded and transcribed, followed by a detailed analysis. A similar technique was used by the researchers in the second study. However, unlike the first study where researchers conducted 30 interviews only in 10 different facilities, in this case, the researchers identified 28 different districts in the country where 84 interviews were conducted. The first research results are reliable as they were obtained from healthcare facilities serving a large number of patients daily. However, the small number of interviews could affect data credibility. On the other hand, the second research used a large sample size and focused mostly on staff shortage. Although it addressed the issues at hand, the researchers provided limited information on the possible solutions.

Results

After the selection of 30 healthcare participants for the interviews. Only 27 interviews were conducted. The researchers aimed to address two factors: the extra-organization factors and intra-organizational factors that affect the standards of services in the obstetric department. However, the researcher emphasized the internal factors that affect quality improvement (Portela et al., 2018). The researchers identified a shortage of staff and the inability to work together as a major challenge in the provision of standard care to patients in the study. Collaboration and teamwork were often a challenge in facilities with limited staff, a situation that affected outcomes.

In the second study, the researchers noted that staff shortage increased workload by more than 40%. The increase in workload reduced their efficiency. In addition, the study revealed that reduced staff from one profession is likely to affect other professions. The study also demonstrated that the reduced efficiency of the staff is attributed to the psychological and physical impact caused by staff shortage. Despite the differences in the number of participants and the approach used to obtain information on both studies, it is evident that staff shortage could be among the major factors associated with high mortality, especially in developing countries (Bradley et al., 2015). The study demonstrates the importance of resilience in nursing practice. Nurses need to have a mechanism to adopt changes in workplaces that could affect their performance. In addition, they need to develop stress management skills and the aspect of self-care, which reduces the physical and psychological impact of challenges faced in workplaces.

Ethical Considerations

Ethical considerations are among the major factors that need to be accounted for in research. The considerations to be considered often differ with the type of research, the participants involved, and the governing bodies. The issues of informed consent and privacy are among the factors that need to be considered in qualitative research. Informed consent involves informing the participants about the nature of the study, the reason for conducting the study, its potential harms, and possible solutions (Human Experimentation, 2010). Privacy and confidentiality are often applied in the gathering and storage of data. In the two studies, the researchers informed the participants of the research, which gave them free will to participate. In qualitative research, interviews are expected to be done in private rooms, free from interruptions. Also, the data obtained should be stored safely to avoid unauthorized access. In both studies, the researchers did not give detailed information on the measures taken to maintain high levels of privacy. However, all the other ethical factors were considered.

References

Bradley, S., Kamwendo, F., Chipeta, E., Chimwaza, W., de Pinho, H., & McAuliffe, E. (2015). Too few staff, too many patients: a qualitative study of the impact on obstetric care providers and on quality of care in Malawi. BMC Pregnancy And Childbirth, 15(1). https://doi.org/10.1186/s12884-015-0492-5

Human Experimentation. (2010). The Ethical Considerations of Medical Experimentation on Human Subjects. Qcc.cuny.edu. Retrieved 27 August 2020, from https://www.qcc.cuny.edu/SocialSciences/ppecorino/MEDICAL_ETHICS_TEXT/Chapter_7_Human_Experimentation/Reading-Nazi-experimentation.htm.

Portela, M., Lima, S., da Costa Reis, L., Martins, M., & Aveling, E. (2018). Challenges to the improvement of obstetric care in maternity hospitals of a large Brazilian city: an exploratory qualitative approach on contextual issues. BMC Pregnancy And Childbirth, 18(1). https://doi.org/10.1186/s12884-018-2088-3