McMillan (2017) conducted this study to determine the effects of Jean Watson’s Human Caring Theory on the nurse perception and application of Caring attributes and the impact on nurse communication. This study took place at an acute care hospital’s adult medical-surgical units. The background of this study was the low score on the nurse commination domain within the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. 47 nurses from five different units participated in pre and post-survey after implementation of Jean Watson’s caring theory and her Caritas processes into bedside patient care nursing routine. The data collected from surveys were analyzed statistically by the use of chi-square test. The statistical results revealed that there was 43% increase in HCAHPS results for the nurse communication domain, after the education sessions.
In order to critique this study, I used the rapid critical appraisal (RCA) checklist by Melnyk and Fineout-Overholt (2019). The elements relevant to this study are explained below.
The research question of this study was, “ Will the creation of Jean Watson’s theory and her Caritas processes teaching program, have a positive effect on the nurse perception and application of caring attributes in daily nursing routine and an increase in HCAHPS, specially nurse communication, which measures the patient perception of the nurses’ care” (McMillan, 2017).
Purpose of the Study
The purpose of this study was to re-focus and improve the quality of patient-centered care and increase overall patient satisfaction scores. This study clearly mentions the population that is the nurses; implementation of education program; and the setting at the acute care hospital’s five medical-surgical units.
The study’s aim was to educate nurses on Jean Watson’s Theory of Human Caring and strategies to incorporate her Caritas processes into daily nursing routine.
The study was designed to use pre and post-survey from nurses at adult medical- surgical units. The quantitative research design was used to complete the Caring Attributes Scale (CAS). Both pre and post-survey scores were used to determine the effects of Jean Watson’s Theory’s education on nurses.
Sample Size, Sampling Technique, and Characteristics
This study used 47 registered nurses from surgical medical units. A convenience sampling technique for an online survey was used. All nurses were emailed using the hospital’s internal website with a direct link to the survey. This convenience sampling technique seems unsuitable for the quantitative type of study due to bias answers from the participants. There were total 67 nurses who completed the pretest but only 47 of these nurses completed posttest. The participant nurses were categorized by demographic categories of age, level of education, and the nursing experience.
Pre and posttest survey was categorized according to the demographic categories. The data collected from these tests was statistically analyzed by using chi-square test. The test results were used to determine if the education based on Jean Watson’s Theory and her Caritas processes exhibited any difference. In addition, HCAHPS scores were used before and after education sessions with the help of organization’s surveyors.
Limitations, and Results
There were several limitations in this study that might affect the results. First of all this study used the convenience technique by emailing the link of survey to the nurses. Secondly, leadership changed including nurse managers, clinical educators on the units, and assistant nurse mangers within the project timeframe. Therefore, it made it hard to enforce education on new nurses. The results would’ve been different if the education was conducted on the same nurses from start to end. In addition, only 47 nurses completed the post-survey out of 67 nurses who completed the pretest. There is no reason provided in the study regarding nurses not completing the post survey. This missing data can affect the validity and reliability of the research study.
The Implication for Clinical Practice, and Future Research
This study’s outcome is beneficial in addressing that Jean Watson’s Theory should be offered to all the nursing staff. Providing education to nurses and creating awareness in regards to caring can eventually improve the perception of nurses toward care and patient satisfaction. This study was conducted on nurses only in medical-surgical units within the organization; so in future research, it will be beneficial to conduct this project throughout the entire organization. The broader sample size will be helpful in analyzing the nurse perception of caring with more accuracy.