NR 439 Discussion Designs – A Plan to Study for the Truth

Discussion Questions

This week we learned how research designs are different and help us to objectively study nursing problems; the key is to decide which type of research and design will serve the purpose or intent to find a solution. After completing Week 4 readings and lesson, answer the following:

• Reflect on your learning about Quantitative and Qualitative research; share two ways that helped you understand how they are different.
• Choose one category of study design that you found interesting and describe; include what you learned about the design and how you believe it can help study nursing problems.
• Refer back to your clinical nursing priority problem and evidence you located for your week 3 assignment: The nursing-evidenced practice (NEBP) committee has requested for you to make a recommendation to the team: Describe the type of research and the design that you believe would be the best way to study your problem. Discuss your rationale.

Title: NR 439 Discussion Designs – A Plan to Study for the Truth

Please see that there are THREE questions you must answer here. Students frequently have difficulty differentiating between quantitative and qualitative studies.  Quantitative studies are fairly straightforward.  If you think of the word “quantity”, it means how many, expressed in numbers.  So, quantitative studies are always expressed in numbers – the percentage of respondents with BSNs, the overall course rating of 3.8 (mean), or the statistical difference between the intervention group and the control group.

It gets tricky when qualitative studies are described as dealing with perceptions, feelings, and experiences.  This is very true, but it all depends on how you collect and analyze the data.  Let’s say I want to research nurses’ perceptions of administrative support when a change is initiated.  On the surface, that sounds like a qualitative study.  However, let’s say I collect the data with a survey instrument that has Likert-type response with a number assigned to the responses (Strongly agree = 5, Agree = 4, Neither agree or disagree = 3, disagree = 2, strongly disagree = 1).

My questions are somewhat as follows:  My charge nurse was available to help implement the change, Time was given during work hours to attend seminars related to the change, There was time given to practice the change before it was implemented, etc.  This survey is definitely exploring nurses’ perceptions and feelings.  However, their answers to the questions can be quantified by calculating the mean.  Therefore, it is a quantitative study, not qualitative, even though it is not comparing outcomes, or finding a correlation between events.

In the same scenario, let’s say instead of using a survey with forced-choice, Likert-style questions, I used open-ended questions – How do you feel about the preparation you were given related to this change?  That would make it a qualitative study.  I would be examining feelings, but instead of having quantifiable answers, I would have to analyze the responses for themes. The same holds true for interviews “Tell me about the support you received from administration when the change was implemented” or focus groups discussing the concepts.

So, the bottom line is – determining whether a study is going to be (or is) quantitative or qualitative frequently boils down to the data collection and analysis methods.  Is the data collected with an instrument that can be quantified?  Are the results expressed in numbers?  If so, it is a quantitative study.  Is the data collected through open-ended questions, interviews, focus groups, or narratives of observations?  Are the data analyzed by identifying themes?  If so, it is a qualitative study.

For the third question, please remind the class of your clinical nursing priority problem from your Week 3 assignment.

The first answer is OK, but there are a couple of issues here…

In the second question you said, “The category of design research I choose is Qualitative research. For my research I feel it is most suitable.  It focuses on the individual’s experience of the care/treatment they are receiving.  This translates to patient satisfaction.”  While patient satisfaction is subjective, whether or not your study is qualitative depends on how you collect the data.  See my discussion launch post for clarification.

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Second, you said in the third question, “The patient will be surveyed on their perspective of their care.  This is qualitative research.”  If your desired outcome is that HCAPHS scores would improve, that is measurable by numbers.  What were the scores?  Did they improve or not?  That makes it a quantitative design, not qualitative.  See my discussion launch post for clarification.

Can you try this again?

Reflect on your learning about Quantitative and Qualitative research; share two ways that helped you understand how they are different.

The word “quantitative” to me is related to quantity or numbers, and the word of “qualitative” is related to quality. When I do grocery shopping, with same amount of money, I could buy two times volume on non-organic produce than organic produce (quantitative vs qualitative).

Professor Charneia’s example gives me a clear distinguish of these two terms. Quantitative study is a type of study conducted in a traditional method, it measures the identified variables of interest in a trust and valid way. (Houser, 2018). Quantitative research is a process of objectively collecting data and analyzing numerical data.

Its’ goals are to test the relationships between variables, generalize results to audience (Houser, 2018). Quantitative research use satistics to identify the significant differences between groups of data. Quantitative research can be counted, measured, and represented with data. Quantitative research is structured, objective and conclusive.

Qualitative study is an exploratory study. It focuses on an understanding of underlying reasons, opinions, and motivations (Houser, 2018). Qualitative study provides insights of an issue, help the researchers to understand a situation, develop ideas. Qualitative study is a process of collecting, analyzing, and interpreting non-numerical data, such as concepts, and descriptions. It can be conducted through observations, interviews and case studies (Houser, 2018). The study usually uses open-ended questions, facilitates the responders to response with their own words. Qualitative study required less or no structure. It is interpretive and subjective (Houser, 2018).

Choose one category of study design that you found interesting and describe; include what you learned about the design and how you believe it can help study nursing problems.

Quantitative study interests me the most. This type of research is most useful in nursing evidence-based practice. It is used to improve nurses’ clinical intervention, and outcome. It allows nurses to determine if the intervention has resulted a desired effect or if the intervention is needed to be changed or modified. Through presenting numerical data, quantitative study answer questions about nursing intervention that can influence outcomes (Houser, 2018). Quantitative study offers strong evidence for the benefit of an intervention and the cause and effect in nursing practice, the vital of nursing evidence-based practice.

I used Quantitative study in my week 3 assignment. Through the accurate numeric data collection, valid measurements, and results analyzing, quantitative study provides trustworthy evidence of nursing intervention. Quantitative study is important due to its’ accurate approach for collecting and analyzing measurable data.

Refer back to your clinical nursing priority problem and evidence you located for your week 3 assignment: The nursing-evidenced practice (NEBP) committee has requested for you to make a recommendation to the team: Describe the type of research and the design that you believe would be the best way to study your problem. Discuss your rationale.

I chose the study of CAUTI as my nursing priority in my week 3 assignment. CAUTI is most prevalent hospital-associate infection (Woten, 2018). ICU patient has the highest risk of developing CAUTI. It is also preventable by nursing interventions. Quantitative approach is the most effective way to conduct this study. The numerical data accurately reflect the declined of CAUTI compared to standardized infection ratio, decreased ICU CAUTI incidents, and shorter in catheter days compared to without nursing interventions (Scanlon, 2020).

Quasi-experimental design is the study of the cause and effect by using existing groups to test interventions. I believe this design best to fit my CAUTI research. My research goal is obtaining the most accurate data and prove that multimodal nursing intervention can effectively prevent and reduce CAUTI. It is one of our nursing optimal goals: provide patients with best evidence-based practice, prevent harm, and safe lives.

Reference

Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Jones and Bartlett.

Scanlon, K. A. (2020). Saving lives and reducing harm: A CAUTI reduction program. Nursing Economic\$. May/Jun2017, Vol. 35 Issue 3, p134-141. 8p. 1 Diagram, 1 Chart, 4 Graphs., Database

Woten, M. & Mennella, H. National patient safety goals (The joint commission, 2018): selecting evidence-based measures to monitor catheter-associated urinary tract infections (CAUTIs)https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nup&AN=T903601&site=eds-live&scope=siteLinks to an external site.

Title: NR 439 Discussion Designs – A Plan to Study for the Truth

I remember studying the difference quantitative and qualitative when I was in grade school and high school when we do our science projects and our teacher always reiterated “quantity” being numbers. So when you mentioned it, that’s exactly how I remember how to differentiate them.

You said “determining whether a study is going to be (or is) quantitative or qualitative frequently boils down to the data collection and analysis methods.” – I agree with this one. It all boils down to what the objective of the research it to figure out if it is going to be a quantitative or qualitative.

Question1.

Reflect on your learning about Quantitative and Qualitative research; share two ways that helped you understand how they are different.

Quantitative Research focuses on a traditional approach in which the environment is tightly controlled by the researcher.  The variables are identified and measured in a reliable and valid way.

Qualitative Research focuses on the individual’s perception rather than that of the researcher.  Qualitative research believes there is no one view of reality, but is the individual s perception of what is their reality.

Question2.

Choose one category of study design that you found interesting and describe; include what you learned about the design and how you believe it can help study nursing problems.

The category of design research I choose is the Experimental design. It refers to studies of causes and effects, which are usually under taken to determine the effectiveness of the intervention. Houser(2019).  After going back and reviewing the literature, I feel the most suitable research is the mixed approach, which combines quantitative and qualitative elements it involves the description of the measurable state of a phenomenon and the individual subjective response to it. Houser(2018).This translates to patient satisfaction.  The nurse/researcher establishes relationship/partnership with the common goal to assist the individual to a healthy state.  In my area this means the delivery of a healthy mother and baby

Question 3

Refer back to your clinical nursing priority problem and evidence you located for your week 3 assignment:  The nursing-evidenced practice (NEBP) committee has requested for you to make a recommendation to the team:  Describe the type of research and the design that you believe would be the best way to study your problem.  Discuss your rationale.

For the priority problem that I chose, excessive call light usage.  I would suggest that the committee initiate the ‘Nurse hourly rounding survey’ on every patient admitted for delivery.  The use of the patient care white board is where the hourly rounds will be marked off.  The nurse checks each hour that she interacts with the patient.  This is the opportunity for patient teaching and care assistance.  The follow-up was conducted in postpartum, by the members of the committee members.  1

100/100 patients were surveyed about their perspective of their care they had received. The results improved by 38-40%, to 98-100% satisfaction with the Nurse hourly rounding. Patients were impressed by the personalized care they felt they had received. This is quantitative/ qualitative research. I would suggest that survey be initially conducted for 3-6 months and then compare them with the HCAPHS scores.

Reference

Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Jones and Bartlett.

Title: NR 439 Discussion Designs – A Plan to Study for the Truth

I agree with you that excessive call light usage will lead to alarm fatigue.  Just this week we had a patients family member put the call light on 3 times, while the patient wasn’t even in the room.  After the 3rd time I had to explain to the visitor that if they needed anything that it was important for them to come out to the desk to ask a question.  Their needs were wanting to know when the procedure would be done, if we could get them some water, and an update on the procedure.

To coincide with hourly rounding, I would like to see if there is data collected on rapid response and code blue calls when hourly rounding is present vs not.  I have only ever worked in an ICU and in my current procedural area, so I am sure that hourly rounding on a floor is much more difficult with an increased number of awake, talking patients, but even more so then its important to notice the minor changes happening in a patient.  I would also like to see if there is information related to excessive call light use and family initiated rapid response calls.  We used a “Code H” where a family member can call the operator if they feel that there is something wrong with the patient that is not being addressed.

I am not sure that we have it in place any more, but I could see this also leading to an alarm fatigue so to speak.  In a study by Dwyer, et. al, (2020), the authors found that “communication issues were central to more than half the activations, 35% of cases required no clinical intervention, with communication alone sufficient to achieve resolution”.  I feel that this goes along with your statement that sometimes our patients just feel forgotten about throughout the day.

Dwyer, T, Flenday, T, Khal, J, Quinney, L.  (2020).  Evaluation of a patient and family activated escalation system: Ryan’s Rule.  Australian Critical Care.  January 2020 33(1):39-46

Reflect on your learning about Quantitative and Qualitative research; share two ways that helped you understand how they are different.

To be honest, Professor, your initial post to clarify the two made it really simple for me to understand the difference between Quantitative and Qualitative research. The examples you provided were accurate and really clarified the definitions of the two research types for me. I am a visual learner, so imagining those scenarios of numbers versus open ended questions narrowed down the major difference between Quantitative and Qualitative research. Prior to this class I always had somewhat of an understanding of the two, but was never asked how tye were different, so I never really had to think about it until now.

Another way that helped me understand how they are different was reading the lesson from this week. In the lesson it states that quantitative research is simply, “This type of research is based on a traditional, formal, objective, scientific approach in which numbers (numerical data) are collected and used to produce knowledge or information” (Houser, 2018; Polit & Beck, 2018). In addition to this, this weeks lesson also used a visual diagram to demonstrate what quantitative and qualitative research is, and that really helped me visualize the difference an aid to my type of learning style to better understand the difference.

Choose one category of study design that you found interesting and describe; include what you learned about the design and how you believe it can help study nursing problems.

I found the Quasi-experimental design the most interesting because of how common it is in nursing studies, and I was interested in finding out why this type. According to the lesson, Quasi-experimental design, “Mimic experimental except for the selection and assignment of subjects, are used to examine causal relationships or determine the effect similar to true experimental; however, lacks rigor and control over the manipulation of treatment, management of the setting, and/or selection of the subjects, it uses convenience sampling, and comparison groups are already existing so it is not a true control group” (Houser, 2018; Polit & Beck, 2018).

Upon looking into more research to find out why this design study is more prevalent nursing, I came to the conclusion that according to Themes, “quasi-experimental studies are important to consider in relation to evidence-based practice because they provide the two highest levels of evidence (Level II and Level III) for a single study (Themes, 2017) . Then, to understand quasi design even more, Theme mentioned that quasi experimental designs differ from nonexperimental designs in one single but major way. In quasi experimental designs “the researcher does not observe behaviors and actions, but actively intervenes by manipulating study variables to bring about a desired effect. By manipulating an independent variable, the researcher can measure change in behaviors or actions, which is the dependent variable” (Themes, 2017).

Refer back to your clinical nursing priority problem and evidence you located for your week 3 assignment: The nursing-evidenced practice (NEBP) committee has requested for you to make a recommendation to the team: Describe the type of research and the design that you believe would be the best way to study your problem. Discuss your rationale.

My clinical nursing priority was the prevention of HAI, focusing on VAP or HAP. I believe the best way to study this problem would be a quantitative study. You can count the number of patients infected with HAP or VAP, and you can count the number of patients using the Incentive Spirometer the right way, and you can count the number of post op patients. This is all measurable, including the max volume inspired into the Incentive Spirometer to document progress in lung function.

The design that I believe would be ideal for this problem would be the Quasi-Experimental design, because of its level of evidence and accuracy in research because of these levels of evidence. In the healthcare field you need to be as accurate as possible. Although the argument can be made that it could be a qualitative study if we are observing the usage of the Incentive Spirometer, but that is not our problem here. Our problem is not patients using the Incentive Spirometer wrong but acquiring pneumonia throughout their stay at the hospital.

References-

Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Jones and Bartlett.

Polit, D., & Beck, C. (2018). Essentials of nursing research: Appraising evidence for nursing practice (9th ed.). Wolters Kluwer Themes, U. F. O. (2017, February 15). Experimental and quasi-experimental designs. Nurse Key. https://nursekey.com/experimental-and-quasi-experimental-designs/Links to an external site..

Title: NR 439 Discussion Designs – A Plan to Study for the Truth

I support you that the professor’s initial explanation enabled us to understand the difference between the two types of research, quantitative and qualitative. The professor’s examples at the beginning of the lesson were all accurate and helped immensely in clarifying the types of studies. It made it easy for me to understand the content that we were to learn in the week. I agree with you that before the professor’s class, many of us had little knowledge of quantitative and qualitative research and could not give examples.

Therefore, the professor’s session helped immensely to understand and differentiate the types of research and read the week’s lesson. I agree with you that a visual diagram was also significant in differentiating the two types of research in the class and the visual learning helped in understanding their differences (Zuzelo, 2019).

I may not be in total agreement with you on the type of design that was most interesting. However, your choice of Quasi-experimental design is good. This design is among the most exciting study design because it is commonly found in many studies in the nursing field. The frequency of this design in nursing research makes it interesting to see why most researchers prefer it. I agree with you that the importance of quasi-experimental studies in considering the relation to evidence-based practices is why this study design is mainly used in nursing research.

In conclusion, your  study problem can be studied using a quantitative study. I strongly concur with this since the best way to look at Grace’s study problem is by counting the number of patients using the spirometer the right way and the number of post-operative patients (Zuzelo, 2019).  This can only be measured using the quantitative study, specifically the quasi-experimental design

Reference

Zuzelo, P. R. (2019). Critically Appraising Research Studies and Reports, Holistic Nursing Practice: Volume 33 – Issue 6 – p 370-372. Doi: 10.1097/HNP.0000000000000356