NURS 3150 Week 3 Assignment – Methods Used in Quantitative Research
Purpose of study: The objective of this research was to obtain a quantitative analysis of patient and nurse outcomes of practice change in reporting for bedside nursing. Past literature had shown the benefits of bedside nursing reports but had not quantified the results, and this study aimed to achieve this purpose. Data were collected from seven medical-surgical units in a university hospital that had implemented a combination of recording and reporting bedside nursing. The data was analyzed by checking the related change in nursing satisfaction, patient satisfaction; patient falls, nursing overtime, and medication errors (Sand-Jecklin & Sherman, 2014).
Research Design
The purpose of the researcher is to identify and gather reports utilizing a quantitative outcome that indicates a nursing practice change in the bedside nursing report. This study used a research design called Quasi-Experimental pre- and post-implementation to quantify the results of bedside reporting. Quasi-experimental studies in nursing are conducted to determine the effects of nursing interventions or treatments (independent variables) on patient outcomes (dependent variables) (Grove et al., 2013, p. 49). Quasi-experimental studies indicate performing the nursing assessment or practices that help to check changes in patient falls during the evolution of shift an hour prior to and after the implementation of bedside reports to determine patient outcomes.
Sample Selection
In this research study, there is various sample selection collection on the patients/families and nurses for pre-implementation and post-implementation in regards to assessing related changes based on nursing satisfaction, patient satisfaction, patient falls, nursing overtime, and medication error (Sand- Jecklin & Sherman, 2014). The first data collection was selected from a reference line sample size of 233 patients, then 157 patients data collected for the three months and 154 patients used at 13 months. All data collection periods were done during post-implementation.
Also, sample selection was performed on the 70 family members as a baseline data collection; 72 samples were selected for three months and 53 for 13 months of study, which are all done for post-implementation in preparation for data collection. In the research study for nurse satisfaction, the sample used was 148 nurses as a baseline data collection; 98 samples were used for three months, and 54 were executed for the 13 months, which were all performed during the post-implementation survey period (Sand-Jecklin & Sherman, 2014).
The study reported by Sand-Jecklin and Sherman (2013) did find significant improvements in patient information as a result of bedside reports using a large sample size of 302 patients/families pre-implementation and 250 post-implementation.
NURS 3150 Week 3 Assignment – Methods Used in Quantitative Research
Data Collection Methods
There are several methods used in data collection in this research study which are observation and questionnaire. The researcher designed questions and displayed them as questionnaires and online interviews. The surveys were used as data collection from patients and families. Then, the researcher group used online interviews for the nurses, patients, and families that were not available for questionnaires. Another data collection method is fall observation, where patients are observed during falls followed by medication errors (Sand-Jecklin & Sherman, 2014).
Data Collection Measures/Tools
The researcher utilized three tools to measure data collection such as observation, online interviews, and questionnaires. The nurse behavior data were collected from patients answering 17 questions via Questionnaires. Online interviews are designed in questionnaire styles that are used by nurses to indicate the effectiveness of bedside reports for both patients and staff. The observation method was used to monitor the number of times patients fell out of bed (Sand-Jecklin & Sherman, 2014). Measurements of falls done during the shift change and any other falls that happened outside the shift change report were not included and measured. For example, based on the report, the amount of patient falls during an end-of-shift change reduced from 20 pre-implementation to 13 in three-month post-implementation and finally 4 in 13 months post-implementation (Sand-Jecklin & Sherman, 2014). Nursing overtime is measured through employee time records. The work time records are monitored by nine nurses in each unit to ensure the uniformity or equality of nurses in regard to nurse working experience. The measurement of overtime minutes done in 10 shifts each month.
Plans for Data Analysis
Data analysis planning is performed with ANOVA tests to check the pre-implementation and post-implementation patients’ and nurses’ data collections to compare the changes between the two for a detailed explanation of medication errors and patient fall and other variables that might alter the resulting study. Patients’ narrative analysis was performed (Sand-Jecklin & Sherman, 2014). In research studies, analyzing data decreases, identifies, arranges, and creates meaning to the information analyzed (Gray, Grove, & Sutherland, 2017). This study identified and explained each data collected from various people shows bedside reporting that includes patients, family, and nurses/staff performance in avoiding many errors in nursing care practices from happening.
Strengths
The initial step in conducting quantitative, qualitative, outcomes, and intervention research to solve this issue is to identify the problem (Grove et al., 2013).
The Strengths of this study are the research design method and Quasi-Experimental pre- and post-implementation to quantify the results of bedside reporting. Due to the size of the samples being large and representative of the population, the researcher was able to assess prior implementation to post-implementation, thereby having quicker results based on their differences during changes. Quasi-experimental studies in nursing are conducted to determine the effects of nursing interventions or treatments (independent variables) on patient outcomes (dependent variables) (Grove et al., 2013, p. 48)
The author used a Likert-type format using five agreement options (strong agree to disagree strongly) which made it easy for patients/families to answer the questions without difficulty.
Also, identifying the demographics of nurses’ age, years of working as a nurse, educational background, and shift work made the data to be reliable. Also, patients’ and nurses, initial data are collected in the same month. The most strengths are that the initial or baseline data are collected before any experiment, thereby giving the researcher ideas on what to expect before and after the intervention to compare the differences.
NURS 3150 Week 3 Assignment – Methods Used in Quantitative Research
Weaknesses
There are three gaps identified in this research study as the implementation of bedside reports took a lot of time which hinders nurses’ interest in the report that comes with an attitude towards staff and patients. Wakefield et al. (2012) state that it is helpful to measure staff willingness to pre- and mid-process change. Assessing staff attitudes and perceptions can give insight into how open staff will be in new turn. Also, when the time is managed well during bedside nurse reports, it will increase patient and nurse satisfaction, including patient outcomes in regard to safety measures. I believe that the safety of patients’ falls should include all staff in their implementations and not only nurses because teamwork is the key to patient quality care and safety. Studies have shown that proper education and training of healthcare workers increases compliance with and adoption of best practices (e.g., attention to safety culture, avoidance of falls ) to prevent patient injury (Agency for Healthcare Research and Quality (AHRQ), 2008). Training and education have to give to all staff in regard to the prevention of patients falling at the beginning of a shift, during a shift change, and toward the end of a shift. According to (Olrich et al., 2012), “Study findings suggest hourly rounding by nursing personnel positively impacts patient fall rates.”
Due to HIPPA law, bedside reports could hinder patient privacy and confidentiality, but using blended nursing reports could eliminate the issue. Nurses should give a report that does not hamper patients’ privacy at the bedside during a shift change, and the rest of the report could record. But there are increasing inconsistencies in the operations of the blended bedside shift report. According to Sand- Jecklin and Sherman stated that even though some nurses complain that bedside reports take a long time, there is no evidence to indicate that the nurses accumulated over time due to nursing reports.
Giving patients’ family to fill out the survey for the patient that is unable to fill out the questionnaires might hinder the accuracy of the report; thereby, the validity and reliability of the research is questioned. For example, if a patient verbalized the survey answers to the family, how is the researcher sure the family wrote down the patient information, given there is potential for bias and inconsistency? I suggest that patients who are unable to fill out the survey need to verbalize their answers to the researcher to get a valid result.
Also, this research study was based only on one area of nursing, which is a medical-surgical unit which hinders the accuracy of the study due to the sample size is not representative of the whole population of nursing and patient’s responses in all nursing areas/specialties. I believe this study should involve all areas/specialties of acute care facilities to provide additional documentation of ‘best practices’ regarding nursing shift reports.
References
Agency for Healthcare Research and Quality (AHRQ). (2008). Patient safety and quality: An evidence-based handbook for nurses. AHRQ Publication No. 08-0043. Rockville, MD: AHRQ; 2008 Apr. Available from: http://archive.ahrq.gov/professionals/clinicians- providers/resources/nursing/resources/nurseshdbk/index.htm
Boswell, C. & Cannon, S. (2017). Introduction to nursing research incorporating evidence-based Practice (4th ed.). Burlington, MA: Jones and Bartlett Learning.
Gray, J. R, Grove, S. K., & Sutherland, S. (2017). The practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Elsevier. ISBN: 978-0-323-37758-4.
Grove, S. K., Burns, N., & Gray, J. R. (2013).The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence. (7th ed.) St. Louis, MO: Elsevier.
Wakefield, D.., Ragan, R., Brandt, J., & Tregnago, M. (2012). Making the Transition to Nursing Bedside Shift Reports. The Joint Commission Journal on Quality and Patient Safety, 38(6). doi: 10.1016/s1553- 7250(12)38031-8
Towne, S. D., Ory, M. G., & Smith, M. L. (2014). Cost of fall-related hospitalizations among older adults. Population Heath Management, 17(6), 351-356. doi:10.1089/pop.2014.0002
Mitchell, M.D., Lavenberg, J.G., Trotta, R.L., & Umscheid, C.A. (2014). Hourly rounding to improve Nursing responsiveness. The Journal of Nursing Administration, 44(9), 462-472. Retrieved from Ovid.
Towne, S. D., Ory, M. G., & Smith, M. L. (2014). Cost of fall-related hospitalizations among older adults. Population Health Management, 17(6), 351-356. doi:10.1089/pop.2014.0002 Quantitative Research: Week 3 Assignment
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Question 
As you have explored in this course, your next step in the research process is to determine what type of research design and methods you will use to engage in research for your research question. While it is possible that many research designs and methods might be appropriate for your particular research question, gaining a firm understanding of different research designs and methods is another useful skill for engaging in nursing research and practice.