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Problems Brought About By Research In Nursing
Problems Brought About By Research In Nursing
Contents
TOC o “1-3” h z u a.Relevance of the Research Problem PAGEREF _Toc383359383 h 1b. Levels of Evidence PAGEREF _Toc383359384 h 2c. Clarity of Included Studies, specifically the designs PAGEREF _Toc383359385 h 3d. Describe Overall Findings PAGEREF _Toc383359386 h 4e. Conclusions with implications for your current practice and future research. PAGEREF _Toc383359387 h 5
a.Relevance of the Research ProblemAccording to Cagle, Rokoske, Durham, Spence & Hanson (2012), one aim of conducting the study was to estimate the levels of use of the electronic data in hospitals, to determine whether the quality measurement practices used had discrepancies especially by comparing the electronic data and manual data, and to also identify the various organizational characteristics, which are associated with the use of electronic data instead of the manual data collection. One importance of using the electronic data is the ability to monitor a wide range of quality-related data (Cagle, Rokoske, Durham, Spence & Hanson, 2012). This information provides much more useful information that has minimal discrepancies as compared to the manual data collection process.
The use of superior components such as the use of advanced planning care, better experience during the nursing care of patients especially those who are dying, the type and quality health care services are more likely to be included and documented in the electronic data by users. The use of electronic data is important in the monitoring of quality (Cohen, Elhadad & Elhadad, 2013). Most hospitals have migrated from the previous methods of using manual data entry. This method had a lot of discrepancies because during that period, the health care industry was being faced with increased and radical regulatory scrutiny. Most hospitals had to comply with the daily activities using electronic data (Cohen, Elhadad & Elhadad, 2013). Due to the improvements made in the health care services, most hospital providers become focused on documentation of clinical data in order to ensure that the data elements to be recorded are tracked down properly and that eligible and comprehensive data are recorded clearly (Cohen, Elhadad & Elhadad, 2013).
b. Levels of EvidenceRegarding the use electronic documentation, and how it is useful in improving the quality of treatment for Hemodialysis patients, there has been little evidence supporting these practices. In terms of measuring quality, two factors still remain dominant. One of the factors is reliability and the other being validity (Thiru, Hassey & Sullivan, 2003). Reliability, which is also the predecessor to validity, is defined as the measure of stability. It is also appraised through comparing and subjecting the various prevalent rates (Thiru, Hassey & Sullivan, 2003). In the past, most studies that were conducted used old statistical methods. An example of such methods includes MSGP4 (Thiru, Hassey & Sullivan, 2003).previous studies also incorporated variations, which include making better decision making based on the reliability of the live data. Such old methods of collecting statistics cannot be able to measure validity of the electronic patient record and therefore, presenting discrepancies.
The electronic patient record provides adequate and sufficient information unlike the manual patient record. The electronic patient record is sensitive to discrepancies and it provides a positive and predicative value (Thiru, Hassey & Sullivan, 2003). The manual data collection methods include questionnaires, surveys and reference standards (Cusack, Hripcsak, Bloomrosen, Rosenbloom, Weaver, Wright, Vawdrey, Walker & Mamykina 2012). Patients form part of the reference standards but the problem with such data is the perception pertaining to morbidity or even the concordance with treatment. As a result, the health care is left with the task of answering the question relating to the real health condition of a patient. In answering the question, three objectives have to be put in place. One objective is whether the answer lies within the subjective dimension. The other ways is to determine whether the answer exists in the diagnostic or objective aspects (Thiru, Hassey & Sullivan, 2003). Surveys and the use of questionnaires on the other hand, can be used in the provision of very uncertain answers.
c. Clarity of Included Studies, specifically the designsIn recent times, manual data collection of patient records have been replaced with new and better methods including the electronic health record data (Cohen, Elhadad & Elhadad, 2013). With the increased ease of use of the electronic health record information, certain opportunities present themselves as well as the free-text notes by patients especially when it comes to addressing the issue of phenotype extraction (Cohen, Elhadad & Elhadad, 2013). One such method is the text mining method. This method in particular is crucial for disease modeling by means of mapping the named entity beforehand to terminologies. After mapping the named entities, text mining method helps to cluster the related terms semantically (Cohen, Elhadad & Elhadad, 2013). The other related study is the electronic health record, EHR, corpora, which exhibits certain linguistic and statistical traits when compared to the bio-medical corpora literature domain.
A good number clinicians prefer to copy and paste the information obtained from previous notes, which had been retrieved and being used in present encounters with patients (Cohen, Elhadad & Elhadad, 2013). Major discrepancies are likely to be observed when such methods are used and are found within the patient records. After much analysis of an EHR corpus system used on a large scale, and then quantify the redundancy in terms of semantic and concept of word reputation, one observes that the levels of redundancy come to about thirty percent and the distribution of the semantics and words not being uniform. Paying a careful and well thought attention towards the structure of corpus analysis in advance helps in ensuring better text mining techniques. An example is evident when the results obtained when the EHR corpus is preprocessed with fingerprints and in the end, the results become better (Cohen, Elhadad & Elhadad, 2013).
d. Describe Overall FindingsQuite a number of hospital agencies are faced with the challenge of shifting their focus on the constantly changing regulatory regulations and at the same time, maintaining the high standards of quality health care. One way of increasing efficiency is through the use of electronic medical records, which provide a platform for recording data that is consistent (Melnyk, & Fineout-Overholt, 2011). The electronic data is important than the manual data collection method because it helps the medical practitioner to use eligible and evidence based protocols within the work place therefore, delivering adequate and better patient services. According to Walrod (2012), the compliance with the regulatory regulations has made the electronic health documentation become the tool of preference by most hospitals nationwide.
Thiru, Hassey & Sullivan (2003), proved that in the past, research was conducted to investigate the importance of electronic health data and their usefulness. In order to obtain quality data, focusing the research attention towards patient identification and the diagnostic data became crucial. Surveys served the purpose in quite a number of the research carried out. The use of survey became ideal in situations that incorporated external forces in setting the direction of changes that would take effect (Thiru, Hassey & Sullivan, 2003). The other factor, which has been at the forefront in favoring the variety of practices that embrace setting the speed for scientific advancements include the appraisal of the quality of data obtained (Thiru, Hassey & Sullivan, 2003). In so doing, the future of research related to nursing would become fruitful. Even though the information in the electronic health record may be positive, at times such information tends to be an over estimate of the intended data (Thiru, Hassey & Sullivan, 2003).
e. Conclusions with implications for your current practice and future research.The future of research in nursing is dependent on current practices within the health care department. Most of the current electronic health data responds to an increasing complex and authoritative medico-legal system, which incorporates stringent regulatory measures as well (Cusack, Hripcsak, Bloomrosen et al, 2012). Such processes, more often, result to unnecessary data capture and in the end; the process of recording such data becomes bulky. As per the health policy meeting held by the American Medical Informatics Association in 2011, certain key issues were addressed in order to ensure the future of EHR is secure. One way was through supporting the care of patients by improving the outcomes of individuals and the larger population as well (Cusack, Hripcsak, Bloomrosen et al, 2012). Advancements in technology would continue to grow over time especially with relation to EHR. More sophisticated data would be incorporated within the health care in terms of recording and analysis of patient records. Even with technological advancements, the core issuers addressed in the paper ought to be considered and implemented sufficiently so as to have a more holistic electronic health data record that promoters the well being of an individual as well as proper treatment of diseases.
Reference
Cagle, J. G., Rokoske, F., S., Durham, D., Spence, A., P. & Hanson, L., C. (2012). Use of electronic documentation for quality improvement in hospice. Retrieved February 09, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/22267819
Cohen, R., Elhadad, M. & Elhadad, N. (2013). Redundancy in electronic health record corpora. Retrieved February 09, 2013, from http://www.biomedcentral.com/1471-2105/14/10Cusack, C., M., Hripcsak, G., Bloomrosen, M., Rosenbloom, S. T., Weaver, C. A., Wright, A., Vawdrey, D., K., Walker, J. & Mamykina, L. (2012). The future state of clinical data capture and documentation: a report from AMIA’s 2011 Policy Meeting. Retrieved February 09, 2013, from http://jamia.bmj.com/content/early/2012/09/07/amiajnl-2012-001093.fullMelnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-Based Practice in Nursing & Healthcare. Philadelphia, PA: Lippincott Williams & Wilkins
Thiru, K., Hassey, A., & Sullivan, F. (2003). Systematic review of scope and quality of electronic patient record data in primary care. Retrieved February 09, 2013, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC155692/
Walrod, A. (2012). Hospice Documentation and the Electronic Medical Record. Retrieved February 09, 2013, from http://blog.healthmedx.com/blog-0/bid/53022/Hospice-Documentation-and-the-Electronic-Medical-Record
Hand hygiene among nurses in Turkey,
Hand hygiene among nurses in Turkey
Name
Institutional Affiliation
Hand hygiene among nurses in Turkey
Health practitioners always get infected by several diseases in their levels of action. Some of these infections result from a myriad of ways. However, the most common is failure to wash hands after attending to patients. In this manner, they end up being infected by the patients. Consequently, they may pass such infections to fellow health practitioners through shaking of hands (Ivanov and Blue, 2007). The research study aimed at determining whether failure to wash hands after attending the patients could be the cause of infection to the health practitioners. The study involved a total of 129 nurses.
Protection of human participants
The study comprised of several participants. A total number of 129 participants were interviewed in the study (Akyol, 2007). This followed the acquisition of an informed consent from the agencies where the study was conducted. Other than the agency, the participants also submitted to the survey. Some participated voluntarily while a good number never seemed to have participated voluntarily during the survey. However, no matter the nature of participation, an informed consent arose from both the participants and the survey agency.
There were several benefits as well as risks to the participants. The authors identified that hand-washing with detergents could prevent the risks of cross-transmission of the infections (Akyol, 2007). This was quite crucial in keeping in check the rate of transmission of such infections between the parties involved. Prevention of such infections also minimizes cases of infection by other related microorganisms. In addition, the researchers noticed that hand cleaning can increase microbial shedding, reduce the lipid content in the skin, as well as increase the transepidermal water loss. This is quite crucial in maintaining the number of infectious microorganisms in the body.
Lastly, the authors identified that hand hygiene was critical to participants since it could lead to increase in skin Ph. This creates unconducive environment to some of the microorganisms, thus, minimizing the infections. However, some risks were also associated with hand washing using detergents. The authors noted that regular hand washing using detergents could damage skin. This was responsible for the irritation felt by the participants (Akyol, 2007). Therefore, the use of alcohol-based formulations was recommended over the use of detergents like soaps to minimize irritations.
Data collection
In data collection, it is of crucial significance to identify the variables. This consists of both the dependent and independent variables. The research survey clearly identified these variables as hand-washing and cleanliness. These were the two major variables identified by the survey. The data used in the survey was collected using closed questionnaire (Akyol, 2007). The questionnaire method was used since all the participants approached agreed to fully participate in the research survey.
Each participant was presented with a questionnaire. Each questionnaire took a minimum of 15 minutes and a maximum of 20 minutes to be completed. This was quite appropriate since it gave ample time for each participant to respond effectively to the questions within the questionnaire. The investigator personally distributed the questionnaires to the nurses in their various departments. This was quite crucial since it ensured all the responses are collected without getting lost along the way. The administration of each questionnaire followed a certain sequence. In total, there were three parts for the administration of the questionnaires.
The first part involved acquiring the demographic information of the respondent. This consisted of the respondent’s age, marital status, education, as well as educational level (Akyol, 2007). Part one of the questionnaire also detailed information concerning the frequency and reasons for or against hand washing, duty at clinic, as well as access to the hand cleaning detergents. The second part detailed the quality of the hand-washing techniques employed by each participant. In this part, the researcher used Fieldmans’ criteria to aid in analyzing the quality. The last part involved relating hand-washing and cleanliness with regards to the different techniques of hand-washing employed by each participant. In this part, the questions raised were in two options namely yes or no, followed by a brief explanation.
However, this research study should have employed other methods of data collection other than questionnaires alone. The use of closed questions could also lead to biasness since they guide the respondents. In this manner, there could be biasness since the such questions reflect what the investigator has in mind. This is depicted by the time duration provided for each questionnaire with regards to the number and content of each question. Therefore, the investigator ought to conduct open interviews with the respondents alongside issuing questionnaires. This might help in minimizing the levels of biasness.
Data management and analysis
Data management is always critical in research activities. It is notable to highlight that data analysis is always the most important in data management. This follows that all results in the report depend on the outcomes from the data analysis. The data entry and analysis was done using Excel and SPSS software respectively (Akyol, 2007). The tools used for analysis include parametric tests and descriptive. In the analysis, statistical significance with a P-Value of < 0.005 was realized following comparison of variables. The software was used to ensure accuracy of the analysis.
However, the author fails to highlight completely how the rigor process was assured. This follows that the author fails to show how he maintained a paper trail of all the analysis processes employed. In addition, the author fails to depict how researcher-biasness was minimized. Even though qualified personnel analyzed the data, there is no likelihood that a comparison of the results was done. This means that maybe only one researcher analyzed the data and provided the results. Therefore, here could have been some levels of biasness in the results that may have influenced the report.
Interpretation of the findings
The research depicted that the nurses had poor qualities with regards to hand-washing. In addition, the author also deduced that the nurses experience difficulties in washing their hands in clinical areas. This may be true since several nurses may not see the sense of washing their hands because they mostly wear hand gloves when attending to the patients. In the survey, the researchers identified several limitations regarding the poor hand hygiene by the nurses. First, they noted that the inadequacy of operational materials as well as dense working conditions hindered the frequent washing of hands (Akyol, 2007). In addition, the soaring of hands after washing with soaps discouraged most nurses from washing their hands.
However, it is significant o note that the author presented the findings in a very coherent manner. The findings from this survey are very important to all sectors of nursing. Therefore, they can be applied in very any areas of nursing. This will create awareness as well as educate the nurses on several issues touching on cleanliness and infections. Even though this survey was done and results reported, further survey is still necessary. Further studies are critical in exploring and providing credible comparisons based on the practices. This helps in broadening the knowledge on the field, thus enhancing the levels of hygiene, as well as minimize incidences of infections.
References
Akyol, A. D. (2007). Hand Hygiene among nurses in Turkey: options and practices. Journal of Clinical Nursing 16, 431-437.
Ivanov, L. L., & Blue, C. L. (2007). Public health nursing: Leadership, policy, & practice. Australia: Delmar Cengage Delmar.
Problems and Solutions
Problem StatementWhat constitutes a successful and all rounded leader for efficient running of a charter school is not well defined. The issue is further worsened by the many variant hurdles the leadership has to overcome in creating and implementing such a school. The roles of the schools head are ever expanding, and their duties and tasks continue expanding making it a hard task to meet all the daily demands to their time (Rutherford, 2006). Specifically, the closure of charter schools by the state is of utmost concern. Thus, the leaders and other stakeholders need developed guides from the experiences of peers who have implemented successful curricula for their students. This study will investigate the techniques and means employed by some of the more successful leaders of charter schools in Florida.
Purpose of the Study The purpose of the qualitative research or phenomenological study will be to gather, sort, analyze and present interpretations on data collected about skills in effective leadership among leaders of various chartered schools in Florida. The research will employ a qualitative approach since the hypothesis involves a human scenario which is open ended and as thus will open broader perspectives (Creswell, 2005). Interviews will be the most ideal data collection means.
Research Questions and Phenomena The study will more specifically seek to answer the following Questions. This is from the observation that charter schools are faced by the problem of scarcity in materials, personnel, support, space and poor anticipation of various needs from all stakeholders (Downing, Spencer and Cavallo, 2004, P.18).
Research Questions and Phenomena Description.R1: What are the necessary leadership skills in running a Charter school?
R2: What issues or concerns influence the thinking of these school leaders once they have operational institutions?
Significance of the StudyA reciprocal analysis of the leadership qualities exhibited by the leaderships of various charter schools will assist in formulating the best practice guideline. The guideline will be applied by the future and current leaders in assessing their decisions. Knowing what caused failure or success will also aid in firewalling against possible shortcomings that could lead to deregistration or school collapse. Further, the trend of under par performance by students in these schools could be significantly reduced with school leaders formulating blue prints based on best practices.
Preliminary Review of the LiteratureAccording to a 2004 report from the U.S. department of education, a charter school is a public school operated and designed by private person(s) and/or organizations. They have the leeway to operate within or outside the public school programme but with monitoring from state or local school authorities (Estes, 2006). They give more opportunities to students, choice to parents and flexible innovativeness to teachers. Leadership is crucial in this sector since leaders provide managerial skills and act as educators. Successes in these schools as businesses and educational facets could be directly attributed to the leaders (Zimmer & Buddin, 2007). Qualitative study is the most appropriate mode since the aim is to understand the skills necessary to increase creativity and innovativeness leaders might apply to broaden methods in instructional delivery. Information will be analyzed with respect to the existing literature and as such libraries both public and private will be used. These books will include journals, handbooks, dictionaries, indexes, electronic references, abstracts and other databases. The following theories will be broadly analyzed.
•What is the most effective combination of leadership skills for effective management of a Charter school? Does this set of skills occur naturally to some and is absent in others? Could these skills be learnt and internalized as a set of best practices in all schools?
•What is the role of technology in the success of charter schools?
Research MethodologyThis qualitative study will involve the use of questionnaires and person to person interviews in trying to achieve its objectives. It is seen as desirable to use qualitative methods since it describes the incidence from the participant’s viewpoint (Creswell, 2005). This can be contrasted to quantitive techniques which use narrow lineation to assign numeric values to experiences. The research can further be defined as non experimental in that the aim is not to test or set out to define a relationship between different variables.
Research DesignThe research will seek to interview leaders of charter schools in Florida that can be considered to have ‘at risk’ students. These students are those with more probability of dropping out of school due to various factors. Geographically, the research will be within the boundaries of Florida. Consent will be sought from the participants with complete information being supplied to them. Confidentiality of their response will be fundamental, and anonymity will be assured where sought.
Sources of Data.Charter school leaders will be sent through the mail or e-mail. Where time and resources allow face to face interviews will be conducted at the convenience of the respondents. The interview questions will be open ended, and an introduction letter together with a consent form will be attached. Where necessary, follow up meetings will be conducted to further understand any answer that is seen as complex. Data Collection Procedures.The study will seek to interview at least ten leaders of charter schools with ‘at risk’ students within Florida. The interview questions will be formulated in a way that gathers as much information as possible on the leadership skills that might lead to success in charter schools. Posted questionnaires will be accompanied by self addresses envelopes with stamps. Where necessary, polite reminders will be sent to those respondents who appear to delay in returning their questionnaires.
Data Analysis Procedures.
The questionnaires will be reviewed exhaustively and coding of key phrases and words done. The QSR international made NVivo8 software will be used to analyze the data.
References
Fuller, B. (2000). Inside charter schools: The paradox of radical decentralization. Cambridge, Mass: Harvard University Press.
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Gerstner, L. V. (1994). Reinventing education: Entrepreneurship in America’s public schools. New York: Dutton.
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Griffin, N. C., & Wohlstetter, P. (April 01, 2001). Building a Plane While Flying It: Early Lessons from Developing Charter Schools. Teachers College Record, 103, 2, 336-65.
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Lynch, S., & Colorado. (2008). Colorado charter schools special education compliance plan guidelines: Negotiating new and renewal charter contracts for Colorado charter schools. Denver, Colo: Colorado Dept. of Education, Exceptional Student Leadership Unit.
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Rutherford, D. (2006). The Cambridge companion to early modern philosophy. Cambridge, UK: Cambridge University Press.