The Effects of Missed Nursing Care on Patients - Research Proposal Example

? RESEARCH PROPOSAL 4.0 Objectives On a more generalized approach or primary focus, this study is guided by the objective of examining and exploring broadly the effects of missed nursing care on patients who are hospitalized. Despite many of the previous studies conducted under the theme focusing on the objective, there lacks empirical evaluation of the findings postulated. This study therefore focuses on generating an empirical justification to the relationship between the missed care by nurses to hospitalized patients and the effects resultant to the patients. The study will also focus on the objective of contributing to the existing research findings under the theme, which would be instrumental in guiding the future studies under the topic. Moreover, secondary objectives to this study are to develop policy recommendations that would guide the medical fraternity and more specifically the nursing teams in embracing their role in attending to the needs of the patients. It will also be a justification to direct future studies focusing to address the same or more related theme to the current theme under study. Scope of the study Many of the previous studies carried out under the theme of missed care and the effects on hospitalized patients have been strategically focused on qualitative analysis of the scenario and thus negate the quantitative/statistical evaluation. This study will therefore be instrumental and specific in analyzing the likelihood of occurrence of such errors as omissions and commissions and the empirical connection of these errors and the states of the hospitalized patients. Questions This study will be guided by such questions as: how does the occurrence of errors of omission and or commission influence the recovery process of hospitalized patients? Moreover, can we justifiably ascribe rising cases of fatalities and health deterioration by the patients to missed nursing care or better put to such errors as of commission and omission by the nursing fraternity? Hypothesis This study runs under the guidance of two hypotheses, which are based on a generalization of ideas, which will need to be substantiated by the research. I. Hypothesis: If the overall outcome of medical care offered to patients is related to consistency and strict observance of the necessary care, then the fatalities and unfortunate happenings to patients are to be blamed on missed care or errors of commission and omission. II. Hypothesis: deterioration of patients’ health as well as fatalities in hospitalized patients is directly related to missed nursing care. 5.0 Methodology Intervention designs Unlike research methods that are used by researchers to refer to distinct techniques that are applied while carrying out a research study, the research methodology describes the vast number of processes that a researcher involves while studying specific phenomena. Methodologies therefore refer to the systematic process through which a research study is carried out. Research methods are categorically part of the methodologies that are utilized by a researcher within the framework of carrying out a research study. This section describes the various procedures that will be used during the testing of the hypothesis, collecting of data and management of data upon which this study is based. The section additionally explains the methods that will be used during data analysis and the description entailing the scope of the procedure that will eventually lead to the answering of the hypothetical question that was generated to guide the whole study. Environment of the study Methodology is a critical step while carrying out a research study in that through literature review, one is able to know whether it is a study that has ever been done and if so the methods applied previously and the outcomes that were gotten. It therefore assists the research in determining whether his/her methods have been used in the past and what other methods have ever been used. Moreover, the methodology may depend on the research being either structured or unstructured within the qualitative/quantitative analysis. In this study, we shall adopt a general hospital environment through which the data collection processes will be based on and in which the application of the study’s finding will be expected. Inclusion and Exclusion criteria Medical practitioners in Canada based hospitals will be included in the study where all the participants will be required to have at least two years experience in the medical field. The experience would be necessary to ascertain the validity of the information given and the conclusions made in the questionnaires by the respondents. On the other hand, the nursing practitioners who are non-residents as well as those without the minimum practicing period of two years are to be excluded in the study. In addition, persons of unsound mind or questionable character in terms of nursing practicing ethics will also be excluded from the study. Through this criterion, the study will be effective in confirming the reliability on the data collected and the overall conclusions arrived at. Procedures of data collection Within the empirical context of research study, the researcher identifies the overall population, decides on the observable variables and then quantification of the empirical research is done. This involves the methods of measuring the variables, estimating the respective parameters and then testing the hypothesis. This however, does not necessarily rely on any specific theorem. Nevertheless, the conceptual or theoretical research studies are guided by some abstract ideas or theories. However, the two perspectives; the theoretical as well as the empirical perspectives complement each other for the reliability of the findings that are resultant of a study. The research paradigm adopted as either being qualitative or quantitative is equally very instrumental in deciding on the methodology to be applied. Qualitative and quantitative research studies depend on the major differences notable on the nature of reality, epistemology (relationships being studied), use of language, role of values as well as the overall research process (Aylward and Clarke, 2005). Analytical methods are applicable within the context of testable variable within studies. Other relationships are not testable hence; the studies adopt the deductive methodologies of carrying out a research study. On the other hand, whenever research variables relate in manners that are both predictable through theoretical deductions and can be testable, the studies will employ the use of the two simultaneously. Deductions from the study findings will then be applicable in general context within the capacity of the study to project and make inferences. For instance, in studying the effects of entrepreneurship within firms and the effects, our study has employed the use of analytical methodology of testing data and making possible inferences. Through testing the significance of the values gotten through regression methods, we ascertain the impact of each variable to the overall deductions arrived at. The research will employ use of raw data from sampled hospitals and health facilities, which offer the hospitalization services to patients. Focus group interviews as well as the customized individual surveys will assist in collecting the required data. Mortality rates from the respective hospitals over a certain period, say two years, will be gotten from control systems and the record departments and the associated causes of death be collected. Research Design This research study adopts descriptive qualitative and quantitative survey designs (Taylor, 2005). The two perspectives; the theoretical as well as the empirical perspectives complement each other for the reliability of the findings that are resultant of a study. In qualitative analysis, theoretical deductions and conclusions would be instrumental while quantitative conclusions will rely on statistical analysis, which will particularly be on established correlations between the variables of mortality rates and the perceived rates of missed nursing care. Instruments of data collection Data will be collected from the respondents using a structured questionnaire, which will be self-completed. Pre-testing of the questionnaire will be done to ensure that the questionnaire will gather the correct responses, and to assess the return rate of the respondents. These two practices will enable the investigating team to assess the viability of using mailed questionnaires. The questionnaire will be structured in such a manner that the respondent will be required to choose a response from a list or a scale from for instance, strongly disagree to strongly agree, or vice versa. A questionnaire will be used in this study because it will be the most convenient and economical for collecting data from the public, and will cover a big geographic area. Quantitative measurement refers to the collection of numerical values in relation to a measurement such as height, length, weight, deaths etc which are eventually analyzed through mathematical procedures while qualitative measurement deals with observation where one generalizes the observation; length can be categorized into long or short, height be categorized into tall or short and weight be categorized into heavy or light. Basic traits in quantitative data enable collection to be done through standardized methods, be replicated as well as be analyzed through statistical methods. Strategies in numerical data collection range from: clinical trials/experiments, observation and recording, collecting factual data from management control systems as well as through administering of surveys. The surveys adopt interviews and administering of questionnaires; which can be open group or closed questionnaires (Anon, nd). For instance, while analyzing the effectiveness of nursing practices in a hospital, we evaluate the overall output in terms of the number of patients who successfully recover as influenced by various factors such as the effectiveness in nursing care delivered. We take an example of the number of patients discharged daily as compared to the fatalities recorded over a given period. In the experiment we can adopt the observation recording strategy of data collection or better still check through the management control system of the bakery. Strategies of data analysis Various statistical analyses will be computed, such as descriptive statistics, including means, and percentages, among other descriptive statistics. Descriptive statistics are easy to compute and give a general view of study results, such as the extent to which missed care or the errors of commission and omission affect the recovery of hospitalized patients within the countries health facilities. Other aspects, which revolve around the effectiveness of the care, delivered to patients such as the experience of the medical practitioners, the availability of necessary tools and equipment to handle the patients’ cases as well as the general environment of the hospital will be essential in explaining the conclusions arrived at. Quantitative statistical analysis, including Chi-square test will be used to test the hypothesis. Chi-square for variance will be used to confirm if the study has a definite variance over the issue of missed nursing care. 6.0 Ethical considerations In ethical behavior, a person does not only rely on other peoples approval, rather decision making rely more on personal happiness, self approval, inner benefit from the decision as well as the habitual practices especially as pertains religion. Being ethical or better still making ethical decisions is the ability to choose between options that are presented guided by personal respect, trustworthiness, fairness, responsibility good citizenship and caring attitude. Research studies as this normally take to cognition the necessity to work under the framework of ethics in order to respect the opinions and decisions of persons involved in the study. Therefore, it is ethical to seek ethical approval from the school representing the higher authority in this context as well as have ethical principles and frameworks that will guide the respondents in the data collection stage. Approval to conduct the investigation using will be sought from review board/committee of the university. Before answering the questions in the questionnaire, all study participants will be required to read and sign the consent form that will be included in the questionnaire. All returned questionnaires without signed consent forms or unaccompanied by a signed consent form will be considered invalid for statistical analysis. The respondents will be required to consent to participate in the survey through filling a consent form, while the questionnaires will lack respondents’ names for secrecy purposes. All questionnaires will have telephone numbers and a postal address printed on them. Participants will be advised to use these contacts to ask questions or seek clarification on any unclear issues from the principal investigator (Orb, Eisenhauer and Wynaden, 2000). 7.0 Relevance and anticipated effects A researcher adopts various theoretical approaches that are relevant to his or her study including positivism, and realism. It is a common/universal opinion that researchers adopt approaches based on past or philosophical reasons. Occasionally, researchers only use procedures and techniques that relate to the study topic of interest. However, a research is reliable if conducted based on clear and accurate methods. That is, certain approaches are considered preferable for specific categories of research. The specificity in research methods ensures that the data collection practices and data analysis/statistical methods produce reliable results. On the other hand, research methods ensure validity by guaranteeing the outcomes and conclusions are in reality what they happen to be. For these two reasons, researchers undertake triangulation to obtain validity and consistency of the outcomes of a research. A piece of investigation could be said to be justifiable if only agreed to be accurate. My study has the basic objective of evaluating the effects of missed nursing care to the hospitalized patients. We therefore focus on the deductive conclusions that would be arrived at through the analysis of the data collected. From the theories of efficiency in service delivery, generalization of the findings will be made. Moreover, in the event that the findings support the hypothesis that the fatalities and mortality rate is directly related the care provided, then policy formulations from the study will support the improvement of efficiency by the nurses to reduce the cases of errors either by commission or by omission (Kalisch et al, 2011). On the other hand, if the result fails to support the hypothesis, the findings will be instrumental in helping the management and other stakeholders in the medical industry to make sound policies that would be effective in overcoming the challenges emanating from missed nursing care to the overall output in a hospital. Moreover, the findings of the study will be instrumental in shaping the direction of future studies in the theme of missed care by medical practitioners and the effects to the patients. This study will observe all research protocols to ensure validity and reliability of the outcomes, as they are likely to influence the conclusions on the contribution of effective health care to the Canadian medical industry at large. References Anonymous, (nd) Quantitative and Qualitative Data collection methods. Data Collection Methods. Retrieved from Aylward D. and Clarke R. (2005). Research models and methodologies. HDR seminar series. Faculty of commerce spring session 2005. Retrieved from: Kalisch B. J. et al, (2011). Hospital Variation in Missed Nursing Care. American Journal of Medical Quality, XX(X) 1 –9. Orb A., Eisenhauer L. and Wynaden D., (2000). Ethics in Qualitative Research. Journal of nursing scholarship, 33(1), 93-96. Taylor, G. R. (2005). Integrating Quantitative And Qualitative Methods in Research. Lanham: University Press of America. Appendix Questionnaire for qualitative data collection for the sample hospitals. SECTION 1 Department rating: (To be filled by any medical staff) The following departments actively contribute to the overall performance of the hospital regarding the attendance to patients. On a scale of 1-10, rate the success of the respective department to harness ‘patients’ output of the entire hospital or medical facility (Where 1 represent best performance and 10 worst performances). a) The outpatient department (1) (2) (3) (4) (5) (6) (7) (8) (9) (9) (10) Comment…………………………………………………………………………………………………………………. b) Nursing department (1) (2) (3) (4) (5) (6) (7) (8) (9) (9) (10) Comment…………………………………………………………………………………………………………………. c) Department of pharmacy and medical supplies (1) (2) (3) (4) (5) (6) (7) (8) (9) (9) (10) Comment…………………………………………………………………………………………………………………. d) Clinical department (1) (2) (3) (4) (5) (6) (7) (8) (9) (9) (10) Comment…………………………………………………………………………………………………………………. e) The laboratory department (1) (2) (3) (4) (5) (6) (7) (8) (9) (9) (10) Comment…………………………………………………………………………………………………………………. Any other (specify) ………………………………………………………………………………………………………………………………………………….. (1) (2) (3) (4) (5) (6) (7) (8) (9) (9) (10) Comment…………………………………………………………………………………………………………………. SECTION 2 Opinion section: (To be filled by any medical staff) 1. In your opinion, should the nursing department be blamed on rising cases of mortalities and complications to hospitalized patients? (Tick where appropriate) a. (Yes)……….. b. (No)……….. Why…………………………………………………………………………………………………………………………………………….. 2. Is the management’s intervention in nursing affairs beneficial to improving the performance of the hospitalized patients? (Tick where appropriate) a. (Yes)……….. b. (No)……….. Why…………………………………………………………………………………………………………………………………………….. 3. What methods should the hospital management employ to intervene in improving nurses performances? Disciplinary layoffs (Tick where appropriate) (Yes)……….. (No)……….. Why…………………………………………………………………………………………………………………………………………….. Redeployment (Tick where appropriate) (Yes)……….. (No)……….. Why…………………………………………………………………………………………………………………………………………….. Regular reorganization (Tick where appropriate) (Yes)……….. (No)……….. Why…………………………………………………………………………………………………………………………………………….. Any other (specify) ………………………………………………………………………………………………………………………………………………….. SECTION 3 Strictly for management On a scale of 1-5, rate the responsiveness of the patient outcomes in your hospital with improved nursing care in the different department (Where 1 represent lowest performance and 5 best performances). The outpatient department (1) (2) (3) (4) (5) Comment…………………………………………………………………………………………………………………. Nursing department (1) (2) (3) (4) (5) Comment…………………………………………………………………………………………………………………. Department of pharmacy and medical supplies (1) (2) (3) (4) (5) Comment…………………………………………………………………………………………………………………. Clinical department (1) (2) (3) (4) (5) Comment…………………………………………………………………………………………………………………. The laboratory department (1) (2) (3) (4) (5) Comment…………………………………………………………………………………………………………………. Any other (specify) ………………………………………………………………………………………………………………………………………………….. (1) (2) (3) (4) (5) Comment…………………………………………………………………………………………………………………. Read More