Posted: September 13th, 2017

Assignment #3

Assignment #3

Order Description

THERE ARE 2 QUESTIONS THAT NEED TO BE ANSWERED (I AM RESPONSIBLE TO ANSWER ONLY #1 ON THE FIRST SECTION). EACH SECTION HAS ITS OWN RUBRICS. YOU WILL FIND THE SECOND QUESTION BELOW ASSIGNMENT #1&#2 WHICH IS NEEDED TO ANSWER THE FIRST QUESITON. I’VE ALSO ENCLUDED AN EXAMPLE THAT WAS PROVIDED BY THE TEACHER FOR THE FIRST QUESTION.
Instructions: Using your readings you have done up to now for this course, and building upon your answers on Assignment 1 and Assignment 2, answer the questions below. This assignment is worth 10% of your final grade. The content of the three course assignments will be the majority of the content of your comprehensive assignment.
1. What are the considerations specific to sampling for your specific chosen research design to answer your research question? ( for example: effect size, sample size needed for power; interviewees needed to answer question) A response of 6 sentences is a maximum.
**I am not responsible to answer #2&#3** they are provided to you as part of the assignment.
2. What is the preliminary analysis you will use to either code data (qualitative) or to obtain descriptive statistics (quantitative)? (For example: boxplots and histograms to look at distribution of outcome variables between two groups OR coding by primary, secondary and tertiary levels of experiencing during an interview). What do you expect this analysis to help you with before you answer your primary research question in the final analysis? A response of 12 sentences is a maximum.
3. What type of analysis will you use to answer your primary research question of interest? ( for example: a two tailed 2 sample test to see the difference in means between two levels of treatment OR grounded theory analysis to develop theories from open ended interviews with new orientees regarding lateral violence in the workplace). A response of 8 sentences is a maximum.

RUBRIC ASSINGMENT THREE

Instructions: Using your readings you have done up to now for this course, and building upon your answers on Assignment 1 and Assignment 2, answer the 3 questions below. The content of the three course assignments will be the majority of the content of your comprehensive final assignment.

THIS ASSINGMENT IS WORTH 10% OF YOUR FINAL GRADE
Writing style (spelling, grammar) and APA formatting 2 POINTS
No or Minor errors [0-2] 2 points
3-5 errors 1 point
>5 errors 0 points
1. What are the considerations specific to sampling for your specific chosen research design to answer your research question? ( for example: sample size needed for power; interviewees needed to answer question) A response of 6 sentences is a maximum. 3 points
Answers completely 3 point
Partial response 1.5 points
No answer 0 points

THIS IS ASSIGNMENT #1
CAUTI Complications

1. Identify a current research problem related to advanced nursing practice that is of interest to you. Include WHY this is a problem. (Limit response to no more than 3 sentences).
Catheter-associated urinary tract infection (CAUTI) is a growing problem in hospitals today. Complications associated with CAUTI cause discomfort to the patient, prolonged hospital stay, and increased cost and mortality. Evidence-based practice show that to reduce the rate of CAUTI we need to shorten the time of catheter use with timely removal of urinary catheters.
2. Develop a research question to provide information about the research problem. This needs to be stated as a question. (This should be a one sentence response).
Can Catheter-associated urinary tract infections (CAUTI) be reduced by evaluating the need every shift (q12 hours) for them to remain indwelling?
3. Looking at the above research question, do you believe it will best be answered by a qualitative or quantitative study and support your decision as to why you believe the answers would best be provided by the type of study you have chosen. (This should be a response of no more than 3 sentences). It is possible to have a mixed methods study but it is not recommended that you choose to do this type of project. It may be too complex for novice researchers.
A quantitative study will be our approach to support the evidence. Information in regards to the study is best retrieved in a hospital setting by acquiring the information from the different units within. We will be looking at catheters that have remained indwelling for unexplained intervals to determine if the incidence of UTI’s is higher in longer length of catheter use.
4. Now, again looking at your research question you framed above, identify your variables. If, applicable identify which is the dependent [outcome] and which is the independent (or predictor) variable. (Here, limit to 1 predictor or independent variable, and 1 dependent or outcome variable.)
Independent Variable: Length of Urinary Catheters
Dependent Variable: Urinary Tract Infections (UTI’s)
“The presumed cause is the independent variable, and the presumed effect is the dependent variable” (Polit & Beck, 2008, p.58).
5. What conceptual or operational definitions will you assign to your variables chosen to explore? (Conceptual and operational definitions are very important and are not the same things. Check with the Nursing Research text by Polit and Beck (9th edition, 2012) page 52 for description of conceptual and operational definitions.) Tell me which definition you are providing.
In quantitative studies, such as the one stated above, concepts need to be defined from the beginning of the study. This will indicate how the variables will be measured. “An operational definition of a concept specifies the operations that researchers must perform to measure it” (Polit & Beck, 2012, p. 52). In the above study, the operational definitions of the variables are as follows:
Independent Variable: Urinary catheters will be measured in number of catheters patients with indwelling urinary catheter with a diagnosis of UTI.
Dependent Variable: Urinary Tract Infection (UTI) will be defined as number of diagnoses of UTI with a positive urine culture > 100,000.
References
Polit, D. F., & Tatano Beck, C. (2012). Nursing research: Generating and assessing evidence for Nursing Practice (9th ed.). Philadelphia: Wolters Kluwer: Lippincott, Williams & Wilkins.
Wilson, M., Wilde, M., Webb, M., Thompson, D., Parker, D., Harwood, J.,…Gray, M. (2009). Nursing interventions to reduce the risk of catheter associated urinary tract infections. Journal of Wound, Ostomy and Continence Nursing, 36(2), 137-154.

THIS IS ASSINGMENT #2
CAUTI Complications (Assignment 2)
1.Look back at the research question and the variables that you defined in Assignment #1. Now, think about what kind of a study you would design to answer the question with the variables defined. For example: Would it be an experiment, a quasi- experiment or a non- experimental design, and why? A response of 4 sentences is a maximum.
We would use a quasi-experimental design. We would examine patients who are currently undergoing treatment for Cather-Associated Urinary Tract Infection (CAUTI), those who are now cured after undergoing successful medication, and analyze the complications associated with CAUTI. We would use this method because it is a random assignment that would be effective if performed on sick individuals in order to yield the required results.
2. Would you get your data retrospectively or prospectively, and why? A response of 3 sentences is maximum.
We would gather our data retrospectively using a reliable sample of CAUTI patients from a reputable hospital for one week. This would allow enough time to perform the needed research. We would use this criterion because the research applies observations and interviews to gather the required information.
3. List some threats to validity of your study (internal or external) or credibility, confirmability threats if a qualitative design. A response of 12 bulleted threats is maximum. You may not be able to come up with 12, that is fine.
4. Now go back and think of ways to control for some of these threats with your design. You may not be able to control for all, that is fine as well, these would need to be listed in limitations of a proposed study design, we will discuss in final exam.
QUESTIONS 3 & 4 – RESPONSES WERE INCORPORATED TOGETHER. QUESTION 3 ANSWERS ARE IN ORANGE. QUESTION 4 ANSWERS ARE IN BLUE.
Variables interfering with internal validity
• Temporal Ambiguity: Undiagnosed/underlying urinary tract infection prior to catheter insertion.
Increased susceptibility to infection with immunocompromised patients.
• Collect the data on any documented preexisting UTI’s, documented immunocompromised patients, and remove from sampling.
• History: Technique of catheter care by various healthcare personnel in contact with patient such as perianal care with bathing and changing drainage bags when necessary.
• Educate staff on importance of diligent catheter care during dwell time and maintenance of sterile technique with drainage bag changes. Follow up for compliance.
• Maturation: Effects of disease, post-operative recovery period and various other medical states which can impact results of data.
• Collect data on vital signs, lab work (including differential white blood counts), and other infectious processes that may be present concurrently with urinary catheter use and consider as explanation for results.
• Instrumentation: Technique of inserting urinary catheters by various RN’s.
• Chose only specific RN’s to insert urinary catheters in patients in the study.
• Technique of obtaining sterile urine samples by various RN’s.
• Chose only specific RN’s to obtain sterile urine samples.
• Experimental mortality: Patient not available at final stage of study to collect data.
• Collect all data within specified time frames. Data review of care plans to capture any patients potentially being transferred or discharged during this time frame.
• Selection bias: Indications for urinary catheters. Utilized for chronic versus acute reasons.
• Collect all data regarding necessity of indwelling urinary catheter. Incorporate this data into study results.
Variables interfering with EXTERNAL validity
• Interaction effects of selection biases and the experimental variable: Effects of the interaction of the chronic verses acute necessity, duration of dwell time and the documented urinary tract infections at the conclusion of study.
• Collect all data regarding the reason for necessity, duration, and result of urine culture and document/include all data in the final conclusion of study.
• Multiple treatment interference: Antibiotic therapy prescribed and administered for reasons other than urinary tract infection. This can alter urine culture results.
• Collect all data regarding antibiotic administration and include in results of study.
5. What type of an instrument would you use to get your data (an instrument can be a survey or a scale or simply an interview or observing someone’s behavior and recording it)? How would you know if it is a valid and reliable instrument to use? A maximum of 4 sentences here. Validity and reliability are two separate concepts. Please address BOTH for your instruments.
The instrument most appropriate for this study is a record review. This type of data collection has high validity due to the documentation of patients with lab results greater than 100,000. These results are located in each chart in order to elicit the diagnosis of urinary tract infections for each patient. There may be some question regarding reliability of the instrument due to the possibility of inaccurate information gained from tainted urine cultures.

WORKED EXAMPLE FOR ASSINGMENT THREE

Instructions: Using your readings you have done up to now for this course, and building upon your answers on Assignment 1 and Assignment 2, answer the questions below. This assignment is worth 5% of your final grade. The content of the three course assignments will be the majority of the content of your comprehensive final assignment.

1. What are the considerations specific to sampling for your specific chosen research design to answer your research question? ( for example: sample size needed for power; interviewees needed to answer question) A response of 6 sentences is a maximum.
To answer the question “ Does saline lavage increase the incidence of Ventilator Associated Pneumonia (VAP) in Adult Critically Ill Patients in Intensive Care Settings?” I defined my variables as: saline lavage (IV with two levels: got the lavage with suction/did not get lavage with suction)and VAP (DV with two levels: pt. developed VAP/pt. did not develop VAP). Due to the discrete ( nominal) data type of both of these variables I will need to have a minimum of 87 participants in each group to have power of .8 and to be able to detect a medium effect size at an alpha level of .05 . I will oversample with 100 participants in each groups to allow for missing data. I originally had planned for a two week retrospective study, but due to the sample size needed I plan to increase time of the study to two months and include ventilator dependent patients from three additional critical care units in our institution.

FINAL ASSIGNEMNT QUESTION

Instructions: Use your readings and feedback from this semester to answer the below questions. Take your answers from Assignment 1, 2 and 3 and copy and paste them into this final document. The readings you have done up to now for this course, and building upon your answers on Assignment 1 and Assignment 2, answer the 3 questions below. This comprehensive final assignment is worth 25% of your grade. You have completed most of the work for this assignment throughout your other 3 assignments.

2. Now, look at your work and first congratulate yourselves on all that you have learned as novice nurse researchers. Then reflect on the different stages of the process you have just completed through these three assignments (the process was that you developed a rudimentary research proposal). Write approx. 1 double-spaced answer (no more than 2 paragraphs) describing the elements of a research proposal that were easier than expected, more difficult than expected, and going forward how these exercises have impacted your view of the nursing research process.