NRS 433 Topic 3 DQ 2 Describe sampling theory and provide examples to illustrate your definition
NRS 433 Topic 3 DQ 2 Describe sampling theory and provide examples to illustrate your definition
Topic 3 DQ 2
Apr 18-22, 2022
Describe sampling theory and provide examples to illustrate your definition. Discuss generalizability as it applies to nursing research.
As we expand on quantitative research, you might find this video helpful:
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Scientific research is what guides nursing practice. Furthermore, research provides evidence-based data to support evidence-based practice (EBP) (Yates, 2015). Improving patient outcomes through the utilization of EBP should be the goal of the nurse. Yates (2015) mentions that through quality improvement (QI) projects, further research opportunities could be developed.
As we embark on nursing research and advancement professionally, think about your unit-based QI projects. Do you think your QI project could be transformed into a research study? It is not always an easy feat, for some there are reservations because of a lack of support from peers or leaders (Yates, 2015). Sometimes change it can take others more time to align with QI projects and research studies. Yates (2015) the following as means of increased interest in research: “nursing education is strengthened, time away from direct care is allocated for conducting research activities, consultant resources such as methodologists and biostatisticians are available to staff, institutional and organizational support of research are strengthened”.
Yates, M. (2015). Research in nursing practice. AJN, American Journal of Nursing, 115(5), 11. https://doi.org/10.1097/01.naj.0000465010.34824.62
At the organization I work for there are many areas that would benefit from a research study. One that is very important for the continued growth of the organization is the retention of trainees in class. The more trainees we graduate the better revenue because we will be able to increase the number of cases we accept to service. There are two populations that we have great success within retention which are Spanish and Chinese trainees. They average a 90 to 100% graduation rate. Unfortunately, the African Americans average a 45 to 60% retention rate. I am responsible to document the start of class and those at the completion of class. The organization tries to be very careful concerning this issue as not to stereotype anyone or have issues with discrimination. I believe this is why they would never go further than what they have been doing to attain the information needed to see why the retention is low with this population. There has been success with research on retention, Murray, et al., (2022) concluded that the use of evidence-based strategies can improve retention. Murray et al., (2022) started with 42 and ended with 36 which was an 86% retention. They even mentioned some of the suggestions I made to the QI department that I felt might help to retain trainees. Suggestions made; recruitment location/places we are looking to interview for admission, educational background to address if they are ready for our program, services, resources, and incentives like daycare, carfare, food programs, uniforms, and books. Mentorship and support are essential for continued growth, guidance, a sense of worth and importance. My peers take it upon themselves to support and mentor their trainees, we could do even more if we had the support of upper management.
For us to assist this population we need to understand their needs, a research project would most definitely assist with this. I would hate to think cost would interfere with the organizations decision not to invest in something that could bring profit in the long run. The statement has been made that our department does not bring in money, but if we don’t graduate enough trainees to work with the clients, they can’t increase the number of clients they accept into the health care program.
NRS 433 Topic 3 DQ 2 Describe sampling theory and provide examples to illustrate your definition
Murray, T. A., Simmons, K. J., Boyd, E., Holmes, S., Bobo, T. L., & Turner, J. (2022). Evidence-based strategies to advance BSN student diversity. Journal of Professional Nursing, 39, 122. https://doi-org.lopes.idm.oclc.org/10.1016/j.profnurs.2021.12.013
Dr. Felder, I believe there are a lot of QI projects in my unit that could be transformed into research studies. But I do not think it is because of a lack of support from my peers or leadership, but rather something deeper in the system that we do not quite understand.
Some of the QI issues in our unit are: surgery not starting on time, no orders the day of surgery or H & Ps being done by physicians, and scheduled cases that do not fit the criteria for outpatient ASCs. Most of these issues are from certain surgeons and their schedulers. All healthcare personnel prioritize improving the quality and safety of care, and it is a never-ending effort. Efforts to enhance the quality, safety, and efficiency of health-care delivery have frequently focused on modifying methods of service organization and delivery (Hill et al., 2020). The goal of quality improvement is to increase the quality of care we provide to our patients so that we can keep them safe, which is the main priority. We also, as nurses, continuously strive to improve our practice to make our job more efficient. Helping identify problems and implementing actions to improve them helps create the best possible outcomes. Leadership created a system in my unit where we daily go over problems and concerns. Every morning, staff members gather around a white board, and we discuss and write on the board the problems that we faced the day before. Then leadership identifies what needs to be looked at so they can help find solutions to solve those problems. So far, I believe it has been a positive thing since it allows us to focus on the things that have been continuously producing difficulties and find a method to address them so that they do not reoccur.
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Hill, J.E., Stephani, A.M., Sapple, P., and Clegg, A.J. (2020). The effectiveness of continuous quality improvement for developing professional practice and improving health care outcomes: A systematic review. Implementation Science, 15 (23)
Both the American Nurses Association and the American Association of Critical-Care Nurses identify participation in quality improvement (QI) efforts as part of a nurse’s role (Whiteman et al.,2021). In the hospital I work, nurses are strongly encouraged to participate in quality improvement programs in order to improve quality of care and patients’ safety. Nurses who provide direct care to patients are in a unique position to identify areas of improvement. Solving complex problems, however, requires in-depth exploration of both the issue and the factors contributing to it. Nurses can utilize hospital data and reports (quality or risk reports) to gather additional information for the areas of improvement and nursing management always willing to share this data with nursing staff.
QI initiatives can also arise from interactions with patients and families or from new knowledge as well. I want to share my experience of participating in QI project on my unit. The goal of this QI effort was to improve nursing knowledge of Alcohol Withdrawal Syndrome (AWS) and adhering to our hospital new Alcohol Withdrawal Policy which was implemented in 2019. With the help of QI department, I was able to collect the data showing overwhelming noncompliance with the new policy in regards of assessment, implementation and documentation. as a result, patients who were diagnosed with ETOH withdrawal were not managed and treated correctly and were at risk for complications, increased length of stay and transfers to higher levels of care. Pre-educational survey of our nursing staff revealed that nurses caring for this patient population were unaware of psychology of AWS and DTs and lacked confidence of caring for these patients. In addition, nurses expressed confusion with the use of assessment tools and documentation according to the new policy. Together with education department and pharmacist, we created an educational binder and TIP sheet to increase adherence to the policy. In addition, I conducted small group “workshops” on our unit to make sure that no gaps are left in knowledge. This QI project was very successful. I received positive feedback for QI department and from nurses on our unit.
From my personal experience I can confirm that Quality Improvement requires an interprofessional team effort. I had very good support from other departments while working and implementing this project. This QI could be potentially a further research opportunity. After reviewing and researching number of studies I came to the conclusion that there is no universal approach of treating AW patients and Alcohol Withdrawal Syndrome is overlooked and mismanaged, therefore many hospitals have different protocols of AWS.
Whiteman K, Jaglowski J, Stephens K (2021). Critical Thinking Tools for Quality Improvement Projects. Crit Care Nurse 1 April 2021; 41 (2): e1–e9. doi: https://doi.org/10.4037/ccn2021914
I’m not aware of any quality improvement projects at my workplace because I have only been at my job for two weeks. One research project I feel could be a quality improvement study in the future is the education model used at our facility to support new graduate. Through the years I have seen new graduates struggle on the floor, and I recall struggling myself. More experienced nurses tend to not support new graduates. If a new graduate nurse doesn’t feel supported enough to ask questions, they may put a patient at risk or be a risk for dissatisfaction in their new nursing practice. Quality improvement studies have been conducted in this area. One study focused on a clinical education model, “known as the Collaborative Clusters Education Model” (Grealish, 2018). This qualitative study aimed provided studied facilitators’ perspectives of implementing the education model offered to new graduates. It was found that education models that provided access two major areas one being clinical experiences and the other providing opportunities for the new graduate to discuss those experiences create a better educational experience and support best practice. To spark the interest in a quality improvement study involving new graduates’ education models, stakeholders can look at retention data or survey new graduates after initial employment and onboarding.
Grealish, L., van de Mortel, T., Brown, C., Frommolt, V., Grafton, E., Havell, M., Needham, J., Shaw, J., Henderson, A., & Armit, L. (2018). Redesigning clinical education for nursing students and newly qualified nurses: A quality improvement study. Nurse Education in Practice, 33, 84–89. https://doi-org.lopes.idm.oclc.org/10.1016/j.nepr.2018.09.005
Apr 23, 2022, 7:25 PM
Generalizability is a mainstay of quantitative research. In quantitative research, Carminati (2018), states that generalizability has become so important to quantitative research studies, and is used to evaluate the rigor of the study. Additionally, the samples in quantitative research are what factors into the generalizability. Furthermore, quantitative research and the inclusion of rigor with generalizability leads to results that are more accurate (Crarminati, 2018). Nonetheless, the more rigor found in research, the stronger the research results.
I can see how the size of the sample size could lead to some generalizability. Carminati (2018) noted that some researchers feel that the validity of a study could occur from convenience sampling with generalizability. Would you consider convenience sampling to be present in this study? Is there convenience sampling in your articles? If so, was there generalizability?
Carminati, L. (2018). Generalizability in qualitative research: A tale of two traditions. Qualitative Health Research, 28(13), 2094–2101. https://doi.org/10.1177/1049732318788379
Apr 23, 2022, 7:24 PM
Generalizability is a pertinent aspect of quantitative research. We know that generalizations can be applied to samples. Kayri and Büyüköztürk (2009) discuss how this can affect results if there are limitations related to the sample size. Oftentimes, smaller samples sizes and generalizations in quantitative research pose reliability issues for results. If research is conducted on smaller sample sizes, it can be biased based on sampling errors. Furthermore, generalizations can impact independent and dependent variables. When considering observational studies, Kayri and Büyüköztürk (2009) assert that sample sizes are critical in observational studies. With an increase in the sample size, there is a reduction in generalizability. With smaller sample sizes, additional techniques are needed to validate results (Kayri & Büyüköztürk, 2009).
Kayri, M., & Büyüköztürk, Ş. (2009). The examining of generalization quantitative scientific findings by using the jackknife method: An application (pp. 1769–1780). https://files.eric.ed.gov/fulltext/EJ867369.pdf
Sampling of a population is done for research because it is not practical to use a complete population. The goal is to get a large sample in order to have confidence in the information you acquire from the research (Ellis, 2020). Evidence-based practice is derived from this, the information gathered from the experiments is needed to make choices about patient care. The choice to use sampling depends on the hypothesis being tested, two groups would be used one for testing and one for comparison. There are two ways to collect a sample, probability, and non-probability. In probability it is a random selection which tries to get people in the study that really represent the population. It is important to watch for variables that cannot be controlled by just looking at what you want for example mental illness (Ellis, 2020). With probability sampling everyone has an equal opportunity to be selected under the criteria that has been selected and for the best representation in the study. The sample is divided, and you try to ensure similarities in your groups. An example would be a study on the success of a new wound dressing on a leg ulcer, or the effectiveness of a new diabetic medication (Ellis, 2020). Random selection must be done properly to avoid any bias.
Non-probability sampling is not done randomly, it could be convenience sampling by inviting someone to participate or snowballing where those same people invite others. This form of sampling is considered less expensive, you can work with a group of your choice, may be less time consuming and done on the researchers’ assumptions about characteristics of the population (El-Masri, 2017). An example of non-probability is a study of knowledge and practice of girls age 13-19 for hygiene during menstruation from selected schools using a questionnaire (Anchal, et al., 2020).
Generalizability in nursing research is related to the target population relationship to one another. The ability to separate information that is relevant or irrelevant in the sample. It is always best to have a larger sample for a better outcome (Kukull & Gabguli, 2012). If findings are the same as in other areas of your population, and just in the one you are studying, than the findings are deemed better. The more generalization then it is more useful.
Anchal, K., Ekambir, K., Gurjeet, K., Harsharn, K., Hrwinder, K., Kirandeep, Harpreet, K., Rizwan, K., & Gurpreet, B. (2020). Knowledge and Practice Regarding Menstrual Hygiene among Adolescent Girls of Selected Schools. Baba Farid University Nursing Journal, 19(2), 37–41. https://eds-p-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=61&sid=e7e52dd8-0a4a-49da-a062-043a8a7ea934%40redis
ELLIS, P. (2020). Sampling in quantitative research (1). Wounds UK, 16(2), 102–103. https://eds-p-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=37&sid=e7e52dd8-0a4a-49da-a062-043a8a7ea934%40redis
EL-MASRI, M. M. (2017). Introduction to research sampling. Canadian Nurse, 113(1), 20. https://eds-p-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=64&sid=e7e52dd8-0a4a-49da-a062-043a8a7ea934%40redis
Kukull, W. A., & Ganguli, M. (2012). Generalizability: the trees, the forest, and the low-hanging fruit. Neurology, 78(23), 1886–1891. https://doi.org/10.1212/WNL.0b013e318258f812
As you indicated there are two methods in collecting a sample, probability and non-probability. Non-probability sampling is a sampling strategy that researchers choose samples based on subjective judgement. This particular method requires a lot of discipline. The researcher must be well informed in order to successfully use this strategy. In qualitative research, this method is utilized. Convenience sampling, consecutive sampling, quota sampling, judgmental or purposive sampling, and snowball sampling are five types of non-probability sampling. In clinical research, convenience sampling is the most common and commonly utilized strategy. According to Elfil & Negida, (2017), researchers select subjects based on their availability and accessibility. Elfil & Negida, (2017), use Egyptian patients with Hepatitis C virus as an example. These patients infected with Hepatitis will become accessible population for researchers using this type of sampling. To perform this research, the accessible population will go to two different hospitals. This study will cover all patients who attend the two hospitals and match the criteria.
Elfil, M., & Negida, A. (2017). Sampling methods in Clinical Research; an Educational Review. Emergency (Tehran, Iran), 5(1), e52.
Non-probability sampling as you stated is not done randomly and can be used for a number of different reasons. It can also be utilized when completing qualitative or quantitative research. Non-probability sampling is typically seen more in qualitative studies. In a qualitative study conducted by Liu et al. (2020), researchers investigated the mental health status of health staff and looked to identify the key population of psychological intervention. In this particular study, non-probability sampling was done when selecting participants as the participants were health care staff. In this study they researched a total of 4679 doctors and nurses from 348 hospitals in 31 provinces of mainland China (Liu et al., 2020). From this they were able to make a generalization of all health care workers in China as it relates to their mental health status since working during the Covid-19 pandemic by only surveying a sample of healthcare workers in that country.
Liu, Z., Han, B., Jiang, R., Huang, Y., Ma, C., Wen, J., … & Ma, Y. (2020). Mental health status of doctors and nurses during COVID-19 epidemic in China. http://dx.doi.org/10.2139/ssrn.3551329
The example you choose is so significant for what the health care system all around the world is going through. This is research that should be ongoing in order to provide the needed services health care professionals need. The number of health care professionals that was used seem to be small (4679) since the population of doctors and nurses for 2020 was almost 8 million (Zhang, 2020). Just imagine how many out of 8 million may be suffering from Anxiety, depression, distress, and other mental health illnesses as mentioned in your article (Liu, et al., 2020). I would believe that the generalization that relates to mental health issues for health professionals is very accurate and needs further research. Are the health professionals getting the help they need?
The United States has approximately 4 million nurses (Schnur, 2020) and over 1 million physicians (Michas, 2021) who I can only imagine the mental health concerns there may be after COVID19, when a shortage of nurses was already a concern. There are many medical facilities that have established some sort of assistance programs for their staff to address the affects of COVID19 on their mental health. Groups, individual counseling, peer support, stress and coping skills has led to treatment referrals. Research has gathered feedback which was positive and suggest the continued need for programs to support the workforce (Mellins, et al., 2020). Research of this type should continue well after COVID is under control to ensure healthcare is returning to normal mentally, preferably better than before. Maybe a larger sample could be use to ensure all populations and mental concerns for healthcare professionals will be captured. Stress has a way of bringing out hidden issues.