Discussion: The Nurse’s Role in Promoting Quality Health Care

As you have noted in this course and in your practice, nurses have an integral role in promoting a just culture focused on patient safety in their health care organizations. Determining resources to prevent error and improve patient safety can often be a battle, and this scenario illustrates how one organization makes strides to make sure resources are available in the interest of patient safety. As you review the scenario, consider the nurse’s role in promoting a just culture in your practice setting.

By Day 3

Post a description of the role of the staff nurse for promoting quality in a high-performing health care organization. Define the organizational culture of your health care organization, or one with which you are familiar, and identify the leadership style of the CEO and CNO in your organization. Explain how your senior leadership supports—or does not support—changes that require financing/budget to support patient safety. Describe the strategies you might be able to implement to move your health care organization to a high-performing organization.

Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist)

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations.  

  

Practice Experience: Developing a Quality Improvement Plan

Storyboard Instructions

The Practice Experience Project Storyboard is a brief, visual summary of a completed quality improvement initiative. The storyboard highlights key aspects of a quality improvement effort by documenting the Practice Experience Project from beginning to end. 

The course template uses a PowerPoint format to complete this assignment. You only need to provide two slides, no more. The first slide is the summary of your project; the second slide is the reference page. You will need to choose the most pertinent information from your practice experience and Capstone Paper to complete the Storyboard. No voiceover is required.  

The completed storyboard is submitted for grading and also serves as the main post for the Week 6 Practice Experience discussion.  

 

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4-Phenomenological research and grounded theory are common methods of conducting qualitative research.

Similarities:

·          Both collect data from their subjects’ perceptions and perspectives

·          Both do their best to make sure their findings are not influenced by preconceived notions or judgments

·          Both explore their participants’ personal experiences

·          Both seek understanding the meaning of events and experiences on peoples’ lives, (Driessnack, 2007)

Differences:

·          Phenomenological research focuses on understanding the impact an experience has on a person’s life. The only sources of information are the people experiencing the event (phenomena). This type of research is often limited to interviews only, (Driessnack, 2007)

·          Grounded theory research includes a variety of data sources, including diaries, observations, images, and past research. They compare the data they collected with older data and look for differences and contradictions, as well as social patterns.

References

Driessnack, M., Sousa, V. D., & Mendes, I. C. (2007). An overview of research designs relevant to nursing: part 2: qualitative research designs.

  

5-“The purpose of phenomenological research is to provide a thorough description of a lived experience. Some researchers will summarize their findings with a written summary that combines the findings into a thorough description or an exemplar of the experience” (Grove 70).

“Grounded theory research is an inductive technique that emerged from the discipline of sociology. The term grounded means the theory developed from the research has its roots in the data from which it was derived. Most scholars base the grounded theory methodology on symbolic interaction theory. George Herbert Mead (Mead, 1934), a social psychologist, developed symbolic interaction theory, which involves exploring how people define reality and how their beliefs are related to their actions. Reality is created by attaching meanings to situations. Meaning is expressed in such symbols as words, religious objects, patterns of behavior, and clothing. These symbolic meanings are the basis for actions and interactions. However, symbolic meanings are different for each individual, and we cannot completely know the symbolic meanings for another individual” (Grove 70-71).

“Grounded theory has been used most frequently to study areas in which little previous research has been conducted and to gain a new viewpoint in familiar areas of research. Through their interviews to understand the perspectives of persons who were dying, Glaser and Strauss (1967) developed grounded theory research as a method and published a book describing it as a qualitative method. Nurses were attracted to the method because of its applicability to the life experiences of persons with health problems and its potential for developing explanations of human behavior (Wuerst, 2012)” (Grove 71).

“Ethnographic research was developed by anthropologists as a method to study cultures through immersion in the culture over time. The word ethnography means “portrait of a people.” Anthropologists study a people’s origins, past ways of living, and ways of surviving through time—in other words, their culture. Culture is the focus of ethnography. Early ethnography researchers studied primitive, foreign, or remote cultures (Savage, 2006). Such studies enabled the researcher who spent a year or longer in another culture to acquire new perspectives about a specific people, including their ways of living, believing, and adapting to changing environmental circumstances. This reflects the emic approach, one of studying behaviors from within the culture that recognizes the uniqueness of the individual (Ponterotto, 2005). The emic view from inside the culture is the typical goal of ethnography” (Grove 74).

I feel as though phenomenological research and grounded research have the most similarities due to the fact they both want to get to the root of the research by analyzing data from the core. Both types of research analyze both, people and experiences. I prefer grounded research because I like to investigate and analyze current and new research to understand it and create a different viewpoint, and maybe even learn about some of my own discoveries related to that research.

References

Grove, Susan, Jennifer Gray, Nancy Burns. Understanding Nursing Research, 6th Edition.      Saunders, 092014. VitalBook file.

  

6-I use the online lecture notes to my advantage. They are very helpful for discussion questions. I do not have a hard copy of either the Burns and Gray textbook or the APA manual. I use online information about 99% of the time. I go to owlpurdue.com when I have questions about APA format/quotes. I feel as though it is quicker to have access to online materials whether your are at home on the computer or on your phone. Technology has took off in the last few years.

Hope this is helpful.

-Shelby.

 

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4-I agree with you that Sampling theory was developed to determine the most effective way of acquiring a sample that accurately reflects the population under study. A sample is the selected group of people or elements in a study. The sample selected should represent an identified population or a particular group of individuals or elements that is the focus of the research. And  to add that Sampling theory is also  the study of the relationship that exist between a target population and the samples that are drawn from the population and this only applies to samples that are drawn randomly.  The main concepts of the sampling theory are the target population, representative samples and sampling plans or methods.

Target population is also known as research universe.  The subject of investigation is the whole statistical data.  A sampling plan normally states methods that are to be used to collect random samples from the population in such a way that there is very minimal to zero biasness.  The methods can use random probability sampling techniques.

The following steps are normally involved when developing a sampling plan, they are as follows,

Identification of parameters to be measured.

Designing intervals of measurement.

Selection of sample sizes

Establishment of data storage formats

Assigning roles and responsible to the research teams.

Generalizability is the process of extrapolating the research findings of a sample population to the general population.  The reason behind it, that the sample population that was selected represented the entire population. As such the research could extrapolate the findings and make a conclusion that represents the entire population.

   References:

Chambers, R, Chambers R, L & Skinner, C(2003), Analysis of Survey Data. Retrieved from https://www.powells.com/books/analysis.

Korn, E & Graubard, B. (1999) Analysis of Health Surveys. Retrieved from online library .wiley.com.

  

5-‘In theoretical sampling the sample is ‘not selected from the population based on certain variables prior to the study, rather the initial sample is determined to examine the phenomena where it is found to exist. Then, data collection is guided by a sampling strategy called theoretical sampling. This implies that the researcher starts the study with a sample where the phenomenon occurs and then the next stage of data collection is when theoretical sampling begins. Theoretical sampling is the process of data collection whereby the researcher simultaneously collects, codes and analyses the data to decide what data to collect next. Deciding where to sample next according to emerging codes and categories is theoretical sampling” (Coyne, 1997)

An example might include a group of Caucasian men, ages 60-70, diagnosis of heart failure. The study could include the effects of following a sodium and fluid restriction diet and the impact on the men’s health.

“Generalizability is a measure of how useful the results of a study are for a broader group of people or situations. If the results of a study are broadly applicable to many different types of people or situations, the study is said to have good generalizability. If the results can only be applied to a very narrow population or in a very specific situation, the results have poor generalizability” (Hydrocephalus, n.d)

Coyne, I. (1997). Sampling in qualitative research. Purposeful and theoretical sampling; merging or clear

             boundaries? Journal of Advanced Nursing, 26(3), 623-630. Retrieved 9 13, 2018, from

             http://corcom300-

             s12-lay.wikispaces.umb.edu/file/view/article_sampling_qualitative.pdf

Hydrocephalus Association, n.d. Research 101:  Generalizability. Retrieved 9 13, 2018, from

  

6-I agree with you that Sampling is choosing a determinate variable within a research study.  There are many steps in the process of choosing a sample.” Sampling theory was developed to determine the most effective way of acquiring a sample that accurately reflects the population under study. And  to add that Sampling also entails studying a chosen group of people who represents a larger population.  Sampling theory describes two sampling domains: probability sampling and non-probability sampling.   In probability sampling findings can be generalized to the given population while in non-probability sampling, findings can only be generalized to the place the study was done. (Summers, 1991)

Probability sampling methods are systemic sampling, random sampling and cluster sampling while non-probability sampling methods involves theoretical sampling, purposeful sampling, network sampling and convenience sampling. (Thompson,1999)

The textbook defines generalizability as the extendibility “of the implication of the findings from the samples or situation that was studied to a larger population or situation.” (Grove et al. 2015).  In my opinion, findings from a health-related research study should only be generated if it is performed among many people and is proven to be accurate multiple times.

        References:

Grove, S, Gray, J & Burns, N.( 2015) Understanding Nursing Research, 6th edition.

Summers, S(1991) Selecting a sample from a research study. Post Anesthesia Nurse. Retrieved from http://ebn.bmj.com.

Thompson, C(1999) .If you could just provide me with a sample: examining sampling in qualitative and quantitative research papers. Retrieved from http://ebn.bmj.com.

 

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4-  The article by the author “The Role of Spirituality in Health Care “informative in its analysis and attention to the spiritual needs of the patient which is often overlooked (Puchalski ,2001). Spirituality in terms of disease and healing is important and can help with coping and recovery when facing a chronic illness, suffering, or a loss. These belief values can vary from person to person however they tend to have an overarching core principle of a spiritual faith-based core belief set. As part of a physical work-up and collection of history and physical data is collected a spiritual history is also taken and incorporated into the healthcare treatment model in this way the healthcare professionals are providing a holistic all-encompassing care of the patient also addressing the spiritual needs of the patient (Puchalski ,2001).

                                                                                 Reference:

Puchalski, C. M. (2001, October). The role of spirituality in health care. Retrieved December 18, 2018. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305900/

 
 

5- I found the published article by Puchalski (2001), to be very interesting as it demonstrated numerous examples of research based on the use of spirituality in the healthcare setting. In an example developed by Dr. Puchalski and a group of physicians with the intent of helping healthcare professionals better encounter and address spirituality with their patients and how it can positively can impact the patients’ health and the overall success of the treatment being rendered by the healthcare team.  As part of a physical work-up and collection of history and physical data is collected a spiritual history is also taken and incorporated into the healthcare treatment model in this way the healthcare professionals are providing a holistic all-encompassing care of the patient also addressing the spiritual needs of the patient (Puchalski ,2001).

                                                                             Reference:

Puchalski, C. M. (2001, October). The role of spirituality in health care. Retrieved December 18, 2018. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305900/

 

6-The aspects of the topic readings that I found most interesting were the  “polarity between the older and newer nursing theories.” The older nursing process theories are associated with taxonomies and quantitative measures, whereas the new holistic theories use more qualitative measures and softer phenomena. The revolution in the approach of how we think about nursing and nursing interventions in association to ethical decision making. With the belief that nursing is both a science and an art, the new theories expand upon this concept. The other aspect that is interesting to me is using world views to challenge contemporary ethos by using philosophical clarity and religious sensitivity.

After reading about the analysis of disease and healing I would agree that the involvement of spirituality helps enhance recovery and facilitate healing in our patients. I found the required article to read, “The Role of Spirituality in Health Care” very interesting and informative. Patients who are ill and suffering can use their spirituality to recover and heal. It was so interesting to read that patients who were spiritual and had certain beliefs lived longer and recovered faster than non spiritual patients. I think that spirituality lets us and our patients worry less and let go or live in the present moment.

-Michelle Childress

References: 

Puchalski C. M. (2001). The role of spirituality in health care. Proceedings (Baylor University. Medical Center), 14(4), 352-7.

 

 

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