Nursing, Research Proposal Example

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Research Proposal

What is the relationship between extended inpatient stays for nursing home debilitated patients in the hospital and nosocomial infection, specifically MRSA in Los Angeles, California?

Outline

Theoretical Framework

  • Description of theoretical framework to be utilized.
  • Identification of concepts to be explored.
  • Rationale for choosing framework

Review of the Literature

  • Appropriateness of review and the proposal focus.
  • Inclusion of primary or secondary sources

Methodology

  • -Description of study type (quantitative or qualitative) (quantitative).
  • -Description of study design (correlational)
  • Rationale for the use of the selected design.
  • Inclusion of sample size, type, sampling method, inclusion/exclusion criteria, setting, data collection method (instrument) and data collection process.

Method for Protection of Human Subjects (consent). (Questionnaire and consent forms included as Appendices)

Data Analysis (10 points)

  • Data analysis method appropriate for study design.
  • Method of data analysis clearly stated.
  • Method for displaying findings is stated.

Applicability to Nursing (5 points)

  • Research focuses on a problem significant to nursing.
  • Research contribution to nursing knowledge.
  • Proposal is complete so that another researcher could replicate the study.
  • Statement about areas of nursing that would benefit from this study

Nursing: Research Proposal

What is the relationship between extended inpatient stays for nursing home debilitated patients in the hospital and nosocomial infection, specifically MRSA in Los Angeles, California?

Theoretical Framework

Description of theoretical framework to be utilized

This researcher will adapt an eclectic approach towards applying a theoretical framework to this study. It means more than one theory will be used to interpret and explain findings. The first theory selected pertains to the theory of standards espoused by E. Baskin, K. Krechmer and M. H. Sherif (1998). These theorists contend that there are six dimensions to standards.  Two categories of standard interventionists were identified. First is the standard seeker and secondly the standard creator. In distinguishing which category the health care provider or organization is identified six questions are asked and answers encompassing the six dimensions to standards development. They are:-

  • Why seek a standard?
  • What is the category of product or service to be standardized?
  • When in the product cycle to standardize?
  • Which is the appropriate Standards Development Organization (SDO)?
  • How will consensus be reached?
  • Where will the standard be used?

(Baskin et.al, 1998)

The next theory that has been selected is Jean Watson’s (1978) theory of human caring. In this theory Jean Watson (1978) espoused elements, which ought to be considered during the caring process for effective outcomes. They include:-

  • Carative factors
  • Transpersonal caring relationships
  • Caring moment/caring occasion
  • Expanded view of self and person
  • Caring consciousness as energy( Human/ environment)
  • Phenomenal field/unitary consciousness

(Watson, 1978)

Identification of concepts to be explored

  • Nursing home debilitated patients in hospital
  • Nosocomial infection
  • MRSA
  • Standards
  • Caring

Rationale for choosing framework

The rationale for choosing these two theories in designing the framework for this study was prompted by the fact that this investigation is associated with standard adherence as well as caring models, which ought to be explored from a theoretical premise.

Review of the Literature

Appropriateness of review and the proposal focus.

Five pieces of literature have been selected for review. They are considered appropriate for this study because each relate to nosocomial infection; nursing home debilitated patients in hospital; MRSA; standards and caring.

M., & Daum, R. (2010). Community-Associated Methicillin-Resistant Staphylococcus aureus: Epidemiology and Clinical Consequences of an Emerging Epidemic. Clin Microbiol Rev 23(3): 616–687 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901661/

Johnson, J.T Khoie, T. Shurland, S. Kreisel, K. (2007). Skin and Soft Tissue Infections Caused by Methicillin-Resistant Staphylococcus aureus USA300 Clone. Emerg Infect Dis. 13(8): 1195–1200 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828080/

Klevens, M. Edwards, J., & Richards, C. (2007).  Estimating Health Care-Associated Infections and Deaths in U.S. Hospitals, 2002. Public Health Rep. 122(2): 160–166 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1820440/

D., & Kemmerly, S. (2009). Infection Control and Prevention: A Review of Hospital-Acquired Infections and the Economic Implications. Ochsner Journal, 9(1): 27–31. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096239/

Sydnor, E., & Perl, T. (2011). Hospital Epidemiology and Infection Control in Acute-Care Settings. Clin Microbiol Rev. 24(1): 141–173. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021207/

Inclusion of primary or secondary sources

Both primary and secondary sources have been included in this literature selection. Primary are directly related to research studies conducted offering evidence from cohort studies whereas secondary sources are those referencing studies of other researchers.

Methodology

Description of study type (quantitative or qualitative) (quantitative).

Quantitative studies allow the researcher to create a continuum whereby one aspect of the study reflects a design where variables are not controlled being just observed and another phase they are fully controlled.  In fact it embodies a systematic empirical investigation. It could be any phenomena applying; mathematical, statistical, or numerical data computation techniques. Unlike qualitative research design are explanatory and do not require any statistical calculations in validating findings. Essentially, qualitative studies embrace four main types of designs for efficacy within the research science. They include descriptive, correlational, causal-comparative/quasi experimental and experimental research (Creswell, 2008).

Description of study design (correlational)

The quantitative design choice is correlational. This type of design tries to find out the extent to which a relationship exists between two or more variables applying statistical analysis. The researcher seeks to interpret data retrieved after statistical inferences are made. As such, it is possible to determine trends as well as patterns indicative of certain causal relationships among variables. However, correlational study designs do not prove any of these causal relationships, but simply identifies them based from data analysis. Data relationships are the concerns of correlational study designs (Creswell, 2008).

Rationale for the use of the selected design.

Reasons for selecting a qualitative approach incorporating correlational design is the desire to establish a relationship between/among variables identified in the study. Precisely, the question informing this research asks, what is the relationship between extended inpatient stays for nursing home debilitated patients in the hospital and nosocomial infection, specifically MRSA in Los Angeles, California? Clearly, the research requires that the extent to which extended inpatient stays for nursing home debilitated patients is related to nosocomial infections specifically MRSA be identified.

Inclusion of sample size, type, sampling method, inclusion/exclusion criteria, setting, data collection method (instrument) and data collection process

The anticipated sample size for this study is between 100 -200 nurses, who will be randomly selected to complete questionnaires pertaining to specific aspects of the research subject. The inclusion criteria would be nurses working with nursing home debilitated patients in the hospital; obviously exclusion would be those nurses outside this geographic setting. Patients data which will be retrieved and recorded are those who contracted s nosocomial infections specifically MRSA in Los Angeles, California after extended hospitalization.

Method for Protection of Human Subjects (consent).

(Questionnaire and consent forms attached in Appendix)

Data Analysis

Data analysis method appropriate for study design.

This would be conducted using computer data analysis software applicable to quantitative studies name the generic SPSS. SPSS Statistics is a software package utilized for statistical analyses as in quantitative studies. The software was produced by Long SPSS Inc and acquired by IBM in 2009. Current versions are marketed as IBM SPSS Statistics. It is capable of producing Descriptive statistics conducting Cross tabulation calculating frequencies as well as offering descriptions, Explorations and, ratio statistics analyses (Argyrous, 2007).

My reason for selecting this data analysis method is that it reduces and /eliminates errors in calculation; manages data appropriately by adding variables, observations as well as recoding. The graphical illustration features are phenomenal and the researcher does not have to make any additional ones to display data. Besides many people can use the data file at the same time saving time. Consequently, the data analysis process is conducted must fast, with more efficiency. Data would be displayed in graphs, frequencies after mean, median and standard deviations have been calculated. Tables will also be used in the display process (Argyrous, 2007).

Applicability to Nursing

Research focuses on a problem significant to nursing.

Infections occurring in hospital denote nursing care irregularities. More importantly it reflects the quality of nursing care executed within the particular organizations. Certainly, it is not a favorable outcome and in many instances lead to serious lawsuits. Hence, this study is very nursing science at this times when incidences of infection are increasing nationally.

Research contribution to nursing knowledge.

It is hoped that the findings of this research add to the body of knowledge regarding
nursing home debilitated patients in the hospital and nosocomial infection, specifically MRSA in Los Angeles, California.

Statement about areas of nursing that would benefit from this study

Areas of nursing expected to benefit from this study include infection control nurses (ICN); providers who extended nursing home patients’’ hospital stay will be alerted to the irregularities occurring among hospitals across the country. Nursing managers could use the evidence derived from this study for implementation in clinical settings.

References

Argyrous, G. (2007).  Statistics for Research: With a Guide to SPSS. SAGE, London

Baskin, E. Krechmer, K., & Sherif, M. (1998). Six Dimensions of Standards: Contribution towards a Theory of Standardization. Communications Standards Review Palo Alto, CA, USA.

Creswell, J. W. (2008). Educational Research: Planning, conducting, and evaluating quantitative and qualitative research (3rd ed.). Upper Saddle River: Pearson.

Watson, J. (1978). Theory of human Caring. University of Colorado

Appendix 1: Survey/Questionnaire

Section1-Pateint’s Data.

Patient’s Age:

Diagnosis upon admission:-

Nosocomial infection/MRSA acquired during stay: Yes/No

Date of admission:-

Date of discharge:-

Section 11- Health care provider’s impressions

Please tick true/false

  1. Nursing home debilitated patients are acquiring MRSA before being admitted to hospital?
  2. Since working in this hospital that nursing home debilitated patients are becoming infected with MRSA?
  3. Most nursing home debilitated patients are already infected with MRSA upon admission.
  4. Nursing home debilitated patients are acquiring MRSA after being admitted to hospital.
  5. A problem exists regarding nursing home debilitated patients becoming infected with MRSA in the hospital
  6. A problem exists regarding nursing home debilitated patients becoming infected with MRSA in the nursing home.
  7. Hospital employees are responsible the nursing home debilitated patients to become infected with MRSA in the hospitals.
  8. Nursing home employees are not responsible for nursing home debilitated patients to becoming infected with MRSA in the nursing homes.
  9. Lack of proper hand washing causes nursing home debilitated nurses; physicians, nurses, certified nursing assistants to being infected with MRSA.
  10. Improper use of personal protective equipment such as gloves, mask, gown, and/or eye protection by nursing home debilitated nurses is responsible for MRSA spread among staff.

Appendix 11: Patient consent form to retrieve data from charts

 If you agree to participate in this study information regarding infections incurred durin an extended hospital stay will be retrieved from your chart.

What Are My Rights As A Participant?

Taking part in this study is voluntary.  You may choose not to take part or may leave the study at any time.  Leaving the study or choosing not to take part will not result in any penalty or loss of benefits to which you are entitled.

Disclaimer/Withdraw

Your participation in this research study is completely voluntary.  If you choose not to participate, that will not affect your present or future care.  If you decide to participate, you are free to withdraw your consent and discontinue participation at any time without prejudice to your present or future care.

Whom Do I Call If I Have Questions or Problems?

For questions about the study or a research-related injury, contact your study doctor at the telephone numbers on page one of this form.  For questions about your rights as a research participant, contact the Director of the Office of Regulatory Affairs (a group of people who review the research to protect your rights) at 215-898-2614.

Signature

Your signature below indicates that you have been given the opportunity to read this consent form and to ask questions.  Your questions have been answered to your satisfaction.  You voluntarily agree to participate in this research study.  Upon signing below, you will receive a copy of the consent form.

_________________________   _______________________________   ________________________

Name of Participant                          Signature of Participant                                Date

_________________________   _______________________________   ________________________

Name of Person Obtaining                Signature of Person Obtaining                      Date

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