Can Catheter-associated urinary tract infections (CAUTI) be reduced by continuously evaluating the need for them to remain indwelling on a daily basis?
Research assignment #2
Order Description
This will be a paper that will have 3 separate parts to it. This is the 1st of 3. I am only responsible for questions #1 and #2 and answers are only a couple of sentences long each, which is stated at the end of each question. This part is based on a paper that has already been submitted which you will find at the end. No real references are yet needed but will be for the next assignment. I will be keeping the same writer for all of the assignments due.
Instructions: Using your readings you have done up to now for this course, and building upon your answers on Assignment 1, answer the 5 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 final assignment.
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
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2. Would you get your data retrospectively or prospectively, and why? A response of 3 sentences is maximum.
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 assignment.
Note: This is the historical reference for experimental design and threats to validity. This is considered the key to all later work on these topics. Refer to the rubric and the worked example for more information about the threats. They are listed there
Campbell, D. T. and Stanleny, J. C. (1963): Experimental and Quasi-Experimental Design for Research. You can access this reference in the Supplemental Reading included in this Unit.
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. A maximum of 4 sentences here.
RUBRIC
ASSIGNMENT TWO
HNG 541
THIS ASSIGNMENT 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. Look back at the research question and the variables that you defined in Quiz 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. 1 point
Answers all parts of QUESTION (what and why) 1 point
Answers 1 of 2 PARTS 0.5 point
Answers 0 of 2 parts 0 points
2. Would you get your data retrospectively or prospectively, and why? A response of 3 sentences is maximum. 1 point
Answers all parts of question (what and why) 1 point
Answers 1 of 2 parts 0.5 points
Answers 0 of 2 parts 0 points
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. SEE CAMPBELL & STANLEY EXTRA RESOURCE BELOW! 2 points
At least 3 threats to validity & answers all parts of question (what and why) 2 points
1-2 threats to validity 1 point
No threats to validity 0 points
Rationale : even RCT have threats to validity: for example: instrumentation, maturation, history, experimental mortality.
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. This is fine as well, these would need to be listed in limitations of a proposed study design, we will discuss in final exam. 2 points
Tries to reflect at all on control for threats in design 2 points
Reflects on SOME threats 1 point
No answer 0 points
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? (Maximum size is 4 sentences) 2 points
Answers all parts of question (type and validity and reliability) 2 point
Answers 2 of 3 1 point
Answers 1 of 3 0.5 points
Answers 0 of 3 parts 0 points
This is an Example of what they are looking for:
Instructions: Using your readings you have done up to now for this course, and building upon your answers on Quiz 1, answer the 5 questions below. This quiz is worth 5% of your final grade. The content of the three course quizzes will be the majority of the content of your comprehensive final exam. NOTE: Ques 1,2, 5 are .333 pts ea. Ques 3 and 4 are 2 pts.
1. Look back at the research question and the variables that you defined in Quiz 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. Please copy and paste your research question above Answer 1.
Does saline lavage increase the incidence of Ventilator Associated Pneumonia (VAP) in Adult Critically Ill Patients in Intensive Care Settings?
I would use a quasi- experimental design. I would look at patients who had lavage with saline and those who did not pre- suctioning to compare counts of those who developed VAP between the 2 groups. It is a quasi – experimental design as random assignment to saline is not feasible in this institution as the order varies by practitioner.
2. Would you get your data retrospectively or prospectively, and why? A response of 3 sentences is maximum.
I would obtain my data retrospectively with a convenience sample of ventilator dependent adult ICU patients from a large level one metropolitan hospital from a two week period in the year 2010. As there is no random assignment to treatment and this is an observational quasi experiment there is no retrospective assignment to treatment group.
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. SEE CAMPBELL & STANLEY EXTRA RESOURCE BELOW!
This is a quantitative study with many threats to both internal and external validity (see my bullets below in green).
Eight extraneous variables can interfere with internal validity:
1. History, the specific events occurring between the first and second measurements in addition to the experimental variables. Pts may have aspiration pneumonia associated with tube feedings, turn and positioning, or ventilator tubing change and not the saline lavage in these 2 week period of measurement.
2. Maturation, processes within the participants as a function of the passage of time (not specific to particular events), e.g., growing older, hungrier, more tired, and so on. Pts may get more suspetible to VAP due to overwhelmed immune system and not saline lavage.
3. Testing, the effects of taking a test upon the scores of a second testing. We don’t have this as we are not giving test or survey.
4. Instrumentation, changes in calibration of a measurement tool or changes in the observers or scorers may produce changes in the obtained measurements. What one radiologist reads as a VAP may not meet the criteria of another.
5. Statistical regression, operating where groups have been selected on the basis of their extreme scores. Should not occur as we are pulling all ventilator dependent pts during this 2 week period.
6. Selection, biases resulting from differential selection of respondents for the comparison groups. Selection bias here would not be from PTS selecting lavage or not, but practitioners may order lavage on pts who are different from pts they would NOT routinely order a saline lavage on ( pts who are “more congested, dry, etc). this makes us have pts who do not look the same on average aside from lavage or no lavage.
7. Experimental mortality, or differential loss of respondents from the comparison groups.
Pts may expire or get transferred from unit and out of study, and we would not have their end point data.
8. Selection-maturation interaction, etc. e.g., in multiple-group quasi-experimental designs. We could have this and will look for interactions here.
Four factors jeopardizing external validity or representativeness are:
9. Reactive or interaction effect of testing, a pretest might increase This is not applicable to us as we are not giving a pretest.
10. Interaction effects of selection biases and the experimental variable. Yes, we could have this as practitioners may select a different type of pt to get the NS lavage or not get it pre-suction.
11. Reactive effects of experimental arrangements, which would preclude generalization about the effect of the experimental variable upon persons being exposed to it in non-experimental settings. We are not doing an experiment, so this should generalize well to other non- experimental setting.
12. Multiple-treatment interference, where effects of earlier treatments are not erasable. Only one tx given in our hypothesized design, BUT, VERY REALISTICALLY, some pts may get saline intermittently, some when not ordered ( by a practitioner who does routinely for example on all pts: resp therapist for example), so this is going to be a problem as far as “fidelity to treatment”.
This is Assignment #1 that was turned in:
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 continuously evaluating the need for them to remain indwelling on a daily basis?
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 duration of these foley catheters could be responsible for associated infections.
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: 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 operation 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.
