Ethnographic Research in Hospital Settings

Planning and Design Analysis Grid

Ethnographic Research of Patient Care

Deitrick L; Bokovoy J; Stern G; and Panik A. (2006) Dance of the call bells: using ethnography to evaluate patient satisfaction with quality of care. Journal of Nursing Care Quality, 21(4): 316-24. Retreived http://bluescrubbrigade.wikispaces.com/file/view/Dance+of+the+Call+Bells.pdf

Is the research Qualitative or Quantitative?

The research study is qualitative and uses ethnographic methodologies.

Ethnographic methods can provide insights into patients' perceptions of quality of care.

The study examined problems related to answering patient call lights on an inpatient unit in the hospital. The call bell problem was perceived to have three different components: Answering the call bell, communicating the patient's request, and following through with the request.

Purpose:

The purpose of the research was to understand the perceptions of nursing staff and patients with respect to the use of the nurse call bells as it reflects on patient care.

Hypothesis/aims:

Since this was an ethnographic study, hypotheses are not used in the manner they are used in positivist research. The aim of the study was to probe for insights into the perceptions patients hold regarding their quality of care.

Independent variable:

In ethnographic research, independent variables and dependent variables do not play a major role in the research design or plan for collecting and analyzing data. Ethnographic research entails a phenomenological approach in which the perceptions of the study participants are presented as accounts that express the lived lives of the people being studied.

Dependent variable:

The analysis strategy included the following: Creating data-maps, examining photos, unpacking interview transcripts, reviewing observation notes, reading satisfaction surveys, and conducting member checks with study participants, to ask if conclusions were correct, and to understand how the data compare across sources. The qualitative research term for this type of cross- checking of data is triangulation. The process helps to validate and corroborate findings.

Theoretical framework:

The theoretical framework of the qualitative study is phenomenology and grounded theory.

Population:

The hospital ethnographer conducted 60 hours of observations on all 3 shifts in the medical-surgical unit over a 3-month period. The population consisted of all the stakeholders on the floor during the time observations were occurring.

Setting:

The setting for the study was one 36-bed medical-surgical inpatient unit of a hospital over a period of three months in the spring of 2002.

Sampling method:

Data was collected through interviews with 23 inpatients, 9 family members, and 17 staff members, including nurses, nursing supervisors, nursing assistants, care managers, and respiratory therapists. Convenience and stratified sampling methods were used.

Practice application:

The dance metaphor is used to describe differences in staff behaviors related to answering call bells on the unit in the study. A well-choreographed call bell answering system can be used to promote patient safety, enhance patient satisfaction, and increase professional self-regard in nurses who participate in the plan for elevated responsiveness to patient concerns and requests.

Level of evidence:

While the nurse call bell system has the potential to gather basic data such as the number of calls and the response times, collecting and analyzing this information was not a component of this ethnographic study. While analyzing this type of data may shed light on staff performance and patient satisfaction, qualitative data can also provide strong insights.

Is the article useful for evidence-based practice (EBP), Outcomes Research, both, or neither? Explain your answer.

From the findings presented in this article, it is apparent that the research is relevant to evidence-based practice and outcomes research. The study is qualitative in approach, but it is entirely possible to replicate the study with an accompanying quantitative component that would more strongly support EBP. For outcomes research, the following recommendations are relevant: