Research methods and applications

Nursing Research Design and Sampling Methodology

Quantitative research asks the statistical question of how many, how much, or how often, and attempts to quantify the extent to which a target group is inclined to behave in a certain manner or to hold certain opinions. It can be helpful in establishing a correlation between certain positive and negative behaviors with desirable outcomes. There are a variety of ways of conducting quantitative research. One of the most effective is the use of random samplings, often regarded as the most 'pure and statistically correct' and usually the most costly method of selection (Mori 2008). "In random sampling, each item or element of the population has an equal chance of being chosen at each draw. A sample is random if the method for obtaining the sample meets the criterion of randomness (each element having an equal chance at each draw). The actual composition of the sample itself does not determine whether or not it was a random sample" (Lane, 2007).

To begin preliminary research into ways to prevent nosocomial infections, infections that originate or occur in a hospital or hospital-like setting, I would like to conduct a research study upon my staff of nurses. Nosocomial infections are dangerous because they are often antibiotic-resistant. Patients tend to be susceptible to such infections when they have broken skin or have injuries with exposed mucous membranes (Abedon, 1998). One possible way to limit the spread of such infections is hand-washing. "These pathogens also tend to become incorporated into the normal flora of hospital workers," and thus acquired, these "opportunistic infections thus tend to be both very available for transmission to patients and not easily treated once infections are under way" (Abedon, 1998). However, because it is difficult to monitor or quantify in a busy day how much a nurse does or does not wash his or her hands, I would suggest the following: the structure of my research would require the ward of nurses in question to be filmed over the course of the day, and their behavior regarding hand-washing would be observed by a monitor. Researchers would track how much and how often particular nurses washed their hands over the course of a day using the recoded film.

Immediately, one might protest that some nurses might deal with patients more susceptible to such infections than others. The likelihood of contracting nosocomial infections is often highly dependant upon what ailment the individual patient has contracted. Patients with urinary tract infections, surgical wounds, respiratory tract ailments, patients skin lesions (especially burns), blood diseases, gastrointestinal tract infections, and central nervous system complaints are all more susceptible than patients with other illnesses without exposed wounds or tissue (Abedon, 1998). To take this into account, the illnesses of patients treated by the nurses would be recorded, and nurses that treated a disproportionately high or low number of high-risk patients would be excluded from the study.

However, there are other variables that could affect the results. For example, patients with weakened immune symptoms might be more likely to catch such an infection. To minimize the risk of other patient variables interfering with the data, the nurses whose hand-washing methods would be subject to study would be chosen from the wider sampling at random, with the controls upon the extreme cases cited above. The nurses would be identified as frequent or low-frequency hand-washers, depending on how much or how often they washed their hands during patient treatment, after, and before. The number of nosocomial infections in the patients they cared for would likewise be tracked, and thus extent to which frequent hand-washing could prevent the spread of infectious agents that give rise to such antibiotic-resistant complaints would be discerned by tracking the correlation between infection and amount of hand-washing used by the nurse.

The advantage of using a video observance and tracking methodology to obtain the random sampling would be in part to note what other precautions were observed by nurses, to see if these precautions should also be controlled for in the data analysis. Other precautions include the fact that nurses should avoid direct contact with patients, and patient body fluids, should wear barriers such as gloves when contact is necessary or expected with patients, should avoid at all costs the nurse's exposure to sharp instruments, especially body fluid-contaminated sharp instruments, and should not expose their own skin to patients with exposed body fluids, or "weeping wounds" (Abedon, 1998).