This assignment will focus on the research methodology for the study that you proposed in your Problem Significance and Review of Literature Assignment. Once again, your modules and your textbook will help you develop the sections of this paper. For example, when you are deciding on your study design, you will go to the Module 6 and review the power points and read Chapters 9 and 10 in your textbook. The information in these resources will help you decide on the type of design that best fits your study.
Here are some tips for the sections of the Methodology Assignment. Use the following headings to develop APA headings for your paper. Include the following information in each section.
Purpose: Use the corrected draft from your other assignment. Identify the purpose of the study. You will write this as: The purpose of the study is to….
Methodology
Research Design: identify the type of design you will use. Be specific—descriptive, quasi-experimental or experimental is not enough. Examples might include: Randomized control trial, cohort, correlational, pre-test-post-test, etc. The text provides descriptions of the designs. Be sure to include why the design is appropriate for the study. This sentence should be referenced. For example:
Type of design: A cross-sectional, correlational study will be conducted to examine the relationship between knowledge of HIV transmission, prophylactic use of antiretroviral medications, altruism, and the use of safe sexual practices (no reference needed since this is our study). A cross-sectional design is a non-experimental research design in which the data is collected at one point in time (LoBiondo-Wood & Haber, 2019). Because participants will be completing variable specific questionnaires at one point in time, the research design is appropriate for the study.
Extraneous variables: These can be situational—such as a cold environment when taking a test, personal—such as an individual taking a test being sleepless; or researcher based—such as if the researcher gave clues on how to act or respond during the study. Additionally, using self-report instruments or tools might be an extraneous variable—because the individual is having to ‘self-report information’).
Sampling plan: describe the type of sampling plan you will conduct—usually a non-probability or probability sample—the LoBiondo-Wood and Haber textbook describes the types of sampling plans you can choose to fit your study. Be sure to indicate the specific sampling plan and to reference the information.
Population: include the population your sample will represent and an estimated sample size you would obtain to conduct the study. Be sure to include exclusion and inclusion criteria and remember that these criteria can help to control extraneous variables and bias too.
Obtaining sample: describe how you would obtain the sample. Describe your recruitment process or any plans for using flyers or advertisements. If you plan a randomized study, how will you randomize the participants (coin toss/computer program)?
Plan for Data Collection: describe the how, when, and where of data collection. Be sure to include that you will first obtain IRB approval and how you will obtain informed consent—include the venue where you would conduct the study.
Data Collection Tools/Measures:
If you decide to use a tool (questionnaire or instrument) from a study you read, include the number of items (or questions) the tool has, who created the tool, and reliability and validity of the tool. A copy of the tool should be added as an appendix to the paper. If the reliability and validity of the tool is not available in the literature, this would be a limitation.
If you plan to develop your own data collection tool, a copy must be provided as an appendix. Be sure to describe how your methodology speaks to reliability and validity and how the tool you develop ensures accurate measurement of the variable. For example, if you plan to examine the number of hours someone walks per week, how will you document that to ensure consistency among participants? If you plan to develop a table for data entry, that must also be included as an appendix. All appendices are placed behind the references.
If using physiologic measures, describe how you will ensure consistency in data collection among all participants.
After receiving feedback on this assignment, you will be able to incorporate the sections of this paper into your final Bare Bones Proposal assignment. See the attached grading rubric below.
Methodology Assignment
Student’s Name
Institutional Affiliation
Course
Instructor’s Name
Date
Methodology Assignment
The Purpose of the Study
The purpose of this study is to evaluate the effectiveness of Fall TIPS (Tailoring Interventions for Patient Safety) in reducing fall rates among hospitalized patients.
Methodology
Study Design
The research design for this study is a quantitative quasi-experimental study design. The quasi-experimental design resembles experimental research but is not true experimental research (Mayhob & Amin, 2022). This research design fits this study because it is majorly used in the field setting, such as a hospital setting, where random assignment may be difficult or impossible. Quasi-experimental design often evaluates the effectiveness of treatment such as a type of psychotherapy or an educational intervention (Khoja, 2021). Because the independent variable is manipulated before the dependent variable is measured, quasi-experimental research eliminates the directionality problem.
This study will include pre-and-post intervention (pre-posttest design) data about fall rates to evaluate the effectiveness of Fall TIPS (Tailoring Interventions for Patient Safety) in reducing fall rates among hospitalized patients (Dykes et al., 2020). Data on pre-intervention will be obtained one month before the start of the study. One month before the start of the intervention will form the baseline for the study. The post-intervention data will be collected one month after the implementation of the intervention (Mayhob & Amin, 2022). All the pre-and-post intervention data were retrieved from the hospital’s electronic health record.
The pre-and-post intervention data included fall the overall rate of patient falls per 1000 patient-days, the overall rate of falls with injury per 1000 patient-days, and the patient’s demographics such as mean age, causes of falls, diagnosis, comorbidities, during the study period (Dykes et al., 2019). The data were obtained one month before the implementation of the TIPS too will be obtained. The primary difference between this design and a true experimental design is that a quasi-experimental project does not include the random allocation of participants.
Sampling Plan
A convenience sampling method will be used in this study to obtain the appropriate subject samples. This method of sampling is also called availability sampling (Khoja, 2021). It involves a non-probability sampling method that is based on data collection from every population member who is conveniently available to participate in the study. The project population includes all patients admitted to the hospital (Dykes et al., 2020). One important thing to note is that the sample population must reflect the total population to draw reliable conclusions and inferences based on the study results.
The sample size will include at least 58 patients, which is a 50 percent proportion of the overall patient population admitted to the hospital. A power analysis will be used to achieve a 95% confidence level. Generally, an online calculator will use Lehr’s formula to ensure the sample size obtains a 95% confidence level (Khoja, 2021). The sample will be obtained by retrieving the patient’s information from the electronic health records. The inclusion criteria will include all patients who have had attest two episodes of falls either at home or within the hospitals (Khoja, 2021). Also, the patients must have been admitted to the hospital for at least one month, ages between 60-80 years, and must agree to participate in the study.
Patients who meet the criteria will be included regardless of whether they experienced injurious or non-injurious falls. Exclusion criteria will include all patients who have cognitive impairment and psychiatric conditions that affected rational reasoning (Khoja, 2021). Pediatric patients will be excluded. Other exclusion criteria include outpatients and those below the appropriate age. Additionally, patients who are admitted in less than a month to the commencement of the study will not be included (Mayhob & Amin, 2022). The baseline measurements will be set at one month before the intervention implementation, therefore, all participants must have stayed (admitted) within the hospital for a period not less than one month.
Data Collection Procedures
Before the beginning of data collection, the researcher seeks approval from the institutional review board (IBR). The hospital has an internal IBR, which is constituted to review and monitor all research studies involving human subjects (Khoja, 2021). The IBR has the authority to approve, disapprove, or require modification of the proposed project. The IBR approved the Fall TIPS intervention as well as the Handoff clinical evaluation exercise (CEX) (Khoja, 2021). All the participants were provided with a consents letter to sign after a comprehensive explanation about the study.
The intervention is Fall TIPS (Tailoring Interventions for Patient Safety). It is a novel evidence-based program that is widely applied in preventing falls among those at risk (Dykes et al., 2019). The TIPS consists of three steps: identifying risk factors, developing a tailored or personalized plan to decrease risk, and consistently carrying out the plan. In this study, all nurses in the hospital will first undergo training for two weeks about Fall TIPS (Dykes et al., 2020). The copies of the Fall TIPS were provided to all bedside nurses and used color-coded clinical decision support linking risk factors and evidence-based intervention (Khoja, 2021). Nurses administered the Fall TIPS interventions to patients at admission and during each shift with the patient and family, if a family member is available.
Data collection will happen every day using the electronic health and the CEX tool. The nurses will record the number of falls per day including the injurious ones and feed the information in the electronic health record system (Dykes et al., 2019). The researcher and the nurse in charge will perform daily random rounds during shifts to audit staff nurses using the handoff CEX audit tool. The CEX audit tool will be used to observe staff nurses implementing Fall TIPS in the hospital.
The variables will be measured by comparing the post and pre-intervention data. The primary outcome will be the overall rate of patient falls per 1000 patient days. Secondary outcomes include the overall rate of injurious patient falls per 1000 patient days (Khoja, 2021). If the rate of overall patient falls and injurious patient falls are reduced from the baseline, then the intervention is effective.
Measures or Data Collection Tools
Various tools will be used to collect data. The first one is the Electronic privacy information center (EPIC) which is a type of electronic health record (EHR) founded in 1979 by Judith R. Faulkner. a valid and reliable tool from which to obtain pertinent numerical data to assess the efficacy of practice change (Khoja, 2021). Apart from data collection, it also allows effective communication among healthcare providers. EHR is supported in the literature as reliable and valid too. Another tool is the Handoff clinical evaluation exercise (CEX) (Khoja, 2021). The Handoff CEX (clinical evaluation exercise) consists of seven domains scored on a 1-9 scale, where 1 to 3 is unsatisfactory and 7 to 9 is superior. The tool was developed by the hospital to ensure a safe and effective transfer of pertinent patient information about the risk of falls using TIPS to implement tailored fall prevention interventions during the care processes (Khoja, 2021). CEX is a valid and reliable assessment tool.
References
Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., … & Bates, D. W. (2020). Evaluation of A Patient-Centered Fall-Prevention Tool Kit to Reduce Falls and Injuries: A Nonrandomized Controlled Trial. JAMA network open, 3(11), e2025889-e2025889. https://doi.org/10.1001/jama.2010.1567
Dykes, P. C., Adelman, J. S., Alfieri, L., Bogaisky, M., Carroll, D., Carter, E., … & Spivack, L. B. (2019). The fall TIPS (tailoring interventions for patient safety) program: A collaboration to end the persistent problem of patient Falls. Nurse Leader, 17(4), 365-370. https://www.falltips.org/wp-content/uploads/2019/09/Dykes-2019.pdf
Khoja, A. (2021). Implementation of Tailored Interventions for Patient Safety (TIPS) to Reduce Fall Rates (Doctoral dissertation, Grand Canyon University). https://www.proquest.com/docview/2531206918?pqorigsite=gscholar&fromopenview=true
Mayhob, M. M., & Amin, M. A. (2022). Fall Prevention Interventions: Tailored Approach versus Routine Interventions among Elderly Hospitalized Patients. American Journal of Nursing Research, 10(1), 26-33. http://article.scinursingresearch.com/pdf/ajnr-10-1-4.pdf