Strategies to Enhance Quality

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Section 1

Strategies to Enhance Quality

Qualitative research methodology is appropriate for theory development and clinical inquiry, which contributes to the advancement of nursing practice in order to ensure that quality and consistency prevails in the research study. Rigor is a framework for ensuring credibility and validity in qualitative research, and in order to ensure quality and consistency, rigor must be present. Decisions regarding what methodology is used have major implications regarding the integrity, quality, and the interpretation of the study results (Qazi, H. 2011). The goal of this section is to outline methods that are utilized in the process of research studies.

Generating findings from natural settings without manipulation is the aim of qualitative research. All qualitative research requires validity and reliability. There are several strategies used to enhance quality for this research study.Persistent observation enhances quality to increase credibility. One strategy is persistent observation such as the 60 hour observations performed by the hospital ethnographer, a Registered Nurse, and doctoral observation. This observation was instrumental in providing information about the day-to-day operations on the medical-surgical unit. These observations were completed along with mapping, interviews, and the photography. Another strategy used to increase/promote credibility is prolonged engagement (Qazi, H. 2011). The hospital ethnographer conducted a 6o hour observation in a 3 month period. During the 3 month period the day-to-day functioning was uncovered. The observations of the medical inpatient unit was observed first followed by a quality-minded strategy, which not only included methods and strategies of the observations but also developed strategies that were important for mapping and photography. The credibility was enhanced through the collaborative use of several ethnography methods:

Credibility

Credibility criteria involve the use of results of qualitative research in a believable and trustworthy manner based on the perspective of the participants. In the study, the data was collected simultaneously, thus strengthening the trustworthiness of the study (Cutcliffe, J., & McKenna, H. 1999). The strategies include not only what researchers do (study tasks), but who the researcher are. The credentials and qualifications of the researcher are important in regards to credibility. In this study, the observation was conducted by an ethnographer, a Registered Nurse, and a doctorial prepared anthropologist. The qualifications of the qualitative researchers increased the level of quality, credibility and trustworthiness. Research is affected by the qualification and perspective of the researcher, and a high quality qualitative research also includes a quality driven paradigm that includes other focus and strategic engagements.

Credibility was demonstrated by the accuracy and validity of findings that are assured through documentation and observation of the data of the hospital’s ethnographer, the RN, and the doctoral prepared anthropologist. The purposeful sampling of data was evident in this study. This sample included 23 patients, 9 family members, and 17 staff nurses of a 36 bed medical-surgical unit at one hospital (Cutcliffe, J., & McKenna, H. 1999). The sample was adequate and it has transferability because the manner in which the observations and data was obtained can be duplicated with similar results. Mapping and photography provided baseline information and layout to those involved in the study, including the stakeholders. Triangulation of data was also present, as exhibited by comparing the data from the maps, photos; to see how it compares to other sources. This crosschecking of data from the different sources (mapping, photographs) was essential in validating findings. For instance, the photograph documents and levels of call light activities with the nurses being present at nursing station provided great significance to the study. The map demonstrated the position and location of the nurses in relation to the patient rooms (Prior, D. D., & Miller, L. M. 2012). The data collection and recording procedures were appropriate and accurate as described by the researcher. It was also observed that bias was minimized in authenticity.

Criticality and Integrity

Interviews and observations by the researchers confirmed that there was need of improvement and the cross checking of the findings. There was also a wide consultation with colleagues (peer debriefing), which is important in improving the quality of research findings (Prior, D. D., & Miller, L. M. 2012).The hospital ethnographer conducted observation and realized that there was integrity and criticality in the findings. Methods of improving validation in qualitative research include methods of data collection and respondent validation as well as clear methods of data collection and sampling techniques as detailed in the detailed in the reports.

Credibility

This study was carried out in a way to enhance believability; clearly by the use of ethnographic methods, which included gaining entry, mapping, photography, observations, interviews, and analysis strategy.The credibility was enhanced through the collaborative use of several ethnography methods. Credibility criteria involve the use of results of qualitative research in a believable and trustworthy manner. Credibility deals with the value of the information rather than the amount of data ( KEMPARAJ, U., & CHAVAN, S. 2013). Techniques to gauge how accurate the findings are include data triangulation. With triangulation, the data goes through multiple checks. The credibility of results can only be judged by the participants. The interviews clearly demonstrated that there was a problem with the call bell system.

The strategies that enhance the dependability of a study include careful documentation, triangulation, and member checking. These elements were included with this study. This has an indication that the findings have consistency and can be repeated. The study also included elements that would ensure triangulation and at the same time enhance conformability. Prolonged engagement and persistent observation enhances the quality and consistency.

Section 2

Study in the context of validity

The study expresses some level of validity in the sense that it talks about a bell used in the hospital by patients to seek people’s attention when they are in need. It is valid in the sense that it is a practice that has undergone an assessment to find out the quality of patient care and patient satisfaction in the medical-surgical units in the hospitals (KEMPARAJ, U., & CHAVAN, S. 2013). The study is all about things that happen to patients in the hospitals and how they are treated by those who should be caring for them. The study also has some level of criticality and authenticity since it employs the use of qualitative methods, majorly ethnography, which are very important in collecting data concerning patient satisfaction and the quality of healthcare. Ethnology is increasingly becoming valued and recognized in the health sector although some research findings raise questions on its validity due to the problems of objectivity and inadequate qualitative research methods. The credibility and trustworthiness of the quality research findings should be analyzed by testing the emerging theories of deductive quantitative research (Behrens, E. L., & Liu, W. 2014). The findings of the study show that the credibility of a qualitative data after all other research findings are considered and analyzed. The establishment of the credibility of a qualitative research finding becomes very strenuous because of a large volume of data involved in research findings. However, for a qualitative research to be credible, it is necessary for the researcher to make it explicit, what methods they use to establish credibility of data interpretations.

The criticism of ethnography is basically applied to the credibility and authenticity of qualitative research. It may be quite difficult to separate ethnography from other types of qualitative research when trying to demonstrate ethnography’s unique deficits. Ethnology should never be viewed as having distinct boundaries but should rather be taken to belong to broader paradigm of the qualitative research. Ethnography is criticized based on the perceived polarity between naturalism and positivism. Most of the criticisms of ethnography are epistemological and ontological in nature. The research can also be criticized based on the ambiguity of the qualitative research findings. This has been observed by a large number of research analysts and observers. Ethnography, as a scientific endeavor, lacks the consensus and precision in definition and this forms the basis of criticism of ethnography. There have been expression of reservations in regards to the consistency and credibility of ethnographic researches. The subjectivity of ethnographic study has an implication that it becomes impossible for other researchers to replicate similar findings of previous ethnographic studies (Behrens, E. L., & Liu, W. 2014). Ethnography has the authenticity and the credibility since it is a very relevant methodology that researchers rely on in their efforts to understand specific issues affecting the society such as how patient s are treated in the hospitals by those who should be taking care of them. Ethnography enables individuals to understand the relationship existing between people and the society where they live. It offers the opportunity to individuals to share their perspectives concerning how the society operates. These can be used by researchers to base their criticisms.

References

Behrens, E. L., & Liu, W. (2014). Review of ‘Qualitative strategies for ethnocultural research’. Cultural Diversity And Ethnic Minority Psychology, 20(1), 140-142. doi:10.1037/a0030752

Cutcliffe, J., & McKenna, H. (1999). Establishing the credibility of qualitative research findings: the plot thickens. Journal Of Advanced Nursing, 30(2), 374-380. doi:10.1046/j.1365-2648.1999.01090.x

KEMPARAJ, U., & CHAVAN, S. (2013). QUALITATIVE RESEARCH: A BRIEF DESCRIPTION. Indian Journal Of Medical Sciences, 67(3/4), 89-98. doi:10.4103/0019-5359.12112

Prior, D. D., & Miller, L. M. (2012). Webethnography. International Journal Of Market Research, 54(4), 503-520. doi:10.2501/IJMR-54-4-503-520Qazi, H. (2011). Evaluating goodness in qualitative researcher. Bangladesh Journal Of Medical Science, 10(1), 11-20.

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