Quantitative, Qualitative, Mixed Methods, and Triangulation Research Simplified.

For the novice nurse researcher, identifying a clinical researchable problem may be simple, but discerning an appropriate research approach may be daunting. What are the differences among quantitative, qualitative, mixed methods, and triangulation research? Which method is applicable for the study one wants to conduct? This article discusses the two main research traditions (quantitative and qualitative) and the differences and similarities in methods for frontline nurses. It simplifies and clarifies how the reader might enhance the rigor of the research study by using mixed methods or triangulation. The four types of research are described, and examples are provided to support readers to plan projects, use the most appropriate method, and effectively communicate findings. [J Contin Educ Nurs. 2024;55(7):338-344.].

Standardizing Nurse Transition to Practice: An Infrastructure to Support Nursing Excellence.

Nurse residency programs (NRPs) require effective structures and processes to ensure achievement of desired outcomes, including program accreditation, newly licensed nurse retention, and a healthy nursing workforce for the future. A healthcare system created strategic positions of director of nursing workforce transitions and nursing workforce professional development specialists to standardize an NRP across six hospitals and to achieve Practice Transition Accreditation Program accreditation. The positions provide a strong infrastructure to optimize nurse transition to practice.

Evidence-Based Practice Implementation: Dependent on Capacity and Capabilities.

OBJECTIVE: This study was conducted to determine the benefits, facilitators, and barriers of implementing evidence-based practice (EBP) into organizational culture. BACKGROUND: Implementing EBP leads to higher quality of patient outcome care, improved patient outcomes, and decreased healthcare costs. Nurse leader (NL) influence is essential for successful EBP implementation. METHODS: Data were collected using a descriptive qualitative approach with focus group interviews using 2 open-ended questions. Participants included NL attendees at the 2022 Association of California Nurse Leaders Annual Program/Conference. Data were analyzed and themes were identified using Sandelowski's method. RESULTS: Two overarching themes emerged: capacity (the amount something can produce) and capabilities (the power or ability to do something). CONCLUSIONS: Healthcare organizations need to invest in building NLs' capacity to implement EBP and allocate resources to strengthen the organization's capabilities in supporting EBP.

Preceptor Course Structures and Processes Contributing to Newly Licensed Nurse Outcomes.

BACKGROUND: This article describes a preceptor program implemented across a health care system with standardized structures and processes that contribute to newly licensed nurse outcomes, including role satisfaction and retention. METHOD: A quantitative design used two psychometrically tested instruments with data collected through Internet-based surveys. RESULTS: Newly licensed nurses' perceptions of their preceptors were consistently favorable. Newly licensed nurse retention from 2019 through 2022 was 93% at 1 year. CONCLUSION: Preceptor programs are a critical element in facilitating the transition of newly licensed nurses to professional practice. The success of the program is dependent on the quality of preceptors, who must be carefully selected, educated, and evaluated for the role. [J Contin Educ Nurs. 2023;54(10):448-453.].

Research, Evidence-Based Practice, and Quality Improvement Simplified.

Is the research process different than evidence-based practice and quality improvement, or is it the same? Scattered evidence and misperceptions regarding research, evidence-based practice, and quality improvement make the answer unclear among nurses. This article clarifies and simplifies the three processes for frontline clinical nurses and nurse leaders. The three processes are described and discussed to give the reader standards for differentiating one from the other. The similarities and differences are highlighted, and examples are provided for contextualization of the methods. [J Contin Educ Nurs. 2023;54(1):40-48.].

Development and Implementation of a Nurse Residency Program Stakeholder Evaluation.

The American Nurses Credentialing Center (ANCC) Practice Transition Accreditation Program® (PTAP) annually awards the Program Director of the Year at the ANCC PTAP Symposium. This year the Commission on Accreditation in Practice Transition Programs and ANCC PTAP team is ecstatic to announce Dr. Kim Failla, from Sharp HealthCare, as the awardee. Dr. Failla's dedication to nurses in transition and quality improvement is impressive. Learn here about the Sharp HealthCare PTAP journey and their stakeholder evaluation tool. [J Contin Educ Nurs. 2022;53(5):195-197.].

Psychometric Testing of a Nurse Residency Program Stakeholder Evaluation Survey.

This article describes the development and psychometric testing of a 43-item nurse residency program stakeholder evaluation. The valid and reliable survey provides nursing professional development practitioners with insight into opportunities to improve nurse residency program design and educational content. Survey results may also substantiate human and capital resources required for effective programs.

A 1-Year Accredited Nurse Residency Program's Effect on Intent to Leave.

OBJECTIVE: This article describes the evaluation of a system-wide program to enhance new graduate nurse resident (NGNR) experience, enculturation, and commitment to the organization. BACKGROUND: Structured nurse residency programs support NGNR transition to the work environment and increase retention and organizational commitment. METHODS: The study used a descriptive, comparative design measuring NGNR perceptions of affective commitment, job satisfaction, job stress, and other variables over 3 times from baseline to 24 months. RESULTS: Findings demonstrated a reduction in affective commitment and an increase in nursing stress from baseline to 12 and 24 months of employment. The highest mean in intent to leave occurred at 12 months, highlighting the vulnerability of the NGNR at that time. CONCLUSIONS: Nurse leaders must consider resources supporting NGNRs beyond the traditional 12 months to ensure retention and organizational commitment, thereby decreasing intent to leave.

Does Gender Matter in Septic Patient Outcomes?

PURPOSE: The purpose of this study was to examine potential gender disparities in relation to factors associated with sepsis management among a cohort of patients admitted through an emergency department with a discharge diagnosis of severe sepsis or septic shock. Sepsis is one of the leading causes of death globally, with significant associated costs. Predictors of survival for those with sepsis-related diagnoses are complex. DESIGN AND METHODS: The study had a retrospective, descriptive cross-sectional design. The sample (N = 482) included patients 18 years of age or older who presented to the emergency department of a nonprofit, Magnet-recognized, acute care hospital located in southern California. Subjects included those who subsequently met the criteria for a discharge diagnosis of severe sepsis or septic shock as defined by the Surviving Sepsis Campaign. Patient characteristics, clinical variables, care management processes, and outcomes were extracted from the electronic health record. A multivariate model was analyzed. FINDINGS: The sample included 234 women (48.5%) and 248 men (51.5%). Logistic regression with eight independent variables (discharge diagnosis, age, comorbidities, length of hospital stay, source of infection, first serum lactate level measured, recommended fluids administered, and gender) reliably predicted odds for patient survival, Ï°2 (12) = 118.38, p < .001, and correctly classified 77.3% of cases. All eight independent variables significantly contributed to the model. Men had a higher likelihood of hospital survival than women (odds ratio 1.68; 95% confidence interval 1.01-2.79; p = .045). CONCLUSIONS: The Surviving Sepsis Campaign has provided a clear pathway for care of patients with sepsis-related diagnoses. Therapeutic strategies should be developed to address differences in outcome by gender. The adoption of more aggressive applications of evidence-based interventions for these patients may result in better patient outcomes. CLINICAL RELEVANCE: Providers should understand the importance of adhering to sepsis protocols, minimizing treatment disparities, and recognizing gender differences.

Systematic Review of Gender Differences in Sepsis Management and Outcomes.

PURPOSE: Contributors to disparities in sepsis management have been attributed to genetic susceptibility, differences in clinical presentation, and healthcare delivery. The influence of gender on survival or mortality of patients with sepsis-related diagnoses is unclear. The purpose of the current study was to systematically review published research to identify factors and outcomes associated with sepsis management and outcomes based on gender differences. METHODS: Covering a period from 2006 to 2016, a literature search was conducted on four electronic data bases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCO, MedlinePlus, and PubMed. Content analysis of each article was performed independently by two authors. The guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was the method used to assess the quality of evidence of the articles in this review. FINDINGS: A full review was completed on a total of 452 identified potentially relevant publications, and 7 publications met inclusion criteria. The methodological approaches included prospective and retrospective observational studies, and prospective and historical cohort studies. The aim of these studies was to identify if gender differences exist related to sepsis-related mortality, completion of Surviving Sepsis Campaign resuscitation bundle elements, sepsis-related care processes, and sepsis-related incidence and source. CONCLUSIONS: Clinical sepsis studies evaluating gender and sepsis-related management and mortality are inconclusive and complex. Three different outcomes exist: no difference, higher risk in females, or higher risk in males. Further studies are needed to support the presence of gender disparities on sepsis-related healthcare outcomes. CLINICAL RELEVANCE: Providers should understand the importance of adhering to sepsis protocols and minimizing treatment disparities including gender differences.

Assessing Learning Styles of Graduate Entry Nursing Students as a Classroom Research Activity: A quantitative research study.

BACKGROUND: A number of studies across different disciplines have investigated students' learning styles. Differences are known to exist between graduate and baccalaureate nursing students. However, few studies have investigated the learning styles of students in graduate entry nursing programs. . OBJECTIVES: Study objective was to describe graduate entry nursing students' learning styles. DESIGN/SETTING/PARTICIPANTS/METHODS: A descriptive design was used for this study. The Index of Learning Styles (ILS) was administered to 202 graduate entry nursing student volunteers at a southwestern university. Descriptive statistics, tests of association, reliability, and validity were performed. Graduate nursing students and faculty participated in data collection, analysis, and dissemination of the results. RESULTS: Predominant learning styles were: sensing - 82.7%, visual - 78.7%, sequential - 65.8%, and active - 59.9%. Inter-item reliabilities for the postulated subscales were: sensing/intuitive (α=0.70), visual/verbal (α=0.694), sequential/global (α=0.599), and active/reflective (α=0.572). Confirmatory factor analysis for results of validity were: χ2(896)=1110.25, p<0.001, CFI=0.779, TLI=0.766, WRMR=1.14, and RMSEA =0.034. CONCLUSIONS: Predominant learning styles described students as being concrete thinkers oriented toward facts (sensing); preferring pictures, diagrams, flow charts, demonstrations (visual); being linear thinkers (sequencing); and enjoying working in groups and trying things out (active),. The predominant learning styles suggest educators teach concepts through simulation, discussion, and application of knowledge. Multiple studies, including this one, provided similar psychometric results. Similar reliability and validity results for the ILS have been noted in previous studies and therefore provide sufficient evidence to use the ILS with graduate entry nursing students. This study provided faculty with numerous opportunities for actively engaging students in data collection, analysis, and dissemination of results.

Manager and staff perceptions of the manager's leadership style.

OBJECTIVE: The purpose of this study was to look at manager and staff perceptions of the manager's leadership style and to determine what effect transformational leadership style has on job satisfaction. BACKGROUND: Nursing job satisfaction is a critical element in addressing the nursing shortage. Literature supports that job satisfaction is related to nurse manager leadership style. This fact has caused nurse managers to carefully consider their leadership style and the impact it has on the nurses they manage. METHODS: A descriptive correlational, comparative design was used in a convenience sample of nurse managers and their direct report nursing staff (n = 92). RESULTS: A correlation was found between nurse manager transformational leadership style and nurse job satisfaction (r = 0.348, P < .05). CONCLUSION: Transformational leadership style was associated with higher levels of job satisfaction. The findings added to the knowledge about variables that are correlated with job satisfaction, which is a critical issue to nursing.