Evidence-Based Practice Project Proposal on Data Collection

Data Collection

Data Collection Methods, Timelines, and Key Activities

The qualitative research methodology to be used in the EBP will consider the views and responses of healthcare practitioners and young adult patients. The objective of the data collection process will be to find answers to the question: How can the family nurse practitioner work with community-based organizations to promote the prevention of unwanted pregnancies and STDs among young adults between the ages of 17-26 in South Florida? This question will require information collected from healthcare practitioners, particularly family nurse practitioners, as well as patients who have undergone the proposed intervention process. Each of these groups of participant has a significant role to play in the prevention of unwanted pregnancies and STDs among young adults (Mackie, Mitchell, & Marshall, 2018). Collaboration with community-based organizations will also provide a wider perspective on the problems that need solving. According to Bhatt and Bathija (2018), community-based organizations play a crucial role in pushing for the delivery of better quality healthcare. As such, there will be need to involve community-based organization leaders in the processes, since the proposed intervention requires a collaborative approach between them and the healthcare fraternity.

Various types of data will be collected. Most of the data collection will be done using a combination of surveys and interviews. The data to be collected from healthcare practitioners will be aimed at establishing their understanding about their roles with regards to the promotion of the prevention of unwanted pregnancies and STDs; how they can collaborate with community-based organizations to find solutions to the mentioned problems; and their perceived efficiency of the proposed intervention measures. This data will be collected through semi-structured surveys in which the researcher has the opportunity to ask for clarification if need be (McIntosh & Morse, 2015). The young adult patients, on the other hand, will provide information on what they consider their understanding of the prevalence of unwanted pregnancies and STDs among youths, as well as on their perceptions about the implemented interventions and suggestions of improvements to make in those interventions. This data will be collected through spontaneous interviews. For the CBOs, the objective will be to find out their expectations from family nurse practitioners and how those expectations can be met through consistent practice. In this case, data will be collected through surveys.

The survey will be designed to include questions that target the perceptions of different participant groups in the interventions towards the promotion of pregnancy and STDs prevention in South Florida. The survey questionnaire for healthcare providers will be divided into two sections. The first section will provide questions on the demographic details of participants including requests for their roles in healthcare, age, and work departments. The second section will include questions on the prevalence of unwanted pregnancies among young adults, the impacts of unwanted pregnancies and STDs on the young adult population, the roles of family nurse practitioners in the prevention of unwanted pregnancies and STDs, actions taken by healthcare providers in managing reproductive and sexual health issues, and the potential contributions of community-based organizations towards the prevention of unwanted pregnancy and STDs among young adults in South Florida. Using this survey, data will be collected within healthcare facility settings over 2 weeks.

For the CBOs, the survey will comprise of only one question on the demographics of the participants. A representative from the identified CBOs will provide information on the activities of the CBO and their contributions to community health. A total of 3 CBOs are targeted in the EBP. The survey will ask questions around the specific activities in which the CBO is involved, and which contribute to the health of the community, the roles that healthcare providers, particularly family nurse practitioners are expected to engage in regarding the prevention of unwanted pregnancies and STDs, and the potential for collaboration between healthcare providers and community-based organizations. The data will be collected over 2 weeks following appointments with the different CBOs on different days of the week. The data obtained from the community-based organizations and healthcare practitioners will be used to formulate the interventions to be applied to the youths. This is based on the argument presented by Woo, Lee, and Tam (2017) which points out the need for a collaborative approach in solving community health problems. As previously explained, the most basic intervention in which the family nurse practitioners will be involved in is the education of young adults on risk factors for reproductive and sexual health issues, particularly unwanted pregnancies and STDs. The objective would be to use at most three minutes of a patient’s time to communicate to them about self-protection from these issues. The data collected from the patients, therefore, will involve asking questions about their knowledge of STDs and unwanted pregnancies, and the impacts of the spontaneous awareness on their perception of reproductive and sexual health issues. The objective of this survey is aligned to the arguments presented by Maxwell, Radzilani-Makatu, and Takalani (2016) concerning the awareness of teenagers about unwanted pregnancy and STDs prevention. The EBP will identify the gaps available in the awareness and thus align the phases of the intervention process to the available gaps in unwanted pregnancy and STDs prevention.

From these procedures, the data collection points include the healthcare facilities and CBO meetings. At the healthcare facilities, data will be collected from the healthcare service providers and patients. The CBO meetings will be the point of contact with the community-based organization leaders. The data collection procedures deviate from the conventional administrative data collection methods used in healthcare research. Sarkies et al. (2015) pointed out that healthcare research through administrative data collection has not been confirmed effective and efficient, especially where the objective is to determine the efficiency of healthcare services. The selected points, therefore, offer a sustainable and cost-effective opportunity for data collection, which can be translated into practice for family nurse practitioners. The data will be collected in a month. The first two weeks will be used for the healthcare practitioner sourced data collection and the next two weeks will be for the collection of data from the CBOs and patients.

Achieving Data Saturation

Data saturation implies that the level of data collection and analysis in which a researcher engages provides no room for further information collection. In the proposed EBP, different methods of data saturation will be used to realize the intended objectives. The first approach will involve theoretical saturation since it is most suitable for grounded theory-based studies. Saturation in such grounded theory studies is accomplished through the development of theoretical thematic categories, which are linked to the methodology in use (Saunders et al., 2018). The focus of this approach to saturation is on the sampling process, whereby the sample size and characteristics represent an entire range of divergent perspectives in the topic of study. By considering views from community-based organizations, healthcare practitioners and patients, this EBP achieves participant divergence and hence data saturation.

The second approach that will be used to attain data saturation is the inductive thematic saturation approach discussed by Saunders et al. (2018). This approach focuses on data analysis, which is conducted to exhaust the emergence of new data or information. Through deductive abstractive data analysis, it will be possible to exhaust the emergence of new data.

Enhancing Data Quality

Data quality is a function of several factors in healthcare research. Data collection, in particular, plays an essential role in determining the eventual data quality. For instance, issues with data duplication, missing values in data records, incorrect report formats, and inconsistencies in the data can all contribute significantly to poor data quality. In this EBP, data quality is one of the areas that have been emphasized by the researcher to enhance the quality of data at all stages of the research. One of the methods that would be used for enhancing data quality is through the clearing of data errors. Data errors are easier to clear when using research information systems that identify missing values, duplicate data, and correct data formatting. The specific approaches to data clearing include correction and standardization especially for inconsistencies in the data and consolidation for duplicated data. Additionally, enrichment could be used as an approach to improving the data quality, by expanding the scope of the already available data with additional data from other sources. In this way, the information eventually presented in the EBP becomes not only rich enough but also capable of filling available information gaps (Azeroual & Abousba, 2017). Information on demographics and geographic data can be good enrichment tools for research information.

Analysis

Organization

Organizing qualitative research analysis can be a challenging process due to the variety of data that is commonly associated with qualitative data collection methodologies. According to Moser and Korstjens (2016), data analysis in qualitative research cannot be considered a distinctive and independent part of the research process; rather, qualitative data analysis is a progressive practice performed throughout the research process from the data collection stage to the final data presentation. In the EBP, the convention developed by Moser and Kostjens will be adopted for the data analysis, whereby an iterative process will be implemented in the data analysis. The researcher will go back and forth between the data collection and the data analysis, breaking down collected data into distinctive designs that form the heart of qualitative research. The process of sampling- data collection- data analysis will be iterative to foster the accumulation of rich data that can aid in effective decision making. The principle under application here is that any emerging factors from the data analysis stage should influence the next course of action in both sampling and data collection. The data analysis process, therefore, begins with the preparation of field notes immediately after contact with the first participant.

For clearer organization and communication of the data analysis phase, Moser and Korstjens (2016) opine that maintaining a transcript is an essential practice. Accordingly, the EBP will consider this, ensuring that the information is reported exactly as communicated by the participants. In particular, there will be a need for the interviews conducted with patients to be taped for effective verbatim transcription. For the surveys and observations made during the CBO visits, the researcher will pay attention to non-verbal communication methods, ensuring that they are not only accurate but also unbiased during recording and analysis. The researcher will be aiming at establishing legitimacy and insight in the findings given that the findings from the study should be used as evidence-based solutions to the prevention of unwanted pregnancy and STDs among young adults. The iterative process, therefore, is considered the best tool to push the research towards attaining the intended objective of obtaining quality information from the participants.

Use of Themes and Coding

In most qualitative research practices, data coding and themes are considered effective towards achieving some of the ethical requirements, particularly when working with human subjects. Elliot (2018) posits that the types of codes and themes used by qualitative researchers largely depend on the methodological background used in the research, the research questions to be answered, and the study practicalities. Moreover, the selection of themes and codes for use in research requires a response to questions centering on aspects such as frequency of data collection, the magnitude of data to be used, and the density of data distribution. Various methods of data coding and theme development are available in qualitative research and the decision on which ones to use depends on the researcher’s convenience. When referring to data coding in the context of the present study, the definition by Gonzalez (2016), in which the author points out that the coding process in grounded theory research entails breaking apart collected data to understand what it means before restricting the same data meaningfully will be considered. This is based on the argument that there is “considerable confusion regarding what coding actually is” (Elliot, 2018).

For this EBP, various themes will be used during data analysis and abstraction from the primary data collection process. For instance, the major themes under which the data will be coded and/or presented include the themes of reproductive and sexual health; unwanted pregnancy and contraception; STDs and their prevention; community and healthcare practitioners; and reproductive health. Each of these themes presents a unique position in the context of the present research. Vaismoradi, Jones, Turunen, and Snelgrove (2016) describe various approaches to data coding in qualitative research, from which the proposed EBP will derive its coding process. The objective of data coding in this regard is to break down large data masses into easily manageable chunks of information, which can be linked directly to the study objectives. The EBP will use different types of coding approaches to maximize information abstraction from all participants. Some of the conventional approaches to data coding include conceptual coding, relationship coding, participant perspective coding, participant characteristic coding, and the setting code. For this EBP, the most prevalent coding techniques include the participant perspective coding, in which data is assigned to codes based on distinctive perspectives shared by participants on subjects such as unwanted pregnancy prevention and contraceptives and/or the role of healthcare providers in promoting the prevention of such reproductive and sexual health outcomes. When coding the data, the themes are broken down from the largest cluster to the lowest. For instance, the theme of reproductive and sexual health issues will be broken down to reproductive health issues as one of the core components; this will be further broken down to risk factors; then to reproductive health outcomes; then finally to unwanted pregnancies and contraception.

Triangulation in the EBP

When talking about reproductive health issues in any given community, the role of different stakeholders and the community at large has to be accorded specific attention. For instance, the proposed EBP will be focusing on the responsibilities of family nurse practitioners in promoting the prevention of unwanted pregnancies and STDs among young adults. From this objective alone, it is clear that there are three different categories of stakeholders namely, the family nurse practitioners, the targeted young adults, and the community-based organizations with which the family health practitioners ought to collaborate. Understanding the intended phenomenon to the point that can foster the development of grounded theory requires data collection from multiple sources, not only through primary qualitative data collection methods but also through secondary data collection processes. This naturally means that there is a need for variation in data collection methods and sampling procedures, which is the principle behind triangulation in research.

In a study by Fusch, Fusch, and Ness (2018), bias mitigation, promotion of social change, and enhancement of data saturation can be achieved through multiple triangulation as done in the proposed EBP. In this particular scenario, multiple triangulation was performed through variation of methods and variation of sampling techniques. For the methods, there is a combination of surveys and interviews, each targeting a specific participant group. In this way, the scope of the information collected can vary significantly, resulting in greater depth of information. Furthermore, triangulation will also be achieved through variation of sampling approaches. The choice of healthcare providers and the patients to participate in the study is based on a convenience sampling approach, with that of the CBOs based on a random sampling procedure.

Evaluation

The most profound outcome improvement upon implementation of this project will be through the realization of better health outcomes among patients. Yazdakhasti, Pourreza, Pirak, and Abdi (2015) provide detailed descriptions of the social and economic costs of unwanted pregnancies and STDs. From these impacts, it is clear that healthcare professionals, community-based organizations, and young adults can benefit significantly through the implementation of this project. For instance, the most significant impact will be felt by the young adults who are presently at risk of unwanted pregnancy and STDs. Some of these young adults expose themselves to risk factors due to lack of awareness and enhancing their awareness can help reduce the risk of exposure. As such, implementing projects such as this one,in which the core objective is to prevent unwanted pregnancies and STDs, can result in significant protection of those who would otherwise remain at risk.

The healthcare providers, particularly family nurse practitioners, are also bound to experience a lower influx of patients with unwanted pregnancies and/or STDs and other preventable health outcomes. In this way, the efficiency of service delivery among nurses can improve significantly as they would have more time to attend to patients with other health conditions. In effect, reduced unwanted pregnancy rates and rates of STDs can help in reducing fatigue among healthcare practitioners, improving process safety and efficiency, and reducing medical incidences that are related to fatigue.

This project would also result in reduced economic and social costs of taking care of children from unwanted pregnancies, pregnant mothers, as well as those who are suffering from STDs. According to Jayaweera, Ngui, Hall, and Gerdts (2018), various outcomes are associated with unwanted pregnancy and STDs among young adults, some of which reduce their propensity to seek help when faced with such situations. For instance, stigma, limited access to preventive services, mistrust of health service providers and healthcare facilities, and mistreatment are some of the commonly cited reasons for the failure of young adults to seek reproductive health support. Moral judgment is another factor that contributes to low access to information about reproductive health. By training community-based organizations as part of the proposed interventions in this project, it is expected that the information will be distributed downwards to young adults. This would not only improve outcomes in terms of enhanced access to information but also in terms of the specific health outcomes of having better information. The community will lift its productivity through better quality of health.
Improvements to Nursing Practice

This project has the potential to result in various improvements to nursing care in family nurse practice as well as at the individual level. According to Goshu and Yitayew (2019), unplanned pregnancy is one of the major problems of the public health sector for various reasons. Some of the consequences of unplanned pregnancy include increased risk to eclampsia, preeclampsia, and other outcomes such as physical abnormality and maternal death. Each of these outcomes implies that family nurse practitioners have to do much more than conventional nursing practice, resulting in higher tension levels. Additionally, unintended pregnancy also motivates unsafe abortions, which complicate maternal healthcare. As such, both unwanted pregnancy and STDs are considered problems to the public health sector. By implementing the interventions in the proposed project, therefore, it will be possible to improve the experiences of healthcare providers, particularly family nurse practitioners who have to deal with client issues daily.

For the family practice nurses, another improvement in nursing practice would be in the work environment. Most nurses across different occupational sectors suffer from fatigue syndrome. There is a stronger risk of the syndrome among nurses working in very busy departments, particularly those dealing with women and children. Such nurses are in constant contact with patients suffering from different conditions, thus an increased risk of infection from those diseases. This can contribute to stress and emotional disturbance among the nurses. The reduced population of patients in the hospital as a result of preventing unwanted pregnancies and STDs can contribute to the better working environment through increased access to healthcare providers and reduced crowding.

Besides improving the experiences of healthcare providers by entangling the complexity of maternal care process, the project also promises to improve nursing practice through improved outcomes. Studies have shown that poor health outcomes are undesirable for nurses (Goshu & Yitayew, 2019). The perceived self-efficacy of nurses is based on various factors and is also influenced by several factors. Besides the ratio of positive to negative outcomes, another indication of the high efficacy is the nurse’s intention to stay longer in a role. Molero, Perez-Fuentes, and Gazquez (2018) aver that there is a significant relationship between the self-efficacy of nurses and their self-esteem. At the same time, it has been established that having a higher number of patients to attend to in any given healthcare scenario results in burnout among nurses, which also contributes to low efficacy and subsequently low self-esteem. It is, therefore, deductible that through the implementation of the proposed project, the efficacy of several nurses will be improved.

Dissemination of Results

Data Sharing with Stakeholders

Data sharing is considered one of the ways through which research findings can be translated into evidence-based practice. Levenstein and Lyle (2018), for instance, assert that data sharing promotes progress in scientific fields by enabling replication of information obtained through research into practice. Several ways can be used in data sharing concerning healthcare research data, and the choice of method depends on the intended objective of data sharing. For this EBP, data sharing approaches will be chosen depending on the target stakeholders and the objectives of the data. For the patients, the objective is to create awareness of the need for preventive measures against unwanted pregnancies and STDs among the young adult population. This means that the best methods for data sharing would involve practices such as social media use, community-based forums for information sharing, and televised awareness messages that can be sponsored by different governmental and non-governmental organizations. The community-based organizations would also need similar forums through which they would be empowered to disseminate awareness on the risks of unwanted pregnancy and STDs among youths.

Data Sharing with Facility, Community, State, and National Levels

Among the healthcare providers, the best approaches to data sharing would involve health facility-based forums in which evidence on the role of family nurse practitioners on the prevention of unwanted pregnancies and STDs is provided. This group of stakeholders is considered well versed with the specific risk factors surrounding reproductive and sexual health issues among youths. The objective of communicating the data to them, therefore, is to show that they also have a role to play and to clarify that role to them. The facility-based forums will also be used to share resources for the spontaneous awareness platforms that they would run in the presence of patients. Written communication is considered the most common and most effective form of communication in healthcare (Vermeir et al., 2015). Therefore, sharing the data at the facility level will also entail sharing publications through the facility library.

Data dissemination will need to be carried out at different levels of administration. The state and the national government levels are currently aware of the prevalence rates of unwanted pregnancies and STDs among young adults in South Florida. They have records showing the economic and social costs of unwanted pregnancy and STDs in the community. Thus, there is a need to create awareness of the need to engage in projects that would promote the prevention of such health outcomes. One of the ways through which this information can be disseminated to the community, state, and national levels is through the use of policy documents and publications. Sending publications to the national department of health and human services can help to share data on the findings of this research and subsequently to gain government input in the project implementation either through professional advice or financial assistance. At the national level, correspondence and creating collaborative forums for information sharing have also been cited as appropriate methods of data sharing. Conclusively, various healthcare journals publish EBP-based studies, which are peer reviewed and can be accessed by all stakeholders in healthcare (Glied, Wittenberg, & Israeli, 2018). The final approach to data sharing for future use purposes, therefore, will be to publish the EBP in a recognized healthcare journal.

Conclusion

The prevalence rate for unwanted pregnancy and STDs among young adults has been increasing across the world significantly. In South Florida, the increasing rates of unwanted pregnancy and STDs among individuals between 17 and 26 years of age is a cause of concern, and thus one of the reproductive and sexual health issues that need to be addressed urgently. Finding sustainable solutions to the promotion of pregnancy and STD prevention among youths requires a collaborative approach that considers the community perspectives as well as those of the healthcare fraternity (Woo et al., 2017). This collaborative approach is proposed in this EBP, which hopes to explore the roles that family nurse practitioners can play in collaboration with community-based organizations to prevent unwanted pregnancies and STDs among young adults. The project proposes an intervention measure that will enable healthcare practitioners to create awareness of unwanted pregnancy outcomes as well as risk factors for STDs through spontaneous 3-minute discussions with random young adults.

The proposed project promises various outcomes at the micro and macro levels to young adult healthcare. Through the implementation of the proposals made in the project, healthcare improvement will be achieved in the form of reduced complexity of healthcare service delivery, increased efficacy of healthcare services due to reduced fatigue among workers, reduced healthcare costs, and better social and economic outcomes for families of young adults as a result of reduced numbers of unwanted babies. Furthermore, the study will contribute to the academia by expanding the dearth of published information on the role of family nurse practitioners and community-based organizations on the prevention of unwanted pregnancies and STDs as described by Mackie et al. (2018) for healthcare academic research projects.

 

 

 

 

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