Learning Goal: I’m working on a nursing discussion question and need support to help me learn.
A clinical quality problem I chose to use in this discussion would be the strive for reducing hospital readmissions. The best design for this quality improvement would be an experimental design. The reason that an experimental design would work best for this clinical quality problem is because a randomly picked group with a the formed controlled group would be best for a general look at reducing hospital readmissions. For example a random group of individuals who have left the hospital, the percentage of those who had to be readmitted would be closer to the general public percentage. Whereas if they were to only pick and choose certain individuals, like only those who were readmitted, there wouldn’t be an effective way of seeing what is causing these readmissions by not using a controlled group of those not readmitted, as a quasi-experimental design is. On a bigger scale, a way to go about this experimental design could be to pick hospitals at random and see their data in reference to readmissions, those who have responded to incentives to reduce readmissions and those who have not. Using the experimental design for this clinical quality problem would be best also because when conducting this experiment, a broad group of individuals and hospitals of all units, situations, and ages could be picked therefore leading to a more accurate finding. The strengths of this method include a better control of variables and an easy way of seeing the causes and effects. The weaknesses of this design include that because the individuals are grouped, those who know about the experiment might try to shape their experiences to fit what they think the outcome may be. With an experiment like this, strategies to reduce hospital readmissions can be implemented in all hospitals reducing the amount in the general public.
Urinary catheters are widely used in clinics. However, there is a problem when using this catheter, and the patient may be at increased risk of getting a urinary tract infection. So, we must look at this problem and work to reduce urinary tract infections caused by urinary catheters (CAUTI). For this clinical problem, we can do a quasi-experimental design to see the effectiveness of the methods that will be used to reduce CAUTI. According to (Harris et al., 2016), “Quasi-experiments are studies that aim to evaluate interventions but that do not use randomization. Similar to randomized trials, quasi-experiments aim to demonstrate causality between an intervention and an outcome”. After getting consent from the participants who use a urinary catheter, the participants will be divided into two groups. The participant can choose which group they want, one group will receive intervention to prevent urinary infection, and the other group will receive the usual care. The goal is to determine whether or not the methods that will be used effectively reduce urinary tract infections. Through this process, there are strengths and weaknesses in using quasi-experiment. As the book points out, it is practical, affordable, feasible, and has generalizable results. For example, if the methods taken to reduce or prevent CAUTI are effective, we can follow that for most patients with a catheter. That is one of the strengths of quasi-experimental design. In addition, compared to controlled experimental designs, these are more flexible for use in the practice setting ” (LoBiondo-Wood& Haber, 2017).
Furthermore, some studies or hypotheses cannot be implemented with an experimental design for several reasons, like when an experiment affects research ethics. So, in this case, the researcher applies quasi-experimental. On the other hand, the quasi-experimental design does not use randomization, which can be one of the weaknesses.