course materials

1. Discussion: practice issue that would benefit from utilizing a mixed
methods approach
Discussion: practice issue that would benefit from utilizing a mixed methods approach ON
Discussion: practice issue that would benefit from utilizing a mixed methods approach1-
Propose a research question related to your potential research project that would require a
qualitative research approach. Select the best qualitative method that could answer the
research question proposed? What are the strengths and weaknesses of that method?2-
Identify a practice issue that would benefit from utilizing a mixed methods approach.
Discuss how the quantitative and qualitative data would complement one another and add
strength to the study. Discuss the challenges that you might encounter in using a mixed
methods approach. your discussion using current mixed methods research articles.
Discussion: practice issue that would benefit from utilizing a mixed methods
approach(Essentials I-IX)• Essential I: Background for Practice from Sciences and
Humanities o Recognizes that the master’s-prepared nurse integrates scientific findings
from nursing, biopsychosocial fields, genetics, public health, quality improvement, and
organizational sciences for the continual improvement of nursing care across diverse
settings. • Essential II: Organizational and Systems Leadership o Recognizes that
organizational and systems leadership are critical to the promotion of high quality and safe
patient care. Leadership skills are needed that emphasize ethical and critical decision
making, effective working relationships, and a systems-perspective. • Essential III: Quality
Improvement and Safety o Recognizes that a master’s-prepared nurse must be articulate in
the methods, tools, performance measures, and standards related to quality, as well as
prepared to apply quality principles within an organization. • Essential IV: Translating and
Integrating Scholarship into Practice o Recognizes that the master’s-prepared nurse applies
research outcomes within the practice setting, resolves practice problems, works as a
change agent, and disseminates results. • Discussion: practice issue that would benefit from
utilizing a mixed methods approach Essential V: Informatics and Healthcare Technologies 5
o Recognizes that the master’s-prepared nurse uses patient-care technologies to deliver and
enhance care and uses communication technologies to integrate and coordinate care. •
Essential VI: Health Policy and Advocacy o Recognizes that the master’s-prepared nurse is
able to intervene at the system level through the policy development process and to employ
advocacy strategies to influence health and health care. • Essential VII: Interprofessional
Collaboration for Improving Patient and Population Health Outcomes o Recognizes that the

2. master’s-prepared nurse, as a member and leader of interprofessional teams,
communicates, collaborates, and consults with other health professionals to manage and
coordinate care. • Essential VIII: Clinical Prevention and Population Health for Improving
Health o Recognizes that the master’s-prepared nurse applies and integrates broad,
organizational, client-centered, and culturally appropriate concepts in the planning,
delivery, management, and evaluation of evidence-based clinical prevention and population
care and services to individuals, families, and aggregates/identified populations. • Essential
IX: Master’s-Level Nursing Practice o Recognizes that nursing practice, at the master’s level,
is broadly defined as any form of nursing intervention that influences healthcare outcomes
for individuals, populations, or systems. Master’s-level nursing graduates must have an
advanced level of understanding of nursing and relevant sciences as well as the ability to
integrate this knowledge into practice. . Nursing practice interventions include both direct
and indirect care components.Discussion: practice issue that would benefit from utilizing a
mixed methods approachattachment_1attachment_2Unformatted Attachment
PreviewRunning head: CHALLENGES IN TRANSITIONAL CARE Challenges in Transitional
Care Frank Calderon Florida National University Dr. Jorge Hirigoyen 2/1/2019 1
CHALLENGES IN TRANSITIONAL CARE 2 Challenges in Transitional Care Introduction to
the Problem The case of failure in transitional care for the elderly and the chronically ill
patients shows the challenges in transitional care. Transitional nursing is the continuity of
treatment of the patients during the movement from one health center to another or home.
The incidence rehospitalization of people who have been released from the medical
facilities to go home for recovery is high. According to Ortiz research, in 2015, 35.6% of
hospital readmission within 30days of discharge is of elderly patients of age 75- 84. The
authors indicate that this is due to the patients worsening instead of getting better.
Caregivers report that they do not know how to handle the patients that are left in their
care. Storm and Aase (2014) elaborate that physicians say that elderly patients who have
acute conditions are in vulnerable positions of breakdown if the proper transition is absent.
This is after evaluating that some of the deaths reported of elderly patients in home-based
and community- based care be caused by poor. Ye and Quan (2016) point out that in 2012,
China had the practice of the medical practitioners discontinuing patient’s care once the
patient is discharged. The recovery care task was left with caregivers. This practice led to 30
percent of patient declining in their well-being and regular functioning after been released
from the hospital especially the elderly. In the homebased care, they lacked professional
monitoring. In addition to the issue in the transition of the elderly from the hospital to their
home, the other failure is the transitional care within the medical setting. Ortiz (2019)
explains that the main case identified is medication mix-up and CHALLENGES IN
TRANSITIONAL CARE 3 error during the movement of the patient emergency department to
the intensive care unit. It also includes the surgical unit setting. Problem Statement Lack of
specialized nursing intervention is the cause of the challenges in transitional care. It causes
the readmission of elderly patients with acute illness. The handoff of patients with no clear
communication to the caregivers on how to take of them cause mishandling of the patient
(Morphet & Williams, 2014). Discussion: practice issue that would benefit from utilizing a
mixed methods approachMost caregivers as well not trained on how to provide primary

3. care to their patient. As a result, they develop other conditions, or their case elevates and
hence the need to go back to the hospital. In some case, the patient may lack friends or
family members to look after him or her. In such a situation, the patient requires a
transitional nurse to fulfill his/her medical needs. The absence of one threatens the life and
well-being of the patient. The difficulties of transitional care within the medical setting are
as a result of lack of specialized nurses who are skilled and knowledgeable about providing
professional care. Storm and Aase (2014) illustrate that the issue of delay in the provision of
therapy places the patient at risk. This is a challenge that results because of unprofessional
nurse handling the transfer of the patient from unit to another. A specialized nurse is aware
of the importance of timely and complete communication. Poor transitional care in
chronically ill people exists due to improper coordination between the emergency
department nurse and the one in the ICU. Ortiz (2019) asserts that lack of organization
confuses the right therapy for the patient which in turn causes the delay in the recovery of
the patient or the development of complications. Furthermore, unlike a regular nurse, a
specialized nurse provides quality transitional care. They are experienced, well-trained and
knowledgeable in giving transitional care. A CHALLENGES IN TRANSITIONAL CARE 4
general nurse will administer primary care for an ill person who is hospitalized. It is evident
that the provision of transitional care by ordinary medical practitioners is the cause of low-
quality care. This creates patient and caregiver dissatisfaction. The significance of the
problem to Nursing The research problem is significant to nursing. The problem is; lack of
specialized nursing is the cause for the challenges in transition care. It directly concerns the
nursing profession. It raises awareness of the weakness of nursing in transitional care. It
identifies that nursing service in transitional care is poor. Patients are sent off without
continuity care from professionals till they fully recover. Moreover, the wrong care is given
to the patients when they are moved within hospitals from one setting to entity as nurses
commonly provide the wrong medication. The problem also informs the nurses their
weakness in communication. It implies that unspecialized nurse is not keen in providing
timely and complete information to facilitate continuity care. It mainly raises concerns in
nurses in units where that transfer takes place. The problem as well illuminates to nurses
that poor professional coordination between them is resulting in transitional care
challenges since it hinders consultation and provision of information. It similarly notifies
the nurses their shortfall in performing specific crucial nursing roles. The first one is
ensuring the patient with no caregiver receives transitional care from them. Secondly, it is
educating the caregivers on how to handle the patients. In addition to informing the nurses
on the weak areas, it is enlightening them how to improve the nursing job. It is asserted that
specializing in transition care will enhance their task of providing care to patients.
Therefore, it is recommended that nurses who deal with transitional care get additional
education CHALLENGES IN TRANSITIONAL CARE 5 to gain skill. Finally, the problem
cautions the nurses on the impact of lack of knowledge and expertise. It shows that the
implications are detrimental to the patients whose health are already vulnerable. Purpose
of the Research The purpose of the research is to improve the quality of transitional care.
There is a lot of research about the quality of the general health in the hospital. Therefore,
various stakeholders have invested in facilitating quality treatment. Nevertheless, the issue

4. of transitional care has not little study and as a result their no broad awareness of the
matter concerning transitional care, its challenges, and importance. This, in return, has led
to little attention from the government, physicians and donor, individuals who can
contribute to promoting good transitional care. This prompted my research on challenges in
transitional care to implore the health stakeholders to look into the issue and promote
quality transitional care. Furthermore, I considered research into the challenges of
transitional care would be a way to inform the nurses on the areas of their weakness and as
a result, encourage them to improve. It will eventually translate to quality transitional care.
Discussion: practice issue that would benefit from utilizing a mixed methods approachMy
research exposes the challenges faced in transitional care and the problem which is lack of
specialized nurses. In addition to the nurses, it also creates awareness for the caregiver and
relevance of seeking help from transitional nurses. My study likewise enlightens the
medical trainers on the significance of including transitional care in the nursing curriculum.
Consequently, all nurses will have basic knowledge of rendering such care Finally, through
researching the subject on transitional care, I offer a platform for further research into the
area. Therefore, it will promote a better understanding of the issues facing transitional care.
This helps the stakeholders to see the severity of the issue and provide CHALLENGES IN
TRANSITIONAL CARE 6 assistance. Further research will likewise suggest better solutions
to address the problem facing transitional care. Research Questions What is the impact of
unspecialized nursing in transitional care? Why do unspecialized nurses promote low-
quality transitional care? What are the pros and cons of specialized nursing versus general
nursing? Master’s Essentials Alignment with My Topic Master’s essentials align with my
topic. It concurs with what my topic implies. The second essential indicates that
organizational and system leadership is crucial in quality and safe patient care. My topic, on
the other hand, illuminates on the importance of leadership in patient care as some of the
challenges like communication and corporation are due to lack of leadership. Master’s
essential III as well the topic problem which suggests that lack of specialized nurses is the
cause of challenges. The essential state that master-level nurses are aware that quality care
goes hand in hand with the methods and tools used. Similarly, the topic indicates that the
use of unspecialized nurses who have no master is the cause of the low-quality transitional
care. Essential VII, interprofessional collaboration asserts that masters prepared nurse is a
leader and member of the team who can communicate, cooperate and consult with other
professionals. Similarly, the topic agrees as it suggests that the challenges of lack of
communication, coordination, and consultation. It adds that this due to the use of
unspecialized nurses implying that nurses with maser can overcome the challenges.
CHALLENGES IN TRANSITIONAL CARE 7 The topic as well matches with essential IX. It is
concerned with master-level practice. It states that nurses with master’s level have
scientific knowledge and the capability to apply it into practice. My topic suggests that
unspecialized nurses are not as competent as the specialized ones who have a master’s
degree. Therefore, they pose challenges in transitional care which wouldn’t have been the
case if specialized nurses conducted the care. This essential as well claim that master’s
prepared nurses can influence positive healthcare result. The topic echoes that specialized
nurses perform transitional care better compared to general nurses. CHALLENGES IN

5. TRANSITIONAL CARE 8 References Morphet, J., Griffiths, D. L., Innes, K., Crawford, K., Crow,
S., & Williams, A. (2014). Shortfalls in residents’ transfer documentation: Challenges for
emergency department staff. Australasian Emergency Nursing Journal, 17(3), 98-105. Ortiz,
M. R. (2019). Transitional Care: Nursing Knowledge and Policy Implications. Nursing
Science Quarterly, 32(1), 73-77. Storm, M., Siemsen, I. M., Laugaland, K., Dyrstad, D., & Aase,
K. (2014). Quality in transitional care of the elderly: Key challenges and relevant
improvement measures. International Journal of Integrated Care, 14(2). Ye, Z. J., Liu, M. L.,
Cai, R. Q., Zhong, M. X., Huang, H., Liang, M. Z., & Quan, X. M. (2016). Development of the
Transitional Care Model for nursing care in Mainland China: a literature review.
International journal of nursing sciences, 3(1), 113-130. Running Head: DESIGN PHASE 2 1
Design Phase 2 Frank Calderon Florida National University 2/27/2019 DESIGN PHASE 2 2
Design Phase 2 Methodology and Design of the Study The study of transitions included the
acute admissions of elderly individuals to the hospitals up to the nursing homes of from the
home to a home with a home-based care services. Additionally, it included the discharge
transitions of elderly from hospitals to a nursing home or home also to home-based care
services. Therefore, the methodology included participant observation of admission and
discharge transition process. This involved an open-ended conversation with the patients
and also with the patient’s next of kin’s while involving the health care personnel (Design
and Methodology of a Mixed Methods Follow-up Study to the 2014 Ghana Demographic and
Health Survey, 2017). The observation also entails a collection of data which is guided by a
thematic guide which is adapted to the admission and discharge transition in the health
facilities. Discussion: practice issue that would benefit from utilizing a mixed methods
approachDuring the observation, the admission includes observing the patient being
handed over from the ambulance to the paramedics and healthcare professionals in the
emergency departments so that the patient can be observed until he is handed over to the
medical ward for further treatments. During this research, the observation covers the data
on interaction, coordination as well as dialogue between the health practitioners and the
patient. The observation ends when the researcher has a short conversation with the
patient and also with the healthcare personnel on the admission day so as to help in
clarification of some aspects pertaining to the current admission as well as the entire
process of admission. DESIGN PHASE 2 3 Additionally, the observation of transitions of
discharge commenced at the hospital ward on the expected day of discharge. It involved the
conversation between the researcher and the healthcare practitioner and the person who is
going to be discharged. The interaction also with the coordination and dialogue taking place
between the healthcare practitioner and the patient is observed. Such a conversation is very
helpful since it helps in understanding the discharge processes and discharge transition.
Short follow of up conversation also helps in understanding more the processes and the
bases of decisions made before a patient is discharged (Design and Methodology of a Mixed
Methods Follow-up Study to the 2014 Ghana Demographic and Health Survey, 2017).
Sampling Methodology The sampling method used in the research was sampling which was
utilized in the recruitment of the participants to take part in the study. Additionally, the
homecare offices in various municipalities of the country were contacted and informed on
the project and the need for the nursing leaders to participate in interviews which will

6. enable the researches to get the necessary information which will also enhance their
research. From these interviews, data is collected which also shed light on the nursing
leaders role and experience in the process of transition especially for the older patients
from the hospital to home. This implies that the interviews are conducted only for data
collection (Sahu & Singh, 2016). In essence, the semi-structured interview guide dictated
what the interviews should cover and how it should be carried out. It starts with the
general, discussion of transition processes and the patients experienced pertaining to
transitions received at homecare. The participants in this regards will focus on all the
experiences on the transition from the hospital to their homes, and DESIGN PHASE 2 4 then
researchers will decide on what next (Johnson, Pennell, Stoop, & Dorer, 2018). The guide for
the interview also entails themes which include the organization of the internal and
external cooperation, the personal resources together with values which guide the quality
of the care services. Necessary tools Various technologies and tools are used in the research
process. However, the primary consideration if the health information technology tools
which help to smoothen the transition processes of the patients. It is worth noting that
health IT involves numerous technologies such as electronic health records. The electronic
health records entail saving of patient’s information electronically on computers which will
enable retrieving exercise to be very easy. Additionally, it includes clinical decision which
also enables the health care personnel to make an effective decision which ensures that the
patients are handled very well and the decisions made helps them to regain their good
health. In essence, the health IT performs very significant tasks in various aspects of
transitions. It helps in capturing the information pertaining to the patient which helps in
informing the transition processes as well as the clinical history of the patients and what
needs to be done during the transition process. It is coherent that the design of the health IT
has the ability to the transition process especially in ing the individuals who are involved
in the transition processes (Riba, Parikh, & Greden, 2019). With the information technology
as well, the healthcare professionals will be able to connect to the home care services where
the elderly have been taken so that they can be taken care of until they get well or improve
on their health before they are being taken to their respective homes. DESIGN PHASE 2 5
Any algorithms or flow maps created The various algorithms created during the research
include the Fourier transform which helps in enhancing the senses of individuals. This is
because the Fourier transform has been dubbed to be one of the most significant algorithms
in the healthcare sector. Discussion: practice issue that would benefit from utilizing a mixed
methods approachThis transformation is a mathematical technique which is used in
breaking the complex signals which in turn will enable the healthcare personnel to see the
variation in their activities and what needs to be attained. This helps in ensuring that they
attain the objective of the organization. It is also used in medical imaging which helps in
creating date to check whether the patients who had undergone imaging are fit to be
discharged to be taken care of at homes. There is also a Mumps algorithm which is a
healthcare operating system which was developed in the 1960s but has been improved
lately to reflect on the current needs of the patients and the medical sector. Therefore, it can
be denoted as a computer program which is used in the healthcare today to run multiple
programs and enable the healthcare personnel to understand the status of numerous

7. patients and decide on the next course of action. This operating system is currently used in
the powering of the entire hospital departments which helps in the management of clinical
records to enable the healthcare facilities to save a lot of time in assessing the health care
records for patients and improve the workplace efficiency (Morr & AliHassan, 2019).
Consequently, the probabilistic data matching is another algorithm which enables
numerous computer searches which are deterministic to be carried out. This is because it
carried DESIGN PHASE 2 6 out byte by byte comparison which can mainly be used for
typographical or data entry processes. Such probabilistic algorithms are depicted to look for
a various bit of information especially in the medical records while ranking them according
to the likelihood of the patients adopting very well to the medication and estimate the time
which the patient can remain within the hospital before they are discharged to home care
through a transition which will see them gain good health. This probabilistic data help in
retrieving of useful information which helps in research. Further, the medical algorithms as
well as aids for decision making which will help in promoting safe healthcare as it also helps
the healthcare personnel to enable them not to make mistakes when carrying out their
tasks. It is worth noting that with the increase in awareness of the medical errors recently, it
is also believed that the health professionals are using these techniques into guiding them
to offer quality care services and understand the patients and those who need to go to
various homecare homes when they need specialized care. A medical algorithm in this
regard can be a low tech as a lookup or a decision tree which helps in carrying out complex
decision making through the help of programming (Morr & Ali-Hassan, 2019). Therefore,
the medical algorithms remove some of the medical uncertainty decision which in turn will
help in improving the efficiency and most importantly the accuracy of the teams provided.
Notably, the health score which helps in quantifying illness also is another algorithm which
helps in evaluating the health status of the patients and deciding whether they should be
discharged to the …Discussion: practice issue that would benefit from utilizing a mixed
methods approach