This document presents a proposed qualitative research study on the prevalence of nosocomial (hospital-acquired) infections. The study would use an action research methodology involving interviews with nurses, doctors, and managers from 25 hospitals. The interviews aim to understand infection risks, prevention practices, and challenges. A literature review identifies common infections like ventilator-associated pneumonia and risk factors like inadequate policies. The analysis will develop themes from interview transcripts to inform conclusions. The qualitative design allows exploring perceptions and behaviors contributing to infections beyond what statistics show.

1. Suzanne Biehl
Qualitative Research Report
Composition 2
March 11th, 2014
Mental Health and Higher Education
Introduction
“The average age of onset for many mental health conditions is
the typical college age range of 18 to 24 years old, said
Courtney Knowles, executive director of The JED Foundation”
(Tartakovsky). These mental health conditions are a result of
the many stressors that students regularly face. A few of the
main stressors are due to anxiety pertaining to academics,
financial, and social struggles. A majority of these pressures are
rooted in actual problems, but some of them are solely
perceived by the individual.
The academic aspect contains some of the most apparent
stressors dealt with throughout college. In order to be
considered a full-time student, one must have a course load of
at least twelve credits, about three to four classes. Most majors
require about a hundred and twenty-five credits to graduate.
This means that taking only twelve credits per semester would
greatly lengthen the number of semesters spent in college. This
is a great source of worry for some students.
The rising cost of higher education is another common stressor.
Many college students are low on cash, this due to their young
age and the fact that many are coming straight out of high
school and into college without spending time in the work force.
Of course even if they were financially stable college debt is
almost completely unavoidable. In the U.S. during 2010-2011
the average tuition cost for public institutions was $13,297.
“Between 2000–01 and 2010–11, prices for undergraduate
tuition, room, and board at public institutions rose 42

2. percent…” (U.S. Department of Education). That cost means a
lot of cash straight out of pocket or a pile of student loans to get
through and obtain a degree.
Another stressor is the social anxiety and all around general
anxiety that comes along with attending college. Social anxiety
specifically is something to be addressed during college. With
how integrated technology is into our daily lives it has become
harder to establish and gain the fundamental social skills that
employers are requiring. Social skills are extremely important
because once out of school and into the workforce many
students must interact face-to-face with clients and co-workers.
According to the data collected in a 2010 survey conducted by
American College Health Association, 38% of male and 54% of
female college students have felt overwhelming anxiety within
the last year. Another striking statistic from the same survey
states that, 30% of students have felt so depressed that it was
difficult to function (ACHA). Most students will face some sort
of mental health challenge before graduating. That challenge
may be something temporary or even lifelong. But, what kinds
of challenges are students facing? How is this affecting the
people around me who are attending college? Is there a
connection between attending college and students developing
mental health conditions?
Literature Review
With the increasing number of students deciding to attend
higher education, the stress to succeed is becoming even
greater. This stress really gets to a good deal of students. For
that reason alone there are numerous studies on mental health in
college age individuals. Along with studies on the topic, many
works have also been published on how to help with the
numerous stresses of being a student.
A U.S. News article written by Brian Burnsed discusses many
reasons why a student may become depressed at some point in
their academic journey. As he discusses these reasons he
focuses greatly on tips to help ease the stress. His 5 tips
include: exercise, don’t be a hermit, use school counseling, take

3. advantage of technology, and go to sleep (Burnsed). His tips are
the same as many tips giving by most professionals in the
counseling field. With certain actions, like the ones above, an
individual can help reduce the stress and anxiety put unto their
mind and body.
Methodology
For qualitative data sources and procedures my research refined
down to a survey. I have developed and released a survey of
seven questions that all relate to higher education and mental
health. The survey contained multiple yes and no type
questions. All questions also provide a space to further the
response. This survey was available online through
surveymonkey.com. It was accessible February 26th thru March
6th, 2014. Most if not all responses were collected from friends.
I had twenty four participants in the survey.
The survey was my best research options because it provides me
with multiple responses, some detailed and some left more
simple. The survey provided me with multiple answers to the
same question to allow me to observe the similarities and
differences within the group. I also obtained averages and
information which I have displayed statistically.
All research has been conducted and I have sorted through all of
the information to form a more cohesive way to display my
collected data. In terms of the survey I have laid out the
responses to each in the form of individual charts.
Findings
Survey Results
Personal College experience
Over the course of one week, this survey was taken by twenty-
five students from numerous universities. I only had one
unsalvageable set of responses which is not included in the data

4. shown above.
Findings continued…
As the data from my survey shows, the majority of participants
are full-time undergraduate sophomores. In my survey 60% of
students had no mental health problems before entering school,
but have felt that their mental health has suffered due to being
in school. 44% of students with mental health problems also
admit that it has affected their academic performance. 60% of
the students without mental health problems agreed that having
a disorder could affect a student’s performance.
I assumed most college students would face some sort of mental
health challenge before graduating and the data indicates that it
was a correct assumption. This data displays that a majority of
college students have dealt with mental health issues and the
effects of it on their academics. When it comes to seeking help,
only about half of those who need it actually end up getting it.
Conclusion
A. Interpret your findings – Explain what they mean
B. Discuss how the findings can be applied – what comes next?
Even though mental health issues are becoming less taboo
and more people are being diagnosed it is still a struggle that
we still have a lot to learn about. Already being stressed out
from the mental health issue many people are too overwhelmed
to seek help or even discuss their health with friends and
family. Many people still believe that mental health is a bunch
of phooey to get money out of you. The brain can get sick or
function improperly; it is an organ just like the rest and its
health is crucial.
Work Cited
ACHA. "ACHA-NCHA II Reference Group Executive

5. Summary." Acha-ncha.org. American College
Health Association, Spring 2010. Web. 4 Mar. 2014.
Burnsed, Brian. "5 Tips to Avoid Depression in College." US
News. U.S.News & World Report, 19 Nov. 2010. Web. 4
Mar. 2014.
Tartakovsky, Margarita, M.S. "Depression and Anxiety Among
College Students | Psych Central."
Psychcentral.com. PsychCentral, 2013. Web. 4 Mar. 2014.
U.S. Department of Education, National Center for Education
Statistics, and Digest of Education Statistics. "Fast
Facts." National Center for Education Statistics. Institute of
Education Sciences, n.d. Web. 4 Mar. 2014
Number of Semesters Attended 1 2 3 4 5 6
7 8 0 2 11 8 0 1 0 3 Full-
time or Part-time Part-time Full-time 0 25
Undergraduate or Graduate Graduate Undergraduate 1
24 2. Have you ever felt that your mental health has
suffered due to being in school? Yes (15) No (7) Unsure
(3) 15 7 3 3. Did you have any prior mental health
issues before attending college? Yes (10) No (15) 10 15
4. Have you been diagnosed with a mental health disorder?
Have you been diagnosed with a mental health disorder? Yes
(12) No (11) Undiagnosed, but still suffer from mental health
problems (2) 12 11 2 5. Are you seeking treatment?
Yes No Not Needed 7 5 13 6. Do you feel
that your mental health is affecting your academic preformance?
Yes No No Mental Health Problems 11 9 5
7. If you do not suffer from any sort of mental disorder do you
think that having a disorder could affect a person's academic
performance?
7. If you do not suffer from any sort of mental disorder do you
think that having a disorder could affect a person's educational
performance? Yes No I suffer from a mental disorder, this
question doesn't apply to me 15 9 1 Currently
Attending Yes No 23 2

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Alzaid
Healthcare Proposal: Prevalence of Nosocomial Infection
Introduction
Hospital-acquired infection is considered to be the most urgent
issue that needs immediate solutions. There may be different
causes, reasons, and underpinnings of infections, including
viral, fungal, and bacterial pathogens, which refer to the most
common kinds of bloodstream infection, such as ventilator-
associated pneumonia, surgical site infections, and urinary tract
infections. In response to these challenges, healthcare
professionals should pay specific attention to quality
management and hygiene within hospital to prevent the
prevalence of nosocomial infection. While researching the
topic, the emphasis will be placed on such aspects as
identification of the most frequently occurred diseases, risk
factors causing infection occurrence, measures taken by nursing
professionals to prevent nosocomial infection, diagnosing, and
possible recommendations on the situation improvement.
Review Relevant Literature
In the studies by Sohn et al., the researchers pay attention to
define the risk rates nosocomial infections (827). They have
also conducted national assessment of hospital-based infections
to define its prevalence, associated risk factors, and prevention
measures. Based on a survey of nosocomial infections, the data
has been gathered on diagnoses, therapeutic interventions,
treatments, and outcomes (Sohn et al. 826). The results have
revealed that about 12 % of 827 patients had hospital-acquired
infections, including bloodstream, lower respiratory tract, ear-

7. nose-throat, and urinary infections.
Rosenthal et al. have also dedicated their research to analyzing
the work of intensive care units in Asia, Africa, Latin, America,
and Europe to define that developing countries’ units are similar
to those presented in the United States (96). However, the rate
of device-associated infections has been significantly higher. In
particular, it has been reported that 13.6 % of ventilator-
associated pneumonia cases have been detected in the country,
as compared to 3.3 % in the US units (Rosental et al. 96).
Additionally, Helder, Brug, Looman, van Goudoever, and
Kornelisse assume that bloodstream infections are regarded as
the most dangerous ones because they cause higher rates of
morbidity in neonatal ICUs (1246). The researchers have also
argued that relevant hand hygiene is essential to comply with
the highest quality standards. The infants with bloodstream
infections that they received at hospital face serious threats.
And therefore, hand hygiene interventions should be controlled.
Additionally, the results of the study are congruent with the
advancement of hand hygiene practices in healthcare with the
introduction of education program.
Infection control is a priority for each hospital organization
because it minimizes the risks of hospital-acquired disease.
Using algorithms and guidelines for controlling infections
should be a priority for every healthcare organization. In this
respect, Cohen et al. investigate the risks associated with the
spread of C. difficile diarrhea infection. The scholars believe
that the infection spread is predetermined by inadequate
healthcare policies and quality standards. By providing the
epidemiology and diagnosis, Cohen et al. have assumed that “C.
difficile accounts for 20-30 % of cases of antibiotic-associated
diarrhea and is the most commonly recognized cause of
infectious diarrhea in healthcare settings” (n. p.). Therefore, the
mechanisms for disease prevention in hospitals should be
reconsidered to define what changes should be made to increase
high quality standards.
Research Questions

8. 1. What are the quality standards for infection control and
prevention in hospitals?
2. Are there any risk factors associated with nosocomial
infection spread?
3. What intervention programs could be implemented to manage
hospital-acquired infections?
Methodology
The Qualitative Data Source and Procedures
The main benefit of qualitative research consists in the
possibility to observe the existing trends in managing problems,
as well as define behavioral patterns and responses to a specific
phenomenon. In the context of managing hospital-acquired
infection, a review of literature will help the scholars to define
the cases of infection spread, the main causes, as well as
possible interventions. In order to answer the research questions
and meet the objectives, the action research method could be the
best option for problem solving in nursing. In particular,
Streubert, Streubert and Carpenter assume, “the characteristics
of action research provide nurse research with a framework for
exposing group knowledge and planning with thoe most
involved rather than imposing expert knowledge and planning”
(300). Therefore, action method aims to enhance the methods
for research, as well as shed light on real-world problems.
Participants
The participants will be chosen from 25 hospitals from different
regions in the United States. These will be volunteer nurses that
will be informed about the research objective and the overall
process. Prior to participating into interviews, nurses will be e-
mailed by the research to reply back with a formal written
content. The interviews will be composed of ten semi-structured
questions that will relate to the evaluation of nurses’ behavior,
daily practices, and problems at work. The interviews will be

9. recorded and transcribed to split information into thematic
nodes. The participants will involve nurses, physicians, and
manager to understand the route of the problem from all
dimensions.
Justification for the Methodology
The qualitative observational study based on action research
methods is the best way to understand the origins, problems,
and challenges of infection control and prevention within
hospitals. In particular, the research implies active engagement
into the research and constant adjustment to the received
findings (Streubert et al. 300). Therefore, qualitative analysis of
information seems to be more efficient in terms of the depth of
research because statistical data fails to provide assessment of
existing perceptions and behaviors.
Analysis
The data analysis will be carried out as soon as the interview
responses are divided into thematic nodes. The evaluation of
participants’ behavior and reactions is also of great value
because it defines their attitude to the objectives of the
research.
Contributing to the Data Analysis
The data analysis can be supported with statistics and related
case studies withdrawn from literature to have a better idea of
its validity and reliability. Mental process is essential for
drawing the corresponding conclusions and assumptions and,
therefore, the researchers must develop themes and problems
before they receive information from the participants to make
sure that the research relates to the research questions.
Works Cited
Cohen, Stuart H., Dale N. Gerding, Stuart Johnson, Ciaran P.
Kelly, Vivian G. Loo, Clifford McDonald, Jaque Pepin, and
Mark Wilcox. Clinical Practice Guidelines for Clostridium
Difficile Infection in Adults: 2010 Update by the Society for
Healthcare Epidemiology of America (SHEA) and the Infectious
Disease Society of America. Infection Control and Hospital

10. Epidemiology, 31.5 (2010).
Goudoever, Rene F. Kornelisse. Care unit: An intervention
study with before and after comparison. International Journal of
Nursing Studies, 47.10 (2010).
Rosenthal, Victor, D., Dennis, G., Maki, Silom Hamulitrat,
Eduardo A. Medeiros, Subhash Kumar Todi…and Maria
Eugenia Guzman Siritt. International Nosocomial Infections
Control Consortium (INICC) report, data summary for 2003-
2008, issued June 2009. American Journal of Infection Control,
38.2 (2010).
Sohn, Annette, H., Denise O. Garrett, Ronda L. Sinkowitz-
Cochran, Lisa A. Grohskopf, Gail, L Levine, …and William
Jarvis. Prevalence of Nosocomial Infections in Neonatal
Intensive Care Unit Patients: Results from the First National
Point-Prevalence Survey. The Journal Of Pediatrics, 139.6
(2001).
Streubert, Helen, S., Helen J. Streubert, and Dona Rinaldi
Carpenter. Qualitative research in nursing: Advancing the
humanistic imperative. Philadelphia: Lippincott Williams &
Wilkins, 2011.