Running head CRITIQUE QUANTITATIVE, QUALITATIVE, OR MIXED METHODS.docx

Running head: CRITIQUE QUANTITATIVE, QUALITATIVE,
OR MIXED METHODS DESIGN
5
CRITIQUE OF QUANTITATIVE, QUALITATIVE, OR MIXED
METHODS DESIGN
Critiquing Quantitative, Qualitative, or Mixed Methods Studies
Adenike George
Walden University
NURS 6052: Essentials of Evidence-Based Practice
April 11, 2019
Critique of Quantitative, Qualitative, or Mixed Method Design

Both quantitative and qualitative methods play a pivotal role in
nursing research. Qualitative research helps nurses and other
healthcare workers to understand the experiences of the patients
on health and illness. Quantitative data allows researchers to
use an accurate approach in data collection and analysis. When
using quantitative techniques, data can be analyzed using either
descriptive statistics or inferential statistics which allows the
researchers to derive important facts like demographics,
preference trends, and differences between the groups. The
paper comprehensively critiques quantitative and quantitative
techniques of research. Furthermore, the author will also give
reasons as to why qualitative methods should be regarded as
scientific.
The overall value of quantitative and Qualitative Research
Quantitative studies allow the researchers to present data in
terms of numbers. Since data is in numeric form, researchers
can apply statistical techniques in analyzing it. These include
descriptive statistics like mean, mode, median, standard
deviation and inferential statistics such as ANOVA, t-tests,
correlation and regression analysis. Statistical analysis allows
us to derive important facts from data such as preference trends,
demographics, and differences between groups. For instance, by
conducting a mixed methods study to determine the feeding
experiences of infants among teen mothers in North Carolina,
Tucker and colleagues were able to compare breastfeeding
trends among various population groups. The multiple groups
compared were likely to initiate breastfeeding as follows:
Hispanic teens 89%, Black American teens 41%, and White
teens 52% (Tucker et al., 2011).
The high strength of quantitative analysis lies in providing data
that is descriptive. The descriptive statistics helps us to capture
a snapshot of the population. When analyzed appropriate, the
descriptive data enables us to make general conclusions
concerning the population. For instance, through detailed data
analysis, Tucker and co-researchers were able to observe that
there were a large number of adolescents who ceased

breastfeeding within the first month drawing the need for nurses
to conduct individualized follow-ups the early days after
hospital discharge. These follow-ups would significantly assist
in addressing the conventional technical problems and offer
support in managing back to school transition (Tucker et al.,
2011).
Qualitative research allows researchers to determine the client’s
perspective on healthcare. It enables researchers to observe
certain behaviors and experiences among the population making
appropriate conclusions. For example, by conducting a
qualitative study to assess the perspectives of hospital-based
nurses on initiating best practices for breastfeeding, Wedding
and colleagues were able to point the existence of a disparity
between the nurses’ intention to support breastfeeding.
Therefore, Wedding et al. (2011) concluded that there is a need
to provide these nurses at non-BF/BFI hospitals with an
education based on WHO Baby Friendly standards.
Reasons why Qualitative research should be classified as a real
science.
If one tells me that qualitative research is not real science, I
would disagree with that person. The commonly known
examples of qualitative methods include case studies, open-
ended interviews, and observations. The reason why many
people view them as non-scientific is that they ignore statistical
inferences and concentrate on collecting in-depth data to answer
the research question comprehensively. Qualitative techniques
have low reliability and are usually discredited since they are
regarded as less scientific. Although qualitative data seems to
lack scientific attributes, we should not underestimate these
methods and take them at face value. Qualitative methods of
study pass the four criteria used for determining whether a
process is scientific namely replicability, precision,
falsifiability, and parsimony, and are thus scientific.
Conclusion
It is difficult to underestimate the importance of quantitative
and qualitative research in nursing. Quantitative methods allow

us to present data in terms of numbers, and thus we can draw
essential facts such as preference trends, demographics, and
differences between groups. Through the use of qualitative
techniques, we can be able to observe certain behaviors and the
lived experiences of the study populations. There are four
criteria used to discern whether a method is scientific or not.
These are replicability, precision, falsifiability, and parsimony.
It would be wrong to classify qualitative methods as non-
scientific since they pass the above criteria.
References
Tucker, C. M., Wilson, E. K., & Samandari, G. (2011). Infant
feeding experiences among teen mothers in North Carolina:
Findings from a mixed-methods study. International
Breastfeeding Journal, 6(1), 14.
Weddig, J., Baker, S. S., & Auld, G. (2011). Perspectives of
hospital‐based nurses on breastfeeding initiation best
practices. Journal of Obstetric, Gynecologic & Neonatal
Nursing, 40(2), 166-178.

1
8
In Caring for Patients with Dementia, Is It More Effective to
Provide One on One Staffing Versus Utilizing Lock Door Units
to Reduce Injuries?
Adenike George
Walden University
Determining the Most Appropriate Means of Caring for
Dementia Patients. Between One on One Staffing Versus
Utilizing Lock Door Units to Reduce Injuries
The intent of this paper is to analyze and describe five sources
that offer evidence on the PICOT question. The paper uses
articles categorized as level 1 and 2 according to the quality of
information available. There are three level 1 papers and 2 level
2 papers. The PICOT question states that in an acute Mental
Health unit, what is an effective treatment plan to prevent
injuries and promote safety for the demented patients? A review
of previous research is imperative for best practice and
evidence-based practice and is in line with the sentiments
expressed by Polit and Beck (2017).
Article #1
The first article is research conducted by Sampson et al. (2014)
that focuses on investigating the prevalence of behavioral and
psychiatric symptoms among individuals with dementia.
According to the researchers, dementia is often experienced
among older persons who are admitted to acute hospitals.
Understanding the behavioral and psychiatric symptoms of these
patients can be vital in reducing the challenges experienced by
hospital personnel in caring for these patients. Sampson et al.
(2014) used a longitudinal cohort approach that involved 230
individuals suffering from dementia. All participants were
above seventy years and had acute illnesses. The study found
that there was high impairment of the respondents. Seventy-five

percent of the respondents were found to have behavioral and
psychiatric characteristics that made it difficult for the hospital
personnel to offer services. Most showed aggression, activity
disturbance, sleep disturbance, and anxiety. Sampson et al.
(2014) conclude that the hospital staff could benefit from
specialist psychiatric services. The study can be categorized as
level 1 due to the use of primary data and a significant
population study that guarantees the results were representative
of what happens in the hospital setting.
Article #2
The secord paper by Ziegenbein, Anreis, Brüggen, Ohlmeier,
and Kropp (2006) allude that hospital emergency departments
often offer services to individuals with psychiatric problems. In
this context, the medical staff working in emergency rooms are
faced with the challenge of deciding whether to admit or treat
these people as outpatients. The study used the Central
Interdisciplinary Emergency Department (CED), which provided
data on psychiatric treatments in the Medical University of
Hannover. The research is imperative in understating how the
patients are admitted and how the students are engaged. The
study found that among the 2632 patients who visited the
Medical Centre for psychiatric treatment, 51.4% ended up as
inpatients. Additionally, patients with dementia were often
admitted compared to other psychiatric illnesses. According to
Ziegenbein et al. (2006), the patients were admitted due to the
high probability of them committing suicide. The findings show
that restraining measures and acute conditions also influenced
the rate of patients being admitted. The study can be
categorized as a level 1 source due to its use of credible data
that has been collected over a long period.
Article #3
The third study by Lyketsos, Sheppard, and Rabins (2000) was
focused on investigating the prevalence of dementia in a general
hospital setting to identify the reasons why individuals with
dementia are admitted and the link that exist between the

illnesses and length of stay in the hospital, costs, and in-
hospital mortality rate. Lyketsos et al. (2000) used data from
the hospital database gathered between 1996 and 1997. The
study focused on patients above sixty years, who totaled up to
21,251 patients. The investigators found that the prevalence of
dementia among the discharged individuals was at 3.9% and age
influenced it. The patients stayed in the hospital for a mean of
10.4 days, and their expenses were $4000 more compared to
other patients. The study concluded that dementia is widely
experienced among patients admitted to the general inpatient
units. Lyketsos et al. (2000) suggest that early identification of
dementia can be imperative in improving caregiving and
reducing costs for the patients. The study can be categorized at
level 1 due to the quality of data used. It also does not offer
imperative information on the financial implications of
dementia, which have not been widely explored by researchers.
Article #4
The fourth research by Spencer, Foster, Whittamore, Goldberg,
and Harwood (2013) is focused on examining the perspectives,
attitudes, and experiences among caregivers for individuals with
dementia in the general hospital. The researchers compare a
Specialist Medical and Mental Health Unit (MMHU) with
normal health care center wards. Spencer et al. (2013) employ a
qualitative approach implemented using randomized controlled
trials. Semi-structured interviews were employed to gather
information among the caregivers handling patients with mental
illnesses admitted to the institution. The study was conducted
over four months, and it involved forty participants. The
researchers found that the main themes emerging from the
research that was related to family caregivers touched on issues
of boredom, practice skills and experiences, self-respect, vital
care, hospital setting, and low of information between the
medical personnel. Caregivers from the specialized unit showed
that they were aware of appropriate management of dementia.
Also, they were aware of the need for improvements in offering

services, the ward, and staff knowledge. Nevertheless, the
research found that communication and engagement of family
caregivers were perceived to be insufficient. Spencer et al.
(2013) conclude that specialized care is more effective in
offering the best practice services and improving the
environment for the medical personnel. The research can be
ranked at level 2 as it explores the issues faced by the patients
and the best approach for staff to engage in offering services.
Article #5
The fifth study conducted by Fukuda, Himizu, and Seto (2015)
identifys that dementia is a major public health problem, which
has led many people to be admitted to acute care hospitals. The
researchers focused on the challenges faced by caregivers to
offer services for patients with dementia in acute care
institutions in Japan. The study used a qualitative approach that
included focus group interviews among six acute hospitals in
the country. The respondents were nurses working in surgical
and internal medicine wards except those in intensive care
units. The study was conducted between February and December
2008. Fifty nurses were engaged in the research. Fukuda et al.
(2015) identified seven groups of issues that faced patients with
dementia. The issues included problematic patient behaviors, a
recurrent problem, and issues affecting various individuals that
ended up forming a burdensome cycle. The issues were
attributed to the lack of experience and challenges in the
organization in the hospitals. The nurses coped with these
issues by developing protection plans for themselves and the
institution. Conclusively, Fukuda et al. (2015) suggest that
issues in offering services for dementia patients are due to
interactive issues that become burdensome. Nevertheless, the
caregivers reported that they did their best to adapt to these
conditions. The paper can be ranked as level 2 due to the quality
of data that offers a clear indication of the situation in
caregiving for dementia patients.

Consistencies Inconsistencies and Contradictions
All sources show that dementia is a key issue affecting patients
and their families. Additionally, dementia patients pose
significant challenges to the medical personnel. The issues
faced by the caregivers are associated with patients being
admitted to the hospital, and the investigation is carried out
using different research approaches. While other studies address
dementia among different ages, Sampson et al. (2014) and
Lyketsos et al. (2000) offers a specific approach that focuses on
dementia among the elderly. The researchers in the two studies
concluded that dementia is highly experienced by older people.
Unlike other studies that gather primary data or use secondary
sources for the research, the research work by Ziegenbein et al.
(2006) and Spencer et al. (2013) utilizes the information
provided by hospitals to conduct their investigations. Despite
the rich data available for these studies, the data is from
different periods and involves a huge population, increasing the
chances of errors occurring. Additionally, the data might have
been compromised by other stakeholders. Nevertheless, the
information is imperative because it provides a wider
perspective on how admitted patients interact with the staff and
the challenges faced, which have not been highlighted by other
studies selected for the paper. Fukuda et al. (2015) used a
different approach than other studies by focusing on issues
faced by the nurses by engaging them directly. The study offers
a fresh perspective by gathering data from the caregivers who
interact with the patients on a daily basis. Unlike other studies,
this study offers a better approach in understanding the
importance of nursing in offering care for the Dementia
patients.
Summary
The literature review and these sources are key in answering the
PICOT question In an acute Mental Health unit, what is an
effective treatment plan to prevent injuries and promote safety

for the demented patients? All sources show consensus that
dementia is a major challenge among patients admitted in the
hospital. There are many issues that emerge from admitting
these patients that make it hard for caregivers to engage in the
practice appropriately. The issues include behavioral and
psychiatric problems among the patients. Although nurses try to
deal with these issues, they are often challenging making it
appropriate to seek specialized care. In this light, specialized
institutions and personnel offer the best care for dementia
patients. In this light, a one on one approach to care giving is
much better in caring for dementia patients to prevent injuries
compared to other approaches proposed.
References
Fukuda, R., Shimizu, Y., & Seto, N. (2015). Issues experienced
while administering care to patients with dementia in acute care
hospitals: A study based on focus group interviews.
International Journal of Qualitative Studies on Health and Well-
Being, 10(25828)), 0–13.
Lyketsos, C. G., Sheppard, J. E., & Rabins, P. V. (2000).
Dementia in Elderly Persons in a General Hospital. The
American Journal of Psychiatry, 157(May), 704–707.
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating
and assessing evidence
for nursing practice (10th ed.). Philadelphia, PA:
Wolters Kluwer Health/ Lippincott Williams & Wilkins.
Sampson, E. L., White, N., Leurent, B., Scott, S., Lord, K.,
Louise, J. R., & Jones, L. (2014). Behavioural and psychiatric
symptoms in people with dementia admitted to the acute
hospital: Prospective cohort study. British Journal of
Psychiatry, 205(3), 189–196.
Spencer, K., Foster, P., Whittamore, K. H., Goldberg, S. E., &

Harwood, R. H. (2013). Delivering dementia care differently —
evaluating the differences and similarities between a specialist
medical and mental health unit and standard acute care wards : a
qualitative study of family carers ’ perceptions of quality of
care. BMJ Open,3(12).
Ziegenbein, M., Anreis, C., Brüggen, B., Ohlmeier, M., &
Kropp, S. (2006). Possible criteria for inpatient psychiatric
admissions: which patients are transferred from emergency
services to inpatient psychiatric treatment? BMC Health
Services Research, 6(1), 150.
Running Head: INTRODUCTION TO COURSE PROJECT
1
INTRODUCTION TO COURSE PROJECT
2
Introduction to Course Project
Adenike George
Walden University
3/10/18
Background
Older patients above the age of 65 are at higher risk of patient
fall in hospitals and settings because of age-related issue and
mobility issues. A fall is a sudden, unintended, descending
movement of the body towards the floor or other surface,
excluding falls resulting from violent blows or deliberate
actions. Patient falls occur in hospitalized patients of all ages,
in residences and among those who receive home care, and they
can cause serious injuries, disability and in some cases death
(Brosey & March, 2015). Nurses are expected to respond to
alarms, and if there is no alarm fatigue, it is more likely that
there will be no delay in response, and this improves patient
safety. Nurses seek to improve outcome and quality of care, and
one way to do this is by reducing the risk of patient falls and

responding to call light. Parenting patient falls will improve the
well-being of patients, improves the quality of care, patient
safety and is associated with lower hospital costs.
Questions
What influences the hospital fall prevention strategies?
This requires information from the staff and the hospital
standards to identify policies on fall prevention and who
monitors the effectiveness of these policies. A survey provided
to nurses and the nurse managers would help to identify the fall
prevention strategies and their effectiveness.
What affects detection and monitoring of patient fall?
Health practitioners, especially, nurses are expected to monitor
and report patient falls and how often they occur, which makes
it easier to analyze the causes of patient falls and identify the
most appropriate patient fall strategies. This information is
based on responses from the nurses.
Do purposeful hourly rounds affect the patient's call lights?
Well structured hourly rounds allow nurses to check on patients
regularly and they address patent issues based on what the
information they have. When properly implemented the hourly
round program can reduce the need for call lights and improve
health outcomes.
Doeshourly roundingaffect patient safety satisfaction?
Elderly people tend to have reduced mobility and poor
coordination when compared to younger patients, while they
require more medical attention depending on their contusive
status and health needs. If there are regular hourly rounds, it is
easier to demine whether there is a risk of falls and deal with
the issue. This is analyzed by getting feedback and responses
from the patients.
Doeshourly roundingaffect reduce the patient fall rate?

Age is one of risk factors that increases patient fall during
hospitalization, and the impact of rounding is analyzed by
considering whether there is a significant change in patient fall
rate after implementing hourly rounding. This is the most
relevant question linked to the topic as the aim is to evaluate
the effectiveness of hourly rounds in reducing patient falls and
improving patient safety. There are patient risk factors
associated with the risk of falls and need to be identified where
there is also monitoring of the patient progress.
PICOT
P- (Patient, population): Older patients in long term facility
I- (intervention/issue): Structured hourly rounding
C- (Comparison): Use of call lights
O- (Outcome): Decreased falls and fall-related injuries
Possible keywords
Patient fall, patient safety, elderly/ older patients, hourly
rounding, intentional rounding, fall injuries, call light usage,
patient satisfaction, patient fall prevention, risk assessment
patient readmission rates
Identifying patients at risk of falls requires considering
individual risk factorslike the cognitive state, history of falls in
previous hospitalizations, medications, age, altered vision, and
reduced mobility. Hourly rounding is likely effective since there
is reevaluation of the risk of patient falls at various times
throughout the time the patients hospitalized. The nurses attend
to the immediate and needs of patients, and evaluate the
general measures of prevention and supervise the activities
indicated in patient fall prevention protocols and standards (Al
Danaf et al., 2018). The risk of falls as one of the goals to
improve patient safety in hospitals, and there are additional
costs associated with patient falls including that the treatment
of fall related injuries and staying longer in hospitals. Patient
falls remain a persistent problem in hospitals yet implementing

a more structured rounding approach may increase patient safety
and reduce risk of fall and injuries such as falls and hip
fractures (Ryan et al., 2018).Ideally, implementing preventive
strategies should involve multiple interventions while health
practitioners should be encouraged to report all falls or notify
the relevant authorities.
Reference
Al Danaf, J., Chang, B. H., Shaear, M., Johnson, K. M., Miller,
S., Nester, L., ... & Aboumatar, H. J. (2018). Surfacing and
addressing hospitalized patients’ needs: Proactive nurse
rounding as a tool. Journal of nursing management, 26(5), 540-
547.
Brosey, L. A., & March, K. S. (2015). Effectiveness of
structured hourly nurse rounding on patient satisfaction and
clinical outcomes. Journal of Nursing Care Quality, 30(2), 153-
159.
Ryan, L., Jackson, D., Woods, C., & Usher, K. (2018).
Intentional Rounding–an integrative literature review. Journal
of advanced nursing.

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