A nurse manager in a trauma intensive care unit conducts a quality improvement evaluation project

Question

During this process, she discovers that patients with adult respiratory distress syndrome almost always have better outcomes when they are placed in the five beds located further away from the nursing station. Examining the data, she discovers that the room doors in these five rooms are consistently half-closed or three-quarters closed. In addition, nurses have been documenting that these patients sleep more than the other ten patients on the unit. What are the nurse's options for generalizing the findings?
a. There is no practical use for this research; no generalization is appropriate.
b. Findings should be generalized immediately, and in print. These are important findings.
c. The nurse can present the findings at conferences, but generalization is limited to the hospital in which the data were collected.
d. The nurse manager can obtain permission from an institutional review board to conduct a formal research study, in order to formally test hypotheses, and then generalize the findings of this second study.
e. Arrangements should be made immediately on the unit to keep all patients' doors half-closed or three-quarters closed.

Answer 1

ANS: C, D
Methodological limitations limit the credibility of the findings and restrict the population to which the findings can be generalized. Methodological limitations result from factors such as nonrepresentative samples, weak designs, single setting, limited control over treatment (intervention) implementation, instruments with limited reliability and validity, limited control over data collection, and improper use of statistical analyses. Quality improvement research, by definition, is methodologically limited, because of its location-specific findings and lack of controls.