HLT362 Week 2 Discussion (dq1+dq2) Latest DQ1 Topic 2 DQ 1 Complete

HLT362 Week 2 Discussion (dq1+dq2) Latest DQ1 Topic 2 DQ 1 System Admin Max Points: 8.0 Select a research article, other than the articles from your assignments, from the GCU library. Provide an overview of the study and describe the strategy that was used to select the sample from the population. Evaluate the effectiveness of the sampling method selected. Provide support for your answer. Include the article title and permalink in your post. Reply Ascending | Descending My Posts | Substantive |Flagged | All Feb 24, 2019 07:50 PM0 Like Profile Picture Melissa Dulin 3 posts Re:Re:Re:Topic 2 DQ 1 Ashley, I agree, post surgery patients should never be allowed to stand or walk unassisted. I don't know of a "standard" amount of time that should be observed prior to being unassisted, but post anesthesia nurses are (or should be) trained in the dangers of an unassisted post op patient. I know there are anesthesia criteria for dismissal, but feel that patients should be assisted at all times prior to dismissal. Reference: DISCHARGE CRITERIA FOR PHASE I & II- POST ANESTHESIA CARE Retrieved from Reply | Quote & Reply | Report Abuse Feb 24, 2019 05:57 PM0 Like Profile Picture Elizabeth Tarango 4 posts Re:Re:Topic 2 DQ 1 Amy thank you for the information provided Nurse to patient ratio is good topic to pay attention as nurse to patient ratios seem be a cause of the burnout in nurses that our country faces. With nursing shortage also being a main cause of an increase in patient to nurse ratio. The statistics have shown that appropiate staffing decrease error and increase patient satisfaction (Haddad LM, 2018). This is something that all nurse should be interested and work together to obtain better patient to nurse ratios. Reference: Haddad LM, Toney-Butler TJ. Nursing Shortage. [Updated 2019 Jan 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: Reply | Quote & Reply | Report Abuse Feb 24, 2019 02:42 AM0 Like Profile Picture Me 4 posts Re:Re:Random versus Non-Random Sampling Venice, Random sampling is important because it allows the researcher to conduct the study without bias. It might be tempting to only include people who will sway the results in the favor of your hypothesis. One way to prevent this is to do a double blind study, so that the participant and the study institute do not know if they will be in the study or the control group. Reply | Quote & Reply | Edit | Delete Feb 23, 2019 07:37 PM0 Like Profile Picture James McDermott 5 posts Re:Re:Topic 2 DQ 1 Thank you Dina for the study on patient falls. I started as a new grad almost 9 years ago on a Medical (Med-Surg) floors and in that time the patient ratios went from 5 to 1 (with a flex of 6:1) to 6 to 1 (with a flex of 7:1). There was certainly an increase in patient falls after that conversion on the floor I worked on. With usually only one CNA/PCT instead of the usual 2 that should have been on the floor and over-worked and stressed nurses there was almost no chance any nurse could prevent every fall under those conditions. I'm surprised in the study the percentage of falls were not higher. Reply | Quote & Reply | Report Abuse Feb 23, 2019 07:31 PM0 Like Profile Picture James McDermott 5 posts Re:Re:Topic 2 DQ 1 Thank you for the topic and your notes on patient ratios. I agree with the study. Even without statistical evidence of my own to have as proof of concept I have worked many different areas such as Med-Surg and Telemetry before making my way to the ICU. And in those other areas the hospitals were always trying to increase the patient ratios for the nurses and were successful in doing so in both areas in the last 10 years. I would love to see the statistics from my organization on whether patient mortality has increased in those areas as a result of increasing patient ratios for their nurses and what their turnover rate is now compared to 10 years ago. Reply | Quote & Reply | Report Abuse Feb 23, 2019 08:07 AM0 LikeSubstantive Post Profile Picture Lisa Mason 6 posts Re:Re:Topic 2 DQ 1 Amy, I could go on and on about this issue. I have worked on units when I was a new nurse and didn't know any better where we were severely understaffed. It was horrible and the reason why I left to find other employment. I am so glad I did. I learned there are other places that do not understaff. These places are usually the better hospitals also. We still have a long way to go but I believe this issue is being worked on. In a study on understaffing and error producing conditions, it was reported than in the United States of America, it is estimated that 44,000 to 98,000 people die in hospitals each year, victims of preventable errors(3). In Brazil, the Superior Court of Justice (STJ) registered a 1,600% increase in medical errors lawsuits in the last 14 years, and death (28.16%) was the most claimed reason ( Silva-Santos, et al, 2018). To me this is unacceptable. They used quanti-qualitative research between the interval of 1995 to 2010. The used descriptive statistics and the qualitative data to analyze by using the Human Error Theory and Sociology of Work. This was a table of descriptions of the errors made, which really highligted the issue. It was quite revealing. I believe this could be categorized as descriptive or ordinal data because you had alot of descriptive data with percentages used for data. Silva-Santos, H., Araújo-dos-Santos, T., Santos Alves, A., Navegantes da Silva, M., Oliveira Gonçalves Costa, H., & Meira de Melo, C. M. (2018). Error-producing conditions in nursing staff work. Revista Brasileira de Enfermagem , 71 (4), 1858–1864. Reply | Quote & Reply Feb 23, 2019 07:44 AM0 LikeSubstantive Post Profile Picture Magdalena Kloskowski 4 posts Re:Re:Topic 2 DQ 1 Krystal, Adding to the discussion, according to CDC, Second Hand Smoke (SHS) hurts babies and children, and children exposed to SHS breathe in the same chemicals that smokers do. Homes are the main place where children are most exposed to SHS. Although SHS exposure has fallen in the past 5 years, children are still heavily exposed to it, and are the most vulnerable to the poison in SHS. 4 out of 10 US children ages 3-11 are exposed to dangerous chemicals in second hand smoke, that is over 40% of US kids ages 3-11. Making homes and cars smoke free reduces exposure of SHS in children and non smoking adults. Reference: Children in the Home. (2018, February 28). Retrieved February 23, 2019, from Reply | Quote & Reply Feb 23, 2019 07:29 AM0 LikeSubstantive Post Profile Picture Lisa Mason 6 posts Re:Re:Topic 2 DQ 1 Ashley, In addition to your post. One of the most simple ways to control the spread of infection starts with us. Hand hygeine is one of the simplest and cheapest ways to prevent infection. A study was done on nurses' knowledge of proper technique of hand hygeine. What was shocking was the majority of the nurses, (76%) reported adhering to the principles of good hand hygiene and 54.2% of the nurse could not correctly mention the steps of proper hand‑washing technique. They could not properly verbalize the 5 moments of hand hygeine which was; washing hands before touching patients 2) washing hands after touching patients 3) washing hands after handling secretions 4) washing hands after before wearing gloves 5) washing hands after wearing gloves (Lawal, et al, 2018). I am part of a survelence team at our hospital and document whether a staff member is performing hand hygeine. While I just started this, it is difficult sometimes to approach someone to provide coaching on this subject. So far, it has been met with good attitudes. This surprises me but I am glad. I am proud to be a part of a good practice which will help protect our patients in the long run. Lawal, T., Monsudi, K., Zubayr, B., Michael, G., Duru, C., Ibrahim, Z., & Aliyu, I. (2018). Hand hygiene practices among nurses in health facility in a semi-urban setting. International Journal of Health & Allied Sciences , 7 (3), 191–195. Reply | Quote & Reply Feb 23, 2019 06:44 AM1 LikeSubstantive Post Profile Picture Michelle Smith 7 posts Re:Visual Summary of the Sampling Methods I found this very interesting. This really helps putting together the different types of sampling. It makes me think of our satisfaction surveys that are done each year for the nurses as part of the NDNQI and even the Gallop surveys. Does anyone else do the surveys at there place of employment? It will make me think differently when it. Sometimes I find that it is bias in a way that they ask the questions with the answers they choose. How about you? Reply | Quote & Reply Feb 23, 2019 06:30 AM0 LikeSubstantive Post Profile Picture Michelle Smith 7 posts Re:Re:Topic 2 DQ 1 Ashley, this was a great study. Money spent on blood stream infections is outrageous! By helping to reduce infections rates, it is important to maintain sterile procedures and using standard precautions with all patients. Have you ever had an incidence that you had to ask the doctor to put on gloves or wash their hands? It is a very uncomfortable conversation yet as a provider we need to have it. We are a teaching hospital and at first we found it as an educational conversation yet at times we find that it may be that same colleague that doesn't use standard precautions. It can be frustrating. At the hospital I work at, I am on a quality council committee and each month we review our NDNQI nursing sensitive indicators and we review pressure injuries, CLABSI and CAUTI and break them down to each unit and barriers that may have prevented us from the incident. It would be interesting to do our own study on what the cost savings would be on the hospital acquired infections would be. Does your organization have available, monthly reports of infection rates? Reply | Quote & Reply Feb 23, 2019 05:55 AM0 LikeSubstantive Post Profile Picture Renee Fuller 5 posts Re:Re:Topic 2 DQ 1 Good morning Charles, to add to your post for Arizona. Catheter-associated urinary tract infections is 1% lower compared to the national baseline. When a urinary catheter is not put in correctly, not kept clean, or left in a patient for too long, germs can travel through the catheter and infect the bladder and kidneys. Arizona hospitals reported no significant change in CAUTIs between 2013 and 2014. 13% Among the 48 hospitals in Arizona with enough data to calculate an SIR, 13% had an SIR significantly higher (worse) than 1.00, the value of the national SIR. Centers for Disease Control and Prevention. 2014 National and State Healthcare-Associated Infections Progress Report. Published March, 2016. Retrieved from Reply | Quote & Reply Feb 22, 2019 10:48 PM0 LikeSubstantive Post Profile Picture Samantha Mowry 4 posts Re:Re:Topic 2 DQ 1 Hi Dina, I found your article very interesting. The quesion I would have for your article is what were the staffing ratios for each of these units. In the article it was reported that the hghest amount of falls was in the medical unit and the lowest in the surgical unit. I know when I worked on a medical unit I was in charge of anywhere from 6-10 patients and higher patient to RN ratios there was higher risk for falls. This often left myself running from room to room with little down time where as in more critical units the patient to nurse ratio is lower. In searching for the information the article reports they calculated total LPN, RN, and overall (LPN plus RN) nursing staff time showing results for the total hours of nursing care, summing across RN and LPN hours. The article also reports there was no trend in fall or injurious fall rates by staffing level. This was true whether LPN-only, RN-only, or total staffing time was used. Thank you for sharing! Reference: Reply | Quote & Reply Feb 22, 2019 08:49 PM0 LikeSubstantive Post Profile Picture Krystal Almanza 3 posts Re:Re:Topic 2 DQ 1 Hi Maria what a great study. I find it especially interesting since I too live in Stanislaus County. I prefer studies that take a completely randomized approach using a very broad and diverse range of subjects. I wanted to elaborate on population sampling. "Population sampling is the process of taking a subset of subjects that is representative of the entire population. The sample must have sufficient size to warrant statistical analysis. Sampling is done usually because it is impossible to test every single individual in the population. It is also done to save time, money and effort while conducting the research" (Annonymous, 2019). References: Annonymous. (2019). Population Sampling Techniques. Retrieved February 22, 2019, from Reply | Quote & Reply Feb 22, 2019 08:42 PM0 LikeSubstantive Post Profile Picture Krystal Almanza 3 posts Re:Re:Topic 2 DQ 1 Wow Magdalena what a great article that you reviewed. I can see why there would be a higher risk for infection and sepsis with cancer patients since their immune system is compromised and they take imunosuppressing meds but I would be interested to learn why there is a difference in hematologic malignants and those with solid tumors. Reply | Quote & Reply Feb 22, 2019 05:51 PM0 LikeSubstantive Post Profile Picture Ashley Wilson 4 posts Re:Re:Topic 2 DQ 1 Hi Elizabeth, I really enjoyed your response about infections in the ICU. This article does show compelling evdience to utilize the bundle approach every time. According to Dasgupta et. Al. (2015) the nosocomial rate at a 12 bedded combined medical and surgical ICU of a medical college hospital was (11.98%) with the most frequently detected infection being Pneumonia (62.07%) followed by UTI's and finally CLABSI's. Independent variables involved in the study were length of ICU stay and prior antimicrobial therapy which both played a significant role in decrasing rates of nosocomial infections. Out of the 455 patients admitted during the 6-month study period, 242 of them stayed longer than 48 hours. Out of the 242 patients who were followed through discharge, 29 developed an infection and n=213 did not develop an infection. Of those infected 21 were male and 8 were female. The mean length of stay for those infected was 17.28 days and the standard deviation was 8.59. Reference Dasgupta, S., Das, S., Chawan, N. S., & Hazra, A. (2015). Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine , 19 (1), 14-20. Reply | Quote & Reply Feb 22, 2019 05:40 PM0 LikeSubstantive Post Profile Picture Melissa Dulin 3 posts Re:Re:Topic 2 DQ 1 Amy, Your last sentence caught my eye. I find it hard to believe that administrators and those who sit in the white palaces of control, do not see and find a way to remedy this. It is proven that nurse ratios are directly related to patient outcomes and satisfaction. One nurse can only take care of so many duties and patients in a given amount of time. It is humanly impossible to provide everything multiple patients need when there is such a disparity in patients and nurses. As you stated, not only do the patients suffer, but nurses are facing burnout and changing careers due to such heavy workloads. I also think the amount of "paperwork" required now is one source of frustration among all health care providers. Great information. Melissa Reply | Quote & Reply Feb 22, 2019 05:31 PM0 LikeSubstantive Post Profile Picture Ashley Wilson 4 posts Re:Re:Topic 2 DQ 1 Hi Renee, Excellent response to a very pervasive problem in healthcare in general. Horizontal hostility amongst nurses can impact a person's career and life. Stotkowski (2010) states that, "By nature, bullying is the repeated, unreasonable actions of individuals (or groups) directed toward an employee (or a group of employees), intended to intimidate, and by doing so, create a risk to the health and safety of the employee(s)." Bullying often involves a power gradient with the person who is the bully being in or percieving that they are in a position of power. I have personally witnessed horizontal hostility and "nurses eating their young." In recent times, I have read articles where nurses have even committed suicide due to workplace harrassment. Bartholomew (2016) describes a framework for hospital leadership to explore to prevent horizontal hostility and foster an environment of respect. There are two ideas that should be implemented: 1)Make harm visible, frame disruptive behavior as a safery issue and 2)Firmly establish board and senior leadership team commitment. References Stotkowski, A. (2010) A Matter of Respect and Dignity: Bullying in the Nursing Profession. Retrieved from: Bartholomew, K. (2016) Leadership: Ending Nurse-to-Nurse Hostility. Retrieved from: Reply | Quote & Reply Feb 22, 2019 03:58 PM0 LikeSubstantive Post Profile Picture James McDermott 5 posts Re:Re:Topic 2 DQ 1 Thank you for the interesting topic on hip fracture patients. There are a lot of uncontrollable variables for an elderly patient that comes into the hospital with a hip fracture and then goes home. The overwhelming majority of these types of injuries come from patient falls. Elderly people fall for a variety of reasons and variables such as dementia and whether the patient is being continuously monitored at home or lives in assisted living vs independent living, etc. These extraneous variables would make studies, such as the one you described, difficult to quantify what led to success or failure of a rehab program in hospital for 13 vs 18 days inpatient. Reply | Quote & Reply Feb 22, 2019 03:52 PM0 LikeSubstantive Post Profile Picture James McDermott 5 posts Re:Re:Topic 2 DQ 1 The first ICU I ever worked in had a lot of nurse bullying and vying for power within the unit. It was no shocker that due to this that unit had a high turnover rate of nurses (myself included, I lasted a year before leaving for this very reason). This can lead to higher patient mortality in an environment that already has high mortality rates in the ICU as there is constantly an influx of new nurses both new graduate and experienced trying to get into critical care. It is a self deating cycle as the new nurses are then exposed to the same toxic environment that caused others to leave and they too often leave after their year is up and they are allowed to transfer out per facility protocol. Thank you for providing some statistics on the topic. Reply | Quote & Reply Feb 22, 2019 12:29 PM0 LikeSubstantive Post Profile Picture Sabitri Ranabhat 4 posts Re:Re:Topic 2 DQ 1 Hi Samantha, it was great to read your study, though a very small sample size was selected. In medical research, randomized controlled trials are extremely valuable to establish whether a cause-effect relation exists between treatment and outcome and for assessing the cost-effectiveness of treatment. Randomized controlled trials are powerful tools but sometimes their use is limited by ethical and practical issues. Exposing patients to an inferior treatment is often thought to be unethical, for example, depriving multivitamins during pregnancy when folic acid helps prevent neural tube defects. Similarly, failure to perform randomized controlled trials can lead to administration of high-risk treatment. For example, administration of high concentrations of oxygen used in neonates caused retinopathy of prematurity and this was not detected until randomized trials were performed (BMJ, 1998) British Medical Journal (BMJ). (1998). Understanding controlled trials: why are randomized controlled trials important? Retrieved from, Reply | Quote & Reply Feb 22, 2019 12:56 AM1 LikeSubstantive Post Profile Picture Me 4 posts Re:ANSWER:Random versus Non-Random Sampling Julia, Random sampling is important because is uncomplicated, it represent the population, it gives all individual equal chances to be chosen and eliminating the bias. “Random sampling is one of the simplest forms of collecting data from the total population. Under random sampling, each member of the subset carries an equal opportunity of being chosen as a part of the sampling process” (Bennet, Coleman 2019). It is important to note that application of random sampling method requires a list of all potential respondents (sampling frame) to be available beforehand and this can be costly and time-consuming for large studies. The necessity to have a large sample size can be a major disadvantage in practical levels. Problem can be prevented by avoiding the bias during selection. References The Economic Times Retrieved from. Reply | Quote & Reply Feb 21, 2019 11:39 PM1 LikeSubstantive Post Profile Picture Amy Arreola 2 posts Re:Random versus Non-Random Sampling According to Ryan (2018), sampling is defined as the method of choosing the study population or study sample, nonrandom sampling is members of the population will not have the opportunity of being selected for a study sample, and random sampling is every person in a papulation has the opportunity of being selected for the sample study. Reference Ryan, C. (2018). Chapter 2 Population and Sampling Distributions. Applied Statistics for Health Care. Phoenix, Arizona: Grand Canyon University. Reply | Quote & Reply Feb 21, 2019 11:28 PM0 Like Profile Picture Amy Arreola 2 posts Re:Topic 2 DQ 1 A study of nurse to patient ratio has caught my attention. Recently I had the highest number of patients in my career as a new grade and felt I was unable to give my patients the best of care because of the lack of time and increased work load. I chose a research article in relation to patient to nurse ratio and their impacts on the nursing profession and patient outcomes. The study includes evidence-based research which links high nurse to patient ratios with nurse burnout and increased adverse patient outcomes. The purpose of the research project was to determine how low nurse to patient ratios affect patient and nurse safety within an acute care setting. Addressing this issue will lead to improve nursing job satisfaction and decrease adverse patient outcomes. According to the article, types of statistical analysis used were odds ratio, hazard ratios, risk ratios, random-effect model, nurse to patient ratios were calculated with inverse ratios, and fixed effect models. The research concluded nurse job satisfaction and improved patient outcomes were directly rated to a decrease in patient to nurse ratio. With an increase of one nurse patients were 14% less likely to experience an in hospital death. Permalink Reply | Quote & Reply Feb 21, 2019 06:54 PM0 LikeSubstantive Post Profile Picture Ashley Wilson 4 posts Re:Re:Topic 2 DQ 1 Hi Dina, Great response this week and very informative about falls. I think falls are an ever present topic that need constant monitoring and hospitals will always need to improve rates and keep patients safe. I think that it is a good thing that Medicare is no longer rewarding poor behavior such as low staffing ratios that cause patient's to not have enough supervision and in turn injure themselves through falling. I would be curious to see how much falls rates have dropped after Medicare came in. It is difficult, at times, to prevent falls, even with the best fall prevention measures in place, i.e call lights, fall risk bracelets, alarms, careful monitoring. An example would this would be in the surgery center where I work, where a patient insists on using the restroom alone after surgery. 9 times out of ten, the patient is absolutely fine, but occasionally the anesthesia has a superman affect on the patient giving them a false sense of strength/how altered they actually are. Usually they do not fall (in fact I've only heard of one since I've been there) but I see that as a "fall-risk" scenario that should be examined by the surgery center. Again, great response! Reply | Quote & Reply Feb 21, 2019 05:51 PM0 Like Profile Picture Ashley Wilson 4 posts Re:Topic 2 DQ 1 This study was conducted in Canada to determine the costs associated with nosocomial Blood Stream Infections in patients receiving Hemodialysis in 2004 and estimate the investment expenses to establish an infection control program in general-hospitals and conduct cost-benefit analysis. The method that was used was a combination of inferential and descriptive statistics that were compiled from a variety of previous database surveillance and other research studies. It has been reported that over 220,000 nosocomial infections are acquired in healthcare facilities and 8,000 deaths are attributable to these infections each year in Canada. The most common nosocomial infections are surgical wounds, blood stream and urinary tract infections. Relative risk for BSI is 2.5 times greater with arteriovenous graft access, 15.5 times greater with CVC access, and 22.5 times greater with uncuffed CVC access. These BSI’s come with a great financial burden to the Canadian healthcare system. The possible 20% to 30% reduction of total nosocomial BSIs was hypothesized. Methods: Incidence rates of BSI in Canada Data was used from a public surveillance study by Taylor et. Al. During the 6-month follow up period between December 1, 1998 and May 31,1999, there were 184 BSI’s which occurred in 133,158 dialysis procedure with an incidence of 1.4 cases per 1000 procedures in 11 hemodialysis centers in Canada. Estimation of Average Treatment Cost per Stay The cost of hospital stays by medical condition was utilized between to estimate the cost per BSI stay. The cost attributable to one case of BSI among both genders was $19,418/stay. The treatment costs for outpatients are significantly lower. With no prior studies to extract data, they assumed that the treatment costs to treat outpatient BSI’s were between $8,000-12,000. A sensitivity analysis was done for the cost-benefit of different scenarios. Total Hemodialysis Patients in 2004 15,278 hemodialysis patients and 1,802,922 hemodialysis procedures in Canada in 2004 Investment Cost of Establishing and Maintaining an infection control program in a hospital The investment cost from a study conducted in 1985 was $60,000. The researchers took an inflation rate of 2.74% annually from with a total of 67.4% increment principals. The total cost of establishing and maintaining an infection program in Canada in 2004 was calculated at $100,225. Results: There were a total of 1,802,922 hemodialysis procedures in Canada in 2004. Since the incidence rate was 1.4 cases per 1000 hemodialysis procedures, a total of 2524 BSIs cases were estimated by multiplying 1,802,922 hemodialysis procedures with 1.4 cases/1000 procedures. Total annual cost to treat 2524 BSIs cases was estimated to be 49.01 million by multiplying 2524 BSIs cases by CAD$19,418 per stay for one BSI case. For example, if BSI’s were reduced by 15%, the potential cost-savings would be 7.35 million by multiplying 49.01 million times 15%. Total investment costs and human resources were CAD8.15 million. The savings of avoidable medical costs after establishing infection control programs were CDN$14.52 million. The benefit/cost ratio was 1.0 to 1.8:1. Conclusion: This study provides evidence that the economic benefit from implementing infection control programs could be expected to be well in excess of additional cost postinfection if the reduction of BSI can be reduced by 20% to 30%. Infection control offered double benefits: saving money while simultaneously improving the quality of care Reference Hong, Z., Wu, J., Tisdell, C., O’Leary, C., Gomes, J., Wen, S.-W., & Njoo, H. (2010). Cost–Benefit Analysis of Preventing Nosocomial Bloodstream Infections among Hemodialysis Patients in Canada in 2004. Value in Health, 13, 42–45. Reply | Quote & Reply Feb 21, 2019 03:18 PM0 LikeSubstantive Post Profile Picture Lisa Mason 6 posts Re:Re:Topic 2 DQ 1 Krystal, Second hand smoke is detrementral not only to children but everyone. At our hospital, I have seen lung cancer in patients that were exposed to cigarette smoke but have never smoked themselves. I find it sad that this has to happen. It's also another reason our hospital is a smoke free environment. It goes along with the healthy people objective of 2020 (healthy people, 2019). Tobacco Use. (02/21/2019). Retrieved February 21, 2019, from Reply | Quote & Reply Feb 21, 2019 02:10 PM0 LikeSubstantive Post Profile Picture Renee Fuller 5 posts Re:Re:Topic 2 DQ 1 Hello Krystal, I read your post, then I did not know what zero-inflated poisson regression was, so looked it up. It is used to model count data that has an excess of zero counts. The theory suggests that the excess zeros are generated by a separate process from the count values and that the excess zeros can be modeled independently. Thus, the zip model has two parts, a poisson count model and the logit model for predicting excess zeros. There are two examples. The first, school administrators studied the attendance behavior of high school juniors at two schools. Predictors of the number of days of absence include gender of the student and standardized test scores in math and language arts. The 2nd example, the state wildlife biologists want to model how many fish are being caught by fishermen at a state park. Visitors are asked how long they stayed, how many people were in the group, were there children in the group and how many fish were caught. Some visitors do not fish, but there is no data on whether a person fished or not. Some visitors who did fish did not catch any fish so there are excess zeros in the data because of the people that did not fish. Long, J. S. 1997. Regression Models for Categorical and Limited Dependent Variables. Thousand Oaks, CA: Sage Publications. Everitt, B. S. and Hothorn, T. A Handbook of Statistical Analyses Using R Reply | Quote & Reply Feb 21, 2019 10:46 AM0 Like Profile Picture Julia Lawrence 9 posts ANSWER:Convenience Sampling Very true, Laura. Class, although convenience sampling is very biased, there is one advantage – it’s an inexpensive way to conduct research. Pilot studies often use convenience sampling to detect any data trends. It can then be decided if further exploration through more expensive random sampling methods is warranted. Reply | Quote & Reply | Report Abuse Feb 21, 2019 10:39 AM0 LikeSubstantive Post Profile Picture Michelle Smith 7 posts Re:Re:Topic 2 DQ 1 Krystal, this is a great article. It is so important to help prevent unnecessary emergency room visits. Second hand smoke is preventable and educating the patients and or there parents on this will help reduce the problems of second hand smoke. Thank goodness we are seeing a decline but it still needs to be addressed. Also, we need to remember, as health care workers, addiction is real with smoking and it is a hard addiction to stop for many people. Having that smoking cessation talk with your patients is so important. Having a better education for nursing staff to help with addiction and the talk with your patients should be addressed in my opinion. Do you find this to be true in your position? Reply | Quote & Reply Feb 21, 2019 10:28 AM0 LikeSubstantive Post Profile Picture Michelle Smith 7 posts Re:Re:Topic 2 DQ 1 What a great study to review. This is a major issue and is on the front and center at the hospital in which I work. Last fall we began a new fall risk assessment tool called Hester Davis. Yesterday, we reviewed the trend since we started and what we found was that our fall rates went up! It has been a challenge with assessment as each nurse may chart it differently. The care plans are difficult and there is so much involved in charting the Hester Davis. It is a work in progress and I am hoping it will continue to improve. The positive to the Hester Davis Fall program is that we now use fall mats for high risk patients. While it has been difficult for nursing staff to be compliant because the mats lead to other concerns and barriers but what I found out yesterday was that the mat decreases the impact of a fall by 85%! This alone should help compliance with the nursing staff. We need to provide all the resources we have to help with the prevention of a fall. It would be devastating to lose a patient due to a fall on your watch. NDNQI helps the nurse to identify her weakness in available options when keeping patients safety at the top of there list. Being part of the pressure injury committee and surveying each month all the patients in the hospital, it has made me understand the importance of putting all the pieces together when it comes to patients fall risk assessment, nutritional status and documentation of turning a patient. Nicely done Dina. Reply | Quote & Reply Feb 20, 2019 11:41 PM0 Like Profile Picture Me 4 posts Re:Topic 2 DQ 1 Class, The study of Falls among Adult Patients Hospitalized in the United States, Prevalence and Trends. The purpose of this study was to provide normative data on fall prevalence in US hospitals by unit type and to determine the 27-month secular trend in falls prior to the implementation of the Centers for Medicare and Medicaid Service (CMS) rule which does not reimburse hospitals for care related to injury resulting from hospital falls. Data from the National Database of Nursing Quality Indicators (NDNQI) collected between July 1, 2006 and September 30, 2008 to estimate prevalence and secular trends of falls occurring in adult medical, medical-surgical and surgical nursing units. More than 88 million patient days (pd) of observation were contributed from 6,100 medical, surgical, and medical-surgical nursing units in 1,263 hospitals across the United States. A total of 315,817 falls occurred (rate=3.56 falls/1,000 pd) during the study period, of which 82,332 (26.1%) resulted in an injury (rate=0.93/1,000 pd). Both total fall and injurious fall rates were highest in medical units (fall rate=4.03/1,000 pd; injurious fall rate=1.08/1,000 pd) and lowest in surgery units (fall rate=2.76/1,000 pd; injurious fall rate=0.67/1,000 pd). Falls (0.4% decrease/quarter, p0.0001) and injurious falls (1% decrease per quarter, p0.0001) both decreased over the 27-month study. In this large sample, fall and injurious fall prevalence varied by nursing unit type in US hospitals. Over the 27-month study, there was a small, but statistically significant, decrease in falls (p0.0001) and injurious falls (p0.0001). I think it was effective way of data collection sample because the method was unbiased, and study was for 27 months. References Falls among Adult Patients Hospitalized in the United ... › Journal List › HHS Author Manuscripts Reply | Quote & Reply View Comments Points: 8 Feb 20, 2019 11:41 PM0 Like Profile Picture Me 4 posts Re:Topic 2 DQ 1 Class, The study of Falls among Adult Patients Hospitalized in the United States, Prevalence and Trends. The purpose of this study was to provide normative data on fall prevalence in US hospitals by unit type and to determine the 27-month secular trend in falls prior to the implementation of the Centers for Medicare and Medicaid Service (CMS) rule which does not reimburse hospitals for care related to injury resulting from hospital falls. Data from the National Database of Nursing Quality Indicators (NDNQI) collected between July 1, 2006 and September 30, 2008 to estimate prevalence and secular trends of falls occurring in adult medical, medical-surgical and surgical nursing units. More than 88 million patient days (pd) of observation were contributed from 6,100 medical, surgical, and medical-surgical nursing units in 1,263 hospitals across the United States. A total of 315,817 falls occurred (rate=3.56 falls/1,000 pd) during the study period, of which 82,332 (26.1%) resulted in an injury (rate=0.93/1,000 pd). Both total fall and injurious fall rates were highest in medical units (fall rate=4.03/1,000 pd; injurious fall rate=1.08/1,000 pd) and lowest in surgery units (fall rate=2.76/1,000 pd; injurious fall rate=0.67/1,000 pd). Falls (0.4% decrease/quarter, p0.0001) and injurious falls (1% decrease per quarter, p0.0001) both decreased over the 27-month study. In this large sample, fall and injurious fall prevalence varied by nursing unit type in US hospitals. Over the 27-month study, there was a small, but statistically significant, decrease in falls (p0.0001) and injurious falls (p0.0001). I think it was effective way of data collection sample because the method was unbiased, and study was for 27 months. References Falls among Adult Patients Hospitalized in the United ... › Journal List › HHS Author Manuscripts Reply | Quote & Reply Feb 20, 2019 10:59 PM0 LikeSubstantive Post Profile Picture Samantha Mowry 4 posts Re:Re:Topic 2 DQ 1 Hi Maria, I 100% agree with you statement "Population sampling is the process of taking a subset of subjects that is representative of the entire population. The sample must have sufficient size to warrant statistical analysis." As I was lookng through research articles, I found that many of them had small samples. Which is still effective in see a trend, however I feel it is weak without knowing all the variables. The article I chose to write about I found very itneresting because it pertained to my line of work, hoever they were vague on the sampling and it was of only "32 healthy adults." The end discussion did state they were going to create the trial again, so maybe this was a pre-trial to see if it was workth embarking on. As you said, the sample must have a sufficient size to really see the trends and what the data has to offer. Thank you for sharing. Reply | Quote & Reply Feb 20, 2019 10:54 PM0 Like Profile Picture Krystal Almanza 3 posts Re:Topic 2 DQ 1 I chose an article from the GCU library titled Research Article: Healthcare Costs of Secondhand Smoke Exposure at Home for U.S. Children. In their study data was used from the national health interviews of 2000, 2005, and 2010. Their information was gathered from actual healthcare visits for children aged 3 to 14. They found that excess smoke exposure lead to increased hospital visits but not necessarily over night stays. The increased hospital visits due to second hand smoke exposure amounted to $62.9 million to $215.1 million in annual excess health care costs. Based on the chosen methods for surveying of choosing to evaluate past surveys I don’t feel they obtained the most accurate results they could have. Specific surveys of a group of families may have served better. “Introduction The purpose of this study is to estimate healthcare utilization and healthcare costs due to secondhand smoke exposure at home for children in the U.S. Methods Using data from the 2000, 2005, and 2010 U.S. National Health Interview Surveys, the authors analyzed the association between secondhand smoke exposure at home and utilization of three types of healthcare services (hospital nights, emergency room visits, and doctor visits) for children aged 3–14 years (N=16,860). A zero-inflated Poisson regression model was used to control for sociodemographic characteristics and the number of months without health insurance. The authors determined excess healthcare utilization attributable to secondhand smoke exposure at home for children and then estimated annual secondhand smoke–attributable healthcare costs as the product of annual excess healthcare utilization and unit costs obtained from the 2014 Medical Expenditures Panel Survey. This study was conducted from 2016 to 2018. Results The prevalence of secondhand smoke exposure at home for children in 2000, 2005, and 2010 was 25.0%, 12.3%, and 9.1%, respectively. Secondhand smoke exposure at home was positively associated with emergency room visits, but was not significantly associated with nights at the hospital or doctor visits for children. Secondhand smoke exposure at home for children resulted in an excess of 347,156 emergency room visits in 2000, 124,412 visits in 2005, and 101,570 visits in 2010, which amounted to $215.1 million, $77.1 million, and $62.9 million in excess annual healthcare costs (2014 dollars) in 2000, 2005, and 2010, respectively. Conclusions Although U.S. healthcare costs attributable to secondhand smoke exposure at home for children are declining, interventions to reduce secondhand smoke exposure at home for children are still needed to reduce the economic burden attributable to secondhand smoke exposure” (Yao, T., Sung, H.-Y., Wang, Y., Lightwood, J., & Max, W., 2019). References: Yao, T., Sung, H.-Y., Wang, Y., Lightwood, J., & Max, W. (2019). Research Article: Healthcare Costs of Secondhand Smoke Exposure at Home for U.S. Children. American Journal of Preventive Medicine, 56, 281–287. Permalink: Reply | Quote & Reply Feb 20, 2019 10:52 PM0 LikeSubstantive Post Profile Picture Samantha Mowry 4 posts Re:Re:Topic 2 DQ 1 Hi James, This is very interesting to me! I worked in an ED where the hospital’s primary focus was to reduce the time in diagnosing and treating sepsis. The hospital had what was called a “Sepsis Activation” where based on the patient’s vitals in triage, chief complaints, and the doctors impression the activation would be triggered in as little as a couple minutes. The nurse dials *50, which goes the switchboard and alerts the response team via overhead page. The hospital’s sepsis response team, immediately deploying the ED physician, ED RN, lab technician, x-ray technician, and respiratory therapy technician to administer a sepsis bundle to the patient. The bundle package drops stat orders immediately after activation and repeat at 3hrs and then 6 hour. With the diligence of the all staff, Hilo Medical Center has ranked in the top 10 percent for sepsis survival. Thank you for sharing! Reply | Quote & Reply Feb 20, 2019 10:11 PM0 Like Profile Picture Samantha Mowry 4 posts Re:Topic 2 DQ 1 A research study was done in Australia observing the effect of Dexamethasone given to healthy individuals via IV to see what the influences it would have on a person’s immune system. The focus being that Dexamethasone is commonly used during surgery as a antiemetic (Barden, et al., 2018). Dexamethasone is a glucocorticoid that most commonly used to suppresses inflammation and, in some cases, to treat the airway prior to extubation or to treat nausea and vomiting from chemotherapy (Davis, 2016). Glucocorticoid have commonly known side effect including adrenal suppression, hyperglycemia, and depressed immune response (Barden, et al., 2018). In this study, 32 healthy volunteers were selected to either receive IV saline (the control) or a dose of dexamethasone (2mg, 4mg, or 8mg IV). Venous blood sample were prior to dispensing the medication or control to get a baseline and then at 4hrs, 24hr, and 1 week after the treatments. The results showed that those who received the dexamethasone had dose dependent increase in their neutrophil count for 24 hours. There was also a noted dose dependent reduction in the monocyte, lymphocyte, basophils, and eosinophil counts 4hrs after dispensing which then was followed by a “rebound increase in cell counts” at the 24hr post (Barden, et al., 2018). The study also revealed cell counts were similar to baseline at the 7 day mark. The overall impression of the study was that if similar changes occur in surgical patients, then there may be implications for acute infection risk in the post-operative period. The sampling method used was randomized controlled trial by performing an experimental study on healthy adults. The subjects were divided into two groups where one group unknowingly received saline and one group received dexamethasone. I believe they chose “healthy adults” because they did not want any underlying factors of comorbidities to alterat the results. I think 32 is a small number and would like to have seen a study of 100 or greater. The study also did not report how many were male or female which may also change the results. I also would have liked to know the age break down of the sample population. Over all I think the study is a great idea, especially because my surgical center does dose our patients intraoperatively with IV dexamethasone so I would be curious to see further studies on how it immediately effects the healing process post operatively. Resource: Barden, A., Phillips, M., Hill, L. M., Fletcher, E. M., Mas, E., Loh, P. S., … Corcoran, T. B. (2018). Antiemetic doses of dexamethasone and their effects on immune cell populations and plasma mediators of inflammation resolution in healthy volunteers. Prostaglandins, Leukotrienes and Essential Fatty Acids , 139 , 31–39. Antiemetic doses of dexamethasone and their effects on immune cell populations and plasma mediators of inflammation resolution in healthy volunteers Permalink: Reply | Quote & Reply Feb 20, 2019 09:17 PM0 LikeSubstantive Post Profile Picture Renee Fuller 5 posts Re:Re:Topic 2 DQ 1 Hello Charles, just to add to your post. Urinary tract infection are caused by to the use of an indwelling urinary catheter is one of the most common infections acquired by patients in health care facilities. As biofilm ultimately develops on all of the catheters, the major determinant for development of bacteriuria is duration of catheterization. While the proportion of bacteriuric subjects who develop symptomatic infection is low, the high frequency of use of indwelling urinary catheters means there is a substantial burden attributable to these infections. Catheter-acquired urinary infection is the source for about 20% of episodes of health-care acquired bacteremia in acute care facilities, and over 50% in long term care facilities. The most important interventions to prevent bacteriuria and infection are to limit indwelling catheter use and, when catheter use is necessary, to discontinue the catheter as soon as clinically feasible. Infection control programs in health care facilities must implement and monitor strategies to limit catheter-acquired urinary infection, including surveillance of catheter use, appropriateness of catheter indications, and complications. To prevent these infections, will require technical advances in catheter materials which prevent biofilm formation. Nicolle L. E. (2014). Catheter associated urinary tract infections. Antimicrobial resistance and infection control, 3, 23. doi:10.1186/ Reply | Quote & Reply Feb 20, 2019 08:58 PM0 LikeSubstantive Post Profile Picture Laura Fitts 5 posts Re:Re:Topic 2 DQ 1 Many fecal transplant studies have been shown to be a successful treatment option. When fecal transplant studies first were reported many of the doctors I work with felt that if they contracted c-diff they would not bother with antibiotics, but begin fecal transplant as soon as possible. It has been shown to be a successful treatment for people that have failed traditional antibiotic therapy. The stigma of fecal transplant was initially a burden, but with proven successful outcomes it is not a viable option for many patients suffering with c-diff. Reply | Quote & Reply Feb 20, 2019 08:52 PM1 LikeSubstantive Post Profile Picture Laura Fitts 5 posts Re:Convenience Sampling Convenience sampling can be a starting point for businesses to collect data. One example of convenience sampling given by Research Methodology is the "Pepsi Challenge". A table with two types of soda are set up in a public area for taste testing, and people can chose whether or not to participate. It is convenient as a public area that is crowded will have many subjects to participate in the data collection. It is convenient for the researchers. References Convenience sampling - Research Methodology. (2019). Retrieved from Reply | Quote & Reply Feb 20, 2019 08:38 PM0 Like Profile Picture James McDermott 5 posts Re:Topic 2 DQ 1 The study chosen was applicable to my field of work in the ICU. Patients often come into the ICU in septic shock with hypotension and organ failure being the immediate crisis that must be addressed if the patient is to survive. This study was a study into use of using Leptin administration to prevent the worst symtpoms of sepsis from exacerbating. Sepsis syndrome is the most important cause of mortality in critically ill patients admitted to intensive care units (ICUs). However, current therapies for its prevention and treatment are still unsatisfactory, and the mortality rate is still high. Non-septic ICU patients are vulnerable to acquire sepsis syndrome. Thus, a preventive treatment for this population is needed. During sepsis syndrome and endotoxemia, severe hypotension, tachycardia, oxidative and immune response increase, multiple organ dysfunction syndrome (MODS) and decreased survival are observed. Leptin administration protects against negative effects of sepsis syndrome and endotoxemia. Furthermore, it is has been reported that leptin elevates blood pressure mediated by sympathetic nervous system activation. However, whether leptin administration before sepsis induction mediates its protective effects during sepsis through blood pressure regulation is not known. Therefore, we investigated whether pre-treatment of leptin improves blood pressure and MODS, resulting in survival increase during endotoxemia (Vellejos 2018). As to how the article itself analyzed their own statistics this was their summary regarding how they took their data and accounted for the known variables to achieve a mean. Statistical Analysis: All results are presented as the mean ± SD or mean ± 95% confidence interval (CI) for the relative risk. Differences were considered significant at p 0.05. Significant differences in systolic blood pressure recording experiments were assessed by one-way ANOVA followed by Dunnett’s post-test to compare them with basal recordings and by two-way ANOVA followed by the Bonferroni post-test to compare the vehicle-treated/endotoxemic group with the leptin-treated/endotoxemic group recordings (see the figure legends for detailed explanations). STAT3 phosphorylation was assessed by Student’s t-test (Mann-Whitney). Plasma measurements were performed by one-way ANOVA (Kruskal–Wallis) followed by Dunn’s post-test. Contingency analyses with Fisher’s exact test were used to assess the relative risk of death. Kaplan–Meier curves, the log-rank and Gehan–Breslow–Wilcoxon tests were used to determine survival rates (Vallejos 2018). Their study, and use of statistics and analytics showed evidenced-based results that use of Leptin showed a marked improvement in survival. Alejandro Vallejos, Pedro Olivares, Diego Varela, Cesar Echeverria, Claudio Cabello-Verrugio, Claudio Pérez-Leighton, & Felipe Simon. (2018). Preventive Leptin Administration Protects Against Sepsis Through Improving Hypotension, Tachycardia, Oxidative Stress Burst, Multiple Organ Dysfunction, and Increasing Survival. Frontiers in Physiology, Vol 9 (2018). Reply | Quote & Reply Feb 20, 2019 07:09 PM1 LikeSubstantive Post Profile Picture Renee Fuller 5 posts Re:Re:Topic 2 DQ 1 Hello Lisa, just to add to your post, dependent variable is the variable a researcher is interested in. An independent variable is a variable believed to affect the dependent variable. This is the variable that the researcher will manipulate to see if it makes the dependent variable change, its being studied and measured in the experiment. It's what changes as a result of the changes to the independent variable. An example of a dependent variable is how tall you are at different ages. The dependent variable (height) depends on the independent variable (age). Sarikas, C., (February 2012) PrepScholar. Reply | Quote & Reply Feb 20, 2019 06:34 PM0 LikeSubstantive Post Profile Picture Michelle Smith 7 posts Re:Re:Topic 2 DQ 1 Maria, very nice post! You found a great study to emphasize on. It is very interesting as we learn about the different types of studies and how they are performed. With this information, one can understand the way in which they broke down the survey, who they surveyed and how they came up with the results. Having 3000 people be a sample of the community is great. With that amount, it would show a greater community. With filling out the survey, the chances of being a active participant are great. If one does not take the survey, they will not be part of the survey. In the organization I work for, we take surveys on occasion and I find that there are a lot of employees that like to complain about things but when it comes time to do a survey that may address needs they have, they refuse to take it. So, on that note, if you don't speak, you wont be heard. Reply | Quote & Reply Feb 20, 2019 06:22 PM0 LikeSubstantive Post Profile Picture Michelle Smith 7 posts Re:Re:Topic 2 DQ 1 Self catherization can be complicated by infection if not done correctly. We see patients with urinary tract infections and what complications can come from them. By being mindful and educated on proper technique and being able to demonstrate it, and explaining the complications of not being sterile when performing the catherization one would hope to see less frequent infections. Reviewing the studies helps us to identify the quality of our outcomes in these situations and helping us to make changes as evidence bases practice leads us to the improved outcomes. In my practice, when there is a patient that self caths at home, I ask him to demonstrate his way. One can learn from the patient that has been doing it for a while. Patients may know better as this is there life 24-7. Reply | Quote & Reply Feb 20, 2019 06:12 PM0 Like Profile Picture Melissa Dulin 3 posts Re:Topic 2 DQ 1 Coping strategies among colorectal cancer patients undergoing surgery and the role of the surgeon in mitigating distress: A qualitative study Background Distress is common among cancer patients and leads to worse postoperative outcomes. Surgeons are often the first physicians to have in-depth conversations with patients about a new colorectal cancer diagnosis; therefore, it is important that these surgeons understand how patients cope with the distress of a diagnosis and how they can help patients manage this distress. Methods Patients with colorectal cancer were recruited from an outpatient surgery clinic. Purposive sampling was used to recruit patients if they were either planning to undergo surgery or had undergone surgery within six months. In-depth, open-ended, individual qualitative interviews were performed. Grounded theory was used to develop themes regarding patients’ coping strategies and beliefs regarding the role of the surgeon in helping them cope. Results Patients described their own internal coping strategies using problem-focused, emotion-focused, and meaning-focused techniques. Patients also reported the importance of their social support network for coping. Patients believed surgeons and their teams should help patients manage the emotional components of their cancer diagnosis and surgical experience, especially if patients were experiencing high levels of distress or had inadequate coping skills. They did not believe surgeons themselves should be primarily responsible for helping them cope. Conclusion For surgeons to guide diagnosis and initial management of distress in colorectal cancer patients undergoing surgery, they should screen patients for distress, identify and strengthen patients’ own coping strategies, facilitate a strong social support network, and provide patients with the option to obtain further support from the surgeon's office. I believe the effectiveness of the sampling method is somewhat marginal, as the sample is very small. I believe in order to provide more accurate results the sample size should be much larger. Sandelowski (1995) proposes this principle: "an adequate sample size in qualitative research is one that permits the deep, case-oriented analysis that is a hallmark of all qualitative inquiry, and that results in a new and richly textured understanding of experience” (Sandelowski, 1995). References: Abelson, J. S., Chait, A., Shen, M. J., Charlson, M., Dickerman, A., & Yeo, H. (2019). Colon/RectumPresented at the Academic Surgical Congress 2018: Coping strategies among colorectal cancer patients undergoing surgery and the role of the surgeon in mitigating distress: A qualitative study. Surgery, 165, 461–468. Sandelowski, Margarete, PhD, RN, Sample size in qualitative research, 1995. Retrieved from Permalink: Reply | Quote & Reply Feb 20, 2019 05:44 PM0 LikeSubstantive Post Profile Picture Maria Martinez 3 posts Re:Re:Topic 2 DQ 1 hi Magdalena this is a very interesting article, It is surprizing that the study indicates that the prevalence of HAI is similar than other reports performed in cancer patients. There were no differences between patients with HAI vs. non-HAI, neither in those who had a MDRB isolated and that infection control is the most usefull tool to decrease infections. Back to nursing basics waht hands and keep a clean environment Nightingale used this data analysis to formulate the knowledge of nursing (Nightingale, 1969). Her focus for proper nursing care was on ventilation, appropriate housing, and cleanliness Reference, Grand Canyon University (Ed). (2018). Applied statistics for health care. Retrieved from Reply | Quote & Reply Feb 20, 2019 05:31 PM0 LikeSubstantive Post Profile Picture Maria Martinez 3 posts Re:Re:Topic 2 DQ 1 Hi Laurs this si a good example of purposive sampling because the subjects are the same age and they both have hip fractures and the study was based in 2 hospitals. According to , In some studies they use a larger grup of the community to study the population Population sampling is the process of taking a subset of subjects that is representative of the entire population. The sample must have sufficient size to warrant statistical analysis. Reference, E. (2019). Population Sampling - Representative Subset of a Population. [online] Available at: Reply | Quote & Reply Feb 20, 2019 05:21 PM0 Like Profile Picture Maria Martinez 3 posts Re:Topic 2 DQ 1 San Joaquin County does a community assessment to determine what the community needs are to promote and balance a healthy community. According to the study Healthier San J, Every three years the nonprofit hospitals along with the county public health department and a host of community partners come together to conduct a comprehensive assessment of the health needs in the community and to prioritize those needs. This year’s CHNA process included surveys of nearly 3,000 residents, interviews with key informants, 29 focus group discussions in the community, and data analysis of over 150 indicators, creating a robust picture of the issues affecting people’s health where they live, work, and play. This study helps the county determine the needs of different groups of people in the community. Population sampling is the process of taking a subset of subjects that is representative of the entire population. The sample must have sufficient size to warrant statistical analysis First, your sample is the group of individuals who actually participate in your study. These are the individuals who you end up interviewing (e.g., in a qualitative study) or who actually complete your survey (e.g., in a quantitative study). People who could have been participants in your study but did not actually participate are not considered part of your sample your population is the broader group of people to whom you intend to generalize the results of your study. Your sample will always be a subset of your population. For this study they took the population and surveyed 3000 people. The population is diverse the sample included people of different race, age and gender. This method allows them to take the input of the 3000 people who are the voice of the whole community as the focused group. Reference E. (2019). Population Sampling - Representative Subset of a Population. [online] Available at: H. (2019). [online] Available at: Reply | Quote & Reply Feb 20, 2019 04:24 PM0 Like Profile Picture Julia Lawrence 9 posts Surveys An excellent point, Laura. Class, Laura has made a great point about surveys and biased sampling. Many of you have probably noticed, even in your own work environment, how the data collected or the people responding can limit and/or bias the claim. Anyone, think of an example in your work environment and share with us what you would specifically do to get a random sample. Reply | Quote & Reply | Report Abuse Feb 20, 2019 04:21 PM0 Like Profile Picture Julia Lawrence 9 posts Link: Central Tendency Very good, Elizabeth. Class, here is a link some of you may find helpful in understanding these concepts of central tendency: Reply | Quote & Reply | Report Abuse Feb 20, 2019 04:18 PM0 Like Profile Picture Julia Lawrence 9 posts ANSWER:What Method of Central Tendency? Excellent, Stephanie. Class, to reiterate what Stephanie has said: In a nutshell -- we use the mode for nominal or categorical or qualitative (all the same thing) data. So for the color of hospital gowns, we cannot really find the average of blue or white, but we can find the most common color or mode. Blood pressure is interval data so an average (mean) would make sense. We use median when we are dealing with ordinal data such as a survey rated 1-5 in satisfaction or we can use a median as opposed to a mean if our data is skewed. So mode=qualitative and mean and median can be used for quantitative (numerical data). Reply | Quote & Reply | Report Abuse Feb 20, 2019 04:16 PM0 Like Profile Picture Julia Lawrence 9 posts ANSWER:Random versus Non-Random Sampling Very nice definition between the two types of sampling techniques. Class, i magine random sampling as the umbrella, and underneath this umbrella -- you have systematic sampling, cluster sampling, simple random and stratified sampling. These are unbiased and a form of probability sampling. Standing away from the umbrella, by itself, is convenience sampling. This is biased and nonprobability sampling and has no umbrella to provide it shelter. This is a form of nonrandom sampling. Reply | Quote & Reply | Report Abuse Feb 20, 2019 04:14 PM0 LikeSubstantive Post Profile Picture Charles Freeman 3 posts Re:What Method of Central Tendency? Three measures of central tendency mean, median and mood. When determining patient’s preference mood is the most likely to determine our preference. Blood pressure in 65-year-old women is a continuous data and the use of mean would make more sense. This is partly because the questions state average which indirectly require calculation of the mean Reply | Quote & Reply Feb 20, 2019 04:14 PM0 Like Profile Picture Julia Lawrence 9 posts Convenience Sampling Good example, Lisa. Anyone, do you think there is a purpose in convenience sampling? Especially since it can be so biased. Reply | Quote & Reply | Report Abuse Feb 20, 2019 03:35 PM0 Like Profile Picture Michelle Smith 7 posts Re:Topic 2 DQ 1 The study I chose was “Oral Frozen Fecal Microbiota Transplant (FMT). The capsules are frozen fecal capsules and they are used instead of antibiotics for patients with C. Difficile infection (CDI). The study contained 180 patients which had been treated at Massachusetts General Hospital that was treated with FMT. They had patients aged 7-95 with the median being 64. This would be described as a measure of central tendency. The way they chose the sampling was they chose pat