Week 6

PNUR 129 Foundations

of Research and
Evidence-Based Practice
for Practical Nurses
Week 6 objectives
• Define mixed methods design
• Differentiate between quantitative and
qualitative research design.
• Critique a mixed methods study
• Define and discuss outcomes research
• Discuss nursing-sensitive patient
outcomes
• Review a critical appraisal of an
outcomes study
Mixed-Methods Research
Uses both quantitative and qualitative
designs to answer complex questions.

Often the strengths of each design,

numbers + words, often produces results
with greater breadth and depth as
compared to using only one of the designs.

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Benefits of using both qualitative
and quantitative designs
Quantitative data can support qualitative research
components by identifying representative patients (who
do we need more detailed information from / help select
individuals to be interviewed)

Qualitative data can help develop instruments to be used

in gathering quantitative data (help ask the right
questions) and help interpret, clarify, describe or validate
the quantitative numerical results
Types of mixed-method studies
Challenges of mixed-method designs

Complex to work with the two designs for the same

question

Usually more time consuming because you are doing 2

studies plus connecting the findings at different points
(one design informing next steps for the other design
such as questions in a survey) at the end to expand
understanding of results

More money to do two studies that take more time

Question
What are some research examples that
could benefit from a mixed-methods
research design?

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Group Work
1. Read the article posted in the Week 6 module:
Doorenbos AZ. Mixed methods in nursing research:
An overview and practical examples. Kango Kenkyu.
2014;47(3):207-217

2. Answer the following questions:

a) What type of mixed methods designs were used?
b) How did the researcher combine or interpret the
findings of one component in light of the other?
c) How did the mixed-method design enhance your
understanding of the research question?
Outcomes Research
Focuses on the end result of patient care following
specific healthcare practices and interventions. What
was the patient’s experience?

Understanding the experiences is a valuable tool to

facilitate our healthcare system to make choices
about treatments to integrate those that are effective
into practice.

Outcomes research is used to monitor and improve

the quality of care.

Justifies the cost of care and interventions

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Outcomes research and nursing
Outcomes research is an opportunity for
nurses to improve practice

Nursing sensitive outcomes are those

patient outcomes that are relevant,
based on nurses scope and domain of
practice, and influence by nursing
actions and interventions
Examples of nursing-sensitive outcomes
Outcomes Research Findings
Donabedian’s theory

A wealth of valuable information

An opportunity to engage patients for us to examine if

the results are valid and how to improve them

Share information with stakeholders including clinicians,

public, policy makers, researchers via presentations and
journals

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Types of outcomes measured
Functional status (physical mental social)

Clinical status (signs/symptoms, lab values, mortality)

Satisfaction with care (quality, timely access, general

care)

General well-being (perception of health, energy, pain,

life satisfaction)
There are gaps and inconsistencies in how the patient
experience is measured so Health Quality Ontario and the
Home and Community Care have 3 recommendations

1. Improving patient experience measurement

2. Enablers to support measurement (developing

measurement tools and create data sharing
mechanisms across sectors)

3. Improving the patient experience