3.4 Data collection methods
Mailing and Timeline
The survey timeline and mailings followed the schedule below.
• Post card: The survey was introduced with a post card to alert potential respondents they will receive the survey (Appendix C – Initial Postcard).
• First survey mailing: The first survey mailing was personally addressed to the identified leader for IR within each facility and sent approximately three weeks after the post card.
The mailing included:
o A personalized introductory letter from the PI (Appendix C – First Letter) o An encrypted link to complete the survey online
o The written survey in booklet format
o A postage paid addressed envelope to return survey materials. The return address was to the Vanderbilt University School of Nursing.
• Second survey mailing: The second mailing was personally addressed to the identified leader for IR within each facility and sent approximately three weeks after the first mailing. The mailing included:
o A personalized reminder letter from the PI (Appendix C – Second Letter) o An encrypted link to complete the survey online
o The written survey in booklet format
o A postage paid addressed envelope to return survey materials. The return address was to the Vanderbilt University School of Nursing.
• Final (third) survey mailing: The third and final mailing was personally addressed to the identified leader for IR within each facility and sent two weeks after the second mailing.
The mailing included:
o A personalized final reminder letter from the PI (Appendix C – Final Letter) o An encrypted link to complete the survey online
o The written survey in booklet format
o A postage paid addressed envelope to return survey materials. The return address was to the Vanderbilt University School of Nursing.
o Each mailing and subsequent mailing was numbered so that the PI did not send duplicates to those who had already responded.
• The mailings were sent via the following timeline with each letter asking a specific date of return. The participants were given approximately three weeks to respond to the survey from the date of mailing. This longer time frame accounted for the time it would take for the survey to reach the participant through the hospital mail system. The
timeline followed the proposed schedule below:
Table 2: Survey mailing timeline Timeline
Day 0
Day 21
Day 42
Day 63
Initial post card mailing X
First mailing X
Second mailing X
Final (third) mailing X
• Specific dates included:
o Postcards mailed: 5/4/2018.
o First survey mailing: 5/22/2018; Requested return date: 6/11/2018.
o Second survey mailing: 6/18/2018; Requested return date: 7/9/2018.
o Third survey mailing: 7/18/2018; Requested return date: 8/8/2018.
Instruments
There are no existing instruments available to study the specific nature of the concepts in this phenomenon of interest (POI). Therefore, a survey was developed for purposes of this dissertation using the conceptual framework; the Minnick & Roberts Outcomes Production Framework as a guide (Appendix C – Survey).
Survey questions were developed to obtain the most robust information on the concepts of interest; employment terms, organizational facets, and aspects of labor (Appendix A – Table A 8). The questions were crafted from a detailed literature search on the phenomenon of interest as well as the work completed by previous surveys studying the concepts of interest (A. F.
Minnick et al., 2007; Jack Needleman & Minnick, 2009; Widmar, 2012).
Overall validity, reliability, and credibility of the survey design were enhanced by using the method of card sorting the questions to the concept definitions as well as pilot testing the survey prior to administration to the proposed study sample. Identified weaknesses (i.e. unclear concept definitions) were addressed immediately during survey development.
Credibility, Rigor, Validity of Design, Methods, and Strategies for Minimizing Weaknesses As described, the credibility, rigor, and validity of the survey design were enhanced by using the method of card sorting the questions to the concept definitions as well as pilot testing the survey prior to administration to the proposed study sample. Identified weaknesses (i.e.
unclear concept definitions) were addressed immediately during survey development.
• Card sort
o Card sort one: Card sort completed with six individuals
§ Definitions (Appendix A - Table A 5)
§ The concept definitions for card sort one, were drawn from the health services literature.
§ Results (Appendix A - Table A 6)
o Card sort two: Based on the result and feedback from card sort one, a second card sort was completed for nine questions with five of the six original participants.
One participant from the original group was no longer able to participate due to scheduling constraints.
§ The definitions for card sort two were adjusted for clarity based on the results of card sort one (Appendix A - Table A 5).
§ Results (Appendix A - Table A 7).
• Pilot test
o The survey was pilot tested by a panel of experts in order to identify weaknesses in the survey design or question construction. The panel of experts consisted of six individuals all with ties to IR and other outpatient procedure areas.
o The individuals were each asked to complete the surveys while the PI timed the total minutes until completion, put a check mark next to difficult questions, underlined unclear words, and finally debriefed with the PI to review each question.
o The results of this pilot test were compiled and the survey questions were adjusted to address concerns. Examples of feedback included not abbreviating moderate sedation as MS, adding grid lines and check boxes to questions where necessary, adjusting unclear question spacing, and addressing language throughout the survey to more clearly state questions.
o Average total minutes to completion = 15 minutes.
o The panel of experts interestingly requested adding questions addressing the process of verbal orders within these procedural areas. Unfortunately, this could not be completed in this dissertation due to space constraints. The topic of medication ordering has such depth that it is feasible that a second survey could be constructed which studies this topic alone. Therefore, this is certainly a topic that could be addressed in future studies.
Additional Information Collected about the Facilities
Additional data points were obtained from the most recent AHA data set. This information added organizational detail and descriptors that were not collected by the survey, which enhanced the survey results. Examples of these data points include demographics of the hospitals, total licensed beds, registered nurse, licensed practical nurse, or vocational nurse FTEs, and average daily census.