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1) Peer Discussion Post:? 
Research is a systematic investigation of phenomena for the purposes of generalizing findings to a population. Researchers aim to add to the current body of knowledge about a particular subject, and results are often published in academic journals whereas, quality improvement aims to improve care, processes, or outcomes within an organization (Is it quality improvement or research, 2015). The main difference between the two is the targeted audience. Research is aimed at getting information across to a large group and quality improvement is focused within an organization.
Last month I was part of an audit team that got to go to Ohio to help improve their clinic processes. The staff and I concocted an experiment to see if having two nurses give insulin to 116 inmates was more efficient than only using one. The hypothesis was that by using more staff would cut down on the amount of patients each nurse had to see and we were looking to see if it was not only more efficient timewise but if it was going to be safe and effective for the nurses to have so many inmates in one area at one time. In prison there are a lot of protocols in place so processes take a lot longer than they would in a hospital. For example all syringes and lancets need to be account for by writing down each inmate’s name and number that received a lancet and needle. The quantitative research revealed that using two nurses cut down on time by 56 minutes. This was determined by me timing the activity. For qualitative research, I went back and asked the nurses how they felt during the process. All 4 of the nurses that participated stated they felt safe, effective and were happy because they were able to get of work on time and didn’t feel rushed. The research was presented to the quality control committee which included the warden and director of nursing but they refused to change their processes because using one nurse was “the way they ALWAYS did it.”
Is it quality improvement or research? (2015, April). Retrieved from
https://www.americannursetoday.com/quality-improvement-research/
2) Peer Discussion Post:? 
“Research is a systematic investigation of phenomena for the purposes of generalizing findings to a population. Researchers aim to add to the current body of knowledge about a particular subject, and results are often published in academic journals. Researchers must follow strict policies, obtain consent from subjects, and report any deviation from the protocol. An Institutional Review Board (IRB) must approve the research project before it starts, and a hospital’s administrative personnel must support the project” (Merrill, 2015).
“QI (also called quality assurance) is also systematic, but it aims to improve care, processes, or outcomes within an organization. The purpose of QI is to test a new process using the plan, do, study, act process. This cycle is repeated, and new changes are made to continue to improve the outcome.
Typically, QI results are shared within the organization and might be implemented in other departments. The processes and lessons learned from QI activities can be published; however, it must be clear to the reader that the project was QI and not research. Data published from QI activities are usually aggregated and represented in control charts, histograms, and line graphs.
The hospital should support or approve QI. Some organizations have QI committees that approve and coordinate activities, and some organizations require articles to be approved before submitting for publication.
Some helpful questions to ask to determine if your project is QI include:

Has the intervention been used in other healthcare settings or reported in the literature?
Will the results of this project directly improve patient care or processes at your hospital?
Is the hospital supportive of the project and willing to dedicate employee time and supplies to complete the project?” (Merrill, 2015).

“Qualitative Research is primarily exploratory research. It is used to gain an understanding of underlying reasons, opinions, and motivations. It provides insights into the problem or helps to develop ideas or hypotheses for potential quantitative research. Qualitative Research is also used to uncover trends in thought and opinions, and dive deeper into the problem. Qualitative data collection methods vary using unstructured or semi-structured techniques. Some common methods include focus groups (group discussions), individual interviews, and participation/observations. The sample size is typically small, and respondents are selected to fulfill a given quota” (DeFranzo, 2011).
“Quantitative Research is used to quantify the problem by way of generating numerical data or data that can be transformed into usable statistics. It is used to quantify attitudes, opinions, behaviors, and other defined variables – and generalize results from a larger sample population. Quantitative Research uses measurable data to formulate facts and uncover patterns in research. Quantitative data collection methods are much more structured than Qualitative data collection methods. Quantitative data collection methods include various forms of surveys – online surveys, paper surveys, mobile surveys and kiosk surveys, face-to-face interviews, telephone interviews, longitudinal studies, website interceptors, online polls, and systematic observations” (DeFranzo, 2011).
An example of quantitative research in healthcare would be things like catheter associated blood stream infections, catheter associated urinary tract infections and the effects of proper and repeated cleaning of these items. These studies provide exact numbers and measurable outcomes. They also help improve outcomes and health. In my facility we practice cleaning foley with special wipes every 4 hours to decrease infection rates and we only use foley when absolutely necessary. We also clean central line dressings with a sterile technique every 7 days, keep curos on the hubs, and only use central lines when necessary.
An example of qualitative research is patient satisfaction surveys. These surveys are exploratory research to understand the opinions, experiences, and view points of our patients we have cared for. It helps to identify trends of how we care for patients and where we can improve. My hospital utilizes patient satisfaction surveys as do many hospitals around the US.
References:
DeFranzo. (2011). What’s the difference between qualitative and quantitative research? Retrieved from https://www.snapsurveys.com/blog/qualitative-vs-qu…
Merrill. (2015). Is this quality improvement or research? Retrieved from https://www.americannursetoday.com/quality-improve…
3) Peer Discussion Post:? 
Describe the difference between research and quality improvement. Provide a workplace example where qualitative and quantitative research is applied and how it was used within your organization. When replying to peers, discuss how these research findings might be incorporated into another health care setting.
According to the American Nurse today, a research is said to be a systematic investigation, with the goal of generalizing the results to a population. When conducting a research, the individual conducting the researcher should ensure that a consent is obtained from the subjects participating. While quality on the other hand, aims to improve care, processes or outcomes within a facility or organization (American Nurse today, 2015). Quality improvement results are shared among workers in hopes with helping to improve and implement changes. Research investigates methods and standards. While quality uses evidence-base standards to make changes in the facility.
June Helbig stated that, quantitative research focuses on numbers and numerical values that is measurable. However, qualitative research involves evaluating the variables that are not numerical, data is collected through observation, questions or by using interviews (Helbig, 2018). Example of utilizing quantitative research method in my working facility is, using surveys to improve the care provided and evaluating the experience of patients when receiving care from our facility. All patients receive a questionnaire survey when they first check in, then after being treated they evaluate the care received throughout their visit. Patient who don’t have the capability of completing the questionnaire have the option of using the smiley face survey kiosk. The results are then monitored and evaluated closely to improve the quality of care. Based on the numerical value of what the majority is requiring, the facility then tries to make changes accordingly.
Qualitative research on the other hand involves monitoring on the job incidents and near misses to avoid them from reoccurring. I currently work in an urgent care, few days ago at our employee meeting all employees will be required to have all patient complete a PHQ 9. By asking the two questions which involves: In the past two weeks have you been having difficulty enjoying activities that are pleasurable and feeling down depress or hopeless. All nurses triaging patients must ask these questions, due to high suicide rate, increase alcohols and drug usage. These protocols are in place to assist with lowering suicide and making sure patients suffering from other contributing factors, receive the care that they need. The results are then closely monitored and based on patient improvement; the facility tries to implement changes that will help more patients.
References
American Nurse today. (2015). Is this quality improvement or research. Retrieved from https://www.americannursetoday.com/quality-improvement-research/
Helbig, J. (2018). Statistical Analysis. Retrieved from https://lc.gcumedia.com/hlt362v/applied-statistics-for-health-care/v1.1/#/chapter/4
4) INSTRUCTOR Participation Post:? 
INSTRUCTOR QUESTION
Are statistically significant differences clinically important? What makes statistics clinically important, how can we tell if we should change our normal practices after reading recent publications? What proof in the form of statistics would make you change your day to day practices that you have been practicing for years? If you have changed practices in the past, please describe how you came to this conclusion.

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