Starting in 2012, the Centers for Medicare and Medicaid Services (CMS) initiated fundamental changes to how hospitals are paid for services for Medicare recipients, called Value Based Purchasing. This funding mechanism provides incentives to hospitals to reduce rates of preventable injuries. One of the measures used by CMS is hospital borne infections.

Last month Healthy Hospital hired a new director, Ms. Doit Now. She has reviewed the CMS data for Healthy Hospital and wants to focus on reducing the rate of infections.

The research question for the project is “how can we reduce hospital borne infections?”.

Ms. Now asked her assistant do a background search related to the research question. Mr. Assist found that one key element related to infection rates is effective hand washing and that the Centers for Disease Control provided hand washing guidelines that he could use as a standard (CDC, 2012).

Based on his research, he developed a refined research question: Are staff washing their hands according to standards proposed by the CDC?

In this Discussion, you will recommend a quantitative design to provide numerical data related to hand washing compared to CDC standards.

Director Now could use any of the following designs:

• Behavioral observation
• Correlation research
• Quasi-Experimental design
• Survey research
• True experimental design

Which type of quantitative design do you think is most appropriate? Why?

What specific data collection tool would you use? Why?

What numbers will result from your quantitative process? (Remember that quantitative data designs yield numbers.)

How would you measure the rate of infections? (Remember you need data for both parts of the hypothesis.)

Be sure to define the research terms in your own words with citations in the body of the text and references at the bottom of the post. Explain your choice of design through effective analysis of your option, i.e. identify strengths and weaknesses of your choice and why you believe the strengths outweigh the weaknesses. Discuss the process you will use to implement your idea.

Part 2

Thanks to your great input, Director Now decided to use behavioral observation of all staff on several wards comparing what was observed with the hand washing guidelines from the Centers for Disease Control (Centers for Disease Control and Prevention, 2013).

Director Now is astonished by the results of the quantitative research study. She found that 30% of the time direct clinical staff failed to meet hand washing standards after using the rest room.

This data really helps Director Now as she chooses her next step. Her new refined research questions are:

1. Why is the clinical staff not washing their hands correctly?
2. What specific interventions are needed at Healthy Hospital to ensure that at least 90% of clinical staff washes their hands effectively 90% of the time?

Ms. Now believes the clinical supervisors are the mostly likely group to answer her questions, but knows there are many ways to collect qualitative information. The Director again seeks your input on a specific qualitative process to collect new data.

Director Now knows she could use any of the following:

• Case study
• Ethnographic
• Phenomenological study
• Narrative inquiry research

The procedures she can use include:

• Direct observation
• Focus group
• Interview (structured, unstructured, or semi-structured)
• Stimulated recall

What type of qualitative design do you recommend? Why?

What data collection procedure do you recommend?

Be sure to define the research terms in your own words with citations in the body of the text and references at the bottom of the post. Explain your choice of design and procedures through effective analysis of your option, i.e., identify strengths and weaknesses of your choices and why you believe the strengths outweigh the weaknesses.