After reading the abstract, the initial reaction to the article was to make note if the age or years of experience of the health professionals effected the compliance with universal precautions. The question relates to personal practice experience. In 1989, at the first nursing experience I learned to start IV’s on patients by putting on gloves after palpating the vein, inserting the needle into the vein, verifying the blood return, but before uncapping to insert the IV line. I hope none of the class reading the discussion practices for the Joint Commission or OSHA; however, we are well pass the statute of limitations. The study conducted in 2001 concluded that years of experience or age did not influence whether the health professionals chose to comply with the universal precautions edict for the United Kingdom Health Departments.
The professional doctors and nurses who espouse to evidence based practices chose to use subjective predictors to determine adherence to personal safety guidelines. The researchers discuss reasons for the physician non-compliance as their rejection of the bureaucratic model of uniform practice (Cutter & Jordan, 2003). Anecdotal information supports that the compliance issues occur in many facilities. Recently, in one of the hospitals of my professional practice, the anesthesiologists (doctors and nurses) were eating inside the surgical suite. Questions that remain unanswered from the study are what interventions will solidify compliance with universal precautions. Quantitative Design versus Research Question
Cutter and Jordan (2003) utilized a cross sectional survey design to clarify reasons for non-compliance with infection control guidelines. A cross-sectional survey collects data to make inferences about cause and effect on a population during a specific time-period. The design is non-experimental and is descriptive in focus (Burns & Grove, 2009). This type of design is not as robust as a longitudinal design, in which the participants continue in the study over time, but the design is more cost and time efficient (Hall, 2012). In view of the research question and the need to find an appropriate and timely intervention the cross sectional study is appropriate for the research question. Mixed-Methods Design
Quantitative studies statistically measure analyze results to develop an intervention that addresses the research question. Conversely, qualitative studies are utilized to gain an understanding of the underlying reasons and motivations (Burns & Grove, 2009). In other words, qualitative designs attempt to understand the ‘why’ of the research question. Some research questions beg for answers from a combination of both methods. According to Dr Beck (Laureate, 2010) this is a mixed methods study. Williamson (2005) further explains the goal of a mixed method study is to utilize multiple data collection methods to enhance the inferences from the results of the study. The different perspectives of the data increase the robustness and rigor of the data.
The mixed method of data collection and synthesis is called triangulation (Williamson, 2005). Understanding the triangulation theory leads one to believe that a mixed method design would address the limitations of the cross sectional survey study. A mixed method study utilizing a quantitative design and then conducting a qualitative study with the same participants would have assisted to understand the motivating factors to glean compliance from the health professionals. Moreover, understanding the motivators for this population would assist with determining effective education strategies.
Burns, N., & Grove, S. K. (2009). The practice of nursing research: Appraisal, synthesis and generation of evidence. St Louis, MO: Saunders Elsevier. Cutter, J., & Jordan, S. (2003). Uptake of guideline to avoid and report exposure to blood and body fluids. Journal of Advanced Nursing , 46 (4), 441-452. Hall, J. (2012). Cross-sectional survey design. In P. J. Lavrakas, Encyclopedia of survey research methods. Sage Publishing. Laureate Education. (2010). Research Design. Baltimore, MD: Laureate Education. Williamson, G. R. (2005). Illustrating Triangulation in mixed methods nursing research. Nurse Researcher , 12 (4), 7-18.