The objective of this study was to compare nurses who covered a single school to nurses who covered multiple schools, as well as comparing nurses who were assigned to the general school population, and those that were assigned to CSHCN. The school nurse subsets were defined by describing the child health conditions, emergencies, direct care procedures, nurse care management functions, consultation sources, and benefits or challenges of their role.
The first indication of a qualitative research project was that the interview questions were reasonable. In this case, a community interdisciplinary committee made up of community members from health, education and CSHCN service agencies drafted the survey questions from an extensive literature review. The original questionnaire included fifty items that was reviewed for completeness, clarity and relevance in multiple group discussions over a six month period. Through this process, the questionnaire was clarified and simplified.
The final result was then reviewed by a school medical director, school nurse supervisors, and was pilot tested with two nurses through a verbal discussion for each item to make sure that the content was valid. The final questionnaire consisted of twenty-five questions that utilized either “yes or no” responses, Likert scales and three open ended questions. Ten of these questions dealt with school nurse educational preparation, employment history and job characteristics.
An additional ten questions in the survey inquired about their work related directly to CSHCN, and addressed continuing education history, needs and preferences. Finally, five questions asked nurses about the general health functions of the school within their jurisdiction. The three questions that were designed as opened ended questions asked the participants about their likes and dislikes about the job, challenges of their role, and also requested general comments. The second indicator of a quality research endeavor was the fact that a representative and appropriate sample set were selected for observation.
The participants were recruited from a general nurse population of 103 employed public school nurses in five counties in Florida. The participants represented both rural and urban populations in 2006, which helped to make sure the sample set was broad enough to obtain a representative sampling of the school nurses in the state of Florida. In order to obtain this sample set, a total of five school nurse supervisors identified the number of nurses, and aided in the recruitment of the nurses at the end of the school year.
This was accomplished by the nurse supervisors and researchers sending out packets containing an explanatory cover letter, survey, informed consent, and a stamped return envelope addressed to the researcher. A total of 103 questionnaires were released to the targeted school nurses, and 50 of them responded for a response rate of 48. 5%. The respondents cared for approximately 96,000 children in 183 of the 226 schools in the five counties in Florida. The response rate per county varied between 35. 7% and 100%, with two of the five counties responding at a level below 60%.
Individual study participants included 40 registered nurses, and 10 licensed practical nurses. Approximately 58% of the nurses were employed by school districts, and the remainder was employed by health departments. Registered nurses were more frequently employed by health departments, while licensed practical nurses were more often utilized by school districts. On average, the nurses worked an average of 34. 42 hours per week. The third indicator that this was a qualitative research project was the fact that the results and data are sorted and coded in a systematic and meaningful way.
Throughout the report, there are a number of tables with clear information, precise parameters, and detailed captions indicating the information supplied, as well as the sources of the information. In addition, descriptive statistics were used to report both sample characteristics and survey items. The recorded differences were analyzed using chi-square, 1-way ANOVA and independent sample t tests. The alpha variable for statistical interpretation was set at 0. 05. In addition, the statistical description was conducted by an outside observer, namely SPSS Incorporated of Chicago, Illinois.
A final fourth indicator of a quality qualitative research was the fact that the research had a minimal impact on the setting. Since the questionnaires were distributed through the nurse supervisors, and completed during the spare time of the nurse participants, the likelihood of the study impacting the nurse work setting directly is minimal. While there are at least four indicators of a quality research found within this research document, not every indicator specified is readily apparent.
For example, documentation of the methods used to establish trustworthiness was not clearly established, In addition, practices ensuring the confidentiality and privacy of the participants were not clearly documented. Based on the information provided, there would be a number of opportunities where the responses to the questionnaire could have been viewed by outside or even interested parties. While there is no evidence of this occurring, there is little documentation of the steps taken to prevent it by the researchers.
In conclusion, the researchers who conducted this research study exhibited a number of indications that this study was a qualitative one. These included well developed questions, a well defined sample set, well established data synthesis practices, and evidence of a minimal effect on the sample environment. However, a number of criteria were either not addressed or documentation of such practices were not recorded in the report. Because of this, it cannot be concluded that this study can be placed squarely in a high quality category.
References Kruger BJ, Toker KH, Radjenovic D, Comeaux JM, Macha K. (2009) “School nursing for children with special needs: Does number of schools make a difference? ” Journal of School Health 79: 337-346. Odom, S. L. , Brantlinger, E. , Gersten, R. Horner, R. , Thompson. , Harris, K. (2004) “Quality Indicators for Research in Special Education and Guidelines for Evidence Based Practices: Executive Summary” Task Force on Quality Indicators for Special Education Research Division for Research Council for Exceptional Children