Quasi-experimental Research Design
A quasi-experimental research design will be used to determine the effectiveness of tight glycemic control to manage vascular complications of diabetes. Like a true experiment, quasi-experimental designs aim at establishing a cause-and-effect relationship between variables (Cohen et al., 2018). As a quantitative research method, this approach will ensure the collection of reliable and accurate data to explain the relationship between the independent and dependent variables. Additionally, this design will provide quick data collection and utilize a wide scope of data analysis to improve the accuracy of observed results. The choice of this research design is based on two critical points; ethical and practical reasons. For instance, it is unethical to provide an intervention to certain patients while limiting the same intervention to others as observed in true experiments (Cohen et al., 2018). A quasi-experimental design will allow the study of the same causal relationship without ethical issues. Practically, a quasi-experimental design will be less expensive compared to true experiments.
The effectiveness of tight glycemic control to manage vascular complications of diabetes has been published previously. This study will further expand the effectiveness of the intervention to address vascular complications among elderly patients. The initial steps of conducting the research will involve reaching a consensus among the nursing department, medical-surgical patient division, and clinical pharmacy division to implement the glycemic control protocol. Based on the findings from the literature, an intravenous glucose protocol to ensure maintenance of A1C blood glucose levels between 6.5% to 7.0% (tight glucose control levels) will be initiated (Zimmerman, 2016). To compare the results, the second group will involve patients under the intermediate glycemic control protocol (7.5% and 8.0%) that is often used as the standard glucose control among diabetic patients (Zimmerman, 2016). Insulin doses will be adjusted by nurses based on the blood glucose levels collected from patients using a standardized glucometer.
The patient population selected for this study will include the elderly, aged 65 years and above with diabetes. The medical and surgical units will be used for this research because they harbor most patients with diabetes with only a few with major complications transferred to the intensive care unit. Based on the patient population in the two departments, the estimated sample size for this study will be 60 patients. The patients will be divided into two groups of 30 each with the first group receiving tight glycemic control intervention and the second receiving standard glucose control therapy.
Sampling of patients will use the non-probability approach to ensure selected patients have the required characteristics. To effectively identify the participants, convenience sampling will be applied to obtain data and trends regarding the study without the complications of randomized samples. Data collection during the study will involve accurate documentation of blood glucose levels of patients in the tight glucose and intermediate glycemic control categories. The period of achieving glycemic control in the first group will be recorded including anticipated complications like hypoglycemia and hypotension. The second category of data will involve patients developing vascular complications like nephropathy, neuropathy, and retinopathy during the treatment period. The number of patients requiring special attention like transfer to the ICU from both groups will be recorded including any deaths due to vascular complications.
Power Analysis, Validity, and Reliability
Power can be calculated and reported to comment on the confidence one might have in the conclusions drawn from a study. During hypothesis testing, statistical power helps researchers to find an effect that can lead to conclusions (Cohen et al., 2018). The effectiveness of the testing is based on parameters like effect size, sample size, significance, and statistical power that enable one to make conclusions. Power analysis involves estimating one of these four parameters given values of the other three parameters. For example, power analysis can be used to calculate the minimum sample size for a study. It helps answer questions regarding the statistical power of a study and how big a sample is needed to elicit the desired response.
Validity and reliability are concepts used to evaluate the quality of research by indicating how well a method or test measures something. Validity refers to how well an instrument measures what it is intended to measure and is divided into internal and external validity (Cohen et al., 2018). Internal validity deals with how well the research findings match reality while external validity indicates how well the research findings can be applied to other environments. Reliability refers to the consistency of an instrument to measure something (Cohen et al., 2018). Obtaining similar results under the same circumstances indicates that a tool or test is reliable.
Human Protection, Informed Consent,and Ethical Research
The participation of human subjects in research presents a challenging ethical dilemma because of the risks involved. Human protection during research involves the protection of the patient’s rights, information, and ensuring the research serves to benefit the participants (White, 2020). To ensure human protection during this research, I will submit my proposal to institutional review boards to ensure it meets appropriate ethical guidelines. Regarding the aspect of informed consent, I will explain the potential benefits of the research to the participants and seek approval from each prospective subject (Gelling et al., 2021). Documentation of the informed consent will be necessary and adequate monitoring of data will ensure the safety of subjects.
Ethical nursing research involves following the moral principles to ensure the rights and welfare of individuals during studies. Submitting the research to ethical review boards is one of the steps to ensure research is conducted ethically (Gelling et al., 2021). Secondly, analyzing the risks versus the benefits of the research allows for the preparation and designing processes to minimize anticipated risks.
Cohen, L., Manion, L., & Morrison, K. (2018). Research methods in education. London: Routledge, Taylor & Francis Group.
Gelling, L. H., Ersser, S. J., Heaslip, V., Trenoweth, S., & Tait, D. (2021). Ethical conduct of nursing research. Journal of Clinical Nursing, 30(23-34), e69-e71. https://doi.org/10.1111/jocn.16038
White M. G. (2020). Why human subjects research protection is important. The Ochsner Journal, 20(1), 16–33. https://doi.org/10.31486/toj.20.5012
Zimmerman, R. S. (2016). Diabetes mellitus: Management of microvascular and macrovascular complications. J Cleveland Clinic: Centers for Continuing Education. https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/diabetes-mellitus/
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