Needs Assessment
A needs assessment can be defined as a systematic approach to exploring the attitude, interest, ability, and state of knowledge of a particular group or audience involving a given subject (McCawley, 2009). In healthcare, needs assessment is the systematic approach to the review of health issues that face a population, resulting in agreed priorities and allocation of resources that will minimize inequalities and improve health. A needs assessment is used to learn about fundamental problems and issues that the public faces so that effective programs can be designed to address those needs (Dyson, Hedgecock, Tomkins, & Cooke, 2009). It is also employed as a strategy to uncover what has already been accomplished and any remaining gaps. This information can be used to guide the making of informed decisions regarding the required interventions (McCawley, 2009). A needs assessment is a tool for change that should be undertaken to ensure the development of a project meets the identified needs (Rossati, 2014).
Data Points
This project is intended to explore the prevention of complications of Foley catheter use in surgical patients. In this regard, the data points that will be needed for assessment include the number of surgical patients with Foley catheters who develop complications, the number of surgical patients with Foley catheters who do not develop complications, and the incidence of complications in surgical patients with Foley catheters. Also, will be included hospital length of stay in these patients, the number of hospital readmissions, and morbidity and mortality in these patients.
Need Assessment Process
A needs assessment is a process that is undertaken in five steps. These project planning steps identify practical activities and qualitative and quantitative research exercises that are meant to ensure a systematic and robust assessment, with tangible results is undertaken. The information gathered from the needs assessment can help inform service delivery and enhance population health outcomes. The process can assist the research team to identify priority areas and the underlying factors influencing population health, and in reaching common ground on appropriate interventions that can ensure positive change (McCawley, 2009).
The first step in the needs assessment is getting started and involves identifying the population, the goals to be achieved, the people to be involved, the necessary resources, and any potential risks (Rossati, 2014). The proposed project focuses on surgical patients with Foley catheters. This population is significantly important because Foley catheter use is common in surgical patients, and complications may result in these patients if appropriate preventive measures are not instituted and implemented (Fink, Gilmartin, Richard, Capezuti, Boltz, & Wald, 2012). The goal of the project is to prevent the potential complications of Foley catheter use in surgical patients to improve patient outcomes and reduce healthcare-associated costs. This project requires the involvement of various stakeholders, including hospital management, nurses, surgeons, operating room personnel, infection prevention team, and patients and their families. Potential barriers to this proposed project may include professional boundaries and territorial attitudes, challenges in maintaining team commitment and impetus, the absence of a shared language between sectors, and lack of engagement from the administration. These barriers can be minimized through open communication, the involvement of all stakeholders, and by ensuring transparency, mutual respect, and trust.
The second step in the process is the identification of health priorities. This step involves population profiling, the collection of data, the perception of needs, and identification and assessment of health conditions and the associated determinant factors (Rossati, 2014). Regarding the proposed project, the research acknowledges that complications of Foley catheter use in surgical patients can lead to poor patient outcomes, prolonged length of hospital stay, and increased healthcare-related costs. With appropriate care, however, these complications can be prevented (Wald, Ma, Bratzler, & Kramer, 2008), and that is the focus of this project.
The third step is assessing a health priority for action. This step entails selecting health conditions and determinant factors whose impact is most significant and severe. It also involves determining acceptable and efficient measures and interventions (McCawley, 2009). For this project, Foley catheter use is often indicated for surgical patients due to the limited mobility following surgery. However, complications, such as catheter-associated urinary tract infections (CAUTI), may arise with the use of Foley catheters in these patients, which may impair postoperative recovery. Hand hygiene, appropriate catheter care, and maintenance, and implementation of a nurse-led catheter removal protocol are some of the efficient and acceptable strategies that can be used to prevent these complications (Fink et al., 2012).
The fourth step is planning for change, and entails clarification of intervention aims, action planning, devising a monitoring and evaluation strategy as well as putting in place a risk-management plan (Rossati, 2014). The researcher will clarify the aims of the intervention to the relevant stakeholders and develop a strategy for monitoring and evaluate the project and for risk reduction. The fifth step is moving on or review. This step is where the researcher learns from the project, measures the impact, and selects the next priority (Cavanagh & Chadwick, 2006). The researcher will review the effects of the project on achieving the goal of preventing complications of Foley catheter use in surgical patients. A change in strategy will be necessary if the goal is not achieved.
A needs assessment is necessary when developing a change management project on the prevention of complications of Foley catheter use in surgical patients. The needs assessment will serve as a tool that provides evidence of the population of interest, which can be used to plan for the implementation of this project. It will also offer an opportunity for the researcher to engage with the population of interest so that they can play a role in targeted service planning and allocation of resources. Also, it offers an opportunity for intersectoral collaboration and the development of active and creative interventions regarding the prevention of complications of Foley catheter use in surgical patients. Conducting needs assessment is associated with some advantages that can benefit this project, including strengthened participant involvement in the making of decisions, enhanced teamwork and collaboration, professional skill development and experience, improved communication with the public and other agencies, and better resource utilization (Rossati, 2014).
Closed-ended Questions
- Do you know indications of Foley catheter use in a surgical patient?
- Yes
- No
- Do you know any alternatives to Foley catheter use in a surgical patient?
- Yes
- No
- Do you know any indications of Foley catheter replacement in a surgical patient?
- Yes
- No
- Do you know the complications associated with Foley catheter use in surgical patients?
- Yes
- No
- Do you know any signs and symptoms of complications of Foley catheter use in a surgical patient?
- Yes
- No
- Do you believe complications associated with Foley catheter use in surgical patients can be prevented?
- Yes
- No
- Do you know any strategies that can be used to prevent complications associated with Foley catheter use in surgical patients?
- Yes
- No
- Do you believe that nurse-driven protocols for Foley catheter removal can help prevent complications of Foley catheter use in surgical patients?
- Yes
- No
- Do you believe you have a role to play in the prevention of complications of Foley catheter use in surgical patients?
- Yes
- No
- Do you believe that healthcare workers should work as a team to prevent complications of Foley catheter use in surgical patients?
- Yes
- No
Open-ended Questions
- What are the indications of Foley catheter use in surgical patients?
- What are alternatives available to Foley catheter use in surgical patients?
- What are the complications associated with Foley catheter use in surgical patients?
- What are the signs and symptoms of complications of Foley catheter use in surgical patients?
- What are the consequences of complications of Foley catheter use on surgical patients?
- What impacts can complications of Foley catheter use in surgical patients have in the hospital?
- What strategies do you believe can be used to prevent complications of Foley catheter use in surgical patients?
- What role do nurses have in the prevention of complications of Foley catheter use in surgical patients?
- What do you think is the role of the healthcare team in preventing complications of Foley catheter use in surgical patients?
- What impact do you think prevention of complications of Foley catheter use would have in surgical patients?
Closed-ended versus Open-ended Questions
Closed-ended questions need respondents to select among a set of given response options. Regarding the development of actual research questions and data analysis, closed-ended questions are easy and simple to develop, and quick to analyze (Roberts et al., 2014). Conversely, open-ended questions allow subjects to respond to their words. They are likely to generate responses that provide a personal perspective of the respondent’s thinking. The open-ended question also ensures non-reactivity, in that they do not cut the thinking of respondents in a particular direction (Couper, Kennedy, Conrad, & Tourangeau, 2011).
The primary concern regarding open-ended questions is that they need the respondent to articulate a response rather than their underlying attitudes. Also, non-responses to open-ended questions are likely to arise from ineloquence but not indifference; respondents may fail to respond to open-ended questions because they do not have the required rhetorical device (Roberts et al., 2014). Therefore, unlike closed-ended questions, open-ended questions are more troublesome to answer and need extensive coding (Emde, 2014). Moreover, open-ended questions generate responses that harder to analyze compared with close-ended questions because they require extensive human coding (Roberts et al., 2014).
Both open-ended and closed-ended questions can be used in a needs assessment in this project. Close-ended questions can help in needs evaluation regarding what the researcher believes is relevant to the prevention of complications of Foley catheter use in surgical patients. Conversely, open-ended questions can provide a more detailed perspective of what the respondents believe is important concerning the prevention of complications of Foley catheter use in surgical patients.
Collecting Data and its implied criticism on the importance of Need Assessment
The need to perform a Needs Assessment that ensures that the intervention programs towards eradicating the complications associated with Foley catheter use in surgical patients are implemented proves to be elusive. The process of collecting data begins when the patient is being admitted. Here, the nurses take from the patient the necessary information that would aid in the administration of the whole process. Such information includes the age of the patient, his/her sensory deficiency, the nutrition status, the dehydration rate among other essential information necessary for the process. The information collected or recorded here is critical as it lays the foundation for the health practitioners to assess the contingencies that could be associated with the Foley catheter use as well as the complications associated with its use. The various means that are used in collecting data include the Kardex and EX graph. The process involves collecting both quantitative and qualitative data as soon as the patient is admitted. The information obtained here is critical as it’s used to assess the need for catheter use as well as the possibility of the patient(s) attracting other complications associated with Foley catheter use. A combination of both the qualitative as well as quantitative data is essential for the proper and accurate process of decision making (Noble & Smith, 2015).
Feedback from the Site of Practicum
Before the project’s implementation, an emphasis was put on the various methods that could be deployed in the process of collecting data. This accent was to ensure that the process was free of biases and that that it provided the most accurate information. The stakeholders then vouched for the use of both the qualitative as well as quantitative data collection processes as this would ensure credibility as well as the accuracy of the data collected. The use of questionnaires was agreed upon as a means of collecting data. The surveys include the use of open-ended questions as well as closed-ended questions. The many stakeholders in the healthcare department hold the belief that as a result of a broad spectrum of the various healthcare practices, there is a need to incorporate the open-ended questions in the data collection process (Pope, Van Royen & Baker, 2002). Closed-ended questions were also vouched for by some health practitioners for they helped in providing the requisite information towards the implementation of particular programs. As a result, the open and the questions with closed ends were agreed upon to be used in the process.
Measurement of Validity and Reliability of the Data collected.
There was the need to ascertain the validity and reliability of the quantitative data gathered from this process. The surest way of doing this was to pick on a characteristic that is similar to all or most of the patients in the hospital. The data was then collected from the patients who had shown similar signs and symptoms of the complications of Foley catheter use and compiled. The information obtained here is then used to measure the validity and reliability of the quantitative data collected.
Measurement of trustworthiness in the qualitative data collection
Measurement of reliability here requires the use of a consistent method of collecting information used for a needs assessment. This honesty ensures that the information obtained in the whole process of admission as well as discharging a patient after the Foley catheter administration is accurate and that any complication that could arise as a result of catheter use is properly managed or controlled. This responsibility requires the data collector to be persuasive and that the product of the process be convincing (Elo et al. 2014). The level of trustworthiness in qualitative information takes into account the ability of the information obtained to conform, to be transferable, and how dependable it is to the needed assessment process (Britten, 2012).