NR 300A Week 6 Independent Study Methods Note Example

Methods Note: How the Sensory Aid Evidence Was Gathered and How the Admission Checklist Was Tried on 10 Admissions

Student Name

College of Nursing, Chamberlain University

NR 300A: Directed Independent Study

Instructor Name

Month Day, Year

Methods Note: How the Sensory Aid Evidence Was Gathered and How the Admission Checklist Was Tried on 10 Admissions

Purpose of This Note

This note reports what was done in the study, in the order it was done, including the attempts that did not work. It does not argue for the checklist; that is the job of the evidence summary. Differences from the approved outline are stated where they occur.

Stage 1: The Literature Search, Week 2

Inputs: the question approved in the outline; access to PubMed and CINAHL through the university library; a 30-minute consultation with a librarian on the Monday of Week 2.

The first search, run before the consultation, combined sensory impairment with hospital and older adult. It returned more than 2,000 records in PubMed, most of them about screening for hearing or vision loss, which the outline had excluded. I abandoned it. With the librarian, I rebuilt the search around the aids themselves: hearing aid, hearing loss, eyeglasses, visual impairment and dentures, each combined with hospitalized or inpatient and with aged or older adult, limited to English and to 1995 onward. That search returned about 300 records across both databases after duplicates were removed. Title screening left 31 abstracts to read; 11 of those went to full-text review, and 8 were retained. The three most common reasons for exclusion were a community rather than hospital setting, a focus on screening, and pediatric patients.

Output: the annotated bibliography submitted at the end of Week 2. One source, the systematic review by Shukla et al. (2019), was obtained by interlibrary loan and arrived two days late, which delayed the Week 3 literature summary by three days, as reported in the Week 4 memo.

Stage 2: Building the Checklist, Weeks 3 and 4

Inputs: the unit's electronic admission property form; the unit's property log for the previous three months, with identifiers removed by the nurse manager; the literature summary.

My first plan was to add the checklist questions directly to the electronic property form. In Week 3, I asked the unit's informatics liaison whether this was possible and learned that staff cannot edit the form and that changes go through a request process with a waiting period of several months. I abandoned that route, as the outline had anticipated, and wrote the checklist as a single printed page to be stapled to the front of the admission packet, placed alongside the electronic form rather than replacing it. I chose a page that sits with the packet over a laminated bedside card because Arifaj et al. (2025) had reported low completion, under one in five, for a stand-alone bedside checklist, and I judged that a page already in the nurse's hand at admission was more likely to be used.

The fork on the hearing check, marked as an open decision in the Week 5 draft, was settled by the sponsor on the Wednesday of Week 5: the nurse asks the patient to confirm they can hear clearly, rather than running a repetition test. The whiteboard wording was standardized as proposed, with a line printed at the bottom of the page for copying.

Output: checklist version 1 (Week 4), unchanged through the trial except for the standard whiteboard line, added before the first trial admission.

Permissions and Data Handling

Before the trial, I confirmed with the nurse manager by email, in Week 1 and again in Week 4, that the trial was a usability check of a paper form during normal admissions and not a study of patients. The manager agreed that no patient consent was needed because the checklist asked only the questions the admission property form already covers and recorded nothing about the patients themselves. The tally sheets were kept in a locked drawer at the charge desk during the trial and were shredded after the counts were entered into a spreadsheet on my personal laptop, which held only the counts and the reasons for skips. The sponsor was copied on the Week 4 email.

Stage 3: The Usability Trial, Weeks 5 and 6

Inputs: checklist version 1 with the whiteboard line; the nurse manager's email permission; two night-shift colleagues who had agreed in Week 1; a tally sheet with one row per admission and one column per checklist item, recording done, skipped or not applicable, and a free-text reason for any skip. No patient names, record numbers, ages beyond "65 or older," or clinical details were recorded.

The trial started on the Thursday of Week 5, earlier than the outline planned, as the sponsor approved in response to the Week 4 memo, and ended on the Saturday of Week 6. The trial included any admission of a patient aged 65 or older to the unit during the shifts of the three participating nurses. Ten admissions were reached: four of mine and six of my colleagues'. I timed the four I completed myself with a watch, from picking up the page to writing the last item, because the sponsor agreed that my colleagues would record completion only.

What the Trial Produced

Aids present across the 10 admissions: glasses, 7 patients; hearing aids, 3 patients; dentures, 4 patients.

All applicable items completed: 6 of 10 admissions.

Items skipped: handoff, 3 times (reason recorded each time: "forgot at report"); whiteboard, 2 times ("marker missing," "patient asleep, did later" with no record of later); hearing aid battery or charger question, 1 time ("family took bag home").

Hearing aids missing or not working on arrival: 1 patient, whose left aid had a dead battery. The pocket amplifier was used for the admission conversation. The reverse stethoscope method was not used in any admission.

Time to complete, my four admissions: 2, 3, 3 and 4 minutes.

Dentures found without a labeled cup: 2 of 4 patients, both arriving from the emergency department with dentures wrapped in tissue; both were placed in labeled cups.

Differences From the Approved Method

Trial start: moved from Week 6 to the second half of Week 5, approved by the sponsor.

Timing: recorded for my own four admissions only, not all ten, approved by the sponsor.

Checklist location: a printed page stapled to the admission packet, not an addition to the electronic form, because the form could not be edited.

The reverse stethoscope step: included on the checklist as planned, but not used, so the trial produced no information about it. Hodson et al. (2024) remains the only evidence for it in this study.

References

Arifaj, B., Shakeel, A., Nyam, L., & Sansom-Ninnes, K. (2025). Improving staff awareness of sensory aid needs and dementia status in an old age ward. BMJ Open Quality, 14(4), Article e003369. https://doi.org/10.1136/bmjoq-2025-003369

Hodson, A., Clancy, N., & Foo, I. (2024). The reverse stethoscope technique: A rapid intervention for old age hearing loss. Hospital Practice, 52(1-2), 23-28. https://doi.org/10.1080/21548331.2024.2320067

Shukla, A., Nieman, C. L., Price, C., Harper, M., Lin, F. R., & Reed, N. S. (2019). Impact of hearing loss on patient-provider communication among hospitalized patients: A systematic review. American Journal of Medical Quality, 34(3), 284-292. https://doi.org/10.1177/1062860618798926