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Strategies to Achieve Strong Response Rates to Surveys
Page 16 Within REACH Strategies to Achieve Strong Response Rates to Surveys Kim Carter, PhD, RN, NEA-BC, Senior Director, Nursing Research, EBP & Excellence
Nurse researchers often use surveys as a cost-effective strategy to measure knowledge, attitudes, and perceptions about topics that affect nursing practice and patient care 1,2
. Although survey findings inform health policy and care delivery, low response rates to surveys are a consistent challenge for survey researchers in healthcare 2
. Technological advances in business have introduced the opportunity for administration of surveys using computer and web-based strategies 3
. However, regardless of the methodology implemented to administer the survey, use of random sampling and strong response rates decreases nonresponse bias (the threat that those who do not response are different from those who do respond) and increases confidence in the results being a reflection of the population 2-4
. Nurses and other healthcare workers are bombarded with requests to complete surveys, so it is important to incorporate a solid plan for achieving a strong sample size into the study design to ensure that the study achieves meaningful and generalizable data.
In a meta-analysis of strategies to improve response rates by health care professionals, Cho and colleagues noted that monetary incentives improve participation 2
. While a $1.00 incentive may be enough to encourage response, higher incentive amounts over $30.00 were needed to achieve a 60% response rate 2
. This cost must be factored into the overall cost of the study, and the amount will be considered by the IRB to ensure that coercion is not a threat and that potential risks of study participation are not overshadowed by the amount of the incentive 2
. Other studies have similarly found that small monetary incentives improve nurse response rates, but nonmonetary tokens, like pencils and pens, are less effective for nurses and physicians 1 .
Consideration of how the survey is delivered and follow-up strategies will also enhance survey response rates 1,2
. In a 2013 meta-analysis 2
, Cho noted that higher response rates were achieved with postal surveys. The literature incorporated into their review would now be over a decade old; therefore, it is possible that the preference for mailed paper surveys has changed. Cho suggests that a mixed approach using multiple survey completion alternatives (mailed and electronic) offers the most flexibility to allow completion at the respondent’s convenience 2
. Hoddinott & Bass propose that the Dillman Total Design Survey Method is an effective approach to achieve strong survey response rates 5
. Bogue and Carter used a modified version of the Dillman approach for survey research (manuscript under development) at Carilion, achieving a strong sample size. The Dillman method consists of multiple steps in the survey methodology, including prenotification by a key organizational leader, specific instructions, a means for removal of identifiers and ensuring anonymity, how the questions are presented, color of ink/font, and a precise pattern for follow-up at one, three, and seven weeks 5
. Personalized prenotification and sponsorship is useful 3 , especially when surveys are sent through programs such as REDCap, to assure the participant that the survey email and link are legitimate.
Reminders and prompts are effective 1 .Very specific details should be thoughtfully attended to when planning survey studies. For example, VanGeest & Johnson’s systematic review of how to improve response rates illustrates the impact of type of mailing, noting that first class postage did not result in improved response rates, but certified mail yielded better response. Careful attention to the wording of the reminder is important, and the reminder is most effective if the survey tool or link is again included with the reminder, rather than expecting the recipient to track down the previous invitation and survey 1 .
New and innovative approaches to conducting surveys are arising, such as using web-based bulletin boards and other forms of social media 3
. These approaches allow for more qualitative data collection and may reach groups that may not participate in typically designed survey studies. Survey fatigue is an ongoing challenge, which underscores the need to careful consideration that only well-designed and meaningful surveys, with the minimum number of items necessary, are administered.
Nurses as a group may be homogeneous (similar) because of their shared knowledge, education, and employment 1
. However, efforts to encourage strong response rates will improve the confidence in and usefulness of survey findings.
References
1. VanGeest, J. & Johnson, T. 2011. Surveying nurses: Identifying strategies to improve participation. Evaluation and the Health Professions, 34(4), 487-511. 2. Cho, Y., Johnson, T., & VanGeest, J. 2013. Enhancing surveys of health care professionals: A meta-analysis of techniques to improve response. Evaluation and the Health Professions, 36(3), 382-407. 3. Cope, D. 2014. Using electronic surveys in nursing research. Oncology Nursing Forum, 41(6), 681-682. 4. Taherdoost, H. 2017. Determining sample size; How to calculate survey sample size. International Journal of Economics and Management Systems, 2. 5. Hoddinott, S. & Bass, M. 1986. The Dillman Total Design Survey Method: A sure-fire way to get high survey return rates. Canadian Family Physician, 32, 2366-2368.
Gotta complete that survey!
Courage!
Sara Wohlford, MPH, RN Carilion Clinic Emergency Department American Journal of Nursing (AJN) Mentored Writing Award
Sara was selected as the winner in the 2019 Nurse Faculty Scholars Mentored Writing Award Program for her article, “Increased nursing engagement improves sustainability outcomes for healthcare”. This is an annual program to promote mentorship and develop scholarly writing skills among nurses. It was conceived by the 2012-2015 cohort of The Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars Program to continue the legacy of mentorship and to support scholarship development for all nurses, and AJN is continuing this program as part of their mission to support excellence in nursing publishing. Kim Carter was Sara’s mentor for this submission and Nathalia Esteves-Fuentes was a co-author of this paper scheduled to be published in 2020.
Commitment!
Cathy Jennings, DNP, RN, ACNS-BC CRMH Cardiac Surgery Distinguished Fellow of the National Academies of Practice in Nursing (NAP)
A Distinguished Pracitioner, Scholar or Policy Fellow within NAP is a very high honor that acknowledges outstanding achievements in the Field of Nursing. Cathy will be inducted during a black tie Gala at the 2020 Annual Meeting and Forum in San Diego, CA where she will be awarded the distinctive NAP medallion. Cathy has tirelessly served the cardiac surgery program at Carilion Clinic for 37 years. Cathy lends her expert research skills and mentoring capabilities throughout the Carilion system. *Update - Due to the COVID-19 restrictions in place the gala has been cancelled with no estimated date of rescheduling.
Commitment!
Phyllis Whitehead, PhD, APRN, ACHPN, RN-BC Distinguished Fellow of the National Academies of Practice in Nursing (NAP)
A Distinguished Pracitioner, Scholar or Policy Fellow within NAP is a very high honor that acknowledges outstanding achievements in the Field of Nursing. Phyllis will be inducted during a black tie Gala at the 2020 Annual Meeting and Forum in San Diego, CA where she will be awarded the distinctive NAP medallion. NAP members work collaboratively as an interprofessional community to influence and promote national health policy, legislation, quality healthcare, and research. Phyllis has committed herself to finding better ways to address moral distress and burnout in staff, as well as new opportunities in researching pain management in palliative care. Update - Due to the COVID-19 restrictions in place the gala has been cancelled with no estimated date of rescheduling.
Collaboration!
.Charles Bullins, II, DNP, RN Cardiac Surgery Acute Care Nurse Pracitioner Team Appointed as New Chair of Adult-Gerontology Acute Care Nurse Practitioner Content Expert Panel
The American Nurses Credentialing Center (ANCC) has appointed Charles as the new Chair of Adult - Gerontology Acute Care Nurse Practitioner Content Expert Panel. The appointment will be from October 1, 2019 to December 31, 2021. Charles is committed to the process of bringing gold standard cardiac care resuscitation practices to the bedside of CRMH patients, through the implementation of Cardiac Surgery Advanced Life Support practices. Charles was also recently elected Vice President of the Virginia Nurses Association - Chapter 2 Roanoke Valley. *Update -Due to the COVID-10 restrictions in place the induction scheduled for March 2020 has been postponed
Compassion!
Lia Boggs, BSN, RN, CPN Carilion Clinic Department of Pediatrics March of Dimes 2019 Virginia Nurse of the Year Award Pediatric Award Recipient
The March of Dimes Nurse of the Year award honors extraordinary nurses in our area who go above and beyond to deliver compassionate care. There were 120 nurses nominated from across the state of Virginia, 8 of those nurses were from Carilion. The remarkable efforts of these individuals often go unsung and through the March of Dimes Nurse of the Year Award, they are able to honor those who make a difference in the lives of so many.
Compassion!
Lisa Dishner, MSN, MHA, RN-BC, NEA-BC, PRS Carilion Rehab - Child & Adolescent Health March of Dimes 2019 Virginia Nurse of the Year Award Behavioral Health Award Recipient
The March of Dimes Nurse of the Year award honors extraordinary nurses in our area who go above and beyond to deliver compassionate care. There were 120 nurses nominated from across the state of Virginia, 8 of those nurses were from Carilion. The remarkable efforts of these individuals often go unsung and through the March of Dimes Nurse of the Year Award, they are able to honor those who make a difference in the lives of so many.
Compassion!
Garrett Lawhorn, BSN, RNC-OB, C-EFM Carilion OBGYN Maternal Fetal Health March of Dimes 2019 Virginia Nurse of the Year Award Women’s Health Award Recipient
The March of Dimes Nurse of the Year award honors extraordinary nurses in our area who go above and beyond to deliver compassionate care. There were 120 nurses nominated from across the state of Virginia, 8 of those nurses were from Carilion. The remarkable efforts of these individuals often go unsung and through the March of Dimes Nurse of the Year Award, they are able to honor those who make a difference in the lives of so many.
Collaboration!
.Brandon Jones, MSN, RN, CEN, NEA-BC Carilion Administration - Patient Experience Secretary of the Commonwealth Board Appointments: Board of Nursing
Govenor Ralph Northam appointed Brandon to the Virginia Board of Nursing. His first term will be through June 2021
Allison Parkhurst, BSN, RN and Kara Gibson, RN presented their Nursing Staff Satisfaction on Quality of Care Using a FIM-Based Acuity Tool at the November 2019 ARN conference. The poster focused on the increased acuity challenges on acute in-patient rehabilitation units. They studied the use of an evidence based acuity tool to ensure optimal patient staffing to help enhance nursing staff satisfaction.
(l-r: Allison Parkhurst, Kara Gibson)
American Medical Rehabilitation Providers Association (AMRPA) 2019 Fall Educational Conference & Expo, San Diego, CA
Allison Parkhurst, BSN, RN also shared her study Nursing Staff Satisfaction on Quality of Care Using a FIM-Based Acuity Tool at the AMRPA fall conference in San Diego, CA. The conference focuses on the latest and most innovative strategies to keep rehabilitation professionals ahead of the curve, provide the highest quality of care, and share advocacy efforts.
American Association of Neuroscience Nurses (AANN) International Neurosciences Nurses Research (INNR) Symposium, Austin, TX
Radford University Carilion assistant professor and Carilion Clinic Research Associate, Chris Huson, PhD, RN presented her study, “Perceived stress, cortisol, and depression in adults diagnosed with postconcussion syndrome at a conference that included nurse researchers from diverse disciplines. The INNR addresses international neuroscience nursing research across the continuum of scientific inquiry: bench/basic research/translational research; and planned, ongoing and completed clinical trials. Attendees heard from more than 30 world leaders in neuroscience nursing research.
Samantha Hall, DNP, FNP-BC, CCRN traveled to Philadelphia to present her study Predictors of 30-Day Readmissions After Cardiac Surgery. She noted it was the largest conference she has attended in her nursing career. The majority of her time was spent in the State of the Art Cardiovascular Care sessions. These sessions covered new guideline updates, advances in cardiovascular care including genetics and technology advances. One of the lectures was about the Apple Heart Study (conducted at Stanford). It focused on how Apple watches are being used to monitor patients irregular heart rhythms, including AFib. Samantha learned that the results of this trial will lay the foundation for further utilization of smart watches and devices to help identify and/or monitor our patients with previously unknown/ undiagnosed AF. She noted this may be potentially valuable in the post-cardiac surgery patients where AF is not an uncommon occurrence.
EBP Immersion - OnSite Workshops, Ohio State University Helen Fuld Health Trust National Institute for EBP in Nursing, Columbus, OH
Kim Carter, PhD, RN, NEA-BC, Desiree Beasley, MSN, RN, CCRN, CCNS, Chris Monk, MSN, RN, NEA-BC, Laura Reiter, MSN, RN, CCRN, CNRN participated in the Ohio State University Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare from March 2-6, 2020. This workshop provides a “deep dive” immersion into evidence-based practice (EBP), which is a “problemsolving approach that integrates the conscientious use of best evidence, clinician expertise and patient preferences to make decisions”. Participants learn the step-by-step EBP process as well as effective strategies for implementing EBP in clinical or academic organization of any size or level of complexity. Working with internationally renowned EBP experts and mentors, our team worked in small groups, receiving individualized attention to successfully identify practice challenges and PICO(T) questions, apply literature search and analysis techniques, and develop an action plan for implementing and sustaining EBP changes.
(l-r: Kim Carter, Desiree Beasley, Chris Monk, Laura Reiter)
Watch future editions of Within REACH for their reflections of the experience and summary of the work that they did while there.
October 2019 - March 2020
Carter, K., Bogue, D. October, 11, 2019. Burnout, exhaustion, and communication: Nursing living the balance. ANCC Magnet ®
Conference, Atlanta, GA
Whitehead, P. October 22, 2019. CNS impact on research, evidence based practice, performance improvement/quality improvement. NACNS Webinar. https://nacns.org/professional-resources/ education/archived-webinars/
Bond, D. March 10-13, 2020. Respiratory compromise -The CNS’s voice at the table. NACNS Annual Conference, Indianapolis, IN Jennings, C., Andrews, S., Armbrister, D., Blaukovitch, S., Bolling, K., Bullins, C., Cardenas, A., Fisher, C., Holman, S., Huddleston, D., Joseph, M., Massey, K., Motley, J., Shelton, L., Sink, D. March 5, 2020. Timely ventilator weaning and extubation after cardiac surgery. Carilion Quality Conference, Roanoke, VA
Bishop, S., Klawonn, N., Saville, L. March 12-14, 2020. Development of a consult service within a large hospital system. Perioperative Medicine Summit 2020, Society for Perioperative Assessment and Quality Improvement (SPAQI), Orlando, FL.
Ward, C. March 10-13, 2020. Nursing burnout with substance using inpatients: A new hope. NACNS Annual Conference, Indianapolis, IN
Whitehead, P. March 10-13, 2020. CNS impact on research, evidence based practice, performance improvement/quality improvement. NACNS Annual Conference, Indianapolis, IN
Whitehead, P. March 10-13, 2020. The impact of moral injury/moral distress upon your clinical nurse specialist practice. NACNS Annual Conference, Indianapolis, IN
Wiseman, S., Harvey, E., Bower, K.L. December 2019. Direct peritoneal resuscitation: A novel adjunct to damage control laparotomy. Critical Care Nurse, 39(1), 37-46.
Clark, R., Jennings, C., Carter, K. January 2020. Being a research mentor: A qualitative study. Journal of Nursing Administration, 50(1),16-21.
Ward, C. January-February 2020. EditorialReflections on caring for an aging parent. MedSurg Nursing, 29(1), 7 & 55.
Parkhurst, A., Gibson, K. November 6-9, 2019. Nursing staff satisfaction on quality of care using a FIM-based acuity tool. Reach 2019: Association of Rehabilitation Nurses (ARN), Columbus, OH.
Bond, D., Robinson, D. March 5, 2020. Accuracy of counted respiratory rate, opioid administration, and impact on early warning systems. Carilion Quality Conference, Roanoke, VA.
Bailey, B., Hudson, J., Carter, K. March 5, 2020. The use of an early warning system to improve patient outcomes. Carilion Quality Conference, Roanoke, VA
Bath, J. October 2019. Accepted by the American Nurses Credentialing Center (ANCC) to participate as an Item Writer, who will contribute questions that appear on ANCC certification exams and continuously participate in ANCC test development for a full 36 months.
Bullins, C. November 2019. Appointed by the American Nurse Credentialing Center (ANCC) as New Chair of Adult-Gerontology Acute Care Nurse Practitioner Content Expert Panel.
Wohlford, S. 2019. Awarded the American Journal of Nursing Mentored Writing Award. Mentor - Kim Carter. Co-Author - Nathalia Esteves-Furentes.
Boggs, L., November 2019. Awarded 2019 March of Dimes Virginia Nurse of the Year - Pediatric Award Recipient -Winner
Dishner, L. November 2019. Awarded 2019 March of Dimes Virginia Nurse of the Year - Behavioral Health Award Recipient -Winner
Lawhorn, G. November 2019. Awarded 2019 March of Dimes Virginia Nurse of the Year -Woman’s Health Award Recipient -Winner
Sawyer, A. November 2019. Awarded 2019 March of Dimes Virginia Nurse of the Year - Pediatric Award Recipient - Runner-up.
Jones, B. October 2019. Appointed by Govenor Ralph Northam as his Administration Appointment for the Board of Nursing.
Jennings, C. March 2020. Elected as a Dinstinguished Fellow of the National Academies of Practice (NAP) in Nursing.
Whitehead, P. March 2020. Elected as a Dinstinguished Fellow of the National Academies of Practice (NAP) in Nursing
Carilion nurses nominated for the 2019 March of Dimes Virginia Nurse of the Year award included: A. Henry - NICU C. Tueller - Peds, Postal Ave. C. Ratliff - Infusion Center J. Redden - OR Services
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