Nursing Dissertation Methodolgy Paper on Instrument Assignment

Instrument Assignment


Patient satisfaction has emerged as a pointer of quality care and has become a major aspect that necessitates attention in outcomes research. Outcomes study should as well concentrate on evaluating health involvements which will be delineated in this research as the patients’ perception of the implementation of Press Ganey Survey. Press Ganey Survey is believed to influence contentment and quality care. The outcomes of this research will inform and help hospitals and nursing practitioners in building a health care system that conveys quality care and advances patient satisfaction. The cultural diversity and patient satisfaction information will be analyzed by applying descriptive statistics. The coefficient of variation will as well be used to create unit-level diversity variables for cultural diversity elements. The aim of this research will be to study the relationships between patients’ satisfaction as assessed by the Hospital Consumer Assessment of Healthcare Providers Survey (HCAHPS) survey scores, and patients’ opinions as evaluated by the Press Ganey instrument as well as nurses cultural diversity measures by the Cultural Assessment Questionnaire (Wharam & Sulmasy, 2009).


Patient contentment surveys have thrived in the past several decades. The majority of these instruments proves to be invalid and unreliable beyond certain settings and populations. These satisfaction instruments have differed considerably in content, system of application, sampling techniques and application protocol making generalizability complicated at best (Hobbs, 2009; Polit & Beck, 2008). This study will apply the HCAHPS survey and the Press Ganey Survey that is considered as standardized tools that incorporate these factors in assisting to identify indicators of patient satisfaction.

Patient Satisfaction

As observed, patient satisfaction is usually regarded as a significant element in evaluating the quality of care (Jha, Orav, Zheng, & Epstein, 2008). Hospitals are concentrating on quality care as is prescribed by the government and major leading healthcare agencies; thus, patient satisfaction is an aspect that requires being assessed. For this research, the scores made on the Hospital Consumer Assessment of Health Providers Survey evaluated patient satisfaction. The principle of the HCAHPS tool is to present a standardized survey tool and data collection methodology for evaluating patients’ opinions on quality care. Before the HCAHPS survey, there was no nationwide standard for measuring or freely reporting patients’ opinions of their hospital care experiences (Weech-Maldonado et al., 2012). Hence, this study will apply the HCAHPS survey to make equitable comparisons to support patient satisfaction.

Hospital Consumer Assessment of Healthcare Providers survey (HCAHPS)

HCAHPS is a nationally recognized set of questions that can be integrated with wider, tailored set of hospital-specific items. HCAHPS survey items match the data hospitals presently gather to back improvements in internal patient services and quality connected activities (Sahin, Yilmaz, & Lee, 2007). Use of the HCAHPS survey enables researchers to integrate HCAHPS information into their decision-making regarding hospital performances and evaluates whether the information gathered increases hospitals’ accountability. HCAHPS surveys enable researchers asked questions regarding communication with health care providers (receiving positive responses from patient feedback regarding medication effect). Additionally, the application ofHCAHPS survey is associated with several limitations. Potentially, setting off the cost efficiencies related to integrating HCAHPS with other surveys suffer from several statistical concerns that have resulted in concerns regarding whether it is right to merge HCAHPS with other surveys. These entail issues concerning the impact of a longer survey on response rates, the effect of various response options applied in HCAHPS and customer satisfaction surveys, and the effect of adding HCAHPS to the course of patient investigations (Hill & Lewicki, 2006). The reliability and validity of this instrument will be determined by Cronbach’s coefficient alpha such as communication with nurses, the receptiveness of hospital personnel, sanitation and quietness of the hospital, pain management, communication regarding medicines, discharge information will be determined. The median internal consistency reliability will also be determined (Jha et al., 2008).

Press Ganey Survey

There is presently no suitable and reliable instrument in the literature that evaluates the implementation or view of patient satisfaction in hospitals that offer attention to adult patients. However, this study will comprise of eleven hospitals and healthcare institutions comprising five questions. These questions will be included in the HCAHPS core survey that will be administered using the phone interview for this study. These five extra questions will be scaled to imitate other HCAHPS questions with choices for the answers to comprise always, usually, sometimes, and never. Thus, patients surveyed for this study will answer up to 35 full questions (Palese et al., 2011).

Using investigative and confirmatory factor analyses, construct validity will be evaluated and the correlation of the scale to the nurses’ diversity issues scores (Hill & Lewicki, 2006). Personal interviews will be performed to establish the significance of each item to the general hospital satisfaction, additional appraisal of concept validity. Items, which will be rated as unimportant by patients, will be deleted. This procedure will yield 50 percent reduction of items in the original survey constituting the seven domains formerly remarked. These items will be capable of discriminating the level of quality in various hospitals and had similar levels of internal reliability of other assessments exemplifying patient satisfaction (Chang, Hughes, & Mark, 2006).

Nurses Cultural Diversity

Cultural Assessment Questionnaire

The Cultural Assessment Questionnaire will be used as a specific instrument to determine nurse’s diversity issues relevant to motivational, professional, and work-related issues in a multicultural hospital environment. The Cultural Assessment Questionnaire will measure diversity elements picked out as important to the success of hospital staff. The questionnaire will measure age, religion, language, values and beliefs, ethnic background, gender, and race (Wagner & Bear, 2008). A review of nurses’ cultural diversity and the associated clinical (medical perceptions) about diversity issues (age, religion, language, values and beliefs, ethnic background, gender, and race) will be adapted to direct this research followed by a review of the HCAHPS survey (Boev, 2012). However, a review of the literature establishes that no studies have been conducted concerning the nurse cultural diversity. This instrument will fulfil the aim of this research that examines the relationship between nurses’ diversity issues and patient satisfaction, as assessed by the cultural assessment questionnaire.

The study conducted by Wagner and Bear (2008) only used demographic diversity and d-score but failed to include all diverse factors reviewed in this study. This then makes it difficult to find any appropriate instrument to measure these diversity factors nursing practitioners. I could not find any appropriate instrument to measure these diverse factors. I am, however, planning to work with my advisors to create a questionnaire for nurses, which will allow collection of data about all cultural diversity factors. The psychometric aspects of the cultural assessment survey instrument will be studied in the population examined (Wagner & Bear, 2008). This will be achieved by measuring reliability through assessment of the Cronbach’s coefficient alpha. Some benefits of cultural assessment survey entail its assistance to researchers in getting accurate responses from nurses from a wide cultural background. Additionally, the use of this survey is associated with several limitations such as the difficulty of determining whether nurses provide accurate responses.I will consult a statistician to validate the apposite statistical methods of study. Statistical significance will be fixed at the p< .06 level (Gates  & Mark, 2012).


In summary, this section describes the instruments that will be applied to address the research questions posted for this research. Additionally, the section comprises a description of the HCAHPS tool applied to evaluate patient satisfaction and the collection processes to gather the patient satisfaction information. Furthermore, this section outlined methods to evaluate patient perception and nurses’ cultural diversity with the incorporation of questions from the Press Ganey survey to the HCAHPS survey. Patient satisfaction has emerged as a predictor of quality care and has become a major aspect that dictates the attention in the research outcome (Hill & Lewicki, 2006). This study will concentrate on evaluating health involvements, which will be explained in this research regarding the patients’ perception.


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Hill, T., & Lewicki, P. (2006). Statistics methods and applications. Tulsa, OK: StatSoft, Inc.

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