Qualitative Interviews
A qualitative description (QD) approach was employed for the analysis of
qualitative data. QD yields pragmatic and straightforward descriptions
that stays close to the language of informants with minimal
interpretation from investigators.17 The QD approach
aligns with the goals of this mixed-methods study since it is applicable
for needs assessment as well as intervention development and
refinement.17 Individual semi-structured interviews
with open-ended questions (Appendix B ) were used for data
collection focusing on the clinician and key-stakeholder experience of
the implementation process. Interviewees were selected through
purposively sampling clinicians and key stakeholders who had experience
with project implementation and use.18,19 The only
exclusion criterion was if clinicians and key stakeholders declined to
participate in the interviews. Interviews were conducted either in
person or on the phone by both an independent research assistant who was
not previously involved with project implementation, its use, or with
the ICU, as well as an ICU nurse with previous qualitative research
experience. Interviews were digitally recorded, transcribed verbatim and
anonymized.
Analysis
Quantitative data were analyzed using descriptive statistics while
qualitative data was analyzed in triplicate using the qualitative
content analysis, according to the QD approach.20 No
preconceived themes were derived prior to interviews, and codes were
collected directly from the interview transcripts. These codes were
updated regularly after each interview in order to determine when the
saturation point in the data collection process was attained in which no
new codes were identified, and new themes emerged
infrequently.19 Three investigators (BT, LS, EY)
independently reviewed the 12 transcripts in a process of open coding.
The codes were sorted and organized into clusters and upon looking for
commonalities and differences among the data, themes were derived from
the various categories. After thorough reflection and analysis, the
investigators came together with their own insights and discussed
potential relationships in light of existing knowledge.
To enhance the trustworthiness and credibility of the analysis, data
were triangulated by involving a heterogenous sample of participants
from different disciplines and varied ICU experience. In addition,
member checking involved emailing the final results to interviewees and
researchers to allow for comments and verification.