The Advanced Practice Nursing Data Collection Toolkit: A Compendium of Research Tools

Julie U. Vohra, MSc; Denise Bryant-Lukosius, MScN, PhD


October 07, 2009

In This Article

Tips for Selecting Structure, Process and Outcome Variables, and Measurement Tools

Before selecting a measurement tool, it is helpful to identify the stage of APN role development (ie, which step of the PEPPA framework) that will be studied. The PEPPA step can then guide information needs and the types of structure, process, and outcome variables that should be examined. PEPPA steps 1-6 focus on establishing role structures, including decision-making and planning the development and implementation of an APN role, as well as other potential improvements to the existing model of care. Step 7 focuses on role processes, initiating the implementation plan, and introduction of the APN role. Steps 8 and 9 include the short and long-term evaluations of the APN role, and the new model of care to assess progress and sustainability in achieving desired outcomes. Table 1 describes each of the 9 steps of the PEPPA framework, and provides examples of research questions to consider when identifying information needs and measurement variables or selecting data collection instruments.

The PEPPA framework recommends a formative approach to evaluation of APN role outcomes.[7] With this approach, selected role structure and process variables, identified as important for achieving targeted outcomes, are also measured. This approach provides a more meaningful evaluation compared with approaches that only measure outcome variables because structure and process data can help to explain why specific outcomes may or may not have been fully achieved, and can inform recommendations for enhancing the APN role and/or other aspects of care delivery.

Byers and Brunell[12] provide helpful guidelines for selecting APN evaluation tools or measures of role significance, range, quality, and feasibility. Significant measures are those that provide the most useful and relevant data to APN stakeholders and APN role priorities. Preference should be given to measurement tools that measure factors under the control of the APN, have the scope to examine variables with the necessary breadth or depth, and the ability to discriminate differences in performance (sensitivity). Other considerations include the validity and reliability of the measurement tool, and its ability to account for confounding factors. Tool selection should also consider practical and feasibility issues for implementation, the need for resources and potential costs, and the ability to access data. Other factors to consider are the extent to which measurement tools reflect best practices or gold standards.

Identifying Tools

Instruments for inclusion in the Toolkit were identified through a systematic search of the literature. Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982-2008), Excerpta Medical Database (EMBASE) (1980-2008), and Medical Literature Analysis and Retrieval System Online (MEDLINE) (1950-2008) were searched using the following keywords: "advanced nursing practice," "advanced practice nursing," "advanced practice nurses," "nurse practitioner(s)," "clinical nurse specialist(s)," "nurse clinicians," "nurse anesthetists," "Canada," "United States," "Great Britain," "Australia," and "New Zealand."

Instruments were selected if they were used in APN research and it was possible to obtain a copy of the tool. All obtained instruments were included in the Toolkit, without the use of any methodological filter. A summary of each instrument was prepared that included all information that could be gleaned about the tool. A missing heading in a tool summary means that no information was available. Tools for which available information is limited should be used with caution.

Where possible, our summary of each instrument was reviewed by the tool's author for accuracy and completeness. It is very likely that these tools require further development, and reliability and validity testing. The APN Data Collection Toolkit is not intended to be an exhaustive list of all instruments used in APN research nor does it judge which tool would be best for a specific study.

Toolkit Overview

The Toolkit is organized using the steps of the PEPPA framework, and data collection tools are further categorized by topic. Information regarding each instrument includes: the tool's citation; PubMed links to full-text articles or abstracts; author contact information, price, and availability; a description of the instrument; all available information about the administration, scoring, and psychometric properties of the instrument; a summary of strengths and limitations; other APN research that used the tool; and any related research articles. In addition, where authors have granted permission, a Portable Document Format (PDF) of the instrument is provided.

The Toolkit is a work in progress. More instruments will be added as summaries are completed. Moreover, anyone interested in submitting an original research instrument can do so via the "Contact Us" page of the Toolkit Website. Minimum information required for a new tool includes the name of the instrument and the citation of the published APN study in which the instrument was used.


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