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.