METHODOLOGY Methodology is a science of method. It is the set of methods and principles used to perform a particular activity.

It incorporates some of the most important methodological decision that the researcher makes in conducting the research study. The selection of research design is an important step in research as it is concerned with over all frame work for conducting the study. This chapter deals with methodology adopted for the study and includes the research approach, research design, variables, description of setting, population, sample, sampling techniques, sample criteria, methods of data collection, development and description of questionnaire, validity and reliability, pilot study and plan of data analysis. The present study is aimed to assess the knowledge and practices regarding documentation of patient care among nurses at NIMS, Hyderabad, Andhra Pradesh. RESEARCH APPROACH: The research approach is essential part of any research study. The entire study is based on it. The appropriate choice of the research approach depends on the purpose of the research study that is undertaken. A descriptive and retrospective approach was used in assessing nurses' documentation that suits the best for my study. RESEARCH DESIGN: The plan structure and strategy of investigations of answering the research questions. It is the overall plan or blue print, the researcher selects to carry out their study. The research design selected for this study is non experimental descriptive study. The study design shows that the study was conducted as following: Phase 1: Pilot study was undertaken for 10 samples. Questionnaire was given to sample to measure knowledge levels of nurses regarding documentation of patient care. Checklists was provided covering five areas: TPR chart, drug chart, nurses records, I & O char, and doctors rounds book to measure the nurses practice level regarding documentation of patient care. Phase 2: The sample was 100. Administration of questionnaire and check list was done to measure knowledge and practice levels of nurses regarding documentation of patient care. Phase 3: Analysis and interpretation of knowledge levels.

SETTING OF THE STUDY: The setting selected for the present study is Nizam institution of medical sciences, punjagutta, Hyderabad. The Institute serves through 27 Departments. Out of them, 14 are Super Specialties and others are Supporting Departments. The Institute has a bed strength of 946 beds, out of which 603 are in General Wards, 166 in private rooms and 177 in emergency and post-operative care. There is a Separate Emergency Block in the Institute for emergencies and it is one of its kind in India. This functions like a model hospital with all the facilities round the clock. This Emergency contains about 200 Beds. All Major and Minor emergency surgeries are carried out in Traumatology Operation Theatres (Orthopedics, Plastic Surgery, Surgical Gastroenterology and Neurosurgery). The investigator choose this hospital for the study because it is a Super Specialty hospital, serving all age groups, and have a wide scope in collecting information of documentation of patient care in different aspects of care among nurses. POPULATION: A population is an aggregate of elements showing some common setting of criteria. The population of the present study consists of nurses working at NIMS. SAMPLE AND SAMPLE SIZE: Sample refers to the process of selecting a portion of the population to represent the entire population. The sample for the present study consists of 100 nurses who are rendering their service at NIMS, punjagutta, Hyderabad. SAMPLING TECHNIQUE: Simple random sampling technique which is of non-probability sampling technique was adopted for the study. The study was confined to NIMS, Hyderabad. CRITERIA FOR SELECTION: Inclusion criteria: The study includes the nurses who: Were working in NIMS during the time of study. Were willing to participate in the study. Were available at the time of study or data collection. Exclusion criteria: The study does not include the nurses who: Were not willing to participate in the study. Were not available at the time of study or data collection.

DEVELOPMENT OF THE TOOL: The tool was designed with the help of review of literature from various text books, journals, internet websites and discussion with experts in the field of nursing, the investigators personnel experience and consultation with the experts by tool validity. DESCRIPTION OF TOOL: The structured questionnaire was organized in three sections, section A, section B, and section C. Section A deals with the demographic data of nurses such as age, sex, Professional qualification, Designation, Total years of work experience, current area of work experience, attending in-service education program, working beyond scheduled hours for completing documentation, factors inhibiting and facilitating documentation of patient care. Section B consists of questions related to knowledge of nurses regarding documentation of patient care. It consists of 32 multiple choice questions, with four options, out of four one is the right response and it carries one(1) mark and for each incorrect response score 0 was allotted except for question number 22 each option carries 1 mark and correct answer carries 4 marks, with a total of 36 marks for section B. Section C consists of checklist related to practices of nurses regarding documentation of patient care. It consists of 32 questions, which was assessed retrospectively. Yes answer is allotted one (1) mark and no answer is allotted zero (0) marks, with a total of 32 marks for Section C. Score interpretation: The total score of Section B and C is sixty eight (68) marks. The score was categorized into three groups. 0-50% 51-75% 76-75% below average average above average

ETHICAL CONSIDERATIONS: Ethical clearance and permission was obtained from Nizam Institution of Medical Sciences, Ethical Committee, Hyderabad. VALIDITY OF THE TOOL: In content validity, the adequacy of the content is being studied. It is the assessment of instruments ability to measure what it intends to measure, the degree to which the tool reflects the body of knowledge of the concept being studied. The tool has been validated

by a list of 10 experts from field of nursing and nursing administration. Investigator modified tool based on experts suggestions and results of pilot study, and their suggestions were incorporated. RELIABILITY OF THE TOOL: Reliability is used for assessing the tools quality and adequacy. It is the ability of the instrument to consistently measure what it intends to measure. The reliability was elicited by split half method (spearman brown formula). A sample of 10 were given the questionnaire. The obtained data was subjected for the calculation. The r value was found to be 0.88 for knowledge and 0.93 for practices, which indicated that the tool was reliable. PILOT STUDY: The pilot study is a small preliminary investigation of the small character as of the major study, which is designed to acquaint the researcher with the problems that can be correlated in preparation for large research study. Pilot study will be conducted to ensure the availability of sample, practicability, feasibility and appropriateness of the study. The pilot study was conducted at NIMS, Hyderabad from 22-07-2013 to 27-07-2013. The sample was selected for the studies were 10 Nurses. The sample was selected by nonrandom sampling technique i.e.., simple random sample method. The questionnaire was given to the sample of 10 Nurses and check list was retrospectively assessed and was found to be feasible, practicable and appropriate. DATA COLLECTION PROCEDURE: The data is collected from and100 Nurses at Nizam institution of medical sciences, who were selected through simple random sampling technique. The investigator collected data using structured questionnaires. PLAN FOR DATA ANALYSIS Data analysis is the systematic organization of the raw data to give a meaningful output. Analysis and interpretation of the data for the present study is based on data collection from 100 Nurses through structured questionnaire. The data was tabulated, analyzed and interpreted by using descriptive and inferential statistics. The analysis and interpretation of the data were presented under the following sections. After the data collection, the data were entered in the master sheet and the following statistical methods were planned to use for analyzing the data 1. Frequency and percentage would be used to summarize the sample characteristics.

2. Mean and standard deviation would be computed for assessing knowledge and practices. 3. Chi-square values would be calculated find out the association between knowledge and practices of selected variables. 4. Correlation association between the knowledge and practice of nurses regarding documentation of patient care. 5. Item- wise analysis of knowledge and practice questions. 6. The level of significance was set at 5% level of significance.