Research Test 1
Terms
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- What Constitutes a Research Study
- a. Inquiry into a subject or topic b. Answer a Question c. Substantiate Information VS. "it seems that way"
- Steps of the Research Process
- • Identify problem • Evaluate knowledge about problem • Design research to study problem • Interpret and implement results • Evaluate results of implementation
- Know the Relationship among Nursing Process, Problem Solving, and Research Process
- • Are alike in the main components of taking a problem, looking for possible solutions, and then evaluating the outcome to see what conclusions can be made.
- What is evidence based practice?
- • Evidence based practice is nursing based on what has been found through research, expertise, patient values and preferences to be most beneficial. • Evidence-Based Practice is the conscious, explicit, and judicious use of current best evidence in making decisions about patient care. • Interpretation of scientific evidence by an experienced clinician and the synthesizing of new findings with prior practical and scientific knowledge.
- How is Evidence Based Practice Used?
- − Ask the important clinical question − Collect the most relevant and best evidence − Appraise the evidence critically − Integrate evidence with clinical expertise and patient preferences to make practice decisions − Evaluate outcome of decisions
- Why is Evidence Based Practice Used?
- − A meta-analysis of 84 studies to measure the impact of research-based nursing on patient outcomes found that patients who received research-based nursing interventions could expect better outcomes than the patients who received standard nursing care
- Before 1900 Nursing Research
- − Florence Nightingale − First researcher − Collected and analyzed data − Identified factors related to mortality and morbidity in Crimean War − Theory - Environment Influences Health
- 1900-1929 Nursing Research
- − Suffragette movement − Nursing research related to nursing education − Lavinia Dock − Adelaide Nutting − Isabel Hampton Robb − Lillian Wald − Goldmark Report (1923) Inadequacies in Nursing Education Advanced Education Nursing Doctorate - 1924 − Community Health − Descriptive Studies
- 1930-1949 Nursing Research
- − Depression and WWII − No advancement of research − Little money for education − Brown Report (1948) - nursing education should be at university level
- 1950-1969 Nursing Research
- − Western Interstate Commission for Higher Education − Focus on Role and Characteristics of Nurse − Nursing Research Journal − Grand Nursing Theories − Nursing, Person, Health, Environment King Levine Orem Rogers Roy
- 1970-1989 Nursing Research
- − More research journals − CINAHL − Looked at ethical implication of research − Research Utilization - application to practice − Diagnostic-related Groupings (DRGs) 1980's − National Center for Nursing Research (NCNR) − Cost containment − Use of qualitative research designs − Nursing Theories of Caring Benner Leininger Watson
- 1990-Present Research
- − Social and political agenda researched − Healthy People 2000 - quality of patient care − 1993 - NCNR became National Institute of Nursing Research (NINR) − Scientific knowledge exploded so nursing knowledge needed to increase − Electronics era − Push to incorporate research into practice - Evidence-based Practice
- Original Research Question
- usually imply some sort of action, inquiry, or relationship. "What is the relationship between age and convalescence?" It also is something that can actually be researched or studied. "What are the reactions of women to mastectomy?" It may be patient oriented or not and may be linked to an intervention, but more often it is not.
- Evidence Based Practice Questions
- are related specifically to patient care. They have the format we have discussed (PICO) and are designed for looking for evidence instead of doing original research. They are designed to find out what is known about a topic
- Difference Between EBP and Research Utilization
- • When writing the different ones, think about how you would go about doing the research or finding the evidence. When writing an original research question, I would not put it into PICO format, but ask a question that would obviously require some investigation other than a literature search.
- Who is involved in the Individual level of EBP?
- -Staff Nurse -Nurse Manager -Advanced Practice Nurse -Nurse Executive
- What does the Staff Nurse do in EBP?
- 1st to identify problem Participate in implementing change Part of EBP team Reads evidence and identifies if appropriate Participates in quality measures Suggests solutions
- What does the Nurse Manager do in EBP?
- Create an environment where it is safe to ask questions May challenge staff to seek evidence Tend to be role models Use performance criteria of staff based on EBP
- What does an Advanced Practice Nurse do in EBP?
- Coach/mentor role Facilitate finding evidence Help with synthesis of evidence Help write new standards Model and facilitate system changes
- What does the Nurse Executive do in EBP?
- Climate values EBP Assign managers to show proof of EBP Provide resources Hires people able to use EBP
- What takes place in the Organizational level of EBP?
- − Mission Statement Should include EBP − Performance Expectations − Governance Structure Allows people to think and question − Recognition and Rewards Says "we value your input" − Committees To look at practices and policies − Protocols
- What takes place in the Regional Level of EBP?
- − Library with Database − Hospital/School of Nursing − Regional Centers of Excellence
- What takes place in the National Level of EBP?
- − Agency for Healthcare Research and Quality − National Institute of Nursing Research − Specialty Nursing Organizations − National Nursing Practice Network − American Nurses Credentialing Center
- What takes place in the International level of EBP?
- − Cochrane Collaboration − Sigma Theta Tau International − Joanna Briggs Institute
- What are the different levels of EBP?
- -Individual -Organazational -Regional -National -International
- What is the Numberg Code?
- Ethical Issue with research − Voluntary consent − Results benefit society − Avoid ALL unnecessary harm − Experiments where harm is expected to occur will not be allowed − Experimenter should be highly qualified − If harm is occurring, research must be stopped
- What is Informed Consent?
- − Participant must give, saying they know and understand what risks there are Voluntary participation Informed of possible risks Informed of possible benefits
- How to Respect Person's?
- − Autonomous − Nurse protects those who are of vulnerable population
- What is Beneficience?
- − Maximize benefit, minimize harm
- What is Justice?
- − Fair and equal treatment
- Ethical Issues of Nursing Research
- Nuremberg Code Declaration of Helsinki ANA Code of Ethics in Research Informed Consent Respect for Persons Beneficence Justice Protect subjects' rights Therapy over research Treatment meets standards of care HIPPA Subject withdrawal Report ethical issues Participate on IRB or committee
- What are Human Rights?
- Self Determination Freedom from risk or harm Application to all Support development of knowledge Informed consent IRB participation
- How to Form Citations within Text
- Self Determination Freedom from risk or harm Application to all Support development of knowledge Informed consent IRB participation • Punctuation goes at end of citation, even if in the middle of a sentence • Citation is in parentheses • If more that one author, use & between next to last and last author
- Example of Citations within Text
- • "The average income for all RNs in the U.S. is $57,784" (Katz, 2007, p. 5).
- How to Form References?
- • Written so the reader can find the material • Order of material: -Author(s) name(s) and initials -Date -Period -Title -Periodical -Source • Alphabetize by author • Use Hanging indent
- Example of a Book Refernce
- Author. (Year). Title (ed.). Publisher location: Publisher. Katz, J. R. (2007). A career in nursing: Is it right for me? St. Louis, MO: Mosby Elsevier.
- How to form a Book Reference?
- Use only the initials of the author's first and middle names Capitalize only the first word of the title and the first word after punctuation such as a colon Capitalize any proper nouns in the title Publisher's location includes city, state
- Article References
- Author. (Year). Title of article. Title of Periodical, vol(issue), p-p. DOI or URL. DOI or URL used only with electronic materials Ironside, P. M. (1999). Thinking in nursing education, Part I: A teacher's experience. Nursing and Health Care Perspectives, 20(4), 243-247.
- Electronic Article References
- O'Brien, J. (2007). Now is the time to prepare for millennial faculty. Academic Leader, 23, 1-6. http://www.acenet.edu/resources/chairs
- How to write a Research Question?
- ▫ Concise statement of what is being studied ▫ Flows from problem and purpose ▫ Includes variables ▫ Format depends on type of research
- Examples of Research Questions
- ▫ What are the lived experiences of patients who are bathed in the morning when they are accustomed to bathing in the evening? ▫ What is the anxiety level of patients accustomed to bathing in the evening who are bathed in the morning
- How to write a Research Purpose?
- • More specific than the problem • Tells why study is being done • Explains why this problem should be studied.
- Example of a Research Purpose
- ▫ The purpose of this ethnographic study is to discover the stated patient feelings related to changes in bathing times. ▫ The purpose of this descriptive study is to discover the level of anxiety related to changes in bathing times.
- How to write a Research Hypothesis?
- Concise statement • Includes expected outcome of research • Only used with quantitative research • Usually written as a "null" hypothesis ▫ What the data will NOT support
- Example of a Research Hypothesis
- ▫ Patients who normally bathe in the evening will experience no anxiety when bathed in the morning in the hospital
- How to write EBP Research Question?
- • Are to make decision about patient care • Always includes an intervention or change to patient care • Often compares one intervention with another • Format (PICO) ▫ P = Patient population or condition of interest ▫ I = Intervention ▫ C = Comparison ▫ O = Outcome
- Examples of EBP Research Questions
- • What is the effect of 2-hourly turns (I) on skin integrity (O) compared to 4-hourly turns (C) in patients who are confined to bed (P)? • In an acute medical unit (P), does single-nurse drug administration (I) increase the risk of medication errors (O) compared with dual-nurse administration (O)?
- Identifying Variables in Research Study
- Which parts of PICO are the variables? • Intervention = Independent Variable • Outcome = Dependent Variable • Conceptual definitions • Like a dictionary definition • Operational definitions • The measurement or tool used to measure the variable • How the variable is measured
- Tradition Sources of Evidence
- o Library books o Library databases By visiting a library or library website, searches can be performed based on key words. Librarians can also be very helpful in locating sources
- Internet Sources of Evidence
- o Wikis o Blogs Be careful using these sources because they can be opinionated, not factual o Online journals o Organizational sites o Health links from Universities o Government Sources
- How to Read Evidence?
- • Critiquing Studies • --Look for clues of a good study • --Evaluate for use as evidence • Internet Sources • --If you have any doubts, don't use it • --Check with other reliable sources • --Discuss information with others • --Think about the reliability and validity
- How evidence is used in Research?
- • Identifies what has and hasn't been done before • Supports original research • Used to change or confirm clinical practice • Provides appropriate patient information
- What is a Theory?
- • Set of concepts linked by propositions to provide an explanation of a phenomenon • Links a whole bunch of concepts
- Example of a Theory
- : Nursing students who study adequately increase their nursing knowledge and have good grades which makes them more likely to pass the licensing examination.
- What is a Concept?
- • Words or phrases that convey ideas
- Examples of Concepts
- • Studying adequately • Nursing Knowledge is increased • Good Grades • Pass Licensing Exam
- What are Propositions?
- Statements that link concepts
- Examples of Propositions
- • Studying increases Nursing Knowledge • Nursing Knowledge determines Grades • Increasing Nursing Knowledge increases Grades • Increasing Nursing Knowle dge helps with passing the licensing exam
- Nursing Theories
- • Belief systems that guide nursing practice • Include four elements = metaparadigm
- What is a metaparadigm
- Person (patient) Environment Health Nurse
- Levels of Nursing Theories
- Grand Theories Middle Range Theories Practice Theories
- What are Grand Theories?
- • Attempt to explain all of nursing • Use all 4 concepts • Difficult to test • Very global in content
- What are Middle Range Theories?
- • Can be tested by research • More applicable to practice • Describe, predict, or explain phenomenon • May use pieces of other theories
- What are Practice Theories?
- • Very specific to specific pieces of nursing • Much more testable
- What is a Theoretical Framework?
- • Research is used to test theory • Identifies usability of theory • Identifies if propositions are correct • Identifies additional concepts • Concepts are further refined as variables which are the items actually tested • Conceptual Definitions • Operational Definitions
- What are Conceptuatl Definitions?
- like dictionary definitions
- What are Operational Definitions?
- Tool used to measure variables
- How Theories are used in Nursing Practice?
- Theories are Formed Nursing Research is Conducted Practice is Changed