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NR 439
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NR 439 Week 6 Graded Discussion Topic: Data Analysis and Results
NR 439 Week 6 Graded Discussion Topic: Data Analysis and Results Purpose This week’s graded topics relate to the following Course Outcomes (COs). • ... [Show More] CO 2: Apply research principles to the interpretation of the content of published research studies. (PO 4 & 8) • CO 5: Recognize the role of research findings in evidence-based practice. (PO 7 & 8) • The Assignments Data analysis is key for discovering credible findings from implementing nursing studies. Discussion and conclusions can … made about the meaning of the findings from the data analysis. Share what you learned about descriptive analysis (statistics), inferential analysis (statistics), and qualitative analysis of data; include something that you learned that was interesting to you and your thoughts on why data analysis is necessary for discovering credible findings for nursing. Compare clinical significance and statistical significance; include which one is more meaningful to you when considering application of findings to nursing practice. ANSWER 1. Discuss one of the four basic rules for understanding results in a research study. One of the four basic rules for understanding results in a research study is to understand the purpose of the study (Chamberlain Week 6 Lesson). It is entirely important to recognize the purpose of the study to determine what the results mean towards the question being asked. Without understanding the question being asked or the focus guiding the research, the numerical data or ordinal data collected has no support or definition and can be quite confusing. 2. Compare clinical significance and statistical significance. Which one is more meaningful when considering applying evidence to your practice? When nurses conduct a quantitative analysis of a study, it is important to determine if the results have clinical and statistical significance to the practice. According to Houser, clinical significance is “generally expected to reflect the extent to which an intervention can make a real difference in patients’ lives” (Houser, pg. 357). Statistical significance is based off of the probability (p) due to standard error. Depending on the amount of the probability calculated, Houser states “ If the pvalue is very small, then the probability that the results were due to error is very small, and the researcher can be very confident that the effects of the intervention are real” where as “ If the p value is very large (greater than 0.05 or 5%), then the probability that the results were due to error is very large, and the researcher cannot conclude that the intervention had an effect greater than would be expected from random variations” (Houser, pg. 357). The smaller the p value is, the better the statistical value of the results are and the strength of the data collected. However, the probability just explains the chances of getting similar results. When considering results to apply to evidence-based practice, the more meaningful significance would be clinical significance. Though statistical significance shows the strength in numbers, the ultimate idea of which I would include results to my general practice would be whether or not the results would make a better change towards those patients that I am taking care of. 3. Compare descriptive statistics and inferential statistics in research. Please give an example of each type that could be collected in a study that would be done on your nursing clinical issue you identified in previous weeks. Descriptive statistics according to Houser are “concerned with accurately describing the characteristics of a sample or population” (Houser pg. 353). In relation to my clinical issue of reduction of non-action required alarms from telemetry monitors, an example of this in the article Stop the Noise: A Quality Improvement Project to Decrease Electrocardiographic Nuisance Alarms, would be when they explained in the results about each instance of change in their bundle for alarm reduction. The bundle included methods such as disposable electrodes, daily changes and changing of thresholds (reducing duplicate alarms, shutting off bigeminy and couplet alarms, and changing tachycardia and bradycardia thresholds (40 = brady; 150 = tachy). They described the results of changing the leads and making them disposable did not change the alarm rate of the monitor, however, the threshold change and the silencing of bigeminy and couplet alarms reduced the frequency from a mean of 3.58 per day per bed, to 3.29 per day per bed, and eventually to 3.05 per day per bed. Inferential statistics are “used to determine if results found in a sample can be applied to a population—a condition necessary for confidently generalizing research as a basis for evidence for nursing practice” (Houser, pg. 353). In relation to my clinical issue of reduction of non-action required alarms from telemetry monitors, an example of this from the article Stop the Noise: A Quality Improvement Project to Decrease Electrocardiographic Nuisance Alarms, would be the inferring that with changing all monitors in the world to similar setting adjustments would provide the same suggested reduction of 80 to 90% of non-action required alarms when initiated. That same percentage may not be acquirable but the suggested resolution attempts show that there will be a positive change in the frequency of these alarms. References: Chamberlain College of Nursing. (2016). Reading Research Literature Results. Week 6 [Online lesson]. Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed., p.291,356-357, 482). Sudbury, MA: Jones & Bartlett. Sendelbach, S., Wahl, S., Anthony, A., & Shotts, P. (2015). Stop the Noise: A Quality Improvement Project to Decrease Electrocardiographic Nuisance Alarms. Critical Care Nurse, 35(4), 15-23. doi:10.4037/ccn2015858 [Show Less]
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NR 439 Week 5 Graded Discussion Topic: Samples and Data Collection
NR 439 Week 5 Graded Discussion Topic: Samples and Data Collection Purpose This week’s graded topics relate to the following Course Outcomes (COs). ... [Show More] CO 2: Apply research principles to the interpretation of the content of published research studies. (PO 4 & 8) CO 4: Evaluate published nursing research for credibility and significance related to evidence-based practice. (PO 4 & 8) CO 5: Recognize the role of research findings in evidence-based practice. (PO 7 & 8) The Assignment Access the following information. You may read the PDF online or download it. American Nurses Association. (2014). Fast facts: The nursing workforce 2014: Growth, salaries, education, demographics & trends. ANA. Retrieved from https://www.nursingworld.org/globalassets/practiceandpolicy/workforce/fastfacts_nsgjobgrowthsalaries_updated8-25-15.pdf (Links to an external site.) Review the data presented in the ANA Fast Facts and describe some of the key attributes/characteristics of this sample of the nursing workforce. Discuss some of the data that you found interesting; include what you believe the purpose (intent) of ANA sharing these results. The instruments and tools that we use to collect data need to be reliable and valid. Define these terms and explain the importance of each. Share one way that can be used to collect data that you were not aware of or familiar with. ANSWER 1. Review the secondary data presented in the ANA Fast Facts and describe what the results say about this sample of the nursing workforce. According to the ANA Fast Facts article, there is a projected loss of 555,100 RNs due to retirement which would make the need of RNs be approximately 1.13 million by the year 2022. This article discusses the mean salaries of each level of nurses from RNs to NPs to Instructors as well as the locations where nurses receive the highest median salaries in metro areas 7 being in the east coast. Under the age category, they mention the average age of nurses is 50 years old, with 53% of nurses being older than 50. There has been an increase of licensure annually but the biggest growth was during 2005-2009 with 58.3% from the prior 5 years. From 2010-2013 the percentage of licensures only increased 22.8%. Nurses post-graduation have a higher chance of getting hired with a BSN or MSN than those who only have an associate’s degree. Nursing school applicants for BSN or graduate programs are also at a higher rate of being turned down for programs due to an insufficient number of educators available. 2. Describe the purpose and the intent of the ANA sharing these results? In turn, the instance of the increased need for nurses is going to occur, and facilities rather have nurses with a bachelor’s degree, however the ability for nurses to receive a higher level of education are restricted. The purpose of the ANA sharing these results to the nursing population as well as the public is to show the impending shortage of nurses that will ensue because the current population will soon retire and exit the workforce. I think the intent of this article is also to encourage nurses to pursue a path towards becoming educators to provide more availability in nursing programs and reduce the turndown rate. By encouraging nurses to become professors and share their knowledge, we can gain more new nurses and reduce the effects of this impending shortage. 3. The next process for our study is to collect data. The research design will indicate the best data to be collected. The tools that we use to collect data need to be reliable and valid. Define these terms with respect to research, and explain why they are important. In relation to research, the process of collecting data is essential to develop a valid result. Depending on the type of research being conducted, they could most likely be survey based but according to the Chamberlain week 5 lesson, “Variables must be expressed as numbers in order to analyze them statistically…” (Chamberlain, 2018). The term validity according to Houser is “the ability of an instrument to consistently measure what it is supposed to measure” while reliability is “a reflection of the consistency with which the instrument records the measure” (Houser, 2018, pg. 224) With regards to the tools utilized for data collection, “The reliability and validity of an instrument are the most important characteristics, and they should be documented in the research report. Using an existing instrument is desirable for its efficiency and the capacity to provide a comparison with existing studies” (Houser, 2018, pg. 224). With these tools, it would be ideal for controls to be conducted to evaluate consistency of data before utilizing the instrument during the study to ensure reliability and validity. 4. Consider data collection and measurement methods for your nursing clinical issue. Explain how you would collect data and what measurement methods you would use. For my nursing clinical issue of reducing non-action required alarms from occurring on a telemetry floor, the method of collecting data would be to observe the number of times the alarms went off during a one week period without modifications to the settings and document the frequency of how often they were instances of artifact or instances of Premature ventricular contractions (PVCs). Then with the next week, we would modify methods of monitoring our telemetry monitors such as applying new leads and ensure placement is correct with each patient, and with certain rhythms that patients may be displaying we would tweak the preset alarm settings and see if there is a reduction of non-action required alarms. The modification of lead placement would likely reduce the amount of times the monitor alarmed for artifact and in relation to rhythms, tweaks such as lowering the heart rate threshold for patients with asymptomatic bradycardia from less than 60 to less than 50 would ensure that when the patient was a worrisome low, we would be notified and can alarm the physician. Then with monitoring the amount of times the monitor alarmed during this period of time, we could compare whether the monitor adjustments were beneficial or irrelevant to aiding in reduction of non-action required alarms. In the article Reducing Interruption Fatigue through Improved Alarm Support, they set alarms for the life threatening rhythms such as “asystole, ventricular tachycardia, ventricular fibrillation, extreme tachycardia, extreme bradycardia, apnea, and oxygen desaturation” (pg. 111). Ultimately, from the results I read, they were able to reduce the alarms up to 25% by altering the settings per patient. So hopefully, my study would result in the same way. References: Houser, J. (2018). Nursing research reading, using and creating evidence, (4th ed). Burlington, MA: Jones & Bartlett. American Nurses Association. (2014). Fast facts: The nursing workforce 2014: Growth, salaries, education, demographics & trends. ANA. Jahrsdoerfer, M. (2016). Reducing Interruption Fatigue through Improved Alarm Support. Biomedical Instrumentation & Technology, 50(2), 109-113. [Show Less]
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NR 439 WEEK 3 ASSIGNMENT: PROBLEM-PICOT-EVIDENCE SEARCH (PPE) WORKSHEET
NR 439 WEEK 3 ASSIGNMENT: PROBLEM-PICOT-EVIDENCE SEARCH (PPE) WORKSHEET Problem/PICOT/Evidence Search (PPE) Worksheet Name: Date: Crite-ria Falls ar... [Show More] e a common and serious health problem that can cause devastating consequenc-es. Falls can be prevented through several evidence-based interventions. It’s important for nurses to identify at risk patients who are vulnerable to having a fall such as the elderly with altered mental status, and applying preventive measures to stop a fall from occurring. In a study that was performed at a hospital in Bangalore for a period of five months from March to July 2018. The test concluded that “the major reasons for pa-tient falls were due to patient related factors such as old age, weakness, loss of bal-ance, impaired cognition and environmental factors such as wet bathroom floors, ab-sence of patient call bells and bed rails not being raised”( Ashok 2020). I chose falls as a clinical nursing problem because “Falls are a main cause of morbidity and disability in the elderly.” (Al-Aama, 2018) Implementation of favorable fall prevention program is a vital part of nursing care. Nurses play a significant role in educating patients, fami-lies, and caregivers about the prevention of falls beyond the patients stay outside of the hospital. Clinical Nurs-ing Prac-tice Prob-lem Select and identify ONLY one quality or safe-ty clini-cal pri-ority area from the as-sign-ment guide-lines practice scenar-io. Summa-rize why you be-lieve the nursing practice prob-lem/issue is the most im-portant. Summa-rize your ra-tionale (why) for choos-ing the prob-lem. Clinical Nurs-ing PICOT Ques-tion Using the NR439 Guide for Writing PICOT Ques-tions and Exam-ples located in the assign-ment guide-lines, write out your PICOT ques-tion. Include the PI-COT letters in your ques-tion. Among patients who are the age of 50 years or older diagnosed with altered mental status (P), would the confusion assessment screening tool (CAST) (I) impact the num-ber of falls, (O) compared to no admission fall screening tool (C) over 5 months (T)? Define PICOT Ele-ments Define each of the PICOT ele-ments from your ques-tion above. P- (patient population/patients of interest): Adults 50 years or older diagnosed with altered mental status I- (Intervention): Confusion assessment Screening tool (CAST) . C- (Comparison): continuance of care,/no admission fall screening tool O- (Measurable outcome): Identifying risk factors for falls in patients 50 years or older with altered mental status. T- (Time frame in months): 5 months Evi-dence Re-trieval Process and Sum-mary Using only the Cham-berlain College of Nursing library: (1) Lo-cate evi-dence that is relevant to your chosen nursing practice prob-lem. Explain how you be-lieve the evi-dence is relevant to your chosen nursing practice prob-lem. (2) Ex-plain why you chose the evi-dence (3) Pro-vides a com-plete APA refer-ence to the evi-dence (must include au-thors, year, title of the evi-dence, title of the re-source) (4) Evi-dence must be pub-lished within the last 10 years (5) Pro-vides the per-malink The evidence is relevant to my nursing practice because it was conducted by nurses. I chose the evidence because it had a scenario that matched my problem, and provided numerical data to prove the outcome of the results. Nurses were educated on ways to prevent falls. An environmental safety checklist was prepared and Standard fall pre-vention guidelines was formulated and recommended to the hospital. Ashok, K. (2020, March). An Explorative Study to Prevent the Incidence of Inpatient Falls in a Tertiary Care Hospital https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=her&AN=140756211&site=eds-live&scope=site Impli-cations of the Evi-dence Summa-rize what you learned from the evi-dence. Summa-rize why you be-lieve the nursing evi-dence-based practice commit-tee should focus their next research project on the nursing practice prob-lem. Falls in patients 50 years or older with altered mental status can further deteriorate the patients’ health. I believe falls should be a priority for the committee, and they should focus their next research project on falls. Educating nurses and implementing nursing intervention from preventing falls is a good way to decrease falls in the hospital. (Ashok 2020) “Knowledge of nursing staffs on fall prevention revealed that 3.25% of the nurses had poor knowledge regarding the fall risk assessment, 31.33% of the nurs-es had less knowledge on risk factors and 15.25% were not aware of interventions for fall reduction.” Providing staff meetings and tutorials are good ways of training staff from preventing falls. Good nursing interventions such as bed alarms, 1 on 1 sitters, video monitoring, and placing side rails up, are other great interventions in preventing falls in this population. Evi-dence Search Terms Identify 4 (or more) relevant search-able terms you used for your search for evi-dence. Altered Mental Status, Falls, Fall risk assessment tool, Confusion assessment tool, Bed Alarms, 1 on 1 Supervision Evi-dence Search Strate-gies Select 4 (or more) relevant search strate-gies you used to nar-row/limit your search for evi-dence. __x__ Full text ____ Boolean Operators/Phrase _x___ Selected publication dates within last 10 years ____ Subject, title, or author search box ____ Truncation (used an asterisk * at the beginning or end of a word) ____ Academic or scholarly (Peer Reviewed) journals ___x_ Quotation marks for key words ___x_ Selected key terms from PICOT question ____ Others: (list below) _______________________________ _______________________________ References 1. Ashok, K. (2020, March). An Explorative Study to Prevent the Incidence of Inpatient Falls in a Tertiary Care Hospital. . Retrieved from https://eds-a-ebscohost-com.chamberlainuniversity.idm.oclc.org/eds/detail/detail?vid=1&sid=09de438e-32cc-4505-8a2c-146bdc536c16@sdc-v-sess-mgr01&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ==#AN=140756211&db=her 2. Al-Aama, T. (2018, July). Falls in the elderly: spectrum and prevention. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135440/ h [Show Less]
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NR 439 Week 2 Graded Discussion Topic: Research, Practice Problems, and Questions
NR 439 Week 2 Graded Discussion Topic: Research, Practice Problems, and Questions. Week 2: Assigned Readings Houser, J. (2018). Nursing research: Readi... [Show More] ng, using, and creating evidence (4th ed.). Sudbury, MA: Jones and Bartlett. • Chapter 2: The Research Process and Ways of Knowing • Chapter 4: Finding Problems and Writing Questions Purpose This week's graded topics relate to the following Course Outcome (CO). • CO 1: Examine the sources of evidence that contribute to professional nursing practice. (PO 7) • CO 2:Apply research principles to the interpretation of the content of published research studies. (PO 4 & 8) • CO 5: Recognize the role of research findings in evidence-based practice. (PO 7 & 8) Discussion Professional nurses rely on research findings to inform practice decisions; they use critical thinking to apply research directly to specific patient care situations. Think about an independent nursing practice problem you care passionately about and would be interested in searching for evidence. The below problems should not be used: *medical/doctor/physician problems such as medications, or medications administration or effects, diagnostics such as EKGs, labs, cardiac catherizations. *staffing, nurse-to-patient ratios, workforce issues are organizational/system /political/administrative/multi-stakeholder problems which nursing cannot solve independently. • Describe a significant nursing clinical issue, topic of interest, or practice problem that is important to you. Describe why you chose the problem/topic. • Write your clinical question in the PICO(T) format for your nursing practice problem. *To write your clinical question in the PICO(T) format, use the NR439_Guide for writing PICOT Questions and Examples • List each of your PICOT elements. Share why you care about this nursing practice problem and why you believe the problem would benefit from finding the best evidence. ANSWER Professor, “Observations about a practice problem become questions, and these questions lead to nursing research that provides evidence to solve the problem. (Houser, 2018, p. 83).” So my question is teenage pregnancy. As I stated in my introduction, I hope to go on and become a WHNP. But this idea stemmed from my childhood. I, and a few of my peers, became sexually active during our mid-to-late teenage years. I didn’t have many educational talks at home about the acts of sexual intercourse or safe sex practices. I did go to my local Planned Parenthood for birth control but rarely would I get any information or education about sex that I felt prepared me to make safe, sound sexual decisions. This lack of education and immaturity lead to me becoming pregnant at 18 years old. So with that said, I have always wanted to return to the practice to be sure that young men and women were properly educated or safer sex practices as well as pregnancy prevention. According to the CDC, teen pregnancy rates are slowly declining but I believe more resources should be available to young, minority teens of low socioeconomical households. Research is showing that “use of more effective contraception and more information about pregnancy prevention (Livingston & Thomas, 2019)” will help decrease the rate of teen pregnancy. My PICOT question is- In teen, minority women (aged 15-19) of low socioeconomic background (P), would access to youth friendly sexual & reproductive health resources (I) decrease teen pregnancy rates (O) when compared to standard school sex education (C) over the next 5 years (T). P= Teen, minority women (aged 15-19) of low socioeconomic background I= Youth friendly sexual & reproductive health resources C= Standard school sex education O= Teen pregnancy rates T= 5 years Reference About Teen Pregnancy. (2019, March 1). Retrieved January 14, 2020, from https://www.cdc.gov/teenpregnancy/about/index.htm. Houser, J. (2018). Nursing research: reading, using, and creating evidence (Fourth). Burlington, MA: Jones & Bartlett Learning. Livingston, G., & Thomas, D. (2019, August 2). Why is the U.S. teen birth rate falling? Retrieved January 14, 2020, from https://www.pewresearch.org/fact-tank/2019/08/02/why-is-the-teen-birth-rate-falling/. [Show Less]
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NR 439 Week 1 Graded Discussion Topic: Introduction to Evidence-based Practice
NR 439 Week 1 Graded Discussion Topic: Introduction to Evidence-based Practice • Chapter 1: The Importance of Research as Evidence in Nursing • Chapt... [Show More] er 3: Ethical and Legal Considerations in Research Purpose This week's graded topics relate to the following Course Outcomes (COs). • CO 3: Identify ethical issues common to research involving human subjects. (PO 6) • CO 5: Recognize the role of research findings in evidence-based practice. (PO 7 & 8) Discussion We begin our journey into discovering the new world of research and evidence-based practice (EBP) by exploring our past. After completing the required readings and lesson, answer the following: • Explain how research has evolved since the Florence Nightingale era. • Discuss how research and EBP are different; include how you believe research supports EBP for nursing. • Describe one past/historical unethical breach of research conduct; then, share how you would ensure care of a study participant using one ethical or legal research consideration (guideline/principle). ANSWER Florence Nightingale was the pioneer of nursing research. As she was the first to “introduce the concept of scientific inquiry as a basis for nursing practice (Houser, 2018, p. 6).” Her collection of evidence of soldier’s health conditions using statistical methods during the Crimean War lead to incorporating nursing education into universities and ultimately to development of the National Institute of Nursing Research. Nightingale’s work established the groundwork in ensuring that nursing practice would “improve the health of individuals, families, communities and populations through evidence-based nursing practice (NINR, 2019).” Nursing research differs from evidence-based practice (EBP) because research is a “process of inquiry that uses guidelines to produce unbiased, trustworthy answers to questions about nursing practice (Houser, 2018, p. 5)” where EBP uses “scientific evidence integrated with clinical experience and incorporating patient’s vales and preferences (Houser, 2018, p. 13).” Nursing research is used as the foundation to support the triad of EBP to help medical professionals integrate research outcomes into clinical practice decision making, policies and guidelines. A past unethical breech of research was the discovery that some 500+ foster infants and children in New York City over the span of 20 years (1985-2005) were being used as human subjects of a clinical trial testing experimental AIDS medications and vaccines that lead to the unfortunate death of 80 children (Vera Institute of Justice Final Report, 2009). It was founded that NYC Child Services, whom were the “legal guardians” of foster children, granted these agencies permission to test mediations and vaccines in exchange for payment. The research company was also received large grants for conducting this research on children. I believe foster children were chosen intentionally because they were a vulnerable population unable to give consent. Their respect of person was violated. They were not able to make an informed decision, they were not protected, nor were they given an individual representative/advocate who could have protected their dignity. As the lesson and law states- “no research can be done that could lead to death or disability (CCON, NR-439, 2020, Week 1 Lesson).” So, to answer the question of how I would ensure the care of those study participants, my answer is that these children should have been given individual advocates to protect them and the study should have been halted the moment researchers knew the medications/vaccines would cause harm or death. Reference Chamberlain College of Nursing (CCON). (2020). NR-439 RN Evidence-Based Practice; Week 1: Introduction of Evidence-Based Practice [Online lesson]. Downers Grove, IL: DeVry Education Group. Houser, J. (2018). Nursing research: reading, using, and creating evidence (Fourth). Burlington, MA: Jones & Bartlett Learning. National Institute of Nursing Research (NINR). (2019, December 19). Retrieved January 4, 2020, from https://www.nih.gov/about-nih/what-we-do/nih-almanac/national-institute-nursing-research-ninr. Vera Institute of Justice Final Report (2009): 80 NYC Foster Children Died in AIDS Drug Trials. (2016, September 13). Retrieved January 2, 2020, from https://ahrp.org/2009-commissioned-investigation-absolves-nyc-of-80-foster-children-deaths-in-aids-trials/. [Show Less]
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NR 439 Week 4 Graded Discussion Topic: Designs – A Plan to Study for the Truth
NR 439 Week 4 Graded Discussion Topic: Designs – A Plan to Study for the Truth NR 439 Week 4 Graded Discussion Topic: Designs – A Plan to Study for th... [Show More] e Truth Week 4: Assigned Readings Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Sudbury, MA: Jones and Bartlett. • Chapter 2: The Research Process and Ways of Knowing • Chapter 6: Selecting an Appropriate Research Design Purpose This week's graded topics relate to the following Course Outcomes (COs). • CO 2: Apply research principles to the interpretation of the content of published research studies. (PO 4 & 8) • CO 4: Evaluate published nursing research for credibility and significance related to evidence-based practice. (PO 4 & 8) Discussion This week we learned how research designs are different and help us to objectively study nursing problems; the key is to decide which type of research and design will serve the purpose or intent to find a solution. After completing Week 4 readings and lesson, answer the following: • Reflect on your learning about Quantitative and Qualitative research; share two ways that helped you understand how they are different. • Choose one category of study design that you found interesting and describe; include what you learned about the design and how you believe it can help study nursing problems. • Refer back to your clinical nursing priority problem and evidence you located for your week 3 assignment: o The nursing-evidenced practice (NEBP) committee has requested for you to make a recommendation to the team: Describe the type of research and the design that you believe would be the best way to study your problem. Discuss your rationale. ANSWER Professor, “Qualitative research is a naturalistic approach to research in which the focus is on understanding the meaning of an experience from the individual’s perspective (Houser, 2018, p. 35).” The researcher is exploring the perspective from the eye of the participant to gain their knowledge and insight on an issue. Sometimes, that background information helps the researcher develop a premise for a prospective quantitative research project. Qualitative research can also be used discover trends or find the deeper reasons for certain issues a person or group is experiencing. “Quantitative research is a traditional approach to research in which variables are identified and measured in a reliable and valid way (Houser, 2018, p. 34).” The information obtained from this research can be used as statistical data of several variables such as behaviors, attitudes, opinions, or choices to discover patterns or support facts. Quantitative data is a structured method of collecting surveys, interviews, studies, and observations. The category of study design that I found interesting was ethnographic which is the study of people in their own environment. This research is done using observations and interviews, but the interesting part is in knowing that perception is not the same reality for everyone. “What people see depends on what previous visual and conceptual experience has taught (Bjerknes & Bjørk, 2012).” Many experiments asking people to describe the ink blot is a prime example of this. But it is through understanding the persons point of view better helps understand how people come to certain conclusions. I think this design would work for my nursing problem of implementing the Matter of Balance (MOB) fall prevention program decrease or prevent number of hospital-related falls or injury. Because there is no current program available, the researcher would be gathering information from each nurse and patient through “observations, interviews, and document analysis used to gain insight of fall prevention interventions from the perspective of nurses and patients (Bjerknes & Bjørk, 2012). Reference Bjerknes, M. S., & Bjørk, I. T. (2012). Entry into Nursing: An Ethnographic Study of Newly Qualified Nurses Taking on the Nursing Role in a Hospital Setting. Nursing Research and Practice, 2012, 1–7. doi: 10.1155/2012/690348 Houser, J. (2018). Nursing research: reading, using, and creating evidence (Fourth). Burlington, MA: Jones & Bartlett Learning. [Show Less]
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NR 439 Week 5 Assignment: Research Designs A Critical Element for a Credible Nursing Practice.
NR 439 Week 5 Assignment: Research Designs A Critical Element for a Credible Nursing Practice. Chamberlain College of Nursing Research Designs: A Cr... [Show More] itical Element for a Credible Nursing Practice Nursing is a scope of practice that is established from evidence. Research is needed to provide such evidence. Research is done to find fresh conclusions through experimenting and investigating interventions. “Nursing research is a systematic process of inquiry that uses rigorous guidelines to produce unbiased, trustworthy answers to questions about nursing practice” (Houser, 2018, P.5). Patient outcomes are improved by this, hence, the importance for nurses to understand research. Nurses need to comprehend the basic principles of research in order to stay current in their practice. Nursing practice is constantly changing based off of new evidence from new research. This research helps nurses stay up-to-date in their practice thus improving patient care and outcomes. The purpose of this paper is to help nurses understand the basic principles of research, the importance of nursing research, and how it leads to credible nursing practice through evidence. Quantitative Research Quantitative research is an organized study of examining evidence. It gathers such evidence from various sources using techniques such as inquires, questionnaires, and ballots. Quantitative research obtains results by populating stats from samples substantial in size. The data from quantitative research is effortlessly analyzed and is essential for investigators to create prophecies. The prophecies are important and used to change nursing practices. One type of quantitative design is correlational research. Correlational research is when the person researching visually examines two variables in order to comprehend and evaluate the connection between them. A valuable feature of this design is that it is non-experimental. This is a good design to use when performing an experiment is not feasible. Quantitative research has improved nursing practice. It has done so by producing beneficial data that contributes to evidence-based practice changes. It ensures nurses have been educated on common practices on topics such as patient education. It is also used to establish additional constructive materials for nurses. Nurses can use these constructive materials to better educate themselves and if needed, their patients. Qualitative Research Qualitative research is a means of study that looks for detailed comprehension of phenomena within normal surroundings. The investigator functions as an evidence collecting tool that aims attention on finding out the why of the phenomena. That is done by examining participants direct experiences on the subject matter being researched. Qualitative research is important in cultivating theories and concepts. Once these theories and concepts are researched and studied, the results will lead to improved nursing practices. One type of qualitative design is the phenomenological method. The purpose of this design is to be able to explain what way any one person participating in the study experiences the precise occasion being researched. Phenomenological method collects data from its participants through asking questions, observations, and written inquiries. It is profoundly worried about how its participants perceive things during the precise occasion which is an extremely important feature of the design. Qualitative research has improved nursing practice. It has done so by contributing to nursing research through things like clinical trials. The data that is collected from clinical trials is evaluated and elucidated. Those evaluated and elucidated results is where evidence comes from in evidence-based nursing practice. These trials give assurance that current nursing practices stem from the most accurate evidence. Research Sampling Research sampling is a particular technique that looks at a group of human beings or objects from within a bigger population for calculation. The research sample needs to symbolize the population as a whole to guarantee the results are able to be assumed for all. Research sampling is important in producing precise data and results. There are various research sampling strategies that are used. A strategy used in quantitative research is non-probability sampling. Non-probability sampling does not work with chance techniques to choose its sample. It is often used in research when chance techniques are not attainable to acquire a representative sample. Non-probability sampling includes approaches such as purposive and convenience (Cook & Cook, 2017). Another research sampling strategy is probability sampling. It is the opposite of the previously discussed strategy. Probability sampling does use chance to choose its sample. It strides to secure all representatives from a population has a possibility of being picked. Probability sampling includes different approaches such as simple random, systematic, cluster, and stratified random (Cook & Cook, 2017). Credible Nursing Practice Nurses are asked to discover and apply reliable and valid evidence to back their clinical judgement and skills. Nurses need to build their clinical judgement and skills on best practice evidence from nursing research. Nursing research is vital in producing evidence for nursing practice to be based off of. The data collected ensures that nurses are practicing safely. Evidence-based nursing practice is credible nursing practice that enhances patient outcomes and overall satisfaction. Conclusion Nurses require research to stay up-to-date in their current practice to effectively implement quality care to their patients. Quality care leads to better patient outcomes and satisfaction. Quantitative and qualitative research have meaningful offerings in nursing research. Both research types need to be well planned out with proper sampling. The evidence provided through research leads to credible evidence-based nursing practice. Nurses base their practice on evidence from research throughout their career. References Cook, B. G., & Cook, L. (2017). Do Research Findings Apply to My Students? Examining Study Samples and Sampling. Learning Disabilities Research & Practice (Wiley-Blackwell), 32(2), 78–84. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1111/ldrp.12132 Houser, J. (2018). Nursing research: Reading, using and creating evidence (4th ed.). Burlington, MA: Jones & Bartlett Learning. [Show Less]
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NR 439 Week 8 Graded Discussion Topic: The Evidence-Nursing Practice Connection
NR 439 Week 8 Graded Discussion Topic: The Evidence-Nursing Practice Connection Purpose This week’s graded topics relate to the following Course Outcom... [Show More] e (CO). CO 1: Examine the sources of evidence that contribute to professional nursing practice. (PO 7) CO 5: Recognize the role of research findings in evidence-based practice. (PO 7 & 8) The Assignment Improving patient care and outcomes is paramount to the practice of nursing. As we conclude our learning journey through our world of research and evidence-based practice, it is important to reflect upon your time spent in the course: Think about nursing practice and describe one barrier that you feel prohibits nurses from engaging in EBP; share one strategy you could use to facilitate the use of evidence to help improve nursing care for patients. Reflect back over your time in the course and describe how your thinking has changed about nursing research and evidence-based practice; describe one new learning during this course that you believe was the most helpful. ANSWER Under evidence-based nursing practice, nurses would utilize data in making accurate and informed clinical decisions, and also to monitor improvements and facilitate workflow. This helps in improving patient care and outcomes. For instance, the use of a Real Time Locator System (RTLS) helps in streamlining nursing and patient workflow by improving communication to minimize errors and inefficiencies that are critical to quality patient care and outcomes. Thinking about nursing practice, I think that the delivery of consistent high-quality nursing services in the healthcare system is faced with huge challenges nowadays. The adoption and use of evidence-based practice (EBP) provides a reliable problem-solving approach which is based on the best available and valid evidence, hence promoting quality patient care, individual professional development, and reduced healthcare costs (Tacia et al., 2015). One of the barriers that prohibit nurses from engaging in EBP is lack of time and knowledge. Most nurses and clinicians often cite lack of time as one of the factors that hinder their adoption and proper implementation of EBP to achieve quality patient care. Also, lack of knowledge of uncertainty about the process involved in EBP implementation such as critiquing literature related to the nursing problem being addressed, and appraising it is also a huge barrier (Khammarnia et al., 2015). One strategy that I could use to facilitate the use of evidence in improving the nursing care for the patients is engaging appropriate stakeholders. By engaging appropriate stakeholders when implementing EBP in nursing, nurses are able to build trust between themselves and the patients. Also, working with appropriate stakeholders enables the nurses to learn from their experience and provide positive inputs to the implementation of evidence-based practice (Khammarnia et al., 2015). This is because the involvement of these stakeholders helps in identifying the outcomes measures of the practice. Additionally, having a buy-in from the beginning through the involvement of relevant stakeholders helps the nurses in planning for better implementation of EBP. Reflecting back over my time in this course, I believe that my thinking has changed significantly as far as nursing research and the use of evidence-based practice in nursing is concerned. During this course, I have learned that nursing research is important to nurses and healthcare professionals because it enables them to determine the most effective practices to improve patient care. Through nursing research, new information will always be coming to light and this information is used to respond to changes in the healthcare environment to improve patient care and outcomes (Stevens, 2013). Additionally, I have learned that EBP involves a thorough use of the current best research-based evidence to make accurate decisions about patient care. EBP is a problem-solving approach that integrates a healthcare professional’s own clinical expertise, a systematic search for the most relevant evidence to clinical questions and its critique, and patient values and preferences. At the end of this course, the one learning that was most helpful and will be important in my future career is the knowledge that EBP allows healthcare practitioners to evaluate clinical guidelines, research, and other information resources based on the quality of the findings, and apply the results of this evaluation to nursing practice. References Khammarnia, M., Haj Mohammadi, M., Amani, Z., Rezaeian, S. and Setoodehzadeh, F. (2015). Barriers to Implementation of Evidence Based Practice in Zahedan Teaching Hospitals, Iran, 2014. Nursing Research and Practice, 2015, pp.1-5. Stevens, K. (2013). The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas. OJIN: The Online Journal of Issues in Nursing Vol. 18, No. 2, Manuscript 4. Tacia, L., Biskupski, K., Pheley, A. and Lehto, R. (2015). Identifying barriers to evidence-based practice adoption: A focus group study. Clinical Nursing Studies, 3(2). [Show Less]
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NR 439 Week 6 Assignment: Reading Research Literature Worksheet
Week 6: Reading Research Literature Worksheet Complete the following required worksheet using the required article for the current session. Access the ... [Show More] required article from the assignment guidelines. Purpose of the Study: Using information from the required article and your own words, summarize the purpose of the study. Describe what the study is about. The main purpose of this study is to determine the relationship between gynecologic cancer and distress in patients in the clinical setting (O’Connor, Tanner, Miller, Watts & Musiello, 2017. The study took place over 6 months, and involved the use of research tools (Distress Thermometer and a Problem List), along with communication between the patient (subject), research officer, oncology nurse, and social worker, to determine the severity of emotional and physical distress that the patient was experiencing (O’Connor et al., 2017). Research & Design: Using information from the required article and your own words, summarize the description of the type of research and the design of the study. Include how it supports the purpose (aim or intent) of the study. The type of research and design that was implemented in the study was a case study design. Ridder (2017) explains that a case study is a study about a person, a group of people or a unit, where the researcher examines in-depth data that relates to several variables in the study. Ridder (2017) also states that case studies examine complex phenomena in the natural setting to increase the understanding of them. In this study, data from the Distress Thermometer (DT) and Problem List (PL) were examined on each subject in detail, which provided the health care professionals information that they needed in order to streamline patient care (O’Connor et al., 2017). The study explored the phenomenon of the relationship between cancer and distress, which is also an important aspect of a case study design. Mixed methods that included quantitative and qualitative care were also used in the study (O’Connor et al., 2017). According to Tariq and Woodman (2013), mixed methods use both quantitative and qualitative methods in a single study. Tariq and Woodman (2013) also state that mixed methods give a voice to study participants and ensure that study findings are grounded in participants’ experiences. The quantitative method that was performed in the study involved data collection and analysis that was taken from the subject’s completion of the DT and the PL (O’Connor et al., 2017). The qualitative method included the consultations between the health care professionals and the subjects after the quantitative data was gathered and analyzed from the DT and the PL (O’Connor et al., 2017). It was shown that by using the DT and PL that patient’s “opened-up” about more issues and concerns about their cancer and asked questions that they might have been reluctant to ask (O’Connor et al., 2017). One research tool that is used in the study is the Distress Thermometer (DT). A DT is “a self-reported distress scale that the patient’s use to determine their level of distress” (Cutillo, O’Hea, Person, Lessard, Harralson, & Boudreaux, 2017, p.329). O’Connor et al., (2017) state that the DT is scored from 0 (no distress) to 10 (high distress). The subjects score their level of distress that they are feeling, and the health care workers collect and analyze the data (O’Connor et al., 2017). Another tool that is used in the study is a Problem List (PL) (Cutillo et al., 2017). The PL is a check-off list that lists practical, physical, mental and social problems that the patient is encountering (Cutillo et al., 2017). The PL accompanies the DT so that more qualitative data can be identified and the correct intervention/s can be implemented by the health care workers (O’Connor et al., 2017). Sample: Using information from the required article and your own words, summarize the population (sample) for the study; include key characteristics, sample size, sampling technique. In this study, the population of interest was women with gynecologic cancer in the clinical setting of West Australia public women’s and newborns’ tertiary teaching hospital, King Edward Memorial Hospital (O’Connor et al., 2017). The samples that were chosen from the population consisted of sixty-two women with gynecologic cancer (O’Connor et al., 2017). The characteristics of the samples that were chosen were all over 18 years or older, they had gynecologic cancer, and they were able to comprehend and fill the DT and PL forms out (O’Connor et al., 2017). The age range was from 25-94 years old, and the median age was 58 years old (O’Connor et al., 2017). The sampling technique used in the study was random sampling. All of the women in the sample population that met the criteria of the study (18 or older, had gynecologic cancer, could fill the DT and PL forms out) were chosen and asked to participate in the study. Data Collection: Using information from the required article and your own words, summarize one data that was collected and how the data was collected from the study. One piece of data that was collected in this study was the data from the DT screening. A DT is “a self-reported distress scale that the patient’s use to determine their level of distress” (Cutillo et al., 2017, p.329). The DT is scored from 0 (no distress) to 10 (high distress), and a patient with a score of 4 or higher indicates the need for a follow up (O’Connor et al.,2017). Along with the DT screening, a PL was used in the study (Cutillo et al., 2017). The PL is a check-off list that lists practical, physical, mental and social problems that the patient is encountering (Cutillo et al., 2017). The PL accompanies the DT so that more in depth information can be identified, and the correct intervention(s) can be implemented by the health care workers (O’Connor et al., 2017). When the patient opted to participate in the study, they were given the DT screening sheet and PL sheet to determine their level of distress by a research officer (O’Connor et al., 2017). Once these were filled out by the subject the oncology nurse, social worker (if needed), and the subject consulted about the results of the DT and PL, and the proper referrals were made (if needed) (O’Connor et al., 2017). Data Analysis: Using information from the required article and your own words, summarize one of the data analysis/ tests performed or one method of data analysis from the study; include what you know/learned about the descriptive or statistical test or data analysis method. Descriptive statistics help to describe and understand the features of a data set by giving short summaries about the sample and measures the data (Mishra, Pandey, Singh, Gupta, Sahu & Keshri, 2019). Descriptive statistics was used in this study to tally and analyze the rating scores of the DT (O’Connor et al., 2017). I learned that out of the sixty-two subjects, forty-one of them rated a 4 or higher on their DT screening sheet and twenty-one rated a 3 or lower (O’Connor et al., 2017). Out of the forty-one subjects that rated a 4 or higher, twenty-one rated a 7 or higher (O’Connor et al., 2017). The analysis of the descriptive statistics tells me that sixty-six percent of the subjects need a referral due to their DT scores, and that thirty-three percent of those subjects have a high distress level and need to be monitored (O’Connor et al., 2017). Limitations: Using information from the required article and your own words, summarize one limitation reported in the study. One limitation that was reported in the study was that not every patient that attended the clinic was approached by the researchers to see if they met the criteria to participate in the study (O’Connor et al., 2017). Sometimes the patient’s visit was so quick that the researcher officer did not have the opportunity to ask them to participate (O’Connor et al., 2017). Another reason that not every patient was asked to participate in the study that visited the clinic was due to the occasional absence of a research officer (O’Connor et al., 2017). Without the research officer at the clinic, there was no chance of the study being initiated to the subjects (O’Connor et al., 2017). Findings/Discussion: Using information from the required article and your own words, summarize one of the authors' findings/discussion reported in the study. Include one interesting detail you learned from reading the study. One of the specific findings that the study reported was the problems identified on the PL. Out of the 62 subjects that participated in the study, the top category of the problems identified was emotional problems (O’Connor et al., 2017). The top emotional problems that were identified were nervousness, being worried, and fear; with nervousness being the top problem identified (O’Connor et al., 2017). Out of the 62 subjects, 39 identified nervousness as an identifiable problem (O’Connor et al., 2017). On the DT range (which goes “hand in hand” with the PL), 10 out of the 12 patients that had cervical cancer scored in the 7-10 range compared to the other gynecologic cancer patients (O’Connor et al., 2017). One interesting detail that I learned from reading the study was that about 12% of the subjects with gynecologic cancer have had it for a year or more (O’Connor et al., 2017). I think that gynecologic cancer patients need the DT and PL screenings as soon as they are diagnosed with cancer throughout their term with the cancer. Distress can change in intensity, depending on the prognosis of the type of gynecologic cancer and/or how a person’s cancer reacts to treatment. Support and continual assessment of a patient’s distress level should be part of the holistic care plan for the patient Reading Research Literature: Summarize why it is important for you to read and understand research literature. Summarize what you learned from completing the reading research literature activity worksheet. It is very important when reading research literature to understand all of the components that are involved during the specific study. For instance, it took me several times (about 20) to read over the assigned article to get a clear understanding of the data results and meanings. In reading this research study, I learned the importance of screening with a DT and PL for distress in patients with any type of cancer. The results of the study showed that screenings and interventions help patients with their levels of distress by enabling them to think in a broader spectrum about issues that they may have not known to ask, or might have been too embarrassed to ask (O’Connor et al., 2017). The results also showed that the health care professionals benefited from the DT and PL (O’Connor et al., 2017). The screenings helped the health care professionals to determine what specific level of distress the patient was at so that they can implement the correct resources before a crisis occurred (O’Connor et al., 2017). It is through reading and understanding research literature that keeps nurses up-to-date on current studies. When the implementations of current evidence-based practices are used in nursing, optimal patient care can be achieved. [Show Less]
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NR 439 Week 3 Graded Discussion: The Literature Review and Searching for Evidence
NR 439 Week 3 Graded Discussion: The Literature Review and Searching for Evidence This week’s graded topics relate to the following Course Outcomes (COs... [Show More] ). CO 1: Examine the sources of evidence that contribute to professional nursing practice. (PO 7) CO 2: Apply research principles to the interpretation of the content of published research studies. (POs 4 & 8) CO 4: Evaluate published nursing research for credibility and clinical significance related to evidence-based practice. (POs 4 & 8) You must access the following article to answer the questions: Baker, N., Taggart, H., Nivens, A. & Tillman, P. (2015). Delirium: Why are nurses confused? MedSurg Nursing, 24(1), 15-22. permalink (Links to an external site.)Links to an external site. Locate the literature review section. Summarize using your own words one of the study/literature findings; include how the author’s review of literature (studies) supported the research purpose/problem. Share something that was interesting to you as you read through the literature review. Describe one strategy you would use to create a strong literature review/search for evidence. Share your thoughts on the importance of a thorough review of the literature. ANSWER After reading the article Baker, N., Taggart, H., Nivens, A. & Tillman, P. (2015). Delirium: Why are nurses confused? MedSurg Nursing, I concluded that the authors of the article were interested in investigating whether delirium is under-diagnosed and under-recognized by the nursing professionals. The authors were also interested in researching the whether the frequent assessments by nursing professionals is key to early detection and treatment. According to the authors of the article, one of the literature findings of the ability of the nurses to recognize delirium in patients is by Voyer (2008). According to this study, there is a significant evidence to show that nurses under-recognize delirium in the long-term care of the older patients (adults) Voyer (2008) observed that the incidence of delirium in the patient participants was 71.5%. Among the identified participants, nurses could only identify delirium in only 13% of the participants. In their review of the research, Baker, Taggart, Nivens, & Tillman (2015) were able to support their research of the problem. As I read through the literature review section of the article, one thing that was interesting to me is that despite taking over 15 hours of dementia detection and instruction on delirium, the nurse investigators still ended up with poor results that could not identify the condition. This is interesting and worrying at the same time because it implies that the possibility of misdiagnosis or un-recognition of delirium is high. One strategy that I learned and that would help in creating a strong literature review/search for evidence is the use of appropriate resources obtained from reliable databases. For instance, I would use Cumulative Index to Nursing and Allied Health Literature (CINAHL) to review the nursing research because it is one of the most important databases available for nursing research professionals (Houser, 2018). References Baker, N., Taggart, H., Nivens, A. & Tillman, P. (2015). Delirium: Why are nurses confused? MedSurg Nursing, 24(1), 15-22. Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th Ed.). Burlington, MA: Jones & Bartlett Learning. [Show Less]
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