Fundamentals of Nursing CH 2: Theory, Research, and Evidence based Practice

What was nursing like in the 20th century?

-women entering the workforce -nursing began to focus on education and research -nursing came to be recognized as a science -masters and PhD programs prove that society accepts that nursing is a science -In 2011 the Institute of Medicine (IOM) reported that nursing needs research for nursing practice, nursing education, and nursing leadership to meet the needs of patients and to become full partners in advancing health

Traditional Knowledge

"We've always done it this way" passed down from generation to generation

What was nursing like in the 50s?

-knowledge was acquired through lectures from physicians and through practical experience by caring for the sick. -Nursing care was carried out under the control of hospital administration and physicians -Based on traditional ideas and following orders as well as on common wisdom based on common sense

To ensure that a research study is ethical, a nurse researcher must observe which human rights for participants?

Fair treatment Self-determinism Privacy Anonymity

Who is considered to be the first nursing theorist who conceptualized nursing in terms of manipulating the environment?

Florence Nightingale

Who was the first nursing theorist?

Florence Nightingale

A community health nurse has been visiting a diabetic client whose morning fasting glucose levels are constantly elevated. Upon further assessment, the nurse determines that the client's spouse does not understand how to prepare meals following the prescribed diabetic diet. Using Dorothea Orem's Self-Care Theory, how can the nurse help meet the needs of this client?

Arrange an evaluation appointment with a dietitian.

Which is a focus of medical research rather than nursing research?

Drug metabolism

Which activity best helps the nurse apply theory to practice?

Evidence-based research

A nurse is planning to conduct a nursing research study and is seeking federal funding. Which institution would be most helpful for the nurse to contact regarding acquiring funding?

National Institute of Nursing Research

Nurses in an ICU noticed that their clients required fewer interventions for pain when the ICU was quiet. They then asked a researcher to design a study about the effects of noise on the pain levels of hospitalized clients. How does this demonstrate the ultimate goal of expanding the nursing body of knowledge?

Nursing research helps improve ways to promote and maintain health.

A group of nurses is planning to investigate the effectiveness of turning immobilized stroke clients more frequently in order to prevent skin breakdown. The team has begun by formulating a PICO question. Which element will the "O" in the team's PICO question refer to?

Preventing skin breakdown

A nurse is discussing dietary issues with a Latino client in the clinic. The client states, "My grandmother always told me that I needed to include beans in my diet so that my muscles would grow." The information that the client is expressing is known as what?

Traditional Knowledge

A novice nurse is sharing a newly published research article which outlines a different approach in preventing a wound infection after surgery with a colleague and states the nurse is going to try this new method. Which is the best response from the colleague?

Wait until the method is analyzed to ensure it will be appropriate for their clients.

A nurse is preparing to conduct a research study and uses the PICO format to develop the foreground question which is: "In adults, does reducing salt intake, compared to no change in salt intake, lower blood pressure?" The nurse identifies the "P" as:

adults

A nurse is preparing to conduct a research study and uses the PICO format to develop the foreground question which is: "In adults, does reducing salt intake, compared to no change in salt intake, lower blood pressure?" The nurse identifies the "P" as:

adults.

Phenomenology

describe experiences as they are lived by the subjects being studied

Historical

examines events of the past to increase understanding of the nursing profession today

Grounded Theory

how people describe their own reality and how their beliefs are related to their actions in a social scene

Ultimate outcome of what nursing is:

improved patient care

Science

observing, identifying, describing, investigating, and explaining events and occurrences that are perceived in the world

Developmental theory

outlines the process of growth and development of people as orderly and predictable -many influences on each stage

RIE

rapid improvement event

Philosophy

study of wisdom, fundamental knowledge, and the processes we use to develop and construct our perceptions of life

Adaptation theory

the adjustment of living matter to other living things and to environmental conditions -involves interaction and response

Abraham Maslow

theory of human needs essential to human life

Erik Erickson

theory of psychological development based on socialization

Evidence-based care emphasizes decision making based on the best available evidence and:

use of outcome studies to guide decisions.

Ethnography

used to examine issues of a culture that are of interest to nursing

The second step in implementation of evidence-based practice includes systematic review. To complete a systematic review of the literature, what must the nurse do?

Summarize findings from multiple studies that are related to a particular nursing practice.

80% of all hospital acquired infections are:

CLASBI (central line- associated bloodstream infection) CAUTI (catheter- associated urinary tract infection) VAP (ventilator- associated pneumonia)

A nurse develops the following foreground question using the PICOT format in preparation for a research study: "In overweight clients, how do chromium supplements compared to no supplements help with weight loss?" Which part of the question reflects the intervention?

Chromium supplements

Authoritative Knowledge

Comes from an expert. Senior staff teaching a skill to a new graduate nurse

In selecting sources to include in a literature review for a nursing research project, which would be most helpful?

Cumulative Index to Nursing and Allied Health Literature

Qualitative

Data in the form of words (To gain insight by discovering meanings in words)

Quantitative

Data that is in numbers

Process

A series of actions, changes, or functions intended to bring about a desired result.

A nurse is reading a research article from a nursing journal. The nurse is aware that the opening paragraph summarizing the article and the research findings is a good place to start. What part of the article is the nurse reading?

Abstract

When looking at a model for evidence-based practice, what is the final step of the process?

Evaluating practice change

Which theory emphasizes the relationships between the whole and the parts, and describes how parts function and behave?

General systems theory

Who is responsible for the General Systems Theory, what is it?

Ludwig Van Bertalanffy. How to break systems into parts and figure out how the parts work together in systems

What is the best explanation for the way evidence-based practice (EBP) has changed the way nursing care is delivered?

Nursing care now uses EBP as a means of ensuring quality care.

Which theory describes, explains, predicts, and controls outcomes in nursing practice?

Nursing theory

Scientific Knowledge

Obtained through scientific method (research)

PICO

P: patient, population, problem I: intervention C: comparison O: outcome

The focus of nursing is always on which of the four common concepts in nursing theory?

Person

Nursing research:

encompasses research to improve the care of people in the clinical setting as well as the broader study of people and the nursing profession, including studies of education, policy development, ethics, and nursing history