EBP Exam I (Ch. 1, 2, & 3)
Iowa Model of Research in Practice
was revised in 2001 and renamed the Iowa Model of Evidence Based Practice to Promote Quality Care and included steps on how to carry out processes and activities of EBP
responsibility
willingness to respect one's professional obligations and follow through on promises
Key nursing research journals include
-Advances in Nursing Science -Applied Nursing Research -Image: Journal of Nursing Scholarship -Nursing Research -Nursing Science Quarterly -Research in Nursing and Health -Scholarship Inquiry for Nursing Practice -Western Journal of Nursing Research
What were some things the Germans did for experiments?
-Air Force pilots were placed in vacuum chambers that could duplicate the low air pressure and anoxia (the Germans were interested in understanding if pilots could survive at extremely high altitudes) -they were also involved in investigating survival times after pilots parachuted into cold water -pilots were immersed for hours in tubs of ice water -some pilots were fed nothing for days but saltwater -in some concentration camps, Polish women were shot and slashed on the legs and the wounds were then stuffed with glass, dirt, and various bacteria cultures and sewn shut. These wounds were then traded with experimental anti-infective agents
List of Vulnerable Populations
-Children; Elderly -Cognitively impaired; mentally incapacitated -Human fetus; Neonate -Students; Employees -Prisoners -Terminally ill patients; Sedated or unconscious (comatose) patients
Important features or Characteristics of EBP
-EBP is a problem solving approach that considers the context of the nurse's current clinical experience -EBP brings together the best available research evidence by combing research with knowledge and theory -EBP allows patient values to be heard. If they are to serve the patient, the unique preferences, concerns, and expectations each patient brings to a clinical encounter are integrated into clinical decisions
The ANA developed two documents that provide direction for nurses engaged in research activities:
-Guidelines for Investigative Function of Nurses -Human Rights Guidelines for Nurses in Clinical and Other Research
Foreground questions include four components (PICO):
-P: patient/population -I: intervention -C: comparison -O: outcomes
informed consent
-Process of providing an individual with sufficient information regarding his/her participation in a research study. -Central Element: Principle of Self-Determination -Key Elements: (1) provide sufficient information about the study to all participants, (2) ensure the participant comprehends the information provided, and (3) participation is voluntary and can withdraw at any time.
anonymity
-a condition in which the identity of subjects remains unknown, even to the researcher, to protect subjects participating in a study and to promote objective results
MD consult
-a database that provides full-text access to textbooks, journal articles, practice guidelines, patient education handouts, and drug awareness
non experimental research
-a descriptive study that does not exhibit a great amount of control over variables
research team
-a group that collaborates to conduct a research project, from determining the initial research question through communicating the results
Three limitations of evidence based practice
-a shortage of coherent, consistent scientific evidence -difficulties in applying any evidence to care of individual patients -barriers to any practice of high quality medicine
meta-analysis
-a statistical method that takes the results of many studies in a specific area and synthesizes their findings to draw conclusions regarding the state of the science in the area of focus
experimental research
-a study in which the researcher manipulates and controls one or more variables and observes the effect on one or more other variables
cross sectional research
-a study that collects data at a particular point in time and does not require follow up
retrospective research
-a study that examines data collected in the past
prospective research
-a study that examines data collected in the present
longitudinal research
-a study that follows a cohort of subjects and collects data over time
nursing research
-a systematic process of investigating problems to gain knowledge about improving care that nurses provide
scientific method
-a systematic research process that involves the following steps: selecting and defining the problem, formulating research questions or hypotheses or both, collecting data, analyzing data, and reporting results
correlational research
-a type of non experimental study designed to examine relationship between and among variables
descriptive research
-a type of non experimental study designed to provide a knowledge base when little is known about a phenomenon; used to describe variables rather than to test a predicted relationship
basic research
-a type of study designed to develop the knowledge base and extend theory without direct focus on clinical application
applied research
-a type of study designed to gather knowledge that has direct clinical application
Two factors emerge when attempting to ensure the right to freedom from injury:
-ability of the benefit to justify participants' exposure to involved risks -the participants' vulnerability
objectivity
-ability to distance the research process as much as possible from the scientist's personal beliefs, values, and attitudes
Data Access
-all coinvestigators on a team have access to data, as agreed on at the beginning of the research project, and all assume responsibility for safeguarding data confidentiality -without violating subject information confidentiality, scientists should provide data to the journal editor, if requested, to enable a more complete evaluation of manuscripts -following publication of results, scientists may be expected to provide sufficient information to enable other qualified scientists to replicate the study -different considerations apply before publication. Research materials and data are considered privileged until they are formally disseminated. Disclosure or sharing data prior to peer review and publication may violate confidentiality -sharing of results with the news media should only be done following completion of peer review -any discoveries/inventions from research leading to patents are governed by policies of the institution -investigators are encouraged to provide other researchers, including graduate students with access to their data for purposes of secondary analysis
quantitative research
-an approach for generating knowledge based on determining knowledge based on determining how much of a given behavior, characteristic, or phenomenon is present
qualitative research
-an approach for generating knowledge using methods of inquiry that emphasize subjectivity and the meaning of an experience for the individual
ways of knowing
-an assortment of methods used to acquire new knowledge, including tradition, authority, trial and error, and intuition
Guidelines for Authorship of Published papers
-authors contribute substantially to the published work. This involves assuming responsibility for two or more of the following areas: conception and design, execution of the study, analysis and interpretation of data, and preparation and revision of the manuscript. Others, who provide financial, technical, information, or other kinds of support, may be acknowledged but may not be considered authors. -decisions about conferring and ordering of authorship need to be made in advance, based on the foregoing considerations. Order may be reassessed if contributions change -status of individuals, such as trainees/students or their rank per se, should not be a determining factor in authorship decisions -it is important to realize that the principal investigator, when directing a team on sponsored projects, assumes overall responsibility for all publications resulting from the project, regardless of his or her authorship status, unless negotiated otherwise -all authors should review the final manuscript and take responsibility for the work -duplicate and fragmented publications should be avoided. When the same or substantially similar content is reported in two or more publications, authors should notify editors, who should inform reviewers -authors should provide additional information requested by editors (e.g., raw data, delineation of authors' contributions, assurances that appropriate regulatory guidelines have been met in the conduct of research) -when parties disagree on authorship matters, they are encouraged to seek consultation from colleagues
Nuremberg Code
-developed in 1947 to address protection of human participants and basic principles of ethical behavior -articles within the code emphasize adequate protection of subjects from risk or harm, the right to withdraw from experimentation, and adequate qualifications of those conducting research
Postdoctoral Programs
-establish programs of research with formal mentorship from senior researchers/scientists
Master's Degree in Nursing
-evaluate research findings -develop and implement evidence-based practice guidelines -identify practice and systems problems requiring study -collaborate and assist others in initiating research
The concept of EBM has been expanded and applied across all health care areas under the term what?
-evidence based health care (EBH) or evidence based practice -both terms refer to the critical appraisal of research findings and decisions regarding whether, and how, to use findings in the care of patients
PICO Model
-four components (P-Patient/Population/Problem; I-Intervention; C-Comparison; O-Outcome) that provides structure when writing clinical questions
knowledge-focused triggers
-ideas that emerge from staff when they read, listen to research presentations, or encounter EBP guidelines by federal agencies or specialty organizations
problem-focused triggers
-ideas that emerge from stage in the context of clinical practice by examining quality improvement data, risk surveillance data, benchmarking data, or a recurrence of a clinical problem
Declaration of Helsinki
-in 1964, the World Medical Association met in Finland and developed guidelines for physicians conducting research -the essence of the Declaration was the need for subjects to be informed of the benefits of the study before consenting to participate in the research -subjects were to be informed when their participation could be harmful or of little value to them
The Tuskegee Syphilis Study
-included 400 black sharecroppers diagnosed with syphilis and 200 black men who did not have syphilis -begin in 1932 and ended in 1972 -the USPHS did not inform subjects that they were part of a research study on syphilis -they were told that they were being treated for bad blood -1933, USPHS decided to continue the study and treat the subjects with mercurial ointment, a noneffective drug -1936, first reports were out that men with syphilis developed more complications than did the control group -1946, death rate for men with untreated syphilis was twice as high as for the control group -1955, reported that more than 30% of those autopsied died directly from advanced syphilitic lesions of the CV or CNS
What is important about nursing research?
-it is an established reality -it is no longer necessary to justify its value -nurses must focus on improving their understanding of the research process and fostering the development of research designs that provide the information needed to explain, change, and expand nursing practice
Reasons for the Delay in Using Research Findings in Nursing Practice
-nurses in practice do not know about research findings -nurses in practice are often not clear about who will benefit from the research findings or about the risk involved -nurses in practice do not usually associate with those individuals (i.e., scientists, academic researchers) who produce knowledge. There is often a lack of dialogue between researchers and clinicians -nurse researchers and nurse clinicians use different languages --nurses in practice lack the skills to locate and read research reports -research is often reported in language of statistics instead of being reported in clinically meaningful terms -nurses and nurse managers do not develop opportunities for acceptance and introduction of innovation
What is the major difference between scientific research and nursing research?
-nursing research primarily involves studying people, and people do not behavior consistently, as do chemical in a laboratory -in a laboratory setting, it is much easier to explain, predict, and control the situation -ethical considerations do not allow the full range of experimental techniques with people
Right to Freedom from Injury
-participants have the right not to incur physical or emotional injury as a result of participating -if there is a possibility that any injury could occur, subjects need to know an estimate of the extent of such injury before giving their consent
What are ways to expand your knowledge of research-extension activities?
-participate in or set up a journal club in a practice setting in which nurse colleagues discuss research articles -attend research presentations at professional conferences of interest to you. -help develop an idea for a research study -review a completed research proposal and offer your clinical expertise and mentorship, if possible -assist in data collection research, for example, distributing questionnaires to patients or observing and recording patients' behaviors -collaborate on the development of an idea for a research project in your field -participate on a hospital or university institutional review board that examines the ethical aspects of a proposed study
confidentiality
-protecting data that are gathered or learned from patients by not disclosing information without their permission
AIDSLINE indexes
-published literature HIV infections and AIDS -it focuses on the biomedical, epidemiological, oncological, health care administration, and social and behavioral sciences literature -indexes literature from journal articles, monographs, meeting abstracts and papers, newsletters, and government reports
Research-focused Doctoral Programs
-pursue intellectual inquiry and conduct independent research for the purpose of extending nursing knowledge -plan and launch independent programs of research
background questions
-questions focusing on basic or general knowledge about a condition and/or disorder
foreground questions
-questions focusing on specific knowledge to inform clinical decisions or actions
Baccalaureate Degree in Nursing
-read, understand, interpret, and apply research findings from nursing and other disciplines into clinical practice -understand basic elements of evidence based nursing practice -work with others to identify potential nursing research problems that need to be investigated -collaborate on research teams -share research findings with colleagues
research consumer
-readers of nursing research whose objective is to apply findings to nursing practice or to use the findings to conduct further research
clinical expertise
-refers to the proficiency and judgment nurses acquire through clinical experience and clinical practice -the best clinical evidence can inform, but never replace, clinical expertise -it also decides whether the evidence applies to the individual patient and how it is integrated into a clinical decision
3 Human Rights according to the ANA guidelines
-right to freedom from injury -right to privacy and dignity -right to anonymity and confidentiality
The Steps associated with Guiding the Process of EBP include
-selecting a topic and formulating a question -forming a team -tracking down the best possible evidence -appraising the evidence critically
What are the general steps associated with the research process?
-selecting and defining the problem -selecting a research design -collecting the data -analyzing the data -using the research findings
Data management
-specific teams should develop and agree on procedures appropriate for the project -data are collected according to stated protocol -potential sources of bias in design and conduct are identified and minimized by researchers -scientists have the responsibility to ascertain that data are reported accurately, including the decision rules used for collecting and analyzing data -if an error is discovered, it is corrected and made public -the principal investigator is responsible for ensuring that data are of high quality and that steps are takin to prevent intentional withholding or selective reporting of data that may be contrary to investigator expectations -it is recommended that original data be preserved for a period of 5 to 7 years or longer, as there is reasonable expectation that the original data will continue to be the basis of ongoing research, publication, or both. Exceptions involving considerations for human subjects may be negotiated with the institutional review board
ACP Journal Club
-the ACP (american College of Physicians) Journal Club summarizes and interprets the best evidence of one recent study or review article from traditional journals, based on the criteria provided by the practitioner
Selecting a Topic and Formulating a Clinical question
-the Iowa Model of Evidence Based Practice to Promote Quality Care -the selection of a topic can be either a knowledge focused trigger or problem focused trigger
The Willowbrook Study
-the Willowbrook State School on Staten Island, New York -the focus of unethical research from the 1950s to 1970 -subjects were mentally handicapped children who were given either intramuscular or oral doses of hepatitis B virus -if parents wanted their kids to attend school, parents were required to sign their child on as a study participant and they gave consent for the administration of the hepatitis B virus -no parents were informed of the dangers of the hepatitis B virus -Willowbrook closed its doors to new admissions but continued to admit new residents -the researches believed they were conducting an ethical research call "natural experiments" -the belief was the if there was no cure or treatment for a particular disease, then observing its course with the informed consent of participants is a study of nature
replication
-the ability of researchers to repeat a study using the same variables and methods or slight variations of them
What is evidence-based practice?
-the clinical decisions and actions based on research findings -it relies on evidence from research to clinicians making an effort to integrate research findings into clinical thinking and decision making
evidence-based medicine (EBM)
-the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of EBM means integrating individual clinical expertise with the best available external clinical evidence from systematic research
Evidence based nursing (EBN)
-the conscientious, explicit, and judicious use of theory derived, research based information in making decisions about care delivery to individuals or groups of patients and in consideration of individual needs and preferences -stresses the use of research findings
evidence-based nursing (EBN)
-the conscientious, explicit, and judicious use of theory-derived, research-based information in making decisions about care delivery to individuals or groups of patients and in consideration of individual needs and preferences
MEDLINE
-the largest biomedical research literature database and is available on CD-ROM and the Internet -comprises information from several print indexes, including Index Medicus, Index to Dental Literature, and International Nursing Index.
research utilization
-the process by which knowledge generated from research becomes incorporated into clinical practice
scientific inquiry
-the process of analyzing data critically that have been fathered systemically about a particular phenomenon -a process in which, observable, verifiable data are systematically collected from our surroundings through our senses to describe, explain or predict events
human rights
-the protection of subjects participating in a research study; includes the right to freedom from injury, the right to privacy and dignity, and the right to anonymity and confidentiality
risk-benefit ratio
-the relationship between potential harm to subjects and potential positive outcomes gained by participating in a research stud; an evaluation used by subjects to make voluntary informed consent
Step 2: Selecting the Research design
-the researcher designs the study and plans the methods of subject selection, testing, and measurement to ensure that all procedures are clearly defined -the choice of design is based on how the research problem is conceptualized -the design helps guide to help with the selection of appropriate methods for analyzing the data
Step 3: Collecting data
-the researcher implements the plans that were designed -this step is the most time consuming -after the data is collected and recorded, the researcher must organize the information into an appropriate form for analysis
Four major categories associated with EBP
-therapy, treatment, diagnostic tests, and prognosis -may not require RCTs, or RCTs may have not been conducted
National Guideline Clearinghouse
-this Clearinghouse provides a collection of evidence-based clinical practice guidelines
vulnerable research participant
-those persons who are relatively or absolutely incapable of protecting their own interests and unable to provide meaningful informed consent
Components of Informed Consent
-title of the study -personnel engaged in the study (e.g. principal investigator, coinvestigator(s), research assistants) -invitation to participate in the study (e.g. "You are invited to participate in a research study"; not "requested", "chosen", or "eligible") -reason the particular person is being invited to participate -clear description of the purpose of the study -detailed description of procedures of the study (e.g., descriptions what will actually occur; how much time is required of the subject; whether hospitalization will be required and whether it will always, sometimes, or never be required and whether it will always, sometimes, or never be required as part of the subject's standard care; how much and how often blood will be drawn, if applicable) -potential risks to subjects, including psychological, social, and physical risks (e.g. explanation of steps that will be taken to protect against risks; estimation of likelihood of occurrence, severity, and duration of potential risks, if applicable) -potential benefits of the study (e.g. identification of desired benefit to society, the risk-benefit ratio, statement of whether there are direct subject benefits) -economic considerations (e.g., whether subjects will incur any additional expenses as a result of participation) -confidentiality considerations (e.g. explanation of steps that will be taken to ensure the confidentiality of information that is obtained during the course of the study, such as who will have access to the data and when the data and specimens will be destroyed) -freedom of subjects to ask questions and withdraw from the study at any time without penalty
What is the goal of research?
-to discover new knowledge and relationships and find solutions to problems or questions -it is synonymous with problem solving
What is the major responsibility of an IRB?
-to review research proposals at convened meetings to ensure that federal guidelines are followed -it also ensures that the researcher is not violating right of human participants -they also review the procedures for selecting subjects, ensuring voluntary informed consent, clearly written descriptions, and confidentiality
Practice-focused Doctoral Programs
-translate scientific knowledge into complex clinical interventions tailored to meet individual, family, and community health and illness needs -use advanced leadership knowledge and skills to evaluate the translation of research into practice and collaborate with new researchers/scientists on new health policy research opportunities -focus on evaluation and use of research rather than the conduct of research
Qualitative research emphasizes on what?
-verbal descriptions and the meaning of the experience for the individual -it also emphasizes the understanding of phenomena from the individual's perspective
Evidence based medicine (EBM)
-was originally defined by Sackett and colleagues as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. -EBM means integrating individual clinical expertise with the best available external clinical evidence from systematic research
Code of Ethics
A set of guiding principles that all members of a profession accept.
Research Participants at RISK
ALL participants: a basic responsibility of the researcher and those assigned to assist in carrying out the study is to protect all research participants from harm while they are participating in a study.
EBMR combines several electronic databases including
MEDLINE, HealthSTAR, CANCERLIT, AIDSLINE, Best Evidence (BE) and the Cochrane Database of Systematic Reviews
NCNR
National Center for Nursing Research
True/False: The research process is circular.
True
What is nursing?
a discipline with its own body of knowledge that focuses on knowing and understanding individuals and their health experiences
What is the result from cross sectional research?
a measurement of what exists today, with no attempt to document changes over time in either the past of the future
What is meta-analysis sometimes referred to as?
a quantitative synthesis, is not a research design, rather, it is a method that takes the results of many studies in a specific area and synthesizes their findings to draw conclusions regarding the state of the science in the area of focus.
Background questions include two essential components:
a question (who, what, where, how, why) and a verb
nursing science
a unique body of nursing knowledge
accountability
ability to answer for one's actions
advocacy
advocate for health, safety rights
fidelity
agreement to keep promises
use of the best evidence from patient centered clinical research
allows accuracy and precision of diagnostic tests; the power of prognosis markers; and the efficacy and safety of therapeutic and preventive regimens
clinical practice
an integral part of nursing's activities, along with education clinicians and administration of nursing services
Vulnerable Population
anyone who is unable to provide meaningful informed consent.
What are some ways to obtain informed consent if some have physical handicaps?
audiotaped or videotaped recording may be used to present information and obtain verbal consent
risk/benefit ratio
benefits should exceed the risk
CANCERLIT indexes
cancer literature, including journal article, government reports, technical reports, meeting abstracts and papers, and monographs
What does the Scientific Integrity Guidelines include?
data access and management and publication practices.
Research
deals with discovering or generating new knowledge
Scholarly publications
documents that communicate to other professionals the methods and achievements use in academic study and research investigation
What is prospective research?
examines data collected in the present. These studies are more reliable than retrospective studies because of the potential for greater control of data collection
What is the difference between experimental research and non experimental research?
experimental research involves manipulation whereas non experimental research involves more descriptive or exploratory measures
Appraising the Evidence Critically
for many years, the focus on "effectiveness of health care interventions" has been the main reason RCTs have been ranked as the strongest level of evidence
autonomy
freedom from external control
randomized control trials (RCTs)
have become the "gold standard" for judging the strength and quality of the evidence
As consumers of research, what do nurses need to know?
how information is gathered and organized in a research or scientific context
Best evidence from research studies is found?
in a number of electronic databases. The best of these is Evidence Based Medicine Reviews (EBMRs) from OVID Technologies, which includes the Cochrane Database of Systematic Reviews
Where is applied research usually performed?
in actual practice conditions, on subjects who represent the group to which the results will be applied
Instead of individual subjects being the unit of analysis,
individual studies are the unit of analysis
The term "research"
is derived from an earlier word that means to go around, to explore, and to circle
What is the focus of research priorities?
is on health promotion and disease prevention; improving quality of life through self management, symptom management, and caregiving; eliminating health disparities; and taking the lead in addressing end-of-life research
What did the Declaration of Helsinki allow?
it allowed legal guardians to grant permission to enroll subjects in research and recommended written consent be given
What is the value of the use of the scientific method?
it can be replicated by other researchers
What is retrospective research?
it examines data collected in the past, typified by review of medical records
What does repeating a study do for research?
it increases the extent to which the research findings can be generalized, providing additional evidence of validity
What does the research process involve?
it involves decision making in order to consider various alternatives and to decide what methods will answer particular research question(s) or test hypotheses.
What is the purpose of applied research?
it is conducted to gain knowledge that can be used in a practical setting
Sharing Research evidence and Findings
it is important for health care professionals to share research evidence and findings with patients and their families with professional sensitivity and responsibility
What is an advantage of an expedited review?
it is usually completed in less time than that required for a full IRB review
What does basic research closely resemble?
it resembles the work done in laboratories and is associated with scientists
What is evidence based practice?
it was derived from the principle that health care professionals should not center their practice on tradition or experience, but rather on scientific research findings . The term also originated within the field of medicine; it was initially termed evidence based medicine (EBM)
What was the purpose of the Willowbrook Study?
it was to determine the period of infectivity of infectious hepatitis
Reporting of research can take many forms including:
journal articles, abstracts, oral presentations, and poster presentations
Guidelines for Scientific integrity
nurse scientists are guided by principles that include respect for the integrity of knowledge, collegiality, honesty, trust, objectivity, and openness
As members of the research team,
nurses can collaborate on the development of an idea and actually participate in the design and production of a study
the NINR seeks to extend?
nursing science by integrating the biological and behavioral sciences, employing new technologies to research questions, improving research methods, and developing the scientists of the futures
What are two characteristics that are unique to the scientific method?
objectivity and the use of empirical data
What is the focus with HealthSTAR indexes?
on both clinical and nonclinical aspects of health care delivery. Material from books, book chapters, government documents, newspaper articles, and technical reports
Examples of knowledge focused triggers
pain management, prevention of skin breakdown, assessment of nasogastric tube placement, and potency of arterial lines
What tools are used for qualitative research?
participant observation, in-depth interviews, case studies, ethnographies, and narrative analyses which are used to gain new knowledge
Research Utilization Models
provide guidelines or steps on how to design and implement research utilization projections.
HealthSTAR indexes
published literature on health services, technology, administration, and research
MEDLINE indexes
published research in allied health, biological sciences, information sciences, physical sciences, and the humanities.
What is scientific inquiry sometimes referred to?
quantitative research
The Research Practice Gap
refers to that period from when knowledge is produced to when it is practiced by health care professionals
clinical experience
refers to the nurse's ability to use his or her clinical skills and past experience to identify each patient's unique health state and diagnosis, the individual risks, and benefits of potential interventions
Problem solving
refers to using current knowledge
What is the role of the research consumer?
requires the ability to read and evaluate research reports
What is proposed in Step 1 of the research process?
research questions, hypotheses, or both
Authorship in any type of journal indicates?
responsibility for the published work and significant contribution to the conception and execution of the paper
What does the scientific method involve?
selecting and defining a problem, formulating research question(s) or hypotheses or both, collecting data, analyzing data, and reporting results
The National Institues of Health (NIH) require
that all individuals receiving a NIH award must successfully complete an educational program reviewing issues (e.g., key historical events, ethical principles, informed consent, role of institutional review boards) that impact guidelines on human participant protection in research
The scope of research activities for which nurses are responsible is clearly articulated in a publication of what?
the American Association of Colleges of Nursing titled Position Statement on Nursing Research and Position Statement on Education for Participation in Nursing Research, published by the American Nurses Association
What developed the Scientific Integrity Guidelines?
the Midwest Nursing Research Society
In 1986, what was established under the Health Research Extension Act and the auspices of the American Nurses Association?
the National Center for Nursing Research (NCNR)
What was launched in 1987?
the National Nursing Research Agenda and it was to provide structure for selecting initiatives and developing the knowledge based for nursing practice.
World War II
the Nazi party exploited people's trust in the medical community and public health by performing unethical experiments on populations they discriminated against
What is the purpose of research utilization?
the application of available knowledge to improve patient outcomes
What is nursing research?
the systematic application of the scientific method to the study of phenomena of interest to the nursing profession
What did the CDC and Prevention conduct?
they conducted studies in the rural South to determine the prevalence of syphilis among blacks while exploring the possibilities of treatment. Tuskegee, a town in Macon County, Alabama, was found to have the highest incidence of syphilis among six counties.
What do the articles of Nuremberg Code serve as?
they serve as a standard against which to measure the individual rights of subjects participating in experimental and clinical research
In 1993, what was the NCNR awarded?
they were awarded the status of an institute in the structure of the National Institutes of Health (NIH) and was renamed the National Institute of Nursing Research (NINR)
How can knowledge be gained?
through tradition, authority, trial and error, personal experience, intuition, logical reasoning, and use of the scientific method
What was the purpose of the NCNR?
to conduct a program of grants and wards supporting nursing research and training, to promote health, and to further the prevention and mitigation of the effects of disease
Why do researchers continually review the literature?
to keep up with the most current information and to refer to other research reports to get ideas for sampling, operational definitions, and research designs
What is the purpose of basic research?
to obtain empirical data that can be used to develop, refine, or test a theory without immediate concern for direct application to clinical practice
What is the mission of the NINR?
to promote and improve health of individuals, families, communities, and populations. It supports and conducts clinical and basic research training on health and illness across the lifespan
What does research utilization emphasize?
translating empirically derived knowledge into real world application
What was the purpose of the study at Johns Hopkins University?
was to gain a better understanding of the pathophysiology of asthma, specifically the mechanism of airway hyper responsiveness -the study was based on the hypothesis that in normal individuals, lung inflation protects the airways from obstruction through a neural mechanism that might be lacking or impaired in people with asthma
The Crisis at Johns Hopkins University
-April 2001, a 24 year old healthy volunteer and technician -participants were given hexamethonium which treats hypertension but was removed from US market in 1972 after the FDA -the healthy volunteer died as a result of progressive hypotension and multi organ failure -after the death of the volunteer, Johns Hopkins temporarily suspended all studies involving health volunteers
The Cochrane Library
-an electronic library designed to make available the evidence needed to make informed health care decisions
Step 4: Analyzing the Data
-analyzing, interpreting and making valid conclusions about the data -statistical procedures are applied to summarize the quantitative data in a meaningful way -research hypotheses will bee either supported or not supported -analysis of results leads to new questions that stimulate further study
empirical data
-documented evidence through direct observation rather than a researcher's subjective belief
InfoPOEMS
-infoPOEMS (Patient-Oriented Evidence that Matters) is a database similar to the ACP Journal Club; it reviews and provides commentary on recent articles
Who typically serve on IRBs?
-lawyers -lay persons -clergy -the decision to approve, modify, or disapprove a proposal must be made by a majority of IRB members
Cochrane Database of Systematic Reviews
-one of the most popular databases is The Cochrane Library, which reviews and summarizes individual clinical trials and systematic reviews from more than 100 medical journals.
Step 5: Using Research Findings
-researchers have the responsibility of sharing their findings with other colleagues
research rigor
-striving for excellence in research, which involves discipline, scrupulous adherence to detail, and strict accuracy
nursing science
-the body of knowledge that is unique to the discipline of nursing
triangulation
-use of quantitative and qualitative methods to collect data about a particular phenomenon
What is science?
a method of knowing and acquiring new knowledge
beneficence
do good or actively do good
Examples of problem focused triggers
increased incidence of deep vein thrombosis, and pulmonary emboli
What is knowledge?
information acquired in a variety of ways
What did the nursing research agenda emphasize?
linking research to practice along with providing nurse researchers with an opportunity to interact among themselves and with researchers from other disciplines.
When human rights are violated,
nurses must report the concern to both the researcher and the IRB
What does descriptive research use?
questionnaires, surveys, interviews, or observations to collect data
Examples of NINR supported research include
-Cancer -End of Life -Feeding tubes -Care of AIDS Patients in Hospital Units -Diabetes -Cardiovascular Disease -Pain -Transitional Care
Examples of knowing:
-being familiar with a person -comprehending the facts -acquiring a psychomotor skill -mastering a subject matter
Step 1: Selecting and Defining the problem
-involves selecting and defining an area of research that provides an opportunity to advance nursing knowledge -through a review of related literature, the researcher determines a rationale for conducting the study, a justification of the need to investigate the problem, and a theoretical framework for interpreting the results.
Quantitative research emphasizes on what?
-measurement, questionnaires, and surveys to advance nursing science -more of objective data
What is the difference between Evidence Based Practice vs. Research Utilization?
-research utilization is the process by which knowledge generated from research becomes incorporated into clinical practice -this process involves critical analysis of research findings along with implementation and evaluation of changes in practices
Institutional Review Boards
-review groups that are responsible for ensuring that researchers do not engage in unethical behavior or conduct poorly designed research studies
Agency for Healthcare Research and Quality (AHRQ)
-the AHRQ has promoted EBP through the establishment of 12 Evidence-Based Practice Centers (EPCs)
What is purpose of Developing Professional Guidelines?
-to ensure the protection of human participants while research is conducted -these are based on the Nuremberg Code and the Declaration of Helsinki
True/False: The research process is flexible.
True
Limitations unique to the practice of EBM include
a need for developing skills in researching and appraising the research, the limited amount of time in practice to master such skills, and scarce resources to access the evidence
justice
act of fairness
disseminating research findings
an integral part of the research process
non-maleficence
do no harm
confidentiality
mandates the protection of a person's personal information
What is basic research referred to as?
pure or fundamental research
