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Yoost Chapter 13: Evidence-Based Practice and Nursing Research TERMS

Terms in this set (63)

Evidence Based Practice
is the integregration of best research evidence with
1) Clinical Expertise
2) Patient Values & Needs
3) the delivery of quality, effective Health care
What is the ultimate goal of EVP?
To promote positive outcomes for the patient
Research is defined as
the diligent, systemic inquiry or investigation to validate and refine existing knowledge and generate new knowledge

"systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalizable knowledge"
basic research
research conducted to generate theories which help provide explanations for phenomena
What are three types of research used to gather data?
Quantitative, Qualitative, Combined
Applied research
testing theories in different situations with different popularions
Quantitative Research
research that collects and reports data primarily in numerical form
- based on postpositivist philosophy, which assumes taht reality is objective, fixed, stable, observable, measureable, and value free and assumes that the approach is deductive in nature and it seeks to gain knowledge through scientific and experimental research
Clinical research
conducted to test theories about the effectiveness of interventions
Deductive reasoning
formulates a conclusion from a large amount of data
What are two criteria are measured from the ANA standards of professional performance that require nurses to use research findings in practice?
1) Nurses need to use the best available evidence, which includes research findings, to guide their practice decisions
2) Nurses participate in research activities that are appropriate for their position and level of education. Activities may include identifying problems in the clinical setting that may be researched, participating in data collection, participating as a member on a research committee or research program; sharing research findings the nurse has found with others; using research findings to develop policies, procedures, and standards for patient health care at facilities, and incorporating research as part of ongoing learning as a nurse
What are the three different types of quantitative research?
Descriptive research
Correlational research
Experimental research
What is the NINR? Where is it? What is its mission?
National Institute for Nursing Research
Mission: to promote and improve the health of individuals, families, & communities. Support and conduct clinical and basic research training on health and illness across the lifespan
Descriptive research
identifies data and characteristics about the population or phenomena.
Phenomena
a fact, event, or circumstance that can be observed or experienced
Correlational Research
type of quantitative research used to explore a relationship between two variables, such as weight and age. There is no control over the variables in this research. May be done by looking retrospectively at a phenomena
Variable
concept or item that has values that can change and that can be measured, manipulated, or controlled in the study
Experimental Research
Type of quantitative research that explores the causal relationships between variables. Examines whether or not one variable has a cause-and effect relationship with another, such as BP medication having an effect on decreasing BP
Quasi-experimental research
type of quantitative research conducted to explain relationships, clarify why certain events happen, and examine causality between selected independent and dependent variables
What are 4 types of Qualitative research?
Phenomenology, grounded theory, ethnography, and historical
Phenomenological research
Qualitative theory that explores the experiences of a specific group of people experiencing a similar event in their lives; lived experiences
Grounded theory research
Qualitative theory that consists of deriving a theory from the data collected in the research
Has been used to study postpartum depression, communication processes, and the way people with HIV manage their illness.
Ethnography
A qualitative research method that focuses on the sociology of meaning through close field observation of a sociocultural phenomenon. Studies way of life of a group of people by close observation of them over a relatively long period of time.
Historical Research
studies historical documents to determine an accurate picture of a past event or time period
When does a literature review occur?
After a research problem is identified and after ethical procedures are addressed
literature review process
identify sources of the literature
seek and retrieve the literature
collect and record information
analyze and synthesize information
systematic review
a literature review that provides comprehensive, unbiased analysis though the use of a strict scientific design to select and assess each of the studies
- includes an overview of the subject, which involves dividing the literature into categories of articles that support a particular position and those that do not, conclusions are drawn about their contributions based on the persuasiveness of their findings.
meta-analysis
a "study of studies" that merges the findings of related studies to discover similarities and differences
What happens after the literature review?
Hypothesis or research questions are formulated
hypothesis
statement about two or more variables and their relationship to each other.
sample
consists of individuals in the population from whom the data will be collected
Instruments
data collection tools; i.e. questionnaires, interviews, focus groups, diagnostic information concerning patients or information (age, gender, ethnicity, vital signs)
Independent variable
The experimental factor that is manipulated; the variable whose effect is being studied. In research, this variable comprises the experimental treatment or intervention, and it is manipulated to yield various outcomes
dependent variable
The outcome factor; the variable that may change in response to manipulations of the independent variable.
Controlled study
Clinical trial in which the subjects are distributed into groups which are either subjected to the experimental procedure (as use of a drug) or which serve as controls. The purpose of this type of study is to prevent bias and ensure the outcome results from treatment rather than another factor.
instiutional review board (IRB)
a review committee established to help protects the rights and welfare of human research subjects. Regulations require board approval for research involving human subjects if it is funded or regulated by the federal government. Most institutions, professional orgs, and scholarly journals apply the same requirements
human subject
A living individual about whom an investigator conducting research obtains (1) data through intervention or interaction with the individual or (2) identifiable private information
Interventions: the full range of strategies designed to protect health and prevent disease, disability, and death
Interaction: refers to any communication or contact during the research
Beneficence Principle
reminds researchers to minimize harms and maximize benefits
Justice Principle
requires researchers treat people fairly and design research to select subjects equitably and avoid exploitation of vulnerable populations
Autonomy Principle
ability to understand and process info and ability to volunteer. Vulnerable subjects are those with diminished autonomy.
Informed consent
An ethical principle requiring that research participants be told enough to enable them to choose whether they wish to participate.
Begins when the subjects are recruited and continues throughout the research process
Confidentiality
assurance that information can be viewed only by those requiring access
anonymity
means a persons identity or personal info is not known. When collected, this type of data must be kept anonymous.
Data Analysis
techniques used to summarize words or numbers and create a meaningful result for interpretation. Quantitative analysis involves statistical analysis and Qualitative involves content analysis.
Dissemination
Communication and distribution of the research findings. May occur by publication in a journal, an oral presentation, or at a workshop
How did Nightingale contribute to EBP?
Her method of including rigorous monitoring of the effectiveness of interventions and treatments provided the initial basis for EVP. Her work was based on trial and error, careful observation, discussion with patients, and clinical experience. She used statistical data to improve sanitation, health, nursing education, and health administration. She applied a statistical approach to the study of public health and mortality data and used a pie chart to display research findings.
When did nursing publish it's first EBP journal?
1998
Archie Cochrane
- called for efforts to make research summaries about interventions available to HCPs
- efforts led to development of Cochrane center and Cochran Collaboration
- aims to help providers make good health care decisions by preparing and disseminating systematic reviews of the effects of health care interventions
Research utilization
A subset of evidence-based practice that focuses on the application of research findings to improve clinical practice. As research is conducted, over time evidence accumulates on a topic. Eventually the evidence becomes accepted into practice. Often, there is a considerable gap in the amt of time between conducting the research and its acceptance. Research utilization is the direct application of findings from a single study to patient care (e.g. tracheal suctioning techniques)
What are the 6 phases of EBP?
1) Assess the need for change in practice
2) Locate the best evidence
3) Critically analyze the evidence
4) Design practice change
5) Implement and evaluate changes in practice
6) Integrate and maintain change in practice
The following incorporates what stage of the EBP model for change?

- Include stakeholders
- collect internal data about current practice
- compare external data with internal data
- identify problem
- link problem interventions and outcomes
Phase 1 - Assess the need for change in practice
The following incorporates what stage of the EBP model for change?

- ID types of sources of evidence
- Review research concepts
- Plan the search and review
- Conduct the service
Phase 2: Locate the best evidence
The following incorporates what stage of the EBP model for change?
- Critically appraise and weigh the evidence
- Synthesize the best evidence
- Assess feasibility, benefits, and risks of new practice
Phase 3: Critically analyze the evidence
The following incorporates what stage of the EBP model for change?
- define proposed change
- ID needed resources
- design the evaluation of the pilot
- design the implementation plan
Phase 4: Design practice change
The following incorporates what stage of EBP?
- implement pilot study
- evaluate processes outcomes, and costs
- develop conclusions and recommendations
Phase 5: Implement and evaluate change in practice
The following incorporates what stage of the EBP model for change?
- communicate recommended changes to stakeholders
- integrate into standards of practice
- monitor process and outcomes periodically
- celebrate and disseminate results of project
Phase 6: Integrate and maintain change in practice
stakeholder
An individual, group, or organization who may affect, be affected by, or perceive itself to be affected by a decision, activity, or outcome of a project.
ue
1. Assess need for change by identifying a problem
- nurse collects data about the current practice to determine what is being done in response to the identified problem. Major stakeholders such as staff nurses, patients, administrators are involved
2. Developing a question: formulating a specific research question so the nurse can effectively research the literature databases.
3. Searching for and Evaluating Evidence: using general info (background sources), filtered resources, and unfiltered resources
4. Develop the plan
5. Implement the plan
6. Reevaluate
PICOT
method of formulating a research question
(Patient, population or problem/ Intervention / Comparison Intervention / Outcomes / Time)
general information (background) resources
provide detailed information, provide presentation of info or types of therapies. Include UpToDate, STAT!Ref, and MD consult
filtered resources
literature that has been searched & evaluated for you
Unfiltered resources
provides the most recent information but is not designed for answering clinical questions because you have to evaluate the information first; takes time, effort, and expertise
validity
the extent to which a test measures or predicts what it is supposed to
what does MAGNET status refer to?
Recognition diven by the American Nurses Credentialing Center, an affiliate of the ANA. To be given this status hospitals must satisfy a set of criteria designed to measure the strength and quality of nursing.
Characterized by:
- excellent patient outcomes due to nursing
- a high level of nursing job satisfaction with a low nurse turnover rate
- appropriate resolution of any grievances
- supports an EBP enviro, which includes nurses autonomy to improve the quality of health care through research utilization
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