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Terms in this set (152)
What is research
systematic inquiry that uses disciplined methods to answer questions and solve problems
Nursing Research
systematic inquiry designed to develop trustworthy evidence about issues of importance to nurses and their clients
Triple Aim
Improve Health
Lower Costs
Better Care
Source of Evidence
Tradition
Authority
Clinical Experience
Logical Reasoning
Assembled Information
Scientific Method/Disciplined research
National Institute of Nursing Research - MISSION
Supports clinical and basic research to establish a scientific basis for the care of individuals across the life span.
Paradigm
A world view; a general perspective on the complexities of the real world, with certain assumptions about reality
Positivist assumption
Reality
exists.
There is a real world driven by natural causes.
Constructivist Assumption
Reality is multiple and subjective, constructed by individuals
Research Method
the technique used to structure a study and to gather, analyze and interpret information
Quantitative Research
Most often allied with positivist tradition Primary Numerical. Directed at description. Cause and effect
Qualitative Research
most often allied with the constructivist tradition. Constructivist. Primary word based. Holistic.
Mixed Methods
Uses a little bit of both
Purposes of Research
identification and description. exploration. explanation. prediction and control.
descriptive research
identify the nature and attributes of a nursing phenomena and sometimes the relationships among these phenomena
Explanatory Research
Provides a basis for conducting studies for the purposes of predicting and controlling patient outcomes
Relationships among variables are clarified
Predictive Research
Estimate the probability of a specific outcome in a given situation
Control
Manipulate the situation to produce the desired outcome
Basic Research (Pure Research)
Pursuit of knowledge for knowledge sake
Applied Research
An investigation that seeks to find solutions to practical problems.
Role of Nurses in Research
Continuum of participation, from producers of research to skilled consumers of research findings who use research evidence in their practice
Evidence Bases Practice
The use of the best available evidence in making patient care decisions, and such evidence typically comes from research conducted by nurses and other health care professionals"
Research Utilization
involves critical analysis and evaluation of research findings and then determining how these findings fit into clinical practice.
Quality Improvement
focuses on systems , processes, satisfaction, and cost outcomes, usually within a specific organization.
PICOT
Population
Intervention
Comparison
Outcome
Time
What is PICOT
Acronym to help nurses researcher remember the essentials components when developing clinical research questions.
Clinical Research Questions
- Aim to address a patient or population's physical, psychological, social, or financial problem; May also address risk reduction
- ANSWERABLE by analyzing extant evidence
PICOT abbreviation
P- The Population of Interest; Problem
I - The Interventions that you're curious about
C - The Comparison
O - The outcome of the intervention
T - Timeframe
T/F - Clinical Research became increasingly important in the 1960s.
False - Not until 1980s
T/F - Application of the positivist paradigm involves viewing reality as being driven by natural causes.
True -
T/F - Quantitative research is allied with the constructivist tradition.
False
T/F Quantitative research attempts to identify a phenomenon.
False
Which of the following would be the first step when personally investigating evidence for a specific nursing care problem?
Asking answerable clinical questions.
Which statement best describes qualitative research? SATA
- Studies are conducted in natural setting.
- Data are collected from a large number of subjects.
- Data collected tend to be numeric
- The research design is systematic and subjective.-
- Studies are conducted in natural setting.
In caring for patients, it is important for the nurse to realize that evidence-base practice is
Dependent on patient values and expectations
A nurse wonders if patients who have abdominal surgery and who rock in a rocking chair have a reduced incidence of post operative paralytic ileus during hospitalization when compared with patients who receive standard nursing care following surgery?•
Dissect this statement into a PICOT Question?
• P = patients who have abdominal surgery
• I = rock in a rocking chair
• C = standard nursing care
• O = reduced incidence of post operative paralytic ileus
• T = during hospitalization
Which of the following responses best identifies the population being studied in the following research question? "Do patients who use guided imagery during chemotherapy experience less nausea and vomiting than patients who practice relaxation techniques?"
- A. Cancer patients
- B. Patients who use guided imagery
- C. Patients with nausea and vomiting
- D. Chemotherapy patients
- D. Chemotherapy patients
Steps for Evidence Based Practice
1. Ask Question
2. Search for Evidence
3. Appraise
4. Synthesize
5. Adapt
6. Implement
7. Evaluate
What is literature
All written sources relevant to the topic that you have selected, including articles published in periodicals or journals etc.
Primary Source
Written by the person who originated or is responsible for generating the ideas published.
secondary source
summaries or quotes content from primary sources
Peer Reviewed Article
means that the author of the research report, clinical description, or theoretical explanation submitted a manuscript to a publication editor, who identified scholars familiar with the topic to review the manuscript
Abstract
Brief summary that quickly tells you if the article is research or clinically based. An abstract summarizes the purpose of the article. It also includes the major themes or findings and the implications for nursing practice.
Introduction
- The introduction contains more information about the purpose of the article.
• There is usually brief supporting evidence as to why the topic is important.
Literature Review
The literature review offers an argument about what led the author to conduct a study or report on a clinical topic.
Manuscript Narrative•
The "middle section," or narrative, of an article differs according to the type of evidence-based article it is
Purpose Statement
Explains the focus or intent of a research study. It includes research questions or hypotheses—predictions made about the relationship or differences among study variables
Method or Design
Explains how a research study was organized and conducted to answer the research question or test the hypothesis.
• This section explains the type of study that was conducted (e.g., Randomized Control Trial (RCT), case control study, descriptive study, or qualitative study) and the number of subjects or people who participated in the study.
Analysis
This section explains how the data collected in a study are analyzed.
• The analysis section helps to determine whether a study was conducted in a way that allows you to trust the results and use them to inform practice
appraise
Critically and efficiently appraise or the information sources
Search
Efficiently search for research evidence
• Search for and collect the most relevant and best evidence to answer clinical questions
synthesize
Interpret all the information that is appraised and form recommendations to translate the evidence into practice
Adapt
Adapt the information to the local context.Integrate with:- Your own clinical expertise and knowledge of clinical setting- Patient preferences and values- Evidence from qualitative research
Implement
Decide whether (and plan how) to implement the adapted evidence into practice or policy
Evaluate
Assess the effectiveness of implementation efforts
Barriers to research and EBP
Misperception or negative views about research and evidence-based practice
Lack of knowledge about research methods and EBP strategies
Low comfort level with library and search techniques and too many journals
Lack of time to search for and appraise the evidence
Organizational constraints, such as lack of administrative support or incentives
Peer pressure to continue with practices steeped in tradition
Facilitator to Research and EBP
Support and encouragement from administer
Organization capacity for changes that includes strong support at all levels of leadership
UpToDate
The UpToDate system is an evidence-based clinical resource.
UpToDate combines evidence with clinical expertise to give you clinical answers you need.
Professional Identity in Nursing
a sense of oneself that is influenced by characteristics, norms, and values of the nursing discipline, resulting in an individual thinking, acting, and feeling like a nurse.
Values and Ethics
a set of core values and principles that guide conduct
knowledge
Analysis and application of information derived from nursing an other disciplines, experiences, critical reflection and scientific discovery.
Leadership
Inspiring self and others to transforms a shared vision into reality.
Empowers other through support, motivation and direction.
Professional Comportment
A nurse's professional behavior demonstrated through words, actions and presence.
Ethics
ideal human behavior and ideals ways of being: distinguish btwn right and wrong
Morals
specific beliefs and behaviors based on personal judgment that are based on a person ethics
Bioethics
Ethics related to health care issues
Nursing ethics
ethics related to the nurse patient relationship where the nurse is the main care provider involved in the issue
Moral Reasoning
making decisions based on morals
autonomy
Is a person ability to make their own decisons
Beneficence
Actions done to benefit others
Nonmaleficence
Is the avoidance of actions that harm others, intentionally or unintentionally
Veracity
Being truthful, regardless of circumstances and not to deceive or mislead intentionally.
Justice
refers to fairness
ANA Code of Ethics for Nurses (2015)
A statement of ethical obligation and duties of every nurse
A non-negotiable professional ethical standard
An expression of our commitment to society
The ICN Code of Ethics for Nurses (2012)
Nurses have four fundamental responsibilities: to promote health, to prevent illness, to restore health and to alleviate suffering. The need for nursing is universal.
Common Theme of ANA and ICN Codes
Focus on the importance of nurses delivering compassionate patient care aimed at alleviating suffering; patient is the central focus of nurses' work •
Applies to all nurses in all settings and roles; nonnegotiable ethical nursing standards with a focus on social values, people, relationships, and professional ideals •
Share values of respect, privacy, equality, and advocacy
Both codes illustrate idea of nurses' moral self-respect
Nurses and people
The nurse's primary professional responsibility is to people requiring nursing care.
nurses and practice
The nurse carries personal responsibility and accountability for nursing practice, and for maintaining competence by continual learning.
Nurses and the Profession
the nurse assumes the major role in determining & implementing acceptable standards of clinical nursing practice, management, research, & education
nurses and co-workers
The nurse sustains a collaborative and respectful relationship with co-workers in nursing and other fields.
Nurse Leadership
"The Nurse of the Future will influence the behavior of individuals or groups of individuals within their environment in a way that will facilitate the establishment and acquisition/achievement of shared goals"
Comportment in Nursing
Comportment is defined as a dignified manner or conduct. Professional comportment is critical in determining a nurse's effectiveness in relating, communicating, and collaborating with colleagues and members of the healthcare team.
Comportment is a nurse's professional behavior, which is demonstrated through words, action, and presence.
Ways to develop Leadership Skills in Schools
Be engaged
Join professional nursing organizations: ANA, NSNA
Participate in school organizations/functions
Network
Goals of the Magnet Program
Promote quality in an environment that supports professional nursing practice
Identifies excellence in delivery of nursing services to patients
Provide mechanism for dissemination of best practices in nursing services
Characteristics of Magnet Nursing
High- Quality patient Care
Clinical Autonomy and responsibility
Participatory Decision making
Strong nurse leaders
Community Involvement
Two-Way communication with Staff
Opportunity and encouragement of professional development
Benefits of Magnet Designation
Improved quality patient outcomes
Enhanced Organizational Culture
Improved nurse recruitment and retention
Enhanced safety outcomes
Enhanced competitive advantage
Essentials of Magnetism
Opportunities to work with other competent nurses
Good Nurses Physician
Nurse Autonomy and Accountability
Supportive Nurse Manager-Supervior
Control over nursing practice and practice environment
14 Forces of Magnetism
1. Quality of nursing leadership
2. Organizational structure
3. Management style
4. Personnel policies and programs
5. Professional models of care
6. Quality of care
7. Quality improvement
8. Consultation and resources
9. Autonomy
10. Community and the hospital
11. Nurses as
teachers
12. Image of nursing
13. Interdisciplinary relationships
14. Professional development
New Vision for Magnet
Magnet Facilites will
Shape future changes that are important to the nursing profession and to quality patient care outcomes
Serve as models of knowledge and expertise for the delivery of nursing care globally
Strive for discovery and innovation
Lead Healthcare reformation Page 16-32
AN Definition of Nursing
Nursing is the protection, promotion and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response and advocacy in the care of individuals, families, communities and populations.
Who are Nurses
Care
Providers
Administrators
Primary Care Providers
Reseachers
Educators
Advocates
Consultants
Business Owners
Specialty RN Certification
Its taking an Exam, practicing as an RN for 2 full yrs, 2000 Hrs of clinical practice within the specialty and continuing education
Nurse Practitioners
Educated to provide direct patient care within a specialty. Need to pass National Certification Exam and Apply for APN Status
Clinical Nurse Specialist
Educated to be a specialized clinical expert. Need to pass National Certification Exam and Apply for APN Status
CRNA
Educated to provide anesthesia and related care before and after surgery. Must have acute care. Need to pass National Certification Exam and Apply for APN Status
Certified Nurse Midwife
Educated to provide care to low risk women during pregnancy, childbirth and post-partum period. Need to pass National Certification Exam and Apply for APN Status
DNP
Is a clinical/practice doctorate that prepares nurses to be practice experts who will translate evidence based research into practice setting
AACN Suggested to Replace
has recommended the Doctorate of Nursing Practice as the educational preparation for APNs, replacing the masters degree
State Nurse Practice Act has not
(the legal determinate of a nurse's scope of practice) have not changed their requirements
What is the purpose of evidence-based practice (EBP)?
Aiding in clinical practice to provide the highest quality and safest health care to achieve the best patient outcomes
Which terms are components of evidence-based practice?
Clinical expertise
Research evidence Patient needs and
values
Which examples of patient needs or values could be considered in evidence-based practice (EBP)?
Health promotion
Illness prevention
Disease management
Which areas comprise the appraisal of articles for evidence-based practice?
Impact
Applicability
Internal validity
What needs to be identified to formulate the question in "Ask the question" step of the 5 "A"s?
Clinical problem
What is the correct order for the 5 "A"s of developing evidence-based practice?
Ask
Access
Appraise
Apply
Audit
What role do nurses assume to ensure patient needs and values are addressed in evidence-based practice (EBP)?
Advocate
Clinical expertise is a combination of which elements?
Experience
Education level
Research knowledge
Which is an important reason for nurses to use evidence-based practice (EBP)?
To promote quality and safe patient care
What is important about sharing evidence-based practice (EBP) findings among health care professionals?
Encourage positive changes in practice
What is important about the audit process in the development of evidence-based practice (EBP)?
Determining the effectiveness of practice change
Why is input from all stakeholders important in the development of evidence-based practice?
Ensures use of clinical expertise
Considers regulatory compliance
Addresses the patient's needs and values
Which type of data did Florence Nightingale collect during the Crimean War?
Morbidity and mortality rates
Which individual or organization is credited with the creation of the concept of evidence-based practice (EBP)?
Archie Cochrane
Which areas were the focuses of nursing research in the 1980s?
Clinical research
Empirical knowledge
Publication of research
Which goal was emphasized in health care following the publication of the Institute of Medicine's (IOM) Crossing the Chasm: A New Health System for the 21st Century?
Quality and safety
In the 2006 American Association of Colleges of Nursing (AACN) position statement on research, the organization stated that it must achieve which goals?
Create a research culture
Obtain funding for research
Develop a research infrastructure
Provide high-quality educational programs
What is the mission of the National Institute of Nursing Research (NINR)?
To promote and improve the health of individuals, families, communities, and populations
A nurse with a BSN may have which roles in nursing research?
Collect data
Use research in practice
Critically appraise research
Utilize EBP in clinical practice
A nurse with which level of education would have a role of coordinating research teams?
PhD
Which activities apply to MSN-prepared nurses in research?
Utilize EBP in clinical practice
Provide clinical expertise for research
Develop and revise protocols and policies for practice
Although qualitative studies were being conducted earlier in history, during which era did publication of these studies start occurring with increased frequency?
1980s
Florence Nightingale's studies focused on which outcome?
Creating a healthy environment for patients
The federal government began to support the evolution of nursing research by creating which organization?
Division of Nursing in the Surgeon General's Office
How does the National Institute of Nursing Research (NINR) currently support nursing research?
It conducts nursing research
It seeks funding for nursing research
It provides training in nursing research
It promotes health, wellness, and illness prevention
Which similarity exists between the missions of the National Institute of Nursing Research (NINR) and the Agency for Health care Research and Quality (AHRQ)
Use of research evidence
How did the Joint Commission have an impact on nursing research in 2002?
By adding the use of evidence-based practice (EBP) to its accreditation
Which nursing role can be performed by nurses at all education levels?
Utilizing EBP in a clinical setting
Which research roles did Florence Nightingale perform in her studies?
Collected data
Identified research problem
Provided clinical expertise in research
Which nursing research role would be exclusively held by a PhD-prepared nurse?
Lead nursing research team
From where are problems identified for nursing research studies?
Clinical practice
Literature reviews
Concerns of funding agencies
Which statement defines a sample in a research a study?
Subset of the target population
What is the purpose of reviewing literature?
To identify gaps in knowledge
Through which ways is nursing knowledge acquired?
Authority
Traditions
Role modeling
Personal experience
Which term is a competency based on Quality Safety and Education for Nurses Initiatives
Evidence-based practice (EBP)
Empirical knowledge in nursing focuses on which areas?
Control
Control
Prediction
Explanation
Description
Prediction
Estimates the probability of an outcome
Control Group
Manipulates the situation to reach a desired outcome
Description
Identifies and encourages understanding of various phenomena
Explanation
Links information together to identify relationships among data
Which component of the scientific research process identifies the goals of the research study?
Purpose
Why is random sampling used?
To ensure each member of the target population has an equal chance of selection
How do theoretical frameworks support nursing research studies?
To test a theory or create a new theory
Hospital policies and procedures may contain which type of nursing knowledge based on customs?
Traditions
Which action exemplifies the development of empirical evidence in nursing research?
Determining the incidence of HIV among Caucasian males
Which QSEN competency includes evidence from nursing research, patient preferences, and clinical expertise?
Evidence-based practice (EBP)
Which statement describes the concepts of knowledge in nursing practice?
The quality of knowledge determine the quality of nursing practice
Which are the components of the scientific research process ?
Control
Prediction
Description
Explanation
Which component of nursing validated and refines existing knowledge and generates new knowledge that influences practice
Research
Level of hierarchy
Level 1 - Systemic review and meta analysis.
Level 2 - RCT or Experimental Study
Level 3 - Quasi-Experimental
Level 4- Mixed Methods systematic review and Qualitative Meta- synthesis
Level 5 - Descriptive Correlational, Predictive correlational and cohort studies
Level 6 - Descriptive Study and Qualitative Study
Level 7 - Opinions of expert committees and authorities
American Association of Colleges of Nursing (AACN)
National voice for baccalaureate- & higher-degree nursing education programs
Establishes quality standards for baccalaureate- & graduate-degree nursing education, assists in implementation of those standards
American Nurses Association (ANA)
The national professional membership association of nurses that works for the improvement of health standards and the availability of healthcare services, fosters high professional standards for the nursing profession, and advances the economic and general welfare of nurses
NSNA (national student nurses association)
advocate for nursing student rights, and take collective and responsible action on social and political issues
AONE (American Organization of Nurse Executives)
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