Nursing Research Exam 3 PDF

Nursing Research Exam 3 :( Criteria for Ending a Search for Evidence (1) - Data must be saturated How to Identify Data Saturation: Repeating themes No New information Comparison across data sets are consistent Importance of saturation: 1. Validity and...

Nursing Research Exam 3 :( Criteria for Ending a Search for Evidence (1) - Data must be saturated How to Identify Data Saturation: Repeating themes No New information Comparison across data sets are consistent Importance of saturation: 1. Validity and Reliability a. Helps ensure research findings are reliable and have sufficient depth to represent the phenomenon studied 2. Efficient data collection a. Allows researchers to stop collecting data once they have enough information to answer their research questions, avoiding unnecessary data collection Evidence Synthesis table Purpose & Use (1) A table that allows researchers to bring together all relevant information on a research question a. Useful in identifying knowledge, establishing an evidence base for best-practice guidelines, or help inform policymakers and practitioners breaks down details and methodology, evidence type, and strength of evidence Promoting a EBP culture (1) The use of technology and having appropriate resources Having access to the library Having enough time (working overtime) To promote a culture of evidence-based practice (EBP) in nursing, healthcare organizations should prioritize strong leadership commitment, provide ongoing education and training on EBP principles, encourage a spirit of inquiry, facilitate access to research resources, establish supportive environments for implementing evidence, and actively involve nurses in the process of evaluating and disseminating research findings to improve patient care Using EBP process to recommend practice change (1) Identifying a clinical question Searching for relevant research Critically appraising the evidence Integrating the findings into practice  Implementing the change Evaluating its effectiveness Essentially, asking a focused question about a current practice, finding the best available research to answer it, analyzing the quality of that research, applying the results to your clinical setting, monitoring the impact of the change, and making adjustments as needed. Practice change recommendation: Create A detailed plan outlining the proposed change including implementation strategies, timelines, and responsible parties Recommended search strategies (1) Synonyms, related concepts, different databases, and citation training, to ensure a comprehensive understanding of the existing research, rather than just focusing on a narrow set of keywords; this allows researchers to identify potential gaps and knowledge and better inform their research direction Key Points… ○ Using Boolean operators employing “OR” between related keywords or synonyms broadens that search by retrieving results containing any of the listed terms. ○ Citation Chaining exploring references list of relevant articles to discover additional related studies that might not have been found through initial searches. ○ Multiple Databases: Accessing various academic databases to capture a wider range of published research on a topic. ○ Subject Headings: Utilizing subject headings provided by the database to identify articles categorized under specific concepts relevant to your research. ○ Precise keywords using specific terms related to your research question will yield more targeted results compared to broad keywords ○ Boolean operators combining keywords with “AND” ensures that all specific terms appear in the retrieved articles, further narrowing the search ○ Limiters limit results by publication date, document type (peer-reviewed articles), language, or other relevant factors. ○ Relevance over quantity a narrow search prioritizes high-quality, relevant articles directly related to your research topic, rather than a large volume of potentially tangential information General Appraisal—Reliability (1) Measurement is not as objective as one might think as error and inconsistency can enter into measurement at many points. Identify PICOT question (2) (P) population (I) intervention (C) comparison (O) outcome (T) time Hierarchy of evidence (2) Rapid Critical Appraisal (RCT)—Validity (1) A measuring instrument may be consistent, but it may fail to capture the essence of the phenomenon of interest. The measure does not truly measure what it is supposed to measure. Partner with Librarian (1) In nursing research, a librarian primarily acts as a vital resource for finding and evaluating relevant research literature, assisting nurses in conducting evidence-based practice by identifying credible sources, teaching effective search strategies, and ensuring the quality of information used to inform clinical decision-making; essentially bridging the gap between nurses and the vast array of medical databases to access the most up-to-date research findings. Overcome Barriers to EBP (1) 1. Identify barriers a. Conduct a self-assessment or team assessment to identify gaps in knowledge, skills, and attitudes towards EBP. You can also use tools like the Evidence-Based Practice Questionnaire (EBPQ) or the Evidence-Based Practice Beliefs Scale (EBPB). 2. Educate a. Provide educational sessions about the EBP process, and attend workshops and continuing education related to EBP. 3. Create a supportive environment a. Ensure that there is a supportive environment for EBP, and that nurses are role models and mentored. 4. Engage stakeholders a. Build trust with stakeholders by engaging them early in the process. Stakeholders can provide input on the project, and help identify outcome measures. 5. Get administration support a. Administration can help develop an organizational culture that supports EBP. They may also be able to inform you about other projects that used similar techniques. 6. Improve search skills a. Nurses may need to improve their search skills, such as using Boolean operators, MeSH terms, truncations, wildcards, search limits, and index browsing. 7. Increase collaboration a. Increase collaboration among team members, and form journal clubs. 8. Use mobile apps a. Use mobile apps to quickly access research. (Google) Disseminating results (1) General criteria appraisal questions (1) Typically focus on the study’s validity (are the results accurate?), reliability (are the results consistent?), and applicability (can the findings be applied to your practice) Using PICOT questions to plan evidence search (1) 3 components of the EBP process 1. Best available research evidence a. refers to the most current and reliable research findings relevant to the clinical situation 2. Clinical expertise a. the practitioners knowledge, skills, and experience in assessing and managing a patient's condition 3. Patient values-preferences a. the unique needs, desires, and concerns of the individual that should be considered when making clinical decisions. (Google) PICOT questions types (1) Therapy-intervention, Diagnosis, Prognosis, Etiology (harm-risk factor), prognosis, and prevention (google) Therapy-intervention: ○ ¨ In patients with (condition), how does (intervention) compared to (comparison intervention) affect (desired outcome)? Diagnosis: ○ ¨for patients with (symptoms), is (diagnostic test) more accurate than (comparison test) in diagnosing (condition)? Etiology/Harm: ○ "Are [people exposed to factor] at increased risk of developing [disease] compared to [people not exposed]? Prognosis: ○ "For patients with [condition], how does [factor] influence the likelihood of [outcome]? Prevention:  ○ "In [population], does [intervention] effectively prevent [disease] compared to [no intervention]? Key points about PICOT questions ​ P - Population: ​ Identifies the specific group of patients relevant to the research question. ​ I - Intervention: ​ Describes the treatment, therapy, or diagnostic test being investigated. ​ C - Comparison: ​ Represents the alternative treatment, standard of care, or control group being compared to the intervention. ​ O - Outcome: ​ States the measurable result or change you want to see as a result of the intervention ​ T- Time The time frame for measuring the desired outcome Implementing evidence (1) Evaluating evidence (1) EBP Barriers (1) Time: Busy clinicians often say they need more time, which can be a barrier to implementing EBP. Resistance: Changing a culture where people are used to doing things a certain way can be challenging. Lack of staff Lack of access to research resources Lack of Organizational Support Lack of access to research findings: This can be a barrier to EBP competency. Inadequate relevant evidence: This can be a challenge to EBP competency. Limited financial resources Limited support Correlation statistic interpretation (1) Indicates the strength and direction of the relationship between 2 variables, showing how much one variable changes as the other changes, but does not prove causation A positive correlation means both variables tend to increase together  A negative correlation means one variable increases are the other decreases, with a value closers to 1 (positive or negative) representing a stronger relationship p-value statistic interpretation (1) P-value in statistics represents the probability of observing data as extreme as what was measured, assuming the null hypothesis is true; Interpretation A p-value less than 0.05 is considered statistically significant, indicating a likely difference or effect exists between groups A p-value greater than 0.05 is not statistically significant, suggesting the observed difference is likely to be due to chance and does not support rejecting the null hypothesis Important considerations Effective Size Sample Size ○ a small sample can lead to a higher p-value, potentially masking a true effect Clinical significant (Google) Quantitative research design (method) identification (1) Inquiry that: (1) examines pre identified issues (2) uses designs that control extraneous variables (3) uses numeric measures to determine levels of various variables (4) analyzes data using statistical or graphing methods Qualitative research design (tradition) identification (1)