DNP 820 TOPIC 2 DQ 2

DNP 820 TOPIC 2 DQ 2

DNP 820 TOPIC 2 DQ 2

What effects can personal bias and beliefs have on a quality improvement project? Describe secondary research and possible sources of bias. What are some useful strategies to recognize bias?  Support your response with relevant literature

EMMANUELA

Personal bias and beliefs can change the way a quality improvement project is practiced in the departmental setting. For instance, an evidence-based protocol was introduced to the emergency department for any patients who arrive with acute Sickle Cell Crisis. This protocol entailed an Emergency Service Index acuity level 2 in which initiates treatment of this patient as soon as possible along with an order set to initiate intravenous access, blood draw for lab orders, intravenous fluids, intravenous pharmacological interventions for pain control within the protocol regimen (1 dose per hours x 3 hours with increase of dosage per order). Although the protocol has a very clear pathway, personal bias and beliefs have caused personal alterations to the protocol and increased door to provider. FitzGerald & Hurst (2017) describe personal bias in healthcare workers as “associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender”. Unfortunately, uncontrollable or unconscious judgments may cause alterations to patient care and communication.  

Secondary research entails a series of reviews of research that has already been conducted. Many of these research articles are systematic reviews and meta-analysis. The systematic reviews synthesize results with statistical analysis (Bowen & Forrest, 2017). The most common sources of bias include annotations, data selection, representation, models/graphs, research design, information bias, selection bias, and publication bias. Publication bias exists in secondary research as the study relies on obtaining results from other research studies. A complete literature review is needed in order to recognize bias. A literature review can aid a scholarly learner to identify bias by reviewing articles for one-sided information and opinions, unsupported claims, inappropriate or extreme language, and presentation of highly selected facts that can lead to a particular outcome. Williams et.al., (2022) report that several databases such as the US Healthcare Cost and Utilization Project (HCUP) aid in limiting bias. The National Inpatient Sample (NIS) is a reliable sampling system that has not demonstrated bias even with the large sample sizes utilized. Bias can occur in sample sizes; therefore, a randomized sample size should be obtained for study purposes in order to retrieve accurate data.  

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Bowen, D. M., & Forrest, J. L. (2017, January). Translating research for evidence-based practice. Access, 10-14. 

FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: A systematic review. BMC Medical Ethics18(1). https://doi.org/10.1186/s12910-017-0179-8 

Williams, G. W., Rihani, R., & Bui, A. (2022). HCUP databases may be helpful in limiting bias. Anesthesia & Analgesia135(4). https://doi.org/10.1213/ane.0000000000006107 

RESPOND HERE

EMMANUELA I agree with you that personal bias and beliefs are impactful in a quality improvement project.  Unfortunately, personal bias interfere with the significance of quality improvement project. As a result, most leaders ensure that there create bias-free environment ahead of planning and implementing quality improvement initiatives. Frequently, personal bias and beliefs are based on unproved information (Dominguez-Moreno et l., 2022). Therefore, there is room of inaccurate details being used to substantiate different personal bias and beliefs. Researching plays an important role in either dismissing or confirming information used to validate personal bias and beliefs. Most of these personal bias interfere with the treatment process and medication. Personal bias in healthcare workers as associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender (Thomas & Booth-McCoy, 2020). Primary and secondary studies are highly-ranked in the evidence pyramid. As a result, these two research designs can be used to examine personal bias and beliefs in healthcare settings. Surprisingly, bias can also be depicted in the research. The most common sources of bias include annotations, data selection, representation, models/graphs, research design, information bias, selection bias, and publication bias.

References

Dominguez-Moreno, R., Venegas-Gómez, V. A., Zepeda-Gutiérrez, L. A., La Rosa-Cuevas, D., José, J., Hernández-Félix, J. H., … & Cantú-Brito, C. (2022). Headache related to personal protective equipment in healthcare workers during COVID-19 pandemic in Mexico: baseline and 6-month follow-up. International Archives of Occupational and Environmental Health, 1-10.

Thomas, B., & Booth-McCoy, A. N. (2020). Blackface, implicit bias, and the informal curriculum: shaping the healthcare workforce, and improving health. Journal of the National Medical Association112(5), 533-540. https://doi.org/10.1016/j.jnma.2020.05.012

ASIATU

Topic 2 DQ 2

What effects can personal bias and beliefs have on a quality improvement project?   

 There are two types of personal bias and beliefs that are inherent in the person’s character. First, confirmation bias that occurs when a belief is formed and other publications used to confirm that belief. This takes place in-the-moment as the individual judges and weighs evidence that confirm the belief as reliable and relevant, while dismissing evidence that does not support the belief. Confirmation bias can lead to bad decision-making as some of the relevant evidence could be ignored simply because it does not support the preconceived belief (Grove & Gray, 2022).

Second, cultural bias that occurs when the individual has assumptions, about the influences and motivations, based on a cultural lens, such as assuming that all nurses or all patients will always react in a specific way. Cultural bias can support stereotypes of culture that lead to ethnic and racial profiling (Grove & Gray, 2022).  

Describe secondary research and possible sources of bias. What are some useful strategies to recognize bias? 

Secondary research involves using already existing, published information/data. The researcher summarizes and collates the existing information to increase the overall research efficiency. A possible source of bias in secondary research is publication bias in which the researcher only favors publications whose findings show positive results. This would result in the research only focusing on publications that have shown a working intervention or confirmed what the researcher initially predicted (Grove & Gray, 2022).

A useful strategy for recognizing bias is to define the bias. This helps in identifying how the bias would occur thus helping in efforts to avoid the bias. There are three main types of bias. First, personal bias that is inherent in a person’s character. Second, design bias that is seen in a design process that has inherent flaws. Third, procedural bias that arbitrarily sets the research steps even if it is not the best (Schmidt & Brown, 2019).

References

Grove, S. K., & Gray, J. R. (2022). Understanding Nursing Research: Building an Evidence-Based Practice (8th ed.). Elsevier Inc.

Schmidt, N., & Brown, J. (2019). Evidence-Based Practice for Nurses: Appraisal and Application of Research (4th ed.). Jones & Bartlett Learning, LLC

RESPOND HERE

ASIATU I concur with you that there are two types of personal bias and beliefs. Unfortunately, these beliefs have a direct impact on a quality improvement project. Some incidents of personal bias interfere with the credibility and accuracy of the project (Oliver et al., 2021). As a result, most project managers ensure that personal bias and beliefs do not interfere with the quality improvement initiatives. Confirmation bias can lead to bad decision-making as some of the relevant evidence could be ignored simply because it does not support the preconceived belief (Wolsiefer & Stone, 2019).  Besides, confirmation bias is based on predetermined judgments found on not tested information. Cultural bias that occurs when the individual has assumptions, about the influences and motivations, based on a cultural lens.  Regrettably, detaching people from their cultural bias may be challenging. Therefore, research is important in handling personal bias and beliefs. Relying on credible research articles help in examining people’s beliefs and bias.

References

Oliver, T. L., Shenkman, R., Diewald, L. K., & Dowdell, E. B. (2021, January). Nursing students’ perspectives on observed weight bias in healthcare settings: A qualitative study. In Nursing Forum (Vol. 56, No. 1, pp. 58-65). https://doi.org/10.1111/nuf.12522

Wolsiefer, K., & Stone, J. (2019). Addressing bias in healthcare: Confrontation as a tool for bias reduction and patient and provider self-advocacy. In Confronting Prejudice and Discrimination (pp. 275-297). Academic Press. https://doi.org/10.1016/B978-0-12-814715-3.00013-8

ELSIE

In healthcare, personal bias can have an impact on medical decision making, communication, adherence to medical advice and provider-patient interactions. It can also ultimately impact patient care and health outcomes. According to Mendez (2017), personal bias and beliefs can have the following effects on a quality improvement project at the workplace: Personal bias and beliefs may prevent people from embracing the change that comes with the quality improvement project. It can cause people to make decisions that are unfair, influence actions and decisions such as who to hire or promote to manage the quality improvement process. It may also affect the evaluation of the quality improvement project and also lead to discriminatory decisions with regards to a protected class of people.

Describe secondary research and possible sources of bias. 

DeVault (2019) defined secondary research is the research conducted with information that has already been compiled and formatted. Secondary research involves the process of summarizing previous works, and the collation or synthesis of existing research works. Secondary research makes use of primary research sources as the source of data for analysis.

Clark (2017) presented 5 sources of bias in secondary research which are outlined below:

Possible sources of bias in secondary research

  1. Social Desirability: Social Desirability occurs in secondary research when the author(s) draw inferences that are linked with socially acceptable choices as against reality. 
  2. Confirmation Bias: Confirmation bias is the tendency of authors to favor the information that confirms their own existing beliefs or hypotheses. It occurs when authors throw more weight to the evidence that confirms their own values and beliefs. It also happens when conclusions are drawn using a previous assumption rather than allowing the research findings to drive the conclusions.
  3. Irrational Escalation: Irrational escalation motivates authors to ignore new research results if the new results override the research decisions already made. 
  4. Cognitive Framing: Cognitive framing occurs when the research outcomes become different when they presented in different ways.
  5. Knowledge Bias: Knowledge bias prevent people from changing their views even when confronted with more current information.

What are some useful strategies to recognize bias? 

  1. Pay attention to the design and methods in the research.
  2. Observe the literature review and data collection process closely and examine if it leans overwhelmingly towards a particular issue or group.
  3. Observe the data sample to confirm if it is a fair representation of the research population.
  4. Acknowledge personal bias on the research topic and guarding against them during literature review and when drawing inferences and conclusions.
  5. When the time between the event and the time of writing is prolonged, the details, such as dates, names and locations may not be accurate.
  6. Older documents reveal attitudes and values that were acceptable in the past but may be unacceptable today.

 References

Clark S. (2017). 5 Research Biases: How to Identify and Avoid Them in Your Research. Retrieved from h./@scottclark/5-research biases-how-to-identify-and-avoid-them-in-your-research-1.

 DeVault, G. (2019). Differences Between Primary and Secondary Market Research. Retrieved from https://www.thebalancesmb.com/what-is-secondary-market-research.

Mendez J. (2017). The Impact of Biases and How to Prevent Their Interference in the Workplace. Retrieved from https://www.insightintodiversity.com/the-impact-of-biases-and-how-to-prevent-their-interference-in-the-workplace/.

REPLY

  • ES


ELSIE it is true that that healthcare sector has also experience the impact of personal bias and beliefs. Unfortunately, personal bias impacts medical decision making, communication, adherence to medical advice and provider-patient interactions. Most personal beliefs and bias are formed from experience, inherited assumptions and unproven information (Chin, 2021). Therefore, there are high chances that personal bias and beliefs may be misleading. Research helps healthcare professionals to recognize and address bias that may interfere with decision-making process. Healthcare professionals may also have personal beliefs that may discredit their competence in handling bias in their patients. Personal bias and beliefs may prevent people from embracing the change that comes with the quality improvement project (Joseph et al., 2021). The belief my depict change as a disruptive routine that may render other people less significant. As a result of fear other stakeholders may be against quality improvement initiatives. Similarly, when eliminating personal bias and belief in QI project, researchers may also introduce new bias and their beliefs.

References

Chin, M. H. (2021). New horizons—addressing healthcare disparities in endocrine disease: bias, science, and patient care. The Journal of Clinical Endocrinology & Metabolism106(12), e4887-e4902. https://doi.org/10.1210/clinem/dgab229

Joseph, O. R., Flint, S. W., Raymond-Williams, R., Awadzi, R., & Johnson, J. (2021). Understanding Healthcare Students’ Experiences of Racial Bias: A Narrative Review of the Role of Implicit Bias and Potential Interventions in Educational Settings. International Journal of Environmental Research and Public Health18(23), 12771. https://doi.org/10.3390/ijerph182312771

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