NR 439 Week 2 Discussion Search for Significant Clinical Issue in a Research Database

NR 439 Week 2 Discussion Search for Significant Clinical Issue in a Research Database

NR 439 Week 2 Discussion Search for Significant Clinical Issue in a Research Database

Search for Significant Clinical Issue in a Research Database

Discuss one of the four basic rules for understanding results in a research study.

According to CCN, 2017-week 6 lesson, the four basic rules for understanding results in a research study are: Understanding the purpose of the study, identify the variables- dependent and independent, identify how the variables are measured, and look at the measures of central tendency and the measures of variability for the study variables. My discussion will be focused on rule # 2 Identify the variables-dependent and independent. Business dictionary defines variable as a characteristic, number, or quantity that increases or decreases over time, or takes different values in different situations. There are two basic types of variables (1) Independent variable that can take different values and can cause corresponding changes in other variables, and (2) Dependent variable are those that can take different values only in response to an independent variable (businessdictionary.com). An example of a variable is patient’s vital signs. We can measure a patient’s vital signs, but they can increase or decrease.

Compare clinical significance and statistical significance. Which one is more meaningful when considering applying evidence to your practice?

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Clinical significance is generally expected to reflect the extent to which an intervention can make a real difference in patients’ lives. Statistical significance is the comparison of differences to standard error and the calculation of the probability of error that gives inferential analysis its strength. Nevertheless, statistical significance is just one of the important measures that determine whether research is truly applicable to practice (Houser, 2018). Statistical significance is a requirement for using evidence in practice: If results are due to error, then their application is irrelevant. At the same time, statistical significance tells the nurse little about whether the results will have a real impact in patient care. (Houser, 2018).

Compare descriptive statistics and inferential statistics in research. Please give an example of each type that could be collected in a study that would be done on your nursing clinical issue you identified in previous week.

Descriptive statistics use numbers narratively, in tables, or in graphic displays to organize and describe the characteristics of a sample (Houser, 2018, p291). It uses data to provide descriptions of the population, either through numerical calculations or graphs or tables. Descriptive statistics are the characteristics that are given to the sample of a research study. Descriptive statistics tell us, who was in the study and what did the study show us about the hypothesis (CCN, 2018). An example of descriptive statistics is my research question: Will follow-up telephone call and visit by home health nurse 3 to 7 days post discharge help reduce the rate of hospital readmission for patients 65 years and above with CHF. The descriptive study for my research will be patients 65 years old and above with CHF.

Inferential statistics can help to make a general statement about the sample population and compare them with other populations. (Houser, 2018). It makes inferences and predictions about a population based on a sample of data taken from the population in question. Inferential statistics help answer the question. How strong is the evidence from the study? “An example of inferential statistics will be all patients 65 years and above with CHF will not experience hospital readmission if they receive follow-up telephone calls and visit by home health nurse 3 to 7 days post discharge.

References

Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Sudbury, MA: Jones & Bartlett.

http://www.businessdictionary.com/definition/variable.htmlLinks to an external site.

https://chamberlain.instructure.com/courses/7426/pages/week-6-lesson?module_item_id=567652


Reflect on your practice and identify a significant nursing clinical issue that you would like to search for evidence in online sources. Formulate searchable, clinical questions in the PICO(T) format for your nursing clinical issue.
Next, review the guidelines for the Research Database Assignment due Week 3. Use your PICO elements to search for ONE research database that is relevant to your nursing clinical issue. Identify the name of the database or data source, its web address (URL), and briefly describe how it is relevant to your nursing clinical issue.

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Participation: RN-to-BSN

In discussions, you, as a student, will interact with your instructor and classmates to explore topics related to the content of this course. You will be graded for the following.

1. Attendance

Discussions (graded): Discussions are a critical learning experience in the online classroom. Participation in all discussions is required.

2. Guidelines and Rubric for Discussions

PURPOSE: Threaded discussions are designed to promote dialogue between faculty and students, and students and their peers. In the discussions students:

  • Demonstrate understanding of concepts for the week
  • Integrate scholarly resources
  • Engage in meaningful dialogue with classmates
  • Express opinions clearly and logically, in a professional manner

Participation Requirement: You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday.

NR 439 Week 2 Discussion Search for Significant Clinical Issue in a Research Database

Participation points: It is expected that you will meet the minimum participation requirement described above. If not:

  • You will receive a 10% point deduction in a thread if your response to the initial question is not posted by 11:59 p.m. MT on Wednesday
  • You will also receive a 10% point deduction in a thread if you do not post at least three (3) times in each thread on at least two (2) separate days.

3. Threaded Discussion Guiding Principles

The ideas and beliefs underpinning the threaded discussions (TDs) guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of TDs provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The TD’s ebb and flow is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the TDs generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. TDs foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.

4. Participation Guidelines

You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday. Discussions for each week close on Sunday at 11:59 p.m. Mountain Time (MT). To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. For courses with Week 8 graded discussions, the threads will close on Wednesday at 11:59 p.m. MT. All discussion requirements must be met by that deadline.

5. Grading Rubric

Discussion Criteria  A
(100%)
Outstanding or highest level of performance
B
(87%)
Very good or high level of performance
C
(76%)
Competent or satisfactory level of performance
F
(0)
Poor or failing or unsatisfactory level of performance
Answers the initial graded threaded discussion question(s)/topic(s), demonstrating knowledge and understanding of concepts for the week.
16 points
Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding regarding all weekly concepts.16 points Addresses most aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of most of the weekly concepts.14 points Addresses some aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of some of the weekly concepts.12 points Minimally addresses the initial discussion question(s) or does not address the initial question(s).0 points
Integrates evidence to support discussion. Sources are credited.*
( APA format not required)
12 points
Integrates evidence to support your discussion from:

  • assigned readings** OR online lessons, AND
  • at least one outside scholarly source.***

Sources are credited.*

12 points

Integrates evidence to support discussion from:

  • assigned readings OR online lesson.

Sources are credited.*

10 points

Integrates evidence to support discussion only from an outside source with no mention of assigned reading or lesson.Sources are credited.*

9 points

Does not integrate any evidence.0 points
Engages in meaningful dialogue with classmates or instructor before the end of the week.
14 points
Responds to a classmate and/or instructor’s post furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion.14 points Responds to a classmate and/or instructor furthering the dialogue by adding some depth to the discussion.12 points Responds to a classmate and/or instructor but does not further the discussion.10 points No response post to another student or instructor.0 points
Communicates in a professional manner.
8 points
Presents information using clear and concise language in an organized manner (minimal errors in English grammar, spelling, syntax, and punctuation).8 points Presents information in an organized manner (few errors in English grammar, spelling, syntax, and punctuation).7 points Presents information using understandable language but is somewhat disorganized (some errors in English grammar, spelling, syntax, and punctuation).6 points Presents information that is not clear, logical, professional or organized to the point that the reader has difficulty understanding the message (numerous errors in English grammar, spelling, syntax, and/or punctuation).0 points
PARTICIPATION:
Response to initial question: Responds to initial discussion question(s) by
Wednesday, 11:59 p.m. M.T.
0 points lost

Student posts an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.

-5 points

Student does not post an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.

PARTICIPATION
Total posts: Participates in the discussion thread at least three times on at least two different days.
0 points lost

Posts in the discussion at least three times AND on two different days.

-5 points

Posts fewer than three times OR does not participate on at least two different days.

NOTES:
* Credited means stating where the information came from (specific article, text, or lesson). Examples: Our text discusses…. The information from our lesson states…, Smith (2010) claimed that…, Mary Manners (personal communication, November 17, 2011)…. APA formatting is not required.
** Assigned readings are those listed on the syllabus or assignments page as required reading. This may include text readings, required articles, or required websites.
*** Scholarly source – per the APA Guidelines in Course Resources, only scholarly sources should be used in assignments. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Wikipedia, Wikis, .com website or blogs should not be used as anyone can add to these. For the discussions, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. Outside sources do not include assigned required readings.
NOTE: A zero is the lowest score that a student can be assigned.

Nursing research is a dynamic process that includes multiple phases: defining the research problem; literature review; selecting a theoretical framework; choosing an appropriate design; defining a sampling strategy; collecting and analyzing data; sharing the findings, and using the evidence in practice. 
 
The Course Outcomes (COs) we will apply in Week 2 include:  
 
Examine the sources of evidence that contribute to professional nursing practice. 
Apply research principles to the interpretation of the content of published research studies. 
 
 
Reflect on your practice, and identify a significant nursing clinical issue or change project that you would like to search for evidence in online sources. Formulate searchable, clinical questions in the PICO(T) format for your nursing clinical issue. 
 
Next, review the guidelines for the PICOT Assignment due Week 3. Use your PICOT elements to search for one report of a single, original study that has been published within the last 5 years from the CCN Library that is relevant to your nursing clinical issue. Briefly, describe how it is relevant to your nursing clinical issue. Remember to give a complete reference to the study. Post your PICOT and research article in this discussion. 
 
 
Remember to integrate references. 
 
Class, please remember, you must answer this question by end of Wednesday to gain participation points.  
I have been an Emergency Department (ED) nurse for seven years. Many people ask why I would want to work in the ED.  The answer is simple.  I like being the first line of care for the patient.  I like that I don’t have time to build a relationship with the patient and the family.  Some may think that sounds cold, but I am one who would take the relationship home with me.  By that, I mean that if I developed a relationship with the patient and family members, it would hurt too much when illness or death overcame the patient.  I would not be able to leave that at work.  I need for my interactions with the patient to be completely medical.  Do I ever get emotionally attached to repeat patients?  Of course but, it is less common in the ED than it would be on an inpatient unit. The nature of ED nurses is often based on the need to provide emergency care. Many of the nurses I have discussed this with feel the same way.  They are too compassionate to allow themselves to become close to the patient.  Also, many of us feel that we have lost some of our faith in the human race because of our roles in the ED.  Because we often only have contact with the patient for a short period of time and we see many patients over and over, many of us suffer from compassion fatigue. The significant clinical issue that effects my department is compassion fatigue. Evidence-Based Practice or “EBP, considers internal and external influences on practice and encourages critical thinking in the judicious application of evidence to the care of the individual patient, patient population, or a system” (Hain, & Kear, 2015, p 12). 

My PICOT would be: 

P – The population of interest for this project is registered nurses who worked in the Emergency Department full time 

I – The intervention is educational training about compassion fatigue.  The intervention takes place off the unit and during a scheduled work tour. 

C- The comparison is a survey taken by RNs prior to the education. 

O- The outcome is reduction of compassion fatigue after the education. 

T- The time frame is 6 months. 

At 6 months, ED RNs take the same survey and values are compared. “Clinicians must critically evaluate research before attempting to implement the findings into practice” (Peterson, et.al, 2014, p 67). 

My PICOT question is “Are RNs who work in the ED, who are educated about compassion fatigue, less likely to suffer from CF?” 

According to the article I found, “compassion fatigue (CF) is a relatively recent concept that refers to the emotional and physical exhaustion affecting healthcare providers, usually as a consequence of caring” (Hamilton, Tran, & Jamieson, 2016, p 1).  The article goes on to state that nurses have been more vocal than doctors about the effects of compassion fatigue over the years.  It also states that the ED is a breeding ground for CF. 

This article is extremely relevant to my clinical question. As with any other issue, education is usually key to prevention and treatment.  

~Candee Crane 

References: 

Hain, D. J., & Kear, T. M. (2015). Using evidence-based practice to move beyond doing                things the way we have always done them. Nephrology Nursing Journal, 42(1),                11–21. 

Hamilton, S., Tran, V. & Jamieson, J. (2016). Compassion fatigue in emergency                           medicine: The cost of caring. Emergency Medicine Australasia, 28(1), 100-103.               doi:1111/1742-6723.12533 

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