NUR 513 Topic 6 DQ 1

NUR 513 Topic 6 DQ 1 

NUR 513 Topic 6 DQ 1

Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Identify the criteria you would use to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria?

Re: Topic 6 DQ 1

My evidenced-based project idea focuses on implementing a community education program that focuses on prevention in regard to stroke risk factors. When implementing any new program, it’s imperative to gather evidence and analyze how it can improve patient outcomes, health policies, service and programs as evidence allows for increased accountability (DeNisco & Barker, 2016). When gathering evidence for any project it’s important to understand different types of research and the different levels of evidence (Glasofer &Townsend, 2019). Evidence strength is dictated by three key characteristics, quality, quantity and consistency (Glasofer &Townsend, 2019). When selecting research for any topic it should be quality research that has results that are valid and not influenced by biases or occur by chance (art). Quantity can be evaluated by identified the number of studies on said topic, the size and population of the studies and the impact of the treatments (Glasofer &Townsend, 2019). Consistency is when results that are similar are found across a few different studies (Glasofer &Townsend, 2019).

When selecting research for my topic I would typically select research topics that are considered level on in the hierarchy of evidence. These are RCT, systematic review of an RCT and metanalysis if an RCT (Glasofer &Townsend, 2019). Under this topic I would likely consider including a mixture of quantitative and qualitative research. When working with prevention practices its important to understand how behavior plays a role in changing health practices and that why it’s important to analyze qualitative research in addition to quantitative.

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NUR 513 Topic 6 DQ 1 Reference

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning.

Glasofer, A., & Townsend, A. B. (2019). Determining the level of evidence. Nursing Critical Care14(6), 22–25. https://doi.org/10.1097/01.ccn.0000580120.03118.1d

RESPOND  HERE (150 WORDS, 2 REFERENCES)

This is insightful Meagan, the implementation of the new research program requires collection and analysis of evidence to improve patient outcomes as well as increased accountability. Understanding different forms of research and levels of evidence are critical in enhancing the validity, reliability, and applicability of the research and evidence-based practice processes. When selecting the research process, it is necessary to consider the level of evidence. Levels of evidence, sometimes called the hierarchy of evidence, are always assigned to the studies on the basis of methodological quality of their validity, design, as well as applicability to patient care (Glasofer & Townsend, 2021). A combination of qualitative and quantitative research processes is always required to enhance the research processes’ effective outcomes. Quantitative research designs require adherence to the data collection and analysis processes. The quantitative approaches are necessary for ensuring the establishment of valid, reliable, as well as applicability of the research outcomes (Bansal et al., 2018). To select a viable research study process, it is necessary for the researcher to consider the hierarchy or level of evidence.

NUR 513 Topic 6 DQ 1 References

Bansal, P., Smith, W. K., & Vaara, E. (2018). New ways of seeing through qualitative research. https://doi.org/10.5465/amj.2018.4004

Glasofer, A., & Townsend, A. B. (2021). Determining the level of evidence: experimental research appraisal. Nursing202151(1), 60-63. https://journals.lww.com/nursing/Abstract/2021/01000/Determining_the_level_of_evidence__Experimental.15.aspx

Re: Topic 6 DQ 1

My idea from Topic 5 DQ 1 was workplace violence (WPV), and my initial topic was much too broad. Before finding the best current evidence, I need to identify a specific clinical problem to best search for an answerable question (DeNisco & Barker, 2016). Using the PICOT template: population, intervention, comparison, outcome, and time, will help create that searchable question.

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Population: Healthcare Workers

Intervention: Education and Training

Comparison: Workplace Violence

Outcome: Prevent or Minimize

Time: 1-year Period

The next step is searching. I recommend a good starting point in PubMed, mostly because articles are specific to nursing and many are free to access. My organization allows access to the commonly used databases such as the Cochran Library, CINAHL, Medline and is a benefit to avoid paying fees for full review articles.  GCU library also offers students access to these same resources.

After obtaining multiple sources of evidence, critical appraisal or grading evidence is next, from the strongest to weakest evidence (DeNisco & Barker, 2016). The gold standard and strongest evidence is a meta-analysis of randomized controlled trials or clinical guidelines based on systematic reviews. Evidence sources may include qualitative or quantitative studies, reviews or clinical expertise, or patient preferences and values. The need is to quickly determine whether it is valid evidence and applicable to practice. Critical appraisal tools exist and ask specific questions based on the methodology or design of the study you are evaluating. Besides validity and usefulness, other criteria to assess include when last updated, clinical context and environment, and patient values and preference. One of my personal favorites, UpToDate, uses a graded approach, 1A being strongest whereas, 2C means a weak recommendation to use an intervention based on both quality of the evidence and patient preference.

Inquiry and asking the best clinical question in a PICOT format is critical to searching and finding the best evidence. Appraising the evidence and integrating this with patient values and preferences is necessary to make evidence-based-practice decisions within nursing.  My Cochrane Library search resulted in very low-to low-quality evidence, with the common databases searched and seven studies being included. There is limited evidence that some interventions might reduce aggression toward healthcare workers (Spelten et al., 2020).  April is National WPV Month and a great place to start to recognize that more research is needed. I recognize I need more experience in this process too.

NUR 513 Topic 6 DQ 1 References

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: essential knowledge for the profession. Jones & Bartlett Learning.

Spelten E;Thomas B;O’Meara PF;Maguire BJ;FitzGerald D;Begg SJ; (2020, April 29). Organizational interventions for preventing and minimizing aggression directed towards healthcare workers by patients and patient advocates. The Cochrane database of systematic reviews. https://pubmed.ncbi.nlm.nih.gov/32352565/.

RESPOND TO BARBARA HERE

This is insightful, Barbara, consideration of the PICOT question is necessary for undertaking different research processes (Abbade et al., 2016). Also, it is always necessary to identify the ideal sources of information such as databases that may be applied in supporting the research process. Most of the databases contain essential forms of information that may be applied in addressing various aspects of the project. CINAHL, Cochran Library, and Medline are some of the databases that can be applied to review some of the best sources of information that can be used to authenticate the information required in the research processes. The quality of research processes often depends on the levels of evidence (Glasofer & Townsend, 2019). The level of evidence is always assigned to the studies on the basis of methodological quality of their validity, design, as well as applicability to patient care. To better develop a quality, reliable, valid, and applicable research process, sticking to the PICOT question is necessary. In other words, different researchers need to consider the PICOT question in ensuring the achievement of quality outcomes.

NUR 513 Topic 6 DQ 1 References

Abbade, L. P., Wang, M., Sriganesh, K., Mbuagbaw, L., & Thabane, L. (2016). Framing of research question using the PICOT format in randomised controlled trials of venous ulcer disease: a protocol for a systematic survey of the literature. BMJ open6(11). https://bmjopen.bmj.com/content/6/11/e013175.short

Glasofer, A., & Townsend, A. B. (2019). Determining the level of evidence. Nursing Critical Care14(6), 22–25. https://doi.org/10.1097/01.ccn.0000580120.03118.1d

GINA

Re: Topic 6 DQ 1

My evidence-based practice would be centered around the utilization of new technologies by bedside nurses. I would do a literature review of peer-reviewed studies to further investigate this issue. Then I would develop a framework and intervention with said technology that could be both quantitatively and qualitatively measured. Both quantitative and qualitative data would be important because it would be necessary to study the numerical data regarding technology use, and it would also be important to know both nurse and patient responses to interventions, which could be gathered through surveys, questionnaires, and interviews. When researching, data would have to be recent, within the last five years, peer-reviewed, with adequate sample sizes. DeNisco and Barker say it best, “Not all evidence is created equal, and there is a need to use the best available evidence,” (2016, p.465). Peer-reviewed research is essential, because it helps maintain the quality of the research. Critical appraisals of research by other academic minds can both validate, provide transparency, ensure professionalism, academic integrity and ethically conducted research (Kelly, et al., 2014). Additionally, research should be recent. Just like the rest of the world, data ages and isn’t always applicable as people, the world, the population, and societies adapt and change. You want sources that reflect the newest and most up to date research available. And finally, data in research can be easily statistically manipulated, so sample sizes matter. If a sample size is too small, it often holds less statistical significance and cannot often be used to generalize to a population.

NUR 513 Topic 6 DQ 1 References

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning.

Kelly, J., Sadeghieh, T., & Adeli, K. (2014). Peer review in scientific publications: Benefits, critiques, and a survival guide. EJIFCC25(3), 227–243. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4975196/

RESPOND  HERE

This is insightful, Gina; in general, the application of technology is on the rise, which calls for increased research processes to enhance the understanding of different ways to integrate technological approaches in the research processes (Spelten et al., 2020). The utilization of technology by the bedside nurses is critical in ensuring quality treatment outcomes and patient safety. Usually, the integration of technology in the healthcare processes reduces the errors associated with general care. The literature review is essential in the study processes because it enhances the understanding of past research outcomes that may be applied in addressing some of the research processes’ aspects. In the research process, it is also necessary to consider qualitative and quantitative research approaches to enhance the achievement of valid, reliable, and applicable research processes (Bansal et al., 2018). While undertaking a literature review, it is necessary for the researcher to consider different databases that have authentic, reliable, and applicable sources of information that can be utilized in identifying the required information.

NUR 513 Topic 6 DQ 1 References

Spelten E;Thomas B;O’Meara PF;Maguire BJ;FitzGerald D;Begg SJ; (2020, April 29). Organizational interventions for preventing and minimizing aggression directed towards healthcare workers by patients and patient advocates. The Cochrane database of systematic reviews. https://pubmed.ncbi.nlm.nih.gov/32352565/.

Bansal, P., Smith, W. K., & Vaara, E. (2018). New ways of seeing through qualitative research. https://doi.org/10.5465/amj.2018.4004

Prevention of hospital-acquired pressure injuries has been a prime focus in the institution I work in due to the change in reimbursement of stage 3 and 4 pressure injuries, as these are preventable harm to patients. This change came into effect in 2008 when the Centers for Medicare and Medicaid Services stopped reimbursement for all stage 3 and stage 4 hospital-acquired pressure injuries (CMS, 2020). The goal in any institution at present is to reduce the number of hospitals acquired pressure injuries and always to be below the national benchmark. The article I choose to discuss here is a qualitative improvement project by Hoedi et al. (2017) published in the Journal of Wound Ostomy and Continence Nursing in 2019. The purpose of the study was to describe the processes involved, the outcomes, and the structural indicators in pressure injury prevention and care. . The article meets the criteria laid out by the “CRAAP (Currency, Relevance, Authority, Accuracy, Purpose) Test” article from the New Jersey Institute of Technology. The five criteria are currency, relevance, authority, accuracy and purpose. This study is an of scholarly qualitative research. The project in the article was conducted in 2017 and was published in 2019, which is relevant as it is within 5 years and is considered current. The information presented in this journal article is relevant to pressure injury prevention and care as it evaluated the structural framework of modalities used in 37 Austrian hospitals and the processes involved which included the implementation of pressure injury prevention interventions in patients. The data collected used a national standardized survey tool used nationally in Austria. The data presented is appropriate for the intended audience which is Nursing & nursing management. This information is enlightening as it gives hope and reinforcement of pressure injury intervention and prevention measures, we are already implementing in the U. S hospitals. The three authors who wrote the article do not have any credentials listed, thus we are unable to identify if the authors are experts in the field of pressure injuries. The source, however, is reliable as it is an academic journal which is the official journal of the Wound Ostomy Continence Society, and it is a renowned international journal that includes original peer-reviewed articles. The publisher is valid and reliable; thus, this article is a good source to cite in my references. There is supporting evidence that is cited in the text of the article and in the references. This article is peer reviewed and uses unbiased language. The information presented is factual as its analyzed well and presented to inform the audience of the severity of the problem and what’s structures and processes can be altered to achieve better outcomes in pressure injury prevention and care.

NUR 513 Topic 6 DQ 1 Reference:

Hospital-acquired conditions. CMS. (n.d.). Retrieved August 29, 2022, from

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-

Payment/HospitalAcqCond/Hospital-Acquired_Conditions

Hoedl, M., Eglseer, D., & Lohrmann, C. (2019). Structure, Process, and Quality Indicators for Pressure

Injury Prevention and Care in Austrian Hospitals: A Quality Improvement Project. Journal of 

          Wound, Ostomy, and Continence Nursing : Official Publication of The Wound, Ostomy and

          Continence Nurses Society46(6), 479–484. https://doi-org/10.1097/WON.0000000000000586

How to evaluate information sources: Craap Test. Research Guides. (n.d.). Retrieved September 5, 2022, from

https://researchguides.njit.edu/evaluate/CRAAP 

The evidence-based project practice involved improving the approach of care delivery in the clinical nurse specialist practice using the holistic nursing theory. Continuous quality improvement process requires critical review and analysis of the nursing scholarly research and developing up-to-date and effective practice interventions. Reviewing quantitative research and peer-reviewed journals is required to further investigate the issue of poor patients’ outcomes in the clinical nursing specialist practice. Such researches provide reliable and credible evidence to support the causative factors to the existence of the issue and based on the report, proper recommendations can be developed to improve the nursing practice.

Various factors are considered in evaluating the appropriateness of a research. First, the research must have employed an appropriate study design and recruited sufficient sample population (Claydon, 2015). For example, the sample population characteristics must represent the true features and experiences of the general population. Enough and appropriate sample population is required to produce credible and reliable research findings. Additionally, the study must have a clear data analysis tool and statistical tests. Randomized control trials are preferred in the clinical research because they present strong evidence to support causality or the existence of a given phenomenon among the populations of interest (Ten Ham-Baloyi & Jordan, 2016).

Selecting an appropriate research is important for evidence-based nursing practice recommendation. The checklists help in ensuring that the conclusion derived from the research is reliable and can be inferred to the general population. Poor choice of the research may lead to misinterpretation of the existing clinical problems; therefore, it may be impossible to fully address the issue because of the lack of sufficient scholarly evidence. Furthermore, the research ought to be based on the targeted population characteristics to be relevant.

References

Claydon, L. S. (2015). Rigour in quantitative research. Nursing Standard29(47), 43.

Ten Ham-Baloyi, W., & Jordan, P. (2016). Systematic review as a research method in postgraduate nursing education. Health Sa Gesondheid21(1), 120-128.

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