(CD) EBP Flashcards
Preparation for care design midterm *on SG
Level Ia
Systematic review of RCT
Level Ib
Systematic review of non-randomized, quasi-experimental
Level IIa
Single RCT
Level IIb
Single non-randomized trial, single quasi-experimental
Level III
Systematic review correlational, observational
Level IV
Single correlational, observational
Level V
Systematic review of qualitative, descriptive, physiological
Level VI
Single qualitative, descriptive, physiological
Level VII
expert opinion, panels, opinions of authorities
The purpose/goal of EBP
Develop practice guidelines. Reduce practice variation Provide most effective care Provide est patient outcomes Decrease health care cost Reduce healthcare provider turnover rate Improves healthcare provider role satisfaction
Role of the BSN nurse in research
Read and critically appraise studies
use best research evidence in practice
Assist with problem identification
Assist with data collection
Ways nurses acquire knowledge?
Traditions Authority Borrowing Trail and error Personal experience Role-modeling and mentorship intuition Reasoning Research
Strength of evidence: A
level 1 evidence
or
consistent findings across II, III, or IV
Strength of evidence: B
Consistent findings from level II, III, IV, or V
not I
Strength of evidence: C
Evidence of levels II, III, IV, or V with inconsistent findings
Strength of evidence: D
Little or no evidence level VI only
Strength of evidence: E
Level VII, panel consensus; opinion of expert, case reports
*Qualitative
Subjective approach used to describe life experiences and situations
*Things to look out for in determining a study is qualitative
An interaction/activity is observed
Small sample size (usually up to 15)
*Quantitative
A formal, objective, systematic, process in which numerical data is used to obtain info
*Things to look out for in determining a study is quantitative
Usually looking at a clinical problem
large to very large sample size
reports with numbers and statistical tests
Are systematic-reviews and meta-analysis considered primary sources?
Yes
Because they take the data and make new conclusions and ideas. They are not just analyzing someone elses data and discussing.
*Pain level in Hispanic patients over 65 that see a group practice arthritis physicians aquatic exercise program where patents can continue to take arthritis medications
Control group
Group that just that only uses their medications
*Pain level in Hispanic patients over 65 that see a group practice arthritis physicians aquatic exercise program where patents can continue to take arthritis medications
Intervention group
Group that participates in the aquatic exercises program
*Pain level in Hispanic patients over 65 that see a group practice arthritis physicians aquatic exercise program where patents can continue to take arthritis medications
independent variable
aquatic program
*Pain level in Hispanic patients over 65 that see a group practice arthritis physicians aquatic exercise program where patents can continue to take arthritis medications
dependent variable
pain level
*Quasi-experimental
Testing an intervention with some sort of lesser control
lack of random selection
and/or
lack of a control group
*Correlational
examining the relationships between two variables
Looks at the nature not cause/effect
*Types of correlation: Negative
One goes up the other goes down
ex/ inc. in the consumption of alcohol and dec. in grade
*Types of correlation: Positive
One goes up and the other goes up
ex/ inc. in hours slept and inc. in grade
*Types of correlation: symetrical
?
*Types of correlation: Asymmetrical
?
Five steps of EBP
Form a clinical question to identify a problem (PICO) Gather the best evidence Analyze the evidence Apply the evidence to clinical practice Asses the result
PICO(T)
Population of interest Intervention of interest Comparison of interest Outcome of interest Time
Steps for conducting a literature review (7)
IDENTIFY the research problem
PLAN the information retrieval process
CARRY out the search strategy
SCREEN the initial list f citations
RETRIEVE full text of studies for evaluation
CRITICALLY appraise the studies quality and findings
SUMMARIZE and synthesis the findings
Requirements for an experimental study
Random sampling
Control group
Control of the intervention
What is the purpose of control in a study?
To increase the probability that the results are true to reality
*Probability sampling types
simple random sampling
Stratified random sampling
Cluster sampling
Systematic sampling
*Non-probability sampling types
Purpose sampling
Network or snowball sampling
Theoretical sampling
*Simple random sampling
Equivalent to putting names in a hat and picking names out until sample size is reached`
*Stratified random sampling
Setting categories/variables that are circuital for representatives and randomly selecting people until each categories either has the same number of people or matches the % in the total population
*Cluster sampling
Developing a list of places in which elements of the identified population can be linked and then using a random selection from the randomly selected places.
ex/ 10 from nursing, 10 from OT, 10 from business.
*Systematic sampling
Creating a list of the people in some type of order (name, age, id number, ect..) and selecting every ___th one. Needs a random starting place
*Convenience sampling
participants are included simply because they are in the right place at the right time.
*Quota sampling
Is convenience sampling with the precaution to be sure populations/participant likely to underepresented are chosen in proportion to what is in the population
*Network/snowball sampling
I pick one person and then ask them to bring 2 people they know and then those 2 people bring 2 people they know.
*Purpose sampling
Picking people of a specific person/type.
Used often to qualitative (interviews)
*Levels of measurement: Nominal
word descriptions
*Levels of measurement: Ordinal
word description, but has an order/hierarchy
*Levels of measurement: Interval
Numbers
No absolute zero
*Levels of measurement: Ratio
Has an absolute zero
comparable
Reliability of measure
Degree of consistency with which it measures the attribute it is supposed to be measuring
*Cronbach’s alpha
Test for reliability–homogeneity
.7 = acceptable
.8 = good
.9 = Excellent
Does alpha equal at least .7?
*Reliability testing looks at?
Stability–same results when the test is repeated
Homogeneity– internal consistency
Equivalence– inter-rater reliability (same results different test)
Generalizbility–
Validity
Degree to which an instrument measures what it is supposed to measure
not reliability: reliable does not mean its valid
*Internal validity
will this intervention/independent variable make a change or difference in the dependable variable
*External validity (problem?)
Are you able to generalize the study to a larger group?
*Scales used for measurement?
Self-reporting
Visual analog (faces)
Likert (1=strongly agree, 2= agree, ect..)
Observational
*Null hypothesis
There is no relationship between the (2) things that are being studied.
-typically the opposite of the alternative/researchers hypothesis
*P value
Measurement of the level of significance
want p<0.05
p<0.05 indicated statistically significance and result were not due to chance
Type 1 error
positive but really negative (false positive)
null hypothesis rejected but should be accepted
researchers hypothesis accepted should be rejected
ex/ autism/vaccines
Type 2 error
negative but really positive (false negative)
null hypothesis accepted but should be rejected
researchers hypothesis rejected should be accepted
*T-test
Symbol
Level of data
Does/used for
S: t
L: interval, ratio
D/U: looks at the differences between two groups
Chi squared
Symbol
Level of data
Does/used for
S: x
L: nominal
D/U: compares expected to what is observed
*Correlation
Symbol
Level of data
Does/used for
S: r
L: interval, ratio
D/U: examines if relationships exist (not direction)
*ANOVA
Symbol
Level of data
Does/used for
S: F
L: interval, ratio
D/U: looks at the difference in means between more than 2 groups. (does not say between what 2 groups tho)
Regression
Symbol
Level of data
Does/used for
S: R
L: interval, ratio
D/U: make predictions about phenomena
Correlation test results
+/- 1 perfect pos/neg relationship
+/- .5 strong
+/- .3-.5 moderate
< +/- .3 weak
post hoc test?
used to determine the location of differences between more than 2 groups
