EBP Exam 1 Flashcards
Define Research
a systematic study/inquiry that validates and refines existing knowledge and develops new knowledge
Define nursing research
a scientific process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences nursing practice
Define evidence based practice
combination of the best research evidence w/ clinical expertise and patients circumstances and values to produce quality health outcomes
EBP Model (3 components of EBP)
- Best research evidence
- Clinical expertise
- Patients’ circumstances and values
Nursing research began when and with whom?
Nursing research began in the 19th century with Florence nightingale
Nursing research 21st century timeline
2000 - Healthy people 2010
2000 - Biological research for nursing
2002 - Joint commission revised polices to support evidence based care
2004 - worldviews on evidence based nursing
2010 - healthy people 2020
2016 - NINR (national institute of nursing research) mission statement and strategic plan updated
2017 - AACN leading initiatives of research
Name the ways of acquiring nursing knowledge
Tradition
Authority
Borrowing
Trial and error
Personal experience
Role modelling
intuition
reasoning
Inductive vs Deductive reasoning
Inductive reasoning - moves from a specific observation to a general principle (EX: my patient’s resp. rate decreased when I administered the opiod, so all opiods will always cause resp. depression)
Deductive reasoning - moves from a general principle to a specific observation (EX: Opiods cause resp. depression, so my patient will suffer resp. depression if I administer the opiod ordered)
Why is research important for EBP? (DII)
Develops empirical knowledge
Identifies best practices that are based on clinical practices
Improves outcomes (for PT, family, nurse, etc.)
The focus of healthcare research and funding has expanded from the treatment of illness to include what?
health promotion and illness prevention
What is QSEN?
(The Quality and Safety Education for Nurses)
An initiative focused on developing the requisite knowledge, skills, and attitude (KSA) statements for each of the competencies for prelicensure and graduate education
Describe Quantitative research
Positivism (one answer or absolute)
Numbers
Large sample
survey
big data
Closed questions
Deductive
Test theory
Describe Qualitative research
Naturalist (many answers or truths)
Words/feelings
Small sample
In-depth analysis
Open ended questions
Inductive
Develop theory
4 Types of Quantitative research and what they are
Descriptive research: explores (measures) what is
Correlational research: examines the relationship between two or more variables; determines strength and type of relationship (NO cause and effect)
Quasi-experimental research: lack of control; examines cause and effect relationship
experimental research: controlled manipulation of at least 1 independent variable; uses experimental AND control group
5 types of Qualitative research and what they are
Phenomenological research: inductive research approach used to describe an experience as it is lived by an individual (i.e. the experience of chronic pain)
Grounded theory research: inductive research technique used to formulate, text, and refine a theory about a particular phenomenon
Ethnographic research: developed by the discipline of anthropology for investigating cultures through an in-depth study of the membranes of the culture
Exploratory - descriptive research: conducted to address an issue/problem in need of a solution and/or understanding
Historical research: a narrative description or analysis of events that occurred in the remote or recent past
What is a mixed methods study?
a study that combines quantitative and qualitative research methods
What is outcomes research?
research that focuses on examining the results of care and determining the changes in health status for the patient and family
Discuss your role in research as a professional nurse
Identify research problems
Assist with data collection
Critique research studies
Summarize research findings for use in practice
Describe the purposes of research in implementing an evidence-based nursing practice
Description
explanation
prediction
control
Define basic research
referred to as pure research or even bench research
Define applied research
called practical research, which includes scientific investigations conducted to generate knowledge that will directly influence or improve clinical practice
Define rigor
the striving for excellence in research
Define control
involves imposing of rules by researchers to decrease possibility of error, thereby increasing the probability that the study’s findings are an accurate reflection of reality
Identify the steps of the qualitative research process
- Identify a research problem
- Formulate the research purpose
- Identify the study methodology
- Review the literature
- Describe the theoretical framework
- State the research objectives, questions, hypotheses, and procedures
- Present results
- Compare data findings
Define sampling
selection of participants/subjects
Rigor is obtained in qualitative research by?
- Openess
- Scrupulous adherence to a philosophical perspective
- Thoroughness in collecting data
- Consideration of all data in subjective theory development phase
Tuskege Syphillis experiment
(1932-1972)
Conducted to determine the natural course of syphilis in adult black men. The study continued into the 1970s, well after an effective treatment for syphilis had been developed.
Willowbrook study
(1932-1972)
conducted from the mid 1950s-1970s at Willowbrook institution for the Mentally Retarded in NY and involved deliberately infecting children with hepatitis virus
Jewish chronic disease hospital study
(1960s)
Conducted on older adults w/ dementia.
“Consenting” participants were injected w/ live cancer cells and examined for response to the cells. Patients were unaware they were being injected with cancerous cells.
5 human rights
Right to self-determination
Right to privacy
Right to anonymity and confidentiality
Right to protection from discomfort and harm
Right to fair selection and treatment
Describe the principle of respect for persons
(based in autonomy)
No coercion
Full disclosure, no deception
Voluntary consent
Persons with diminished autonomy have special protections
Describe the principle of beneficence
(based in promoting good)
Freedom from harm
Freedom from exploitation
Benefit-risk ratios
Describe the principle of justice
(based in fairness)
Fair treatment
Right to privacy
Ethical codes and regulations created between 1933-1996
1933-45: Nazi medical experiment
Experiments violated numerous rights of research subjects, i.e. unjust selection of subjects, involuntary participation, and permanent damage including death
1949: Nuremberg code
Consent, process, protection of subjects from harm, balance of benefits and risks in a study
1964: Declaration of Helsinki
The differentiation of therapeutic research from non-therapeutic research
1973: Department of health, education, and welfare regulation (DHEW)
Regulations set rules for oversight of human subject research which helped stop the Tuskegee Syphilis study
1979: Belmont report
Identified ethical principles to guid selecting subjects, informing them of the risks and benefits of a study and documenting their consent
1996: HIPPA
Privacy law that focuses on protecting electronic storage and transfer of patient info generated through clinical care
Identify the essential elements of the informed consent process in research
DISCLOSURE - essential info for consent
COMPREHENSION - of consent info
COMPETENCE - to give informed consent
IMPORTANT: children are considered to have “diminished autonomy” (diminished autonomy= those who have impaired decision making due to meds, mental illness, or mental capacity); especially special needs children; you must gain ASSENT (assent means that the child agrees to the study AND has the parent’s permission)
VOLUNTARY AGREEMENT - (consent)
Describe the levels of review that an institutional review board (IRB) may use in reviewing a study
EXEMPT from review/procedure: no risk
EXPEDITED review procedure: minimal risk
(i.e. small amounts of blood collected, biological specimens collected through noninvasive means, noninvasive imaging, interview)
FULL/COMPLETE institutional review procedure: invasive/higher than minimal risk (also used when reviewing studies using vulnerable populations)
Describe the current issues in ethical research
GENOMICS - promising area of science related to human disease and healing
(i.e. Henrietta Lacks who was diagnosed w/ cervical cancer)
USE OF ANIMALS IN STUDIES
RESEARCH MISCONDUCT - serous ethical problem that includes plagiarism, falsification, and fabrication of data, and duplicate publication
Define research problem
An area of concern in which there’s a gap in the knowledge needed for nursing practice.
Define research purpose
a clear concise statement of the specific goal/focus of a study
Define extraneous variables
A variable that isn’t being studied that can affect the outcome of your study
If not recognized until the study is in process or cannot be controlled its called a _________ variable
confounding
Define Description, explanation, prediction, and control
Description - involves identifying and understanding the nature of nursing phenomena and (sometimes) the relationships among them
Explanation - clarifies the relationships among phenomena and identifies possible reasons why certain events occur
Prediction - estimating the probability of a specific outcome in a given situation
Control - ability to write a “prescription” to produce the desired results; using the best research evidence nurses could prescribe specific interventions to meet the needs of patients
