Introducing Nursing Research for EBP

Question 1

Research

Answer 1

-Systematic inquiry that relies on methods to solve problems
-Nursing research is systematic inquiry designed to develop evidence about issues of importance to nurses and their clients
-Clinical nursing research is research that is designed to guide nursing practice and to improve health and QOL of clients

Question 2

Nursing research: past and present

Answer 2

-Florence nightingale in 1850s
-Practice-oriented research in 1960s
-Improvements in client care in 1970s
-NCNR established at NIH in 1986

Question 3

Future directions for nursing research

Answer 3

-Continued focus on EBP
-ONgoing growth of research syntheses
-Increased emphasis on patient centeredness
-Greater interest in the applicability of research
-Expanded local research and quality improvement efforts in health care settings

Question 4

Roles of nurses in research

Answer 4

-Consumers of nursing research: nurses who read reports
-Producers of nursing research: nurses who perform research

Question 5

Disciplined research

Answer 5

-Best method of acquiring knowledge
-EBP health care

Question 6

Paradigms

Answer 6

-Paradigm: worldview, general perspective on world’s complexities
-Positivist paradigm: reflection of broad cultural mvmt that emphasizes rational and scientific
-Constructivist (naturalistic) paradigm: countermovement to positivism, major alternative system for conductive research

Question 7

Positive paradigms

Answer 7

-An assumption is a principle believed to be true w/o verifications
-There is reality out there that can be studied and known
-Positivists assume that nature is ordered and regular, and that a reality exists independent of human observation
-Understanding underlying causes of natural phenomena
-Approach involves use of orderly, disciplined procedures w/ tight controls over research situation to test hunches about the nature of phenomena being studied and relationships among them
-Postpositivists recognize impossibility of total objectivity, but strive toward it

Question 8

The scientific method

Answer 8

-Scientific method: orderly procedures to gather quantitative info
-Empirical evidence: evidence rooted in objective reality and gathered thru senses
-Ability to generalize research findings to individuals who did not take part is an important goal

Question 9

Constructive paradigms

Answer 9

-Reality is not a fixed entity but rather a construction of ppl participating in research
-Constructivists take the position of relativism
-Assumes knowledge is maximized when distance btwn inquirer and participants in study is minimized
-Emphasize inherent complexity of humans, their ability to shape their own experiences, the idea that truth is a composite of realities
-Major limitation of scientific method is that it is reductionists (reduces human experience to few concepts under investigation)

Question 10

Multiple paradigms and nursing research

Answer 10

-Ultimate goals: answer questions and solve problems
-External evidence: researchers gather and analyze evidence empirically
-Reliance on human cooperation: researchers must persuade people to participate in study
-Ethical constraints: ethical principles
-Fallibility: all studies have limitations and errors

Question 11

Purposes of nursing research

Answer 11

-Identification
-Description
-Exploration
-Prediction/control
-Explanation

Question 12

Therapy/intervention

Answer 12

-Therapy/intervention questions are addressed by health care researcher who want to learn the benefits of specific actions, tx, products, processes
-Seek to identify effective tx for preventing health problems

Question 13

Dx/assessment

Answer 13

-Dx/assessment question must be addressed
-High-quality instruments w/ documented accuracy are essential for clinical research

Question 14

Prognosis

Answer 14

-Prognosis questions strive to understand outcomes associated w/ disease, estimate their probability of occurring, predict types of ppl for whom the outcomes are most likely
-Studies facilitate development of long-term care plans for pts

Question 15

Etiology/prevention of harm

Answer 15

Determining the factors and exposure that affect or cause illness, mortality, or morbidity

Question 16

Description

Answer 16

-Description questions are not in a category typically identified in EBO-related classifications schemes
-Pt’s pain, physical fxn, confusion, levels of depression

Question 17

Meaning/process questions

Answer 17

Research that offers evidence about what health and illness mean to clients, what barriers they face to positive health practices, and what processes they experience in a transition thru a health care crisis are important to evidence-based nursing practice

Question 18

EBP model

Answer 18

Nurse’s clinical expertise + patient preferences and values + best evidence = clinical decision

Question 19

Sources of best research evidence

Answer 19

-Primary studies: must be critically appraised to determine if evidence is sufficiently rigorous to warrant consideration in practice
-Systematic review: scholarly inquiry that summarizes and evaluates current evidence on a research question
-Meta-analysis: treat the findings from a study as one piece of info
-Metasynthesis: less about combining info and more about amplifying and interpreting it
-Meta-aggregation: aggregative approach to systematic synthesis
-Mixed studies review: efforts to integrate both quantitative and qualitative evidence on a topic

Question 20

Evidence hierarchies and scales

Answer 20

-Evidence hierarchy: ranks evidence source in terms of risk of bias
-LOE scale: rank order types of evidence (level 1 evidence = least biased/best, level 8 = non-research such as expert opinion)

Question 21

PICO

Answer 21

-Population or patients:
-Intervention, influence, exposure
-Comparison
-Outcome