Week Eleven Flashcards
Research
Nursing research sets out to test the statements made by theorists
Theory
A set of established statements or rules that are able to be tested
Practice
When nurses carry out their actions which are driven by multiple factors, including theory and research
Grand Theory
A global, conceptual framework that provides insight into abstract phenomena
Middle-Range Theory
Are less abstract than grand theory.
Address more specific phenomena and reflect practice
Descriptive Theory
Have the ability to explain, relate and predict phenomena of concern, specific to nursing
Prescriptive theory
Addresses nursing interventions, and help predict the consequences of specific interventions
Evidence Based Practice
The judicious use of current best evidence in making decisions about care of individual patients
Evidence informed Practice
The integration of the most informative research evidence with the evidence from expert clinical practice and other sources to produce the best possible care for clients
Steps for Generating Evidence Informed Practice
1⃣ask a question that clearly presents the clinical problem
2⃣identify and gather the most relevant and best evidence
3⃣critically appraise the evidence
4⃣integrate all the evidence with clinical expertise, clients’ preferences, and clients’ values to make a practice decision or change
5⃣evaluate the outcome of the practice decision or change
Problem focused trigger
What is the best dressing to use for this wound?
Problem focused trend
What can we do to reduce the number of ulcers developed in our unit
Knowledges focused trigger
What is the current evidence to improve overall healing for diabetic ulcers
Asking the Clinical Question
P patient population of interest
I intervention of interest
C comparison of interest
O outcome
An evidence informed article must have?
Abstract
Introduction
Literature review
Manuscript narrative
Purpose Statement
Methods or Design
Results or Conclusions
Clinical Implications
Questions to Critique the Evidence
Who wrote this article or conducted this research?…What are their credentials?
Has this published in a credible source?
Is the article based on their personal opinion or on a
research methodology?
Do you think the results are negatively influenced in any way? (bias)
Fundamental Principles of Evidence Based Practice
Only intervene when it is known that a particular treatment is more effective than nature
Ensure that the benefits outweigh the risks
Carper’s Ways of Knowing
Each pattern may be conceived as necessary for achieving mastery in the discipline, but none of them alone should be considered sufficient
There are four patterns: ethics - the moral component esthetics - the art of nursing personal knowledge - therapeutic use of self empirics - hue science of nursing
What is Empirical Knowing?
The Science of Nursing
Knowledge that is systematically organized into
general laws and theories
When reflecting on your practice, asking: What
evidence informed this decision?
What is Personal Knowing?
Referred to as ‘therapeutic use of self’
It is essential that we know ourselves
Promotes wholeness and integrity in the personal encounter
Nursing is an interpersonal process
What is Aesthetic Knowledge?
The Art of Nursing
Expressed through creativity and style
empathy, compassion, holism, and sensitivity
How was this person feeling? Did I accomplish what I set out to do?
What need is being expressed by the patient’s behavior
What is Ethical Knowing?
One of Carper’s ways of knowing
The moral component
Nursing knowledge goes beyond professional code of ethics and includes all voluntary actions that are deliberate and subject to judgement as right or wrong
Focuses on matters of obligation
What are Best Practice Guidelines?
Guiding principles that lead to the most appropriate courses of action in certain practice situations
The Registered Nurses Association of Ontario (RNAO)
Steps to Integrate Best Practice Guidelines into Practice
1⃣identify the problem, review and select knowledge
2⃣adapt knowledge to local context, stakeholder analysis, resource assessment
3⃣assess facilitators and barriers to knowledge use
4⃣select, tailor and implement intervention and implementation strategies
5⃣monitor knowledge use and evaluating outcomes
6⃣sustain knowledge use
