N300 quiz1 CH 1-3

There are many reasons why researchis important to the nursing profession. What is the ultimate goal of nursing research?
a. Documents financial effectiveness of care
b. ensures credibility of the nursing profession
c. promotes evidence based practice in nursing
d. provides accountability for the nursing profession
Promotes evidence based practice in nursing.

There are different roles for nurses invovled in research based on their level of education. Which best describes the role of the BSN=prepared nurse in research?
a. Collaborates with other nurses to design research studies
b. Critiques research studies and applies research t oclinical practice
c. Develops policy based on nursing research findning
d. Assumes the role of primary investigator in a research study
b. critiques research studies and applies research to clinical practice

What is true of replication studies i nursing?
Replication studies are necessary for validation of nursing theory.

What is nursing’s branch of the NIH (ntl Inst of Health)?
National Institute of Nursing Research (NINR)

Which are sources of nursing research problems?
a. existing theories
b. previous research studies
c. personal experiences
d. all of the above
d. all of the above

Existing theories, previous research studies, and person experiences are all sources of nursing research problems.

Nurses can expand their knowledge of research by
a. participating in or set up a journal club
b. attend research participation
c. help develop an idea for a research study
d. all of the above
d. all of the above

Nursing has historically acquired knowledge from an assortment of methods. Wich method has nursing used to generate new ideas and knowledge?
a. tradition
b. personal experience
c. intuition
d. all of these
d. al of these

Nursing uses many methods to generate new ideas and knowledge, including Tradition, Personal Experience, and Intuition.

An approach used to acquire nursing knowledge that describes life experiences is classified as
qualitative research

Nursing research is the key to providing high-quality health care. Through the process of conducting research, nurses
a. ask questions that come up in daily practice that need answers
b. provide data that document the effectiveness of nursing care
c. build a body of knowledge unique to the nursing profession
d. all of these
d. All of these.

– Through the process of conducting research, nurses ask questions that need answers, provide data documenting the effectiveness of care, amd build a bod of knowledge unique to the nursing profession.

The purpose of research is to:
a. describe of explain
b. predict
c. control
d. al of the above
d. all of the above

The purpose of nursing research is to describe or explain, predict, and control.

Triangulation refers to the process of
a. reaching agreement amont members of a research team on identity of concepts of themes
b. collecting data through different research approaches
c. abstracting themes into constructs
d. examining problems to gain knowledge about improving patient care
b. collecting data through different research approaches

The research process may be best characterized as

a. a way of assigning people to groups
b. a set of steps to be carried out in the prescribed order
c. a set of rules that must always be followed
d. a decision-making process that attempts to guard against making false interpretations

d. a decision-making process that attempts to guard against making false interpretations

In some situations, a researcher obtains informed consent without asking the subject to sign his or her name on a written consent form. This may be done to protect the subject’s:

a. human dignity
b. anonyminity
c. right to self determination
d. confidentiality

b. anonymity

Which of the following potential research participants have diminished autonomy and are incompetent to give informed consent?
a. cognitively impaired older adults
b. mentally ill
c. children
d. all of the above
d. all of the above

Cognitively impaired older adults, the mentally ill, and children are incompetent to give informed consent for research because they have diminished autonomy.

A researcher wants to determine if nurses’ levels of empathy for patients change after graduation from nursing school. She measures new graduates, nurses who have worked for 2 years, and nurses who have worked for 4 years as regards to their empathy for patients and compares their scores. This study is:

a. prospective
b. retrospective
c. cross-sectional
d. longitudinal

c. cross-sectional

A researcher is interested in why some elderly patients are discharged when considered not medically stable. The researcher reviews charts of patients who have been discharged in order to explore factors that occurred during the hospitalization and relate these to status at discharge. This study is:

a. prospectiev
b. retrospective
c. cross-sectional
d. longitudinal

b. retrospective

What is the first step associated with evidence-based practice?

a. critiquing the literature
b. identifying the problem
c. implementing a change
d. evaluating the change

b. identifying the problem

Protecting human rights in a research study include the folowing except:

a. right to freedom from risk of injury
b. right to privacy
c. right to anonymity and confidentiality
d. right to payment for participating

d. right to payment for participating

In the heirarchy of reseatrch evidence, what is cosnidered the strongest piece of evidence?

a. case studies
b. expert opinion
c. case control studies
d. randomized clinical trials

d. randomized clinical trials

Which of the following strategies when practicing evidence-based nursing is most amenable for students and staff nurses?

a. replicating previous research studies
b. reading and understanding published research reports
c. prepare an integrative lit review or meta-analysis
d. devoting a specific amount of time workign with an est researcher

b. reading and understanding published research reports

Decisions to change practice based on the evidence should include:
a. relevance
b. consistency
c. sample characteristics
d. all of the above
. all ov the above

Decisions to change practice based on evidence should include relevancy, consistency, and sample characteristics.

How do we assure protetcion for the subjects in a study?
Informed consent and IRB oversignt

Evidence based practice validates
a. current practice
b. changes in practice
c. cost eff and quality care
d. all of the above
d. all of the above.

Evidence-based practice valdates current practice, changes in practice, cost effectiveness and quality care.

T/F: Evaluating the strength of the evidence presented in the research article is not important.

T/F: This course will help me be a good consumer of research?

Why is Research Important in Nursing?
– integral part of nursing activities
– develop, refine, expand nursing science
– lcinical thinking and decisions on scientifically documented info

Nursing has its own body of knowledge, which focuses on
health and wellness

– essential info acquired in a variety of ways
– expected to be accurate reflection of reality
– incorporated and used to direct a persons actions`

Ways of Knowing
– traitions
– authority
– borrowing
– trial and error
– personal experience
– role modeling
– intuition
– reasoning: inductive, deductive
– research

Inductive reasoning
large (general idea) to specific conclusion

specific (small) to generalization

The Scientific Method- essential characteristics
– scientific inquiry
– objectivity
– empirical data

Scientific Inquiry
proces sin which observabe, verifiable data are systematically collected from our surroundings through our senses to describe, explain, or predict events

*observe, verify, collect to describe, explain, predict

5 Research Approaches /types
1. Quantitative
2. Qualitative
3. Outcomes research
4. Replication
5. Triangulation

Quantitative Research
test hypothesis (question), gather data, analyze

Qualitative Research
verbal description of individual- observations, case studies

Outcomes research
– Particularly useful to nursing
– Looking for change in patient’s outcome (improvement, positive outcome)

*very important
verify/validity- generalize OR adapt results

use multiple perspectives
ex- quantitative and qualitative

Nurses Research Roles
Bachelor’s Degree: some (consumer)
Master’s Degree: clinical nurse leaders, admin, adv prac
Practice-Focused Doctoral Degree (DNP)- adv prac nurse
Research Focused Doctoral Degree phD
Postdoc Preparation

BSN Researchse role
– read, understand, interpret, apply research findings into clinical practice
– understand Evidence based nursing practive
– ID research problems
– assist w data collection
– critique research studies
– transfer and implement knowledge into practice

What can you do to promote integrity of nursing science?
– journal clubs, attend research presentations, help develop idea for research study, offer clinical expertise into a proposal, collaborate with researchers, member of IRB, promote nursing research in your organization

Duties of member of research team
– data access
data management

National Institute of Nursing Research. 1993
Part of NIH
Mission: promote and improve health of indiv families comm and pop
– Supports clinical, basic and translational research to build the scientific foundation for clinical practice, prevent disease and disability, manage and eliminate symptosms caused by illness, ehanve palliative and end of life care and train the next gen of scientists

NINR Priorities
– Health promotion and Disease Prevention (in 88: just health promotion)
– Advancing the quality of life- symptom management
– Palliative and end of life care
– Innovation tech and genomics science
88: tech dependency across lifespan
– Investing in Nurse Scientists

Nursing research is essential to
the development and refinement of KNOWLEDGE used to IMPROVE CLINICAL PRACTICE

Research findings need to be viewed as the vehicle for helping to determine the best way to
improve clinical practice

The problem solving process is
not synonymouse with the research process.

* quality improvement v research

Ways of knowing within the discipline of nursing cme from
several diff approaches

Scientific inquiry is different from other types of inquiry in that data is
collected, analyzed, and reported

Throughout the process of identifying and refining a research question, three general criteria should be considered to determine whether a questions is worth pursuing: the research question should be:
and Feasible

What is Research?
– to search again
– to examine carefully
– diligent and systematic inquiry
– discovery of new know;edge
– discovery of relastionships and associations
– finding of solutions to programs and questions

4 Purpose of Research
– Describe
– Explain
– Predict
– Control

5 Steps of the Research Process
1. Selecting and defining the problem
2. Selecting a research design
3. Collecting data
4. Analyzing data
5. Using the research findings

The research Process- Step 1: Selecting and Defining the Problem
– must be significant to =nursing
– add to body of existing knowledge
– problem arises from practice
– review of literature provides backr=ground, rationalte, and justification for study
– develop research question/hypothesis

2. Selecting a Research Design
– overall plan or strcture for planning to answer research questions and/or test hypothesis
– identify METHODS for selecting the sampe, testing, and measurement
* Control findings- consistency/vaidity

Step 3. Collecting Data (Methods)
– data collection
– organizing data for analysis

Step 4. Data Analysis
– analyzing and interpreting results; arriving at conclusions

STep 5. Utilizing the Research Findings
– sharing the findings with colleagues
– implications for practice, consider if it will be implemented

2 types of quantitative research
1. Experimental
2. Non-Experimental

Experimental Research
First type of Quantitative Research.
– control group and research group

*Quasi- experimental: no control group

– Researcher manipulates and controls one or more variables and observes the effect of the manipulation on other variables

Non-Experimental Research
Second type of Quantititavie Research
– Descriptive
– Correlational
– Retrospective v. prospective
– Cross sectional v longitudinal

– Researcher collects data without introducing treatment or making changes. STudies are more descriptive in nature. Describes relationships.

Retrospective study
Look at data after

Cross sectional research
Done once

Longitudinal research
Done over time

Prospective research
Use past medical records- look at what happened before??

Organization of a Research Report (8)
1. Title
2. Abstract
3. Introduction
4. Literature Review
5. Methods
6. Results
7. Dsicussion
8. Results

2 areas of Ethical Consideration in nrusing research
1. rights of human subjects
2. freedom from harm

Rights of Participants in Research Studies
1. COnfidentiality: protecting all data collected within the scope of a research study
2. Anonymity: keeping indiv nameless in relation to their participation
3. Voluntary parcipation
4. Research Particpants at Risk
5. Informed Consent

Research Participants at Risk
a basic resp of the researches and those assigned to assist in carrying outthe study is to protect all research participants from harm while they are participating in a study.
inorm of risks

Informed Consent
process of prov an indiv with sufficient information regarding their participation in a research study

The Tuskegee Syphilis Study
1932- US Public Health Study
– non therapeutic experiment
– promised free medical care
African Americans in Macon Alabama
– study progression of syphilis in Af Am men
– not informed they had syphilis or that treatment (penicillin) existed that could cure. treatment withheld, men told they were being cured
– 28 die, 100 die of complications (of 400)
40 women infected, 19 children born w/ syphilis
– exposed and ended in 1972

declarations about human rights

How were rights violated in Tuskegee SYphilis study?
– not informed about purpose of study
– coudn’t give informed consent
– not protected from harm or informed of risk
– Posed as experiment when actually descriptive study
– treatment withheld- if there is aknown treatment, cannot deny treatment

Human Rights
right to freedom from intrinsic risk of injury including freedom from exploitation.
– right to privacy and dignity
– right to anonymity and confidentiality
– ANA 1975: Human rights guidelines for nurses in clinical and other research roles

Human Dignity
respect for persons
– right to self determination: CONSENT
– participation and withdrawal at any time
– NO coercion: stipends, payment of incentives
– covert data collection= NO
-right to full disclosure
– no deception or misinforming

covert data collection/concealment
collecting info without particpants knowledge and thus without consent

either deliberately witholding information about the study or providing false information to participants

Vulnerable population/research subjects
– Special enrollment criteria to include in studies
– studies must be minimal risk

– children, pregnant, elderly, minorities, phys disabled, unconscious or sedated, dying, poor/homeless, HIV/AIDS, institutionalized people, prisoners, mentally or emotionally disabled persons

***Problem: only upper to mid class healthy adult caucasian men/women can participate in high risk studies! How can these results/studies be interpreted/translated to ither poplations?

Ethical Principles
– beneficence: above all do not harm
– freedom from harm and exploitation. risk-benefit ratio
– Justice: right ot fair treatment even if decide to not partipate or wthdraw
– right to privacy

researchers can’t link participant to data

indiv info can’t be publicly reported
– lock data or info collected
– use code numbers, psuedo names
– aggregate data reporting
– careful protection of all data

How do we assure protecton for research participants
1. Informed Consent
2. IRB

Information components of consent
1. introduction of research activities
2. statement of res purpose
3. selectino of subjects
4. explanatino of procedures
5. description or risks and discomforts
6. description of benefits
7. disclosure of alternatives
8. assurance of anony and conf
9. offer to answer questions
10. voluntary participation
11. option to withdraw
12. consent to incomplete disclosure

Institutional Review of Research Committee
– Provides an external review of ethics, dimensions of proposed research
– significance of study, soundness of design
– Evidence that rights are protected
– Mat also be known as HUMAN SUBJECTS committeed
– Guidelines for eval the protectnoi of human rights in research

Research studies are classfied based on:
the purpose of the study and degree of control

Ethical principles relevant to nursing research were originally derived from ___ ___ and ___ of ____
Nuremberg Code and Declaration of Helsinki

Basc rights of human subjects include:
right to freedom rom injury
right to privacy and dignity
right to anonymity and confidentiality

Informed consent includes the elements of
adequate disclosure, comprehension, and protection from human rights

Characteristics of Evidence Based Practice (EBP)
– critical appraisal of best available research findings
– probem-solving approach that takes into account the nurse’s current clinical experience
– patient preferences, concerns, and expectations integrated into clinical decisions

Evidence based practice vs research utilization
Terms are oten used synonomously, there is a distinct difference
1. Research utilization: process whereby knowledge generated from research becomes incorporated into practice
2. EBP: includes definition of research utilization, but integrates clinical expertise with best available evidence

Problems with research utilization
– resarch findings not always incorp into practice
– not always clear who benefits from research
– diff language used (research and clinicians)
gaps between research- practice

Evidence-based practice validates
– Current practice
– Changes in practice
– Cost effectiveness
– Quality of care

helps form policy

Steps associated with EBP
1. Selecting a topic and formulating a clinical question
use knowledge focused triggers b problem-focused triggers
2. Forming a Team
indiv working in cinical setting/multidisciplinary team
3. Tracking down the best evidence
What do we know about current evidence.. databases eg MEDLINE
4. Appraising the evidence critically

Step 1 (EBP). Selecting a topic and Formulating a Clinical Question
1. Knowledge focused triggers: ideas gen by staff. research, E and P guidelines published by fed agencies or organizations
2. Problem focused triggers: caregivers/staff. quality improvement data. risk-surveillance, benchmarking, financial data. recurrent clinical problems

Background Questions (EBP)
Who (is experiencing problem?- describe population)
Where (setting)
How (is it being addressed/current practic)
Why (reason for current practice)

Ways we try to develop and ask questions
Organizational data: measured within orga and reported- compared to national standards.
eg- patient falls. Record, report, compare to benchmark and ID areas to improve.

Why do we di it like this? is it working? How can we do itbeter?

Foreground Questions- PICO Model
– Specific knowledge to inform clinical decisions
more formal.

P= patient
I= intervention
C= comparison
O= outcome

Form CLinical question and examine differente after applying evidence

(EBP) 2. Foming a Team
Include critical staff members that are involved in selecting the topic, view it as contributing significantly
Composition of a team, key stakeholders ID

(EBP) Step 3- Tracking down the Best Evidence
– search search search
– Evidence databases- Medline, the Cochrane Library, National Guideline Clearing House, Agency for Healthcare Reearch and Quality, etc

Cochrane, Ntl Guideline, AHRQ
Guidelines. Take research papers and combine to form guideline

search peer reviewed research from many journals

Clinical Practice Guideline/Specialty Specific
* pt based or prob based problems
use best avail research practice
developed by indiv w/in specialty

mechanisms to assess clinical roblem
strategies for management of problem and reductions in inapp practice var
statements to assist practitioner decisions about app health care for specific circuumstances
evaluate patient and fam outcomes and produce the delivery of hi qual ebp health care
developed systematically w preresentation from as many interested parties as possible
tested by professionals uninvolved in their development for easabikity
reviewed reularly and midified

EBP Step 4- Appraising the research crictically: Heirarch of Research Evidence
1. Meta analysis of randomized clinical trials (strongest)
2. Individual randomized clinical trials
3. Inidvidual cohort study
4. outcomes research(loko at particular probs)
5. Individual case-controlst iud
6. Case studies (weakest)
7. Expert opinions (weakest)

Decision to Change practice
Prac changes based on evidence
Consider- relevancy, consistency, sample characteristics, feasabikity, risk0benefit ratio, translation

a movement that has developed to assist healthcare professionals to base their care on best research possible
Evidence based practice

incorporates the use of theory-derived and research-based knowledge
Evidence- based nursing

There is ___ in use of findings in clinical practice

____ ___ ___ follows several steps: asking the ight questions, tracking down the right evidence, evaluating the evidence critically and then integrating this evaluation with patient values and circumstances.
Evidence based Medicine

It is important to share research based information evidence and findings with patients and families

Must consider ethical implications

There are many reasons why research is important to the nursing profession. What is the ultimate goal of nursing research? Promotes evidence-based practice in nursing. There are different roles for nurses involved in research based on their level of education. …

Appraise make objective, systematic judgments regarding the credibility, clinical significance, and applicability of research evidence to determine if changes in practice should be made based on the evidence. Algorithm a step-by-step instruction for solving a clinical problem; often consists of …

Research utilization the use of findings from disciplined research in a practical application that is unrelated to the original research; emphasis on translating research findings into real-world applications. CURN Project aimed to increase nurses’ use of research findings by disseminating …

The term “research utilization” is sometimes used synonymously with what? Evidence Based Practice. What is research utilization? The use of findings from a disciplined study or set of studies in a practical application that is unrelated to the original research. …

What is evidence based practice? 1) Clinical practice based on current research findings 2) Use of the best evidence in making decisions regarding client care What are some problem solving approaches incorporated into Evidence Based Practice 1) Critical thinking and …

Clinical practice guideline Practice guidelines that are evidence based, combining a synthesis and appraisal of research evidence with specific recommendations for clinical decisions. Cochrane Collaboration An international organization that aims to facilitate well-informed decisions about health care by preparing systematic …

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