EBP

Nursing Research
a scientific process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences nursing practice
Evidence-based Practice
the conscientious integration of best research evidence with clinical expertise and patient values and needs in the delivery of high-quality, cost-effective health care.
Purpose of research in nursing
includes description, explanation, prediction, and control of phenomenon
Nightingale
first nurse researcher who developed empirical knowledge to improve practice
How knowledge is acquired
tradition, authority, borrowing, trial and error, personal experience, role modeling, intuition, reasoning, and research
Quantitative Research
formal, objective, systematic process using numerical data to obtain information about the world. Used to describe, examine relationships, and determine cause and effect
Qualitative Research
systematic, subjective approach used to describe life experiences and give them meaning. This knowledge will provide meaning and understanding of specific emotions, values, and life experiences.
Outcome Research
focuses on examining the results of care or determining the changes in health status for the patient
Research Evidence in nursing and health care
synthesized using: systematic review, meta-analysis, integrative review, metasummary, and metasynthesis
Systematic review
structured, comprehensive synthesis of quanitative studies in a particular healthcare area to determine the best research evidence available for expert clinicians to use to promote and EBP
Meta-analysis
type of study that statistically pools the results from previous studies into a single quantitative analysis that provides one of the highest levels of evidence for an intervention’s efficacy
Integrative review
research includes the identification, analysis, and synthesis of research findings from independent quanitative, outcomes, and qualitative studies to determine the current knowledge (what is known and not known) in a particular area
Qualitative Research synthesis
includes two categories: qualitative metasummary and qualitative metasynthesis
Qualitative Metasummary
the synthesis of the findings across qualitative reports to describe the current knowledge in an area
Qualitative Metasynthesis
provides fully integrated, novel description or explanation of a target event or experience verses a summary view of that event or experience
Levels of research
Highest: systematic research reviews and meta-analysis of high-quality experimental studies
EB guidelines
rigorous, explicit clinicla guidelines developed based on the best research evidence available in that area
BSN, MSN, & Doctorate Nurses
have clearly designated roles in research
Quantitative research process
involves conceptualizing a research project, planning and implementing that project, an communicating the findings.
Research problem
an area of concern in which there is a gap in the knowledge needed for nursing practice. The research purpose it generated from the problem and identifies the specific goal or aim of the study
Relevant Literature Review
conducted to generate a picture of what is known and unknown about a particular topic and provides a rationale for why the study needs to be conducted
Study framework
the theoretical basis for a study that guides the developement of the study and enables the researcher to link the findings to nursing’s body of knowledge
Research objectives/questions/hypotheses
formulated to bridge the gap between the more abstractly stated research problem, purpose, the study design and plan for data collection and analysis
Study variables
concepts at various levels of abstraction that are measured, manipulated, or controlled in a study
Assumptions
statements that are taken for granted or are considered true even though they have not been scientifically tested
Limitations
theoretical or methodological restrictions in a study that may decrease the generalizability of the findings
Research design
a blueprint for conducting a study that maximizes control over factors that could interfere with the study’s desired outcomes
Population
all of the elements that meet certain criteria for inclusion in a study
Sample
subset of the population that is selected for a particular study
subjects
members of the study
Measurment
process of assigning numerical values to objects, events, or situations in accord with some rule.
Methods of measurment
identified to measure each of the variables in a study
Data collection process
involves precise, systematic gathering of information relevant to the research purpose of the objectives, questions, or hypotheses of a study.
Data analysis
conducted to reduce, organize, and give meaning to the data and to address the research purpose and/or objectives, questions, and hypotheses
Research outcomes
include the conclusions or findings, generalization of findings, implications for nursing, and suggestions for further research
Content of a research report
1-abstract
2-introduction
3-methods
4-results
5- discussion
6-references
reading research reports
skimming, comprehending, and analyzing the report
Critical appraisal of guidelines
1-type of quantitative study (descriptive, correlational, quasi-experimental, or experimental)
2-identification of introduction, methods, results, and discussion
3-identification of steps in the process and were they clear
4-were any steps missing
Quantitative Reasearch
-traditional approach
-includes:descriptive, correlational, quasi-experimental, and experimental
-requires rigor and control
basic/pure research
scientific investigation of that involves the pursuit of “knowledge for knowledge’s sake” or for the pleasure of learning and finding truth
Applied/practical research
a scientific investigation conducted to generate knowledge and will directly influence or improve clinical practice
Qualitative Research
systematic, subjective approach used to describe life experiences and give them meaning using words, instead of numbers
– requires adherence to a philosophical perspective, thouroughness in collecting, analyzing, an interpreting the data and transparency in the description of the methods
Prevention of Bias (qualitative)
researchers set aside their own values and experiences to allow the multiple realities of the persons experiencing a phenomenon to emerge
Phenomenological Researchers
provide descriptions of a specific experience from the perspective of the persons who have lived the experience
Grounded Theory Researchers
explore underlying social processes and describe the meaning of an event as expressed through the symbols of language, religion, relationships, and clothing
-may result in a theoretical framewok
Ethnographic researchers
spend time in a culture to understand the environment, people, power relations, and communication patterns of a work setting, community, or ethnic group.
Historical researchers
explore past events to gain insight into causes and factors surrounding the event
Data collection (qualitative)
occurs in the context of the relationship between the participant and the researcher
Qualitative data
collected through interviews, focus groups, observation, and review of documents
Data management (Qualitative)
analysis and interpretation require clear procedures to ensure methodological rigor and credibility of the findings
Review of literature
summary of current knowledge about a particular practice problem and includes what is known and not known about this problem
-reviewed to summarize knowledge for use in practice or to provide a basis for conducting a study
– introduction, includes data-based sources, and concludes with a summary of current knowledge
Theory
an integrated set of defined concepts and statements that present a view of a phenomenon and can be used to describe, explain, predict, and control that phenomenon
1st step in understanding theories
become familiar with the elements related to theoretical ideas and their application.
-includes concepts, definitions of concepts, relational statements, and a map or model
Conceptual Model
similar to a theory but more abstract, broadly explains phenomenon of interest, expresses assumptions, and reflects a philosophical stance
Framework
-an abstract, logical structure of meaning, such as a portion of a theory, that guides the development of the study, is tested in the study, and enables the researcher to link the findings to nursing’s body of knowledge.
-every study has one
-must identify and define the concepts and the relational statements or propositions being tested and sometimes includes a model or map
Testing a theory
determining the truth of each relational statement in the theory
Middle range theories
less abstract and narrower in scope than conceptual models
Practice/intervention theories
more specific than middle range theories and are designed to theoretically propose specific approaches to particular nursing practice situations
Theoretical basis for phsychological studies
usually derived from physiology, genetics, pathophysiology, and physics and is scientific theory
Scientific Theory
has valid and reliable methods of measuring each concept, and its relational statements or propositions have been tested through research and found to be valid
Critically appraising a framework
requires the identification and evaluation of the concepts, their definitions, and the statements linking the concepts
Intellectual Critical Appraisal of Research
requires careful examination of all aspects of a study to judge its strengths, weaknesses, meaning, and significance.
Reasons for Critically Appraising Research
broaden understanding, improve practice, and provide a background for conducting a study
Critical Appraisal Process
includes: comprehension, comparison, analysis, and evaluation
Critical Appraisal Guideline (qualitative)
includes: assessing significance, rigor, the logic of the conclusions, and the congruence of methods to the research tradition
Benefits of EBP
-joint commission and Magnet hospital program support EBP practice
Models to promote EBP
Stetler Model of Research Utilization to Facilitate EBP and the Iowa Model of Evidence-Based Practice to Promote Quality of Care
Phases of Stetler Model
Preparation, validation, comparative evaluation/decision making, translation/application, and evaluation
The Grove Model for Implementing EBP Guidelines in Practice
provided to assist nurses in determining the quality of EBP guidelines and the steps for using these guidelines in practice
Institutional Review Boards (IRB)
Committee that reviews research to ensure that the researcher is conducting the research ethically
Institutional Review
where a study is examined for ethical concerns by a committee of the researcher’s peers
-policy on protection on human subjecs
Inductive
specific to general
Deductive
general to specific