For this assignment, you will interview with an individual who works in a healthcare institution. It could be a hospital department, an ambulatory facility, a long-term care facility, a health insurance company or managed care organization, an emergency management department, in health information systems, or in a home health or hospice, or health insurance company.

 

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Nursing Research for Evidence-Based Practice

Alice: Would you tell me, please, which way I ought to go from here?

The Cat: That depends a good deal on where you want to get to.

Alice: I don’t much care where.

The Cat: Then it doesn’t much matter which way you go.

—Lewis Carroll, Alice in Wonderland

Effective research begins with the careful formulation of a research question. Because this question will guide the entirety of the research process, it is important for the question to be specific, answerable, meaningful, and manageable. The question, “What is the cure for cancer?” is extremely significant, but it is not specific or manageable enough to promote effective research. Conversely, the question, “Are individuals who play the violin on Fridays in March more likely to contract hepatitis?” is very specific but lacks clinical significance. In order for research to generate meaningful, precise findings, researchers must begin by carefully crafting a question. In addition, researchers must also explore ethical concerns related to the question that they select. Taking the time to craft a relevant, well-constructed question will enable the researcher to have an unambiguous focus as he or she proceeds.

This week, you examine different models for developing a researchable question and reflect on the ethical considerations of research. You also formulate a research question using the PICOT model.

Reference:

Carroll, L. (1865). Alice in wonderland. London, UK: Macmillan.

Learning Objectives

Students will:

• Analyze ethical aspects of research studies
• Evaluate the significance of a health care issue to nursing practice
• Develop an answerable PICOT question for an EBP study

Photo Credit: [JGI/Jamie Grill]/[Blend Images]/Getty Images

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Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 3, “Key Concepts and Steps in Qualitative and Quantitative Research” (for review)
• Chapter 4, “Research Problems, Research Questions, and Hypotheses”

This chapter focuses on the steps in planning a study to generate evidence. These include developing a research question, identifying variables, articulating a problem statement, and generating hypotheses.

• Chapter 7, “Ethics in Nursing Research”

In this chapter, the focus is on the ethical dilemmas that occur when planning and conducting research and the ethical principles that have been enacted for protecting study participants.

Fouka, G., & Mantzorou, M. (2011). What are the major ethical issues in conducting research? Is there a conflict between the research ethics and the nature of nursing? Health Science Journal, 5(1), 3–14.

Retrieved from the Walden Library databases.

This article describes a literature review conducted to determine the most important ethical issues that nurses encounter when undertaking or participating in research. The authors detail the results of the review and make recommendations for solving some of the problems highlighted.

Newcomb, P. (2010). Evolving fairness in research on human subjects. Journal of Child and Adolescent Psychiatric Nursing, 23(3), 123–124.

Retrieved from the Walden Library databases.

In this article, the author describes some of the ethical controversies that may arise in conducting research in human subjects, especially with respect to ownership of genes. The author also stresses the importance of educating research subjects and their families about the ultimate purpose of research.

Yakov, G., Shilo, Y., & Shor, T. (2010). Nurses’ perceptions of ethical issues related to patients’ rights law. Nursing Ethics, 17(4), 501–510.

Retrieved from the Walden Library databases.

The authors of this article detail a study conducted to determine how nursing staff deal with ethical issues in relation to the law. The article emphasizes the difficulty staff had in distinguishing between legal and ethical problems. The authors make several recommendations to deal with legal and ethical problems.

Delwiche, F. (2008). Anatomy of a scholarly research presentation in the health sciences. Retrieved from http://dana.uvm.edu/Anatomy/

This presentation highlights the primary components of scholarly research articles. The presentation details the distinguishing factors of scholarly journals, the peer-review process, and the definition of “primary literature.”

American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Retrieved from http://nursingworld.org/DocumentVault/Ethics-1/Code-of-Ethics-for-Nurses.html

This website provides the code of ethics for nurses to be used in carrying out their responsibilities. There is also a detailed explanation of each provision.

Document: Literature Review Summary Table Template (Word document)

Note: You will use this document to complete the Project throughout this course.

Media

Laureate Education (Producer). (2012a). Anatomy of a research study. Baltimore, MD: Author.

This multimedia piece explains the “anatomy” of both quantitative and qualitative research studies. In addition, there is a brief quiz at the end of the tutorial to measure knowledge about research articles.

Laureate Education (Producer). (2012d). Evidence-based practice and research. Baltimore, MD: Author.

Note: The approximate length of this media piece is 6 minutes.

In this video, Dr. Marianne Chulay talks about the significance of evidence-based practice and research in nursing. She explains how nurses should apply research findings to health care decisions to improve outcomes.

Laureate Education (Producer). (2012h). Overview of evidence-based practice. Baltimore, MD: Author.

Note: The approximate length of this media piece is 5 minutes.

In this video, Dr. Kristen Mauk explains evidence-based practice and its importance to nursing. She also provides a brief overview of the process of conducting original research.

Optional Resources

National Institutes of Health Office of Extramural Research. (2011). Protecting human research participants. Retrieved from http://phrp.nihtraining.com/users/login.php

This website provides a course on ethical research for those involved in research in human subjects. The course supplies basic concepts, principles, and issues relevant to protecting research participants.

University of Oxford. (2005). PICO: Formulating an answerable question. Retrieved from http://learntech.physiol.ox.ac.uk/cochrane_tutorial/cochlibd0e84.php

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Assignment 1: Ethical Dimensions of Research Studies

In the best-selling book, The Immortal Life of Henrietta Lacks (Skloot, 2010), the author highlights the true story of an African-American woman who died in 1951 from cervical cancer. What makes her story unique is that prior to her death, cells from her tumor were removed and successfully grown in a petri dish. This was the first time scientists were able to successfully replicate cells outside the body, and it is estimated that billions of Lacks’ cells have been used in medical research. However, Henrietta Lacks was never asked for permission to take a sample and her family was never made aware of the widespread use of her cells. Although the culturing of her cells has been pivotal for advancing research, strong ethical concerns later arose about using these cells without patient or family approval.

This week’s readings describe historical examples of unethical research, such as a study of syphilis among African-American men in which treatment was withheld and a study in which live cancer cells were injected into elderly patients. Today, stricter controls that seek to protect study participants are placed on researchers, but breaches still occur. Careful attention must be given toward preventing unethical behavior. In this Discussion, you explore ethical considerations and issues in research.

To prepare:

• Select a current health-related case involving research ethics. (If none come to mind, browse the Internet to familiarize yourself with recent cases.)
• As you review the case that you have selected, reflect on the ethical principles discussed in “What Are the Major Ethical Issues in Conducting Research?” article found in this week’s Learning Resources. Which principles were breached in the case you have identified?

Write a description of the case that you selected and the ethical issues involved. Analyze the ethical principles that were breached by the researchers or organizations in your selected case as well as the possible cause of the breach(es). Suggest how the research might have been conducted differently to avoid or minimize the ethical problems. Discuss how research can be done on sensitive issues while still protecting the rights of the research subjects.

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Assignment 2—Literature Review

This is a continuation of the Course Project presented in Week 2. Before you begin, review the Course Project Overview document located in the Week 2 Resources area.

The literature review is a critical piece in the research process because it helps a researcher determine what is currently known about a topic and identify gaps or further questions. Conducting a thorough literature review can be a time-consuming process, but the effort helps establish the foundation for everything that will follow. For this part of your Course Project, you will conduct a brief literature review to find information on the question you developed in Week 2. This will provide you with experience in searching databases and identifying applicable resources.

To prepare:

• Review the information in Chapter 5 of the course text, focusing on the steps for conducting a literature review and for compiling your findings.
• Using the question you selected in your Week 2 Project (Part 1 of the Course Project), locate 5 or more full-text research articles that are relevant to your PICOT question. Include at least 1 systematic review and 1 integrative review if possible. Use the search tools and techniques mentioned in your readings this week to enhance the comprehensiveness and objectivity of your review. You may gather these articles from any appropriate source, but make sure at least 3 of these articles are available as full-text versions through Walden Library’s databases.
• Read through the articles carefully. Eliminate studies that are not appropriate and add others to your list as needed. Although you may include more, you are expected to include a minimum of five articles. Complete a literature review summary table using the Literature Review Summary Table Template located in this week’s Learning Resources.
• Prepare to summarize and synthesize the literature using the information on writing a literature review found in Chapter 5 of the course text.

To complete:

Write a 3- to 4-page literature review that includes the following:

• A synthesis of what the studies reveal about the current state of knowledge on the question that you developed
  • Point out inconsistencies and contradictions in the literature and offer possible explanations for inconsistencies.
• Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry
• Your literature review summary table with all references formatted in correct APA style

Note: Certain aspects of conducting a standard review of literature have not yet been covered in this course. Therefore, while you are invited to critically examine any aspect of the studies (e.g., a study’s design, appropriateness of the theoretic framework, data sampling methods), your conclusion should be considered preliminary. Bear in mind that five studies are typically not enough to reflect the full range of knowledge on a particular question and you are not expected to be familiar enough with research methodology to conduct a comprehensive evaluation of all aspects of the studies.

 

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The field of nursing has changed over time. In a 750‐1,000 word paper, discuss nursing practice today by addressing the following:

1. Explain how nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual.
2. Compare and contrast the differentiated practice competencies between an associate and baccalaureate education in nursing. Explain how scope of practice changes between an associate and baccalaureate nurse.
3. Identify a patient care situation and describe how nursing care, or approaches to decision‐making, differ between the BSN‐prepared nurse and the ADN nurse.
4. Discuss the significance of applying evidence‐based practice to nursing care and explain how the academic preparation of the RN‐BSN nurse supports its application.
5. Discuss how nurses today communicate and collaborate with interdisciplinary teams and how this supports safer and more effective patient outcomes.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

 

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• Using the model for designing clinical questions found in the Rebar and Gersch text,Box 1.3 (Designing Clinical Questions Using PICO or PICOT),
• BOX 1.3 Designing Clinical Questions Using PICO or PICOT PICO – PICOT P = Population: Who you are interested in studying; the population I = Intervention: the treatment or intervention of interest C = Comparison: the intervention you are comparing “I” to in the question O = Outcomes: the outcomes you are planning to measure T = Time of data collection Example: What is the efficacy of individual versus group teaching methods for newly diagnosed adolescent diabetic patients on patient compliance with diabetic regimen? P = adolescent diabetic patients I = individual teaching method C = group teaching method O = patient compliance with diabetic regimenT = new diagnosed through patient compliance measurement
• identify a clinical question based on your own nursing practice and briefly discuss why this is important to you. [Example: Would daily hygiene care (traditional AM care) be better scheduled in the evenings to prepare patients for restful sleep?]
• Select whichever of the four traditional approaches to answering clinical questions discussed in Rebar and Gersch—authority, intuition, professional experience, and reference texts—you believe would best address the question. Include in your discussion why you would select this approach over the other three.
• Answer the following questions:
  • How did you determine that this is an appropriate question to inform nursing practice?
  • Examine factors that would encourage or impede the use of evidence-based information to inform nursing care decisions where you currently practice?

 

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