Nursing Research for Evidence-Based Practice (copy)

Research

Research

A systematic inquiry that relies on disciplined methods to answer questions and solve problems. The ultimate goal is to gain knowledge that can benefit many people.

Nursing Research

A systematic inquiry designed to develop evidence about issues of importance to nurses and their clients.

Clinical Nursing Research

Research designed to guide nursing practice and so improve the health and quality of life of nurses’ clients.

Evidence-Based Practice (EBP)

Involves using the best evidence in making patient care decisions, such evidence typically comes from research conducted by nurses and other health care professionals.

Patient centeredness

It has become a central concern in health care and in research. Efforts are increasing to ensure that research is relevant to them and that they play a role in setting research priorities.

Applicability

More attention is being paid to figuring out how study results can be applied to individual patients or subgroups of patients.

Clinical significance

Growing interest in defining and ascertaining __________ ________. Research findings increasingly must meet the test of being clinically significant, and patients have taken center stage in efforts to define this.

Paradigm

In research parlance, it is a worldview, a general perspective on the world’s complexities.

Positivist paradigm

The paradigm that dominated nursing research for decades

Constructivist paradigm

It began as a countermovement to positivism and is a major alternative system for conducting research in nursing. (sometimes called the naturalistic paradigm)

Research methods

These are the techniques researchers use to structure a study and to gather and analyze relevant information.

Assumption

On Positivist Paradigm, an _________ is a principle that is believed to be true without verification. Paradigms are associated with a set of assumptions that have implications for the kinds of research questions that researchers ask and the methods they use to answer them.

Determinism

The assumption of _________ refers to the positivists’ belief that phenomena are not haphazard but rather have antecedent causes.

Phenomena

Those things in which researchers are interested—such as a health event (e.g., a patient fall), a health outcome (e.g., pain), or a health experience (e.g., living with chronic pain)

Postpositivists

They recognize the impossibility of total objectivity, but they view objectivity as a goal and strive to be as unbiased as possible.

scientific method

The traditional, positivist ________ ______ involves using orderly procedures to gather primarily quantitative information.

Empirical evidence

Evidence that is rooted in objective reality and gathered through the senses rather than through personal beliefs.

Quantitative

Numeric information that results from some type of formal measurement and that is analyzed statistically.

Generalizability

The ability to generalize research findings to individuals who did not take part in the study is an important goal.

Constructivists

They take the position of relativism: If there are multiple interpretations of reality that exists in people’s minds, then there is no process by which the ultimate truth or falsity of the constructions can be determined.

Mixed methods research

Involves the collection and analysis of both qualitative and quantitative data in single study.

Therapy/Intervention Questions

These are addressed by healthcare researchers who want to learn the benefits of specific actions, treatments, products, or processes.

Diagnosis/Assessment Questions

Studies concern the rigorous development and testing of formal instruments to screen, diagnose, and assess patients and to measure clinical outcomes.

Prognosis Questions

Strive to understand the outcomes associated with a disease or a health problem to estimate the probability they will occur.

Etiology Questions

The focus is to prevent harm or treat health problems by knowing what causes them.

Description Questions

They are not in a category typically identified in EBP-related classification schemes, but so many nursing studies have a descriptive purpose that it is included.

Meaning/Process Questions

Researchers can benefit from gaining insight into the clients’ perspective regarding healthcare activities using qualitative research.

Primary studies

They must be critically appraised to determine if the evidence is efficiently rigorous to warrant consideration in nursing practice.

Systematic review

It is not just a lit review—it is a methodical, scholarly inquiry that summarizes and evaluated current evidence on a research question (A basis for most clinical practice guidelines)

Meta-analysis

Treat the findings from a study as one piece of information. The findings from multiple studies on the same topic are combined and analyzed statistically. It is an objective method of integrating a body of findings and observing patterns that might otherwise have gone undetected.

Meta-synthesis

This is less about combining information and more about amplifying and interpreting it. For certain qualitative questions, an aggregative approach to systematic synthesis called meta-aggregation may be appropriate.

Evidence hierarchies

Rank evidence sources in terms of their risk of bias, focusing mainly on risk bias in studies addressing therapy questions. Most are presented in pyramids with least bias at the top.

Level of Evidence (LOE) scales

LEVEL I: Systematic review/meta-analysis of RCTs
LEVEL II: Randomized controlled trial (RCT)
LEVEL III: Nonrandomized trial (quasi-experiment)
LEVEL IV: Systematic review of nonexperimental (observational) studies
LEVEL V: Nonexperimental/observational study
LEVEL VI: Systematic review/meta-analysis of qualitative studies
LEVEL VII: Qualitative study/descriptive study
LEVEL VIII: Non research source

PICO

P: Population or Patients (characteristics of patients or people)
I: Intervention, influence, or exposure (intervention or therapy of interest)
C: Comparison to the “I“ component (with what is the intervention or influence being compared)
O: Outcome(outcome of the interest)

Disciplined Research

considered the best method of acquiring new reliable knowledge

National Center for Nursing Research

NCNR

National Institutes of Health

NIH

National Institute of Nursing Research

NINR

Clinical experience

functional source of knowledge

trial and error

can be practical but the method tends to be haphazard and solutions may be idiosyncratic

probabilistic evidence

learning what the true state of a phenomenon probably is

constructivist

this paradigm assumes that knowledge is maximized when the distance between the inquirer and participants in the study is minimized

3 model leg of evidence based nursing practice

best evidence

patient preferences and values

clinical expertise

Ask, Acquire, Appraise, Apply, Asses

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