Nursing Research Midterm Preparation

What is the difference between nursing research and evidence-based practice (EBP)?

Nursing Research: In this phase, you are developing new knowledge, or reinforcing knowledge that’s already present.

Evidence-Based Practice: In this phase, you are using research that has already been collected and applying it to clinical decision-making. This includes a mixture of using the best evidence (research), using clinical judgement (decision-making), and respecting patient preferences (compassion).

Why is EBP important for nurses?

EBP is relevant for each of the following…

• It makes sure that patients are kept safe.

• It created the clinical practice guidelines so that care is the same throughout different cities/states.

• It makes sure that nursing stays scientific instead of just following doctor’s orders.

• It’s cost-effective and reduces waste.

• It reassures patients where they are at.

• It’s ethically obligated for nurses to follow it.

• Enforced by the institute of medicine (EBP) and the american nurses association (research to practice).

What are the different sources of evidence?

1. Tradition: The way things have always been done.

2. Authority: Because someone said so.

3. Trial and Error: Asking a question and trying it out.

4. Personal Experiences: If it worked for me, it will work for someone else.

5. Intuition: Coming from your gut.

6. Borrowed Evidence: Information from secondary sources.

7. Scientific Research: Accurate studies that guide EBP.

What are the barriers to EBP?

• Lack of exposure to evidence.

• Lack of time to investigate evidence.

• Lack of ability to understand bias.

• Lack of time to reflect on clinical experience.

• Lack of time in clinical encounters.

• Lack of influence in a setting to change the status-quo (like lack of training).

• Lack of understanding EBP.

• Lack of financial support.

  • And more! Think about what you lack.

What are the seven steps of EBP?

1. Cultivate a Spirit of Inquiry: Asking questions about the nursing process and the evidence supporting their usage. Early adopters are the first to embrace innovation, while laggards fail to adopt it (traditionalists).

2. Asking Clinical Questions: Formulate the question into a PICOT question; however, there are others, like ECLIPSE, or WWWW.

3. Searching for Evidence: Look for data using existing databases (CINAHL, PubMed) using keywords and controlled vocabulary.

4. Appraising Evidence: Overlooking the research to see if it’s trustworthy, valuable, and relevant. Was everything done correctly? Is it ethical? Is there bias?

5. Integrate Evidence: Combine the evidence you just found!

6. Evaluate Outcomes: Measure the effectiveness of the interventions based on patient outcomes.

7. Disseminate Results: Share what happened so EBP can become standardized.

What does PICOT stand for?

P - Problem.

I - Intervention.

C - Comparison.

O - Outcomes.

T - Timing.

What is the difference between a background and a foreground question?

Background: Background questions are simple questions you would see in a textbook or an article; based on general knowledge. It helps to increase understanding of something, but there’s no comparisons, and it’s generally simple.

Foreground: Foreground questions are specific (like our PICOT questions) and compare two interventions based on a measurable outcome.

What are the requirements for nurses using AI according to the American Academy of Nursing?

1. AI is meant to support, not supplement, human intervention.

2. Use human-in-the-loop oversight over AI responses.

3. AI usage must align with compassionate, holistic care.

4. Limit bias and lack of equity in AI usage.

What are some of the strategies you can use to narrow down information in a database?

• Subject Headings. Also called MeSH, these help you find information that is tagged around a certain subject (which helps to narrow search if you don’t know exact terminology) through organized keywords.

• Boolean Operators. Using terms like “AND,” “OR,” and “NOT” can help narrow down searches. The usage of parenthesis can narrow this down even further.

• Controlled Vocabulary: Asking to find articles about something instead of specific keywords, which helps to broaden searches.

• Truncation: Use an asterisk at the end of a word to narrow down a search, like “child*” will search for children, childhood, etc.

What are the 7 levels in the hierarchy of evidence, starting with the highest level?

1. Systematic Reviews and Meta Analyses.

2. Randomized Controlled Trials.

3. Controlled Trials Without Randomization (Quasi-Experimental).

4. Cohort Studies / Case-Controlled Studies.

5. Correlational Studies / Systematic Reviews of Qualitative Studies.

6. Case Studies / Single Descriptive Studies.

7. Traditional Literature / Expert Opinion.

What is the difference between quantitative and qualitative evidence?

Quantitative: Based on numbers, statistics, and how much of something you have. These are based on objective information and often have large sample sizes. Evidence is based on gathering empirical evidence in a controlled and structured environment.

Qualitative: Based on lived experiences, feelings, and words. These are based on subjective information and often have smaller sample sizes. It answers the “why” and “how” of different experiences. Researchers often don’t try to control the study.

What is the difference between descriptive, correlational, and experimental research designs?

Research designs are the blueprint:

Descriptive: A research method that is based on subjective information, like observation, interviews, surveys, and case studies.

Correlational: A research method that is based on the relationship between two or more things.

Experimental: A research method that is based on cause and effect.

What are some examples of research methods?

Research methods are the mode of data collection:

• Papers, like questionnaires, surveys, documents, and literature review.

• Communication, like in interviews, focus groups, and through observation.

• Experiments.

What are some tools that are used to appraise evidence?

There is no gold standard for critical appraisal, and the criteria for what is valid research always changes. But, some tests are still useful:

• The CRAAP test: Is it current? Relevant? Authoritative? Accurate? And what is the purpose?

• The PB&J test: Is the study able to be replicated?

What is the difference between internal and external validity?

Internal Validity: What are the factors that caused the results of the study? Or, is there a clear cause-effect relationship? Randomization and control studies often cause more internal validity due to having less confounding factors and bias.

External Validity: How does the data reflect what would happen in the real world? Naturalistic studies have the highest external validity since people don’t know they’re being watched.

What are the four types of validity?

1. Face Validity: Are we doing what it takes to measure what we’re supposed to measure?

2. Concurrent Validity: Can we compare results from an old technique to a new technique?

3. Predictive Validity: Can we accurately predict something?

4. Construct Validity: Did the measurements match the variable?

What is reliability?

Reliability: If something is repeatable and consistent when replicated under the same conditions.

*Reliability may be independent from validity.

What is the difference between descriptive statistics and inferential statistics?

Descriptive: The summary and distribution of a dataset. Mean (average), median (middle), and mode (common) check central tendency; range, standard deviation, variance, and interquartile range check measures of variability.

Inferential: Looking to discover certain information about a large group by studying a smaller one.

What are the four types of sampling?

1. Simple Sampling: A trial in a smaller population where random numbers select the types of participants. Every person has equal opportunity of being selected, but they’re less precise.

2. Systemic Sampling: Every __th patient is selected. This is a more feasible method, but generalizability decreases.

3. Stratified Sampling: Populations are separated and selected randomly from their respective groups. This is inclusive, but does not work well with multiple variables.

4. Convenience Sampling: People are willing to be a part of the study and agree to participate. This is used when the researcher is unable to access other types of samples. Participants are selected based on proximity and availability.

What is the difference between variance and standard deviation?

Variance: The spread between numbers in a dataset (from the mean). The numerical value of the observations. The average taken out of squared deviations.

Standard Deviation: How spread out the data is. The observations that get measured through dispersion within a dataset. The square root of the variance. Low standard deviations are closer to the average, and higher is farther away.

What are the 6 E’s of EBP Evaluation?

1. Establish an action plan.

2. Engage stakeholders.

3. Execute plan.

4. Evaluate.

5. Edit and evolve.

6. Exclaim.

How is EBP evaluated?

EBP evaluation depends on measuring the change of the practice/knowledge/behaviors that are being measured. This is often done through qualitative or quantitative data. In hospitals, this may come from charts, surveys, observation, and reduction in behaviors. This may change the time it takes to do something, the cost of doing something, the rate of staff satisfaction or retention, etc.