Weighing the Evidence

/in /by

 
Nursing homework help
Weighing the Evidence
When conducting original research, the final step researchers must complete is weighing the evidence and interpreting the meanings of their data, statistics, and analyses. This is the culmination of the research process in which all of the research methods and designs can be synthesized into a meaningful conclusion. In this stage, researchers should formulate explanations for what their data indicates, determine whether the data answers their initial research question, identify areas of uncertainty, and consider directions for further research.
In this Discussion, you focus on one of the research articles that you identified for Part 2 of the Course Project (Literature Review). You then explore the process of how the researchers generated conclusions based on their data, consider other possible interpretations of their data, and formulate ideas for further research.
To prepare:
· Review this week’s Learning Resources, focusing on how researchers find meaning in their data and generate sound conclusions. Pay particular attention to Table 2 in the article, “Study Design in Medical Research.”
· Revisit the 5 articles that you identified in Part 2 of the Course Project. Select one to consider for the purpose of this Discussion.
· Read sections of the chosen article where the data is presented, analyzed, and interpreted for meaning. What reasoning process did the researchers use to formulate their conclusions? What explanation did they give to support their conclusions? Were there any weaknesses in their analysis or conclusions?
· Consider possible alternate conclusions that the researchers could have drawn based on their data.
· Examine the findings that the article presents and consider how well they addressed the researcher’s initial question(s). What additional research could be done to build on these findings and gain a fuller understanding of the question?
Required Readings
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.
Review Chapter 2, Fig. 2.1
Chapter 29, “Systematic Reviews of Research Evidence: Meta-analysis, Metasynthesis, and Mixed Studies Review”
This chapter focuses on the different types of systematic reviews. The chapter discusses the advantages of this type of analysis and the steps for conducting a meta-analysis or metasynthesis.
Dingle, P. (2011). Statin statistics: Lies and deception. Positive Health, 180, 1.
In this article, the author outlines how misleading statistics are used to make false claims about the positive use of statin drugs in order to retain a market share of sales for pharmaceutical firms.
Katapodi, M. C., & Northouse, L. L. (2011). Comparative effectiveness research: Using systematic reviews and meta-analyses to synthesize empirical evidence. Research & Theory for Nursing Practice, 25(3), 191–209.
The authors of this article assert that more comparative effectiveness research (CER) is necessary to accommodate the elevated demand for evidence-based health care practices. The article supplies a summary of methodological issues relevant to systematic reviews and meta-analyses used in the process of CER.
Stichler, J. F. (2010). Evaluating the evidence in evidence-based design. Journal of Nursing Administration, 40(9), 348–351.
The quality of evidence used in EBP can vary considerably. This article highlights the necessity of critically appraising facility design research articles and using a hierarchical model to rate the strength of evidence.
Bernd, R., du Prel, J.-B., & Blettner, M. (2009). Study design in medical research: Part 2 of a series on the evaluation of scientific publications. Deutsches Aerzteblatt International, 106(11), 184–189. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695375/pdf/Dtsch_Arztebl_Int-106-0184.pdf
This article provides guidance in evaluating the study design of scientific publications for reliability and credibility. The authors suggest that the most important elements to consider are the question to be answered, the study population, the unit of analysis, the type of study, the measuring technique, and the calculation of sample size.
Walden University. (n.d.a). Paper templates. Retrieved July 23, 2012, from http://writingcenter.waldenu.edu/57.htm
This website provides you access to the School of Nursing Sample Paper, which will serve as a template for formatting your papers.
Media
Laureate Education (Producer). (2012g). Hierarchy of evidence pyramid. Baltimore, MD: Author.
This multimedia piece explains the hierarchy of evidence pyramid. The piece offers definitions and key information for each level of the pyramid.
Laureate Education (Producer). (2012n). Weighing the evidence. Baltimore, MD: Author.
In this video, Dr. Kristen Mauk provides insight about how she analyzed her data and interpreted meanings of what the data showed. She describes how she drew conclusions based on the results and how she explained unexpected findings that were contrary to her initial hypotheses.
\��0

 Creating a Culture of Evidence-Based Practice

/in /by

Nursing homework help

 Creating a Culture of Evidence-Based Practice
An abundance of evidence can be found on almost any medical issue or health topic. Often, the availability of information is not the concern, but rather nurses struggle with how to convey the evidence to others and change practices to better reflect the evidence. Deep-rooted organizational cultures and policies can make some resistant to change, even to changes that can vastly improve the quality, effectiveness, and efficiency of health care. However, there are many strategies that nurses can employ to bring about changes to practice.
In this Discussion, you focus on how to create an organizational culture that supports evidence-based practice.
To prepare:
· Review the information in this week’s Learning Resources. Examine the various suggestions for promoting an organizational culture that embraces the use of EBP.
· Reflect on your own organization’s (or one in which you have worked) support of evidence-based practice. Examine how culture and policies impact the adoption of changes to practice based on evidence. What barriers exist?
· Consider the models and suggestions for promoting evidence-based practice featured in this week’s Learning Resources. Identify models and suggestions that would work well in your organization.
· Reflect on the significance of evidence-based practice in health care. What responsibility do nurses have to promote EBP and change practices to better reflect evidence and research findings?
· Reflect on how nurses can disseminate findings from evidence-based practice research.
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      30, “Disseminating Evidence: Reporting Research Findings”
    In this chapter, the focus is on actually reporting on the research      findings and how to determine the best approach for reaching the desired      audience. The chapter also includes tips on how to organize the      information and describes what is usually included in such reports.

Aitken, L. M., Hackwood, B, Crouch, S., Clayton, S., West, N., Carney, D., & Jack, L. (2011). Creating an environment to implement and sustain evidence based practice: A developmental process. Australian Critical Care, 24(4), 244–254.
This article describes a multi-dimensional EBP program designed to generate sustainable improvement in patient care and patient outcome. The text details the program’s strategies for implementation along with achievements and lessons learned.
Barnsteiner, J. H., Reeder, V. C., Palma, W. H., Preston, A. M., & Walton, M. K. (2010). Promoting evidence-based practice and translational research. Nursing Administration Quarterly, 34(3), 217–225.
In this text, the authors highlight established systems and structures designed to supply staff with resources to translate research and deliver EBP. Additionally, the article explicates a multitude of initiatives designed to disseminate evidence to the point of care.
Cullen, L., & Adams, S. L. (2012). Planning for implementation of evidence-based practice. Journal of Nursing Administration, 42(4), 222–230.
This article provides several models for implementing evidence-based practice within an organization. It introduces four different phases through which an implementation should progress, and provides examples of each.
Estrada, N. (2009). Exploring perceptions of a learning organization by RNs and relationship to EBP beliefs and implementation in the acute care setting. Worldviews on Evidence-Based Nursing, 6(4), 200–209.
In this article, the authors detail a survey design study conducted to determine the relationship between a learning organization’s characteristics and the beliefs of registered nurses with respect to EBP. In addition, the study examines the impact of EBP beliefs on registered nurses’ implementation of EBP.
Fineout-Overholt, E., Williamson, K. M., Kent, B., & Hutchinson, A. M. (2010). Teaching EBP: Strategies for achieving sustainable organizational change toward evidence-based practice. Worldviews on Evidence-Based Nursing, 7(1), 51–53.
The authors of this text suggest multiple strategies for integrating the EBP paradigm at the organizational level. The text provides rationale for why educators should also consider change at the individual level as an effective conduit for disseminating the EBP paradigm at the organizational level.
Munten, G. van den Bogaard, J., Cox, K., Garretsen, H., & Bongers, I. (2010). Implementation of evidence-based practice in nursing using action research: A review. Worldviews on Evidence-Based Nursing, 7(3), 135–157.
This text reviews 21 action research studies to determine what is known about using action research to implement evidence-based practice. The authors explicate the promising features and flaws that were common across the action research studies they used.
Satterfield, J. M., Spring, B., Brownson, R. C., Mullen, E. J., Newhouse, R. P., Walker, B. B., & Whitlock, E. P. (2009). Toward a transdisciplinary model of evidence-based practice. The Milbank Quarterly, 87(2), 368–390.
This article presents the primary issues and challenges in EBP across numerous health disciplines. The authors then posit a transdisciplinary EBP model designed to incorporate the strengths and diminish the flaws of each discipline’s EBP model.
Steurer, L. M.(2010). An evidence-based practice scholars program: One institution’s journey toward excellence. Journal of Continuing Education in Nursing, 41(3), 139–143.
The author of this article details the efforts of an EBP scholars program that was designed to teach an overview of EBP, along with the skills necessary to improve patient outcomes. In addition to the program’s development and implementation, the article highlights lessons learned.
Media
Laureate Education (Producer). (2012k). Translating evidence into practice. Baltimore, MD: Author.
Dr. Kristen Mauk discusses the outcomes of her DNP project in this video. She explains how nurses in the rehabilitation unit where she conducted her project used the results of her project to improve their practices.
Laureate Education (Producer). (2012c). Disseminating findings. Baltimore, MD: Author.
In this video, Dr. Kristen Mauk offers advice for nursing students and practitioners in disseminating the findings of their research and evidence-based practice projects. She identifies many options for dissemination that are available to nurses.

  Security of Health Care Records

/in /by

Nursing homework help

  Security of Health Care Records
With the increase of health information technology used to store and access patient information, the likelihood of security breaches has also risen. In fact, according to the Canadian Medical Association Journal (CMAJ):
In the United States, there was a whopping 97% increase in the number of health records breached from 2010 to 2011… The number of patient records accessed in each breach has also increased substantially, from 26,968 (in 2010) to 49,394 (in 2011). Since August 2009, when the US government regulated that any breach affecting more than 500 patients be publicly disclosed, a total of 385 breaches, involving more than 19 million records, have been reported to the Department of Health and Human Services.
A large portion of those breaches, 39%, occurred because of a lost, stolen, or otherwise compromised portable electronic device—a problem that will likely only get worse as iPads, smartphones, and other gadgets become more common in hospitals. (CMAJ, 2012, p. E215).
Consider your own experiences. Does your organization use portable electronic devices? What safeguards are in place to ensure the security of data and patient information? For this Discussion you consider ethical and security issues surrounding the protection of digital health information.
To prepare
· Review the Learning Resources dealing with the security of digital health care information. Reflect on your own organization or one with which you are familiar, and think about how health information stored electronically is protected.
· Consider the nurse’s responsibility to ensure the protection of patient information. What strategies can you use?
· Reflect on ethical issues that are likely to arise with the increased access to newer, smaller, and more powerful technology tools.
· Consider strategies that can be implemented to ensure that the use of HIT contributes to an overall culture of safety.
Required Readings
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

  • Chapter 5, “Ethical Applications of Informatics”

This chapter examines the ethical dilemmas that arise in nursing informatics. The authors explore the responsibilities for the ethical use of health information technology.

  • Review Chapter 23 “Research: Data Collection,      Processing, and Analytics” (pp. 415–416)

In this section, the author explains information fair use and copyright restrictions. The section describes processes for ensuring the security of a computer network.
Brown, B. (2009a). Improving the privacy and security of personal health records.
Journal of Health Care Compliance, 11(2), 39–40, 68.
The author of this article examines the use of the document titled “Nationwide Privacy and Security Framework for Electronic Exchange of Individually Identified Health Information.” The article describes how the framework aims to construct an approach to address the privacy and security challenges that come with health information exchanges and personal health records.
Dimitropoulos, L., Patel, V., Scheffler, S. A., & Posnack, S. (2011). Public attitudes toward health information exchange: Perceived benefits and concerns.
American Journal of Managed Care, 17, SP111–SP116.
This article describes a study that sought to determine the attitude of consumers toward electronic health information exchanges (HIE), HIE privacy and security concerns, and the relationship between these concerns and the perceived benefits of HIE. The authors recommend solutions to some of the privacy challenges stimulated by HIE.
Goodman, K. W. (2010). Ethics, information technology, and public health: New challenges for the clinician-patient relationship. Journal of Law, Medicine & Ethics, 38(1), 58–63.
In this article, the authors focus on how nurses can use health information technology to help transform health care using the recommendations included in the 2010 Institute of Medicine report “The Future of Nursing, Leading Change, Advancing Health.” The author also discusses the 2011 National Strategy for Quality Improvement in Health Care.
Hoffman, S., & Podgurski, A. (2011). Meaningful use and certification of health information technology: What about safety? Journal of Law, Medicine & Ethics, 39(3), 425–436.
This article stresses the necessity of sufficient safeguards for EHR systems. The author explores current safety regulations for EHR system design and deployment. The author makes additional recommendations for protecting public health in the digital area.
 
Rothstein, M. A. (2010). The Hippocratic bargain and health information technology. Journal of Law, Medicine & Ethics, 38(1), 7–13.
The increasing availability of sensitive patient information granted by electronic health records has generated significant debate about patient privacy. This article examines the potential ethical and legal consequences of patient-directed sequestering of sensitive health information.
Optional Resources
Brown, B. (2009b). Privacy provisions of the American Recovery and Reinvestment Act. Journal of Health Care Compliance, 11(3), 37–38, 72–73.
Retrieved from the Walden Library databases.

Think about the nurse’s role in improving the health literacy of patients.

/in /by

Nursing homework help

Health Literacy
In order to effectively manage their own health, individuals need to have competencies in two areas—basic literacy and basic health literacy. What is the difference? Basic literacy refers to the ability to read, even simple language. Health literacy is defined as, “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (National Coalition for Literacy, 2009). Unfortunately, according to a Department of Education report on health literacy, only 12% of adults aged 16 and older are considered to have a proficient level of health literacy (U.S. Department of Education, 2006). Acquiring health literacy skills has become more complicated with the explosion of online health information, some credible and some misleading.
In this Discussion, you focus on how to help individuals find credible information on the Internet and develop strategies nurses can use to increase the health literacy of their patients.
To prepare:
· Think about the nurse’s role in improving the health literacy of patients.
· Consider the many ways patients access health information, including blogs, social media, patient portals, websites, etc.
· Reflect on experiences you have had with patients who self-diagnose using online medical sources.
· Using the Internet, the Walden Library, or other trustworthy sources, identify a resource that you could introduce to patients to help them evaluate the credibility of health information found online.
· What are some strategies you could employ to improve the health literacy of patients?
Required Readings
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

  • Chapter      17, “Supporting Consumer Information and Education Needs”

This chapter explores health literacy and e-health. The chapter examines a multitude of technology-based approaches to consumer health education.

  • Chapter      18, “Using Informatics to Promote Community/Population Health”

In this chapter, the authors supply an overview of community and population health informatics. The authors explore a variety of informatics tools used to promote community and population health.

  • Chapter      16, “Informatics Tools to Promote Patient Safety and Clinical Outcomes”

The authors of this chapter present strategies for developing a culture of safety using informatics tools. In addition, the chapter analyzes how human factors contribute to errors.
Health literacy: How do your patients rate? (2011). Urology Times, 39(9), 32.
The authors of this article define health literacy and emphasize its poor rates in the United States. Additionally, the authors recommend numerous websites that offer patient education materials.
Huff, C. (2011). Does your patient really understand? H&HN, 85(10), 34.
This article defines hospital literacy and highlights the barriers that prevent it from increasing. It also emphasizes the difficulties created by language and financial costs.
The Harvard School of Public Health. (2010). Health literacy studies. Retrieved from http://www.hsph.harvard.edu/healthliteracy
This website provides information and resources related to health literacy. The site details the field of health literacy and also includes research findings, policy reports and initiatives, and practice strategies and tools.
Office of Disease Prevention and Health Promotion (n.d.). Health literacy online. Retrieved June 19, 2012, from http://www.health.gov/healthliteracyonline/
This webpage supplies a guide to writing and designing health websites aimed at increasing health literacy. The guide presents six strategies that should be used when developing health websites.
U.S. Department of Health and Human Services. (n.d.a). Quick guide to health literacy. Retrieved June 19, 2012, from http://www.health.gov/communication/literacy/quickguide/Quickguide.pdf
This article contains an overview of key health literacy concepts and techniques for improving health literacy. The article also includes examples of health literacy best practices and suggestions for improving health literacy.
Required Media
Agency for Healthcare Research and Quality (Executive Producer). (2012a). Interview with Rachelle Toman, M.D. Ph.D. Rockville, MD: Author. Retrieved from http://www.ahrq.gov/patients-consumers/patient-involvement/ask-your-doctor/videos/clinician06/index.html
In this interview, Dr. Toman discusses the importance of asking patients questions to ensure they have been able to sufficiently communicate their concerns.
Agency for Healthcare Research and Quality (Executive Producer). (2012b). The waiting room video. Rockville, MD: Author. Retrieved from http://www.ahrq.gov/patients-consumers/patient-involvement/ask-your-doctor/videos/waitroom/index.html
This video addresses the importance of communication in the patient-health care professional relationship. It highlights the need to ask meaningful questions to the patient to fully understand issues and concerns.