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NR 265 Exam 2 > Chapter 7,10,22,5,6 > Flashcards

Chapter 7,10,22,5,6 Flashcards

(75 cards)

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1
Q

Evidentialism

A

Framework for understanding how research evidence and patient concert, history, family, etc. are used in a decision making process by the clinicians to determine an EBP POC

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2
Q

Central themes of evidentialism

A

1) clinicians must find and now info upon which decisions are made
2) decisions are based on current evidence

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3
Q

5 underlying assumptions

A

1) decisions=justified if result from responsible behavior
2) external evidence isn’t always enough
3) as ex. evidence changes, the decision makers should too
4) clinical wisdom- decisions made from external evidence depend on validity, reliability, and applicability
5) belief without external evidence is unjustified

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4
Q

McCracken and Corrigan 3 skill sets

A

clinical, technical, organizational

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5
Q

Clinical skill set

A

knowledge, skills, experience related to direct experience with clients

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6
Q

Technical skill set

A

formulating questions, conducting an electronic search, evaluating validity and reliability

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7
Q

Organizational skill set

A

teamwork, organizational design and development, and leadership

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8
Q

Quality improvement

A

used to ID and resolve performance deficiencies, fixes something broken, compares current performance to a standard, focuses on outcomes in the delivery of care

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9
Q

Quality assurance

A

planned, systematic activities that assure quality requirements of a product/service are fulfilled (toaster warranty)

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10
Q

Quality control

A

observation techniques used to fulfill quality requirements (every toaster is up to the same requirements-are we doing what we are supposed to be doing)

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11
Q

Ellwood

A

Outcomes management-what is best for the patient and how do we get there

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12
Q

Ellwood’s priniciples

A

1) emphasize practice standards that providers can use to select interventions
2) measure patient functional status, well-being, and disease-specific clinical outcomes
3) Pool outcome data on a massive scale
4) Analyze and disseminate outcomes

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13
Q

What to find in a quality management department

A

incident reports, patient satisfaction scores, data collected for regulatory or accreditation bodies

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14
Q

what to find in a finance department

A

charges for tests, medications, equipment or supplies, patient days, readmission rates, patient demographics, patient diagnosis coding

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15
Q

what to find in human resources

A

staff turnover and education levels, hours by pay/labor category; contract labor use; provider skill mix, staffing ratios

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16
Q

what to find in clinical systems

A

will vary- at minimum diagnostic test results and pharmacy data

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17
Q

what to find in administration

A

patient complaints

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18
Q

what to find in EHR

A

patient-level info captured through documentation of clinical care

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19
Q

Instrument validity

A

is the instrument measuring what it is supposed to be measuring

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20
Q

instrument reliability

A

does the instrument measure the construct consistently every time it is used

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21
Q

Nominal

A

data sorted into categories using names- gender, presence or absence of a quality

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22
Q

Ordinal

A

data ranked in order

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23
Q

interval

A

numeric data with equal and consistent mathematical values separating each discrete measurement point with NO ABSOLUTE ZERO- Fahrenheit temp scale

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24
Q

Ratio

A

sama as interval but with an absolute zero- Kelvin

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25
Scorecards
Show how indicators compare against each other. allows for observation of intended and unintended. within a hospital
26
Dashboards
Indicators focus on performance. Usually comparing a hospital to another
27
Core ethical principles of safety
nonmaleficence
28
core ethical principles of effectiveness
beneficence
29
core ethical principles of patient-centeredness
autonomy
30
core ethical principles of timeliness
beneficence and nonmaleficence
31
core ethical principles of equity
justice
32
core ethical principles of efficiency
beneficence and nonmaleficence
33
EBQI ethical dilemmas
1) attempts to improve quality for some that may cause harm to others 2) strategies intended to improve quality that waste scarce time/resources 3) activities declared to be quality improvement that may be more accurately described as clinical research
34
Case studies or Case reports
``` reports that describe the history of a single patient (or small group or patients) usually in the form of a story. focus on an aspect of a condition no control group -ranked lower(d) -no generalizations(d) -rare events(a) -hypothesis generation(a) ```
35
case-control
case and control group. start with outcome and explore risk factors/conditions that may have contributed to it - quickly(a) - efficient for rare outcomes(a) - cannot directly obtain absolute risk(d)
36
cohort studies
treatment or condition followed over time for a presumed outcome -disadvantage-large sample size, inefficient for rare outcomes, long periods of time, not as reliable as RCT advantage-causation of a disease or to eval outcome of treatment when RCTs not possible
37
randomized controlled trials
compares effectiveness of different interventions two groups-experimental and control randomly assigned with no bias
38
narrative review
research review. discussion of an issue. supports author's point of view
39
integrative review
summarizes other articles. no summary statistic due to limitations in studies found
40
meta-analysis
statistical approach to synthesizing results of multiple studies. Large sample size. Result is a summary statistic
41
systematic review
compilation of similar studies using a detailed rigorous appraisal method. Minimizes bias in summarizing research
42
prelim questions
``` purpose sample size valid and reliable analysis of data adverse effects/withdrawals results with previous research clinical implication ```
43
Internal validity
the extent to which it can be said the IV causes a change in the DV and the results are not due to other factors
44
external validity
the ability to generalize the findings from a study to the larger population from which the sample size was drawn
45
study reliability
if the study were repeated under the same circumstances, would the results be the same
46
study bias
anything that distorts study findings in a systematic way arising from the methodology of the study
47
selection bias
participants are selectively assigned to groups. RANDOMIZE
48
knowledge of who receives the intervention
can occur if subjects or researchers know subject group assignment. BLIND
49
gatekeeping
convenience sampling. when patients may be chosen because they are more likely to volunteer resulting in a sample not representative of the target population
50
measurement bias
can occur if instruments are incorrectly calibrated or if data collectors deviate from protocols
51
recall bias
can occur when subjects are asked to recall past actions or events
52
information bias
can occur in longitudinal cohort studies if participants know the subject of the study and act difference if they know that they are in the group that is being exposed
53
loss to follow up
attrition could occur due to unforeseen side effects of the intervention
54
contamination
can occur if intervention and control groups have interaction and information is shared
55
confounding variables
relationship between two variables is actually due to a third or unknown or unconsidered variable.
56
reliability 5 question
1) do the numbers add up 2) what is the magnitude of the effect 3) strength of association 4) what is the clinical significance 5) what is the precision of the measurement of effect
57
absolute risk reduction
risk of undesirable outcome is less for treatment than control group
58
absolute risk increase
when risk of an undesirable outcome is more for treatment than control group
59
relative risk
likelihood that outcome will occur in one group versus the other
60
odds ratio
odds of treatment group having the outcome
61
ethnography
the study of a social group's culture through combining participant observation, in-depth interviews, and the collection of artifacts. do not aim at generalizable results
62
grounded theory
used to generate theory that is grounded in empirical data
63
phenomenology
the study of essence through descriptions of lived experiences
64
hermeneutics
philosophy, theories, practices of interpretation
65
narrative analysis
generates and interprets stories about life experiences in a way that allows understanding of interview data
66
content analysis
refers to breaking down data by coding, comparing, contrasting, and categorizing bits of info, then reconstituting them in some new forms, such as description, interpretation, theory
67
purposeful sampling
uses intentional selection of people or events in accordance with the needs of the study
68
theoretical sampling
form of purposeful sampling used in grounded theory
69
nominated/snowball
recruits participants with the help of informants that are already enrolled
70
volunteer/convenience sampling
obtains participants by solicitation or advertising for volunteers who meet the study criteria
71
lincoln and guba
how to appraise qualitative studies
72
credibility
demonstrated by accuracy and validity that is assured by thorough documentation. INTERNAL VALIDITY
73
transferability
demonstrated by info that is sufficient for a research consumer to determine whether findings are meaningful. EXTERNAL VALIDITY
74
dependability
if another researcher can expect similar findings. RELIABILITY
75
confirmability
findings and interpretations are grounded in the data. OBJECTIVITY

NR 265 Exam 2 (1 decks)

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