Quiz #2: Knowledge Transition - Scholarship of integration (Evidence informed care/decision making Flashcards
(80 cards)
1
Q
Why do we need evidence informed care?
A
- Optimize pt, community, populations, outcomes
- improve clinical practice
- achieve coast effective
- accountability
- transparency
2
Q
What are the types of evidence
A
- Quantitative
- qualitative
- mega-analysis
- consensus doc.
- commission report
- regulation
- experiential info
3
Q
What is the role of the nurse in research?
A
- Needs basic competencies
- read & critique evidence informed literature
- make research Q’s
- participate in or conduct research
- evaluate & promote evidence informed practice
4
Q
What is the role of the professional/ specialty organization in research?
A
- Use of evidence to create standards/guidelines
- lobby gov’t for money
- healthy policies and regulations
5
Q
What is the role of the regulatory authority in research?
A
- Use evidence to create standards & guidelines
- Suppose nurses
6
Q
What is the role of the researchers in research?
A
- Identify knowledge gap
- deliver high quality research
- teach new researchers
- achieve effective knowledge transfer
7
Q
What is the role of the educators in research?
A
- Support
- Evidence informed curricula
- promote inquiry
- promote critical thinking
- openness to change
- life-long learners
8
Q
What is the role of health service organizations in research?
A
- reduce barriers
- evaluate outcome
- support
- provide continuing education
9
Q
What is the role of the government in research?
A
- Support systems
- institutions
- funding
10
Q
What is the role of health info institutions in research?
A
- Collect
- Store
- Maintain data
11
Q
What is decision making influenced by?
A
- Evidence
- theory
- values
- judgement
- client choice
- ethics
- regulation
- legislation
- resources
- environment
12
Q
What is a guideline
A
Systematically developed statements to assist a practitioner in decision making about appropriate care for certain circumstances
13
Q
What is a guideline based on?
A
Research, opinions, consensus
14
Q
What is evidence informed decision making?
A
Continuous interactive process involving explicit, conscientious and judicious of best evidence
15
Q
What are quality improvement studies?
A
Nurse or student investigates outcomes of pt’s in a specific settings
16
Q
Why is quality improvement not research?
A
Only applies to one facility
17
Q
What are best practice guidelines?
A
- Formalized collection of documents
- Enables organizations & health systems to focus on pt. care & clinical excellence, using the latest research to inform practices
- Helps to advance gov’t priorities & outcomes
- most appropriate course of action based on research and evidence from practice
18
Q
What is the way to remember how to form a good research Q?
A
PICOT
19
Q
What does the P stand for in PICOT
A
population of interest
20
Q
What does the I stand for in PICOT
A
intervention of interest
21
Q
what does the C stand for in PICOT
A
comparison of interest
22
Q
what does the O stand for in PICOT
A
outcome
23
Q
What does the T stand for in PICOT
A
time
24
Q
What are the 5 steps fo successful evidence informed practice?
A
1) Ask Q that clearly presents problem
2) Identify & gather most relevant and best practice
3) appraise evidence
4) integrate w/ expertise, preference and pt. values
5) evaluate outcome of practice decision
25
What is research literacy
being able to locate, understand & evaluate literature
26
What is research capability
being able to do research
27
what are the three things you critique for?
1) Value
2) Feasibility
4) Unity
28
What are the 2 aspects of feasibility
1) Scientific merti & clinical applicability
| 2) determine if they give strong enough basis
29
What do theories and research do for nursing...?
Improve the practice & overall profession
30
The best research designs use...
both qualitative & quantitative
31
what are some examples of quantitative
Pain severity, rate of wound heal, body temp
| *These test theories and use stats to eliminate bias
32
What are some examples of qualitative
anything that cannot be quantified (emotion)
33
What is validity
did they measure what they tried to measure
34
what is reliability
can it be replicated
35
List the hierarchy of evidence
1) systematic review/ mega-analysis
2) 1-2 well designed, randomized control trials
3) 1+ well designed control trial
4) 1+ well designed case control/ cohort study
5) Systematic review of qualitative
6) single qualitative
7) Opinions of experts
36
What are the critical thinking dispositions?
- Truth seeking
- Open minded
- Analyticity
- systematicity
- self confidence
- inquistiveness
- maturity
37
What is overall research utilization?
use of any findings, any way
38
what is instrumental research utilization
use for pt. care
39
what is conceptual research utilization
used to change thinking or opinion
40
what is symbolic research utilization
used to persuade others
41
What is historical trauma
experienced over many years
42
what is cultural genocide
destruction of practices
43
what is structural racism
legitamized/normalized spectrum of attributes, practices, polices that consistently result in substandard outcome for indigenous
44
Some characteristics of an indigenous world view
- Strong land connection
- old knowledge of land & use
- Focused on the good of ppl
- seasons/elastic sense of time
- diversity, matriarchal
- circular view
- interconnectedness, balance, harmony
45
What are indigenous values?
- Kindness
- sharing
- non-competition
- non-interferance
- responsibility
46
What are the 7 grandfathers?
```
Wisdom
Love
respect
bravery
honesty
humility
truth
*Must develop trust first
```
47
What is a proximal determinant
on an individual level
48
what is an intermediate determinant
infrastructure, resources, system
49
what is a distal determinant
historical, social, economic
50
What is a proportional approach
more invasive = more care should be taken to review
51
what are the 3 value systems for a nurse
1) Society
2) Nursing
3) science
52
What does the society value system mean
human rights
53
what does the nursing value system mean
ethics of caring
54
what does the science nursing value mean
research & inquiry
55
What are the 4 major ethical issues in research
1) Informed consent
2) beneficence
3) respect for autonomy/confidentiality
4) respect for privacy
56
What are ethics
System of principles which can critically change previous considerations about choices or actions
57
what is the nuremberg code
forbidded non-therapeutic research
58
what is the helsinki code
- reminded the public of the need for non-therapeutic research
* BUT subject well being i more important the scientific or social interest
59
What is informed consent
knowingly, voluntarily, intelligently and in a clear way, gives consent
60
what is right to autonomy
self determination in action, according to a personal plan
61
Informed consent seeks too...
1) Rights of autonomous individuals
2) self-determination
3) prevent assaults on integrity of pt.
4) protect liberty & veracity
62
Informed consent needs to incorporate...
1) intro & purpose of study
2) why the subject was selected
3) the procedure
4) any harm or discomfort
5) invasion of privacy or threat to dignity
6) compensation
7) disclosure of alternative
8) noncoersive disclaimer
9) no withdraws penalty, freedom
63
What are the 4 ESSENTIAL PARTS of consent
1) disclosure
2) comprehension
3) competency
4) volunaryness
64
what are the nursing conflicts to do with informed consent
- nurses may have to witnesses
- if the nurse tries to give consent, the pt. may feel obliged
- if they have to withhold info
- advocate for pt. but don't prevent research
65
What is beneficence
the benefits of the research
66
What is non-maleficence
the potential risks
| ***** Higher level of sensitivity to harm
67
What is the whole beneficence of research?
Do effective & significant research to better serve & promote welfare
68
What are the nursing conflicts about beneficience
- vulnerable people
- prohibition of advocacy
- don't prevent nursing knowledge
- best care practices don't align with non-therapeutic studies
- patients who find out their best interests weren't fulfilled may lose their faith in the HC system
69
What is anonymity
protected the subjects identify cannot be linked to a response
70
what is confidentiality
management of private info by the researcher
| ***SOMETIMES broken to protect the moral good of society
71
what is utilitarianism
good for all (eg. confidentiality: U'd tell)
72
What is deontology
moral duty to pt (eg. during confidentiality: U'd not tell)
73
What are the nursing conflicts of anonymity and confidentiality
- reporting in court
- interest of society
- always practice privacy to form trust
74
What is privacy
freedom to decide when private information will be shared
75
what is a privacy breech
- beliefs, attitude, opinion & record shared w/o knowledge or consent
* *some ppl have different def of privacy
* * respectful refusal
* *don't study pt. without permission
76
If you don't respect privacy it may cause loss of..
- dignity
- friendship
- employment
77
if you don't respect privacy it may cause feelings of..
anxiety, guilt, embarrassment, shame
78
Who are the vulnerable groups
- Unable to protect own rights & welfare
- captive (prison, school)
- mentally ill
- old
- children
- dying
- poor
- learning disabilites
- sedated
- unconsious
79
What are researcher skills
- inexperienced work under qualified researchers
- lack of knowledge stated
- ensure validity and reliability
- ethics
1) Competency
2) Careful design
3) worthwhile outcomes
80
What are nursing conflicts about vulnerable groups
- not responsible fro pt. care
- only intervene in harmful situations
- exclude a subject if you end up caring for them
