NURS 8211C
Nurs 8211 research for an evidence-based practice Week 1: Terminology
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Week 1 Terminology
Objectives
Differentiate between nursing research, quality improvement (QI) and an evidence-based practice (EBP) project.
Identify the similarities and differences between research, QI and EBP DNP project in terms of the question to be answered, and the gaps in knowledge or in practice.
Compare and contrast key research terms with terms used in the DNP project including types of hypotheses, levels of measurement, variable types, sample/population, descriptive and inferential statistics.
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Measuring outcomes of care
No longer just the domain of a small cadre of researchers, outcomes research has altered the culture of clinical practice and health care research by changing how we assess the end results of health care services.
AHRQ, 2000
As a doctorally prepared nurse, you will be at the forefront of change for the nursing profession. Understanding how to use statistical analysis is essential (whether to be able to read and understand a published research study or to be able to measure differences in outcomes before and after an intervention).
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An Evidence-Based PRactice
Guided by high quality research
Qualitative and quantitative research types
Quantitative: uses statistics and rigorous research design to eliminate bias
Qualitative: uses words to extract meaning in themes from interviews, focus groups, conversations
DNP Projects are a way to actualize an “evidence-based practice”
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Measuring outcomes of care
Outcomes:
Measure the quality of care
Allow for benchmarking against a standard
Are used in ‘report cards’ that are used by consumers and purchasers to assess quality
Are used to monitor and improve quality
Are essential to new payment approaches
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Research vs. Quality Improvement
Both may use statistics and both may use qualitative methods
The intent of research is to close a knowledge gap
The intent of quality improvement is to close a practice gap
Both rely on previous research evidence to support the endeavor:
Research to show what is known
QI to improve outcomes of care
Three types at Walden:
Quality Improvement
Staff Education
Clinical Practice Guidelines
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Types of Projects for the DNP
Quality Improvement
Clinical Practice Guideline (CPG)
Staff Education
They all use statistics.
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Getting into the language
Gap in knowledge vs. gap in practice
Research questions and hypotheses vs. practice-focused or clinical question
Generalizability vs applicability at the site
Take a look at the three resources in week 1:
Khoja, A., & Moosa, L. (2023). Impact of Tailored Interventions for Patient Safety (TIPS) to Reduce Fall Rates. MEDSURG Nursing, 32(2), 89-93. (QI)
Clinical question: Will the implementation of tailored interventions for patient safety (TIPS) reduce fall rates over 4 weeks?
Tzeng, H., & Yin, C. (2017). A Multihospital Survey on Effective Interventions to Prevent Hospital Falls in Adults. Nursing Economic$, 35(6), 304-313. (Falls – Research)
Main research question: What are highly effective interventions to prevent fall injuries as perceived by RN staff for adult inpatient in acute hospital settings?
Bangura, F. (2024) Development and Evaluation of a Nurse Practitioner–Directed Intentional Rounding Strategy, and its Impact on Decreasing Falls in a Veterans Long-Term Care Facility. (Publication No. 30991997) [Doctor of Nursing Practice Project, Wilmington University] ProQuest Dissertations and Theses Global. (DNP project)
The DNP project aimed to compare the impact of intentional rounding and unstructured rounding on the risk of falls in a long-term facility.
Consider the following:
A question is always written with a question mark at the end. However, a hypothesis is a declarative statement that posits relationships between variables. You rarely see a hypothesis stated in a published research study, rather you will see a research question. (the hypothesis is implicit).
All three of these published papers used some kind of statistical analysis to answer a question, whether a research question or a practice-focused question.
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Commonalities
Research is the highest form of evidence
Quality improvement, clinical practice guidelines (CPGs), and any staff education must be based on existing knowledge (i.e. research, the highest form of evidence)
Quantitative research requires rigorous design to minimize bias and to be able to make inferences from a sample to a larger population
Qualitative research requires rigorous design to extract meaning and intent; to understand human experience
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The Role of Statistics
Objective tools
to present and summarize data
to assess results and answer questions
to support your conclusions
Limitations
Heavy reliance of good research design and valid methods for data collection
Vulnerable to bias
Used in research and in quality improvement.
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Variables
Levels of measurement
Independent vs. dependent
Descriptive
Measures of central tendency and dispersion
Inferential
Enables comparisons and determines the extent of relationships between variables
Statistical terminology
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Probability Theory basics
About predicting from a sample to the population
What are the chances?
Are the changes due to chance, or are they “predictable”?
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