1-Evidence-based practice is what keeps the health care system up-to-date with technology and best-practices; these practices help improve patient outcomes. The first article that I read was research about improving the procedures for collecting and testing urine specimens. In the study, they observed how the collection method was carried out and how long it took for the specimen to reach the laboratory for testing. It was determined that not only were the collection methods flawed but the specimens were sitting too long at room temperature; both influenced the test results. Having contaminated specimens were producing unreliable test results and people were getting a wrong diagnosis with a wrong treatment plan. This study helped identify the major problems along with creating solutions to those problems: mid-stream clean catch, using straight-catheters, proper way to get a specimen from an indwelling-catheter, and appropriate time for the specimen to sit at room temperature. This research article helped improve patient outcomes because it increased the accuracy of the test results which yielded a more specific diagnosis; appropriate treatments increased patient outcomes. In our facility when we collect a urine specimen we keep the specimen in the refrigerator and call the labs for a stat pick-up.
The second article that I read was on improves patient outcome fall prevention in 65+ adults. A prevalent safety issue is injuries that occur from Falls. Elderly and frail have a higher risk of falls that can lead into hip-fractures or even death. Accidental falls can result from an unsafe environment or environmental risk factors for example low blood pressure, dehydration, impaired mobility, unstable gait to name a few. To prevent/reduce the risk for falls staff need to maintain awareness of the environmental safety. I work in an Assisted living facility we have Fall-Risk Assessment tool that we use for each of our residents. But our main intervention is communication with staff and residents. We ensure that there is no trip hazard, we lower the bed to the lowest position when they are in bed, check their rooms and facility for potential safety issues, have mats on the floors next to their bed.
2-Two areas of nursing practice that have been under scrutiny in my facility involve Catheter Associated Urinary Tract Infections (CAUTIs) and Standard precautions. Both seem like basic concepts, but in nursing, sometimes the “basics” get swept to the back of your mind when you are focusing on other issues involved in patient care. Both of these concepts are integral parts of patient safety, which is and should be our number one priority.
In the healthcare setting, the use of an indwelling catheter can be a necessity on many occasions. As nurses, it is imperative that we assess the need carefully for catheter placement, as well as continuously assess the need for the catheter to remain in place. According to a study put forth by BMC Health Services Research, “Urinary tract infection (UTI) as the most common healthcare-associated infection accounts for up to 36% of all healthcare-associated infections. Catheter-associated urinary tract infection (CAUTI) accounts for up to 80% of these” (Vicki, Michelle, & Andrew, 2017). According to this study, the aims of reducing CAUTIs is multifaceted. First and foremost, reduce inappropriate urinary catheterization and duration of catheterization (Vicki et al., 2017). Secondary is that when the use of an indwelling catheter is needed, ensure hand hygiene is performed, sterile technique is maintained and proper perineal care is performed regularly. It is also imperative that the medical staff caring for this patient is continually assessing the need for the catheter to remain in place and that it is removed as soon as possible (Vicki et al., 2017). In my facility, our protocol calls for perineal care to be performed at least once a shift and as necessary when soiled, as well as assessing the continuation of need at least once per shift. The goal in our facility is to have indwelling catheters removed within three days of placement.
The second area of nursing practice that is being stressed by my facility is adherence to standard precautions. We are all aware of what standard precautions are and how important they can be to protect not only ourselves, but our patients as well. “Health workers are exposed to diverse types of agents in the work environment, such as viruses, bacteria, fungi, protozoa, and ectoparasites. Occupational exposure might be caused by accidents with sharps, splashes of blood in mucous membranes, inhalation of aerosols, or larger particles” (Barsalobres, Vieira, Fleck, da Silva Canini, Malaguti-Toffano, & Gir, 2016). In this study that was put out by Brazilian Health Care Programs, the reasoning many healthcare professionals did not exercise proper use of personal protective equipment include “including low risk perception, perception of a poor safety climate at the work environment, conflict between providing the patient with the best care service or protecting themselves from exposure, and the belief that precautions are unnecessary in some situations” (Barsalobres et al., 2016). Another reason mentioned in the study was the understanding of the risk of contamination. In my facility, it is mandatory to utilize standard precautions such as hand washing or the use of antibacterial hand scrub before and after touching a patient as well as when soiled. It is mandatory for us to use gloves, gowns, masks, goggles and face shields on high risk patients. This has changed my practice by making me more aware of the “bad habits” that one can get into. In my facility, we have signs outside of each patient room that state “foam in, foam out” as a reminder to wash our hands and be more mindful of standard precautions in general.
Reference:
Vicki P, Michelle G, Andrew S, et al. Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study. BMC Health Services Research, Vol 17, Iss 1, Pp 1-9 (2017) [serial online]. 2017;(1):1. Available from: Directory of Open Access Journals, Ipswich, MA. Accessed August 30, 2018.
Barsalobres Bottaro, B., Vieira Pereira, F. M., Fleck Reinato, L. A., da Silva Canini, S. M., Malaguti-Toffano, S. E., & Gir, E. (2016). ADHERENCE TO STANDARD PRECAUTIONS BY NURSING PROFESSIONALS: A LITERATURE REVIEW. Journal Of Nursing UFPE / Revista De Enfermagem UFPE, 10(3), 1137-1142. doi:10.5205/reuol.8702-76273-4-SM.1003201625
3-The ability to utilize evidence-based practices is key to improving patient outcomes on every level. This is as true now as it was at the beginning of our industry. Many practices that we take for granted today and assume to be merely common sense originally were developed from intensive research. For instance, hand hygiene while commonly dismissed as obvious can have critical importance in a health care setting. A study done in Saudi Arabia from October 2006 to December 2011, proved this after improving hand hygiene compliance from a baseline of 38% to 85% and realizing the rate of Staphylococcus aureusdecreased from 0.42 in 2006 to 0.08 in 2011 (Al-Tawfig, Abed, Al-Yami, & Birrer, 2013). This was just one of the sicknesses that was prevented in many patients. There were many others. With information like this easily available it is astounding that any nurse would fail to meet compliance standards today.
Another instance of an evidence-based practice improving patient outcome is the practice of rooming-in. This is when a newborn baby and mother stay together in the same room during their stay rather than utilizing a separate nursery. Once again this seems trivial enough to be obvious, but it is a fairly recent trend in mother-baby healthcare that has numerous benefits. These benefits include encourage breastfeeding, giving the mother ample opportunity to ask providers about proper care techniques, and allowing the mother to develop a better understanding of their newborn’s behavior (Shrivastava, Shrivastava, & Ramasamy, 2013). While the industry movement towards rooming-in is still ongoing, it is gaining traction. As a mother-baby nurse, I intend to advocate for this change.
References
Al-Tawfiq, J. A., Abed, M. S., Al-Yami, N., & Birrer, R. B. (2013). Promoting and sustaining a hospital-wide, multifaceted hand hygiene program resulted in significant reduction in health care-associated infections. American Journal of Infection Control, 41(6), 482-486. doi:10.1016/j.ajic.2012.08.009
Shrivastava, S. R., Shrivastava, P. S., & Ramasamy, J. (2013). Fostering the practice of rooming-in in newborn care. Journal of Health Sciences, 3(2), 177. doi:10.17532/jhsci.2013.85
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/in Uncategorized /by developer1-A T-test and a Z-test are almost similar in theory, but have a different application mechanism. The major difference with these two is the size of the sample applied in each case. The t-test is appropriate for smaller samples. Any sample less that 30 units are best analysed using the t-test, while beyond 30 units require a z-test. A z-test is also better if the standard deviation is not known.
T tests are used to compare a given mean to the mean of the given population; it can be applied to either individual values or ones that are paired. The T test can be helpful when you do not know the standard deviation and is best utilized when your sample size is smaller (n<30 sample size) (Lango, 2015). For example, in a Z test you must know the standard
2-Z-test- implies a hypothesis test which ascertains if the means of two datasets are different from each other when variance is given. It is based on normal distribution with a known population variance and a large sample size >30 units
T-test- refers to a type of parametric test that is applied to identify how the means of two sets of data differ from one another when variance is not given. It is based on student T distribution when the population is unknown and the sample size is smaller, <30 units.
Reference
Difference Between t-test and z-test (with Comparison Chart) – Key Differences. (2018, March 10). Retrieved from https://keydifferences.com/difference-between-t-test-and-z-test.html
3-Yes, in theory these two test are common with differences only setting in when applying them. Both used in hypothesis setting, the z-test is better applicable when the standard deviation is known, and when dealing with a larger sample size. A z-test is better to use when dealing with a larger sample size than of over 30. A t-test is better when the sample size is less than 30, and when dealing with an unknown standard deviation
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/in Uncategorized /by developer4-Each alpha level is dependent on the circumstance that surrounds a particular study. The significance level(alpha) is the probability of committing a type 1 error. A type 1 error is committed when the researcher falsely rejects the null hypothesis. A significance level of 0.05 is the standard situation, most especially in the field science.
There are some experiments where you would most likely want to lower the type 1 error rate such as experiment that affects human health, like drug research or studies of psychological treatment. For some experiments, if the consequence of applying null hypothesis is extremely serious, for instance, if null hypothesis applies, there may be death, or serious injury, then you want to try your best to avoid the type I error. That means you must avoid the situation that null hypothesis is true but you reject it. As the significance level is the probability, you will make the type 1 error. So, for such experiments with serious results, we want to make the level smaller than standard situation. So, for such experiments, if you can’t tolerate a 5% chance of being wrong, use a lower significance level, 0.01 for example. 0.01 is common if there’s a possibility of death or serious disease or injury.
If the consequences of being wrong are especially minor such as political research or animal migration studies. you might use a higher significance level, such as 0.1, but this is rare in practice. That is, it may be common that we make the significance level much smaller than 0.05, but we rarely make the level larger than 0.05.
Reference
Hypothesis Testing (cont…) |n.d.| Access Retrieved on 08/08/2018 from https://statistics.laerd.com/statistical-guides/hypothesis-testing-3.php
The idea of significance test. Retrieved on 08/08/2018 from https://www.khanacademy.org.
5-The alpha is the level of statistical significance. It can be any number between 0-1. 0.10, 0.05 and 0.01 are most commonly used. A situation where we would want to accept a higher alpha level is with medical testing. We would much rather have false positive test results that would lead to additional testing, even though it is going to give our patients an insane amount of anxiety. It is better than a false negative where no further testing or treatment would be indicated, and the patient would go untreated.
References
Taylor, C. (2013, March 20). What Level of Alpha Determines Statistical Significance? Retrieved from https://www.thoughtco.com/what-level-of-alpha-determines-significance-3126422
6-Not all results of hypothesis tests are equal. A hypothesis test or test of statistical significance typically has a level of significance attached to it. This level of significance is a number that is typically denoted with eh Greek letter alpha Many journals throughout different disciplines define that statistically significant results are those for which is equal to 0.05 or 5%.
The number represented by is a probability, so it can take a value of any nonnegative real number less than one. Although in theory any number between 0 and 1 can be used for , when it comes to statistical practices this is not the case. Of all levels of significance, the values of 0.10, 0.05, and 0.01 are the most commonly used .
In medical screening for a disease, consider the possibilities of a test that falsely tests positive for a disease with one that falsely tests negative for a disease; a false positive will result in anxiety for our patient but will lead to other tests that will determine that verdict of our test was indeed incorrect; a false negative will give our patient the incorrect assumption that he does not have a disease when he in fact does. The result is that the disease will not be treated; given the choice, scientists would rather have conditions that result in a false positive than a false negative.
Reference
What Level Of Alpha Determines Statistical Significance? |June 25, 2018| Access Date| August 6, 2018 from
Courtney Taylor – https://www.thoughtco.com/what-level-of-alpha-determines-significance-3126422
Hypothesis Testing (cont…) |n.d.| Access Date August 6, 2018| from
https://statistics.laerd.com/statistical-guides/hypothesis-testing-3.php
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/in Uncategorized /by developer1-Many statisticians base ANOVA on the design of the experiment, especially on the protocol that specifies the random assignments of treatment to subjects; the protocol’s description of the assignment mechanism should include a specification of the structure of the treatments and of any blocking. It is also common to apply ANOVA to observational data using an appropriate statistical model.
Some popular designs use following types of ANOVA:
· One-way ANOVA is used to test for differences among two or more independent groups. e.g., different levels of urea application in a crop or different levels of effect of some medicine on groups of patients. However, the one-way ANOVA is used to test for differences among at least three groups, since the two-group case can be covered by t-test when there are only two means to compare.
· Factorial ANOVA is used when the experimenter wants to study the interaction effects among treatments.
2-When dealing with an uninformed person, it is good to make sure the explanations and the follow-up given is as simple as possible and accurate. Variance testing should first be explained as a way to get results from conducting a study or an experiment. There are one-way, two-way, three-way tests where the difference as indicated by their number is according to the variances analyzed in each of the study. One way will have one variable, while three way will have three variables. It is also necessary to make sure there is a connection between the different variables, as they need to come from the same population, and samples selected randomly
3-The analysis or ANOVA is a test that is conducted to find out if the survcey or experiments results are significant. There are different ways that this test might be done, depending on the study at hand. Statisticshowto described them as follows:
In order for the results to be accurate, ANOVA has the following assumptions in regards to the study:
Statisticshowto (n.d) ANOVA test: Definition, types, examples. Retrieved from http://www.statisticshowto.com/probability-and-statistics/hypothesis-testing/anova/
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/in Uncategorized /by developer4-Interaction in statistics can be defined as the effect of one independent variable may depend on the level of the other independent variable. In statistics, an interaction may arise when considering the relationship among three or more variables, and describes a situation in which the simultaneous influence of two variables on the third is not additive. In order to find an interaction, you must have a factorial design, in which the two or more independent variables are “crossed” with one another so that there are observations at every combination of levels of the two independent variables.
The presence of interaction can have important implications for the interpretation of statistical models. If two variables of interest interact, the relationship between each of the interacting variables and a third “dependent variable” depends on the value of the other interacting variables and this makes it hardest to anticipate or predict the consequences of the value of variable that changes particularly if the variable it interacts with are difficult to control. (Eastern & McColl 2016)
Example is if we want to examine the effect of two variables, gender and premature birth on health outcomes, we would first of all outline any differences in health outcome score among gender as a main effect. Similarly, we will describe any difference in the scores of full term/premature as a main effect. The presence of an interaction effect shows that the effect of gender on health outcome varies as a function of premature birth status.
Reference
Easton J.C & McColl 2016: Design of Experiments and Anova. Retrieved August 17, 2018 from https://www.stats.gla.ac.uk/steps/glossar/anova.html#intermpediaiew.com.
5-Thank you all for sharing your examples of the variables interaction. Suppose you formulate a hypothesis and conduct an experiment, but the results were not significant. What information can you gain from that, or has your experiment been a failure? Support your argument with example.
6- for your example. The interaction effect here is useful as it is an indication for the treatment efficacy. It is important to consider different factors when assigning the treatment for the patient, for example looking at the effect at different age, by gender and if the patient will go with one treatment, diet or pills, or both.
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/in Uncategorized /by developer1-“Correlation is not causation” is a statistics mantra according to theguardian.com. “Correlation is not causation” means that just because two things correlate does not necessarily mean that one causes the other. Example provided by the article is as followed: just because people in the UK tend to spend more int eh shops when it is cold and less when it is hot, does not mean cold weather causes frenzied high-street spending; a more plausible explanation would be that cold weather tends to coincide with Christmas and the New Year sales.
Reference
Correlation Is Not Causation | Nathan Green’s S Word |n.d.| Access Date August 21, 2018| from
Nathan Green – https://www.theguardian.com/science/blog/2012/jan/06/correlation-causation
Correlation Vs. Causation: An Example – Towards Data Science |n.d.| Access Date August 21, 2018| from
100001147717970 – https://towardsdatascience.com/correlation-vs-causation-a-real-world-example-9e939c85581e
Linear Correlation | Documentation| n.d.| Access Date August 21, 2018| from
https://www.mathworks.com/help/matlab/data_analysis/linear-correlation.html
2-sure we need more information about the study variables like the sample size, age of participants, health history, smoking history and related variables so in the conclusion you can reduce errors and bias, for example.
3-
for your explanation. A correlation measures the degree of the relationship between the variables, while a casual relation means that one variable causes the other. However, a correlation between two variables does not imply causation.
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/in Uncategorized /by developer1-Statistics are extremely important in every research/study conducted and are even important in our everyday lives. Statistics can be used in many ways, some might use it to prove a new procedure should be used due to evidence based research, some might use it to evalute cause and effect, and some might even use it to sway the populations opinion or views on a certain topic. Statistics can absolutely be used for the betterment of the community or it is be used negatively (whether it is intentional or not). There are many different examples of statistics being used inappropriately. Statisticshowto gives great examples of statistics being used in a negative way:
Statisticshowto (2014) Misleading statistics examples in advertising and the news. Retrieved from http://www.statisticshowto.com/misleading-statistics-examples/
2-The misuse of statistics is common in society trying to influence or drive certain agendas in many fields such as healthcare, sports, politics, advertisement and many others. For the Prime Minister Benjamin to classify statistics as a form of lie, he was not further from the truth, but there is a pre-condition, which should address how researchers are applying the given statistics. When done openly and without bias, while avoiding errors, would increase, the validity and accuracy of conclusions made from the study.
3-Statistics involves mathematical procedures, which involves all the details from conducting a certain research to the conclusion of the research. It starts with raw data collected, compiling of such data, analyzing the data, drawing conclusions before representation. Misuse of statistical data sets happens when researchers and those conducting the study mishandle the data either willingly or unwillingly. Errors made during the process of research end up bringing about mistakes in conclusion while intentional errors are supposed to help spread a certain bias as noted in your hotel advertisement.
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/in Uncategorized /by developer1-Evidence-based practice is what keeps the health care system up-to-date with technology and best-practices; these practices help improve patient outcomes. The first article that I read was research about improving the procedures for collecting and testing urine specimens. In the study, they observed how the collection method was carried out and how long it took for the specimen to reach the laboratory for testing. It was determined that not only were the collection methods flawed but the specimens were sitting too long at room temperature; both influenced the test results. Having contaminated specimens were producing unreliable test results and people were getting a wrong diagnosis with a wrong treatment plan. This study helped identify the major problems along with creating solutions to those problems: mid-stream clean catch, using straight-catheters, proper way to get a specimen from an indwelling-catheter, and appropriate time for the specimen to sit at room temperature. This research article helped improve patient outcomes because it increased the accuracy of the test results which yielded a more specific diagnosis; appropriate treatments increased patient outcomes. In our facility when we collect a urine specimen we keep the specimen in the refrigerator and call the labs for a stat pick-up.
The second article that I read was on improves patient outcome fall prevention in 65+ adults. A prevalent safety issue is injuries that occur from Falls. Elderly and frail have a higher risk of falls that can lead into hip-fractures or even death. Accidental falls can result from an unsafe environment or environmental risk factors for example low blood pressure, dehydration, impaired mobility, unstable gait to name a few. To prevent/reduce the risk for falls staff need to maintain awareness of the environmental safety. I work in an Assisted living facility we have Fall-Risk Assessment tool that we use for each of our residents. But our main intervention is communication with staff and residents. We ensure that there is no trip hazard, we lower the bed to the lowest position when they are in bed, check their rooms and facility for potential safety issues, have mats on the floors next to their bed.
2-Two areas of nursing practice that have been under scrutiny in my facility involve Catheter Associated Urinary Tract Infections (CAUTIs) and Standard precautions. Both seem like basic concepts, but in nursing, sometimes the “basics” get swept to the back of your mind when you are focusing on other issues involved in patient care. Both of these concepts are integral parts of patient safety, which is and should be our number one priority.
In the healthcare setting, the use of an indwelling catheter can be a necessity on many occasions. As nurses, it is imperative that we assess the need carefully for catheter placement, as well as continuously assess the need for the catheter to remain in place. According to a study put forth by BMC Health Services Research, “Urinary tract infection (UTI) as the most common healthcare-associated infection accounts for up to 36% of all healthcare-associated infections. Catheter-associated urinary tract infection (CAUTI) accounts for up to 80% of these” (Vicki, Michelle, & Andrew, 2017). According to this study, the aims of reducing CAUTIs is multifaceted. First and foremost, reduce inappropriate urinary catheterization and duration of catheterization (Vicki et al., 2017). Secondary is that when the use of an indwelling catheter is needed, ensure hand hygiene is performed, sterile technique is maintained and proper perineal care is performed regularly. It is also imperative that the medical staff caring for this patient is continually assessing the need for the catheter to remain in place and that it is removed as soon as possible (Vicki et al., 2017). In my facility, our protocol calls for perineal care to be performed at least once a shift and as necessary when soiled, as well as assessing the continuation of need at least once per shift. The goal in our facility is to have indwelling catheters removed within three days of placement.
The second area of nursing practice that is being stressed by my facility is adherence to standard precautions. We are all aware of what standard precautions are and how important they can be to protect not only ourselves, but our patients as well. “Health workers are exposed to diverse types of agents in the work environment, such as viruses, bacteria, fungi, protozoa, and ectoparasites. Occupational exposure might be caused by accidents with sharps, splashes of blood in mucous membranes, inhalation of aerosols, or larger particles” (Barsalobres, Vieira, Fleck, da Silva Canini, Malaguti-Toffano, & Gir, 2016). In this study that was put out by Brazilian Health Care Programs, the reasoning many healthcare professionals did not exercise proper use of personal protective equipment include “including low risk perception, perception of a poor safety climate at the work environment, conflict between providing the patient with the best care service or protecting themselves from exposure, and the belief that precautions are unnecessary in some situations” (Barsalobres et al., 2016). Another reason mentioned in the study was the understanding of the risk of contamination. In my facility, it is mandatory to utilize standard precautions such as hand washing or the use of antibacterial hand scrub before and after touching a patient as well as when soiled. It is mandatory for us to use gloves, gowns, masks, goggles and face shields on high risk patients. This has changed my practice by making me more aware of the “bad habits” that one can get into. In my facility, we have signs outside of each patient room that state “foam in, foam out” as a reminder to wash our hands and be more mindful of standard precautions in general.
Reference:
Vicki P, Michelle G, Andrew S, et al. Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study. BMC Health Services Research, Vol 17, Iss 1, Pp 1-9 (2017) [serial online]. 2017;(1):1. Available from: Directory of Open Access Journals, Ipswich, MA. Accessed August 30, 2018.
Barsalobres Bottaro, B., Vieira Pereira, F. M., Fleck Reinato, L. A., da Silva Canini, S. M., Malaguti-Toffano, S. E., & Gir, E. (2016). ADHERENCE TO STANDARD PRECAUTIONS BY NURSING PROFESSIONALS: A LITERATURE REVIEW. Journal Of Nursing UFPE / Revista De Enfermagem UFPE, 10(3), 1137-1142. doi:10.5205/reuol.8702-76273-4-SM.1003201625
3-The ability to utilize evidence-based practices is key to improving patient outcomes on every level. This is as true now as it was at the beginning of our industry. Many practices that we take for granted today and assume to be merely common sense originally were developed from intensive research. For instance, hand hygiene while commonly dismissed as obvious can have critical importance in a health care setting. A study done in Saudi Arabia from October 2006 to December 2011, proved this after improving hand hygiene compliance from a baseline of 38% to 85% and realizing the rate of Staphylococcus aureusdecreased from 0.42 in 2006 to 0.08 in 2011 (Al-Tawfig, Abed, Al-Yami, & Birrer, 2013). This was just one of the sicknesses that was prevented in many patients. There were many others. With information like this easily available it is astounding that any nurse would fail to meet compliance standards today.
Another instance of an evidence-based practice improving patient outcome is the practice of rooming-in. This is when a newborn baby and mother stay together in the same room during their stay rather than utilizing a separate nursery. Once again this seems trivial enough to be obvious, but it is a fairly recent trend in mother-baby healthcare that has numerous benefits. These benefits include encourage breastfeeding, giving the mother ample opportunity to ask providers about proper care techniques, and allowing the mother to develop a better understanding of their newborn’s behavior (Shrivastava, Shrivastava, & Ramasamy, 2013). While the industry movement towards rooming-in is still ongoing, it is gaining traction. As a mother-baby nurse, I intend to advocate for this change.
References
Al-Tawfiq, J. A., Abed, M. S., Al-Yami, N., & Birrer, R. B. (2013). Promoting and sustaining a hospital-wide, multifaceted hand hygiene program resulted in significant reduction in health care-associated infections. American Journal of Infection Control, 41(6), 482-486. doi:10.1016/j.ajic.2012.08.009
Shrivastava, S. R., Shrivastava, P. S., & Ramasamy, J. (2013). Fostering the practice of rooming-in in newborn care. Journal of Health Sciences, 3(2), 177. doi:10.17532/jhsci.2013.85
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/in Uncategorized /by developer3-One area of nursing that seems to be an ongoing problem is nurse to patient ratio. I feel like when this subject is brought up to those in charge of staffing, they want to roll their eyes at me or whoever is asking about it. I understand that nurses have been wanting less patients for as long as I can recall. The problem is more than just floor nurses complaining. With the advancements in technology and medicine, patients are able to have their cares at home or surgeries on an outpatient basis. Those “walkie talkie” patients are becoming fewer and fewer in the hospital. The patients that we take care of on a daily basis are sick. And I mean they are sick. These patients that may have been ICU patients in the past are now on acute care floors and are being cared for by a nurse that has four other very sick patients. If they had been admitted to the ICU, their nurse may have only one more patient. Floor nurses are being pulled very thin which also leads to nurses feeling burnt out and can have those nurses looking for a different job, which leads to the nursing shortage (Garretson, 2004). We have continued to have the same nurse to patient ratio for years now even though the patients being seen are getting sicker. If nurses had less patients to care for, closer attention can be given to their patients and the risk of mortality can be decreased (Shekelle, 2013)
Garretson, S. (2004). Nurse to patient ratios in American health care. Nursing Standard, 19(14), 33-37. Retrieved 8 29,
2018, from
https://ncbi.nlm.nih.gov/pubmed/15633873
Shekelle, P. G. (2013). Nurse–Patient Ratios as a Patient Safety Strategy: A Systematic Review. Annals of Internal
5-I like your post. Of course Nurses play an important customer service role for hospitals, doctors offices and other medical facilities. Nurses are the ones with the most frequent, direct patient interaction. I just want to share the best way to provide excellent customer services .
Be personable and connect with patients:
Use appropriate language:
For example: If a patient has a fourth grade reading level do not use every big word and medical term possible when discussing medical information
Show that you care:
Involve patients in their care:
6-Medication errors are one of the most common causes of unintended harm to patients. Med errors can lead to patient disability or even death. The problem is many nurses are in a hurry or don’t even realize they have administered the wrong medication. This can not only lead to possible further harm but does nothing to correct the error as it goes unnoticed. A patient returns from surgery, anxious and in pain, with several I.V. lines and intracranial pressure (ICP), monitor in place. The I.V. tubing used in the operating room differs from the tubing used in the intensive care unit (ICU). In her haste, the ICU nurse prepares to inject morphine into the patient’s ICP drain, which she has mistaken for the central line. She stops just in time when she realizes she is about to make a severe mistake. The nurse did not complete her five rights before administration leading to a med error. With the new mandated law of electronic charting, we are required to scan our meds which may cut back on the number of errors, but I do not believe it will eliminate them. Technology is growing in hospitals and helping nurses to go right path and prevent medication errors, but unfortunately, med error still exists. Nurses can help further eliminate medication errors by following five rights and completing the appropriate checks before administering any medications. A possible benefit to help reduce medication errors may be to extend new grads internships as well. Education is the key to prevent the medication error. Medication administration is a complicated multistep process that encompasses prescribing, transcribing, dispensing, and administering drugs and monitoring patient response. An error can happen at any step. Although many errors arise at the prescribing stage, some are intercepted by pharmacists, nurses, or other staff.
References
American Nurses today-ANA:https://www.americannursetoday.com/medication-errors-best-practices/
Nurse Perceptions of Medication Errors: What We Need to Know for Patient Safety: https://www.nursingcenter.com/journalarticle?Article_ID=514523
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Please Answer Based On These Answers As They Are Listed Each One Must Be Answered In Apaform And Not Less Than 150 Words 18977073
/in Uncategorized /by developer1-If I may also add to your post with regards to situational variables. According the the Association for Customer Research “Numerous studies have shown that the longer the time interval between measures of intention and behavior, the greater the inconsistency in behavior. Empirical evidence is presented to support the theory that this time effect on behavior inconsistency is partially a function of unexpected situational variables. Unexpected situational variables were also shown to affect changes in intentions over time”. (Joseph A. Cote Jr. and John K. Wong (1985). This appears to affect the outcome more than some of the other variables.
2-Canada, 2014).
4)Statistical Control: When using Extraneous variables are present in nearly all studies and influence results. They include any variable which is not directly being studied. It is the goal of researchers to identify and control extraneous variables and to mitigate their effects on the study (Statistics, 2015). There are four ways researchers can intercede on these undesirable variables, either :
1.) Randomization: In large samples, the variable being studied or observed is disbursed randomly throughout the groups. This method does not control the extraneous variables, however it allows for equal influence of the extraneous variable throughout the group. This way each sample is effected equally.
2)Matching: This involves creating subgroups of those with the same confounding variables. These are variables which effect both the independent and dependent variables. These groups can be highly specific or generalized, for example age and sex versus health history.
3)Experimental designs: The design of the experiment itself can be influential on the damage caused by extraneous variables. For example, ineffective sampling criteria or studying too broad of a population (Dissertation the above interventions and the influence of extraneous variables does not improve, researchers can use a tool called ANOVA (Analysis of Variance). This method Among the various statistical tools and techniques, Analysis of Covariance ( ANOVA) helps in reducing the impact of the extraneous factors on the study. This is done by comparing the means of several independent groups and analyzing them for similarities and differences to extract the effects of the undesirable variables. (Laird Statistics, 2018)
References:
Dissertation Canada. (2014). Methods to Control Extraneous Variables. Retrieved from http://www.dissertationcanada.com/blog/methods-to-control-extraneous-variables/
Laird Statistics. (2018). One-way ANOVA. Retrieved from https://statistics.laerd.com/statistical-guides/one-way-anova-statistical-guide.php
Statistics. (2015). What are Extraneous Variables? Retrieved from http://www.statisticshowto.com/extraneous-variable/
3-I liked the study example. Examples such as yours helps to understand the research a little better. I found another definition of extraneous variables while doing some research.
“Every experiment includes extraneous variables. One method of controlling extraneous variables is placing the control group side by side with the experimental group. When an experiment does not give the expected results, further study often reveals an extraneous variable, the scientist did not initially consider, is responsible. Extraneous variables become more difficult to control with human subjects. The participants have different genetics and life experiences. Scientists attempt to eliminate variables by studying large groups of people and by using statistical analysis of the resulting data” (Reference, 2018).
Reference, 2018. What Are Extraneous Variables in a Research Survey? Retrieved 9 19, 2018, from
https://www.reference.com/world-view/extraneous-variables-research-survey-f5f4de93e39c437b#
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Please Answer Based On These Answers As They Are Listed Each One Must Be Answered In Apaform And Not Less Than 150 Words 18977079
/in Uncategorized /by developer4-. I just want to add the levels of evidence from strongest to weakest
· Systemic review of experimental studies (well-designed randomized controlled trials [RCTs])
· Meta-analyses of experimental (RCT) & quasi-experimental studies
· Integrative reviews of experimental (RTC) & quasi-experimental studies
· Single experimental study (RCT)
· Single quasi-experimental study
· Meta-analysis of correlational studies
· Integrative reviews of correlational & descriptive studies
· Qualitative research meta-synthesis & meta-summaries
· Single correlational study
· Single qualitative or descriptive study
· Opinions of respected authorities based upon clinical evidence, reports of expert committees (Grove, Gray, & Burns, 2015, p. 24)
Reference
Grove, S. K., Gray, J., & Burns, N. (2015). Understanding nursing research: Building an evidence-based practice(6th ed.). Retrieved from https://bookshelf.vitalsource.com/ #/books/9781455770601/cfi/20!/4/2/18/18/8/2/4/4/[email protected]:0
5-Let me put my share for peer-review as you mentioned this in your post. Feedback from colleagues with similar backgrounds, expertise and knowledge can be a valuable asset. Positive peer reviews contribute to increased funding opportunities, academic advancement and a good reputation. On the other hand, peer reviewers can fall prey to bias, both positive and negative, which can affect the prospects of the research being reviewed, independent of its quality (APA, 2018).
Peer reviewers are expected to meet strict deadlines, which is a challenge when one has numerous responsibilities. Reviewers are also expected to remain impartial during the review, which can be difficult if the research being reviewed is, for example, submitted by a rival researcher. During the review process, the reviewer must knowledgeably assess the quality of the research, honestly judge the importance of the research and must preserve confidentiality. It is essential that researchers are aware of the expectations and commitments required of a peer reviewer prior to becoming one. Although participating in peer review is a way to provide professional service, those who cannot meet the requirements should seriously consider whether being a peer reviewer is right for them.
Reference
American Psychological Association (2018). Peer review. Retrieved from
http://www.apa.org/research/responsible/peer/index.aspx
6-You mention Meta-analysis in your post, I have some more information about meta-analysis. Meta-analyses are a subset of systematic review. A systematic review attempts to collate empirical evidence that fits prespecified eligibility criteria to answer a specific research question (NCBI,2018). The key characteristics of a systematic review are a clearly stated set of objectives with predefined eligibility criteria for studies; an explicit, reproducible methodology; a systematic search that attempts to identify all studies that meet the eligibility criteria; an assessment of the validity of the findings of the included studies (e.g., through the assessment of risk of bias); and a systematic presentation and synthesis of the attributes and findings from the studies used. Systematic methods are used to minimize bias, thus providing more reliable findings from which conclusions can be drawn and decisions made than traditional review methods. Systematic reviews need not contain a meta-analysis. there are times when it is not appropriate or possible; however, many systematic reviews contain meta-analyses.
Reference
National Center for Biotechnology Information (2018). Meta-analysis in medical research. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3049418/
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