what is evidence/ what are types of evidence?
information acquired through research and the specific evaluation of practice
types=
quantitative studies
qualitative studies
meta analysis
expert opinion in the form of documents, commission reports, regulations, or historical reports
what is evidence informed decision making
Continuous interactive process involving the explicit, conscientious and judicious consideration of the best available evidence to provide care
-deeper understanding than evidence based
evidence-informed practice vs. evidence informed decision making
evidence-informed= use of evidence in the nurses practice
evidence-informed decision making= use of evidence from research using a variety of methodologies
evidence informed decision making builds on..
evidence based health care
what are best practices?
formalized evidence-based collection of documents
BPG program was launched in 1999 by RNAO
-flagship of excellence on both the national and international stage
-enables organizations and health systems to focus on patient care, using latest research
-helped advance government prioritizes as well as patient, provider and organization and health system guidelines
what is the BPG recognized by
the world for its rigorous guideline development and transformational approaches that contribute to implementation science and robust evaluation methodology
what are ethics?
system of principles which can critically change previous considerations about choices and and actions
-branch of philosophy, deals with dynamics of decision making
what are research ethics?
scientific research is governed by an individual, community and social values
-research ethics involve requirements on daily work, the protection of dignity of subjects and the publication of the information in the research
what are the 3 value systems that nurses have to cope with when they participate in research?
societal values about human rights
nursing culture based on the ethic of caring
researchers values about scientific inquiry
what was the 1964 declaration?
1964 declaration of Helsinki, need for non-therapeutic research was initiated
- Declaration emphasized the protection of subjects in this kind of research and strongly proclaimed that the well being of individuals is more important than scientific and social interests
- Interest of subject over interests of society
explain: INFORMED CONSENT
right to autonomy is protected, person knowingly, voluntarily, and intelligently in a clear and manifest way gives their consent ○ Autonomy= ability for self determination in action according to a personal plan
○ Seeks to prevent assaults on the integrity on the patient and personal liberty and veracity
○ Requires knowing risks, benefits, alternatives
○ Incorporates intro of a study, purpose, selection of research subjects, procedures
○ Ability to withdraw
○ Helsinki declaration- interests of study must always prevail over the interests of society and science
Disclosure, comprehension, competency, voluntariness
explain: BENEFICENCE , DO NOT HARM
- non-maleficence= potential risks of participation
- Requires high level of sensitivity from researcher on what constitutes harm
- Both preventing intentional harm and minimizing potential harm
explain: ANONYMITY and CONFIDENTIALITY
- Anonymity is protected when the subjects identity can not be linked with personal responses
- Confidentiality= management of private information by the researcher
explain: RESPECT for privacy
- Freedom an individual has to determine the time, extent, and general circumstances under which private information will be shared with or withheld from others
- Invasion of privacy= beliefs, attitudes, opinions and records are shared without the patients knowledge or consent
explain: VULNERABLE GROUPS OF PEOPLE
- Concern about vulnerable groups and whether it is ethical or not for them to be used as research subjects
- Vulnerability= one characteristic of people unable to protect their own rights and welfare
- Captive populations (prisoners, students, mentally ill persons, aged people, children, critically ill, poor, dying, learning disabilities, unconscious
- Inability to give informed consent and their need for further protection and sensitivity from the researcher
explain: SKILLS OF THE RESEARCHER
3 more important elements:
- Competency of researcher - Careful design - Worthwhile expected outcomes - Nurse researchers should have necessary skill and knowledge
explain: NATURE of NURSING
-Nature and essence of nursing reflects on human beings and their relationship with health
Some- Primary scope of nursing- to help persons to adapt in different stages of illness
-Nursing views person as a whole and health as a subjective and meaningful experience
-Many view caring as most important part
-Predicting individuals needs and preserving dignity
-Vulnerability of the sick & Lack of patient participation= danger of patient exploitation by nurses
explain: ADVOCACY of NURSING
- Protection of human rights of people who cannot defend for themselves
- In literacy, three models
- Rights protection model implies nurses help persons to understand and exercise their rights
- Value based decision model suggests nurses should not impose decisions but assist persons to decide
- Respect for persons model focuses on human dignity, privacy, and self determined choices that the nurse has to protect if the patient is not autonomous or self-determining
questions to ask when critically thinking about research…
- What is the purpose of the study?
- What is the population of interest?
- What research design was used?
- Does the article show that the evidence is valid and reliable?
Summarize the findings from the studying.
