Nurse to nurse incivility

NR449 Evidence Based Practice Required Uniform Assignment: Analyzing Published Research Purpose The purpose

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of this paper is to interpret the two articles identified as most important to the group topic. COURSE OUTCOMES This assignment enables the student to meet the following course outcomes: CO 2: Apply research principles to the interpretation of the content of published research studies. (POs #4 and #8) CO 4: Evaluate published nursing research for credibility and clinical significance related to evidence- based practice. (POs #4 and #8) DUE DATE Refer to the course calendar for due date information. The college’s Late Assignment policy applies to this activity. TOTAL POINTS POSSIBLE: 200 POINTS REQUIREMENTS The paper will include the following. 1. Clinical question a. Description of problem b. Significance of problem c. Purpose of paper 2. Description of findings a. Summarize basics in the Matrix Table as found in Assignment Documents in e-College. b. Describe i. Concepts ii. Methods used iii. Participants iv. Instruments including reliability and validity v. Answer to “Purpose” question vi. Identify next step for group 3. Conclusion of paper 4. Format a. Correct grammar and spelling b. Use of headings for each section c. Use of APA format (sixth edition) d. Page length: three pages NR449 Evidence Based Practice PREPARING THE PAPER 1. Please make sure you do not duplicate articles within your group. 2. Paper should include a title page and a reference page. DIRECTIONS AND ASSIGNMENT CRITERIA Assignment Criteria Clinical Question Points % 1. Problem is described: What is the focus of your group’s work? 2. Significance of the problem is described: What health outcomes result from your problem? Or what statistics document this is a problem? You may find support on websites for government or professional organizations. 3. Purpose of your paper: What will your paper do or describe? “The purpose of this paper is to . . .” 30 15% Description of Findings: Summary 60 Description 30% Description of Findings: Description 60 30% Description of Findings: Conclusion 20 10% **Please note that although most of these questions are the same as you addressed in paper 1, the purpose of this paper is different. You can use your work from paper 1 for items 1 and 2 above, including any suggestions for improvement provided as feedback. Item 3 above should be specific to this paper. Summarize the basics of each article in a matrix table that appears in the appendix. Describe in the body of the paper the following. • What concepts have been studied? • What methods have been used? • Who are the participants or members of the samples? • What instruments have been used? Did the authors describe the reliability and validity? • How do you answer your original “purpose of this paper” question? Do the findings of the articles provide evidence for your answers? If so, how? If not, what is still needed to be able to answer your question? • What is needed for the next step? Identify two questions that can help guide the group’s work. Conclusion: Review major findings in your paper in a summary paragraph. Format Total 30 200 15% 1. Correct grammar and spelling 2. Use headings for each section: Problem, Synthesis of the Literature (Concepts, Methods, Participants, Instruments, Implications for Future Work), Conclusion. 3. APA format (sixth ed.): Appendices follow references. 4. Paper length: Three pages 100% NR449 RUA Analyzing Published Research.docx Revised 07/25/2016 2 NR449 Evidence Based Practice GRADING RUBRIC Assignment Criteria Clinical Question (30 points) Outstanding or Highest Level of Performance Very Good or High Level of Performance Competent or Satisfactory Level of Performance A (92–100%) B (84–91%) C (76–83%) Includes all elements in a manner that is clearly understood. • Problem description provides focus of the group’s work. • Significance of the problem is clearly stated and supported by current evidence. • Purpose of paper is clearly stated. Missing only one element OR One element is not presented clearly • Problem description provides focus of the group’s work. • Significance of the problem is clearly stated and supported by current evidence. • Purpose of paper is clearly stated. 26-27 points Missing two elements OR One element is not presented clearly • Problem description provides focus of the group’s work. • Significance of the problem is clearly stated and supported by current evidence. • Purpose of paper is clearly stated. 23-25 points Poor, Failing or Unsatisfactory Level of Performance F (0–75%) Missing two or more elements AND/OR One or more elements are not presented clearly • Problem description provides focus of the group’s work. • Significance of the problem is clearly stated and supported by current evidence. • Purpose of paper is clearly stated. 0-22 points 28-30 points Description of Findings: Summary (60 points) Summary omits no more than one required item from the Evidence Matrix Table. 55-60 points NR449 RUA Analyzing Published Research.docx Summary omits two or three required items from the Evidence Matrix Table. 51-55 points Revised 07/25/2016 Summary omits four required items from the Evidence Matrix Table. 46-50 points Summary omits five or more required items from the Evidence Matrix Table. 0–45 points 4 NR449 Evidence Based Practice Description of Findings: Description (60 points) Description includes ALL elements. • What concepts have been studied? • What methods have been used? NR449 RUA Analyzing Published Research.docx Description missing no more than one element. • What concepts have been studied? • What methods have been used? Revised 07/25/2016 Description missing no more than two elements. • What concepts have been studied? • What methods have been used? Description missing three or more elements. • What concepts have been studied? • What methods have been used? 5 NR449 Evidence Based Practice • Who are the participants or members of the samples? • What instruments have been used? Did the authors describe the reliability and validity? • How do you answer your original “the purpose of this paper” question? Do the findings of the articles provide evidence for your answers? If so, how? If not, what is still needed to be able to answer your question? • What is needed for the next step? Identify two questions that can help guide the group’s work. • Who are the participants or members of the samples? • What instruments have been used? Did the authors describe the reliability and validity? • How do you answer your original “the purpose of this paper” question? Do the findings of the articles provide evidence for your answers? If so, how? If not, what is still needed to be able to answer your question? • What is needed for the next step? Identify two questions that can help guide the group’s work. • Who are the participants or members of the samples? • What instruments have been used? Did the authors describe the reliability and validity? • How do you answer your original “the purpose of this paper” question? Do the findings of the articles provide evidence for your answers? If so, how? If not, what is still needed to be able to answer your question? • What is needed for the next step? Identify two questions that can help guide the group’s work. • Who are the participants or members of the samples? • What instruments have been used? Did the authors describe the reliability and validity? • How do you answer your original “the purpose of this paper” question? Do the findings of the articles provide evidence for your answers? If so, how? If not, what is still needed to be able to answer your question? • What is needed for the next step? Identify two questions that can help guide the group’s work. 51–55 points 46–50 points 0–45 points 56–60 points NR449 RUA Analyzing Published Research.docx Revised 07/25/2016 6 NR449 Evidence Based Practice Description of Findings: Conclusion (20 points) Summary paragraph includes ALL major findings from article. • Independently extracts complex data from a variety of quantitative sources, presents those data in summary form, makes appropriate connections and inferences consistent with the data, and relates them to a larger context. • Recognizes points of view and value assumptions in formulating interpretation of data collected and articulates the point of view in a given situation. • Identifies misrepresentations in the presentation points of quantitative data and the logical and empirical fallacies in inferences drawn from data. 19-20 points NR449 RUA Analyzing Published Research.docx Summary paragraph omits ONE major finding from article. Summary paragraph omits TWO major findings from article. • Independently extracts complex data from a variety of quantitative sources, presents those data in summary form, makes appropriate connections and inferences consistent with the data, and • Independently extracts complex data from a variety of quantitative sources, presents those data in summary form, makes appropriate connections and inferences consistent with the data, and relates them to a larger context. • Recognizes points of view and value assumptions in formulating interpretation of data collected and articulates the point of view in a given situation. • Identifies misrepresentations in the presentation of quantitative data and the logical and empirical fallacies in inferences drawn from data. relates them to a larger context. • Recognizes points of view and value assumptions in formulating interpretation of data collected and articulates the point of view in a given situation. • Identifies misrepresentations in the presentation of quantitative data and the logical and empirical fallacies in inferences drawn from data. 17-18 points Revised 07/25/2016 16 points Summary paragraph omits THREE or MORE major findings from article. • Independently extracts complex data from a variety of quantitative sources, presents those data in summary form, makes appropriate connections and inferences consistent with the data, and relates them to a larger context. • Recognizes points of view and value assumptions in formulating interpretation of data collected and articulates the point of view in a given situation. • Identifies misrepresentations in the presentation of quantitative data and the logical and empirical fallacies in inferences drawn from data. 0-15 points 7 NR449 Evidence Based Practice Grammar, Spelling, Mechanics, and APA Format (30 points) • Length pages. is three full • Used appropriate APA format and is free of errors. • Includes ALL headings and subheadings as instructed. • Grammar, spelling, and mechanics are free of errors. 28–30 points • Length is no more than one quarter page under or over. • Used appropriate APA format, with one type of error. • Includes ALL headings and subheadings as instructed. • Grammar, spelling, and mechanics have one type of error. 26–27 points • Length is no more than one half page under or over. • Used appropriate APA format, with two types of errors. • Includes ALL headings and subheadings as instructed. • Grammar, spelling, and mechanics have two types of errors. 23–25 points • Length is three quarters of a page or more under or over. • Attempts made to use APA format; three or more types of errors are present. • Includes ALL headings and subheadings as instructed. • Grammar, spelling, and mechanics have three or more types of errors. 0–22 points Total Points Possible = 200 points NR449 RUA Analyzing Published Research.docx Revised 07/25/2016 8 Running Head: INCIVILITY IN NURSING INCIVILITY IN NURSING 2 Nurse to Nurse Incivility Clinical question First, nursing incivility can be described as a certain bad behavior which the nurses use while talking to each other or while addressing people around them including patients thus causing them to underperform in their workplaces due to the lack of a conducive environment. The significance of the problem of nurse to nurse incivility in terms of outcomes is that, nursing incivility in most cases lead to the nurses not giving effective performance in their daily jobs and work assignments because they were not subjected to an environment that was good for quality performances at all times. The picot question that was decided was, how does the level in which the productivity of the nurses vary, does it increase during their first year of working when they are subjected to a good working environment as compared to when they are subjected to an environment that is unpleasant and hostile? (Elias, Polancich, Jones & Convoy, 2015). Therefore, the purpose of this paper is to study and get the needed information concerning the two articles that were previously given since they will help us to give an adequate response on the picot question that was formulated. Level of evidence The type of question that was asked was neither a therapy nor prognosis one, it was basically a descriptive one since it was meant to provide the reasons as to why the productivity could either go high or low depending on what environment the nurses could get in their work places or in a health setting (LoBiondo-Wood & Haber, 2014). When a qualitative study was done about the said question, the results of the analyzation were gotten through many different interviews that were carried out in assurance of getting to know the nurses points of view on INCIVILITY IN NURSING 3 whatever treatment they got in their work places, whether direct treatment or indirect treatment and how it would affect their level of performance in any case. Some of these questions were; are the nurses able to perform their work and assignments on a daily basis because of the good treatment and appreciation they receive from all the people around them including the patients, fellow nurses and even their supervisors? Another question could be, is the level of performance and production of the work of the nurses degrading on a daily basis because of an unpleasant working environment and lack of efficient communication skills between the nurses, patients and the supervisors? On the other hand, when quantitative study was applied, the same results as those of the qualitative study were achieved. Although, for this study some experiments were carried out and the observable data including the behavior, actions, communication skills applied, level of appreciation given to the nurses when they perform effectively and also the environment that was present at the working place during the time of study. These different data samples were used to come up with the necessary information that was needed in order to complete the research. An example of an experiment showed that when the nurses delivered their services properly and outperformed more than what was merely expected, there was a constant increase in their salaries which was done by giving them a bonus that was approved by their supervisors, workmates and also some of the patients. Search strategy The relevant search topics and search terms that were so many. Among them, the search terms were; nursing incivility and nursing incivility in their workplaces. Whereas, the most appropriate search topics that were provided included; what is nursing incivility, how provision a conducive environment lead to an increase of the level of production of the nurses in their health setting and also what an unpleasant environment could cause in a nursing workplace. The INCIVILITY IN NURSING 4 databases that were used and also that provide a good link with the picot question that was chosen were; library databases and electronic databases. The decision that we made that will help us refine our search so as to get the perfect results and also to make sure that we get the articles that were needed to a reasonable number of reviews was to apply the use of limiters. Some of the limiters that were so necessary to use were; publication date, this is because the publication date needed was supposed to be a more current one that will guide us to a search that can deal with the situation accordingly depending on how nurses are able to perform in their workplaces at the current time. Another limiter was scholarly journals which were chosen since they will greatly help in getting firsthand information concerning all that is needed in the search since it comes from people who got the required knowledge on what nursing incivility is and how it affects performance of nurses. Publication type can also be a limiter because when a search from a good publication is chosen, it will help in getting all the necessary information right and precise to the point. Language is another limiter which can greatly help in refining the search since one can be able to select a language that they themselves together with the target audience understand and speak well. The two most relevant articles that will help in providing guidance for the next paper are; LWW journals and also SAGE journals. These two were chosen because they were well based according to the limiters that were set to refine all the searches that were made. Conclusion In conclusion, it was seen that due to how important health information and doing away with incivility in nursing was, it was necessary to get all the information from scholarly sources and also that all search strategies should adequately be planned for and the evidences clearly stated so that the search achieves high quality standards. INCIVILITY IN NURSING 5 References LoBiondo-Wood, G., & Haber, J. (2014). Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences. Elias, B. L., Polancich, S., Jones, C., & Convoy, S. (2015). Evolving the PICOT method for the digital age: The PICOT-D. Journal of Nursing Education, 54(10), 594-599. Chamberlain College of Nursing NR449 Evidence-Based Practice EVIDENCE MATRIX TABLE Article Reference 1 (sample not a real article) Smith, Lewis (2013), What should I eat? A focus for those living with diabetes. Journal of Nursing Education, 1 (4) 111-112. Purpose Hypothesis Study Question Variables Independent(I) Dependent(D) How do educational support groups effect dietary modifications in patients with diabetes? D-Dietary modifications I-Education Study Design Qualitative Sample Size and Selection N- 18 Convenience sampleselected from local support group in Pittsburgh, PA Data Collection Methods Focus Groups Major Findings Support and education improved compliance with dietary modifications. 1 2 3 4 5 NR449 Evidence Matric Table.docx Revised10/20/14 ns/cs 1 Unit 9: Enhancing the Validity of Research Unit 9: Enhancing the Validity of Research Introduction to the Topic: Validity of a research study is a key determinant of its usefulness for practice. Studies with internal and external validity increase trustworthiness and confidence in applying the findings to practice. Internal Validity The level of confidence that an experimental treatment or condition made a difference and that rival explanations were systematically ruled out through study design and control. Conditions Necessary for Causality • Changes in the presumed cause must be related to changes in the presumed effect • The presumed cause must occur before the presumed effect • There are no plausible alternative explanations for the outcome External Validity The ability to generalize the findings from a research study to other populations, places, and situations. External Validity Population Validity Ecological Validity • Can the findings be generalized from a sample to a larger group? • Example: Can findings be generalized from patients in one medical center to patients in an entire health system? • Can the findings be generalized from one set of environmental conditions to another set of environmental conditions? • Example: Can findings be generalized from a medical-surgical unit to a long-term care facility? Validity and Qualitative Research Qualitative research is sample specific and is not intended for generalization. Still, studies should be trustworthy enough that results can be transferred to other settings and situations. A Comparison… Quantitative Internal validity: – Did the intervention cause the outcome? Qualitative Trustworthiness – Did the research represent reality accurately? A Comparison… Quantitative Internal validity: – Were other causes ruled out? – Did the researcher control rival explanations for the outcome? Qualitative Trustworthiness – Was inherent bias controlled? – Did the researcher identify and limit the capacity for bias? A Comparison… Quantitative External validity: – Can these findings be generalized to other populations? Qualitative Applicability/ Transferability – Can these findings be transferred to similar people and settings? Bias in Research • Sampling error • Treatment effects • Measurement error Factors that Jeopardize Internal Validity • • • • • • • History Maturation Testing Instrumentation Treatment effects Selection effects Attrition Threats to External Validity • • • • • Selection effects Time History Novelty Experimenter effects Balancing Internal and External Validity It is paradoxical that the more internal validity a study provides, the weaker the external validity. The more tightly controlled a study, the more artificial it becomes, limiting generalizability. Validity in Qualitative Research • Credibility – Are the findings plausible? – Is the study structured so that the findings are believable? • Trustworthiness – Did the researcher do what was possible to control inherent bias? – How did the researcher limit his/her own bias? External Validity of Qualitative Research • Extension of understanding through applicability • Ability to transfer findings to other samples and settings • Replication of the results in other qualitative and/or quantitative studies Threats to Trustworthiness • • • • Hawthorne Effects Selection effects Historical effects Researcher bias Promote the Validity of Qualitative Research • • • • • • Prolonged or varied field experience Verbatim accounts Triangulation Member checking Bracketing Audit trails Minimize Threat to Internal Validity • • • • Measurement or observation Use of appropriate design elements Control of bias Statistical analysis Minimize Bias • Researcher blinded to group assignment • Primary researcher does not collect data • Objective criteria used for selecting subjects and assigning to groups • Extraneous variables identified and controlled • Attrition was minimized throughout the study Controlling Extraneous Variables The researcher can deal with extraneous variables in three ways: eliminate the threat; control for the threat; or account for the threat in the write-up Statistical Analysis to Strengthen Validity • Determine probability of error – Type I – Type II • Calculating and reporting tests of effect size • Ensuring data meet the fundamental assumptions of the statistical test Conclusions • Internal validity provides reassurance that an intervention worked and no other causes were responsible for the outcome • External validity gives the nurse confidence in generalizing the results to other populations • Trustworthiness allows for transferability of qualitative findings Unit 8: Measurement and Data Collection Unit 8: Measurement and Data Collection Introduction to the Topic: The measurement strategy is essential to provide credible evidence for practice. Using reliable and valid measures is necessary to draw accurate conclusions. Measurement Determination of the quantity of a characteristic that is present; involves assignment of numbers or some other classification. Forms of Measurement • May represent the quantity of the attribute numerically • May sort subjects into categories based on characteristics – Observers may classify the subject – Subjects may self-classify • Only useful if they represent the underlying characteristic of interest Critical Attributes of Measurement in Research Clearly linked to the research question, appropriate to represent the variable of interest, and consistently accurate The Measurement Strategy • Determine the most relevant attributes • Define attributes in operational terms • Select an instrument to reliably capture the attribute • Document the reliability and validity of the instrument • Develop protocols for data gathering • Put quality checks in place Measurement Concepts • • • • Conceptual definitions Operational definitions Primary data Secondary data Primary Data Data are collected directly from subjects • Physiological measurements Psychometric Instrumentation • Collect subjective information directly from subjects (e.g. tools that measure coping, stress or self-esteem) • Key issues: reliability and validity • Use existing instrument if possible Surveys and Questionnaires • • • • • Most common data collection method Systematic tool used to collect data Quantitative/Qualitative/or both Variety of options for delivery Open ended or closed Writing Questions • • • • Clear Succinct Unambiguous Needs to be interpreted the same way by respondents • Avoid leading questions • Avoid emotionally laden questions Secondary Data • Use of data originally collected for another purpose • Efficient and convenient to use • Reduces the time needed for a study • Researcher cannot control the conditions under which the data were collected • Critical: does the secondary data answer the research question? Measurement Error The difference between the true score (the actual amount of an attribute) and the observed score (the amount of attribute measured) Measurement Error • Random Error – Human factors – Bias – Confusion – Environmental variations • Systematic error – A measure is consistently biased Systematic Error Systematic error is the result of: • Measures that are consistent but inaccurate • Measures that are complicated or onerous procedures for the subject • Measures that reflect sensitive or socially taboo topics Minimize Measurement Error • Clear, objective measurement procedures • Reduce variability due to anything except the subject response – Calibration of instrumentation – Use of existing, tested instruments – Ensure instrument reliability Reliability The instrument consistently measures a given trait with precision Instrument Reliability • Internal reliability: Stability within the instrument • Item-total correlation: Stability among individuals • Inter-rater reliability: Stability between raters • Test-retest: Stability over time Validity The ability of an instrument to consistently measure what it is supposed to measure Validity • Content validity: The content of the instrument reflects the attribute • Construct validity: The instrument represents the conceptual issues • Criterion-related validity: – Concurrent – Predictive – Discriminate • Responsiveness Diagnostic Measures • Sensitivity – Measure that indicates an instrument has the capacity to detect disease if it is present • Specificity – Measures that indicates an instrument has the capacity to differentiate when a disease is not present Measurement and Evidence for Practice A well managed and documented measurement strategy supports credibility of the findings and confidence in applying the research in practice Data Collection Methods • • • • • • Traditional methods Online data collection Technology-based data collection Interviews Focus groups Observation Data Management Procedures • Determine how data will be recorded • Develop procedures for data collection – Codebook for data definitions • Plans for managing and organizing data • Procedures for storage of data Using Measurement in Practice • Use instruments to monitor patient conditions • Measures to determine effectiveness of interventions • Patient risk assessment tools Conclusions • Measurement must be clearly linked to the research question • Various types of data are available for measures • Measurement error is always present but can be minimized • Measures should be reliable and valid • Measures and study results can be used in practice
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