MSU NUR 342 midterm Exam latest update with 100% accurate solutions(verified by experts)

research a process to discover new knowledge or new evidence nursing research a systematic inquiry to develop trustworthy evidence about issues of improtance to nursing profession clinical nursing research is designed to guide nursing practice first nurse researcher florence nightingale, lady with the lamp, best known for data collection and analyses during crimean war, reduced mortality rate from 60-42%, evidence based practice most important practical lessons that can be given to nurses is to teach them what to observe, how to observe, what symptoms indicate improvement, what the reverse, which are of importance, which are of none, which are the evidence of neglect, and what kind of neglect. IF YOU CANT GET IN HABIT TO OBSERVE YOU HAD BETTER GIVE UP BEING A NURSE NINR's strategic plan: five areas of focus promoting health and preventing disease symptom management and self management end of life and palliative care innovation the development of nurse scientists evidence based practice making clinical decisions about patient care based on the best possible evidence. best research evidence plus integration of clinical expertise, patient values personalize best evidence to a specific patient's needs within a particular clinical context evidence based practice parts assess, ask, acquire, appraise, integrate, evaluate, disseminate nursing process vs EBP process assess, diagnosis, plann, intervention, eval assess, assk, acquire, appraise, apply, evaluate evidence hierarchy systematic review single RCT single non randomized quasi single prospective cohort single case control single cross sectional single in depth qualitative expert opinion/case reports Q: a clinician is using EBP efforts to research new methods of preventing HAP from occuring in an ICU. what would be the next appropriate step to take after appraising and synthesizing the evidence integrate the evidence into own practice Q: what is the best method of acquiring reliable knowledge on which to base a clinical practice? disciplined research how to appraise evidence quality, magnitude, precise, side effects, financial costs, relevance EBP barriers quality and nature of research, characteristics of nurses, organizational factors paradigm world view or general perspective of the world's complexities positives paradigm reality exists; real world driven by natural causes researcher is independent from those researched values and biases are to be held in check ALLIED WITH QUAN constructivist paradigm reality is multiple and subjective. researcher interacts with those being researched subjectivity and values are inevitable and desirable ALLIED WITH QUAL pre-appraised evidence has been selected from primary studies and evaluated for use by clinicians systematic reviews integrate evidence about a topic in a rigorous, systematic way meta-analysis technique for integrating quantitative research findings statistically meta-synthesis less about reducing information and more about interpreting it steps in EBP 1. Asking clinical questions that can be answered with research evidence 2. Searching for and retrieving relevant evidence 3. Appraising and synthesizing the evidence 4. Integrating the evidence with your own clinical expertise, patient preferences, and local context 5. Assessing the effectiveness of the decision, intervention, or advice PICOT population intervention/influence comparisson outcome timeframe values something that is prized or held dear; something that is deeply cared about what tells you this is better than that purpose of nursing practice is to apply moral values we value self determination, patient well being, patient dignity, trust, truthfulness, privacy, fairness, ethics refers to wrongdoing dilemmas enacting values identifying right values wrong doing acts that clearly violate moral norms. how do we change the situation? ex: excessive use of retraints, racial disparities resolution: eliminate bad actors, systemic analysis and reform dilemmas a conflict in legitimate values what is the right way to proceed? ex: should you ever conceal meds in food of pt with dementia ethical analysis enacting values devising better ways to enact values can this be done better? should palliative care be offered earlier in the cancer trajectory? empirical analysis; clinical innovation right values determining what values should guide professional decisions and behaviors what prinicples should guide clinical action and decisions academic and philosophical analysis review of ethical principles respect for autonomy beneficence nonmaleficence justice liberty the right to pursue one's own interests without interference in health care means: respect for autonomy respect for autonomy the duty of clinicians to respect and enhance patients autonomy over treatment decisions and health care goals is an ACTIVE skill. liberty is PASSIVE skill implementing respect for pt autonomy informed consent advanced directives privacy beneficence one should act for the benefit of others, encompasses both maximizing positive good and minimizing or preventing harm non maleficence an obligation not to inflict harm on others. primum non nocere - above all do no harm hippocrates justice distributive justice not retributive justice fair equitable and appropriate distribution determined by justified norms that structure the terms of social cooperation the paradigm case of injustice is that in which there are two similar individuals in similar circumstances and one of them is treated better or worse than the other John Rawls the veil of ignorance one feature of justice as fairness is to think of parties in the initial situation as rational and mutually disinterested... they are conceived as not taking an interest in each other's interests Jurgen Habermas four conditions of fair discourse all participants must: - have an equal. chance to speak - have an equal chance to interpret speech