NURS 4100 – Quality and Safety Through Evidence-Based Practice

NURS 4100 – Quality and Safety Through Evidence-Based Practice

Nurses are expected to engage in evidence-based practice. As scholar-practitioners, students in this course learn to use evidence in clinical decision making to promote a safe healthcare environment. Students apply course concepts as they identify a current problem in nursing practice and synthesize and evaluate literature, as well as identify changes in practice. Students analyze clinical guidelines and nurse-sensitive indicators in establishing quality and safety initiatives. Students utilize quality improvement models in promoting changes in practice. (Prerequisite(s): NURS 3150.)

  • EP4001 Evidence-Based Practice Models for Research
    Understand the importance of using models to facilitate evidence-based practice.
  • EP4002 Clinical Nursing Issues
    Develop an evidence-based practice question based on a clinical nursing issue.
  • EP4003 Evaluating Research
    Evaluate research related to a clinical practice issue.
  • EP4004 Designing Interventions
    Recommend evidence-based clinical interventions or process improvements to promote positive patient health outcomes.

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Walden University Essays – NURS 4100 Quality & Safety Through Evidence-Based Practice Course Readings

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Peterson, M.H., Barnason, S., Donnelly, B., Hill, K., Miley, H., Riggs, L., & Whiteman, K.(2014). Choosing the best evidence to guide clinical practice: Application of AACN levels of evidence. Critical Care Nurse, 34(2), 58-68.

Sand-Jecklin, K. & Sherman, J. (2014). A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation. Journal of Clinical Nursing, 23(19/20), 2854-2863.

Smucker, D., Regan, S., Elder, N., & Gerrety, E. (2014). Patient safety incidents in home hospice care:  The experiences of hospice interdisciplinary team members. Journal of Palliative Medicine, 17(5), 540-544.

Stetler, C. B., Ritchie, J. A., Rycroft-Malone, J., & Charns, M. P. (2014). Leadership for Evidence-Based Practice: Strategic and Functional Behaviors for Institutionalizing EBP. Worldviews On Evidence-Based Nursing, 11(4), 219-226.

NURS 4100 Sample Paper

Evidence Based Practice: Restraints

Walden University
NURS 4100: Quality and Safety through Evidence Based Practice
Evidence Based Practice: Restraints
Evidence from research has indicated the restraints and seclusion are controversial topic
in mental health hospitals in attempt to control aggressive behaviors displayed by patients.
Restraints are defined as any manual method, physical, material, or equipment that immobilizes
or reduces the ability of the patient to freely move his/her arms, legs body or head. (Raveesh,
Gowda G., Gowda, M. 2019). This method is usually used as a last resort when other
interventions have failed. It is been indicated through research that restraints do not provide
therapeutic value to staff or patients. Evidence from additional research offers alternatives to
restraints and seclusions regarding patient aggressive behaviors. Interest in healthcare today
focuses on the use of alternatives to restraints and seclusions. Restraints have been viewed as
having negative consequences on the patient and the staff, as well as injures and possible death
to the patient. The focus with research provided is to determine with adults in behavioral health
settings (P), how does use of physical restraints with standard therapy (I) compare to use of
behavioral modification therapy in conjunction with standard therapy (C) to reduce assaultive
behaviors (O)?

Evidence Based Studies

In the article Alternative use of restraints: A path toward Humanistic Care (2019)
addressed a study that utilized a randomized control study in Finland. This study noted that
utilizing a six-point approach including
1. Improved leadership
2. Staff development
3. Data Use
4. Patient Involvement
5. Utilizing Seclusion-Restraint Tools
6. Post event Analysis
Helped to reduce the incidence of restraints and seclusion on inpatient units and offer positive
results in assaultive behaviors.
Evidenced based studies have been utilized to help answer this question. An evidence
based quantitative study published in a peer reviewed journal Correlation Between Reduction of
Seclusion and Restraints and Assaults by Patients in Pennsylvania State Hospitals (2015)
focused on hospitals in Pennsylvania that implemented a study 1530 patients who are on or have
been on psychiatric unit. The sample was obtained from records/charts anonymized civilly
committed individuals who were mechanically restrained or secluded in 9 civil hospitals. The
study took place over 108 months. The objective of this study was to assess the use of
containment procedures in Pennsylvania state hospitals from 2001 to 2010 and its effect on
patient-to-patient and patient-to-staff assaults. The purpose of this study assessed the use of
seclusion and restraint in a Pennsylvania State hospital system. The study focused on
mechanical restraints, physical restraints and seclusion. The data was anonymized and reviewed
and structured by utilizing NASMHPD research institutes data dictionary and SPSS, version 22….

NURS 4100 Common Flaws in Quantitative nursing Studies

NURS 4100 Common Flaws in Quantitative nursing Studies

  • NURS 4100 -Quality and Safety Through Evidence-Based Practice
  • BSN Completion Program
  • Walden University
  • Critical Appraisal of Qualitative Research
  • Smucker, D., Regan, S., Elder, N., &   Gerrety, E. (2014). Patient safety   incidents in home hospice care:

The experiences of hospice interdisciplinary team members.  Journal of Palliative Medicine, 17(5), 540-544.

  • Quality
  • Is the journal peer-reviewed?

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

  • Are the authors qualified to conduct the research?
  • Focus of Study
  • What experience or situation are the researchers seeking to understand?
  • Study Design
  • What is the expected outcome of the study?
  • Do the researchers want to describe an event, explain a cultural experience or generate a theory?
  • What is the study design?
  • Data Collection
  • Who were the sample and how were they recruited?
  • How were the data collected?
  • Control
  • How did the researchers control their biases or preconceptions during the data collection process?
  • Data Analysis
  • How were the data analyzed?
  • Do the authors include direct quotes and generalized statements as examples of data?
  • Results
  • What are the main findings of the study?
  • What themes emerged from the analysis?
  • Recommendations
  • Do the authors provide recommendations for future research?
  • Limitations
  • Are the limitations of the study discussed?

 

APPENDIX F

Appraisal Guide:

Findings of a Quantitative Study

 

 

APA Formatted Citation: (4 pts.)

Answer Here:

 

 

Synopsis (16 pts.)

  1. What was the purpose of the study (research questions, purposes, and hypotheses)?

Answer Here:

 

  1. How was the sample obtained?

Answer Here:

 

  1. What inclusion or exclusion criteria were used?

Answer Here:

 

  1. Who from the sample actually participated or contributed data (demographic or clinical profile and dropout rate)?

Answer Here:

 

  1. What methods were used to collect data (e.g., sequence, timing, types of data, and measures)?

Answer Here:

 

  1. Was an intervention tested? Answer Yes or No

 

  1. How was the sample size determined?

Answer Here:

 

  1. Were patients randomly assigned to treatment groups?

Answer Here:

 

  1. What are the main findings of the study? (10 pts.)

Answer Here:

 

Credibility (14 pts.)

 

Yes No Not Clear
Is the study published in a source that required peer review?      
*Did the data obtained and the analysis conducted answer the research question?      
Were the measuring instruments reliable and valid?      
*Were important extraneous variables and bias controlled?      
*If an intervention was tested, answer the following five questions:      
Were participants randomly assigned to groups and were the two groups similar at the start (before the intervention)?      
Were the interventions well defined and consistently delivered?      
Were the groups treated equally other than the difference in interventions?      
If no difference was found, was the sample size large enough to detect a difference if one existed?      
If a difference was found, are you confident it was due to the intervention?      
Are the findings consistent with findings from other studies?      
  All Some No
ARE THE FINDINGS CREDIBLE?                        
       

 

Clinical Significance (6 pts.)

 

  1. Note any difference in means, r2s, or measures of clinical effects (ABI, NNT, RR, OR)

Answer Here: NURS 4100 Common Flaws in Quantitative nursing Studies

 

Yes No Not Clear
*Is the target population clearly described?
*Is the frequency, association, or treatment effect impressive enough for you to be confident that the finding would make a clinical difference if used as the basis for care?
  All Some No
ARE THE FINDINGS CLINICALLY

SIGNIFICANT?                                                    

 

*= Important criteria

 

Comments

Answer Here:

 

Common Flaws in Quantitative Studies

The common flaws associated with quantitative studies include inappropriate representation of the target population; requires large sample size to collect data; lack of ability to control the environment; limited outcomes; and complicated data analysis methods (Rahman, 2017).

Inappropriate representation of the target population can interfere with the study’s targeted aims and objectives. In spite of using the suitable sampling plan, representation of the study participants depends on the probability distribution of the available data. This can result in inaccuracy of probability distribution and result in inaccuracy in proposition (Ponto, 2015). Secondly, quantitative studies need large sample sizes and lack of adequate resources may hinder use of adequate sample size when conducting research and hence affect generalization of the study results (Regnault et al, 2018). Moreover, controlling the environment when conducting quantitative research is difficult. As Rahman (2017) explains, when conducting quantitative research, it can be problematic to control the environment where the respondents give answers during the survey or in the questionnaires. The responses are dependent on specific time and conditions existing during that specific time-frame. NURS 4100 Common Flaws in Quantitative nursing Studies

In addition, quantitative researches are associated with limited outcomes due to the structured questionnaires and surveys with close-ended questions. Therefore, the respondents have limited options when it comes to responses and the close-ended questions leads to restricted outcomes delineated within the research proposal (Ponto, 2015). Therefore, the findings do not always represent the actual happenings, in a generalized form. Finally, quantitative studies require complex data analysis methods such as statistical analysis which can be challenging to researchers without knowledge on statistics (Queirós et al, 2017). The requirement to perform efficient statistical confirmation of findings is very challenging within a quantitative study.

 

 

References

Queirós A, Faria D & Almeida F. (2017). Strengths and Limitations of Qualitative and Quantitative Research Methods. European Journal of Education Studies. 3(9).

Ponto J. (2015). Understanding and Evaluating Survey Research. J Adv Pract Oncol. 6(2), 168–171.

Rahman, S. (2017). The advantages and disadvantages of using qualitative and quantitative approaches and methods in language “testing and assessment” research: a literature review. Journal of Education and Learning. 6(1), 102-112. NURS 4100 Common Flaws in Quantitative nursing Studies

Regnault A, Tom W & Barbic S. (2018). Towards the use of mixed methods inquiry as best practice in health outcomes research. J Patient Rep Outcomes. 2(19).

 

 

APPENDIX F

Appraisal Guide:

Findings of a Quantitative Study

 

 

APA Formatted Citation: (4 pts.)

Answer Here:

 

 

Synopsis (16 pts.)

  1. What was the purpose of the study (research questions, purposes, and hypotheses)?

Answer Here:

 

  1. How was the sample obtained? NURS 4100 Common Flaws in Quantitative nursing Studies

Answer Here:

 

  1. What inclusion or exclusion criteria were used?

Answer Here:

 

  1. Who from the sample actually participated or contributed data (demographic or clinical profile and dropout rate)?

Answer Here:

 

  1. What methods were used to collect data (e.g., sequence, timing, types of data, and measures)?

Answer Here:

 

  1. Was an intervention tested? Answer Yes or No

 

  1. How was the sample size determined?

Answer Here:

 

  1. Were patients randomly assigned to treatment groups?

Answer Here:

 

  1. What are the main findings of the study? (10 pts.)

Answer Here:

 

Credibility (14 pts.)

 

Yes No Not Clear
Is the study published in a source that required peer review?      
*Did the data obtained and the analysis conducted answer the research question?      
Were the measuring instruments reliable and valid?      
*Were important extraneous variables and bias controlled?      
*If an intervention was tested, answer the following five questions:      
Were participants randomly assigned to groups and were the two groups similar at the start (before the intervention)?      
Were the interventions well defined and consistently delivered? NURS 4100 Common Flaws in Quantitative nursing Studies      
Were the groups treated equally other than the difference in interventions?      
If no difference was found, was the sample size large enough to detect a difference if one existed?      
If a difference was found, are you confident it was due to the intervention?      
Are the findings consistent with findings from other studies?      
  All Some No
ARE THE FINDINGS CREDIBLE?                        
       

 

Clinical Significance (6 pts.)

 

  1. Note any difference in means, r2s, or measures of clinical effects (ABI, NNT, RR, OR)

Answer Here:

 

Yes No Not Clear
*Is the target population clearly described?
*Is the frequency, association, or treatment effect impressive enough for you to be confident that the finding would make a clinical difference if used as the basis for care?
  All Some No
ARE THE FINDINGS CLINICALLY

SIGNIFICANT?                                                    

 

*= Important criteria NURS 4100 Common Flaws in Quantitative nursing Studies

 

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