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Chapter 1-10

NURS 360 Chapter Notes - Chapter 1-10: Cluster Sampling, Rebar, Antipositivism

Course Code
NURS 360
Karen McKinnon

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Running head: N360 READING NOTES
N360 Reading Notes
Haley Westra
Nurs 360: Professional Practice VI: Nursing Research
Karen MacKinnon
University of Victoria

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Week 1
1. Brady, N. & Lewin, L. (2007) Evidence-based practice in nursing: Bridging
the gap. Journal of Pediatric Health Care, 21,
Evidence = information that provides a point of view or
contributes to finding the solution to a clinical question
EBP in Nursing
Best research evidence + clinical expertise +
patient values = EBP
Bridge between research and practice
Huge gap between research findings and actual
implementation of new practices
Nightingale identified gaps and collected relevant information
Taking an EBP approach starts with posing the right question
o Followed by utilizing appropriate research databases, implementing nursing
practice changes and evaluating outcomes
Integrating evidence into practice involves planning, implementing, correcting at
mid-course, communication and evaluation
Successful implementation of changes requires congruent goals and objectives
Potential barriers: individual and organizational
o Some people are more open to change than others
o Lack of access, time demands, lack of support etc.
2. Rebar, C.R., & Gersch, C.J. (2015). Understanding research for evidence-
based practice (4th ed.). Philadelphia, PA: Wolters Kluwer. Chapter 1
Initial Inquiries
What is the answer to my practice question? What did the study conclude?
Why did the author(s) reach these conclusions? What did they actually find?
To what types of patients do these research conclusions apply? Who was in the study?
How were those people studied? Why was the study performed that way?
Why ask that question? What do we already know?
Role of Research in the Evolution of Healthcare Professions
Research affects all aspects of healthcare from systems to the provider level
Doctoral-level HCPs are experts in the research process; masters-level HCPs can
critically evaluate and actively participate; baccalaureate-level HCPs can participate,
conduct own research projects w/ support from higher level researchers, and be
members on review boards

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History of Healthcare Research and EBP
Hippocrates: determined illnesses and disease had natural, not supernatural causes,
and were d/t to physical factors (food, water, air) that impacted health
Nightingale: studied environmental factors that affected the health of soldiers
20th-21st centuries: medical research has vastly changed how diseases are diagnosed
Qualitative and quantitative methods can be implemented in study designs to fit the
unique problems within healthcare
Evidence-Based Bridge Theory: states a gap exists between available research (evidence-
based information) and the need for active application of the research for positive growth or
Evidence-Based Models
EBP uses decision-making skills that integrates clinical expertise, scientific evidence
(EBI), and patient/community/population perspectives
o E.g. Iowa Model, Ottawa Model, Joanna Briggs Model
Essential elements of an EBP model:
o Assess assess the situation; identify an issue, concern or question in clinical
o Ask ask a question using a question format (e.g. PICO)
o Acquire find research applicable to the situation/question; finding credible
and current research
o Appraise validate the research findings; analyze, critique and evaluate the
study for validity and applicability
o Apply application of the EBI; integrating clinical expertise, patient
perspectives and scientific knowledge into a plan of action in the provision of
o Evaluate evaluating or measuring patient outcomes as a result of your
When to Seek Evidence
1. Something occurs out of the ordinary in your clinical practice
2. Outcomes of care differ in one or more patients without clear reasons
3. You need to develop a policy, procedure or standards of care
Effective Clinical Questions
Includes a concern that someone has already studied, and can be measured/described
Is a concern that is relevant to your healthcare professional scope of practice
The question should address Who, Where, What and When in terms of the clinical
E.g. What is the best patient teaching method for newly diagnosed adolescent
diabetic patients treated in ambulatory care clinics?
o Who adolescent diabetic patients
o What patient teaching methods
o When newly diagnosed
o Where ambulatory care clinics
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