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Relationships between quality, safety, and coststo director
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Ironridge and Summerville Case Study

In this course, you will work through a case study that is designed to help you apply the principles of evidence-based practice to a problem-focused situation based in two of the CCN islands in Second Life. Here are the instructions, organized by week:

Part 1:

A joint committee of community leaders from Ironridge and Summerville, contiguous cities in Arizona, have met and decided they want to form an ad hoc committee on health and safety issues in their communities. They ask you to do a community assessment for them.

1. TD 1-Qualitative Research

View each of the two short videos in the lesson. You will be conducting a participant observation study for this TD. The research question is: What are the health and safety issues in Ironridge compared to Summerville?

Record the health and safety issues you find in Ironridge and Summerville. Describe one health issue and one safety issue in each city (Ironridge and Summerville). Try to avoid repeating an issue identified by another student if possible.

Why is this participant observation an example of qualitative research? What are other ways, both qualitative and quantitative, that you could research this question? Finally, how are theory, research, and practice advanced by the combination of qualitative and quantitative approaches?

2. TD 2 Ask a PICO(T) Question

Conduct a search of the literature on one of the problems you have identified, using the PICO(T) format. How many "randomized, controlled trials (RCTs)" have you found in comparison to other types of studies? What are the advantages and disadvantages of RCTs in comparison to other types of studies? Generally, how would you summarize your articles?

Part 2:

Concerned with access to health care, community leaders in Ironridge ask you, as MSN-prepared nurses, to help them prioritize the health-related problems in their community and find more information on the top two issues.

1. TD1 - Purposes of research

In Week 1, we identified the priority issues you noted in Ironridge with a short reason why. This week the instructor will divide the class into four (4) collaboration committees so that each committee can discuss a different top priority issue from Week 1 that the instructor has identified. THIS IS NOT A GROUP PROJECT OR GROUP ASSIGNMENT. Each student will be graded individually based on their performance. Since we usually participate in collaborative committees in the practice setting to discuss priority issue, this format will allow our class to discuss four priority issues within the same discussion board.

Each student will need to post twice (once by Wednesday deadline at 11:59 p.m. MT and a peer response to someone in your collaborative committee). In your collaborative committee, discuss what information you will need to know about the issue? What types of research would be most useful (descriptive, explanatory, predictive, prescriptive)? What databases are the most helpful? Please place all committee discussion in the discussion thread forum so everyone can benefit from the discussion.

2. TD 2 - Theory and Variables

Review the differences in descriptive, explanatory, predictive, and prescriptive studies and select one of the predictive or prescriptive articles you find. What are the independent variables (IV), dependent variables (DV), and mediating variables (MVs) you find in the article?How do determining IVs, DVs, and MVshelp you discern the theory tested in the research? In your particular article, what risk factors are identified or what recommendations are provided?

Part 3:

You decide to set up a community study on the two issues you identified in Ironridge. Staying in the same collaborative committeewith your fellow consultants, discuss the following:

1. TD 1 - Plan a Quantitative Study

You will continue to work with the priority issue from your Week 2 committee discussion. First look at your priority issue from Week 2 and describe a quantitative study to address the issue. What would be your research question? How will you select your sample to make sure that your study has external validity? What factors would affect the internal validity of your study? Remember to pick an article that is different from someone else in your committee. You should each have a quantitative study article for this discussion board.

2. TD 2 - Plan a Qualitative Study

You will continue to work with the priority issue from your Week 2 committee. First look at your priority issue from Week 2 and describe a qualitative study to address the issue. Which qualitative design would you use? How will you make sure that the information you obtain is trustworthy? How is trustworthiness in qualitative research similar and different from reliability and validity?

Assignment 1: Research Summary Table -Develop a research summary table on the issue you studied for the community committee. Follow the guidelines for this assignment located in Course Resources and submit your finished product to the Week 3 Dropbox

Part 4:

One of your challenges in setting up a community study is finding participants and figuring out how to ask them to be a part of your study. Think about whom you will approach and how you will approach them.

Assignment 2: Complete the NIH training on research with human subjectsand drop a copy of the certificate you earn in the Week 4 Dropbox.

1. TD 1 - Sampling Issues

Staying in discussionwith your fellow consultants, what type of sample would you need to examine your question and learn more about your issue? What are the various types of sampling you could use, along with their advantages and disadvantages?

2. TD 2 - Ethical Issues

Read these two documents on ethical issues in research:

o Tuskegee syphilis study at http://www.cdc.gov/tuskegee/.

o An overview of questionable studies - Milestones in the history of human subjects protectionat https://ccrod.cancer.gov/confluence/download/attachments/82937373/Milestones%20in%20HSP%20-%20final.pdf?version=1&modificationDate=1344348001577&api=v2

What are the ethical principles violated in the studies described in these documents? What are the implications of this information with respect to recruitment of human subjects in your Ironridge study?

Part 5:

Summerville officials hear about what you are doing in Ironridge. They also want your help but they would like to focus on the safety of their children, especially on bicycle safety.

1. TD 1 - Descriptive Statistics

Complete a PICO(T) search on bicycle safety. What does the research say about this issue? Select one of the articles from your search. Identify the descriptive statistics. Is anything missing? To what extent are minorities included in the study (or is that demographic information available?)? How does the descriptive data help you understand the research?

2. TD 2 - Inferential Statistics

Describe the inferential tests that were used (e.g., t-tests and chi-squares). Given the p-values related to the tests, how do you interpret the results? Are statistically significant findings also clinically significant? What are the recommendations, based on this paper? Share some alternate explanations (mediating or intervening variables) for the results of the study.

Assignment 3: Critique of a Systematic Research Review - Critique a systematic research review related to bicycle safety or one of the issues identified in Week 1. Follow the guidelines for this assignment located in Course Resources and submit your finished product to the Week 5 Dropbox.

Part 6:

Mr. Lowell, the nursing executive at St. Louis Medical Center in Summerville, hears about your consultant work for the cities of Ironridge and Summerville and he asks you to help him evaluate the hospital's evidence-based practice program and recommend an EBP model. He strengthened the staff education department a few years ago with a new MSN-prepared director who could use a consultant to get the evidence-based practice program off the ground.

1. TD 1 - Research Summaries

Preliminarily, you need to help the staff understand the differences between various translation documents. Therefore, in this TD, compare and contrast two of these five types of research summaries: Meta-analysis, meta-synthesis, systematic research reviews, clinical practice guidelines, and care protocols. What are the differences in their purposes, audiences, and authors?

2. TD 2 -EBP Models

Compare and contrast two of the models in the Week 7 lesson. Which would you recommend in this situation and why?

Part 7:

Mr. Lowell is especially concerned about a costly high infection rate in surgical patients at St. Louis Medical Center, along with a lack of concern about patient's psychological needs. He has read about the efforts of the QSEN Institute (http://http://qsen.org/) to promote quality and safety and was surprised to see that patient concerns are inherent in the quality improvement conversation. He asks you to help the new staff education director and the clinical practice council study both problems.

1. TD 1 - Quality, Safety, and Costs

How would you explain the relationships between quality, safety, and coststo the director and staff? How would you demonstrate the importance of nursing care in addressing this issue? What outcome variables would you recommend?

2. TD 1 - Patient and Family Concerns

Mr. Lowell wants to adopt a caring model at St. Louis Medical Centerand asks you to find the latest information on patient and family engagement. What does the literature say about patient and family engagement (Hint: use that phrase in your search) and what would you recommend? What types of research back up these recommendations?

Assignment 4: Analysis and Application of a Clinical Practice Guideline -Select (1) one of the issues identified in Week 1, (2) the bicycle safety issue, or (3) the surgical infection issueand find a very recent (no more than 5 years) clinical practice guideline related to that issue. Follow the guidelines for this assignment located in Course Resources and submit your finished product to the Week 7 Dropbox.

Part 8:

Along with your fellow consultants, you have completed your work in Ironridge and Summerville. As usual, you reflect on the experience.

1. TD 1 - Applying Evidence-based Practice

What specific skills and knowledge that you gained through this experience will be most important as you take on your future roles in nursing? Describe a concrete way in which you anticipate using these skills and knowledge.

Reference

QSEN Institute (2013). Project overview. Retrieved from http://qsen.org/about-qsen/project-overview/




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