Assignment 1: Article Critique 

DNP graduates are expected to apply research findings and integrate nursing science into evidence-based practice. To develop your ability to engage in this high level of nursing practice, you will analyze the strengths and weaknesses of a research study over the next several weeks using the concepts presented throughout Weeks 1 through 9 of the course. Your final analysis will be a 5- to 7-page paper in APA format, that includes the following:

1) Write an introduction ending with a purpose statement (e.g. “the purpose of this study is…).

2) Provide a two paragraph overviews of the study.

3)  Identify three strengths of the study and support your selection (i.e. why is this a

strength)

4)  Identify three weaknesses of the study and support your selection (i.e. why is this a

weakness)

Note: The strengths and weaknesses should be in relation to:

· Design

· Sampling

· Data collection

· Statistical analysis

· Results and discussion.

5)  Propose changes to improve the quality of the study capitalizing on the strengths and

6) improving on the weaknesses you identified in the study.

7)  Summarize the implications for nursing practice. 

8) Write a conclusion for your paper

The purpose of the analysis is to help you develop a deeper understanding of the research process, to inspire you to think critically and deeply about research on a specific topic, and to strengthen your ability to integrate research findings into evidence-based nursing practice. This assignment also gives you practice in analyzing the research literature, which will support you when you begin your DNP project. 

Due Wednesday October 25, 2017 before midnight!

Writing (5 points): Up to 5 points (20%) may be deducted for grammar and APA style errors.

To prepare for this week’s assignment complete the following:

• Select      one of the four research articles cited in this week’s required readings (SEE ATTACHED PDF FILE). 

• Review      the various quantitative research designs presented in the textbook      readings and research articles and discussed in the “Musings: Aligning      Research Question and Methodology” media.
• Consider      the research design used in your selected article. Ask yourself the      following questions. Is the design appropriate for the study? Would a      different design provide better results?

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Research methods for evidence-based practice: Selecting a research topic and developing a hypothesis. Baltimore, MD: Author.

Note: The approximate length of this media piece is 13 minutes.

In this week’s video, Dr. Leiyu Shi discusses the characteristics of a good research hypothesis and details the steps in developing a hypothesis that can be tested through research.

Laureate Education, Inc. (Executive Producer). (2011). Research methods for evidence-based practice: Musings: Aligning research question and methodology. Baltimore, MD: Author.

Note: The approximate length of this media piece is 6 minutes.

This video discusses the importance of having a well-defined research question, which informs the methodology that you use in creating a hypothesis for a research study

Laureate Education. (2011). Important events in clinical research history. Retrieved from http://mym.cdn.laureate-media.com/2dett4d/Walden/CLRA/6100/01/mm/timeline/index.html

This timeline identifies and describes key historical events related to the development of clinical research throughout the ages.

Required Readings

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

Chapter 5, “Research Problem and Purpose”

Chapter 5 outlines how to identify and develop a research problem statement, purpose, and research questions. The chapter also provides examples of both quantitative and qualitative research topics, problems, and purpose.

Chapter 6, “Objectives, Questions, Variables, and Hypothesis”

This chapter explains the different types of hypotheses and assesses how research variables can be used to formulate research objectives in both quantitative and qualitative studies.

Chapter 10, “Quantitative Methodology: Noninterventional Designs and Methods”

Chapter 10 describes the principles of research design and those foundational concepts that influence the selection of an appropriate quantitative design: causality, bias, manipulation, control, and validity.

Chapter 11, “Quantitative Methodology: Interventional Designs and Methods”

This chapter builds on the material presented in Chapter 10 and discusses how to select the most appropriate quantitative research design for addressing a particular research problem.

Select one of the following articles to use for this week’s Assignment:

· Fouquier, K.F. (2011). The concept of motherhood among three generations of African American women. Journal of Nursing Scholarship, 43(2), 145–153. 

· Grey, M., Whittemore, R., Jaser, S., Ambrosino, J., Lindemann, E., Liberti, L., Northrup, V., & Dziura, J. (2009). Effects of coping skills training in school-age children with Type 1 diabetes. Research in Nursing & Health, 32, 405–418. (USE THIS ARTICLE FOR THIS ASSIGNMENT)

· Methey, N.A., Davis-Jackson, J., & Stewart, B.J. (2010). Effectiveness of an aspiration risk-reduction protocol. Nursing Research, 59, 18–25.

· Newhouse, R.P., Morlock. L., Pronovost, P., & Breckenridge-Sproat, S. (2011). Rural hospital nursing: Results of a national survey of nurse executives. Journal of Nursing Administration, 41(3), 129–137.

Handouts

Laureate Education. (2011). Litmus test for a doctoral-level research problem. Baltimore, MD: Author.

Optional Resources

Caress, A., Luker, K., & Chalmers, K. (2010). Promoting the health of people with chronic obstructive pulmonary disease: Patients’ and carers’ views. Journal of Clinical Nursing, 19(3–4), 564–573.

Mbeba, M. M., N., Jere, D. L., Kachingwe, S. I., Crittenden, K. S., McCreary, L. L., … Norr, K. F. (2011). Peer group intervention reduces personal HIV risk for Malawian health workers. Journal of Nursing Scholarship, 43(1), 72–81.

Miller, J., Gaboda, D., Nugent, C., Simpson, T., & Cantor, J. (2011). Parental eligibility and enrollment in state children’s health insurance program: The roles of parental health, employment, and family structure. American Journal of Public Health, 101(2), 274–277.

Su, C., Lu, X., Chen, W., & Wang, T. (2009). Promoting self-management improves the health status of patients having peritoneal dialysis. Journal of Advanced Nursing, 65(7), 1381–1389.

  

Required Reading and Resources

Centers for Disease Control and Prevention [CDC]. (2012). Lesson 4: Displaying public health data. In Principles of epidemiology in public health practice [3rd ed.]. Retrieved from www.cdc.gov/ophss/csels/dsepd/ss1978/lesson4/index.html

Cook, A., Netuveli, G., & Sheikh, A. (2004). Chapter 1: Laying the foundations: Measurements and probability. In Basic skills in statistics: A guide for healthcare professionals (pp. 3-14). London, GBR: Class Publishing. eISBN: 9781859591291.

Statistics Learning Centre. (2011, December 13). Types of data: Nominal, ordinal, interval/ratio . Retrieved from http://www.youtube.com/watch?v=hZxnzfnt5v8

Norman, G. R., & Streiner, D. L. (2014). Section the first: The nature of data and statistics: Chapter 1: The basics. In Biostatistics: The bare essentials [4th ed., e-Book]. Shelton, Connecticut: PMPH-USA, Ltd. eISBN-13: 978-1-60795-279-4. Available in the Trident Online Library EBSCO eBook Collection.

Partners in Information Access for the Public Health Workforce. (2016, August 9). Health data tools and statistics. Retrieved from https://phpartners.org/health_stats.html

HOMEWORK ASSIGNMENT:

Part I (approximately 1–1½ pages, total):

Copy and paste the following examples (1-6 below), then respond by classifying each of the following variables as either: nominal, ordinal, interval, or ratio. Provide a brief explanation where indicated.

1. A researcher studying lifespan      categorizes individuals into single, married, divorced, or widowed. What      type of variable measurement is this?
2. A cognitive scientist places      her subjects into categories based on how anxious they tell her that they      are feeling: “not anxious,” “mildly anxious,” “moderately anxious,” and      “severely anxious,” and she uses the numbers 0, 1, 2 and 3 to label      categories where lower numbers indicate less anxiety. What type of      variable measurement is this? Are the categories mutually exclusive?
3. A Physician diagnoses the      presence or absence of disease (i.e., yes or no). What type of variable      measurement is this?
4. A person weighing 200 lbs. is      considered to be twice as heavy as a person weighing 100 lbs. In this      case, what type of measurement is body weight?
5. A nurse takes measurements of      body temperature on patients and reports them in units of degrees      Farenheit as part of a study. What type of variable measurement is this?
6. Patients rate their experience      in the emergency room on a five point scale from poor to excellent (1 =      very poor, 2 = not very good, 3 = neither good nor bad, 4 = quite good,      and 5 = excellent). What type of variable measurement is this? Is the      difference between a 1 and a 2 necessarily the same as the difference      between a 3 and a 4? Explain briefly.

Part II: Statistics (1/2 page)

Given what you’ve learned in this module about the meaning of “statistics,” choose one of the examples from Part I (1-6), and raise a relevant question of your own that could be answered by a statistician. Then without answering your own question, explain how a pattern could be studied or a useful prediction made based on data that are to be collected.

Part III: Quantitative vs. Qualitative Data (approximately 1–1½ pages)

A health scientist wishes to measure how well participants diagnosed with Post Traumatic Stress Disorder are coping. Explain how a variable such as coping could be measured quantitatively or qualitatively.

  

Nursing and Health Care Informatics Ethics and the Law

 

“Whatever, in connection with my professional service, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret.”
—Confidentiality excerpt from the Hippocratic Oath (as cited in Croll, 2010)

 
 

Traditional schools of medicine have a ritual of reciting oath excerpts such as the one above during their graduation ceremonies. Such excerpts usually revolve around a professional’s promise to uphold the ideals of patient safety and confidentiality to the best of his or her ability.
 

With the continued integration of Health Information Technology (HIT), and advances in technology such as hand-held computers, new ethical considerations have evolved within health care settings. For example, wireless capabilities can provide easier access to information from unauthorized outside parties. While technological advances have led to improvements in health care, they have also created new vulnerabilities. Doctorally prepared nurses need to be aware of ethical issues surrounding the use of patient information, technology, and the respective liabilities.
 

Reference:
Croll, P. (2010). Privacy, security and access with sensitive health information. Studies in Health Technology and Informatics, 151, 167–175.
 

To prepare:

• Reflect      on this week’s Learning Resources, focusing on the ethical and legal      issues associated with usage of data and health information.
• For      this Discussion, identify an ethical issue related to data collection or      information management at your organization or one with which you are      familiar.
• Determine      the potential liabilities that this ethical issue presents by reviewing      the AMIA Code of Ethics.
• Consider      the legal aspects of your ethical issue and the steps that could be taken      to avoid or minimize risk.

By tomorrow Wednesday 09/27/17, 12 pm, write a minimum of 550 words essay in APA format with a minimum of 3 references from the list in the instructions area. Include the level one headings as numbered below:

post a cohesive response that addresses the following:

1) Describe your selected ethical issue (example of ethical issues in nursing Informatics are: Ethical Use of Genomic Information and Electronic Medical Records, Alarm Fatigue, Privacy, Confidentiality, and Data Sharing). Choose one!

2) Analyze the potential liabilities that this issue poses to the organization by referencing the AMIA Code of Ethics.

3) Formulate strategies that the organization could implement to address the ethical issue.

Required Readings

Course Text: American Nurses Association. (2008). Nursing informatics: Scope and standards of practice. Silver Spring, MD: Author.

“Ethics in Nursing Informatics” (p. 49-52)

This page of the text introduces three common ethical codes used in health care today.

Croll, P. (2010). Privacy, security and access with sensitive health information. Studies in Health Technology and Informatics, 151, 167-175.

The author proposes a model for controlling the security of health information networks and systems.

Hjort, B. (2007). AHIMA report addresses evolving role of health care privacy and security officers. Journal of Health Care Compliance, 9(3), 47-68.

This article identifies the challenges and responsibilities of health care workers employed in privacy and security positions.

Layman, E. J. (2008). Ethical issues and the electronic health record. The Health Care Manager, 27(2), 165-176.

The findings within this article provide recommendations for health personnel, leaders, and policy makers when attempting to design ethically sound electronic health records.

Mackenzie, G., & Carter, H. (2010). Medico legal issues. Studies in Health Technology and Informatics, 151, 176-182.

Within this article, the authors provide an overview of the legal issues, precautions, and potential breaches that surround the privacy and security of electronic patient records

O’Keefe-McCarthy, S. (2009). Technologically-mediated nursing care: The impact on moral agency. Nursing Ethics, 16(6), 786-796.

Examine technology’s ability to negatively affect the patient/nurse relationship as decisions are based more on data and less on emotional and pedagogical reasoning by referencing the material found in this article.

Withrow, S. C. (2010). How to avoid a HIPAA horror story. Healthcare Financial Management, 64(8), 82-88.

The HIPAA horror story that is detailed here underlines the importance of adopting HIPAA privacy and security provisions in efforts to reduce potential violations and financial threats.

California HealthCare Foundation. (2011).

Retrieved from http://www.chcf.org/ 

The California HealthCare Foundation outlines quality reform plans that improve efficiency and reduce cost for California’s patients.

Centers for Medicare & Medicaid Services. (2010). CMS EHR meaningful use overview.

https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp 

The U.S. Department of Health and Human Services defines the term meaningful use and also its view of meaningful use criteria, requirements, and financial impact.

American Nurses Association. (2011). Ethics and human rights.

Retrieved from http://nursingworld.org/MainMenuCategories/HealthcareandPolicyIssues/ANAPositionStatements/EthicsandHumanRights.aspx

See this website to view position statement documents developed by the ANA to promote adherence to ethics and human rights.

Healthcare Information and Management Systems. (2011). Privacy & security toolkit.

Retrieved from http://www.himss.org/ASP/topics_pstoolkit.asp

At this website, you will find a categorized tool kit that consists of implementation plans, legislation, and case studies to help health care professionals better understand matters of privacy and security.

The American Medical Informatics Association. (2014). Retrieved from http://www.amia.org/about-amia/ethics

At this website, you will find an American Medical Informatics Code of Ethics for Healthcare Professionals.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Transforming nursing and healthcare through technology: Healthcare informatics: Ethics and law. Baltimore, MD: Author.

Note: The approximate length of this media piece is 10 minutes.

In this week’s media presentation, Dr. Don Detmer gives his insights on the government’s initiatives to create secure and meaningful electronic health records.

 Discussion: Group Management for Just Culture

The concept of a fair and just culture refers to the way an organization handles safety issues. Humans are fallible; they make mistakes. In a just culture, ‘hazardous’ human behavior such as staff errors, near–misses and risky actions are identified and discussed openly in hopes of finding ways to improve processes and systems—not to identify and punish the individual.
—Pepe & Caltado, 2011

This Discussion examines the opportunities of managers in working with groups to promote change that facilitates the delivery of safe, high–quality care.

To Prepare

• Review the information on just culture presented in the Learning Resources.
• For this discussion, you will use the Regulatory Decision Pathway found in Russell, K. A. & Radtke, B. K. (2014).
• Examine an adverse event at the unit level in your organization or one with which you are familiar and apply the Regulatory Decision Pathway.
• Compare the findings of the Regulatory Decision Pathway  to what actually happened at the unit in your organization. Was the event deemed: bad intent, reckless, at risk, or human error? According to the pathway, do you now think it was the correct action?
• Think about how a nurse leader–manager may use just culture as a framework to create or maintain a focus on accountability and outcomes throughout a group. What actions could be taken if a systems–related error was made or if an error resulted from risky behavior?
• How might role conflict and/or ambiguity have contributed to the situation?

Post a description of an adverse event in your organization and your analysis of the issue using the Regulatory Decision Pathway. Explain how role conflict or ambiguity might have influenced this situation. Apply the principles of just culture as you explain how you, as the group’s manager, would handle the situation.

http://sidneydekker.com/wp-content/uploads/2013/01/JustCultureCritique.pdf

http://www.outcome-eng.com/wp-content/uploads/2012/01/manage-risk.pdf

**************Below is a paper to use as reference!!!!!!!!!

PLEASE USE THIS AS A REFERENCE ONLY.

 

Adverse Event

            Adverse events are a part of the healthcare environment and how an event is dealt with can affect patient safety.  The regulatory pathway and just culture are a means of improving the quality of care and safety culture (Russell & Radtke, 2014).  Health care employees need to trust in their organization that an adverse event can be reported so that the organization and employee can learn from the event, and that it is not just a means to place blame.

            An adverse event that took place in the cardiac catheterization lab was a procedure was done on the wrong patient.  A patient that was to have a pacemaker instead ended up having a diagnostic catheterization.  This event involved a patient identification issue by the nurse.  The hospital’s patient identification policy and time out policy were not adhered to by the nurse and then the catheterization team.   The incident was reported to the state, and there were several event meetings with the nurse and physician.  As a result of the investigation, all staff in the catheterization lab were re-educated to the patient identification and time out policy.  All staff had to sign an individual affidavit that they understood the policy.  The nurse was given a written warning.  This event would not have happened if the nurse and catheterization team had adhered to policy.           

Regulatory Decision Pathway

 Using the regulatory decision pathway, the nurse did not intend to harm the patient deliberately.  The nurse asked the patient if she was Ms. X and the patient said yes.  The identification policy is to check the patient’s identification band for name and medical record number against a second identifier.  This was not done.  There were no significant circumstances involving the system that led to the error.  The nurse did not conceal the error or falsify the record.  The nurse did not disregard or consciously take a substantial risk.  She thought she had the correct patient.  There were no similar or serious errors by this nurse.  A reasonably prudent nurse would not have done the same in similar circumstances as the patient identification policy would have been adhered to.  According to the regulatory decision pathway, this was at-risk behavior by the nurse (Russell & Radtke, 2014).

            The catheterization team which included the physician, nurse, physician assistant, and technician contributed to this adverse event.  The team did not follow the time out process policy where everything stops, and patient identification is reconfirmed with other parameters.  Again, following the regulatory decision pathway, the catheterization team demonstrated at-risk behavior.  At-risk behavior involves unsafe practice and carelessness which is shown by the nurse and catheterization team not adhering to policy (Russell & Radtke, 2014). 

Role Conflict

 The cardiac catheterization lab is very fast-paced, and the nurses can feel the stress of the workload.  The procedure area and recovery room was very busy and crowded that day.  Role conflict could have contributed to the situation as there is constant pressure to keep moving.  Role conflict could have contributed in the time-out process not taking place in the procedure room.  Nurses have to initiate the time out process when the physician arrives, and some physicians are not very cooperative in the process.  Since the adverse event, patient identification and the time out policy are strictly adhered to.

Just Culture

 Quality improvement and work environment improvement are a part of just culture (Lockhart, 2015).  Just culture is safety issues, improving processes, and not about punishing individuals (Pepe & Cataldo, 2011).  As the group’s manager using the principles of culture, I would have done firm counseling stressing the significance of the incident, but as this was the nurse’s  first risky behavior, I would not have done a formal written warning with the threat of being fired if it happens again.   Doing a staff meeting and re-educating the policies was appropriate.  Patient identification and the time out process are now part of the cardiac catheterization lab’s monthly quality assurance surveys.  All new employees are well educated in the two policies and must sign an attestation that they understand by the end of orientation.  This adverse event led to improved processes in the cardiac catheterization lab which is the goal of just culture (Pepe & Cataldo, 2011).     

References

Lockhart, L. (2015).  Does your organization have a just culture?  Retrieved from http://www.NursingMadeIncrediblyEasy.com doi-10.1097/01.NME.0000457286.16594.92

Pepe, J., & Cataldo, P. J. (2011).  Manage risk, build a just culture.  Health Progress.  Retrieved from http://www.outcome-eng.com/wp-content/uploads/2012/01/manage-risk.pdf

Russell, K. A. & Radtke, B. K. (2014).  An evidence-based tool for regulatory decision-making: regulatory decision pathway.  Journal of Nursing Regulation, 5(2), 5-9. https://class.waldenu.edu/bbcswebdav/institution/USW1/201810_27/MS_NURS/NURS_6201/readings/USW1_NURS_6201_Russell.pdf

For the C3P Self -Awareness and Conflict Resolution assignment, you will write a Professionalism Strategies Paragraph as directed by your instructor:

In a well-developed paragraph, identify the most important characteristics of professionals in your chosen career field. Describe strategies that you could use to develop those characteristics and maintain an appropriate professional image.

Note : My career field  is Medical Coding and Billing