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Understanding Nursing Research - E-Book

Understanding Nursing Research - E-Book

Susan K. Grove | Jennifer R. Gray | Nancy Burns

(2014)

Additional Information

Book Details

Abstract

As the bestselling nursing research text, Understanding Nursing Research: Building an Evidence-Based Practice, 6th Edition offers unique insights into understanding, appraising, and applying published research to evidence-based practice. It is known for its authoritative content, time-tested systematic approach, and unique research example format — newly redesigned for the sixth edition to better demonstrate how the steps of the research process relate to evidence-based nursing.

"This would be excellent for student nurses, nurses new to research or any nurse with an interest in research." Reviewed by: Helen Reeves, St Giles Walsall Hospice on behalf of Nursing Times, December 2015

  • Authoritative content is written by two of the true pioneers in nursing research, who offer unique, first-hand insights into the field.
  • Research examples provide practice in working with published studies, with many of the examples including Critical Appraisal and Implications for Practice sections.
  • Clear, step-by-step organization introduces the research process and demonstrates how this systematic framework relates to evidence-based practice.
  • Strong emphasis on evidence-based practice helps you develop skills in studying and appraising published research, so you are prepared for your role in working with research evidence.
  • Critical Appraisal Guidelines boxes provide step-by-step guidance in appraising published research studies.
  • Emphasis on critical appraisal versus critique reflects contemporary usage in nursing research and evidence-based practice.
  • Balanced coverage of qualitative research prepares you to approach research questions and clinical questions with an unbiased view of the researcher's methodology.
  • Presentation of two different appraisal processes covers both the traditional in-depth critical appraisal process that prepares you for graduate-level work in research, and the concise, practice-focused research appraisal process that equips you for quick and accurate evaluation of the applicability of research findings to clinical practice.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Inside Front Cover ES2
Contents i
Understanding Nursing Research: Building an Evidence-Based Practice iii
Copyright iv
Contributor and Reviewers v
Dedication vii
Preface viii
Learning Resources to Accompany Understanding Nursing Research, 6th edition x
Evolve Instructor Resources x
Test Bank xi
PowerPoint Slides xi
Image Collection xi
NEW TEACH for Nurses Lesson Plans xi
Evolve Student Resources xi
Study Guide xii
Acknowledgments xiii
Chapter 1: Introduction to Nursing Research and Evidence-Based Practice 1
WHAT IS NURSING RESEARCH? 3
WHAT IS EVIDENCE-BASED PRACTICE? 3
PURPOSES OF RESEARCH FOR IMPLEMENTING AN EVIDENCE-BASED NURSING PRACTICE 6
Description 6
Explanation 7
Prediction 7
Control 8
HISTORICAL DEVELOPMENT OF RESEARCH IN NURSING 9
Florence Nightingale 11
Nursing Research: 1900s through the 1970s 11
Nursing Research: 1980s and 1990s 12
Nursing Research: in the Twenty-First Century 14
Current Actions of the National Institute of Nursing Research 14
Linking Quality and Safety Education for Nursing Competencies and Nursing Research 15
ACQUIRING KNOWLEDGE IN NURSING 15
Traditions 16
Authority 16
Borrowing 16
Trial and Error 17
Personal Experience 17
Role Modeling 17
Intuition 18
Reasoning 18
PARTICULAR INSTANCES 18
GENERAL STATEMENT 18
PREMISES 18
CONCLUSION 18
ACQUIRING KNOWLEDGE THROUGH NURSING RESEARCH 19
Introduction to Quantitative and Qualitative Research 19
Types of Quantitative and Qualitative Research 20
Introduction to Outcomes Research 21
UNDERSTANDING BEST RESEARCH EVIDENCE FOR PRACTICE 21
Strategies Used to Synthesize Research Evidence 22
Levels of Research Evidence 24
Introduction to Evidence-Based Guidelines 25
WHAT IS YOUR ROLE IN NURSING RESEARCH? 25
KEY CONCEPTS 27
REFERENCES 28
Chapter 2: Introduction to Quantitative Research 31
WHAT IS QUANTITATIVE RESEARCH? 32
Types of Quantitative Research 33
Descriptive Research 33
Correlational Research 33
Quasi-Experimental Research 34
Experimental Research 34
Defining Terms Relevant to Quantitative Research 35
Basic Research 35
Applied Research 35
Rigor in Quantitative Research 36
Control in Quantitative Research 36
Extraneous Variables 37
Sampling 37
Research Settings 38
Study Interventions 38
PROBLEM-SOLVING AND NURSING PROCESSES: BASIS FOR UNDERSTANDING THE QUANTITATIVE RESEARCH PROCESS 38
Comparing Problem Solving with the Nursing Process 38
Comparing the Nursing Process with the Research Process 39
IDENTIFYING THE STEPS OF THE QUANTITATIVE RESEARCH PROCESS 40
Research Problem and Purpose 41
Review of Relevant Literature 41
Study Framework 42
Research Objectives, Questions, or Hypotheses 43
Study Variables 44
Study Design 45
Population and Sample 46
Measurement Methods 46
Data Collection 47
Data Analysis 47
Discussion of Research Outcomes 48
READING RESEARCH REPORTS 49
Sources of Research Reports 50
Content of Research Reports 51
Abstract Section 51
Introduction Section 52
Methods Section 53
Results Section 53
Discussion Section 54
References Section 54
Tips for Reading Research Reports 54
PRACTICE READING QUASI-EXPERIMENTAL AND EXPERIMENTAL STUDIES 55
Quasi-Experimental Study 56
Experimental Study 60
KEY CONCEPTS 63
REFERENCES 64
Chapter 3: Introduction to Qualitative Research 66
VALUES OF QUALITATIVE RESEARCHERS 67
RIGOR IN QUALITATIVE RESEARCH 68
QUALITATIVE RESEARCH APPROACHES 68
Phenomenological Research 69
Philosophical Orientation 69
Phenomenology's Outcome 70
Grounded Theory Research 70
Intended Outcome 71
Ethnographic Research 74
Intended Outcome 75
Exploratory-Descriptive Qualitative Research 76
Philosophical Orientation 77
Intended Outcome 77
Historical Research 78
Philosophical Orientation 78
Intended Outcome 79
QUALITATIVE RESEARCH METHODOLOGIES 81
Selection of Participants 82
Researcher-Participant Relationships 82
DATA COLLECTION METHODS 82
Interviews 83
Focus Groups 85
Observation 86
Text as a Source of Qualitative Data 87
DATA MANAGEMENT 88
Organizing Data Files 88
Transcribing Interviews 88
DATA ANALYSIS 88
Codes and Coding 89
Themes and Interpretation 89
KEY CONCEPTS 90
REFERENCES 91
Chapter 4: Examining Ethics in Nursing Research 93
HISTORICAL EVENTS INFLUENCING THE DEVELOPMENT OF ETHICAL CODES AND REGULATIONS 95
Nazi Medical Experiments 95
Nuremberg Code 95
Declaration of Helsinki 96
Tuskegee Syphilis Study 97
Willowbrook Study 97
Jewish Chronic Disease Hospital Study 97
Department of Health, Education, and Welfare, 1973: Regulations for the Protection of Human Research Subjects 98
National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research 98
Current Federal Regulations for the Protection of Human Subjects 99
PROTECTING HUMAN RIGHTS 100
Right to Self-Determination 101
Violation of the Right to Self-Determination 101
Persons with Diminished Autonomy 101
Study participants with legal and mental diminished autonomy 101
Neonates 102
Children 102
Pregnant women and fetuses 104
Persons with mental illness or cognitive impairment 104
Terminally ill subjects 104
Persons confined to institutions 104
Right to Privacy 105
De-Identifying Protected Health Information under the Privacy Rule 106
Limited Data Set and Data Use Agreement 106
Right to Anonymity and Confidentiality 106
Right to Fair Selection and Treatment 107
Fair Selection and Treatment of Subjects 107
Right to Protection from Discomfort and Harm 108
No Anticipated Effects 108
Temporary Discomfort 108
Unusual Levels of Temporary Discomfort 109
Risk of Permanent Damage 109
Certainty of Permanent Damage 109
Critical Appraisal Guidelines to Examine Protection of Human Rights in Studies 109
UNDERSTANDING INFORMED CONSENT 111
Essential Information for Consent 111
Comprehension of Consent Information 112
Competence to Give Consent 112
Voluntary Consent 113
Documentation of Informed Consent 113
Written Signed Consent Waived 114
Written Short Form Consent Documents 114
Formal Written Consent Document 114
Health Insurance Portability and Accountability Act Privacy Rule: Authorization for Research Uses and Disclosure 115
Critical Appraisal Guidelines to Examine Informed Consent in Studies 115
UNDERSTANDING INSTITUTIONAL REVIEW 117
Levels of Reviews Conducted by Institutional Review Boards 117
Influence of Health Insurance Portability and Accountability Act Privacy Rule on Institutional Review Boards 118
EXAMINING THE BENEFIT-RISK RATIO OF A STUDY 119
Critical Appraisal Guidelines for Examining the Ethical Aspects of Studies 120
UNDERSTANDING RESEARCH MISCONDUCT 122
Role of the Office of Research Integrity in Promoting the Conduct of Ethical Research 122
EXAMINING THE USE OF ANIMALS IN RESEARCH 123
KEY CONCEPTS 125
REFERENCES 125
Chapter 5: Research Problems, Purposes, and Hypotheses 129
What Are Research Problems and Purposes? 131
IDENTIFYING THE PROBLEM AND PURPOSE IN QUANTITATIVE, QUALITATIVE, AND OUTCOMES STUDIES 133
Problems and Purposes in Types of Quantitative Studies 133
Problems and Purposes in Types of Qualitative Studies 136
Problems and Purposes in Outcomes Research 140
DETERMINING THE SIGNIFICANCE OF A STUDY PROBLEM AND PURPOSE 140
Influences Nursing Practice 140
Builds on Previous Research 141
Promotes Theory Testing or Development 142
Addresses Nursing Research Priorities 142
EXAMINING THE FEASIBILITY OF A PROBLEM AND PURPOSE 143
Researcher Expertise 144
Money Commitment 144
Availability of Subjects, Facilities, and Equipment 144
Ethical Considerations 145
EXAMINING RESEARCH OBJECTIVES, QUESTIONS, AND HYPOTHESES IN RESEARCH REPORTS 145
Research Objectives or Aims 145
Research Questions 147
Hypotheses 149
Types of Hypotheses 149
Associative versus causal hypotheses 149
Simple versus complex hypotheses 150
Nondirectional versus directional hypotheses 150
Statistical versus research hypotheses 151
Testable Hypothesis 152
UNDERSTANDING STUDY VARIABLES AND RESEARCH CONCEPTS 153
Types of Variables in Quantitative Research 153
Independent and Dependent Variables 153
Research Variables 154
Extraneous Variables 154
Conceptual and Operational Definitions of Variables in Quantitative Research 155
Research Concepts Investigated in Qualitative Research 156
Demographic Variables 157
KEY CONCEPTS 158
REFERENCES 158
Chapter 6: Understanding and Critically Appraising the Literature Review 162
PURPOSE OF THE LITERATURE REVIEW 163
Purpose of the Literature Review in Quantitative Research 163
Purpose of the Literature Review in Qualitative Research 164
SOURCES INCLUDED IN A LITERATURE REVIEW 165
Types of Publications 166
Content of Publications 166
Quality of Sources 167
CRITICALLY APPRAISING LITERATURE REVIEWS 168
Critical Appraisal of a Literature Review in a Quantitative Study 168
Critical Appraisal of a Literature Review in a Qualitative Study 172
REVIEWING THE LITERATURE 176
Preparing to Review the Literature 176
Clarify the purpose of the literature review 176
Select electronic databases and search terms 177
Conducting the Literature Review 178
Search the selected databases 178
Use a table or other method to document the results of your search 178
Refine your Search 178
Review the abstracts to identify relevant studies 179
Obtain full-text copies of relevant articles 179
Ensure that information needed to cite the source is recorded 180
Processing the Literature 180
Read the articles 180
Appraise, analyze, and synthesize the literature 180
Writing the Review of the Literature 183
Develop an outline to organize the information from the review 183
Write each section of the review 184
Create the reference list 184
Check the review and the reference list 185
KEY CONCEPTS 186
REFERENCES 186
Chapter 7: Understanding Theory and Research Frameworks 189
WHAT IS A THEORY? 190
UNDERSTANDING THE ELEMENTS OF THEORY 191
Concepts 191
Relational Statements 193
LEVELS OF THEORETICAL THINKING 194
Grand Nursing Theories 194
Middle Range and Practice Theories 195
Study Frameworks 198
EXAMPLES OF CRITICAL APPRAISAL 199
Framework from a Grand Nursing Theory 199
Framework Based on Middle Range Theory 202
Framework from a Tentative Theory 204
Framework for Physiological Study 205
KEY CONCEPTS 207
REFERENCES 207
Chapter 8: Clarifying Quantitative Research Designs 210
IDENTIFYING DESIGNS USED IN NURSING STUDIES 212
DESCRIPTIVE DESIGNS 212
Typical Descriptive Design 214
Comparative Descriptive Design 216
CORRELATIONAL DESIGNS 217
Descriptive Correlational Design 218
Predictive Correlational Design 220
Model Testing Design 221
UNDERSTANDING CONCEPTS IMPORTANT TO CAUSALITY IN DESIGNS 222
Multicausality 223
Probability 223
Bias 223
Control 224
Manipulation 224
EXAMINING THE VALIDITY OF STUDIES 224
Statistical Conclusion Validity 224
Low Statistical Power 226
Reliability or Precision of Measurement Methods 226
Reliability of Intervention Implementation 226
Extraneous Variances in the Study Setting 226
Internal Validity 226
Subject Selection and Assignment to Groups 227
Subject Attrition 227
History 227
Maturation 227
Construct Validity 227
Inadequate Definitions of Constructs 228
Mono-operation Bias 228
Experimenter Expectancies (Rosenthal Effect) 228
External Validity 228
Interaction of Selection and Treatment 229
Interaction of Setting and Treatment 229
Interaction of History and Treatment 229
ELEMENTS OF DESIGNS EXAMINING CAUSALITY 229
Examining Interventions in Nursing Studies 230
Experimental and Control or Comparison Groups 230
QUASI-EXPERIMENTAL DESIGNS 232
Pretest and Post-test Designs with Comparison Group 233
EXPERIMENTAL DESIGNS 237
Classic Experimental Pretest and Post-test Designs with Experimental and Control Groups 237
Post-test-Only with Control Group Design 239
RANDOMIZED CONTROLLED TRIALS 241
INTRODUCTION TO MIXED-METHODS APPROACHES 243
KEY CONCEPTS 245
REFERENCES 246
Chapter 9: Examining Populations and Samples in Research 248
UNDERSTANDING SAMPLING CONCEPTS 249
Populations and Elements 250
Sampling or Eligibility Criteria 251
REPRESENTATIVENESS OF A SAMPLE IN QUANTITATIVE AND OUTCOMES RESEARCH 252
Random and Systematic Variation of Subjects Values 252
Acceptance and Refusal Rates in Studies 253
Sample Attrition and Retention Rates in Studies 253
Sampling Frames 254
Sampling Methods or Plans 255
PROBABILITY SAMPLING METHODS 257
Simple Random Sampling 259
Stratified Random Sampling 260
Cluster Sampling 261
Systematic Sampling 262
NONPROBABILITY SAMPLING METHODS COMMONLY USED IN QUANTITATIVE RESEARCH 263
Convenience Sampling 264
Quota Sampling 265
SAMPLE SIZE IN QUANTITATIVE STUDIES 266
Effect Size 267
Types of Quantitative Studies 267
Number of Variables 267
Measurement Sensitivity 268
Data Analysis Techniques 268
SAMPLING IN QUALITATIVE RESEARCH 270
Purposeful or Purposive Sampling 270
Network Sampling 271
Theoretical Sampling 273
SAMPLE SIZE IN QUALITATIVE STUDIES 274
Scope of the Study 274
Nature of the Topic 274
Quality of the Information 275
Study Design 275
RESEARCH SETTINGS 276
Natural Setting 277
Partially Controlled Setting 277
Highly Controlled Setting 278
KEY CONCEPTS 278
REFERENCES 279
Chapter 10: Clarifying Measurement and Data Collection in Quantitative Research 281
CONCEPTS OF MEASUREMENT THEORY 283
Directness of Measurement 283
Levels of Measurement 284
Nominal-Level Measurement 284
Ordinal-Level Measurement 284
Interval-Level Measurement 285
Ratio-Level Measurement 286
Measurement Error 286
Reliability 287
Reliability Testing 288
Validity 290
ACCURACY, PRECISION, AND ERROR OF PHYSIOLOGICAL MEASURES 292
Accuracy 292
Precision 292
Error 293
USE OF SENSITIVITY, SPECIFICITY, AND LIKELIHOOD RATIOS TO DETERMINE THE QUALITY OF DIAGNOSTIC AND SCREENING TESTS 295
Sensitivity and Specificity 295
Likelihood Ratios 298
MEASUREMENT STRATEGIES IN NURSING 298
Physiological Measures 298
Observational Measurement 300
Interviews 302
Questionnaires 304
Scales 306
Rating Scales 307
Likert Scale 307
Visual Analog Scales 308
DATA COLLECTION PROCESS 310
Recruitment of Study Participants 310
Consistency in Data Collection 310
Control in the Study Design 311
Studies Obtaining Data from Existing Databases 311
KEY CONCEPTS 313
REFERENCES 314
Chapter 11: Understanding Statistics in Research 317
UNDERSTANDING THE ELEMENTS OF THE STATISTICAL ANALYSIS PROCESS 319
Management of Missing Data 320
Description of the Sample 320
Reliability of Measurement Methods 323
Exploratory Analyses 323
Inferential Statistical Analyses 323
``Data Analysis 324
UNDERSTANDING THEORIES AND CONCEPTS OF THE STATISTICAL ANALYSIS PROCESS 324
Probability Theory 324
Decision Theory, Hypothesis Testing, and Level of Significance 325
Inference and Generalization 326
Normal Curve 326
Tailedness 327
Type I and Type II Errors 328
Power: Controlling the Risk of a Type II Error 329
Degrees of Freedom 329
USING STATISTICS TO DESCRIBE 330
Frequency Distributions 330
Ungrouped Frequency Distributions 330
Grouped Frequency Distributions 330
Percentage Distributions 331
Measures of Central Tendency 331
Mode 331
Median 333
Mean 333
Measures of Dispersion 333
Range 333
Variance 334
Standard Deviation 334
Confidence Interval 334
Standardized Scores 335
Scatterplots 335
Understanding Descriptive Statistical Results 336
DETERMINING THE APPROPRIATENESS OF INFERENTIAL STATISTICS IN STUDIES 337
Critical Appraisal Guidelines for Inferential Statistical Analyses 338
USING STATISTICS TO EXAMINE RELATIONSHIPS 340
Pearson Product-Moment Correlation 340
Interpreting Pearson Correlation Analysis Results 341
Testing the Significance of a Correlation Coefficient 342
Factor Analysis 343
USING STATISTICS TO PREDICT OUTCOMES 344
Regression Analysis 344
Interpreting Results 345
USING STATISTICS TO EXAMINE DIFFERENCES 347
Chi-Square Test of Independence 347
Interpreting Results 347
t-Test 349
Interpreting Results 349
Analysis of Variance (ANOVA) 351
Interpreting Results 351
Analysis of Covariance (ANCOVA) 353
INTERPRETING RESEARCH OUTCOMES 353
Types of Results 353
Significant and Predicted Results 353
Nonsignificant Results 353
Significant and Unpredicted Results 354
Mixed Results 354
Unexpected Results 354
Findings 354
Exploring the Significance of Findings 354
Clinical Importance of Findings 355
Limitations 355
Conclusions 355
Generalizing the Findings 356
Implications for Nursing 356
Recommendations for Further Studies 356
KEY CONCEPTS 358
REFERENCES 359
Chapter 12: Critical Appraisal of Quantitative and Qualitative Research for Nursing Practice 361
WHEN ARE CRITICAL APPRAISALS OF STUDIES IMPLEMENTED IN NURSING? 362
Students' Critical Appraisal of Studies 363
Critical Appraisal of Studies by Practicing Nurses, Nurse Educators, and Researchers 363
Critical Appraisal of Research Following Presentation and Publication 364
Critical Appraisal of Research for Presentation and Publication 364
Critical Appraisal of Research Proposals 364
WHAT ARE THE KEY PRINCIPLES FOR CONDUCTING INTELLECTUAL CRITICAL APPRAISALS OF QUANTITATIVE AND QUALITATIVE STUDIES? 365
UNDERSTANDING THE QUANTITATIVE RESEARCH CRITICAL APPRAISAL PROCESS 366
Step 1: Identifying the Steps of the Research Process in Studies 366
Guidelines for Identifying the Steps of the Research Process in Studies 366
Step 2: Determining the Strengths and Weaknesses in Studies 370
Guidelines for Determining the Strengths and Weaknesses in Studies 371
Step 3: Evaluating the Credibility and Meaning of Study Findings 374
Guidelines for Evaluating the Credibility and Meaning of Study Findings 375
EXAMPLE OF A CRITICAL APPRAISAL OF A QUANTITATIVE STUDY 375
UNDERSTANDING THE QUALITATIVE RESEARCH CRITICAL APPRAISAL PROCESS 389
Step 1: Identifying the Components of the Qualitative Research Process in Studies 389
Guidelines for Identifying the Components of the Research Process in Qualitative Studies 389
Guidelines for Identifying the Components of a Qualitative Study 390
Step 2: Determining the Strengths and Weaknesses in Studies 391
Guidelines for Determining the Strengths and Weaknesses in Studies 392
Step 3: Evaluating the Trustworthiness and Meaning of Study Findings 394
Guidelines for Evaluating the Trustworthiness and Meaning of Study Findings 394
EXAMPLE OF A CRITICAL APPRAISAL OF A QUALITATIVE STUDY 394
KEY CONCEPTS 410
REFERENCES 411
Chapter 13: Building an Evidence-Based Nursing Practice 414
BENEFITS AND BARRIERS RELATED TO EVIDENCE-BASED NURSING PRACTICE 416
Benefits of Evidence-Based Nursing Practice 416
Force 6: Quality Care 417
``Research and Evidence-Based Practice 417
Barriers to Evidence-Based Nursing Practice 418
SEARCHING FOR EVIDENCE-BASED SOURCES 419
CRITICALLY APPRAISING RESEARCH SYNTHESES 421
Critically Appraising Systematic Reviews 421
Step 1 423
Did the title indicate if a systematic review or meta-analysis was conducted? 423
Step 2 423
Did the abstract include a structured summary of the research synthesis? 423
Step 3 423
Was a significant, clear clinical question developed to direct the research synthesis? 423
Step 4 424
Were the purpose and objectives or aims of the review expressed? 424
Step 5 424
Was the literature search criteria clearly identified? 424
Step 6 425
Was a comprehensive, systematic search of the research literature conducted? 425
Step 7 425
Was publication bias addressed? 425
Step 8 425
Was the process for selecting the studies for review detailed? 425
Step 9 428
Were key elements of the studies presented? 428
Step 10 428
Were the studies critically appraised? 428
Step 11 428
Was a meta-analysis conducted as part of the systematic review? 428
Step 12 428
Were the results of the review clearly presented? 428
Step 13 429
Did the report conclude with a clear discussion section? 429
Implications for practice 430
Step 14 430
Was a clear concise report developed for publication? 430
Critically Appraising Meta-Analyses 430
Clinical Question for a Meta-Analysis 432
Purpose and Questions to Direct a Meta-Analysis 432
Search Criteria and Strategies for Meta-Analyses 432
Primary Study Search Strategies 433
Possible Biases for Meta-Analyses and Systematic Reviews 433
Results of Meta-Analysis for Continuous Outcomes 435
Results of Meta-Analysis for Dichotomous Outcomes 435
Critically Appraising Meta-Syntheses 436
Framing for the Meta-Synthesis 438
Searching the Literature and Selecting Sources 439
Appraisal of Studies and Analysis of Data 439
Discussion of Meta-Synthesis Findings 440
Critically Appraising Mixed-Methods Systematic Reviews 440
DEVELOPING CLINICAL QUESTIONS TO IDENTIFY EXISTING RESEARCH-BASED EVIDENCE FOR USE IN PRACTICE 443
MODELS TO PROMOTE EVIDENCE-BASED PRACTICE IN NURSING 447
Stetler Model of Research Utilization to Facilitate Evidence-Based Practice 447
Phase I: Preparation 448
Phase II: Validation 448
Phase III: Comparative Evaluation/Decision Making 448
Phase IV: Translation/Application 449
Phase V: Evaluation 449
Iowa Model of Evidence-Based Practice 450
Application of the Iowa Model of Evidence-Based Practice 450
IMPLEMENTING EVIDENCE-BASED GUIDELINES IN PRACTICE 453
History of the Development of Evidence-Based Guidelines 454
National Guideline Clearinghouse Resources 454
Implementing Evidence-Based Guidelines for Management of Hypertension in Practice 456
INTRODUCTION TO EVIDENCE-BASED PRACTICE CENTERS 460
INTRODUCTION TO TRANSLATIONAL RESEARCH 461
KEY CONCEPTS 461
REFERENCES 463
Chapter 14: Outcomes Research 466
THEORETICAL BASIS OF OUTCOMES RESEARCH 468
NURSING-SENSITIVE OUTCOMES 469
ORIGINS OF OUTCOMES AND PERFORMANCE MONITORING 472
FEDERAL GOVERNMENT INVOLVEMENT IN OUTCOMES RESEARCH 473
Agency for Healthcare Research and Quality (AHRQ) 473
American Recovery and Reinvestment Act 473
National Quality Forum 474
National Database of Nursing Quality Indicators 474
Oncology Nursing Society 476
ADVANCED PRACTICE NURSING OUTCOMES RESEARCH 476
OUTCOMES RESEARCH AND NURSING PRACTICE 477
Evaluating Outcomes of Care 477
Evaluating Structure of Care 478
Evaluating Process of Care 480
Standards of Care 480
Practice Styles, Practice Pattern, and Evidence-Based Practice 481
METHODOLOGIES FOR OUTCOMES STUDIES 481
Samples and Sampling 481
Large Databases as Sample Sources 483
Study Designs 483
Prospective Cohort Studies 484
Retrospective Cohort Studies 485
Population-Based Studies 487
Economic Studies 488
Ethical Studies 488
Measurement Methods 488
STATISTICAL METHODS FOR OUTCOMES STUDIES 491
Analysis of Change 491
Analysis of Improvement 491
CRITICAL APPRAISAL OF OUTCOMES STUDIES 492
Questions Guiding the Critical Appraisal of Outcomes Studies 492
Are the results valid? 492
What are the results? 493
In a study of an outcome such as health-related quality of life (HRQL): 493
How can I apply the results to patient care? 493
Example Critical Appraisal of an Outcomes Study 493
KEY CONCEPTS 494
REFERENCES 495
Glossary 500
Index 515
Inside Back Cover ES3