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Nursingnotes.info nursing-research-review
Nursingnotes.info nursing-research-review
Nursingnotes.info nursing-research-review
Nursingnotes.info nursing-research-review
Nursingnotes.info nursing-research-review
Nursingnotes.info nursing-research-review
Nursingnotes.info nursing-research-review
Nursingnotes.info nursing-research-review
Nursingnotes.info nursing-research-review
Nursingnotes.info nursing-research-review
Nursingnotes.info nursing-research-review
Nursingnotes.info nursing-research-review
Nursingnotes.info nursing-research-review
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Nursingnotes.info nursing-research-review

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  • helpful website that help others. This website has practice exams for various nursing classes as well as videos, presentations, notes, nclex help, and many other tools . Hope they help


    http://www.rnpedia.com/
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  • 1. Visit http://www.nursingnotes.info/ for more RESEARCH – (Kerlinger) systematic, empirical, controlled & critical investigation of a hypothetical proposition related to natural phenomenon. PHENOMENON – anything that affects human life - disease, signs & symptoms, procedures, MD, RNs HYPOTHESIS – educated guess, scientific guess, tentative statement of a supposed answer. - not known yet if true of false, right or wrong RESEARCH - must be conducted to affirm or deny a hypothesis. 4 major Characteristics of a Scientific Research 1. Systematic – follow step by step process. Fr identification of problem to conclusion. 2. Empirical – proper objective. To collect data, facts & evidence to support hypothesis. 3. Controlled – proper planning/ direction. Research design. 4. Critical investigation – fact finding investigation. (synonym) PURPOSE OF ASIENTIFIC NURSING RESEARCH D – descriptive purpose. Gain richer familiarity regarding a phenomena. Observation. 100% known to RN. E – exploratory purpose. 50% still unknown to RN. E – experimental purpose. Perform manipulation. Perform intervention. What to find out cause & effect. D – developmental purposes. Fro improvement of system of care. F Nightingale – birthplace. Italy Training ground: Germany Greatest contribution: environmental theory & training of RNs in Crimean War School: St. Thomas School of Nursing Patient –nursing focus on research 10 MAJOR STEPS 1. Identification or formulation of research problem 2. Review of related literature 3. conceptualization of conceptual/ theoretical framework 4. Formulation/ Adapting hypothesis 5. Choosing the appropriate design 6. Choosing sample from pop 7. Conducting final study or pilot study 8. Collection of data base 9. Analysis & interpretation of data base 10. Disseminating the conclusion & recommendation. Problem: in res – requires a solution Sources (CLIENT) of good problem C – concepts L – literatures I – issues E – essays N – nursing problems T – theories Char of good problem (GRIFINS) G – general applicability – result should be helpful or applicable to all. a.) basic/ Pre – for personal knowledge b.) Applied – focus is solving problems of others Re – researchable – collectable & abundant data F – feasible or measurable
  • 2. a.) time b.) money/ cost c.) participants d.) instruments e.) experience f.) proper ethics of good researcher I – important N – novelty – original to avoid plagiarism. S – significant ETHICS OF A PROPER RESEARCHER: (SCIENTIFIC) S – scientific objective always (good faith) C – consent I – integrity E – equitable (appropriate acknowledgments) liable for N – noble – Respect 3 basic rights of research sample T – truthfulness I – importance of topic to nursing profession C – courage to look for data. Legal owner of chart: Hospital Legal owner of data in the chart: Patient Plagiarism – illegal replication: no consent & acknowledge 3 rights of sample/ pt 1.) Right not to be harmed 2.) Right to self determination – get consent & right to withdraw consent 3.) Right to privacy a.) anonymity – privacy of identity of informant b.) confidentiality – name given but privacy of info/ data Harm that can happen to sample/pt 1.) right from physical , mental & moral harm 2.) Right to self determination Negligence 1.) Commission – unacceptable in standard of practice 2.) Owrission – didn’t do anything. No intervention done. Mental Harm: 1.) Assault – threatened. Mental fear 2.) Assault & Battery – with mental fear & physical harm 3.) Battery – with physical harm. Moral harm – Slander – Oral defamation – Libel Restraint – dependent with doctors order - physical – vest or jacket - chemical – valium A study in the difference in the financial income of Filipinos working in NYC & QC (comparative & basic) Variables – anything that is subject t change on manipulation. 1.) Independent variable – target population IV – stimulus intervention 2.) Dependent variable – response DV – response measured Independent variable Target Population Dependent Variable (stimulus) (Organism) (Response)
  • 3. Place of work Filipino RNs Financial income early review Jan Reviewers Pavolovian Theory (SOR) Stimulus Organism Response Intervening variables comes between independent & dependent ex. Organismic variable internal factors age, sex, gender, color. Extraneous variable – ext influences can be changed Allure, citizenship, educational status Dichotomus variable – 2 choices/ results Ex. Male or Female Polychotmus – multiple choices/ multi variables Preferred food – Japanese, Chinese, Filipino, American Research 1.) Identity Problem 2.) Purpose – objective (SMART) 3.) Define terms 4.) Revision of terms S – smart M – measurable A – attainable R – realistic T – time bound (limit) Conceptual definition – dictionary meaning Operational definition – based on use of research char of problem Toxic – conceptual – waste products Operational – very busy day for RNs Review of related literature Purpose: for proper formulation of conceptual & theoretical framework. Theory – relationship bet concepts Conceptual framework. Illustration showing relationship between variables Paradigm- diagrammatic presentation / illustration of conceptual framework. Source of review literature 1. Conceptual Sources – authors & conceptualists ( DOH book, Lippincott, Mosbys) - for general use, can be sold. 2. Research sources – researchers cant be sold. Types of Hypothesis: 1. NULL hypothesis (-) no relationship, no difference bet 1 variable to another ex. There’s no diff regarding prof Opportunities in US & RP 2. Alterative, simple or operational hypothesis – (+) show a relationship bet 1 variable to another ex. Filipino RNs has more prof opportunities un US 3. complex hypothesis – shows a relationship bet 2 or more variables to another. Ex. Filipino RNs who worked for 5 yrs & passing all CG tests have opportunities to acquire starting salaries, insurance. 4. Directional Hypothesis – specifies the direction of relationship bet variables
  • 4. Ex. Filipino RNs working in USA have more prof opportunities than those in Phil 5. Non directional Hypothesis – no specific direction There is a big difference between all Filipino RNs working in the USA 5 Choosing appropriate design: - skeletal framework of research Research Design: According to application or motive According to approach According to data Method used applicable to quantitative research: survey Case study – focus 1 patient only or 1 family Research Design Application motive Approach Data Basic / pure Applied Quantitative Qualitative (majority answer) facts (single pt) Survey Case study Non experimental 1.) Observe sample subject, Research has 2.) Massive participation 3.) Describe & record 4.) Natural setting – where pop exists Experimental: 1.) Active manipulation – treatment or intervention done 2.) Active participation to sample pop 3.) Controlled setting – lab research units Types of non experimental res design. 1. Historical research design – happened in the past - collect written, published, circulated or archived - pt’s chart ex. Health practices during Crimean War 2. Expost Facto (after facts) (Retrospective) - Antecedent facts happened Study a group of people who have naturally experienced a particular phenomena related to a problem & has something to do with present study - Interview only, no manipulation! Subject is related to present problem. 3. Prospective – focus; future time to look for a data existing subject with future happening Focus: weekend review in pentagon Result: of board exam this coming June Present future 4. Descriptive – no intervention but merely observe & collect data. Ex. Study on absentism in St Lukes Study on environmental pollution in Quezon Types: a.) comparative study – similarity & difference of variables ex. Environmental pollution between variables
  • 5. b.) Correlatonal – relationship between variables ex. Environmental pollution & increased TB cases c.) Evaluative – effects/ results ex. Effects of environmental pollution d.) Survey type – data collection based on majority result Types or survey research 1.) groups – small group 2.) Face to face method - can get response/ feed back right away b.) Mailed survey method Problem; data collection 3.) Time orientation Cross sectional & longitudinal – extend period of time. 2 or more # of groups – 1 core group/ long term study unidentical groups - purpose: dev’t/ study - purpose: comparison - initial & fallow up survey - short term study # of time Steps in experimental type of research design 1. controlled stage – discipline/ direction a controlled group – will not be subjective experimental – group will be manipulated 2. Randominization – choose your sample by chance 3. Manipulation - intervention 4. Measurements of effect – determine the result Quasi experimental- when you lack in steps in experimental Pop – group where you get your sample Types of sampling 1.) Probability – choose sample by chance Types of probability Incidental sampling – these present in coffee shop a.) Simple random sampling – equal chance/ opportunity to be chosen - done if identical or equal footing b.) Stratified random sampling – create subdivided population (divide into 4 levels in school) or substrata before doing randominization c.) Cluster random sampling – create sub areas MNL hospitals – UST – 3rd floor d.) Systematic random sampling – sampling frame 3,000 HIV patients in Phil – write list of names appearing in pop uses multiple number in choosing. 2. Non probability sampling – not by chance - with pre-selected group, with braised group, favoritism a.) Accidental or convenience sampling. Criteria – immediate availability/ accessibility of sample. b.) Purposive/ judgmental sampling. - based on personal knowledge/ info ex. Research on prostitution I know location of prostitution – Ermita Prostitution also in Pasay & Makati I will not choose Pasay & Makati only Ermita because I have personal info c.) Snowball sampling – based on last referral d.) Quota sampling – setting a certain criteria, with favoritism will choose only who he likes. Collection of Data Base: - time & budget consuming – 70 –80% time Methods of collection of data
  • 6. 1.) Questionnaire – source of collection f data - pen & paper type of data 3 Major type of Q a.) Dichotomasis – (2) – answerable by T/F, Y/N, right or wrong b.) Checklist style – rating scale 1,2,3,4,5 poor, fair, average. . . c.) Multiple choice – a) man b) dog c) cat d) all of the above 2.) Records – easiest – get pre existing data – journals, essays, documents, newspapers 3.) Interviewer – use oral communication 1.) Structured – with checklist formal 2.) Non structured – anything goes answer open ended questions. The sample will expand on topic researcher will illicit answers their ACTIVE LISTENING. 4.) observation – ocular approach a.) Participant – journey b.) Non-participant – passive observer but uses tools to determine results of data. 2 main problems in colleting data 1. Hawthorne’s effect – problem in experimental design inaccurate due to consciously being observed (PAASCU accreditation – management keeps school clean before PAASCUA comes to school. 2. Halo Effect – special relationship inaccurate due bias - solution of researcher to avoid halo effect do double blind res method Double blind research – no bias or prejudice on treatment blind folded - gives accuracy due not conscious & biased Analysis & Later pultation of data phase - research is forming a body of knowledge for the purpose providing an answer 2 Methods in presenting your analysis 1.) Qxuantitative – using numerical or graphical presentation of answer ex. 50% of q 500 Filipinos becomes 75% richer - or use pie chart, bar graph, line graph 2.) Quantitive – narrative approach using words (text) & facts ex. Majority of all graduating students prefer to nursing course than PT LEADERSHIP Dissemination of Finding/ Core/ Recommendations Importance of core – conc is final result of study How can conc affect others – recommendation Methods of dissemination of Findings/ Result a.) Book b.) Symposia – oral c.) Publication LEADER will influence LEADERSHIP S P T R 1 Y O L 4 C 2 E group E Called S Followers S 5 goal/ objective– patient – recipient of care
  • 7. RNs implementor, assistant to dentist, Not leader Principles for effective leadership 1. Unity of command – all will receive orders, command from nurse manager/ supervisor 2. Unity of direction – whole group leader &newborns will have goal – towards patient. 3. Subordination of personnel to the general interest - save patient 1st before self (ex fire in pt room) R – remove/ rescue patients A – alert fire alarm C – confine fire in / area E – extinguish fire R – run 4. Esprit de corps – team spirit fault of one is fault of all credit of 1 is credit of all 5. Chain of command - hierarchy Patient reacted to meds given, allergy. Inform MD he will give anti-histamine. Incident report – for purpose of risk management - Report of sudden occurrence - Go to Head nurse Pt has appendicitis. Pain in RLQ who is primarily responsible for patient – Head nurse. HN can delegate to staff nurse pt died. Head Nurse is liable Command responsibility – Respondia Superior Theories of effective leader. 1. Great man theory – to be a good leader, leader must be born. Leaders cant be developed. Some are born a follower. 2. Trait theory – behavior/ characteristic P – personality I – intelligence A – ability Personality – + attitude/ trait/ knows to adjust to pt – adaptability a.) acceptability – can cope, adjust to needs of pt b.) independent c.) creative/ assertive d.) advocate Char of nurse if you are defender of patient against harm/ negligence – advocate Intelligence – proper judgment Proper decision Fluency of speech Ability – influence others – most effective way to influence pt – HI optimum level of is attain OLF Command of others Respect others Participate Cooperate 3. Charismatic theory – charm, charisma, inspirational quality 4. situational theory – a person can be a good leader in 1 situation & a follower in another situation. Case to case Adv – can get best person to the job Disadvantage – there’s no continuity of leadership
  • 8. Styles of leadership: 1. Autocratic – authoritarian, dictatorial, bureaucratic traditional or “Hard leader” - Unilateral style of nursing - Leader is only 1 performing without input from other staff. - Not getting opinion, recommendations Char – unilateral from style of staff leadership – leader does decision making without. A – apathy – not sensitive B – boisterous speech C – consistent Demanding – E – egoistic F – ferocious Putting self in shoes of pet recognize & sensitive to pt. – empathy Not good style in leadership but good in emergency cases. Or during acute crisis. 2. Laizzes Faire/ Frierein/ Loose - excess freedom / or liberates to members - authority neglect patients will suffer control malpractice discipline 3. Democratic / Participative - gets input from members (decision making) - Mutual participation - Members makes mistake – member will get notice/ hearing before discipline = due process Quality/ Skills/ Abilities of good nursing leader: A – authority B – behavior C – Communication skills D – decision making E – ethics F – face conflict A – ability – basis of a leader to unsure / demand task, obligation & resp to his subordinates. 2 types 1. Centralized – top to bottom for proper management of whole hospital - to problems of whole institution 2. Declaralized – bottom (delegation) - to manage directly pts or concerns B. Behavior of good nurse leader: S – specific body of knowledge & skills to do safe care to patient. RN should be competent with scientific rationale P – patient cettered/ client focus A – accountability – liable for result of actions C – confidentiality E – ethics General rule: RN: can be charged with : Invasion of privacy, breach of confidentiality Exemption to gen rule (RN cant be charged with breach of confidentiality ) P – patients consent I – inform/ report to other members of HC team for precautionary measure C – common dse (report) – DOH/ WHO C – crimes – within 48h – report child abuse RA 3573 – Law on notifiable disease
  • 9. Within 24h report disease like – polio & measles 1 week – HIV/ tetanus/ severs acute diarrhea Priority for child – rape – sexual abuse, domestic abuse, all kinds of abuse a.) report to barangay official b.) report to police c.) provide safe environment – focus on pt 1st – reporting can be done within 48h d.) call med legal Rule!! (in order) 1. S – safety 2. R – report 3. R – referral – DSWD, NGO C – communication skills - transfer of ideas / info with understanding Without understanding barrier/ backlog Sender – message – (idea/ info which sender would like to transmit Encoding – verbal or non verbal method Receiver – recipient of communication Decoding – manner of interpretation after receiving messages Feedback – response of receiving after interpreting messages D –decision making E – ethics Principle: 1. Autonomy – independent judgment & decision making who should decide for care of patient. a.) doc b.) attending pt c.) pt d.) relatives Pt refuses to remove lucky bracelet before surgery Bt due- Jehovah’s witness a.) respect decision of pt – respect cultural diversity b.) refer to doc – let doc explain risks involve c.) let pt sign a waver Doctrine of assumption or risk - pt given risks & signed waver - pt will assume all the risks/ danger Pills IUD - string should be checked during & after mens Diaphragm – removed after 6h Toxic shock syndrome Vasectomy – after 2 negative sperm count, 1st is probable 2nd is confirmatory BTL – can do coitus anytime. When pain & bleeding ceases. Principles in leadership Veracity – truth don’t give false reassurance - all med prognosis, dx, sex of baby – given by MD! Beneficence – doing good to pt Non malefience – do no harm 3 type of harm 1. Physical – negligence by commission – performed wrong action negligence by omission – neglect of care 2. Mental – assault – mental threat/ fear battery – physical harm 3. Moral – slander – verbal libel – written, published pictures
  • 10. Tolality – let pt feel like a whole being even if a part is removed. - offer wigs, bandana – CA pt prosthesis, casts, w/c – amputation Double effect – if made to choose between 2 evils, choose the one that will have les bad effect. More good effect Justice of care – priority coz @ pt has unique needs. Basic char or nursing process A – acceptance universable B – based on pts needs C – client focus D – dynamic – update nursing process depending on clients needs E – equitable care F – familiarity G – goal oriented toward solving problem Inviolability of life – respect of life (promote H & prevent disease) - no abortion! Conflict – clash of ideas resulting to crisis Methods to solve conflict. A – avoidance – putting in one corner – dedma – not good method S – smoothing – appealing to conscience/ kindness U – unilateral – force fear, threats correction N – negotiation – best method – both parties will mutually decide & participate to solve problem. Nsg management Mgt – MAN+ TASK = GOAL (pts) Theories: 1. Human relations theory – must focus on proper relationship If needs provided to member (rest day, leave) Achievement of organization 2. Frederick Taylors scientific mgt theory 4 t’s Tao – get rt person/ tao Training Tool Tx 3. Douglas McGregor mgt theory - Theory Y Theory X Positive worker Negative worker - efficient - inefficient diligent negligent trustworthy non trustworthy reliable don’t love job love their job for the money only = minimal supervision only = increase cases of negligence affecting pts. = use cozf I d power to discipline workers 4. Max Weber’s burocaratic (autocratic) theory - whoever is on top would perform mgt functions - centralized - not good style of management 5. Elton Mayo’s behavioral theory - overtime pay, rest day, day off - provide physical needs of worker like rest & recreation - HAWTHORNE’S EFFECT – if worker knows that they are being observed, workers will have better output. 6. Henry Fayol’s principles of mgt a.) Unity of command – one person given instructions to workers b.) Unity of direction – whole team should have one goal, objective, direction towards pt. c.) Subordination – personal general interest – pt 1st before self d.) Esprit de corp – team spirit – all (-) & (+) output credited to the group
  • 11. e.) Chain of command – heiarchy of command Get appropriate orders from MD f.) Channels of communication – MD orders SN SN g.) Respondent supervisor – command responsibility - let master answer for negligence conduct of subordinate - liable: both HN liable for damages – due resp supervisor SN – negligence - jail h.) Security of tenure – i.) Re-numeration of workers – compensation - probationary – 6 months - regular employee Private – RA 4901 – 40% work 8h a day 5 days a week Gov’t – RA 7375 – magna carta for public HWorker 15k Overtime = + 25% Night shift differential = +10% Special non working holiday + 30% Legal Holiday= X2 +100% Occupational Hazard – work related disease Private – SSS – employees compensation Gov’t – GSIS National health Insurance Act – PhilHealth - Provide for unemployed/ employed - Aesthetic, cosmetic, dental not included Maternity leave – 60 days NSD 78 days C/S 1st 4 pregnancies to legit spouse 4. Abortions 5th pregnant - & delivered – not entitled to maternity leave Paternity leave 7 days Stage/ Steps in nursing management process P – planning O – organizing S – staffing D – directing/ delegating Co – coordinating Co – controlling/ eval Planning stage – conceptualizing/ product of mind/ looking at future/ looking prospectively Types: Vision – what org likes to achieve in future Ex. Health for all by 2000 Heath in the hands of the people by 2020 Mission – focus in present - reason why org was established ex. DOH – to five quality health Philosophy – values. Besides org (members) Goal – gen statement of mission Objective – specific statement of mission Goal- nursing form St. Lukes should provide quality care to pt Objective – nursing from St Lukes should have IV training (specific)
  • 12. Policies – set of rules/ regulation of org 3 types of plan 1.) Short term – for every day ordinary activity ex. NCP 2.) Contingency plan – for emergency or acute crisis, stand by plan 3.) Long term plan – duration of care is linger for chronic pts. Ex. CVA pts Budgeting – performed in planning stage - proper allocation of resources - Money, manpower, machine 1.) Operati0nal budget – cheapest – everyday ordinary activities (gloves, gown, goggles – OR, LR, DR,ER) 2.) Personal/ labor budget – used to compensate & re-numerate labor – most important 3.) Capital budget – long term use equipment - MRI equipment, beds Budget – asks “How” Organizing stage – answers the question ‘WHO” Nurse Mgr RN Subordinate Nsg personnel – nurse aid RN will do: (for stable & unstable pt) A – assessment T – health teaching – when best time start discharge E – explain proc to pt health teaching – start during admission of pt P – preparation – computation of dosage A – adm – give meds or treatment T – treatment – oral, IV, ID E – evaluation – nursing care plan J – judgment – PRN meds – nursing will decide when to five Subordinates can perform: (comfort measures only not VS) R – routine tasks – standard procedure, monitor I & O ambulating, bathing bed making - stable pts – predictable outcomes S – stable pts S – supervision of RN Styles/ method delivery care 1. Primary nursing – private duty nurse – from admission to d/c! D – direct plan of care to pt A – active participation/ consent of pt. M – mgt of care – from basic to complex PD will do 24h – from admission t o discharge tip = answer is primary nurse 2. Functional – most useful type D – duty task – 1 RN all patients O – one task H – highly recommended RNS budget 3. Case Method – ICU critical case resp for: T – total care (from basic care to most complex) O – one RN: 1 patient In extreme cases 1:2 pts Staffing stage – “how many” - nurse manager will determine correct # of patients/ RN
  • 13. Staffing pattern – Phil – 40h/ wk/ 5d Traditional – 8h/40h/5d 10h shift – 10h/ 4d Monday – Thursday On call – emergency schedule Baylor plan – M – F (traditional) Sat-Sun (skeletal force) Directing/ Delegation stage – job/ task is done by another pt for you. Gen rule: RN can delegate any task to another RN Except: disciplinary task (this is done by higher person) : confidential task (charting) : technical task (expertice should be done by same expert) : official medical task Coordinating/ collaboration stage 1. canned food – highest purine content (uric) 2. Anchovies – next highest purine content 1. Interpersonal/ intra departmental – collaboration bet 1 nurse to another nurse - - under 1 ward - ex. Endorsement 2. Interdepartmental – collaboration between two or more hosp for benefit of pt. Why RN needs to collaborate to others in HC team? - pt is entitled to continuous care. Evaluation stage – determine whether, plan goal, objective where met or achieved Types” 1. Nurse rounds – 2 x rounds/ day - short term plan Psyche ward – contraindicated nurse rounds in psych ward 2. Checklist – Nurse mgr – evaluates/ rates member 3. Gam H chart – used to evaluate nurses , multiple plan at same time 4. Peer evaluation – co workers – poorest type of eval – cause might be effected by halo effect due to special relationship. Performance Appraisal – pt or client evaluates most reliable coz --------- or care evaluates.

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