NUR590 Topic 6 Discussions

NUR590 Topic 6 Discussions

Topic 6 DQ1 – Influence of Gaps on Research

Gaps are missing pieces of information that are under-explored identified from the literature. The identified gaps are used in carrying out future researches while trying to answer the missing pieces (Hempel et al., 2019). During my literature search, I identified some gaps which could prompt future research. For instance, in single-centered studies where the sample sizes were small. The small sample sizes could not be used as a presentation of the entire population or centers with larger sample sizes. Therefore, future researches could focus on doing multi-centered studies with larger sample sizes that can be used to give the real prevalence while improving the surveillance system. Another gap is uncertainty to compliance with the usage of an EBP.

NUR590 Topic 6 Discussions

Compliance with chlorohexidine, for instance, requires routine daily bathing and using the appropriate technique while applying chlorohexidine. The urge to train and educate nurses on the correct methodology of application and adhering to practice could prompt the development of a research project to address the issue. It is imperative to note that compliance requires periodic reminders, demonstrations, and training on how to carry out the practice. EBP project may target small group training and education on compliance and its effectiveness.

In addition, failure to evaluate the cost-effectiveness of an EBP in different settings is another identifiable gap (Giri et al., 2021 NUR590 Topic 6 Discussions). The cost-effectiveness of using chlorohexidine has been evaluated in various critical settings, however, there is a lack of evidence of its cost-effectiveness in non-critical settings. the clinical findings from critical units can not be used as a representation of non-critical settings due to differences in prevalent infections. Therefore, there is prompt to carry out researches to help in the implementation of an EBP in such settings and evaluate its effectiveness

References

  • Giri, V. K., Kegerreis, K. G., Ren, Y., Bohannon, L. M., Lobaugh-Jin, E., Messina, J. A., Matthews, A., Mowery, Y. M., Sito, E., Lassiter, M., Saullo, J. L., Jung, S.-H., Ma, L., Greenberg, M., Andermann, T. M., van den Brink, M. R. M., Peled, J. U., Gomes, A. L. C., Choi, T., … Sung, A. D. (2021). Chlorhexidine gluconate bathing reduces the incidence of bloodstream infections in adults undergoing inpatient hematopoietic cell transplantation. Transplantation and Cellular Therapy, 27(3), 262.e1-262.e11. https://doi.org/10.1016/j.jtct.2021.01.004
  • Hempel, S., Gore, K., & Belsher, B. (2019). Identifying research gaps and prioritizing psychological health evidence synthesis needs. Medical Care, 57 Suppl 10 Suppl 3(Suppl 3), S259–S264. https://doi.org/10.1097/MLR.0000000000001175

NUR590 Topic 6 Discussions – Topic 6 DQ2 Difference between Statistical and Clinical Significance

Implementation of an evidence-based project requires the understanding and interpretation of research findings. Therefore, understanding clinical and statistical significance is important in result interpretation and enhancing the implementation of an EBP. Statistical significance implies the likelihood of something happening and not solely happening by chance (Fleischmann & Vaughan, 2019). As a result, statistical significance implies that research findings are likely to be true and not occur by chance.

            The probability value (p-value) is used to illustrate the likelihood of a specific result occurring at random, but not the actual variation between the variables. When the probability value created during the analysis is less than the level of confidence required by the researcher, the results are statistically significant. In research studies including evidence-based practice, probability values are typically set at 0.05, implying a 5% chance that the outcome was not produced by chance and a 95% certainty that the factors evaluated in the study have an actual relationship.

Clinical significance on the other hand verifies the extent to which something is happening. It is essentially a subjective assessment of study findings as relevant to the patient under the care and hence likely to impact healthcare provider behavior (Fleischmann & Vaughan, 2019)When medical specialists believe discovery is significant enough to be medically important, it is referred to as a clinically significant result. NUR590 Topic 6 Discussions

Statistical significance must always be established before clinical significance can be evaluated in evidence-based research. Clinical significance, on the other hand, is frequently a subjective assessment that cannot be determined by a single sensory test. By ensuring that the result is statistically significant, I may leverage clinical significance to support favorable results in my project outcome. This is because the vast majority of statistically significant findings have therapeutic implications.

References

Fleischmann, M., & Vaughan, B. (2019). Commentary: Statistical significance and clinical significance – A call to consider patient-reported outcome measures, effect size, confidence interval, and minimal clinically important difference (MCID). Journal of Bodywork and Movement Therapies, 23(4), 690–694. https://doi.org/10.1016/j.jbmt.2019.02.009

NUR590 Topic 6 Discussions INSTRUCTIONS

T6 DQ1:
When reviewing the literature for your evaluation plan and different types of evidence for your project, what gaps in the findings did you encounter? How could these gaps influence other researchers?

NUR590 Topic 6 Discussions T6 DQ2:
Discuss the difference between statistically significant evidence and clinically significant evidence. How would each of these findings be used to advance an evidenced-based practice project?

See NUR590 Topic 7 Discussions Dissemination of EBP Proposal Here