Evidence for Nursing: Understanding Research Concepts

EVIDENCE FOR NURSING:Assessment Item 2: Understanding research conceptsWeight: 35% of overall mark
PART ONE: Contribution to Week 3, Week 4, and Week 5 in-class workshops (max 6 marks)
PART TWO: General Questions on Evidence based Practice (max 12marks)
1. Referring to the Registered nurse standards for practice (2016), explain the role of evidence based practice
in nursing profession? (Max 100 words, 2marks)
According to the Nursing and Midwifery Board of Australia (NMBA) (2017), it is the duty of the registered nurse to
develops a proper plan for nursing practice (standard 5) in order to provide safe, responsive and appropriate quality
of care (standard 6). In order to procure safe care, the observance of evidence-based practice is important. EBP is
the process of collecting processing and then implementing the research findings in order to improve the clinical
practice, patient outcomes and overall work environment (Mackey and Bassendowski 2017).
2. How the Evidence Based Practice model can be integrated in to the tanner’s model of clinical judgment to
enhance nurses’ clinical decision makings? (Max 150 words, 2 marks)
According to the Tanner's Model of Clinical Judgement, the nurses are taught to think by using a proper nursing
process that starts with assessment, diagnosis, proper planning, and application of intervention and subsequent
evaluation of the outcome. However, in practice, the nursing professional use a process that is more organised and
flexible. This organised process of clinical judgement starts with noticing, interpreting, responding and reflecting
(Nielsen, Lasater and Stock 2016). In order to incorporate evidence-based practice in nursing thought-process, the
nurses as required to channelize their critical thinking and clinical judgement based on the prevalent evidence-based
practice. This will be followed by person-centred approach of EBP in order to improve the outcome of care.
3. One of the components of Evidence Based Practice is consideration of the patient’s values and
preferences. What does this mean? Using an example, explain the importance of this component (max
100, 2 marks).
Patient’s value and preferences signifies the development of the clinical priority of nursing care based on the
patients’ immediate need. The values and preferences include physiological, psychological and cultural needs. For
example, if a patient is suffering from diabetes and is over-weight then the nursing priority will not only be insulin
injection. It will also deal with weight-management. The diet plan for the weight management will be designed
based on the preference of the patient. For example if he is a vegetarian then vegetarian diet will be framed. If the
patient is from Culturally and Linguistically Diverse Community (CALD) then CALD nurse will be appointed in order
abide by the cultural preference of the patient (Repo et al. 2017).
4. What are some barriers to implementation of evidence based practice? (Max 3 barriers, 1.5 marks)
Evidence for Nursing Assessment 2: Understanding research concepts 1

Two most frequently cited barriers to EBP include lack of adequate time (first barrier) and a proper organisational
culture (second barrier) in order to implement the change in practice. The staff nurse experiences resistance of lack
of cooperation from the nurse managers and leaders in order to implement EBP and this can be cited and poor
organisational structure. Lack of training among the nurses is the third barrier in implementing EBP (Khammarnia et
al. 2015).
5. What strategies can facilitate evidence based practice in the clinical settings? (Max 3 strategies, 1.5 marks)
Effective education of the nursing professionals or on-job training of the novice nurses will help to implement EBP
under clinical settings. In order to encourage nurses to take part in the training session, trained nurse managers must
be appointed along with an increase in the nurse:patient ratio. Increase in nurse:patient ratio will encourage more
nurse to take part in training or indulge in critical thinking for implementing EBP. The third strategy will include
implementation of the transformational nursing leadership that will bring change in the organisational culture and
will welcome new ideas and will promote team-work (Khammarnia et al. 2015).
6. Why randomised controlled trails are considered as ‘higher level evidence’ compared with cohort studies?
(max 50 words, 2 marks)
In randomised control trials measure treatment or exposure on real patients. The patients are allocated to control or
experimental group randomly and are blinded about the outcome and this helping to reduce potential bias. In cohort
study, the group of patients who are already taking part in treatment is observed and then compared with similar
groups who are not the part of the treatment. Cohort is an observational study and the two groups (study and
placebo) might differ in other parameters apart from the variable in the study and thus might include potential bias
(Quinlan et al. 2019).
7. What is the difference between primary and secondary studies? (1 marks)
In primary study, the original data is collected and then analysed either qualitatively or quantitatively. In secondary
study, the data is collected from previously published articles and the summative data is analysed either qualitatively
or quantitatively (Quinlan et al. 2019).
PART THREEE: Research methodology and results (17 marks)
Read the article bySkou et al. (2015) titled ‘A Randomized, Controlled Trial of Total Knee Replacement’. A copy of this
article is in Assessment 2 folder.
8. What was the aim of this study (1 mark)?
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The aim of the study is to analyse the effectiveness of the knee replacements in comparison to the non-surgical
interventions for treating osteoarthritis.
9. What was the independent variable in this study (0.5 mark)?
Independent variables:
(i) Unilateral total knee replacement + 12 weeks of non-surgical treatment
(ii) Non-surgical treatment (alone)
10. What were dependant variables (name three dependant variables) (1.5 marks)?
Dependent variables
 Reduction in pain
 Improvement in the activities of daily living
 Improvement in the quality of life
11. The study used an intention to treat analysis. What does this mean (1 marks)?
Intention-to-treat analysis is a technique that is frequently used in randomised controlled trials (RCTs). In this
technique the patient is compared in terms of their final results within the groups to which they are randomized
initially, of having dropped out of study or receiving the allocated treatment or violated the protocol. The intention
to treat-analysis help to compare the particular group placebo or experimental group while considering the number
of drops or people who failed to complete the non-surgical treatment (Abraha et al. 2015).
12. How the risk of placebo effect can affect the results of this study? (2 marks)
In the current study, the researcher failed to omit the placebo effect and thus the estimation of the pain through
pains score might include biased results. In the current study, there was no control group or the placebo group. The
comparison was done between surgical+ non surgical intervention and only non-surgical interventions only. There
was placebo group or sham-surgery control group in order to rule out the placebo group. Thus the assessment of
pain between the two experimental group can be biased (Watson 2015).
13. Who was blind to the group allocations in this study (0.5 mark)?
The allocation was done randomly. A total of 100 patients with moderate-to-severe pain in knee osteoarthritis and
were eligible for unilateral total knee replacement were randomly allocated to two different groups: surgical+ non
surgical intervention and only non-surgical interventions only. The authors when conducted the analysis of the
results based on the parameter of pain and improved quality of life, the groups were named as A and B and thus the
authors were blinded about the group allocation at the time of data-analysis.
14. Did the study use an adequate sample size? (Justify your answer, 1.5 marks):
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