NR 439 Week 1 Discussion: Introduction to Evidence-based Practice (graded)
NR 439 Week 1 Discussion: Introduction to Evidence-based Practice (graded)
Purpose
This week’s graded topics relate to the following Course Outcomes (COs).
- CO 3: Identify ethical issues common to research involving human subjects. (PO 6)
- CO 5: Recognize the role of research findings in evidence-based practice. (POs 7 & 8)
Due Date
- During the assigned week (Sunday the start of the assigned week through Sunday the end of the assigned week):
- Posts in the discussion at least two times, and
- Posts in the discussion on two different days
Points Possible
50 points
Directions
- Discussions are designed to promote dialogue between faculty and students, and students and their peers. In discussions students:
- Demonstrate understanding of concepts for the week
- Integrate outside scholarly sources when required
- Engage in meaningful dialogue with classmates and/or instructor
- Express opinions clearly and logically, in a professional manner
- Use the rubric on this page as you compose your answers.
- Best Practices include:
- Participation early in the week is encouraged to stimulate meaningful discussion among classmates and instructor.
- Enter the discussion often during the week to read and learn from posts.
- Select different classmates for your reply each week.
Discussion Questions
We begin our journey into discovering the new world of research and evidence-based practice (EBP) by exploring our past. After completing the required readings and lesson, answer the following:
- Explain how research has evolved since the Florence Nightingale era.
- Discuss how research and EBP are different; include how you believe research supports EBP for nursing.
- Describe one past/historical unethical breach of research conduct; then, share how you would ensure care of a study participant using one ethical or legal research consideration (guideline/principle).
Grading
To view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric. See Syllabus for Grading Rubric Definitions.
This topic is closed for comments.
Class -
This discussion has 3 questions. I encourage you to not wait until the last minute to post your discussion…Frequently I will respond with a reminder that you didn’t answer part of the question, or that you answered part of the question incorrectly, and I want you to be able to take advantage of that feedback.
Also, remember that to earn maximum points, you have to integrate an outside scholarly source into at least one of your 2 discussion posts for the week. The optional readings are NOT considered an outside source.
For the third question, you need to “Describe one past/historical unethical breach of research conduct” Please be sure this is related to research conduct, not potential unethical conduct in a clinical situation. Also, you need to “share how you would ensure care of a study participant using one ethical or legal research consideration”. Again – this is related to research situations, not clinical situations. You need to describe how you would ensure care of a study participant, not a patient.
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I’m looking forward to reading your first discussions this week! You may post for credit beginning Sunday, February 28.
Wow that video shows how cruel and inhumane the countries can be, all in the of science, Justifying their causes for the lying,
manipulation, and over-up of documentation. So sad. This is why it is our duty as nurses to be the patient’s advocate, educate, involve them and their families in their plan of care. Respect and acknowledge their requests and feelings if it is within reason and conducive with the plan of care.
Thanks for sending me the link. I have watched many Unit 731 documentaries. It is very difficult for me to watch these dreadful events had happened in Unit 731: The Japanese researchers studied STDs. They forced prisoners who were infected with syphilis to have sex with healthy ones to see how it spread. They carried out a vivisection, a dissection of a live human without anesthetics, to see blood loss. They infected the prisoners with diseases, then removed the prisoner’s organs while they were alive, so that the researchers could study the effects of the disease before the decomposition could start (Avani, 2018). They conducted an experiment on prisoners, frozen their arms stiff with ice, then put the frozen stiff arms into a vat of hot water. The flesh wound would be stripped off the bones, but the prisoner still alive. Women were raped and injected with disease to study transfer to fetus. A shocking photo found in archives show a Chinese woman was cut open from throat to pelvis, exposing a fully-grown baby in her belly……
Despite thousands of victims, the Japanese government denied the existence of the Unit 731 until 1998. The U.S. used double standard in the postwar responses to the experiments upon different nationalities. The Unit 731 scientists were given immunity from prosecution, and their dehumanized acts were coved-up in exchange for exclusive access to their finding (Brody, et al., 2015).
I still need to have a deeper understanding of the atrocities. But one thing I firmly believe that all humans are born free and equal in dignity and rights. We ought to respect this moral principle at all the time (Human Rights).
Reference
Avani, S., (2018) Unit 731: Japan’s Biological warfare project. https://www.atomicheritage.org/history/unit-731Links to an external site.
Brody, H., Leonard, S. E., & Weindling, P., (2015). United Stated responses to Japanese wartime inhuman experimentation after World War II: National security and wartime exigency. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487829/Links to an external site.
Human Rights. https://www.un.org/en/sections/issues-depth/human-rights/Links to an external site.
Thank you, for your post and for sharing the discussion question. I agree with you that nursing research’s evolution since the Nightingale era has necessitated advancements in the nursing practice and profession for better services to patients. Accordingly, through the systematic process of inquiry that employs rigorous guidelines to produce unbiased answers to nursing practice questions, research remains a critical aspect of effective care delivery. Over 150 years ago, Nightingale pioneered nursing research to understand the effects of the Crimean War on the mortality and morbidity of soldiers at the time (Grove & Gray, 2018). The data gathered by Nightingale transformed nursing research as it led to the development of interest by professionals in practice. Nightingale succeeded in impacting fundamental nursing practice changes and care as it is known today and public health in general.
With time, nursing research transformed because of different factors that included increased understanding to focus on the patient. Early researchers looked at ways to improve quality care delivery amidst lack of access to vital technology at disposal today. Research in nursing would pick in the 1950s, where efforts to apply science in nursing were advanced for better outcomes. Nursing education did not exist, and in most cases, nurse practitioners learned through apprenticeship programs. However, due to increased nursing education research, the need to train nurses as professionals led to the establishment of nursing schools in different parts of the country (Grove & Gray, 2018). Present research in nursing focuses on enhancing patient-centred care approaches using evidence-based practice. Nurses now can specialize in research through terminal degrees like a doctor of philosophy in nursing (PhD). The implication is that research in nursing is critical in providing quality care. 
Reference
Grove, S. K., & Gray, J. R. (2018). Understanding Nursing Research E-Book: Building an
Evidence-Based Practice. Elsevier Health Sciences.
I, too, was shocked about the different consequences that were applied to the German Nazis and to the Japanese regarding the atrocities they committed, especially after reading the book “Unbroken”. We are STILL chasing Nazis, and the Japanese were never really held accountable. It’s all political – we needed Japan to be our ally because of their geographical position, and we needed their goods.
If you get a chance, read the book. It was also made into a movie, but I think the book was better.
I totally agree with your point. Thanks for your recommendation! I will read the book.
I was skeptical about the vaccine as well….and in truth, I am still skeptical even though I am fully vaccinated (I had the first shot at the end of December and the 2nd shot mid January). I have been tested several times over (both swab and antibody tests) and by the Good Graces, I have not contracted the virus. However, I still chose to get the vaccine anyway because my 75yr old mother lives with me and my brother is severely immunocompromised – and I’m around both of them ALL THE TIME. With my potential exposure to covid positive patients at the hospital, I would feel so guilty if I was one of those asymptomatic people that unknowingly contracted the virus and then passed it on to my loved ones.
That being said, after receiving both vaccines, and seeing how I reacted to it vs. seeing how others have reacted to the vaccines or actual contraction of the virus (or a combination of the two), I wholeheartedly believe that I would have been one of those asymptomatic people. I had absolutely no reaction to the vaccine whatsoever. Some of my coworkers who never had covid had a bad reaction to the 2nd dose…and my coworkers that had covid and then received the first vaccine said they felt like they had covid all over again (they had no reaction with the 2nd shot). So I truly believe I would have been one of those people “spreading the love” without knowing.
My family (husband, mom, brothers, sisters-in-law, and nieces) have said they will not receive the vaccine and I respect their wishes not to. But for my peace of mind, I wanted to make sure I was doing my part to protect them from exposure despite my own reservations of the escalation for the research and the vaccine.
I really enjoyed reading your post this week. I am familiar with EBP from hearing about it in school and even completing a project at my old hospital but this is still a topic that makes me feel uncomfortable as I am not great when it comes to nursing research. I really loved how you pointed out that today EBP is a major part of healthcare quality and patient outcomes. This absolutely correct because healthcare will continue to keep evolving and it is important that we stay on top of everything and keep changing our policies to give our patients the best care but to also keep them safe at the same time.
Over the past several weeks, I have been picking up a few extra days in the vaccination clinic at our facility. I’ve had the opportunity to admister several hudred doses of the Moderna vaccine. I just wanted to add that a majority of those that I vaccinated were extremely grateful to have the opportunity to be vaccinated. There were still quite a few people that had some doubts, but thay was definitely the minority. A majority of those that I vaccinated couldn’t thank me enough. I was glad to provide this service to them. I hope, as we all do, that this ends soon!
I enjoyed your post very informative. I also wonder if there will be long term effects of the Covid-19 vaccine as it was released very fast. I myself have not received as am breast-feeding and the implications of the side effects on breastfeeding were not held. I do think their will be any long term effects, if anything history has shown us is that vaccines have helped the vast majority. Both the Pfizer and Moderna vaccinations are mRNA vaccines, which is nothing new scientist have been working how to modify mRNA.
All viruses contain nucleic acids in the form of Deoxyribonucleic acid (DNA) or Ribonucleic acid (RNA). DNA, RNA, and proteins are essential for existence. DNA carries all genetic information for cell growth and replication. RNA copies the DNA and thus regulates the expression of genes in form of Messenger Ribonucleuic acid mRNA which carries the genetic code from DNA from the cell’s nucleus to ribosomes where protein synthesis occurs.
Proteins repair parts of the body and allows metabolic reactions to occur. Medications and vaccines that utilizes mRNA cause our cells to make a protein or specific piece of protein that triggers an immune response that creates antibodies and produces killer cells. So with this scientist just build on it based on the virus they are trying to target.
https://www.health.harvard.edu/blog/why-are-mrna-vaccines-so-exciting-2020121021599
Explain how research has evolved since the Florence Nightingale era
When Florence Nightingale initiated change it was based on her collecting information and applying scientific data to it to show the benefit of the change. Unfortunately, in the years following there was not much scientific data being collected in nursing and that was probably because nurses went through apprenticeships and not formal education (Houser, 2018). Since then, nurses now have more formal education and nursing research is a key part of that. More nursing journals have been published that focus on nursing research and the National Institute of Nursing Research was formed (Houser, 2018).
Discuss how research and EBP are different; include how you believe research supports EBP for nursing.
Nursing research is a process to produce answers to questions about the nursing process, it integrates findings from multiple sources to develop a guide for best practice, finds solutions for existing issues, and tests our traditional approaches of patient care (Houser, 2018). Evidence-based practice (EBP) takes the best scientific research and integrates it with clinical experience and blends it with nursing care (Houser, 2018). In my opinion, I believe that you cannot have EBP outcomes without having the research. The research is an integral part of developing practices that will promote effective and safe care of patients. You need to take the research results incorporated them into practice groups and present them to a panel of experts, and then evaluate the quality-of-life outcomes (Houser, 2018).
Describe one past/historical unethical breach of research conduct; then, share how you would ensure care of a study participant using one ethical or legal research consideration (guideline/principle).
One major unethical breach was during World War II with the Nazi’s brutal experiments. Their experiments concentrated on methods of killing but their results caused death, disfigurement, or permanent disabilities (Algahtani et al., 2018). At the end of the war, these crimes were tried and led to the Nuremberg Code of medical ethics (Algahtani et al., 2018). The Nuremberg Code established guidelines to be followed for research. Here are some of the guidelines: “consent is voluntary and informed for subjects who participate in medical experimentation, the knowledge gained is unobtainable by any other means, death or disability is not an expected outcome, and properly qualified scientists conduct the experiments” (Algahtani et al., 2018). In my research study, I would ensure respect for the participants by obtaining informed consent, explain the risks and benefits of the study, and explain my selection process.
References
Algahtani, H., Bajunaid, M., & Shirah, B. (2018). Unethical human research in the field of neuroscience: a historical review. Neurological Sciences, 39(5), 829–834. https://doi.org/10.1007/s10072-018-3245-1Links to an external site.
Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Jones & Bartlett Learning.
The Nazi experiments were awful, but as you said, they led to the Nuremberg Code. I’ve included a link to a document that includes other things in the code besides informed consent.
Great discussion – thanks for sharing with the class!
Thank you for that link. I am glad to see that they took those 10 codes/standards and made them part of the medical code of ethics. I also found it interesting that the Nuremberg Code is also what first started the testing on animals before human trials (Houser, 2018), but now we have the animal rights groups who believe it is animal cruelty. I do love animals but in my opinion, I feel starting trials on animals is better than starting on humans, especially if you don’t know if the outcome may cause death, injury, or disability.
Reference
Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Jones & Bartlett Learning.
I agree with you when you said that you cannot have EBP without research. The two go hand in hand. Studies can be used to research patient outcomes with a variety of nursing care, but this data is useless if it is not used to better patient outcomes. Continuing education for nurses is necessary to improve their practice. Having the most up to date information is so important to provide these patients with the best care possible.
I found it very interesting to read about the Nuremberg Code. I was unaware of the history surrounding the Nazi’s experimental medicine during the war. I knew that they did this to the Jewish people, but I did not know that this code was made to prevent experiments from ever happening again. Thank you for posting, you did a nice job.