Boston College Nursing Discussion

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Nursing Research & Evidence-Based Practice

Module 3 Case Study Discussion Questions

Chapter 10

A patient has urinary incontinence (UI). The nurse is unable to determine the exact cause of the incontinence because the client is unable to communicate most needs and responds little to staff and family. This problem is of significant concern because the client has skin integrity and hydration concerns.

1. If the nurse were to conduct research on the causes of UI on this unit, what would be the benefits of a cross-sectional versus longitudinal design?

2. Two other nurses note that they have seen other patients started on the cholinesterase inhibitors (for Alzheimer disease) and had problems with incontinence. What type of research would help to identify any possible correlation between this type of medication and UI?

3. What would be inclusion and exclusion factors for patients whose data may be used when assessing the effects Alzheimer disease medication may have on UI?

Chapter 11

The nurse is teaching new parents the importance of immunizations. The parents voice concerns about the safety of vaccines. In an effort to answer the parents’ questions, the nurse accesses the following from the Agency for Healthcare Research and Quality:

Evidence-Based Practice Center Systematic Review Protocol: Safety of Vaccines Used for Routine Immunization of Adults (Including Pregnant Women) and Children

http://effectivehealthcare.ahrq.gov/ehc/products/4…

1. The nurse wants to find out what types of studies were used to help develop this protocol. Where can that information be found?

2. Initially after studies are identified for potential inclusion, how did they finalize the list of studies that would be considered?

3. What is meant when assessing the strength of evidence?

Chapter 12

The nurse on the long-term care unit is concerned about the incidence of pressure ulcers in the facility. He has noted what feels like an increase in pressure ulcers for clients who have cognitive impairment. As he considers how to address this problem, it becomes clear that he must identify not only clients with cognitive impairment but also individuals with a combination of cognitive impairment and pressure ulcers. He also notes that he would like to identify the clients with cognitive impairment who are most at risk before the pressure ulcers occur.

1. The nurse performs a retrospective chart audit on all current residents presently with cognitive impairment and pressure ulcers. This is known as what type of sampling?

2. Describe the bias concern with this type of sampling (a retrospective chart audit of all current residents with cognitive impairment and pressure ulcers).

3. Why would the nurse want to explore probability sampling as opposed to nonprobability sampling?

Chapter 14

A pediatric nurse is a case manager on a neonatal cardiology floor. This facility is in a location where many Native Americans are served. The nurse wants to better understand how the Native American women attach with their babies when the children are born with congenital heart defects.

Note: For this case study, students will need to access the article Alhusen, J. L., Gross, D., Hayatt, M. J., Woods, A. B., & Sharps, P. W. (2012). The influence of maternal-fetal attachment and health practices on neonatal outcomes in low-income, urban women. Research in Nursing Health,35(2), 112-20. doi: 10.1002/nur.21464.

1. A nurse researcher who would administer the Maternal-Fetal Attachment Scale (MFAS) would be using what type of methodology?

2. The nurse researcher wants to collect data on outcomes of the Native American neonates to assess for any correlation between MFAS scores and outcomes. To do this, a chart review was initiated. How can the nurse researcher ensure that chart reviews are done correctly?

3. The nurse researcher reviewed an article in which the MFAS was used on African American mothers. There is concern that the findings or tool may not be appropriate for Native American mothers. What is the nature of this concern?

Chapter 15

The third-semester nursing students are in the skills lab. Today they will be assessed for competency related to managing parenteral medication. Because of the number of students, three faculty members will perform the assessments (also known as check-offs). Students are randomly assigned a faculty member and number in line. They must wait their turn for their faculty member to perform the assigned skills.

1. A few students heard that one faculty member was “easier” than the other two. Discuss this from a validity and reliability perspective.

2. Propose a strategy to help ensure that grading during the assessment is valid.

3. Propose a strategy to help ensure that grading during the assessment is valid.