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Research Week 15 Please submit minimum of 250 word statement with references regarding this week chapter reading, explain what are some of the important aspects of this week’s reading, provide examples when possible. Thanks. Jorge Ch 26 & 27 Chapter 26 Patient Safety and Quality Research Patient Safety and Quality Research To Err is Human: Building a Safer Health Systems is a report by the Institute of Medicine and has been the impetus for a great increase in research on improving the safety and quality of patient care 2 Patient Safety and Quality Research More than 15 years after the Institute of Medicine report was released, the quality of care provided in the United States is still uneven and patients are still at risk of harm from medication errors, healthcare-associated infections, obstetrical adverse effects, and so on (Kronick, 2014) 3 Research Study Versus Quality Improvement Project Quality improvement projects are institution based and the ensuing investigation is oriented toward identifying gaps in safety procedures and policies in that institution and taking corrective action 4 Research Study Versus Quality Improvement Project A research study is a systematic investigation of phenomena that is designed to contribute new knowledge A research study protocol needs to be reviewed by an institutional review board (IRB) 5 Research Study Versus Quality Improvement Project Whether a research study or quality improvement project, attention to the design of the study, adequacy of data collection, and appropriate data analysis are necessary 6 Examples of Patient Safety Research Schoonover and colleagues (2014) conducted a secondary analysis of data from a study of medication discrepancies found when patients transition from acute care to home They found that the odds of unplanned hospital readmission was 5.45 times greater for those with higher medication regimen complexity 7 Examples of Patient Safety Research Taber and colleagues (2014) looked at contributions to a hospitalization for patients with a transplanted kidney 64% of participants experienced at least one medication error 12% experienced a clinically significant medication error 8 Examples of Patient Safety Research Nationwide Children’s Hospital instituted a hospital-wide culture transformation using the Institute of Healthcare Improvement (IHI) model of improvement and expanded its quality improvement program, which lowered the hospital’s serious safety event rate by 83% 9 Design Challenges in Patient Safety Research Placing specific boundaries around the event of concern Identifying the event in existing patient records, especially in the qualitative portions of the record 10 Design Challenges in Patient Safety Research Noting the sequence of events and the date the event of interest occurred Comparing populations across different facilities Measuring the degree of baseline adherence 11 Design Challenges in Patient Safety Research Using organization-wide interventions Encompassing the contextual complexity of system change Analyzing complex data 12 Ethical Research Considerations It is often very difficult to obtain the consent of every patient to be included in the study; however, individual patients need to be given the opportunity whether they want to be part of the study or not 13 Ethical Research Considerations The Office for Human Research Protections has issued guidelines when considering a request for waiver of consent: Research involves no more than minimal risk Only the minimum information necessary to conduct the research will be collected 14 Ethical Research Considerations The Office for Human Research Protections has issued guidelines when considering a request for waiver of consent: Confidentiality must be maintained; particular attention needs to be paid to collection of any identifying information 15 Ethical Research Considerations Situations that may qualify for a waiver of consent are: The research cannot be reasonably carried out unless consent is waived Scientific rigor of the research would be threatened by consent procedures 16 Ethical Research Considerations Baker and Persell (2015) made a few additional considerations to waivers: If consent cannot be obtained from every subject then the research should only pose minimal risk to the subjects of the research Consider if the intervention can ethically be withheld from the comparison group 17 Ethical Research Considerations Baker and Persell (2015) made a few additional considerations to waivers: Data obtained under waiver of consent should be collected as part of routine care, but if this cannot be done then consent may be necessary 18 Guidelines for Publishing Safety and Quality Study Results Indicate in the title that some type of improvement in the quality of care was the purpose of the study Be sure the review of the literature is balanced Provide sufficient detail about implementation of the improvement intervention 19 Guidelines for Publishing Safety and Quality Study Results Description of the environment should include organization and patient characteristics and factors likely to influence the improvement project Use appropriate analyses 20 Guidelines for Publishing Safety and Quality Study Results When analyzing the outcomes, report the strength of the intervention effect When reporting outcomes, include both benefits and harms, successes and failures, and lessons learned Include estimates of cost factors 21 Guidelines for Publishing Safety and Quality Study Results Describe the local problem and the intended improvement Write a description of the individuals or groups involved in the project and characteristics of the setting in which the study was done 22 Chapter 27 Developing a Program of Research Program of Research A program of research is a sequential “series of related studies aimed at addressing a particular knowledge gap” of importance to one’s discipline (Pranulis, 1991) 2 Program of Research The opposite approach to deliberately building a program of research would be to conduct a number of discrete, unrelated studies on various topics This is a more opportunistic, less planned approach to building a research portfolio 3 Program of Research Research trajectory is having a clear path to a long-term goal in mind This helps to guide your choices and maintain your focus as you build your research career 4 Advantages of a Program of Research Builds expertise in your chosen area of research Increases the likelihood you will be able to make a substantial contribution to the nursing practice 5 Advantages of a Program of Research Raises the quality of your studies because you will have greater expertise when concentrating on one subject area you know very well Allows you to see new patterns and connections that lead to new discoveries 6 Launching a Program of Research Choose an area of great interest to you Be sure the topic is also important to nursing Consider focusing on a persistent problem Be willing to drop a line of research that turns out to be a dead end 7 Launching a Program of Research Begin with a small study (this might be a master’s project or doctoral dissertation) The goal of your first study is to gain new insights into the subject of interest Continue with a second small or medium-size study building on the first study 8 Launching a Program of Research The second study is often a pilot study used to test your ideas and procedures before launching a larger study Begin to form a research team including both colleagues and research assistants 9 Launching a Program of Research Become involved in larger, more complex studies, either as the lead investigator or as a co-investigator Add “branches” to your research now, increasing breadth as well as depth 10 Launching a Program of Research All along, present findings at conferences and publish the results in professional journals As an established scholar and researcher you will now mentor new researchers, serve as a grant reviewer, or become a consultant 11