Part One

 

Introduction

 

              In this research paper, the researchers aim to develop a new technique to determine and upgrade strength of recommendation (SOR) by incorporating both-research evidence and expert opinion for clinical practices. In the current clinical practice, the guidelines of existing methodology do not allow SOR to be upgraded for certain recommendations.

 

Research Question

 

                The underlying research questions associated with the study are as follows.

 

• How current methodology in current clinical practice guidelines the grading of strength of recommendation (SOR)?
• Does the new methodology of grading strength of SOR, developed with ten recommendations, is more flexible (less constraint) than traditional technique and offers more advantages to allow SOR to be upgraded for which randomized controlled trials are impractical or unethical?

 

 

 

 

Variables

 

             The traditional methodology which is the reference point in the study is the independent variable, and new system that supports the SOR in clinical practice is the independent variable. SOR in the new system introduces depends upon the existing methodology.

 

Experimental Design

 

             The study has employed a Delphi technique with a multi-disciplinary panel for developing 10 recommendations relating to the role of exercise in the management of OA of the knee or hip. The relevant literature review has provided evidence of each recommendation. The results of research evidence were recorded on a 10 cm VAS. Then, group of recommendations were made and at 95% confidence interval level mean VAS was calculated. One way ANOVA variance analysis was conducted to test the mean VAS calculated.

 

Instruments of measurement

 

             The measurement instruments designed for study were reliable and valid. The researchers were highly concerned to conduct the research as appropriate enough for producing desired outcome. For ensuring that the measurements correct, these were assessed by relevant though literatures review. Highest care has been given in statistical test to produce a reliable conclusion.

 

 

 

Data Type

 

            Before One way ANOVA variance analysis, for each recommendations the mean VAS and standard deviation were calculated. Thus, the categorical data have been converted to numerical data for statistical analysis in the study.

 

Statistics Used

 

            One way ANOVA variance analysis has been used in the study to test whether new methodology of grading strength of SOR, developed with ten recommendations, is more flexible (less constraint) than traditional technique and offers more advantages to allow SOR to be upgraded for which randomized controlled trials are impractical or unethical. In the One way ANOVA variance analysis, mainly the mean VAS of new methodology of grading strength of SOR has been tested. ANOVA test employs F test statistic. The result of the statistical test is that there is a significant difference across the groups (P<0.001) and significant linearity (P<0.001).

 

Conclusion of Research

 

           The conclusion of the research is that the existing methodology does not allow SOR to be upgraded for recommendation for which randomized controlled trials are impractical or unethical and the new methodology of grading strength of SOR, developed with ten recommendations, is more flexible than traditional technique and offers more advantages to allow SOR to be upgraded. The answer of the research question has been given based on the result of statistical test. The conclusion made by the statistical test was significant.

 

Controlling of Error

 

           The error in statistical test was controlled with extensive level literature search and summary analysis for each recommendations. Extensive level literature search and summary analysis for each recommendations enabled to reduce error with data analysis. Type one error in the statistical analysis has been checked with properly determining and fixing the level of confidence and accordingly level of significance in the study.

 

Concern with research study

 

            A proposition in the study that was not recommended showed significant linearity on one-way ANOVA. Also, certain recommendations were not possible to assess in randomized controlled trials for practical limitations, and was not possible to recommend strongly over existing traditional; methodology.

 

Conclusion

 

             Based on the result of study, it can be said that the change recommended by the researcher is valid in statistical sense, and can be implemented for making practice changes in hospitals.

 

 

 

 

 

Part Two

 

Introduction

 

              In this research paper, the researchers aim to suggest evidence-based practice instead of oral-care practices the ICU nurses by pointing out its effectiveness of evidence-based practice by relating to more personal or professional characteristics.

 

Research Question

 

           The underlying research questions associated with the study are as follows.

• What is more prioritized by the ICU nurses- oral-care practices or evidence-based practices?
• Does the evidence-based practice is more effective than oral-care practices based on more relating to personal or professional characteristics?

 

Variables

 

             In the study the existing oral care practices is the independent variable, and demographic & professional characteristics is the independent variable. The link of demographic & professional characteristics to oral care practices has been tried to dig out.

 

Sample Size

 

             The study was conducted with a sample of 218 practicing ICU nurses in 2004-2005. The sample selecting technique was convenience sampling.

 

Experimental Design

 

            The study has employed in two sections. In first section, a survey with a questionnaire containing demographic and professional characteristics (age, gender, ICU experience, nursing education etc.) was conducted. In the second section a checklist which includes a listing of current oral care practices containing equipment used, solution used etc. and timing of oral care practices. Nurses were asked check the list properly and provide their response.

 

Instruments of measurement

 

              The measurement instruments designed for study were reliable and valid. The researchers were highly concerned to conduct the research as appropriate enough for producing desired outcome. For ensuring that the measurements correct, these were assessed by relevant though literatures review. Highest care has been given in statistical test to produce a reliable conclusion.

 

Data Type

 

            This study is based on numerical data. The response of the ICU nurses with respect to oral care practices has been converted to numerical data for analysis and regression model running.

 

Statistics used

 

             Descriptive statistic Measure of central tendency and dispersion have been used to describe the response of the ICU nurses with respect to oral care practices.

The study was also based on ANOVA model. ANOVA model has been used for determining the difference in EBP based on demographic and professional characteristic. ANOVA test employs F test statistic. The F Test statistic was found as not statistically significant in the model.

 

Conclusion of Research

 

            The conclusion of the research is that while ICU nurses prioritize more oral-care practices over evidence-based practices but there is not statistical significant relationship in between demographic & professional characteristics to oral care practices. Thus, attempt should be undertaken for encouraging the ICU nurses to introduce and use evidence-based practices. The answer of the research question had been given not proving no direct link to the demographic & professional characteristics to oral care practices.

 

Controlling of Error

 

              The error in statistical test was controlled with extensive level literature search and summary analysis for. The literatures were constructed by a committee of experienced ICU nurses. Highest care has been provided in sample selection so that error is minimized. Type one error in the statistical analysis has been checked with properly determining and fixing the level of confidence and accordingly level of significance in the study.

 

Concern with research study

 

             The study does not find any direct relationship in between the demographic & professional characteristics to oral care practices, and based upon the result concluded that evidence-based practice should be introduced. More extensive research is required on evidence-based practices on make a more reliable conclusion.

 

Conclusion

 

             Practicing ICU nurses are not adhere to evidence-based practice. Adherence to evidence-based practice is more effective than oral-care practices as it more relates to personal or professional characteristics.

 

 

Roddy, E., Zhang, W., Doherty, M., Arden, N. K., Barlow, J., Birrell, F., et al. (2006). Evidence-based clinical guidelines: A new system to better determine true strength of recommendation. Journal of Evaluation in Clinical Practice, 12(3), 347-352. Retrieved from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=20870724&site=ehost-live&scope=site

 

Ganz, F., Fink, N., Raanan, O., Asher, M., Bruttin, M., Nun, M., et al. (2009). ICU nurses' oral-care practices and the current best evidence. Journal of Nursing Scholarship, 41(2), 132-138.  Retrieved from http://library.gcu.edu:2048/login?url=http://proquest.umi.com.library.gcu.edu:2048/pqdweb?did=1780947491&sid=1&Fmt=3&clientId=48377&RQT=309&VName=PQD