Chapter 6 (Lesson 2)

Question 1

_____ is rooted in MEDICINE and embraced by the ENTIRE HEALTH CARE COMMUNITY.

DEFINITION: is “the CONSCIENTIOUS, EXPLICIT, AND JUDICIOUS USE OF CURRENT BEST EVIDENCE in making decisions about the CARE OF INDIVIDUAL PATIENTS” (Sackett et al., 1996, p. 71).

PROCESS: Involves FORMULATING A CLINICAL QUESTION, FINDING AND EVALUATING EVIDENCE WITHOUT BIAS, and APPLYING IT APPROPRIATELY to a specific patient.

MORAL REASON FOR EBP: Professional caregivers have a MORAL OBLIGATION to practice in a manner that KEEPS THE PATIENT’S INTEREST FOREMOST by achieving the GREATEST GOOD and AVOIDING HARM.

CLINICAL DECISION MAKING is at its core an ETHICAL MATTER. Enthusiasm for EBP should not overlook its LIMITATIONS or ETHICAL DILEMMAS hidden beneath efforts to produce effective outcomes.

Answer 1

EVIDENCE-BASED PRACTICE (EBP)

Question 2

CORE ETHICAL ISSUE IN MEDICAL RESEARCH

• The core ethical issue is the need for VOLUNTARY CONSENT of the potential research subject so that a FULLY INFORMED INDIVIDUAL PARTICIPATES.
• Significant progress on this issue came from the NUREMBERG TRIALS.

Question 3

_____
- Nursing research must demonstrate ETHICAL VALUES that reflect the VALUES OF THE PROFESSION.

• HUMAN RIGHTS, EQUITY, and JUSTICE are stressed in relation to educators and researchers.

The FOUR PRINCIPAL ELEMENTS are:
1. _____
2. _____
3. _____ – states that the researcher must “CONDUCT, DISSEMINATE, AND UTILIZE RESEARCH TO ADVANCE THE NURSING PROFESSION.”
4. _____

Answer 3

INTERNATIONAL COUNCIL OF NURSES (ICN) PRINCIPAL ELEMENTS (2012)

PPPC
NURSES AND PEOPLE
NURSES AND PRACTICE
NURSES AND THE PROFESSION
NURSES AND CO-WORKERS

Question 4

CODE OF ETHICS FOR NURSES BY ANA (2015)

• Identifies specific VULNERABLE POPULATIONS: _____, THE _____, _____, _____, and THE _____.
• Indicates that the NURSE CLINICIAN identifies CLINICAL PROBLEMS, and the RESEARCHER DESIGNS THE STUDY in association with the clinician—ensuring that RESEARCH TOPICS IN NURSING SHOULD FOCUS ON PRACTICE.

Answer 4

CHILDREN, ELDERLY, PRISONERS, STUDENTS, POOR

Question 5

ETHICAL CONSIDERATIONS IN NURSING RESEARCH

1. _____: INSTITUTIONAL REVIEW BOARD (IRB)
   - Most nurse researchers are associated with INSTITUTIONS THAT REQUIRE ADHERENCE TO ETHICAL REGULATIONS.
   - MAIN PURPOSE OF AN IRB: To PROTECT HUMAN SUBJECTS, especially VULNERABLE POPULATIONS (e.g., CHILDREN, PRISONERS, PREGNANT WOMEN, HANDICAPPED/MENTALLY DISABLED, or ECONOMICALLY/EDUCATIONALLY DISADVANTAGED PERSONS).
   - Responsible for MONITORING THE RESEARCH.
2. _____
   - Nurse researchers must utilize ETHICAL SENSITIVITY to decide what is appropriate, have the ABILITY TO PERCEIVE RIGHTNESS AND WRONGNESS, and know how one’s actions affect the WELFARE OF ANOTHER PERSON.
   - The researcher should allocate TIME AND EFFORT to ensure the project meets all INSTITUTIONAL ETHICAL GUIDELINES.
   - ETHICAL BEHAVIOR requires INTELLECTUAL HONESTY: giving credit, not using ideas without acknowledgment, and not initiating data collection before INSTITUTIONAL APPROVAL.
3. _____
   - Developing appropriate questions is CRUCIAL FOR A FORMAL STUDY.
   - PURPOSE: To NARROW THE TOPIC, CLARIFY METHODOLOGY, determine if the topic has USEFUL QUESTIONS, and ensure SIGNIFICANT RESULTS that will ADD TO NURSING KNOWLEDGE.
   - Questions should be BROAD ENOUGH TO OBTAIN RESULTS, yet not so broad as to yield DIFFUSE OR MEANINGLESS RESULTS.

Answer 5

ENVIRONMENT FOR ETHICAL RESEARCH

DEVELOPING A RESEARCHABLE TOPIC

DEVELOPING RESEARCHABLE QUESTIONS

Question 6

4. _____
   - VULNERABLE POPULATIONS (the very young, frail elderly, prisoners, mentally incompetent, and women) are always a concern.
   - The key ethical issue: the individual must have FREEDOM OF CHOICE to participate or not and may WITHDRAW AT ANY TIME.
   - The researcher should REGULARLY CHECK with the subject to ensure they are still WILLING AND INFORMED.
   - COMPENSATION: Only TRANSPORTATION COSTS or LOSS OF EARNINGS due to participation may be compensated.
   - CHILD PARTICIPANTS: Research using children includes ALL USUAL ETHICAL ISSUES plus OTHER COMPOUNDING FACTORS.
5. _____
   - PROTECTION OF VULNERABLE HUMAN SUBJECTS remains the CRITICAL ETHICAL ISSUE.
   - Concern for the WELFARE OF HUMAN SUBJECTS is NEGATED WHEN SCIENTIFIC MISCONDUCT OCCURS, which is an EXTREMELY SERIOUS ISSUE.

Answer 6

PARTICIPANT RECRUITMENT AND INFORMED CONSENT

DATA COLLECTION AND DATA ANALYSIS