Discussion question:

Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Identify the criteria you would use to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria?

Discussion post

In Topic 5 DQ 1 the topic I chose to discuss was the need for an improved surgical item counting, with a standardized process. As discussed previously, this is a nationally recognized problem by The Joint Commission as evidenced by their release of a sentinel event alert regarding unintentional retained surgical items. Evidence-based practice is the use of information originating from theory and peer-reviewed research, applied to decision making, clinical practice, and consideration of individual needs and preferences (DeNisco & Baker, 2016). When examining the problem of an inadequate surgical count process and how to improve it to delivery safe and high-quality patient care, both qualitative and quantitative research will be useful. Before a department can improve their surgical count process, determining why their process is ineffective will help steer their project. Qualitative studies can help identify characteristics and circumstances when retained surgical items occur (RSIs), whereas, quantitative studies can help examine statistical data like incident rates and variables within various settings and surgical cases. Randomized controlled trials are the gold standard of medical research but that is not the case for nursing research, it requires a holistic approach and use of a broad range of methodologies (DeNisco & Baker, 2016). Retrospective analysis and case study reviews would be the most ethical approach to this research, with holding a hypothesized safer approach to counting surgical items from patients within a study would not be appropriate. I could not imagine explaining the risks to research candidates that they would possibly experience a surgical counting process that would risk retaining a surgical item in their body after their procedure. In this case we need to examine data and information from previous incidences.

Appropriateness of the research starts with a successful literature search to provide evidence to support your decision or change. Utilizing the steps for an efficient search outlined in our text like using key words from the PICOT, establishment of inclusion and exclusion criteria, utilization of tools to limit the search to topic of interest, and organize studies in meaningful manner like a matrix (DeNisco & Baker, 2016). Once you have substantial information and studies, examination of the material will help you further assess the appropriateness. A good understanding of the hierarchies for grading evidence will help you assess the strengthen and weaknesses of evidence found in a literature review, most hierarchy models believe meta-analysis of systematic reviews are the most beneficial and sound evidence and expert opinions being the lowest (DeNisco & Baker, 2016). Various appraisal tools exist to assist practitioners with the synthesis of literature to determine the appropriateness and ask a variety of questions based on the type of research design used within the study (DeNisco & Baker, 2016). Some of the criteria assessed by these tools include credibility (publication, credentials, conflicts of interest), validity (variable characteristics, sample size, results reported clearly), generalizability, and level of evidence within the design (DeNisco & Baker, 2016).

It is important to utilize studies that have the strongest quality of evidence. Use of evidence with strength will ensure that practitioners can be sure the evidence and practice change they implement produce the desired effect rather than an undesired one (DeNisco & Baker, 2016). Studies with strong validity, large sample sizes, ability to generate generalization, unbiased and lacking conflicts of interest are strong indicators for evidence appropriate to your project. With the concern for retained surgical items, an article about a radiofrequency technology counting device that the company of the device funded the researchers would show a conflict of interest and possible have bias. This wouldn’t be the best article for me if I am looking for evidence to support a standardized counting process to eliminate human error.

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession(3rd ed.). Burlington, MA: Jones & Bartlett Learning. ISBN-13: 9781284072570