Completing the Roddy Analysis Worksheet - Term Paper Example

? Roddy and Ganz Assessments Number Question Completing the Roddy Analysis Worksheet The research question How to develop a new method for the purpose of determining the SOR and incorporating the research evidence and expert opinion. Using a multidisciplinary panel to produce 10 recommendations that relate to the role of exercise in the management of osteoarthritis (OA) of the knee or hip. Independent and dependent variables Dependent variable: management of OA of the knee and hip Independent variables: exercise therapy The sample size The choosing of the sample size The sample size is 95 The research has used panel sampling Experimental design The use of the experimental group The experimental design is a pre-post test design. In the use of a pre-post test design, Roddy et al (2006) consider data that had been collected by study participants’ performance before the research study took place. The research has also used one-way ANOVA in carrying out a variance analysis, to assess the difference between the groups in the research. Validity and reliability of the instruments of measurement The validity and reliability of the research study is underscored by the fact that the research uses the Delphi technique to determine the relevance of exercise therapy in managing OA. The data that has been collected factored the participants’ results that were produced before the research study was carried out. The results have then been considered in the study. Researchers are categorical that the pre-post test design is the best way of showing relations of causality, which the research is about. The significant differences that has been assigned across the two groups is p= 0.001, while the significant linearity is p=0.001. Data types included The research uses discrete data. Statistics used The purpose of the statistics The results Roddy and his group use secondary data. The statistics have been used to determine whether or not, existing methodology allows SOR to be appraised for recommendations with randomized controlled trials which have been rendered unethical or impractical. The statistics show a similarity between the traditional methodology and the strength of recommendation (SOR) used. Researchers’ conclusion Roddy and his group conclude that when comparing existing traditional methodology the newer systems of grading SOR will be less constrained and will offer an advantage of enabling the SOR to be appraised according to expert opinions which are consistent with the fundamentals of evidence-based medicine. Controlling the error Roddy and his group control the error by assigning significant differences between the research group and a significant linearity of p= 0.001 (in both cases) Concerns with the study The research study is very thorough and binding in establishing whether existing methodology allows SOR to be appraised for recommendations with randomized controlled trials which have been rendered unethical or impractical, or not. Analyzing and Supporting Whether the Changes Recommended Are Statistically Valid It is clear that the changes recommended by Roddy et al (2006) are statistically valid and sound enough to make practice changes in a hospital. The chief reason for this observation is that the recommendation considers the category of the evidence (which ranges from 1 to 4) and the mean strengths of the recommendations, in order to determine the strength of recommendation (ranging from A to D). Only the ninth of the ten recommendations is not recommendable. The recommendations show logical relations of correlation and causality between aerobic exercises and health status among patients with hip and knee OA. The rationale of the research that Roddy et al (2006) conducted also confirms the validity of the research recommendations. This is because, generally, and according to Roddy et al (2006), clinical guidelines gauge the validity of the recommendations, according to the compelling nature of supporting evidence which has been adduced in the study. This is to the effect that existing methodology does not allow that SOR is upgraded for the recommendations. This is the case if the recommendations for which the randomized and controlled trials are unethical or impractical. It is only by observing this measure that a reliable method of determining SOR and incorporating expert opinion and research evidence can be established. Conversely, the soundness of the recommendations made is underscored by the fact that the mean of the VAS scores registered for all the traditional SOR groups (labeled from A to D) and the not-recommended proposition exhibit a significant linearity on a single-way ANOVA. This takes care of the fringe cases such as the instance where some recommendations could not be assessed through randomized control trials for practical reasons, and therefore remained non-recommendable through the observation of the traditional methodology. The strength of the recommendations is also underscored by the measures that have been taken to safeguard the validity of the research method used. The research study considered the use of Delphi technique to arrive at the 10 recommendations for the role that the administration of exercise therapy plays in the management and treatment of osteoarthritis (OA) of the knee and the hip. The traditional method was used to determine the SOR recommendation, with the traditional method having been linked to the type of research evidence in the systematic literature search, as opposed to the visual analogue scale (VAS). The recommendations are also based on the research findings. The research findings in turn have their validity being premised on the use of the one-way ANOVA variance study. Particularly, after the allocation of the traditional strength of recommendation, the mean VAS was calculated, so that the differences determined between the groups are subjected to a one-way ANOVA variance study. Resultantly, the findings upon which the recommendations are drawn reflected a significant linearity on the one-way ANOVA. Question 2: Ganz Analysis Worksheet The research question Describing the oral care practices that ICU nurses conduct; to compare these practices with the present evidence-based practice; and to determine whether using evidence-based practice (EBP) was associated with professional and demographic characteristics. Independent and dependent variables Independent variable: demographic and professional characteristics Dependent variable: present evidence-based practice. The sample size The choosing of the sample size The sample size comprises 218 practicing Intensive Care Unit nurses in 2004-2005. The sampling method used is convenience sampling. Experimental design The use of the experimental group The nation survey uses a convenience sample of 218 ICU nurses (who were practicing between 2004 and 2005) and rates the level of priority in oral care on a scale of 0 to 100. The score is computed to represent the sum of 14 items that are related to assessment, equipment, techniques and solutions associated with the present best evidence. The score was subsequently analyzed using ANOVA to establish the differences of EBP, based on professional and demographic characteristics. Validity and reliability of the instruments of measurement The use of ANOVA to establish the differences of EBP, based on both demographic and professional characteristics guarantees the reliability of the research study. Data types included This research investigation uses quantitative data, particularly, discrete figures and percentages. The nurses are also found to have rated oral care for the intubated patients with a priority of 67 +/-27.1. Statistics used The purpose of the statistics The results The statistics used were primary, since they were collected from the very statistical information produced by ICU nurses, as they went about discharging their duties. The statistics are used to establish whether using evidence-based practice (EBP) was associated with professional and demographic characteristics, by considering the statistical findings produced by 218 ICU nurses. The statistical findings have it that the use of gauze pads accounted for 84%, tongue depressors 55%, and toothbrushes, 34%. The commonest solution that was used was chlorhexidine, accounting for 75%. 44% brushed their patients’ teeth, 71% did oral assessment prior to the issuance of oral care, while 57% documented their oral care. Researchers’ conclusion How the researchers answered the research questions Although the nurses highly prioritized oral care yet most of them did not integrate the latest evidence to their current work- practice. The researchers also found an absence of correlation between research utilization and professional or personal characteristics. Controlling the error The research study controlled the error by using ANOVA to determine the differences between EBP practices that are based on demographic and those that are based on professional characteristics. The researchers also work within the priority range within which nurses rated oral care for the intubated patients, 67 +/-27.1. Concerns with the study The research has been dexterously carried out, since all measures have been meticulously put in place to ensure that the internal and external validity of the research remain intact. Analyzing and Supporting Whether the Changes Recommended Are Statistically Valid The changes that Ganz and his proteges recommend are statistically valid. Particularly, the recommendation that Ganz et al (2009) make is that attempts should be made to encourage ICU nurses to embrace the use of EBP and oral-care protocols when attending to patients. This is because, the statistical findings showed wide variations between and within units, in terms of equipment, techniques and solutions used. This showed that practicing ICU nurses in this study did not often adhere to the latest EBP. Because of this, these nurses should be encouraged to embrace the use of EBP as a way of improving patient care. The validity of the recommendations is seen in the statistical findings which Ganz et al (2009) produce to show the disparity between the technological provisions which enable the use of EBP and the practicing ICU nurses’ observation of EBP. Particularly, it is established that gauze pads accounts for 84% of the most commonly used equipment, while chlorhexidine accounted for 75% of the most commonly used solution. This shows that although the technological provisions are present, yet nurses were not consistent in using them. The erratic use of the equipment, techniques and solutions as facets of EBP is clearly attested by the fact that only 57% of the practicing ICU nurses consistently documented the oral care that they gave, while it is obvious that evidence-based practice goes hand in hand with the documentation of healthcare reports. The case above shows the need to encourage ICU practicing nurses to adopt the consistent use of EBP and oral-care protocols. This move to encourage ICU nurses to adopt the use of EBP can be catalyzed by implementing mechanisms to ensure that the documentation of oral care at the onset, medial and terminal positions of oral care becomes integrated as part of oral-care protocols. It is against this backdrop that this culture of documenting information as a way of using EBP can be inculcated into the minds of the practicing nurses. The need to inculcate the culture of EBP among the practicing ICU nurses as is recommended by Ganz et al (2009) is not necessitated by ignorance or a negative attitude among the nurses, but by lack of constant acquaintance with the provisions of EBP. This is shown by the nurses in the research ranking oral care highly, in terms of priority, but not implementing the latest pieces o evidence as they go about their current practice. Again, the need to inculcate the observation of EBP provisions among all practicing ICU nurses is timely and very necessary, since the research findings show that research utilization or the observation of EBP was not at all related to professional or personal characteristics. This shows clearly that in the attempt to entrench the observation of research utilization and EBP, there should be no consideration of the ICU nurses’ personal, professional or demographic backgrounds. Instead, the measure should be implemented fully in concerned hospitals. The gravity behind the findings is also that the healthcare services sector will be most efficient and beneficial when research utilization and the observation of EBP are respected. References Ganz, D., Fink, F. N., Raanan, O., Asher, M., Nun, M. B., Benbinishty, J. (2009). ICU Nurses' Oral-Care Practices and the Current Best Evidence. Journal of Nursing Scholarship, 41 (2), 132-8. Roddy, E. Zhang, W. & Arden, N. (2006). Evidence-based clinical guidelines: a new system to better determine true strength of recommendation. Journal of Evaluating Clinical Practice, 12 (3), 347-52. Read More