Wright State University-Miami Valley
College of Nursing and Health
Spring 2012 Section 02
COURSE NUMBER: NUR 788
COURSE TITLE: Nursing Research Application and Utilization
PREREQUISITES: Nursing 707 and Nursing 708 in Master’s Program
CATALOG DESCRIPTION: Evaluation, utilization, and application of the research process
CREDIT HOURS: 3 credit hours
COURSE LOCATION & CLASS TIME: Monday
Time:
Location:
Classroom And Small Group Work
1:00pm-2:50pm
3:00pm - 3:50 pm
044 Rike Hall
COURSE FACULTY:
Barbara A. Fowler, PhD, PHCNS, BC
Professor
126 University Hall
Office (937) 775-2607
barbara.fowler@wright.edu
Office hours: Monday 4:00pm to 6:00pm (open) or
by appointment
FACULTY SECRETARIES: Julie Greenup (937-775-2576) and Sharon Brannon (937-775-2577) – 101 University
Hall (UH)
COURSE OBJECTIVES:
1.
2.
3.
4.
5.
6.
Demonstrate an understanding of research related to an identified nursing problem.
Critically analyze the current knowledge related to nursing problem.
Utilize information systems for the storage and retrieval of data, consistent with a particular population focus.
Initiate a line of inquiry into comprehensive databases in order to utilize available research in the practice of
nursing.
Write and communicate effectively regarding nursing research.
Develop a strategy for the incorporation of the research into professional nursing practice.
REQUIRED READING:
Melnyk, B.M., & Fineout-Overholt, E. (2011). Evidence-Based Practice in Nursing and Healthcare: A Guide to Best
Practice. (2nd ed.) Philadelphia, PA: Lippincott Williams & Wilkins.
Supplemental Articles:
Additional readings will be required. These readings will be available electronically in the content section of the
corresponding week on Pilot.
TEACHING STRATEGIES: Lecture, discussion, student presentations, critical appraisal of the evidence through
survey methods, possibly guest presentation from former students, midterm and final exam, and peer evaluation.
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Spring 2012 (Fowler)
COURSE POLICIES:
1. Students are expected to attend class weekly and actively participate in discussion and demonstrate
evidence of weekly readings by completion of assignments.
2. All assignments that are not submitted on the assigned date will result in a 10% penalty in grade.
3. Failure to submit any assignment will result in a zero. You are encouraged to keep up with the assigned
readings and plan for contingencies. This means you must plan ahead and make time to complete readings
and assignments before they are due. Emailing the course faculty the night something is due indicates that
you did not start soon enough. If there is a true emergency please contact the faculty.
4. WSU email is the best way to communicate with me. In most situations, I will provide a reply within a 24hour period on weekdays. There may be a longer time period in reply to e-mails during weekends.
5. Do NOT plan to complete any assignments in one day or over one-weekend. Completion of the
assignments requires integration of ideas from assigned readings, feedback from course faculty, and related
or supportive course materials.
6. The final exam will be offered during finals week (date & time - TBA). Please note: the final exam cannot be
taken earlier than scheduled, except in extreme emergency or if the student has made special
arrangements with the course faculty at least one prior to the final exam.
ACADEMIC EXPECTATIONS:
APA (6th edition) style format is to be used for all assignments.
Academic Honesty
 All papers in this course are expected to reflect the individual student’s critical thinking; therefore,
students are to submit only work for which they are solely responsible.
 Penalties for academic dishonesty and student procedure in academic dishonesty prosecution are clarified
in the Wright State University Student Handbook and on the Office of Community Standards & Student
Conduct website at www.wright.edu/students/judicial.
 Please be aware that a sentence which is minimally changed (only a few words are changed, added,
or subtracted) is not paraphrasing – it is plagiarism. Direct quotes require quotation marks and
correct citations with page numbers. Paraphrasing also requires citations.
 See APA 6th edition pp. 15-16 regarding plagiarism and pp.169-192 regarding quotations, paraphrasing, and
citations.
COURSE REQUIRMENTS AND EVALUATION
●Draft Group Paper:
Background of the clinical issue/problem using the PICOT format for inquiry
Pilot question (s); appropriate interventions & practice changes do you choose to
focus on this problem; the feasibility of two EBP implementation
frameworks/models for change to address the problem.
Maximum of 4 pages – double-spaced + submit the PICOT practice table;
cover page, and references.
●Each student in the established group must complete three (3) individual critiques of
research studies or supportive literature citations.
% POINTS
DUE DATE
7%
April 10, 2012 by
11:59pm (EST)
15%
April 25, 2012 by
11:59pm (EST)
2.5%
April 25, 2012 by
11:59pm (EST)
15%
April 30, 2012 (first
hour of class + brief
Refer to wk. 3 & 4 for hierarchy of types of evidence (single research studies to RCTSs)
After written feedback from the course faculty, this assignment must be included in the
compilation of studies for the group’s critique of collective evidence.
■Each student is expected to complete a peer evaluation of each member in their group
at half-way period (formative evaluation). Peer evaluations must be submitted in 1
combined document.
●Midterm Examination
May include a combination of multiple choice, true/false, & matching questions,
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Spring 2012 (Fowler)
and is designed to evaluate your understanding of the assigned readings, weekly
discussions, and class content delivered by the course faculty through week 5.
The midterm exam will cover content in week 1-5.
■Each student is expected to participate in the 20-minute EBPCP - PPT Podium
Presentation to your peers and course faculty during the 9th week of the quarter.
●Each group of 3 to 4 students will prepare and submit a 25-page computer-generated
proposal for an EBPCP. See page 4 & 5 for the criteria for the group paper.
Each student is expected to complete a peer evaluation on each member in their group at
the completion of the group project (summative). Peer evaluations must be
submitted in 1 combined document.
●Comprehensive Final Examination
May include a combination of multiple choice, true/false, & matching questions,
and are designed to evaluate your understanding of the assigned readings, weekly
discussions, and class content presented beginning with the first week of class;
however, most content will test your understanding of new lectures and discussions.
The final comprehensive exam will cover content in week 1-10, but mostly week 6-10.
TOTAL POINTS
Grading Scale:
 90-100 percent
 80-89.99
 70-79.99
 60-69.99
 0 - 59.99
=A
=B
=C
=D
=F
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Spring 2012 (Fowler)
M/T exam review)
8%
25%
2.5%
25%
100%
May 21. 2012 (all
student groups)
May 26, 2012 by
11:59pm (EST)
May 29, 2012 by
11:59pm
Final exam week;
date and time TBA.
NUR 788 (02) CLASS Schedule – Spring Quarter 2012
TOPICAL OUTLINE
Class
Week 1
March 26
Content
Course Overview (Brief orientation and
learning activities)
Introduction to Evidence-based practice
(EBP)
Link between research and EBP
 Getting started-spirit of inquiry
 Concept of change
 Asking compelling questions
(PICOT) format
Finding Relevant Evidence to Answer
PICOT Clinical Questions
Week 2
April 2
Guest
Presenter:
Ximena
Chrisagis,
librarian
Week 3
April 9
Models to Guide Implementation of
Evidence-Based Practice
 EBP implementation models
Creating a Vision & Motivating Change
Models of Change
Search strategies (2nd hour of class from
2:15-3:00pm)
Databases )Cochrane, Pub Med, &
CINAHL)
 Keywords
Types of research evidence:
Levels of evidence-hierarchy
●Single studies to RCTs
Reading Assignments and Related Class Activities
Readings:
Chapter 1-3 Melnyk & Fineout-Overholt
Melnyk, B., Fineout-Overholt, E., Stillwell, S., & Williamson, K. (2009). Igniting a spirit
of inquiry: An essential foundation for evidence-based practice. AJN, 109,
(11), 49-52.
Melnyk, B., Fineout-Overholt, E., Stillwell, S., & Williamson, K. (2010). The seven
steps of evidence-based practice. AJN, 110, (1), 51-53.
Stillwell, S., Fineout-Overholt, E, Melnyk, B., & Williamson, K. (2010). Asking the
clinical question: A key step in evidence-based practice. AJN, 110, (3), 58-61.
Establish groups of 3-4 students for EBP proposal & PPT presentation based on
NUR 707 proposals and interests of small groups (45-minutes)
Readings:
Chapter 3, 11 & 12 Melnyk & Fineout-Overholt
Levin, R. F., Keefer, J. M., Marren, J., Vetter, M.J., Lauder, B., & Sobolewski, S.
(2010). Evidence-based practice improvement: Merging 2 paradigms.
Journal of Nursing Care Quality, 25, (2), 117-126.
Stillwell, S., Fineout-Overholt, E, Melnyk, B., & Williamson, K. (2010). Searching for
the evidence: Strategies to help you conduct a successful search. AJN, 110,
(5), 41-47.
Identify key words for literature search (work with librarian for doing your searches)
Small group work – begin writing draft paper of the first assignment and searching
databases for supportive materials for the group paper (45-minutes)
Readings:
Chapter 5-6 Melnyk & Fineout-Overholt
Fineout-Overholt, E., Melnyk, B, Stillwell, S., & Williamson, K. (2010). Critical
appraisal of the evidence. Part 1: An introduction to gathering, evaluating,
and recording the evidence, AJN, 110, 7, 47-52.
Fineout-Overholt, E., Melnyk, B, Stillwell, S., & Williamson, K. (2010). Critical
appraisal of the evidence. Part II: Digging deeper-examining the “keeper”
studies. AJN, 110, 9, 41-48.
Draft Paper: Background to the clinical issue/problem, PICOT question(s), most
appropriate interventions, and 2 EBP implementation framework/models –
Paper due: April 10, 2012 by 11:59pm (EST) submit via Pilot drop box
Small group work for EBP proposal & PPT presentation (45 minutes)
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Spring 2012 (Fowler)
Week 4
April 16
Types of research evidence: (cont’d)
Levels of evidence-hierarchy
■Cont’d + Clinical practice guidelines
Rapid critical appraisal of the evidence
Synthesis Tables for conducting an
evidence review
Readings:
Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical
appraisal of the evidence: Part III, The process of synthesis: seeing
similarities + differences across the body of evidence. AJN, 110, (11), 43-51.
This article will give you the step-by-step process in rapid critical appraisal,
developing evaluation tables, as well as synthesis tables.
Use them as a guide during completion of your individual critiques.
Melnyk & Fineout-Overholt (pp. 513-518)
Draft Paper: Background to the clinical issue/problem, PICOT question, & EBP
implementation framework/model - Returned by April 17, 2012 by 11:59pm (EST) –
Submitted in group leader’s Pilot drop box.
Week 5
April 23
Week 6
April 30
Critical Appraisal of Quantitative and
Qualitative Evidence for Clinical Decision
Making
 Evaluation Tables
 Rapid Critical Appraisal of
Guidelines
 National Guideline Clearing House
(guideline.gov)
 AGREE II instrument
 Recommendations
Moving from Evidence to Action
●Patient Concerns, Choices, &
Clinical Judgment; Implementation
Small group work for EBP proposal & PPT presentation (45 minutes)
Study guide for Midterm Exam posted in Pilot this week
Peer evaluations AND Individual critiques (X 3 each student)- Due : April 25, 2012
by 11:59pm (EST) submit via Pilot drop box
Small group work for EBP proposal & PPT presentation (45 minutes)
Midterm examination ~ first hour of class followed by a brief M/T exam review
(1:00pm-2:15pm)
Readings:
Chapter 6 & 8 Melnyk & Fineout-Overholt
Melnyk, B., Fineout-Overholt, E., Ford, L.G., & Stillwell, S., (2011). Sustaining
evidence-based practice through organizational policies and an
innovative model. AJN, 111, (9), 57-60.
Peer evaluations AND individual critiques (X 3 each student) - Returned by May 2,
2012 by 11:59pm (EST) – via Pilot drop box.
Week 7
May 7
Evaluation of Practice Change
●Evaluation Models for Assessing
Change
●Outcomes Evaluation
●Measuring Outcomes
●Data appraisal & data management
Budgeting
●Funding Sources
●GANTT chart
Small group work for EBP proposal & PPT presentation (45 minutes)
Readings:
Chapter 9-10 Melnyk & Fineout-Overholt
Fineout-Overholt, E, Ford, L.G., Williamson, K., Melnyk, B., & Stillwell, S., (2011).
Following the Evidence: Planning for Sustainable Change. AJN, 111, (1),
54-60.
Ford, L.G., Fineout-Overholt, E, Melnyk, B., & Stillwell, S., (2011). Implementing an
evidence-based practice change: Beginning the transformation from an idea
to reality. AJN, 111, (3), 54-60.
Ford, L.G., Fineout-Overholt, E, Melnyk, B., & Stillwell, S., (2011). Rolling out the
rapid response team. AJN, 111, (5), 42-47.
Small group work for EBP proposal & PPT presentation (45 minutes)
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Spring 2012 (Fowler)
Week 8
May 14
Week 9
May 21
Week 10
May 28
Ethical Considerations
 IRB
Readings:
Chapters: 16 & 20 Melnyk & Fineout-Overholt
Disseminating Evidence
 Paper/podium presentation
 Poster presentation
Fineout-Overholt, E, Ford, L.G., Melnyk, B., & Stillwell, S., (2011). Evaluation and
disseminating the impact of an evidence-based intervention: Show and tell.
AJN, 111, (7), 56-59.
Your turn! Groups of 3-4 students will
have approximately 20-minutes to present
their PPT and Podium Presentations + Q &
A period
No class; Memorial Day Holiday
Small group work for EBP proposal & PPT presentation (45 minutes)
Final group paper due: May 26, 2012 by 11:59pm (EST) to Pilot drop box
Complete faculty evaluation
Study guide for Final Exam posted in Pilot this week
Final group paper will be returned by June 2, 2012 by 11:59pm (EST)
Finals
Week
June 4
Peer evaluations due - May 29, 2012 by 11:59pm (EST – via Pilot drop box.
Peer evaluations returned – June 5, 2012 by 11:59pm (EST – via Pilot drop box.
Final exam date & time – TBA
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Final Paper Criteria
1. Cover page, table of contents, including list of tables and figures, and appendices (0.5 point)
2. Abstract – 250 – 300 word abstract – MAXIMUM (1 pg. length); single-space (1.5 points).
3.
Statement of the Problem (2 pts; 0.25 pt. each) – Draft of part of this assignment has been graded (2–2.5 pgs.)
a. Identify the “compelling” question using PICOT format
b. Provide a clear description of the clinical problem using PICOT format
c. Explain why the problem requires change
d. How was the problem identified?
e. How many individuals are affected? What are their characteristics?
f. What are possible interventions (practice changes) to counter the problem?
g. Which intervention (practice change) are you choosing to focus on in this problem?
h. Provide a logical synthesis of the problem supporting the need to proceed with the practice change.
4. Planning the Practice Change Team (1.5 points; 0.5 point each) – (2 pgs.)
a. What disciplines and/or professions need to be represented on a team for planning this practice change?
b. Identify key informants within the practice site that should be involved in the practice change?
c. Should any agencies outside the practice site be involved? If so, what are these agencies and why should they
be represented?
5. Critical Appraisal of Evidence (5 points; 2.5 points each = A and B): This section must include the following
components.
a. 3 - 4 pg. summary or synthesis of relevant supporting materials and ideas from staff, patient education
materials, patient records, and evidenced-based guidelines or benchmarks such as the Cochrane Review or
Agency for Healthcare Research and Quality (AHRQ) that support your practice change (2.5 points).
b. Group critique of collective evidence (2.5 points) – (3 – 3.5 pgs.)
i. What is the strength of the evidence to make a change? Provide the scheme you used to determine
strength, e.g., consistent findings or recurrent themes from authors, etc.
ii. Provide a synthesis table of your articles and a narrative format in the text of the proposal summarizing
the evidence and strength.
6. Plan a Pilot Test of the Change (5 points; 0.5 points each) – (6 -7 pgs).
a. Identify what model for change you are using and why you selected it.
b. Specify the specific aims or objectives of the practice change
c. Describe the clinical setting for the change
d. Do you think you will receive support for the change project from physicians, other nurses and administrators in
your agency or healthcare system? Why or why not?
e. Describe the client/patient population to serve as the target of the change. How will subjects be approached or
recruited for this pilot? (Who, where, when, how, and how many?)
f. Describe the intervention.
g. Describe who might resist making changes. Explain
h. Describe special accommodations that may have to be made to implement the change.
i. Describe the timetable for implementing the changes. Use of a Gantt chart is helpful to determine in what order
change is expected or likely to occur?
j. Describe successful strategies for persuading others to support your contentions or actively support the project
change.
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Spring 2012 (Fowler)
7. Evaluation (3 points; 0.3 points each) – (2-3 pgs.)
a. What outcomes will be measured?
b. How will outcomes be measured? Brief discussion of measures used, including R&V measurement used.
c. Include specific information regarding frequency/timing of data collection methods.
d. Include specific information regarding the disciplines of persons collecting the data.
e. Describe the evaluation strategy/approach to be used in assessing the effects of the practice change (e.g.,
Donabedien’s framework, formative and summative, etc.).
f. Provide rationale for your choice of evaluation strategy/approach..
g. Describe the plan to monitor implementation of the practice change.
h. Describe the plan to monitor the long-term effect of the practice change.
i. How will you know that the practice change project is succeeding or failing?
8. Dissemination Of Findings
a. Professional Power point (PPT) podium presentation of the practice change project is worth 8% of the course
grade. All groups – May 21, 2012 (week 9).
9. Human Subjects Concerns (1 points) – identify potential concerns and how addressed (1/2 pg.)
10. Budget Page (1.5 points = total) - 0.5 point each section = a, b, c (1-1½ pg.)
a. How will the changes such as new materials, new record keeping systems, and/or training be paid for?
b. Include a table with the following budget categories (if applicable):
i. Personnel (e.g., nurses as change agents, other nursing and support staff)
ii. New materials
iii. New record keeping systems
iv. Training of personnel
v. Travel
c. Can the cost of the practice change be justified?
11. Format and Style (4 points TOTAL)
a. The practice change proposal should not exceed 25 double-spaced, typewritten/word processed pages,
excluding title page, table of contents, appendices, and references.
b. The practice change proposal must adhere to 6th edition APA writing style format and presented as listed
above using the following headings and subheadings.
i. Hint: 0.9 inch margins translate to 1 inch margins on the type-written/word processed document.
c. The preferred font style is Arial or Times New Romans using 11 or 12 pitch.
d. The practice change proposal must use correct grammar and is free of spelling and writing-style or syntax
errors.
e. The practice change proposal must be supported by appropriate references (required & recommended
readings, and other sources as needed).
Paper due: May 26, 2012 by 11:59pm (EST) – submit to Pilot drop box
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Spring 2012 (Fowler)
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