Matias Noll Ivan Silveira Topic 8 Dq 1And 2 Respo

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Matias Noll Ivan Silveira Topic 8 Dq 1And 2 Respo

I need two replies to my peers discussion questions, one reference each, only within the last 5 years 100 to 200 words each should be enough. I’ve included their discussions questions.

Question 1 Based on how you will evaluate your EBP project, which independent and dependent variables do you need to collect? Why?

In analytical health research, there are generally two types of variables, independent variables, and dependent variables. Independent variables are what we expect which will influence the dependent variable and the dependent variable is what happens because of the independent variable (National Library of Medicine, n. d). It is critical to identify both variables in the planning phase of a practice change project to evaluate the effectiveness of the project. In my proposed practice change project, the independent variables are the seven components of the Surgical Site Infection (SSI) prevention bundle: preoperative skin preparation with an alcohol-based solution (Chloraprep) after donning sterile gloves with 3 minutes of the dry time, re-gowning and gloving of the surgical personal who performed the skin prep, the entire surgical team is making a change of gloves before the closure of the abdomen, skin prep around the incision prior to fascia closure, re-drape the surgical site after the skin prep, use of a dedicated closure tray for abdominal closure, scrub nurse will change the gloves after the first closing count is complete. The dependent variables are SSI in colorectal surgeries, length of hospital stay, superficial SSI, deep SSI, and organ space SSI (Hewitt et al, 2017). The effect of the practice change proposal depends on the adherence to the new practice which is the use of a bundle in an effort to reduce SSI in colorectal surgeries. In this case, the dependent variable (SSI) depends on the implementation of independent variables (SSI bundle).

Two main variables will be used in the research. The independent variable and the dependent variable. The independent variables are the variables that can be controlled or changed to tests its effects on the dependent variable (Alvarez, 2016). The dependent variable cannot be changed, and it is usually being tested.

The dependent variable is chronic back pain. The independent variables are the demographic, socioeconomic, exercise level, hereditary, psychosocial, strength, behavioural factors, anthropometric, epidemiological and postural factors (Matias Noll Ivan Silveira de Avelar, 2016). Back pain is associates with demographic, sex and age. Research shows that it affects more women than men. Men and women older than sixty years are more likely to report cases of back pain. Epidemiological data I’ll give factors such as height, cigarette smoking and extreme weight and how likely they cause back pain. The research will prove whether height, body weight and body mass (anthropometric) have a direct relation to the risk of back pain.

Psychosocial factors that the research will consider are loneliness and loss of sleep in the previous years of a person and how they could cause chronic back pain. the hereditary variable will bring out ethnicity and genetics. Some chronic illnesses are genetic. Behavioural and postural factors will include sleeping time per night, reading, studying in bed, sitting posture while writing or typing.

Question 2

“The purpose of all research is to describe and explain variance in the world” (Variables, n.d., para. 1). Variance is the difference and can be variation that occurs naturally in the world or change that we create as a result of manipulation. A variable is either a result of some force or is itself the force that causes a change in another variable. (Variables, n.d.) There are independent and dependent variables which are basically the cause and effect. Independent variables are the cause and dependent variables are the effect. (Thomas, 2020)

In my project the independent variable would be bedside multidisciplinary rounding and the dependent variables would be patient satisfaction, shorter lengths of stay (LOS) and less readmissions. Variables are important because they are the basic units of information studies and interpreted. Carefully analyzing and interpreting the values of each variable to make sense of how things relate to each other is the sole purpose of research studies. (Variables, n.d.) In my study it is important to analyze the relation between taking multidisciplinary rounding to the bedside and patient outcomes. If there is in fact an effect then it will be important to continue to do rounding at the bedside versus at the nurses station.

Question 3

In analytical health research, there are generally two types of variables, independent variables, and dependent variables. Independent variables are what we expect which will influence the dependent variable and the dependent variable is what happens because of the independent variable (National Library of Medicine, n. d). It is critical to identify both variables in the planning phase of a practice change project to evaluate the effectiveness of the project. In my proposed practice change project, the independent variables are the seven components of the Surgical Site Infection (SSI) prevention bundle: preoperative skin preparation with an alcohol-based solution (Chloraprep) after donning sterile gloves with 3 minutes of the dry time, re-gowning and gloving of the surgical personal who performed the skin prep, the entire surgical team is making a change of gloves before the closure of the abdomen, skin prep around the incision prior to fascia closure, re-drape the surgical site after the skin prep, use of a dedicated closure tray for abdominal closure, scrub nurse will change the gloves after the first closing count is complete. The dependent variables are SSI in colorectal surgeries, length of hospital stay, superficial SSI, deep SSI, and organ space SSI (Hewitt et al, 2017). The effect of the practice change proposal depends on the adherence to the new practice which is the use of a bundle in an effort to reduce SSI in colorectal surgeries. In this case, the dependent variable (SSI) depends on the implementation of independent variables (SSI bundle).

Question 4 Not all EBP projects result in statistically significant results. Define clinical significance, and explain the difference between clinical and statistical significance. How can you use clinical significance to support positive outcomes in your project?

Clinical significance can be defined as how essential the effect of a given treatment is to the patient who received the treatment (van Rijn et al. 2017). In other words, it means the vital outcomes of treatment on it change the daily life of a person that is noticeable. Clinical significance and statistical significance are two different concepts. While clinical significance is the noticeable outcome of a given treatment, statistical significance indicates how reliable the results of a given study can be (van Rijn et al. 2017). Therefore, clinical signs are more practical and reliable results that are accurate. Statistical significance, on the other hand, means the probability that the results from a given study are valid. Hence statistical significance is more relied on analysis of results and determining the chances of whether such results can be applied on practical terms.

Clinical significant results can be vital in the project because the outcomes of the independent variables need to be noticeable (van Rijn et al. 2017). For instance, it would be important to know how educating patients about hypertension will impact the lives of these patients. Hence the use of clinical significance will be vital in checking the effectiveness of the project.

Question 5 “In medical terms, clinical significance (also known as practical significance) is assigned to a result where a course of treatment has had genuine and quantifiable effects” (MHA online, 2021, p. 1). Clinical significance pertains to the practical life importance or benefits of research findings. It often measures the magnitude of the relationship between the independent variable and the outcome variable. Statistical significance seeks to verify that an effect is taking place. It can be a helpful tool for decision-makers when considering the results of a particular study. However, it should not be the primary determinant of truth, efficacy, or importance. Clinical significance answers whether the change one may observe in the outcome because of the proposed intervention or exposure is big enough to warrant real-life implications. In a clinical trial, when two interventions are compared and statistical significance is obtained for the outcome variable, the null hypothesis is rejected and thus it is concluded that one treatment procedure is better than the other. However, a statistically significant reduction in symptom ratings may or may not represent a clinically meaningful treatment response (Polit, 2017).

In the practice change proposal of the SSI prevention bundle, the implementation of bundle components includes safe and effective patient care practices and a safe clinical practice environment. The safe practices incorporated in the bundle can create enhanced surgical recovery which may not be evident in the statistical measurement.

Question 6 All evidence-based project (EBP) projects must give statistically significant results because the primary preliminary t of a project is its ability to bring change. Therefore, a good research project aspires to change the current healthcare sector (Tenny & Abdelgawad, 2019). Despite the statistical significance, health professionals often rely on the clinical significance of the EBP results to make healthcare recommendations. Unlike statistical significance, clinical significance gives the practical importance of medication. For instance, in my project, if the implementation of multifactorial measures and mental health education among the inmates in the correctional facilities can reduce the suicide-related incidences from the current rate to approximately two percent; then the project is clinically significant. Consequently, all the correctional facilities should adopt the project.

Clinical significance and statistical significance differ in that the latter stresses the change an event can bring without determining the effect and direction of the change. In statistical significance, a negative or adverse change is considered significant; however, clinical significance focuses on bringing change that can make healthcare provision better (Polit, 2017). Statistical significance uses the p-value, such that when the p-value is less than 0.05, then the activity is statistically significant. Clinical significance can help prove and provide vivid explanations for the research results because they are more practical and have noticeable effects on the patients’ daily lives. In my research, the project is clinically significant if it helps reduce the incidence and prevalence of suicide-related deaths among the inmates in the correctional facilities.