Outcomes of Hospital Patients Discussion

1(fb) My change of practice evidence-based project aims to evaluate the outcomes of patients, and the discharge rates by changing the intrathecal epidural medication and by removing immediately after surgery. In every study, there are two key variables to consider when collecting information, and implicit very essential for evaluation of the outcomes (Melnyk & Fineout-Overholt,2019). One of the dependent variables that I would consider for my evidence-based project is the health outcomes for the patients undergoing cesarean section. Changing the medication for anesthesia, and the practice, by removing immediately after surgery the intrathecal epidural, can determine if the application will improve our postpartum patients with implicit good benefits for the babies. The outcomes, such as well-controlled pain after surgery and decreasing the hospital stay, will include improvement of quality of life for our mothers/ babies and improved the perception of care. Evaluating the implementation process, for three months, the results collected through peer assessment, audit, and self-reflection will provide the evidence for the success of the project.

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The independent variable required in the evaluation of the evidence-based project is the approval between the interprofessional teams, in the change of medication and acceptance in the practice in our hospital. Acceptance and approval, for both changes, will be realized by providing the knowledge, education, and training for our staff to have the skills and feel comfortable in applying the new practice.

Another example that I would consider as an independent variable is a necessary dose for morphine and the dependent variable will be related to the frequency/intensity of symptoms for the new medication.

2 (kmc) Independent and dependent variables are important in research and are critical to understand when performing research and doing the evidence-based change project that I am working on of decreasing the blood culture collection contamination rate. In this change project, I am controlling and changing variables to see if they have a direct relation to decrease the contamination rate. Then the rates will be reviewed after 3 months and interventions adjusted.

Independent variables are variables that are manipulated by the researcher in experimental research. The independent variable is thought to have an effect on the dependent variable (GCU, 2018). The independent variable are more important to consider since if they are not controlled or watched, there can be confusion as to which variable caused the result in your dependent variable. This will be critical for me to watch for as there are many factors that could affect the results of my change project, including some that are not modified by me.

For my change project, the independent variables include the pre-packaging of blood culture supplies, education on proper collection procedure and pre and post education survey testing. The reasons for these independent variable changes are as follows; pre-packaging provides the clinician with all supplies needed to draw the cultures, which should decrease the need to interrupt mid-procedure to gather more supplies, increasing contamination risk, the education portion reinforces process and rates and resulting outcomes.

Dependent variables are what is being studied or the outcome of the assessment. the dependent variable relies on other variables, hence the name dependent. (Flannelly et.al., 2014) For my change project, the dependent variable is the rate of blood culture contamination. The goal is to reduce blood culture contamination rates, leading to a reduction of the rates to a level at or below the national standard, and decreasing patient impacts such as length of stay, unnecessary antibiotics and increased costs.

3 (tw) The purpose of proposing and implementing my evidence-based change project is to help improve the delivery of quality care to the community and help improve communication amongst the staff. As mentioned prior, it is also important to be able to evaluate the effectiveness of the implemented change project. In order to effectively evaluate any evidence-based change project dependent and independent variables need to be identified and collected. According to University of Southern California Libraries Research Guides (2020), a Dependent Variable is

“The variable that depends on other factors that are measured. These variables are expected to change as a result of an experimental manipulation of the independent variable or variables. It is the presumed effect.” And the Independent Variable is “The variable that is stable and unaffected by the other variables you are trying to measure. It refers to the condition of an experiment that is systematically manipulated by the investigator. It is the presumed cause.” (Paras. 1-2)

For my project, patient and staff/job satisfaction will serve as my dependent variables and independent variables is the instructional methods and training that influence the outcome (patient and job satisfaction). The reason for my choices of independent and dependent variables is because the ultimate goal of this project is to implement instructional methods and training to implicit a change and improve satisfaction for both patients and staff.

4 (ds) While statistical significance indicates reliability of the research conducted, clinical significance indicates the impact of the research on clinical practice (Ranganathan, Pramesh, and Buyse, 2015). Both are often confused for one another but are actually different. Clinical significance is important to actual practice and represents the impact a study had on real participants (Ranganathan, Pramesh, and Buyse, 2015). If a clinical trial of a new nursing intervention for diabetic patients proved effective in lowering the majority of the participants A1Cs and was promising in controlling their diabetes and decreasing comorbidities, one might look at this as clinical significance and adopt these interventions into every day practice. If a study I find proved effective in displaying the clinical significance of the intervention, such as immense success with implementing a health coaching program, than this is something important I would want to include in my project to prove a point, creating positive outcomes in my own research project and making a difference.Outcomes of Hospital Patients Discussion

5 (CMC) If you feel like there were some negative outcomes, or the clinical/ statistical results were insignificant would you and how would you make changes to create positive outcomes next time?

6 (fb) Understanding the importance and the difference between statistical and clinical significance when interpreting your research is essential for evidence-based project implementation. Statistical significance is established by an analysis conducted by researchers. A clinical significance is established by nurses and the experts who will decide if a statistically significant difference is clinically important and relevant and true (Heavey,2015).

In research studies, outcomes are statistically significant when the probability value shaped throughout the analysis is less than the certainty level needed by a researcher. Clinical significance is a subjective understanding of research findings as meaningful for patients under care, and therefore likely to influence the actions of healthcare providers (Heavey, 2015).

In evidenced-based research practice, a clinical significance will be considered when the expert team ( such as nurses, physicians, and other medical staff ) believe that the result of the research will have a positive outcome for the patients, while statistical significance will be determined by the statistic records, and should be proved by the latest research before following with the expert team to prove clinically significant.Outcomes of Hospital Patients Discussion

In my project, after researching the statistical significance and the majority of articles proved the significance of my literature review, I can follow on using clinical significance to support the positive outcomes for the patients through my evaluation plan, reviewing the patients and feedback from nurse