EIDM - 2

N2NN3 Evidence-Informed Decision-Making Exercise Terminology and Concepts in EIDM (Week 3) Learning Goal This exercise introduces students to common terminology and concepts used in EIDM. Learning Outcomes Through preparation prior to class, class discussion and in-class learning activities, the following areas are addressed: 1. Developing clinical questions using PICO. 2. Identifying common quantitative research designs. 3. Understanding common terminology and concepts used in EIDM. 4. Critical appraisal of an intervention study using standardized critiquing criteria. 5. Formulating recommendations to address clinical questions based on the Model for Evidence-Based Clinical Decisions (Cullum et al., 2008, p. 12). Learning Activities Prior to Tutorial 1. Complete the EIDM online learning module “EIDM Terminology and Concepts” 2. Read the following chapters in Cullum et al. (2008) as necessary · Thompson, C. (2008). If you could just provide me with a sample: Examining sampling in quantitative and qualitative research papers. In N. Cullum, D. Ciliska, R. B. Haynes, S. Marks (Eds.), Evidence-based nursing: An introduction (pp. 58-65). Oxford, UK: Blackwell Publishing Ltd. · Shulz, K. F. (2008). Assessing allocation concealment and blinding in randomized controlled trials: Why bother? In N. Cullum, D. Ciliska, R. B. Haynes, S. Marks (Eds.), Evidence-based nursing: An introduction (pp. 116-120). Oxford, UK: Blackwell Publishing Ltd. · Devereaux, P. J. (2008). The term ‘double bind’ leaves readers in the dark. In N. Cullum, D. Ciliska, R. B. Haynes, S. Marks (Eds.), Evidence-based nursing: An introduction (pp. 130-134). Oxford, UK: Blackwell Publishing Ltd. · Ciliska, D., Cullum, N., & DiCenso, A. (2008). The fundamentals of quantitative measurement. In N. Cullum, D. Ciliska, R. B. Haynes, S. Marks (Eds.), Evidence-based nursing: An introduction (pp. 67-71). Oxford, UK: Blackwell Publishing Ltd. · Cullum, N., & Petherick. (2008). Evaluation of studies of treatment or prevention interventions. In N. Cullum, D. Ciliska, R. B. Haynes, S. Marks (Eds.), Evidence-based nursing: An introduction (pp. 104-116). Oxford, UK: Blackwell Publishing Ltd. NOTE: only pages 104-110 (up to “What are the results”) 3. Review the following scenario: You are a nurse working in the McMaster Emergency Room (ER) caring for an adult female patient who presented with hematemesis (or vomiting blood). You are at her bedside when the physician discusses the treatment plan with the patient, which includes the insertion of a nasogastric (NG) tube. After the physician leaves, you take a moment to review the procedure. The patient explains that she has had a NG tube before and remembers how painful it was to be inserted. She asks if there is anything you can do while inserting the NG tube to make it less painful. You recall receiving an article alert from Mac PLUS FS about the use of lidocaine gel instead of the lubricant jell that is usually used for this procedure. You are able to log onto Mac PLUS FS and retrieve the study by Uri et al. (2010). P:I:C:O: pain 4. Retrieve the following intervention study. Uri, O., Yosefov, L., Haim, A., Behrbalk, E., & Halpern, P. (2011). Lidocaine gel as an anesthetic protocol for nasogastric tube insertion in the ED. American Journal of Emergency Medicine, 29, 386-390. http://journals1.scholarsportal.info.libaccess.lib.mcmaster.ca/pdf/07356757/v29i0004/386_lgaaapntiite.xml 5. Complete the Worksheet for EIDM Concepts/Terminology for Intervention Studies (on the next page). 6. Bring the Uri et al. (2011) study and the completed Worksheet for EIDM Concepts/Terminology for Intervention Studies to class. During Tutorial 1. Review the Worksheet for EIDM Concepts/Terminology for Intervention Studies. 2. Discuss EIDM concepts and terminology. 3. Discuss how the presence or lack of EIDM concepts and terminology might bias (or affect) the outcome(s). 4. Determine if there is evidence in the Uri et al. study to address the clinical question that was formulated. 5. Formulate recommendations to address the clinical question using the Uri et al. (2011) study which incorporate the Model for Evidence- Based Clinical Decisions. N2NN3 Evidence-Informed Decision-Making Exercise Terminology and Concepts in EIDM (Week 3) Learning Goal This exercise introduces students to common terminology and concepts used in EIDM. Learning Outcomes Through preparation prior to class, class discussion and in-class learning activities, the following areas are addressed: 1. Developing clinical questions using PICO. 2. Identifying common quantitative research designs. 3. Understanding common terminology and concepts used in EIDM. 4. Critical appraisal of an intervention study using standardized critiquing criteria. 5. Formulating recommendations to address clinical questions based on the Model for Evidence-Based Clinical Decisions (Cullum et al., 2008, p. 12). Learning Activities Prior to Tutorial 1. Complete the EIDM online learning module “EIDM Terminology and Concepts” 2. Read the following chapters in Cullum et al. (2008) as necessary · Thompson, C. (2008). If you could just provide me with a sample: Examining sampling in quantitative and qualitative research papers. In N. Cullum, D. Ciliska, R. B. Haynes, S. Marks (Eds.), Evidence-based nursing: An introduction (pp. 58-65). Oxford, UK: Blackwell Publishing Ltd. · Shulz, K. F. (2008). Assessing allocation concealment and blinding in randomized controlled trials: Why bother? In N. Cullum, D. Ciliska, R. B. Haynes, S. Marks (Eds.), Evidence-based nursing: An introduction (pp. 116-120). Oxford, UK: Blackwell Publishing Ltd. · Devereaux, P. J. (2008). The term ‘double bind’ leaves readers in the dark. In N. Cullum, D. Ciliska, R. B. Haynes, S. Marks (Eds.), Evidence-based nursing: An introduction (pp. 130-134). Oxford, UK: Blackwell Publishing Ltd. · Ciliska, D., Cullum, N., & DiCenso, A. (2008). The fundamentals of quantitative measurement. In N. Cullum, D. Ciliska, R. B. Haynes, S. Marks (Eds.), Evidence-based nursing: An introduction (pp. 67-71). Oxford, UK: Blackwell Publishing Ltd. · Cullum, N., & Petherick. (2008). Evaluation of studies of treatment or prevention interventions. In N. Cullum, D. Ciliska, R. B. Haynes, S. Marks (Eds.), Evidence-based nursing: An introduction (pp. 104-116). Oxford, UK: Blackwell Publishing Ltd. NOTE: only pages 104-110 (up to “What are the results”) 3. Review the following scenario: You are a nurse working in the McMaster Emergency Room (ER) caring for an adult female patient who presented with hematemesis (or vomiting blood). You are at her bedside when the physician discusses the treatment plan with the patient, which includes the insertion of a nasogastric (NG) tube. After the physician leaves, you take a moment to review the procedure. The patient explains that she has had a NG tube before and remembers how painful it was to be inserted. She asks if there is anything you can do while inserting the NG tube to make it less painful. You recall receiving an article alert from Mac PLUS FS about the use of lidocaine gel instead of the lubricant jell that is usually used for this procedure. You are able to log onto Mac PLUS FS and retrieve the study by Uri et al. (2010). 4. Retrieve the following intervention study. Uri, O., Yosefov, L., Haim, A., Behrbalk, E., & Halpern, P. (2011). Lidocaine gel as an anesthetic protocol for nasogastric tube insertion in the ED. American Journal of Emergency Medicine, 29, 386-390. http://journals1.scholarsportal.info.libaccess.lib.mcmaster.ca/pdf/07356757/v29i0004/386_lgaaapntiite.xml 5. Complete the Worksheet for EIDM Concepts/Terminology for Intervention Studies (on the next page). 6. Bring the Uri et al. (2011) study and the completed Worksheet for EIDM Concepts/Terminology for Intervention Studies to class. During Tutorial 1. Review the Worksheet for EIDM Concepts/Terminology for Intervention Studies. 2. Discuss EIDM concepts and terminology. 3. Discuss how the presence or lack of EIDM concepts and terminology might bias (or affect) the outcome(s). 4. Determine if there is evidence in the Uri et al. study to address the clinical question that was formulated. 5. Formulate recommendations to address the clinical question using the Uri et al. (2011) study which incorporate the Model for Evidence- Based Clinical Decisions. EIDM Concepts/Terminology for Intervention Studies Worksheet Questions Comments 1. What is the PICO question from the above scenario? PICO question sentence doesn't have to be in the same order as PICO P: I: C: O: 2. What is the PICO question of the study? P: gastro insertion in the ER I: 2% ladicane gell C: non anaesthetic lubricant gell KY O: measuring pain. Hemodynamically stable adults requiring gastro insertion for ... 3. Were patients randomized? yes - it tells us this in the abstract 4. This study is what type of quantitative research design? Draw the design. 5. Was randomization concealed? 6. Were groups shown to be similar in all known determinants of the outcome? 7. Were patients blinded? 8. Were clinicians delivering the intervention blinded? 9. Were outcome assessors blinded? 10. Was follow-up complete? 11. Were patients analysed in the groups to which they were assigned? 12. Reading the result(s)/conclusion(s) in the abstract of the study, how would you apply the results to address the PICO question from the scenario?