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Topic 8 DQ 1
This is the question
Based on your Topic 7 Capstone Change Project Evaluation Plan, explain the dependent variable that is being measured and the independent variable that is being manipulated. Hypothesize the results of the manipulation of the independent variable and the change you expect to occur in the dependent variable.
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1. The project focuses on the reduction of Surgical site infections post operatively by implementing 2 CHG showers preoperatively as a part of skin preparation. The dependent variable is also called outcome variable is directly linked to the primary outcome of the study (Kaliyadan & Kulkarni, 2019). The independent variables (explanatory variable) in a study could be various external factors which could be manipulated to achieve the required outcome. The variables should have some properties such as good reliability and validity, low bias, feasibility/practicality, low cost, objectivity, clarity, and acceptance.
The dependent variable in this project is Surgical site infection. The independent variable is CHG shower application by implementing from the preoperative clinic by better education, proving CHG showers by the PCTs and nurses as a team and documenting the compliance in patients’ electronic record. The variable which was manipulated was sharing the workload between the day shift and night shift PCTs, a phone call reminder was added with the text message to take the CHG showers as ordered was initiated. The expected hypothesis would be the Surgical site infection would be reduced by 20% by the end of next 2 months and it is moving on in proper direction. Improved adherence to evidence-based preventive measures related to appropriate antimicrobial prophylaxis can decrease the rate of SSI (Seidelman & Anderson, 2021).
-Nigel
2. One of the goals of my evaluation plan is for staff to be educated on the use and importance of active warming for surgical patients. The outcome is that 80% of staff will voice an increase in understanding of the importance of using active warming. Independent variables are the cause, while dependent variables are the effect (Bhandari, 2022). The dependent variable is staff understanding while the independent variable is staff education. Staff education is the cause and staff understanding is the effect.
Another example is the application of an active warming method for maintaining normothermia in surgical patients. The dependent variable is patient temperature. The independent variable is active warming. Active warming is the cause and temperature is the effect. Manipulation of independent variable is done to see how they affect the dependent variable. Manipulation of the active warming device could be setting the device at different temperatures to see how that affects the dependent variable of patient temperature. The change I would expect to see is the higher the temperature is set on the active warming device; the higher the patient’s temperature will be. Setting the temperature higher on the active warming device could also decrease the amount of time needed to recover a patient’s temperature if it were to become hypothermic.
-Morgan
3. When it comes to conducting research in order to implement new projects it is imperative to understand the differences between the variables that can influence the outcomes. Independent variables affect the value of other variables, whereas dependent variables are influenced by other factors (Andrade, 2021). In other words, The cause is represented by an independent variable. Its value is unrelated to the other factors in your study. The effect or dependent variable is the result of the independent variable. Its value is reliant on changes in the independent variable (Bhandari, 2023).
In my EBP project the dependent variable is the reduction of hospital readmissions for patients with Congestive Heart Failure. On the other hand, the independent variable is the use of an educational handout where the materials are easily accessible and it is also easy to understand the information plus it has the phone numbers that are relevant such as cardiologist and rimary care physician.
In theory, the handout being provided and explained to all patients with a diagnosis of CHF whether it is a new diagnosis or previous will show a decrease in hospital readmissions and will only be seen in the hospital when the signs and symptoms hit the red emergency area of the handout but education will be provided to the patients about if the symptoms are treated earlier in the yellow stage of the handout it has better outcomes to the patients. If the handout is not provided to patients with a CHF diagnosis then the hospital readmission rates will continue to be high. With the handout the readmission are projected to decrease approximately 10% within the next 6 weeks. Nursing staff is working on utlizing the handout on a more consistent basis but when it is being utilized patients are understanding the education being provided which has been collected during leader rounding.
-Faith
4. In the Topic 7 Capstone Change Project Evaluation Plan, the dependent variable being measured is the incidence of falls among elderly patients. This variable is dependent because it is the outcome we aim to influence through the implementation of various interventions. The independent variable being manipulated is the comprehensive fall prevention program, which includes strategies such as staff training on fall risk assessment protocols, patient and family education, and enhancing cultural competence among nursing staff. The hypothesis for the project posits that the implementation of the comprehensive fall prevention program will lead to a significant reduction in the incidence of falls among elderly patients. Specifically, we expect a 30% reduction in fall incidents within six months of program implementation. This hypothesis is based on existing literature which supports the effectiveness of multifaceted fall prevention strategies in reducing fall rates in hospital settings (Ambrose et al., 2020).
By manipulating the independent variable—implementing the comprehensive fall prevention program—we expect the dependent variable, the incidence of falls, to decrease. The anticipated outcome is not only a reduction in the number of falls but also an improvement in staff compliance with fall risk assessment protocols, increased patient and family participation in fall prevention efforts, and enhanced cultural competence among the nursing staff. These changes are expected to create a safer environment for elderly patients, ultimately leading to fewer fall-related injuries and hospitalizations (Gillespie et al., 2022). Manipulating the independent variable of implementing a fall prevention program should lead to a positive change in the dependent variable, reducing fall incidents and improving overall patient safety.
-Josephine
Topic 8 DQ 2
This is the question
Not all EBP projects result in statistically significant results. Explain the difference between clinical and statistical significance. How can you use clinical significance to support positive outcomes in your project?
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5. Clinical significance observes dissimilarity between the two groups or the two treatment modalities (Sharma, 2021). Clinically significant is when research results are clinically relevant and can be used to assess the effectiveness or efficacy of a treatment modality. Clinically significant outcomes are those that improves the patient’s quality of life and make them attain well-being including physical function, mental status, and ability to engage in social life.
Statistical significance implies whether there is any mathematical significance to the carried analysis of the results or not. Statistical significance are the results being due to chance; that it is not likely that the differences occurred by chance alone (Carpenter et al., 2021). Statistical significance results do not necessarily mean that the results are clinically relevant and lead to improvement in the quality of life of the individuals. The researchers need to consider both statistical and clinical significance since research outcomes can be statistically significant but not clinically relevant from a clinical point of view (Sharma, 2021).
In my change project to reduce healthcare-associated infections through hand hygiene, the outcome will be determined by the clinical significance of the results. Clinical significance helps assess and determine the success of HH protocol compliance by collecting data from pre and post-surveys to determine the outcome. For example, the hand hygiene protocols I am focusing on include educating and training nurses and staff, implementing hand hygiene CDC techniques, and using Electronic Monitoring Systems for Hand Hygiene compliance. Clinical significance will determine if the outcomes have improved the quality of medical care over two months in both subjective and objective terms. This includes improvements in performance status, duration of healthcare-associated infection remission, as well as improvements in quality of life, and physical, emotional, and social well-being.
-Susan
6. In evidence-based practice (EBP) projects, it is crucial to differentiate between clinical significance and statistical significance. Statistical significance refers to the likelihood that the observed results are not due to chance, usually determined by a p-value of less than 0.05 (Kim, 2017). It indicates whether an intervention has a measurable effect, but it does not necessarily reflect the magnitude or practical importance of the effect. Clinical significance, on the other hand, pertains to the practical or real-world importance of an intervention’s effect on patient outcomes. It considers whether the change observed has a meaningful impact on patient care, quality of life, or overall health. For instance, a small but statistically significant reduction in fall rates might not be clinically significant if the reduction does not translate into fewer injuries or improved patient safety (Polit & Beck, 2021).
In the implementation of a Fall Prevention Program, even if the results are not statistically significant, clinical significance can still support positive outcomes. For example, if the program results in improved staff compliance with fall risk assessments and increased patient and family participation in fall prevention strategies, these outcomes can be clinically significant. They can enhance patient safety, improve care quality, and potentially prevent severe injuries from falls, which may not be fully captured by statistical analysis alone (Gillespie et al., 2022). To support the positive outcomes of the project, you can highlight improvements in process measures, such as adherence to protocols and patient education levels, as indicators of clinical significance. Emphasizing the practical benefits and real-world impacts of the interventions can demonstrate the value of the fall prevention program, even if statistical significance is not achieved.
-Josephine
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