Date of Learning Log: 20/09/2024
Time: 09:30-16:00
Learning Activity 1: Introduction to Methods and Methodologies.
In this learning activity, I explored the importance of evidence-based practice (EBP) in enhancing the quality of care. I examined various EBP frameworks and demonstrated an understanding of the strengths and weaknesses of different forms of evidence used in health and social research and service evaluation. Finally, I analysed the professional issues that may arise when implementing EBP.
A research methodology is a strategic plan that directs the selection and application of research methods. It serves as a framework for collecting, analysing, and interpreting data, ensuring that the research is systematic, valid, and credible. This approach is particularly relevant to evidence-based practices in health and social care.
Methods refer to the specific tools and techniques employed to gather data in research. These can include a variety of approaches such as surveys, interviews, focus groups, observations, and experiments, each tailored to capture different types of information. For instance, surveys might be used to collect quantitative data from a large population, while interviews may delve deeper into individual experiences and perspectives, providing qualitative insights.
On the other hand, methodologies encompass the overarching theoretical frameworks that guide the selection and application of these methods. They provide the underlying rationale for why a particular method is chosen and how it aligns with the research objectives. Common methodologies include qualitative approaches, which focus on exploring complex phenomena through understanding and interpretation, and quantitative approaches, which emphasise measurement and statistical analysis to test hypotheses. By integrating various methods within these methodologies, researchers can enhance the robustness of their studies and draw more comprehensive conclusions.
Quantitative focuses on quantity (numbers) – counting, measuring, analysing numerical data.
Qualitative focuses on quality (words) – understanding quality of experiences or phenomena – words, interviews, observations and narratives.
Mixed methods combines both qualitative and quantitative.
Common research methodologies in healthcare:
- Phenomenology:
Focuses on lived experiences (e.g., understanding patients’ experiences with chronic illness). - Ethnography:
Studies cultures and communities (e.g., understanding how a healthcare practice works within a specific group). - Randomised Controlled Trials (RCTs):
Tests the effectiveness of interventions by randomly assigning participants into groups (e.g., testing new medication efficacy). - Cohort Studies:
It follows a group over time to observe outcomes (e.g., studying the long-term effects of a healthcare intervention or smoking effects).
PDSA Methodology:
Plan: Identify Your Problems
This stage involves defining the problem and determining the objectives for improvement. In research terms, this is when you generate your research question and decide whether a qualitative or quantitative methodology is most appropriate
Do: Test Potential Solutions
At this stage, the research methodology is applied to collect data, whether through qualitative interviews or focus groups or quantitative experiments or surveys.
Check: Study Results
Here, the data is analysed to see whether the solution or intervention had the desired effect. This is where the analysis of either qualitative (themes and narratives) or quantitative (statistical analysis) data takes place.
Act: Implement the Best Solution
Finally, based on the results, the findings can be used to implement the best solution in practice or suggest changes in policy. This is the application of the findings to real-world nursing or healthcare practices.
Learning Activity 2: Search Strategies and Hierarchies of Evidence
In this learning activity, I engaged in a comprehensive literature search by employing various search strategies. I explored different databases and utilized specific keywords to gather relevant articles and studies. Throughout this process, I deepened my understanding of the hierarchy of evidence, which helped me assess the quality and reliability of the sources I found. I meticulously evaluated the literature to determine how each piece of evidence could be effectively applied in practice. This involved critically analysing methodologies, results, and implications, ensuring that the evidence I selected was both applicable and beneficial for real-world situations.
There are various forms of literature that you might come across while researching or examining previous studies. Each form offers a different degree of evidence, and grasping these classifications will assist you in determining their appropriate use and evaluating their credibility.
- Clinical Guidelines
- Clinical guidelines provide evidence-based recommendations to guide healthcare professionals in making decisions about patient care. They are created by expert panels after reviewing large bodies of evidence.
- Example: NICE (National Institute for Health and Care Excellence) guidelines in the UK.
- Systematic Reviews
- A systematic review synthesises the results of multiple studies on the same topic to draw a more comprehensive conclusion.
- Why it’s valuable: Systematic reviews provide high-level evidence as they minimise bias by including a broad range of research.
- Research Studies
- These include primary studies such as randomised controlled trials (RCTs), cohort studies, and case-control studies, which generate new data.
- Importance: Primary studies form the backbone of clinical evidence.
4 Internet Articles
- While articles from websites may provide useful background information or recent updates, they are generally considered lower-quality sources of evidence due to lack of rigorous peer review.
- Non-Research Articles
- These include opinion pieces, editorials, and commentaries. While helpful for insight or debate, they are not evidence-based and should not be the primary source for clinical decision-making.
- Grey Literature
- This refers to information produced outside traditional publishing channels. It includes conference proceedings, government reports, or unpublished studies.
- Why it matters: Grey literature can provide insight into emerging issues but should be approached with caution as it may not have undergone peer review.
NB: There is a difference between a systematic review and a meta-analysis. A systematic review summarises and evaluates the research but does not combine results statistically. A meta-analysis goes a step further by statistically combining data from multiple studies.
KSB ADDRESSED:
Knowledge:
| K1 | Understand the code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC 2018), and how to fulfill all registration requirements |
| K3 | Understand the professional responsibility to adopt a healthy lifestyle to maintain the level of personal fitness and well-being required to meet people’s needs for mental and physical care |
| K6 | Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice |
| K7 | Understand the importance of courage and transparency and apply the Duty of Candour |
| K9 | Understand the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people |
| K10 | Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes |
| K11 | Understand the factors that may lead to inequalities in health outcomes |
| K12 | Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being |
| K13 | Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes |
| K14 | Understand the importance of health screening |
| K15 | Understand human development from conception to death, to enable delivery of person-centred safe and effective care |
| K16 | Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care |
| K17 | Understand commonly encountered mental, physical, behavioural and cognitive health conditions as applied to delivery of care |
| K18 | Understand and apply the principles and processes for making reasonable adjustments |
| K19 | Know how and when to escalate to the appropriate professional for expert help and advice |
| K20 | Know how people’s needs for safety, dignity, privacy, comfort and sleep can be met |
| K21 | Understand co-morbidities and the demands of meeting people’s holistic needs when prioritising care |
| K22 | Know how to meet people’s needs related to nutrition, hydration and bladder and bowel health |
| K23 | Know how to meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity |
| K24 | Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain |
| K26 | Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld |
| K27 | Understand the principles of safe and effective administration and optimisation of medicines in accordance with local and national policies |
| K28 | Understand the effects of medicines, allergies, drug sensitivity, side effects, contraindications and adverse reactions |
| K29 | Understand the different ways by which medicines can be prescribed |
| K30 | Understand the principles of health and safety legislation and regulations and maintain safe work and care environments |
| K37 | Understand the challenges of providing safe nursing care for people with complex co-morbidities and complex care needs |
| K38 | Understand the complexities of providing mental, cognitive, behavioural and physical care needs across a wide range of integrated care settings |
| K39 | Understand the principles and processes involved in supporting people and families with a range of care needs to maintain optimal independence and avoid unnecessary interventions and disruptions to their lives |
| K40 | Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings or services |
| K41 | Know the roles, responsibilities and scope of practice of different members of the nursing and interdisciplinary team, and own role within it |
| K42 | Understand and apply the principles of human factors and environmental factors when working in teams |
| K43 | Understand the influence of policy and political drivers that impact health and care provision |
Skills:
| S1 | Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and fulfil all registration requirements |
| S2 | Keep complete, clear, accurate and timely records |
| S3 | Recognise and report any factors that may adversely impact safe and effective care provision |
| S4 | Take responsibility for continuous self-reflection, seeking and responding to support and feedback to develop professional knowledge and skills |
| S5 | Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018) |
| S6 | Act as an ambassador for their profession and promote public confidence in health and care services |
| S7 | Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges |
| S8 | Recognise signs of vulnerability in self or colleagues and the action required to minimise risks to health |
| S9 | Develop, manage and maintain appropriate relationships with people, their families, carers and colleagues |
| S10 | Provide, promote, and where appropriate advocate for, non-discriminatory, person-centred and sensitive care at all times, reflecting on people’s values and beliefs, diverse backgrounds, cultural characteristics, language requirements, needs and preferences, taking account of any need for adjustments |
| S21 | Monitor the effectiveness of care in partnership with people, families and carers, documenting progress and reporting outcomes |
| S22 | Take personal responsibility to ensure that relevant information is shared according to local policy and appropriate immediate action is taken to provide adequate safeguarding and that concerns are escalated |
| S23 | Work in partnership with people, to encourage shared decision making, in order to support individuals, their families and carers to manage their own care when appropriate |
| S24 | Perform a range of nursing procedures and manage devices, to meet people’s need for safe, effective and person-centred care |
| S25 | Meet people’s needs for safety, dignity, privacy, comfort and sleep |
| S26 | Meet people’s needs related to nutrition, hydration and bladder and bowel health |
| S27 | Meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity |
| S28 | Support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain |
| S29 | Give information and support to people who are dying, their families and the bereaved and provide care to the deceased |
| S30 | Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed |
| S31 | Act in line with any end of life decisions and orders, organ and tissue donation protocols, infection protocols, advanced planning decisions, living wills and lasting powers of attorney for health |
| S32 | Work collaboratively and in partnership with professionals from different agencies in interdisciplinary teams |
| S33 | Maintain safe work and care environments |
| S34 | Act in line with local and national organisational frameworks, legislation and regulations to report risks, and implement actions as instructed, following up and escalating as required |
| S35 | Accurately undertake risk assessments, using contemporary assessment tools |
| S36 | Respond to and escalate potential hazards that may affect the safety of people |
| S37 | Participate in data collection to support audit activity, and contribute to the implementation of quality improvement strategies |
| S38 | Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers and family members |
| S39 | Recognise when people need help to facilitate equitable access to care, support and escalate concerns appropriately |
| S40 | Support and motivate other members of the care team and interact confidently with them |
| S41 | Monitor and review the quality of care delivered, providing challenge and constructive feedback when an aspect of care has been delegated to others |
Behaviour:
| B1 | Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences |
| B2 | Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice |
| B3 | Be adaptable, reliable and consistent, show discretion, resilience and self-awareness |