Why would outcomes research use an entire database, rather than merely selecting a sample? (Select all that apply.)
a. Use of the whole database provides an analysis that addresses the entire patient population.
b. Permission to use an entire data base implies that the entire data base must be studied.
c. Small effect sizes and multiple variables demand huge samples, if statistical significance is to be achieved.
d. Accurate determination of risk throughout the system is the focus of outcomes research.
e. Cost is not an issue.
ANS: A, C, D
Outcome design strategies tend to have less control than traditional research designs and, except for the clinical trial, seldom use random samples; rather, they use large representative samples. Rather than using sampling criteria that restrict subjects included in the study to decrease possible biases and that reduce the variance and increase the possibility of identifying a statistically significant difference, outcomes researchers seek large heterogeneous samples that reflect, as much as possible, all patients who would be receiving care in the real world. One source of samples used for outcomes studies is large databases. Two broad categories of databases emerge from patient care encounters: clinical databases and administrative. A prospective cohort study is an epidemiological study in which the researcher identifies a group of people who are at risk for experiencing a particular event; they are optimally identified and followed through use of a database.
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A long-term care nurse is organizing a depression screening program for the residents. One of the nurse's peers questions why they need to do this, stating, "we are busy enough all ready." What is the best response by the nurse?
A) "Studies show that as many as 43% of institutionalized elderly adults show symptoms of clinical depression. Depression symptoms are often associated with chronic illness and pain." B) "Studies show that as many at 63% of institutionalized elderly adults show symptoms of clinical depression. Depression symptoms are often associated with chronic illness and pain." C) "Depression is uncommon in elderly clients, but we need to screen all of our clients to find the few that have symptoms." D) "Screening our clients for various diseases will show their families that we are trying to give them the best care possible."
The nurse reviews laboratory results for a client and notes that the erythrocyte sedimentation rate (ESR) is 32 mm/hr. What action by the nurse is best?
a. Document the findings and call the health care provider. b. Assess the client for any manifestations of infection or inflammation. c. Review the client's chart to see what me-dications have been given. d. Call the physician and request blood cul-tures and a chest x-ray.
Individual A has worked as an LPN/LVN for a year. The agency where she works discovers that the registration document she presented at the time she was hired was altered to remove the name of the rightful registrant and show her name instead
What are the possible outcomes of this situation? (Select all that apply.) a. The state board of nursing, when notified, will charge the nurse with fraud and deceit. b. The agency will terminate the employment of the individual. c. The agency will notify all patients for whom the individual cared to determine injury. d. The individual will be arrested for misrepresentation. e. The individual's license to practice will be revoked.
The nurse assessing a child who is suspected of being a victim of abuse will interview the child privately and will:
a. find out what the child was doing before the injuries occurred b. reassure the child that he or she is not "in trouble" and that the child has not done anything wrong c. tell the child that he or she has nothing to fear from the parents or the legal system d. see what the child has done in response to any abusive behavior from the parents