DNP 820 Topic 1 DQ 2 Compare the PhD and DNP degrees

DNP 820 Topic 1 DQ 2 Compare the PhD and DNP degrees

DNP 820 Topic 1 DQ 2

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Compare the PhD and DNP degrees. Define the differences in roles and education associated with the two degrees. Describe future opportunities for DNP-prepared nurses.

RReview the “Levels of Evidence in Research” document located in the Class Resources. Refer to this resource as needed throughout the course.

Why is it important to use research that has a high level of evidence when applying research to practice? Search for a primary quantitative research article for the intervention for your proposed DPI Project. Explain how this article meets the required evidence level required for a primary research article.

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Primary research scholarly articles that are either quantitative or qualitative are needed in order to verify original sources of new knowledge or innovations. These articles heavily describe the intervention along with the impact on the given population. Some examples of primary research include randomized controlled studies, cohort studies, and case report studies. These studies involve participants and/or observation by researchers. Friesent et.al (2017) completed a pilot study by translating research into evidence-based practice (EBP) at the bedside. It was identified that organizational administrators further invest in nurse driven EBP implementation to advance clinical practice.

The American Heart Association (AHA) and the American College of Cardiology (ACC) recommends an electrocardiography (ECG) for any patient that arrives to the Emergency Department with a chief complaint of chest pain. The recommendation is to have the primary ECG completed within ten minutes of arrival (Gulati et.al, 2021). The AHA/ACC clinical guideline for the evaluation and diagnosis of chest pain was derived from a literature review of primary research articles based on studies that were randomized, non-randomized, observational, reviews, registries, and others. Based on AHA/ACC’s clinical guidelines, this DNP learner can utilize these guidelines and develop a protocol to change the acquisition of ECGs from the treatment area to intake to reduce the amount of time an ECG is completed from arrival. Yiadom et.al (2017) completed a prospective cohort study by developing a protocol for timely ECG completion based on the patient’s arrival complaint of chest pain. The authors identified patients upon arrival based on an early ECG screening at intake. The research obtained demonstrated the need for an ECG protocol to enhance door-to-ECG time frame. The authors reported a median time of 31 minutes to ECG completion and of 472,166 adult patients who screened positive for chest pain, 407 were diagnosed with ST-elevation myocardial infarction (STEMI) (Yiadom et.al, 2017). This article explains the requirements to meet the standards of the AHA/ACC guideline with an implementation protocol. This DNP learner believes that an implementation of ECG completion upon arrival will decrease door-to-ECG, increase identification of STEMI diagnoses, and therefore increase transfer to the cardiology service to obtain goals of door-to-needle within 30 minutes and door-to-balloon within 90 minutes per AHA STEMI guidelines.

Friesen, M. A., Brady, J. M., Milligan, R., & Christensen, P. (2017). Findings from a pilot study: Bringing evidence-based practice to the bedside. Worldviews on Evidence-Based Nursing, 14(1), 22-34.

Gulati, M., Levy, P. D., Mukherjee, D., Amsterdam, E., Bhatt, D. L., Birtcher, K. K., Blankstein, R., Boyd, J., Bullock-Palmer, R. P., Conejo, T., Diercks, D. B., Gentile, F., Greenwood, J. P., Hess, E. P., Hollenberg, S. M., Jaber, W. A., Jneid, H., Joglar, J. A., Morrow, D. A., … Shaw, L. J. (2021). 2021 AHA/ACC/ASE/Chest/Saem/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 144(22). https://doi.org/10.1161/cir.0000000000001029

Yiadom, M. Y., Baugh, C. W., McWade, C. M., Liu, X., Song, K. J., Patterson, B. W., Jenkins, C. A., Tanski, M., Mills, A. M., Salazar, G., Wang, T. J., Dittus, R. S., Liu, D., & Storrow, A. B. (2017). Performance of Emergency Department screening criteria for an early ECG to identify st‐segment elevation myocardial infarction. Journal of the American Heart Association, 6(3). https://doi.org/10.1161/jaha.116.003528

RESPOND HERE

I agree with you that verifying original sources of new knowledge and innovation is important in any form of research. There are chances that some materials may have inaccurate and unreliable information (Zhang & Parker, 2019). When unreliable primary research scholarly materials are deployed in either quantitative or qualitative studies there are high chances that the research may be misleading. As a result, researchers take their time to assess the articles to be used in compiling their research works. These articles heavily describe the intervention along with the impact on the given population. The details of these articles make them crucial in supporting research. Unfortunately, some researchers take limited time to examine these materials. Hence, some errors are transferred to other stages of research. Some examples of primary research include randomized controlled studies, cohort studies, and case report studies (Katkade et al., 2018). These studies give researchers active role in obtaining data. Therefore, observation is common primary research approach.

References

Katkade, V. B., Sanders, K. N., & Zou, K. H. (2018). Real world data: an opportunity to supplement existing evidence for the use of long-established medicines in health care decision making. Journal of multidisciplinary healthcare, 11, 295. doi: 10.2147/JMDH.S160029

Zhang, F., & Parker, S. K. (2019). Reorienting job crafting research: A hierarchical structure of job crafting concepts and integrative review. Journal of organizational behavior, 40(2), 126-146. https://doi.org/10.1002/job.2332

There are various levels of evidence that are placed in a hierarchy. A study that applies a higher level of evidence indicates there has been more rigorous testing and evaluation for that particular topic. A level one study is comprised of randomized control trials, meta-analyses, systematic reviews, and clinical practice guidelines. This is the highest level of evidence. Level one studies may be primary research or secondary research. Secondary research synthesizes the research of others. Level two includes cohort studies. Case report studies make up level three. Level four is composed of case reports and case series. The lowest level of evidence is level five which includes animal or laboratory studies. A higher level of evidence should have more rigorous testing behind the study. As one is reading and evaluating the research, especially as level one evidence, the researcher should critically scrutinize the study design to ensure adequate results (Harvey, 2020). As one goes through the different levels of research, there is less rigorous design in the study which may introduce bias or research errors (Glasofer & Townsend, 2019). By using the highest level of evidence to translate into practice, there is more confidence that the intervention will have a true impact on the variable.

Schallom et al. (2020) implemented a research study across seven critical care units evaluating the effect of an early mobility program on different outcomes. The outcomes evaluated include mobility level, length of stay, and delirium. This particular study is a level two in regards to levels of evidence in research. As a primary research article, this cohort study has pre and post-intervention data. Previous literature is supportive of the interventions evaluated within this study. It further helps to establish early mobility as a reliable intervention as this particular study evaluated seven different types of specialty intensive care units. It looked at a broader group compared to only a surgical, medical or trauma unit. While it is not a randomized control study, it is a well laid out study that helps to advance the body of knowledge regarding early mobility programs in an adult intensive care unit with a quasi-experimental design.

References

Glasofer, A & Townsend, A. B. (2019). Determining the level of evidence experimental research appraisal. Nursing Critical Care, 14, (6), 22-25. Doi: 10.1097/01.CCN.0000580120.03118.1d

Harvey, E. (2020). Can we use levels of evidence to make a decision? Canadian Journal of Surgery, 63(1), E86. Doi: 10.1503.cjs.001920

Shallom, M, Tymkew, H., Vyers, K., Prentice, D., Sona, C., Norris, T. & Arroyo, C. (2020). Implementation of an interdisciplinary AACN early mobility protocol. Critical Care Nurse, 40 (4), e7-e17. Doi: https://doi.org/10.4037/ccn2020632

RESPOND HERE

ANGELA it is true that there are various levels of evidence. The different levels are placed in hierarchy that helps researchers in located the right sources of information to incorporate in their research.  Most studies prefer highest levels of evidence. The highest levels assure researchers of accurate and reliable research findings (Wakabayashi & Kuroki, 2022). Besides, a study that applies a higher level of evidence indicates there has been more rigorous testing and evaluation for that particular topic. Therefore, most people prioritize highly-ranked evidence. A level one study is comprised of randomized control trials, meta-analyses, systematic reviews, and clinical practice guidelines (Greenhalgh et al., 2018). A level one of evidence is assumed to be most reliable due to the highest level of evidence. Primary and second research may be classified under first level of evidence. Level two includes cohort studies. Case report studies make up level three. Level four is composed of case reports and case series. The lowest level of evidence is level five which includes animal or laboratory studies.

References

Greenhalgh, T., Thorne, S., & Malterud, K. (2018). Time to challenge the spurious hierarchy of systematic over narrative reviews?. European journal of clinical investigation, 48(6). doi: 10.1111/eci.12931

Wakabayashi, T., & Kuroki, M. (2022). Organizational Identity, Incentive Schemes, and Performance in a Corporate Hierarchy: Theory and Evidence. Incentive Schemes, and Performance in a Corporate Hierarchy: Theory and Evidence (January 13, 2022). http://dx.doi.org/10.2139/ssrn.3687868

Review the “Levels of Evidence in Research” document.

Why is it important to use research that has a high level of evidence when applying research to practice?

The levels of evidence is an important component of evidence-based practice. These levels present a system of rating evidence when determining the effectiveness of the presented intervention. The ranking presents a hierarchy according to probability of bias and systematic errors. Expert opinions are assigned the lowest level because they have high risk of bias and systematic errors – biased by the author’s opinions and experiences, and do not have a control of confounding factors (Schmidt & Brown, 2019).

On the other hand, randomized controlled trials are assigned the highest level because they are unbiased and have less risk of systematic errors. It is important to use research that has a high level of evidence when applying research to practice because the high level of evidence indicates that the evidence is not bias by the author’s opinions and experiences. Additionally, high level of evidence has less risk of systematic errors because there is control of confounding factors (Schmidt & Brown, 2019).

Search for a primary quantitative research article for the intervention for your proposed DPI Project. Explain how this article meets the required evidence level required for a primary research article.

Thapa, Bhandari and Pathak (2021) is a journal article that presents the results of a quantitative research study exploring the attitudes of nursing students towards e-learning. It notes that e-learning presented a ready solution for meeting education needs in the midst of Covid-19 pandemic as learning institutions remained closed. Applying a descriptive, cross-sectional study that recruited a sample of 470 nursing students subjected to self-administered validated questionnaires, the study noted that about half of nursing students have a positive attitude towards learning.

This article meets the evidence level required for a primary research article because it is a first publication of the research findings and is written by the researchers themselves. It directly engages nursing students as the primary source of information/data. besides that, it highlights the different steps in the research process by including sections such as abstract, introduction/background, methods, results, discussion and conclusion (Schmidt & Brown, 2019).

References

Schmidt, N., & Brown, J. (2019). Evidence-Based Practice for Nurses: Appraisal and Application of Research (4th ed.). Jones & Bartlett Learning, LLC.

Thapa, P., Bhandari, S. L., & Pathak, S. (2021). Nursing students’ attitude on the practice of e-learning: A cross-sectional survey amid COVID-19 in Nepal. PloS one, 16(6), e0253651. https://doi.org/10.1371/journal.pone.0253651

RESPOND HERE

ASIATU it is true the levels of evidence is an important component of evidence-based practice.  Researchers can choose the suitable evidence based on the nature of their studies. However, in most cases highest levels of evidence are believed to be most suitable and accurate (Waters & Rankin, 2019). These levels present a system of rating evidence when determining the effectiveness of the presented intervention. Locating accurate and factual information in research ensures that research attains its objectives. The ranking presents a hierarchy according to probability of bias and systematic errors (Grove et al., 2022). The ranking lists evidence based on the accuracy levels. Level one evidence are considered to be the highest while level four is the lowest accuracy levels. Randomized controlled trials are assigned the highest level because they are unbiased and have less risk of systematic errors. Research articles with highest manipulation levels are ranked lowest in the hierarchy. It is important to use research that has a high level of evidence.

References

Grove, A., Clarke, A., & Currie, G. (2022). Knowledge mobilisation in orthopaedic surgery in England: Why hierarchies of knowledge bear little relation to the hierarchy of evidence in professionally socialised groups. Evidence & Policy, 18(1), 127-147. DOI: https://doi.org/10.1332/174426420X16028608136504

Waters, N., & Rankin, J. M. (2019). The hierarchy of evidence in advanced wound care: The social organization of limitations in knowledge. Nursing Inquiry, 26(4), e12312.  https://doi.org/10.1111/nin.12312

Name:  Discussion Rubric

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		Excellent 90–100	Good 80–89	Fair 70–79	Poor 0–69
Main Posting: Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.		40 (40%) – 44 (44%) Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources.	35 (35%) – 39 (39%) Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references.	31 (31%) – 34 (34%) Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references.	0 (0%) – 30 (30%) Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references.
Main Posting: Writing		6 (6%) – 6 (6%) Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style.	5 (5%) – 5 (5%) Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style.	4 (4%) – 4 (4%) Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors.	0 (0%) – 3 (3%) Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Posting: Timely and full participation		9 (9%) – 10 (10%) Meets requirements for timely, full, and active participation. Posts main Discussion by due date.	8 (8%) – 8 (8%) Meets requirements for full participation. Posts main Discussion by due date.	7 (7%) – 7 (7%) Posts main Discussion by due date.	0 (0%) – 6 (6%) Does not meet requirements for full participation. Does not post main Discussion by due date.
First Response: Post to colleague’s main post that is reflective and justified with credible sources.		9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting.	7 (7%) – 7 (7%) Response is on topic and may have some depth.	0 (0%) – 6 (6%) Response may not be on topic and lacks depth.
First Response: Writing		6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English.	4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
First Response: Timely and full participation		5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date.	4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date.	3 (3%) – 3 (3%) Posts by due date.	0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date.
Second Response: Post to colleague’s main post that is reflective and justified with credible sources.		9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting.	7 (7%) – 7 (7%) Response is on topic and may have some depth.	0 (0%) – 6 (6%) Response may not be on topic and lacks depth.
Second Response: Writing		6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English.	4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
Second Response: Timely and full participation		5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date.	4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date.	3 (3%) – 3 (3%) Posts by due date.	0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date.
Total Points: 100

Name:  Discussion Rubric