HCA 699 Topic 5 DQ 1

Reliability and validity are related qualities but independent. They are similar
to the terms "precision" and "accuracy," respectively. A wind-up clock that does
not work is accurate (valid) twice a day. But it lacks precision (reliability). A
digital clock that is always 5 minutes slow is never accurate (valid) but is very
precise (reliable). Elaborate on the assessment instrument used in your project
to ensure validity and reliability.

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Feb 26, 2018 11:15 PM
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Christopher Sun
1 posts
Re:Topic 5 DQ 1

The assessment instruments that are described analyze both accuracy and
reliability so within my project the precision measure would have to be the
amount of times homeless individuals visit the depots for their aid. The
accuracy measurement would have to consist of how many depots there are in
a given area. What I mean by that are the more there are the more they are
used and the more the population is being helped. My only fear would be is
that certain depots depending on their location will observe more then others
or fewer then others. However at the end of the day qualities that are
observed are dependent of one another. According to Zanis, D. A., McLellan,
(1994), who examined the reliability and validity of the addiction severity
index to find out that alcohol, drug, and psychiatric composite scores and
severity ratings had good discriminant and concurrent validity when compared
with other measures within homeless people.

Zanis, D. A., McLellan, A. T., Cnaan, R. A., & Randall, M. (1994). Reliability and
validity of the Addiction Severity Index with a homeless sample. Journal Of
Substance Abuse Treatment, 11(6), 541-548. doi:10.1016/0740-5472(94)90005-
1
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Feb 26, 2018 09:38 PM
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Amy Johnson
5 posts
Re:Re:Topic 5 DQ 1
Hi Olaide,
I'm just curious...do you have any plans to couple your measurement of
obesity with another type of measure, perhaps body fat? BMI is routinely used
in health care as it is a reliable tool - a specific height and weight will
consistently yield the same results. However, the results are not always valid
as it does not always indicate obesity. Those with athletic builds often fall into
the overweight or obese categories simply because they have a large amount of
muscle mass, even though they may have less than 10% body fat. How will you
account for the population that falls into this category in your study?
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Feb 26, 2018 09:25 PM
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Amy Johnson
5 posts
Re:Re:Topic 5 DQ 1
Interesting topic Kay. What is the intervention? You mentioned a "training." Is
this a type of stress management training that is to be used to prevent or
manage burnout among nurses?
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Feb 26, 2018 09:16 PM
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Julia Mitchell
3 posts
Re:Re:Topic 5 DQ 1
Hi Kay,
Great topic. Considering that burnout is the number one challenge in nurse
retention, your project should be very interesting. The study I found, although
from 2009, helped me to understand how this assessment tool works and the
study found that it could be using to study the correlations of nurse burnout
globally (Poghosyan, Aiken, and Sloan, 2009). The definition of burnout is a
psychological syndrome involving emotional exhaustion, depersonalization, and
a diminished sense of personal accomplishment that occurred among various
professionals who work with other people in challenging situations. Maslach
was right that burnout does undermine the care and professional attention
patients receive from nurses and now it applies to other professionals like
teachers, police officers, social workers, and more.
Thank you for sharing your thoughts on your project!
Poghosyan, L., Aiken, L. H., & Sloane, D. M. (2009). Factor structure of the
Maslach Burnout Inventory: An analysis of data from large scale cross-sectional
surveys of nurses from eight countries. International Journal of Nursing
Studies, 46(7), 894–902. http://doi.org/10.1016/j.ijnurstu.2009.03.004
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Feb 26, 2018 08:57 PM
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Julia Mitchell
3 posts
Re:Re:Topic 5 DQ 1
Hi Austin,
Do you mind me asking what your research project is on?
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Feb 26, 2018 06:04 PM
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Ana Bantasan
3 posts
Re:Re:Topic 5 DQ 1
Mental heath is one major issue today. That is good that you pick that topic.
Surverys and statistical analysis is a good tool for assessment in this topic. In
my project I also use these measurement to gather information about the
peformance of professional healthcare in the hospital in communicating with
each other and to their patients. Using these two measurement you mentioned,
indeed, will help the overall validity of the project and in addition to help the
validty and reliability is also using peer-reviewed to support the degree of
research.
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Feb 26, 2018 05:47 PM
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Ana Bantasan
3 posts
Re:Re:Topic 5 DQ 1
Olaide,

Obisity is one of the major topic in health care system and economic. That is
great that you choose this topic. There are two techniques that can be use to
assessed weight and heigh measurement and overweight status. One is the
WHO Mass Index for age references tables and simplified overweight screening
instrument without BMI caculations. You are on the right track on using BMI as
measurement that is one is stable over time. Are you focusing on certain age of
obesity?
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Feb 26, 2018 12:54 PM
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Kay Bedford
2 posts
Re:Re:Topic 5 DQ 1
Hello Whitney,

Your post was very informative. I am glad that you stated that we should
examine both the clinical and statistical significance of the results as part of
our checklist in order to provide substantial reliability of information that
would have been gained through research. Do you think that it would be more
beneficial to examine articles with a different patient population? Maybe you
would get a better idea of how the changes effect other populations and then
you can compare to get the best solution.

Kay
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Feb 26, 2018 12:48 PM
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Kay Bedford
2 posts
Re:Topic 5 DQ 1
The assessment instrument that was used in my project to ensure validity and
reliability was The Maslach Burnout Inventory. This tool not only used to
measure burnout in nurses. It can be used prior to and after training. This
inventory evaluates three areas that can cause burnout in nurses such as
emotional exhaustion, de-personalization and person accomplishment. These
areas as used a lot by nurses in the pediatric intensive care units. It gives at
least 22 questions that are answered prior to the training and the same
questions are given after the training is over.

It measures emotional exhaustion. It includes the how their feelings of being

emotionally overextended and exhausted by one’s work; depersonalization
which measures the unfeeling and impersonal response toward recipients of
one’s service, care treatment or instruction and lastly, how they feel about
their competence and successful achievement in their work (Maslach and
Jackson, 2018).
References

Maslach, C. and Jackson, S. (2018). MBI: Human Services Survey. Retrieved

from http://www.mindgarden.com/314-mbi-human-services-
survey#horizontalTab3.
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Feb 26, 2018 09:45 AM
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Deanna Silva
4 posts
Re:Re:Topic 5 DQ 1
Julia,
I enjoyed reading your post and find your research topic interesting. As the
former nurse manager for a hospital Care Coordination department, I can say
anecdotally having care coordinators in the outpatient setting monitoring
medication management could have a great impact on 30-day readmissions. I
find the data analysis methods you are considering to be valid and this
information should give you a good idea if your plan is working. With an
increased emphasis on decreasing 30-day readmissions and reimbursements
tied to these metrics, it highlights the need of all care providers to work
together to help patients get the care they need in the right setting.
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Feb 26, 2018 09:22 AM
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Whitney Black
1 posts
Re:Topic 5 DQ 1
When examining studies for this evidence-based project, the validity and
reliability were two important factors to consider. According to Dang et. al.
(2012), the internal validity examines the potential presence of bias and the
external validity examines the similarities of the study's environment and that
of the reader. The search for potential process improvements for the
emergency department (EDs) involved examining articles in EDs with a similar
size and patient population. Sayah, Rogers, Devarajan, Kingsley-Rocker and
Lobon (2014) explaining in their article that the implementation of similar
process changes would only yield similiar results if the ED has similar
environments. As a part of our ED system initiative we took their
recommendation into consideration and applied portions of their process
improvements. The application of any new process requires tweaking to ensure
if adequately meets the needs of the location. A study's reliability speaks to
the credibility and significance of the results. As a part of the appraisal
checklist, Fineout-Overholt (2012) recommends examining both the clinical and
statistical significance of the results.

Dang, D, Mazurek Melnyk, B., Fineout-Overholt, E., Ciliska, D., DiCenso, A.,
Cullen, L., Cvach, M., Larrabee, J.H., Rycroft-Malone, J., Schultz, A.A.,
Stetler, C.B. & Stevens, K.R. (2012). Models to Guide Implementation and
Sustainability of Evidence-Based Practice. Evidence-Based Practice in Nursing &
Healthcare (pp. 274-277). China: Wolters Kluwer Health.
Sayah, A., Rogers, L., Devarajan, K., Kingsley-Rocker, L. & Lobon, L.F. (2014).
Minimizing ED Waiting Times and Improving Patient Flow and Experience of
Care. Emergency Medicine International, pp. 1-8. doi:10.1155/2014/981472
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Feb 25, 2018 11:26 PM
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Pina Lomotey
2 posts
Re:Re:Topic 5 DQ 1
Hi Amy, my proposed solution is similar to yours and examines the advantages
of implementing an integrated CDSS system to improve care planning for
cancer patients. Using standardized data sets from within patient records in
the EMR such as quality measure indicators and demographics would ensure the
validity of the data and conclusions that are derived from the data would be
reliable. Determining the reliability and validity of the study is an essential
component in critiquing the research and can influence the decision about
whether to rely on the evidence from the research in changing clinical
practice.
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Feb 25, 2018 06:53 PM
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Julia Mitchell
3 posts
Re:Topic 5 DQ 1
Currently, the standard for validation requires evidence from five sources:
content, response process, internal structure, relations with other variables,
and consequences (Leung, 2015). That does not mean the type of data used to
contribute to each evidence sources are reliable. From start to finish, the
appropriateness of each components: the research question, methodology, the
design, sampling and data analysis, and results are valid for the sample and
context. Process and results must be replicable to ensure reliability and
consistency. Although there are margins of variation, data must be similar in
results. Determining how rigorously the issues of reliability and validity have
been addressed in a study is an essential component in the critique of research
as well as influencing the decision about whether to implement of the study
findings into nursing practice (Heale and Tywcross, 2015).
My research question is to determine if the implementation of a clinical care
coordination in the primary care setting will reduce adverse medication events
and decrease 30-day readmissions by older adults. Even though case series are
least reliable in results, I feel using the Modified Delphi Technique with phone,
mail, or email responses, to survey patients on the effectiveness of the
coordinator, would yield needed data to improve or make changes to the role
and workflow of the coordinator. Survey of the primary care providers and staff
would also be done to collect data on how their workflow has been reduced
due to the coordinator implementation. Data analysis can also be used from ED
and hospital admissions due to adverse advents or readmissions.
Heale, R., & Twycross, A. (2015). Validity and reliability in quantitative
studies. Evidence-based nursing, ebnurs-2015.
Leung, L. (2015). Validity, reliability, and generalizability in qualitative
research. Journal of family medicine and primary care, 4(3), 324.
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Feb 25, 2018 03:25 PM
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Emily Harris
3 posts
Re:Re:Topic 5 DQ 1
Pina,
I enjoyed reading your post. When I looked for studies and information
regarding my project I found that at times when trying to improve healthcare
quality that qualitative studies can be beneficial. Despite their ranking and
inability to standardize responses since qualitative studies are usually
subjective they are useful in determining if quality does go up. For example,
some scales in quantitative studies use scales such as the quality of life scale
and others which can be subjective and dependent on how the subjects feel.
Did you find this as well in your searches?
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Feb 25, 2018 08:54 AM
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Deanna Silva
4 posts
Re:Re:Topic 5 DQ 1
Hi Olaide,
BMI is a valid assessment instrument. BMI can be used in a variety of ways
depending on what your research question is. For example, if you want to
measure weight loss in overweight patients you can measure BMI pre and post
implementation of weight loss techniques. BMI could also be used as a way to
measure a population that is overweight. If you introduce education or exercise
and healthy eating habits and measured the success over a period of time, the
BMI of the group could be measured pre and post implementation. One of the
most important points about using an assessments instrument such as BMI is
remembering to get pre implementation data so that you truly have something
to measure post implementation.
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Feb 25, 2018 08:29 AM
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Amy Johnson
5 posts
Re:Re:Re:Topic 5 DQ 1
The ordering of specific treatments as evidenced by the data sourced from the
EHR will be the most reliable and valid data as it directly correlates use of the
revised, evidence-based order set embedded with clinical decision support to
the treatments being ordered for a particular diagnosis.
As an example, lets’ say the recommended systemic corticosteroid therapy for
COPD patients is ordered 60% of the time in the three months pre-intervention,
and that once the revised EBP order set is in place, this order is placed on 90%
of patients with a COPD diagnosis for a steady 3 months. By examining the
data, one could ensure that the right numbers were being captured to ensure
validity of the instrument of measurement. A comparison of both the pre-
intervention and post-intervention groups would also be done to look for any
co-founding variables. I feel like this data will provide the most valid and
reliable results as the measures are pinpointed towards specific recommended
treatments.
However, I don’t feel like this data is as meaningful if it is not also reflected in
an improvement in quality measures and outcomes. Increasing compliance
with systemic corticosteroid therapy by 30% is not as impactful on an
organizational level as decreasing COPD readmissions by 10%. Looking at
readmission rates alone though, is not as reliable as the individual treatment as
there is too much potential for influence of cofounding variables such as
differences in patient population, or other outpatient interventions that cannot
be controlled.
For these reasons I feel like the combination of the more reliable and valid EHR
data, along with the more applicable quality data will provide substantial
support for the proposed intervention.
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Feb 25, 2018 08:14 AM
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Ed Paluch
4 posts
Re:Re:Topic 5 DQ 1
Angela -
Your point on standardization is a key one, since this can help to ensure some
level of homogeneity in data sets and also, help validate the result set based
on this level of homogeneity. However, is there any effect of TOO much
standardization on the issue of generalizability of study results?
Ed
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Feb 25, 2018 07:59 AM
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Thomas Woahloe
3 posts
Re:Re:Re:Topic 5 DQ 1
Thanks Prof Ed.
Statistical significance is inferred usually based on the
methodology of the research work, and clinical meaning is
always attached to quantitative and cohort studies (for
example). Relying on only one method to provide information
about a research will only reflect a part of sample's achievement.
Additionally, an outcome may be difficult to assess using only
one method. For each Outcome, a combination of direct and
indirect assessment methods should be used. For example,
responses from student surveys may be informative, however,
when combined with students’ test results they will be more
meaningful, valid, and reliable.
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Feb 24, 2018 11:29 PM
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Pina Lomotey
2 posts
Re:Topic 5 DQ 1
Evidence based research includes implementation of well conducted quality
research studies and consideration must be given to the measurement of the
validity and reliability of the research (Heale & Twycross, 2015). My proposed
solution is to implement a real time clinical decision support integrated with
relevant data from eternal cancer databases and evidence based research to
support clinicians in providing more accurate treatment plans for cancer
patients.
Randomly selecting the patients using the EMR ensured that that sample was as
representative as possible. Standardization of terminologies were used to code
patient interactions based on National Cancer Institute (NCI) codes. The
validity of the intervention could be evaluated by measuring the cycle of care
for patients who received interventional treatment from the facilities - pre and
post intervention. Patients were classified according to their prognosis during
the peri diagnosis period, treatment period and post intervention period and
were linked to EHR data from all the healthcare systems included in the
research. Using data obtained from EHR reduced the likelihood of omitting
patients who actually had cancer or who had benefitted from the intervention.
Restructuring the data obtained from the integrated databases facilitated the
understanding of the pathways of care and enhance the validity and reliability
of the study.
Qualitative interviews were also used to measure the attitudes and feedback
from providers and patients on the effectiveness of the intervention.
Reference
Heale, R., & Twycross, A. (2015). Validity and reliability in quantitative
studies. Evidence-Based Nursing, 18(3), 66.
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Feb 24, 2018 11:06 PM
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Me
2 posts
Re:Re:Topic 5 DQ 1
Ana,
You research project will be such an interesting one. Communication is
very important in delivering patient care safety. It is very important that
there should be a very good communication between health care
professionals and patients. This will give our patients comfort and
assurance that they have good relationship with their health care
personel. Communication in a healthcare setting is one of the most
important tools we have for providing great patient care and improving
patient satisfaction. Communication and patient care has to be taken
seriously and training team members to break down these
communication barriers to provide excellent patient care should as well
be a goal.
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Feb 24, 2018 10:57 PM
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Me
2 posts
Re:Topic 5 DQ 1
A valid instrument is one that measures what it is purported to measure.
For example, aninstrument that is expected to measure fear should
indeed measure fear (and not anxiety, for example). A reliable
instrument is one that is stable over time (i.e., it performs the same way
each time responders answer the questions) and is composed of
individual items or questions that consistently measure thesame
construct (Melnyk, & Fineout-Overholt, 2015). Several statistical
techniques can be applied to instrument results to determine the
irreliability. My research project is focused on the increase of obesity in
the U.S today. Obesity is one of the greatest concern in the U.S today. I
will be using more of the valid instrument to get almost an accurate
result of the search and increase in obesity. Body mass index (BMI) is
the most widely used measure to diagnose obesity. BMI is used to
measure the amount of fat and the body which places the fat into 3
different categories which are normal weight, overweight, and
obese. The common interpretation is that it represents an index of an
individual’s fatness (Nuttall, 2015). It also is widely used as a risk factor
for the development of or the prevalence of several health issues. In
addition, it is widely used in determining public health policies.The BMI
has been useful in population-based studies by virtue of its wide
acceptance in defining specific categories of body mass as a health issue
(Nuttall, 2015).
References
Melnyk, B. & Fineout-Overholt, E. (2015). Evidence-Based Practice in
Nursing & Healthcare: A Guide to Best Practice. 3rd Edition. Wolters
Kluwer. Chapter 5. 89. Retrieved from https://viewer.gcu.edu/9VWKVZ
Nuttall, F. Q. (2015). Body Mass Index: Obesity, BMI, and Health: A
Critical Review. Nutrition Today, 50(3), 117–128.
http://doi.org/10.1097/NT.0000000000000092
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Feb 24, 2018 09:59 PM
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Sarai Miller
1 posts
Re:Topic 5 DQ 1
Hello all,

The aim of quantitative research is to examine the relationships between

variables. A variable is a characteristic or attribute of interest in the research
study that can take on different values and is not constant. Variables may be
straightforward and easy to measure including characteristics such as gender,
weight, height, age, size, and time. Other variable may be more complex and
more difficult to measure. Examples of these types of variables may include
socioeconomic status, attitudes, achievement, education level, and
performance. However, validity refers to whether the measuring instrument
does what it is intended to do, and reliability refers to how consistently it does
so. It is critical that the measurements of variables be both valid and reliable.
If they are not, then researcher's cannot be sure of what they are measuring.

Therfore, reliability and relevance can exist independently of each other,

validity cannot exist without the presence of both reliability and relevance.
The basic statistical techniques I will use in my evidence base proposal will
determine reliability and validity by the Suicide Cognitions Scale correlation
and the Implicit Association Test of suicidality. As with most techniques, the
selection of which to use is based on the number of variables being compared.
For qualitative reseach there are some certain critera to be used to increase
the rigor and trustworthiness of the research

Reference

Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed

methods approaches.

Hopkins, W. G. (2008). Quantitative research design.

Johnson, B., & Christensen, L (2008). Educational research: Quantitative,

qualitative, and mixed approaches
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Feb 24, 2018 08:32 PM
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Angela Arnold
2 posts
Re:Re:Topic 5 DQ 1
Hello Emily,
Thank you for your input about reliability and validity. There are several types
of validity and reliability that can be used to check these results. To test
reliability the following can be used; test re-test reliability, parallel forms
reliability and inter-rater reliability. To tests validity you can utilize face
validity, criterion related validity and formative validity (Uni, 2006).
Reference:
UNI. (2006). Exploring Reliability in Academic Assessment. Retrieved from
https://chfasoa.uni.edu/reliabilityandvalidity.htm
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Feb 24, 2018 07:45 PM
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Angela Arnold
2 posts
Re:Topic 5 DQ 1
Hello fellow classmates,
In research an assessment instrument the yields the same results over and over
again with the same type of subjects is reliability. Dependable and consistent
results are reliability. The assessment of validity begins with reliability.
Validity in research refers to the accuracy that a study answers the study
conclusions and the questions. Validity specifically refers to the measurement
accuracy. Validity is the specific purpose or interpretation of an assessment
tool. We know that in order for study results to be credible that the assessment
instruments must be valid and reliable (NCBI, 2011).
The type of instrument used is dependent upon how reliability is measured.
internal validity and internal structure are two ways in which reliability is
structured. Cronbach alpha tests the internal consistency by calculating the
correlation values. Interrater reliability studies the different observers or
raters. The analysis of the generalizability coefficient looks at the reliability of
the results as well. Assessments instruments are measured for validity by what
they are suppose to measure. It maybe viewed as an evidence-based argument.
Evidence is usually displayed in response process, relationships, consequences,
variables or content (NCBI, 2011).
Reference:
Sullivan, G. M. (2011). A Primer on the Validity of Assessment
Instruments. Journal of Graduate Medical Education, 3(2), 119–120.
http://doi.org/10.4300/JGME-D-11-00075.1
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Feb 24, 2018 06:39 PM
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Yolanda Murphy
1 posts
Re:Topic 5 DQ 1
“The requirement of ‘best evidence’ necessarily restricts the approach to
optimally designed studies, bearing in mind that this depends on the kind of
clinical issue involved” (Fernandez-Dominguez et al., 2014, p. 767). Validity is
the assessment of evidence by examining each study, while focusing on
utilization, then summarizing the evidence that was collected. “It is the
clinician’s responsibility to identify current, high-quality research evidence to
inform his or her clinical decisions” (Melynk et al., 2014). For example, nurses
are concerned about the increased rate of indwelling foley catheter
infections. A nurse notices that there are fewer infections in catheters that
are removed after 48 hours. The research evidence should be both valid and
reliable to produce healthy outcomes. The evidence should be examined
thoroughly and closely to ensure the success of the evidence-based
project. Reliability and validity provide a strong structure for evidence-based
practice outcomes and the change needed. Before implementing the change,
assessment and evaluation of the evidence is necessary.

References
Fernandez-Dominguez, J. C., Sese-Abad, A., Morales-Ascencio, J. M., Olivia-
Pascual-Vaca, A., Salinas-Bueno, I., & Pedro-Gomez, J. E. (2014). Validity and
Reliability of Instruments Aimed at Measuring Evidence-Based Practice in
Physical Therapy: A Systematic Review of Literature. Journal of Evaluation in
Clinical Practice, 20(1), 767-778.

Melnyk, B. & Fineout-Overholt, E. (2015). Evidence-Based Practice in Nursing &

Healthcare. A Guide to Best Practice Third Ed.Philadelphia, PA: Wolters Kluwer
Health.

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Feb 24, 2018 06:21 PM
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August Touchard
1 posts
Re:Topic 5 DQ 1
Reliability refers to the repeatability of findings, meaning if a study were to be
done a second time the results should be the same. In the clock example, if a
clock reads 5:52pm another accurate clock should read the same time, proving
the reliability of what time it is. Validity on the other hand refers to the
credibility and accuracy of the research. Did the results come from a valid
methodology and are they genuine (UC Davis n.d.)? For my research, to ensure
validity and reliability, I have to determine if providing more education and the
new testing will improve quality of care and patient outcomes. The instruments
used in my project assess the amount of tests ordered monthly, time for
results, expert feedback, and patient outcomes. The quantitative results are
apart of my evaluation section and will determine the validity of my proposal
and implementation.
UC Davis (n.d.). Reliability and Validity. Retrieved from
http://psc.dss.ucdavis.edu/sommerb/sommerdemo/intro/validity.htm
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Feb 24, 2018 04:17 PM
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Mikaela Piekarski
1 posts
Re:Topic 5 DQ 1
While compiling the research necessary to complete my project the main
assessment tools used were surveys and statistical analysis. To gather
background information about the types of mental health care provided at
colleges and universities, many of the resources were led by surveys. These
surveys identified the major factors that prevent students from accessing care.
In some of the articles, statistical analysis was done to gather a firm
understanding of the results of the surveys. This led to data that concluded the
success of mental health care on campuses and an educational background of
the reasoning behind why students do not reach out to receive treatment.
Certain articles have identified the barriers by way of surveys. This information
has then applied to define better approaches to providing mental health care
on campuses. The reliability of the research is shown with the common findings
present in each study. The overall validity of the project is supported by the
degree of research that is peer-reviewed and utilized in additional studies.
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Feb 24, 2018 01:09 PM
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Amy Johnson
5 posts
Re:Re:Topic 5 DQ 1
Deanna,
 It appears that you have devised a solid plan for measuring the success of
your proposed intervention. Measuring the number of CAUTI's before after
bundle implementation should produce valid data to support the intervention
and is an obvious measure of success. I think measuring nursing knowledge
prior to and after the intervention is a creative way of validating the impact of
the intervention. Great idea!
If you have a tool that can reliably asses nursing knowledge related to
indwelling catheter care and infection prevention, this could be applied not
only in the post-intervention phase, but at regular intervals afterwards. All too
often, we see a quality initiative that has initial success and then fades away
due to staff turnover or reversion to old practices. Perhaps intermittent
surveys will assist nursing in retaining the knowledge and in anticipating when
it may be time for re-education.
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Feb 24, 2018 12:56 PM
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Ana Bantasan
3 posts
Re:Topic 5 DQ 1
A valid instrument is one that is measure what it is implying to measure
(Melnyk, & Fineout-Overholt, 2015). For example, my research project is
focused on how to make health care professionals communicate better with
patient to achieve patient care deliver safety. In this case, I need to measure
the communication between health care professionals and patient using
external survey, questionnaire to identify communication knowledge of staff
prior to and after treatment. While, a reliable instrument is one that is stable
over time and is composed of individual items or questions that consistently
measure the same construct (Melnyk, & Fineout-Overholt, 2015). In my
research I will use the valid instrument consistently with time and people that
are involved and use the result data for efficacies of practices and approaches.
Reference
Melnyk, B. & Fineout-Overholt, E. (2015). Evidence-Based Practice in Nursing
& Healthcare: A Guide to Best Practice. 3rd Edition. Wolters Kluwer. Chapter
5. 89. Retrieved from https://viewer.gcu.edu/9VWKVZ
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Feb 24, 2018 12:28 PM
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Emily Harris
3 posts
Re:Re:Re:Topic 5 DQ 1
I think that similar to technology and ways in which patient care is conducted
which is always changing, evidence-based practices will need reviews and
evaluations as new studies and means of validation evolve. More accurate
means of testing and evaluation for studies will come about, possibly
invalidating previous studies or requiring studies to be repeated to determine if
results are still significant. Similarly, as far as reliability, since populations and
patient needs change continuously, studies need to assure that they maintain a
diverse subject population and if not, considerations made towards specific
applications should be made.
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Feb 24, 2018 10:49 AM
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Deanna Silva
4 posts
Re:Re:Topic 5 DQ 1
Hi Thomas,
I enjoyed reading your post, your research topic is a very important one. I like
how you suggested we must ask questions in order to discover our goal or
assessment. Once you are able to answer the questions you cited in your post it
becomes more clear what type of assessment instruments to utilize for the
project. For example, in my case I want to know if implementation of bundle
practices decreases CAUTI rates. It is important for me to get data before
implementation and after implementation to measure success. It is also
important for me to survey staff to find out baseline knowledge about CAUTIs
in order to guide education that may be needed to ensure the bundle practices
are effective. Each research project has a different focus, it is important to
use assessment instruments that make the most sense for the individual project
to ensure validity and reliability.
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Feb 24, 2018 07:14 AM
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Ed Paluch
4 posts
Re:Re:Topic 5 DQ 1
Amy -

Thanks for sharing your thoughts on this question. With regard to sourcing data
from the sources you mention, as well as other sources, which of the sets
would you think would be the highest tier of data to allow for optimal validity
and reliability considerations?

Ed
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Feb 23, 2018 08:43 PM
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Deanna Silva
4 posts
Re:Topic 5 DQ 1
A valid instrument measures what it is intended to measure (Melnyk, & Fineout-
Overholt, 2015). For example, my research project is focused on reducing
catheter-associated urinary tract infections (CAUTI) in adults in the acute
hospital setting through implementation of bundle practices. As part of the
bundle I need to know what knowledge nurses already have about indwelling
catheters, care and maintenance prior to education and implementation of
bundle practices. One assessment instrument that is important for my project
is use of a survey, test or questionnaire to identify knowledge of nurses prior to
and after education. A reliable instrument is stable over time and contains
individual items or questions that consistently measures the same thing
(Melnyk, & Fineout-Overholt, 2015). Statistical analysis is a good example of a
reliable instrument. For my project, I want to know how many CAUTIs the
organization had per 1000 catheter days prior to implementation of the bundle
practices and after implementation of bundle practices. Using data such as this
helps me to measure if my efforts have been successful in the reduction of
CAUTIs. Utilizing this data over a several month period can be useful as trends
can be seen. Evaluations and adjustments can be made to the bundle practice
implementation based on what the data reveals.
Reference
Melnyk, B. & Fineout-Overholt, E. (2015). Evidence-Based Practice in Nursing
& Healthcare: A Guide to Best Practice. 3rd Edition. Wolters Kluwer. Chapter
5. 89. Retrieved from https://viewer.gcu.edu/9VWKVZ

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Feb 23, 2018 04:00 PM
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Amy Johnson
5 posts
Re:Topic 5 DQ 1
The solution I will be proposing will be used to enhance inpatient order set
content and provide clinical decision support for physicians with the goal of
increasing adherence to evidence-based treatment plans. The effectiveness of
the intervention will be measured by the frequency that particular
recommended treatments were ordered and by patient outcomes. Although,
the intervention will be applied to all order sets, and thus, the entire patient
population, the measures will focus specific cohorts, which will be high-risk
populations such as those diagnosed with congestive heart failure, COPD,
stroke and sepsis as these are populations for which large amounts of valid
retrospective data already exists.
The retrospective data will be pulled from the EHR for the and will be
compared to data after the clinical decision support system is in
place. Patients admitted with a particular diagnosis group will be the
denominator, while the order for the recommended treatments will be the
numerator. The data from these measures will be trended before and after
implementation of the decision support intervention.
Establishing the characteristics of the populations under study is important
(Melnyk, & Fineout-Overholt, 2015). The characteristics of the included
patients (before and after the intervention) will be compared as any variances
in severity of disease or additional co-morbidities between the two groups
could compromise the validity of the results. The population should be large
enough that these factors are similar between each group and so that the
results can be applied to larger populations.
To ensure validity of the data, diagnosis groups and ordered treatments from
the order entry module within the EHR will be compared with data from coding
and billing systems as well as data that is already being collected for quality
measure reporting.
Reliability is demonstrated through a strong association between exposure and
outcome (Melnyk, & Fineout-Overholt, 2015). To reduce the influence of
cofounding variables, there will be no other simultaneous quality improvement
initiatives directed towards the studied patient populations. Also for this
reason, very specific measures (such as frequency of a prescribed medication
regimen) will be included, along with more broad measures (such as LOS and
readmission rate). The specific measures can be tied to the intervention more
strongly than can the broad outcome measures, thus enhancing the reliability
of the results.

Melnyk, B. & Fineout-Overholt, E. (2015). Evidence-Based Practice in Nursing

& Healthcare: A Guide to Best Practice. 3rd Edition. Wolters Kluwer. Chapter
3. 40, 43. Retrieved from https://viewer.gcu.edu/9VWKVZ
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Feb 23, 2018 10:27 AM
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Chiane Robbins
2 posts
Re:Re:Re:Topic 5 DQ 1
This is something I had to reflect on in my evidence based research. My
research focuses on outcomes of increased access and increased cross specialty
approaches to opioid drug therapy yielding decreased relapse and increased
patient successes. While much evidence shows success with participation in
numerous therapies, clinically meaning may not be the same for this
population. Many individuals in this population have an underlying mental
health disorder that has gone untreated and will need conjunctive treatment
with their recovery. Additionally, many individuals in this population are not
working and therefore do not have health insurance coverage. This means they
have decreased access to care. When looking at research, it is important to
weigh both sides to determine what the best practice will be.
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Feb 23, 2018 10:24 AM
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Chiane Robbins
2 posts
Re:Topic 5 DQ 1
Evidence based research looks at science based data and how it directly
impacts the clinical outcomes of patients (Stevens, 2013). Evidence based
practice is used throughout nursing and health based practices to implement
practice, science and education. My evidence based project aimed to look at
the outcomes of increased access and increased cross specialty approaches to
opioid drug therapy yielding decreased relapse and increased patient
successes. In order to determine what had a direct effect on the outcomes, I
had to look at the research for specific methods and strategies used to
determine statistical proof of success.
In order to determine the reliability and the validity of the findings being used
in my research assessment, I had to look for specific assessment instruments.
One tool heavily relied on was health surveillance tools. These assessed
individuals for treatments and treatment outcomes through statistical
interpretation. I was able to review possible variables and determine success
and failures. Peer reviewed evidence was also used, both qualitative and
quantitative data, to determine if the successes were valid for purposes of this
research population. Evaluation and planning frameworks for health behavior
theory were assessed due to the complex nature of addiction and treatment
therapies.

Reference
Stevens, K. (2013). The Impact of Evidence-Based Nursing and the Next Big
Ideas. Retrieved from
http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPerio
dicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-
Based-Practice.html
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Feb 23, 2018 10:10 AM
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Ed Paluch
4 posts
Re:Re:Topic 5 DQ 1
Thomas-
Thanks for sharing such a detailed reply and comment set relating to your core
project. Your points and comments certainly help to underscore the
importance of validating study data and also study types. Meta analyses helps
to assume some of the burden of this type of effort. However, it is also
important to focus on the difference between statistically significant and
clinically meaningful findings as well. Are there any examples of this type of
issue which come to mind?
Ed
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Feb 23, 2018 10:09 AM
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Ed Paluch
4 posts
Re:Re:Topic 5 DQ 1
Emily -

Thanks for sharing your thoughts on this question. One point of note is that
oftentimes, as more progress is made, assessments of validity and reliability
and how they are viewed can change. What effect does this potential situation
have on background context for a study and also, approaches to deciding on
levels of validity and reliability?

Ed
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Feb 23, 2018 06:23 AM
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Thomas Woahloe
3 posts
Re:Re:Topic 5 DQ 1
Hi Emily,
Thanks for sharing your post with the class.
You have selected a very sensitive and crucial topic for your
project. The measurement of comfort of palliative care for
validity and reliability will involve a lot of literature analysis.
The concept of validity has been undergoing transformations
over time.
Traditionally, the validity of an instrument has been understood
as the extent to which the instrument does in fact measure what
its authors claim that it measures.However, more recently
assessment specialists have asserted that validity is not a fixed
and inherent property of an instrument, but rather an evidence-
based trial about how appropriate the inferences or actions
implemented from the scores of a test are in a given context.
Validation can be seen as the development of a strong validity
argument for the proposed uses of the scores of an instrument
and its relevance to the proposed use (Joint Committee on
Standards for Educational and Psychological Testing of the
American Educational Research Association, American
Psychological Association and national Council on
Measurement in Education, 1999). Defined in this way, validity
is not an inherent property of the instrument; instead, it is related
to the assessment objective.
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Feb 23, 2018 06:10 AM
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Thomas Woahloe
3 posts
Re:Topic 5 DQ 1
The primary focus of evidence based practice is outcomes. The
reliability and validity of evidence based practice outcomes are
the foundation of applicability and the need for change.
Assessment methods are the strategies, techniques, tools and
instruments for collecting information to determine the extent to
which outcomes can lead to desired change. Several methods
can be used to assess outcomes.
The implementation of new and alternative treatment for cancer
is closely linked to the assessment methods, as it enables the
monitoring of progress and achievements, the survival rate of
cancer patients, the improvement of clinical practice, assessment
of program effectiveness, and prolonging the life span of cancer
survivals. To ensure that assessment achieves its purposes, it is
essential to make an appropriate choice of the change
instruments to be used in my proposed project.
Determining the purpose or goal of assessment involves asking
the questions: Why do we want to measure outcomes? What do
we want to measure? And whom do we want to evaluate? The
assessment instruments that would be used in my project will
include the measurement of surveying of survival, scrutinizing
the processes of treatments, clinical assessments and physicians’
collaboration. There are many possible reasons to assess the
consistency of survival rates for cancer patients and relating
survival to particular treatment protocol.
Reference
Assessment METHODS (n.d.). Retrieved from
https://www.wssu.edu/about/assessment-and-
research/.../assessmentmethods.pdf
Melnyk, B. M. & Fineout-Overholt, E., (2014). Evidence-Based
Practice in Nursing & Healthcare: A Guide to Best Practice.
Retrieved from http://gcumedia.com/digital-resources/wolters-
kluwer/2014/evidence-based-practice-in-nursing-and-
healthcare_a-guide-to-best-practice_ebook_3e.php
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Feb 22, 2018 02:28 PM
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Emily Harris
3 posts
Re:Topic 5 DQ 1
The reading explains validity in terms of how the data and information is
measured while reliability is whether this can data can be measured the same
over and over again (Melynk & Fineout-Overholt, 2015). When looking at my
project, I needed to know if not only will education directed at providers will
increase its use but if the increased use will indeed result in a improved health
care delivery quality. The main quantitative results in the studies I found
looked a quality of life and patient satisfaction with palliative care
intervention versus no intervention. The other quantitative studies I needed
included the increased comfort and use of palliative intervention after
providers received education. These results were significant towards the
hypothesis that palliative care improves quality of life and that providers are
more comfortable discussing and using palliative care options after education.
These quantitative studies used scales that are designed to assess specific
quality and comfort/confidence which made them valid. The multiple studies
that also report significant favor towards education and palliative care use help
to make these studies reliable. By using diverse studies, the significance of the
results can be used in a broad sense with all patients who are end-stage or
have a terminal diagnosis.
Reference
Melnyk, B. & Fineout-Overholt, E. (2015). Evidence-Based Practice in Nursing &
Healthcare. A Guide to Best Practice Third Ed. Philadelphia, PA: Wolters
Kluwer Health.