Evidence-Based Practice Beliefs and Behaviors of Nurses Providing Cancer Pain Management
(A Mixed-Methods Approach)
[Author’s name]
Miami Regional College
MSN 5300: Advanced Nursing Inquiry and Evidence-Based Practice
Evidence-Based Practice Beliefs and Behaviors of Nurses Providing Cancer Pain Management
(A Mixed-Methods Approach)
Introduction
Ethics in research provides proper norms of conduct for all the stakeholders to differentiate between the acceptable and unacceptable line of action ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"O6ZooAVO","properties":{"formattedCitation":"(Resnik, 2018)","plainCitation":"(Resnik, 2018)","noteIndex":0},"citationItems":[{"id":"w2OUz1EJ/4dSXfAhD","uris":["http://zotero.org/users/local/7Hi3kAOD/items/WNKXMTIZ"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/WNKXMTIZ"],"itemData":{"id":1187,"type":"book","title":"The Ethics of Research with Human Subjects: Protecting People, Advancing Science, Promoting Trust","publisher":"Springer International Publishing","URL":"https://books.google.com.pk/books?id=uQdGDwAAQBAJ","ISBN":"978-3-319-68756-8","author":[{"family":"Resnik","given":"D. B."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Resnik, 2018). The main objective of considering research ethics is to provide instructions for conducting responsible research. In other words, it ensures the monitoring of researchers during the entire procedure of research according to high ethical standards. Principles of ethics are used as the roadmap by the researcher to ensure the element of morality in the research process. There are many reasons that define the importance of ethics in the field of research. First, ethical norms assist researchers to promote the actual objective of the research study that appeared in the form of delivery of the truth. Second, the consideration of the ethics in the research procedure helps people to develop better forms of cooperation and trust. Protection of human rights, the advancement of scientific research, and the promotion of trust are recognized as the three major aims relevant to the practical form of ethical research. Here the focus is to critically analyze the study, “Evidence-Based practice Beliefs and Behaviors of Nurse Providing Cancer Pain Management: A Mixed-Methods Approach” to identify the prospect of ethical principles.
Research Study Overview
The considered research study was conducted by Eaton et al. in 2015 in order to enhance the approach of research work in the field of healthcare and nursing. Exploration of the actual aim of the research work is important to critically analyze the effectiveness of this research work. The purpose of the research work is to critically illustrate the evidence-based practice (EBP) beliefs and behaviors of nurses specifically in the context of cancer pain management. Selection of appropriate research design is critical to ensure the reliability of the research outcomes. The health concern in case of clinical decision making is addressed by the researchers by focusing on the practical aspects of evidence-based practice (EBP). Undoubtedly, it is crucial to how evidence-based practices can be helpful when it comes to pain cancer management in the clinical setting.
A detailed evaluation of the research article revealed that the mixed-methods approach was adopted by the researchers to adopt both the perspectives of quantitative and qualitative research work. Adoption of the mixed-method research approach helped researchers to observe the phenomenon of evidence-based practice (EBP) considering the functioning approach of two inpatient oncology units ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"0Gyq3Dac","properties":{"formattedCitation":"(Eaton, Meins, Mitchell, Voss, & Doorenbos, 2015)","plainCitation":"(Eaton, Meins, Mitchell, Voss, & Doorenbos, 2015)","noteIndex":0},"citationItems":[{"id":2015,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/B3H7BR72"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/B3H7BR72"],"itemData":{"id":2015,"type":"paper-conference","title":"Evidence-based practice beliefs and behaviors of nurses providing cancer pain management: A mixed-methods approach","container-title":"Oncology nursing forum","publisher":"NIH Public Access","page":"165","volume":"42","author":[{"family":"Eaton","given":"Linda H."},{"family":"Meins","given":"Alexa R."},{"family":"Mitchell","given":"Pamela H."},{"family":"Voss","given":"Joachim"},{"family":"Doorenbos","given":"Ardith Z."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Eaton, Meins, Mitchell, Voss, & Doorenbos, 2015). Descriptive and cross-sectional methods of data collection were adopted by researchers to find out the actual trend of EBP in case of cancer pain management.
The sample size for this research study is limited to 40 registered nurses to assess the practical domains of the main idea of EBP. Particular nurses were selected for the research study who directly responsible to provide direct care to the patients who were dealing with cancer pain. Consideration of the sample size of the study helps to figure out the general application of the outcomes of the research. When it comes to the stage of data collection, then the practical strategies of interviews and web-based surveys were adopted by the researchers to attain feedback from the respondents. Identification of the main research variables of the study is important to examine the actual theme of this piece of research. EBP beliefs, EBP implementation, evidence-based pain management are the main variables of the research study. The main purpose of the inclusion of these variables is to examine the practical nursing approach adopted by registered nurses specifically in the form of evidence-based practice.
Critical evaluation of the results of the research study is also imperative to assess the actual application of the idea of EBP. The findings of the study revealed that nurses agreed to the positive implications of EBP with the consideration of implementation ability. The outcomes of the study also indicate that overall implementation level was low in the case of EBP. It was observed by the researchers that maximum nurses were satisfied with their performance level considering pain management practices. The fundamental themes of the main topic are recognized as the limited definition of EBP, varied evidence-based pain management decision making, limited identification of evidence-based pain management practices, and the integration of nonpharmacologic intervention into the domain of patient care. Exploration of the themes of the research study assists to establish that it is feasible to apply the outcomes in case of the clinical practical domain. The outcomes can be useful for the nursing staff in the process of providing better healthcare services to cancer patients through the adoption of appropriate evidence-based practices. Identification of actual reasons for the low level of EBP implementation by nurses specifically in case of pain management further helps to explore the better ways of healthcare services in clinical nursing practices.
The results of the study revealed some practical measures in the form of implications for the department of nursing. It is established that EBP beliefs and behaviors of nurses need to be considered in case of developing strategies for the sustaining evidence-based pain management practices. A critical assessment of the practical implications of this study on financial grounds is also important to examine the actual suitability of the concept of EBP in case of clinical healthcare services. This research study is ranked as an applied study from a financial aspect as researchers conducted practical research work by conducting the process of research. They used different methods of data collection to attain the response of the sample of the study. The content analysis of the responses explicitly indicated the practical form of the study.
Ethical Issues in Research
The process of research can never rank as complete without considering the aspect of ethics. In other words, ethics is characterized as the one important standard to define the success of the research work. The researcher needs to consider the importance of ethics when it comes to the implications of different phases of the research work. At the first stage, it is crucial for the researcher to figure out the concept of ethical research and determine its importance in the case of research. Understanding of the ethical standards in research eventually assists the researcher to consider ethical issues that might prevail during the process of research. Timely identification of the ethical issues is the only solution to attain the desired form of ethical research.
Detailed understanding of the historical grounds of the research work eventually reveals the risk factors in case of improper approach of ethics. It is imperative for the researcher to critically examine the former research studies on the issue to better figure out the ethical issues that might happen in the case of the research process. The origin of the concept of ethics belongs to the ancient Greek philosophical method of inquiry. This particular method illustrated the basic principles of ethics that provided clear directions for the actions of human beings according to moral conduct. Ethics established as the crucial dynamic of the entire process of decision making concerning the perspectives of right and wrong ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"tYVqas8p","properties":{"formattedCitation":"(Jenn, 2006)","plainCitation":"(Jenn, 2006)","noteIndex":0},"citationItems":[{"id":2016,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/9H4HTBFR"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/9H4HTBFR"],"itemData":{"id":2016,"type":"article-journal","title":"Common ethical issues in research and publication","container-title":"Malaysian family physician: the official journal of the Academy of Family Physicians of Malaysia","page":"74","volume":"1","issue":"2-3","author":[{"family":"Jenn","given":"Ng Chirk"}],"issued":{"date-parts":[["2006"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Jenn, 2006). The prospect of ethics and moral conduct gain importance in the case of human experimentation over the years due to the growing concern of human errors and ethical concerns.
It is revealed that increasing rate of human exploitations in case of research process encourage to ensure the application of principles of ethics in researcher. This main aim of this form of consideration is to minimize the risk of human biasedness in the research process and ensure proper dealing of ethical issues in research. The major ethical issues in case of research particularly linked with the prospects of informed consent, beneficence, confidentiality, privacy, and the approach of vulnerable groups of people ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"RA2oD44A","properties":{"formattedCitation":"(Silverman, 2016)","plainCitation":"(Silverman, 2016)","noteIndex":0},"citationItems":[{"id":2017,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/FYJWH32Q"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/FYJWH32Q"],"itemData":{"id":2017,"type":"book","title":"Qualitative research","publisher":"Sage","ISBN":"1-4739-8484-X","author":[{"family":"Silverman","given":"David"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Silverman, 2016). It is essential for the researcher to critically consider all these perspectives when it comes to adopting a true perspective of ethics in research. A brief explanation of all these major issues of ethics in research is important to establish the required form of the research process.
Informed consent is established as the mandatory aspect in research to assure the appropriate form of ethical standards. It is a major ethical issue for the researcher to attain proper consent from the respondents when it comes to using their information in the research process or consider them as part of the research. Right of autonomy of each respondent needs to be protected considering the principle of ethics in the form of informed consent. The ethical principle of beneficence indicates that there is a need for assurance of protection of all shareholders during the entire procedure of research work. Harming anyone during the process of research is not permitted when it comes to the assurance of ethical research. Confidentiality is another major aspect that exists in the case of ethical research considering the major principles of the conduct of ethics. It is critical for the researcher to protect the dignity and security of all the respondents during the research procedure and never reveals their personal information for any cause other than research work. Privacy is another critical ethical issue closely linked with the domain of confidentiality of the respondents. It is one basic criteria in research to achieve the objective of ethical research. Another major issue that prevails in case of research is consideration of vulnerable groups in the research procedure. Undoubtedly, it is one tricky prospect for the researcher to make a decision about the inclusion of vulnerable group in research. The researcher needs to be highly vigilant to effectively handle all the major ethical issues in case of the research process.
Protection of Human Rights
Human rights protection is one major agenda of the ethical research that is concerned with the proper consideration of five major principles of ethics. Active involvement of all the principles of ethics is vital to attain the desirable form of human rights during the process of research. Protection of human subjects should be the priority for the researcher to avoid the ethical issues in the case of research work. Comprehensive understanding of the approach of ethical research reveals that there are five prominent aspects in case of human rights that must be protected during the entire process of research work ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Jj4Dq10V","properties":{"formattedCitation":"(Amon, Baral, Beyrer, & Kass, 2012)","plainCitation":"(Amon, Baral, Beyrer, & Kass, 2012)","noteIndex":0},"citationItems":[{"id":2018,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/HB3BIUCT"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/HB3BIUCT"],"itemData":{"id":2018,"type":"article-journal","title":"Human rights research and ethics review: protecting individuals or protecting the state?","container-title":"PLoS medicine","page":"e1001325","volume":"9","issue":"10","author":[{"family":"Amon","given":"Joseph J."},{"family":"Baral","given":"Stefan D."},{"family":"Beyrer","given":"Chris"},{"family":"Kass","given":"Nancy"}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Amon, Baral, Beyrer, & Kass, 2012). Identification of these features of human rights protection ultimately provides a roadmap of research procedure to the researcher.
Exploration of five elements of human rights protection is possible through the critical consideration of five basic principles of research ethics. Informed consent, beneficence, confidentiality, privacy, consideration of the people of vulnerable groups are ranked as the basic features of human rights that need to be protected by the research during the whole process of research work. Proper explanation of all these aspects of human rights protection is helpful domain to achieve the actual objective of human right protection in case of ethical research work. Informed consent is a major step to ensure the proper protection of human rights in the process of research. It is mandatory for the researcher to attain prior permission from all the respondents to ensure their participation in the research process. Self-determination and comfort level of all the shareholders is utmost critical that can never be violated at any cost. Adoption of the principle of ethics in the form of beneficence is also significant that indicate that harming any individual for the sake of research is not an option for the researcher. Assuring physical, psychological, and emotional protection is one of the crucial practical ethical principles of the research work.
Protection of confidentiality of the respondents is another important form of the protection of human rights in case of research work. Researchers are restricted to never share personal information of any respondent without permission. The human right of privacy is closely linked with the practical domain of confidentiality of the respondents in case of the research process. The privacy of human beings can never be violated in any form during the research process. The approach of a vulnerable group of people is another major feature of consideration when it comes to the protection of human rights in case of ethical research. Researchers need to be careful when it comes to the inclusion of vulnerable people as the sample for the research work. It is necessary for the researchers to develop proper guidelines for the vulnerable group of people who might not able to protect their rights.
It is vital to examine how these factors of human rights protection are present specifically in the case of the research study of evidence-based practice beliefs and behaviors of nurses in the provision of cancer pain management. A detailed evaluation of this research study clearly indicates that researchers religiously focus to ensure the standards of human rights protection. The entire procedure of research work was approved by the University of Washington Institutional Review Board. The approval of the study is the clear indication of the appropriate consideration of human rights protection by the researchers. It is clearly mentioned in the study that the ethical principle of informed consent is adopted by the researchers to ensure the willingness of registered nurses who are considered as the potential sample for the study. It is observed that all the potential participants provided their consent for the approach of study participation. Personal information of the participants was gathered by the researchers to identify the nurses’ perspective about the approach of EBP. Attainment of the personal information of all the respondents made it essential for the researchers to ensure the protection of human rights particularly in the forms of confidentiality and the privacy of the nurses.
Sampling Method
Selection of the appropriate sampling method is established as one of the critical aspects of the entire research process. Researchers need to be critical when it comes to adoption of sampling technique according to the actual requirements of the research procedure. A detailed evaluation of different steps of the research work helps to indicate the selected sampling method and its implications on the results of the study. A descriptive, cross-sectional, mixed-methods design of sampling is used by the researchers to collect the responses from the respondents. The sampling approach of mixed-method design permits researchers to attain both forms of qualitative and quantitative research work. A mixed method of sampling ultimately made it easy for the researchers to utilize different methods of data collection for this particular study. 40 registered nurses were selected by inviting them to participate in the study.
It is important to comprehensively analyze both forms of qualitative and quantitative sampling established by authors for this study. This form of understanding further help to examine the effectiveness of the sampling methods selected by the researchers. The technique of questionnaires is used by the researchers in the form of a quantitative method of sampling. Different scales of demographic questionnaire, the EBP Beliefs Scale, The EBP Implementation Scale, and Carlson’s Prior Conditions Instruments. Survey data for this study were gathered from 44 RNs who considered as the sample. Consideration of diverse instruments for the data collection helped researchers to find out the exact responses from the sample according to the actual requirements of this study. Qualitative method of data collection was also used by the researchers to obtain proper responses. The practical technique of individual semi-structured interviews was offered by the researchers to the participants when it comes to sharing their perceptions about the approach of EBP. It is critical to indicate that registered nurses were selected as the sample for this study by considering their interactive role in case of EBP. The level of interaction of registered nurses in the scenario of EBP was established by the researchers as the standard to choose the subjects for participation in this study.
Thorough understanding of the sampling approach of this study revealed that the method of simple random sampling was used by the researchers to attain required responses from the registered nurses. This specific approach of sampling gives equal chance to each registered nurse belongs to EBP to become part of the sample for this study. This particular technique of sampling method established as the one appropriate method to avoid the issue of biasedness. The effectiveness of this specific method can only check by considering the implications of other methods of sampling. There are many other methods of sampling that were the options for the researchers to conduct this particular research work. The implications of the sampling method in the form of simple random sampling clearly indicate that it was the most suitable method for the study which was considered by the researchers. This specific method of data collection allows each member to have an equal chance to become part of the sample of the study. Consideration of the random selection of registered nurses eventually positively influence the domain of outcomes by ensuring unbiased results.
Assessment of the sampling method on ethical grounds is also important to ensure the prevalence of ethical research. The sampling method established by the researchers clearly indicates that principles of ethics were considered by the researchers. Equal chances for each registered nurse in the context of EBP illustrated about the fair process of sampling adopted by the researchers. The population in question in case of this particular research study can never rank as a vulnerable population as registered nurses have complete authority to deliver their consent for the study.
Informed Consent
It is notable to mention that taking informed consent for participants is necessary for any research purpose in order to avoid any enforcement actions. Informed consent is a voluntary agreement which ensures that participants are willing to join a research project ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"GDz5tqiE","properties":{"formattedCitation":"(Grady, 2015)","plainCitation":"(Grady, 2015)","noteIndex":0},"citationItems":[{"id":2021,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/79MFFEXP"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/79MFFEXP"],"itemData":{"id":2021,"type":"article-journal","title":"Enduring and emerging challenges of informed consent","container-title":"New England Journal of Medicine","page":"855-862","volume":"372","issue":"9","author":[{"family":"Grady","given":"Christine"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Grady, 2015). It is considered as an essential aspect of any research before procedures and treatments. Informed consent contains essential information about research and its risks. In the considered research article, 12 nurses participated in an individual semi-structured interview. The basic purpose of this research study is to understand the perception of nurses towards evidence-based practice regarding pain management of cancer. Informed consent was shared with all twelve nurses who participated in this research study to avoid any legal action in the future.
The documentation of evidence-based pain management in the patient medical record is identified through the nurses’ interview. In order to fulfil the paradigm of informed consent, nurses were provided with the necessary information about this research study. It is notable to mention that risks regarding this research study were also discussed with participated nurses. The informed consent for this research study was detailed as it contains information about the purpose of the study, the rights of participates regarding this study, the procedures to be undergone with during the entire interview and the potential risks of participation. It is notable to mention that the legal rights of participated nurses were not waived. The consent was obtained properly in this research study as participated nurses were told about the benefits and risks of their participation. It was made clear with these nurses that their participation is solely dependent on their willingness to join the research study. Sufficient information was provided to the participated nurses, so they had adequate time to make an informed decision about their participation in this research project. The informed consent was taken from the participated nurses through an online web survey method. Participated nurses were told about the duration of this interview in advance so they can manage their time accordingly to avoid any inconvenience later. The duration of the interview ranged from 30 to 45 minutes which was notified in the online consent form.
It is essential to mention that two nurses did not participate in this research study as they were unable to manage sufficient time for a digital interview. Permission for the digital interview was taken from the nurses in order to understand their perception about evidence-based practice in terms of cancer’s pain management. Informed consent is an ethical conduct of human subject’s research. The individual autonomy is completely respected in this research study which ensures that the fundamental ethical principle of the consent is followed in this research study. Each individual is independent of his/her thought and decision in regard to anything. In the considered research study, participated nurses were also given the individual autonomy to decide whether they want to participate in the given research study or not. The voluntary consent of the individual is of utmost importance to ensure the safety and protection of subject along with the integrity of the research study. Furthermore, the interview of each nurse was individually recorded along with consent. Detailed consideration of every precise information was added in the given informed consent. The purpose of the research along with involved procedures was included in the consent. The benefits of the research study were included in the consent along with all foreseeable discomforts and risks to the subject. The consent also includes the length of time expected from participants to contribute their time for this research study. Moreover, the consent also included a statement that any participant can use his/her right to withdraw from the research study without any penalties. The informed consent needs to be detailed and precise about the entire research study and the participation of individuals. Registered nurses were provided with this detailed consent form which contains a clause of every aspect of human rights, human welfare, their right to leave this research study whenever they want, along with positive aspects of the research study.
The consent also included information about the number of subjects that are participating in this research study. The original idea was to include 44 registered nurses in this research study in order to increase the overall size of subjects to get more liable information. Unfortunately, two of these registered nurses refused to join this research study due to busy work schedule. The researchers were unable to change the number of a subject participating in this research study as it was already delivered with nominated registered nurses. However, each registered nurse was notified about the number of actual participants in this research study during the digital interview. One of the important and major considerations of informed consent is the use of non-technical language. It is recommended by the institutional review board to use simple language that is understandable to the participants of any research study. Technological or medical terms need to be explained in lay terms or they should be defined properly so that participants can understand it. In the considered research study, online consent documentation was written in simple, non-technical language so it easily met the expectations of registered nurses. All the medical terms were clearly defined in the informed consent documents to ensure that nurses completely understood its meaning. It is highly important to make the consent documents in the language of the participants to avoid any ambiguity. The consent documentation was prepared in the native language of participated registered nurses. IRB highly recommend not to use exculpatory language in the consent documents whether oral or written. It is noteworthy to mention that the consent documents of considered research study did not include any exculpatory language.
Ethical Scientific Integrity
Development of the significant approach of ethical scientific integrity is also necessary to attain the desirable form of ethical research. The concept of ethical scientific integrity helps to assess the involvement of researchers during the process of research. The principles of scientific integrity recognized as the guideline to determine the appropriate role of the researchers. It is vital to attain information about the contribution of the researchers in the field of research to figure out the truthfulness of their research work. Professional integrity demands researchers to truthfully implement all the stages of the research and present the truth to the world. The criteria of the scientific integrity of the researcher can be used to make better inferences about the actual reliability of the research work. Professional integrity for the field of research demands researcher to describe all the knowledge in the most truthful manner.
The broad idea of scientific integrity comprised of two basic standards that established as the fundamental guidelines for the professional researchers. Firstly, it is important for the researchers to contribute to the paradigm of research by enhancing the overall culture of integrity during the whole procedure of research. The second principle of research integrity is related to the feature of evidence-based policy interests. It is necessary for the researchers to play their role in a legitimate manner by avoiding unnecessary interference in the entire process of research ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"MoBmVG5l","properties":{"formattedCitation":"(Breault, 2006)","plainCitation":"(Breault, 2006)","noteIndex":0},"citationItems":[{"id":2020,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/JIH3L9TL"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/JIH3L9TL"],"itemData":{"id":2020,"type":"article-journal","title":"Protecting human research subjects: The past defines the future","container-title":"Ochsner Journal","page":"15-20","volume":"6","issue":"1","author":[{"family":"Breault","given":"Joseph L."}],"issued":{"date-parts":[["2006"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Breault, 2006). Transparency in the scenario of research is the one core objective of the spectrum of research that needs to be completed by the researcher to achieve the desired form of ethical scientific integrity.
Detailed consideration of credentials of all the researchers is mandatory, who play a critical role in conducting the research on the topic of EBP in the context of cancer pain management. Identification of the designation of each research will help to figure out the authenticity of the research study. Linda H. Eaton is the prestigious name in the field of healthcare nursing, who is performing her role project director in the School of Nursing at the University of Washington. Alexa R. Meins also have an important role in the entire process of this research study. She is the student of PhD degree, who is focus to successfully adopt the approach of research and utilize it to attain valuable knowledge for the field of nursing. The rest of the authors of this research study also working at reputable working positions as professors in the School of Nursing at the University of Washington in Seattle. Proper consideration of the credentials of the researchers of this research work ultimately helps to determine the potential scientific integrity of this piece of research work. The information about the careers of the authors helps to establish the seriousness and the truthfulness that involves the entire procedure of the research work.
The authors of this research study also provide additional information that is helpful to assess the reliability and durability of this research work. It is indicated that this research study was supported by different legal and reputed healthcare institutions of the country. These particular organizations are established with the names of American Cancer Society, the ONS Foundation, and the University of Washington. Furthermore, the role of the National Institute of Nursing Research can also never ignore who awarded this research study. Deep consideration of the ethical grounds of the research study also demands to evaluate the options of data fabrication or inappropriate use of important information. It is observed that the illegal and unethical option of data fabrication was not used by the researchers as an option. Researchers followed each step of the research procedure and present the results they attained from the procedure of research work. All the required data from the respondents is collected by the researchers through the systematic steps and analyze this information through the statistical methods. Describing each step of the research process for the study ensures that fair and ethical means were used by the researchers to identify the trend of EBP in case of cancer pain management. Secondary sources were also correctly used by the researchers by giving credits to the original authors in the forms of proper citations and references. Plagiarism is recognized as another major aspect to characterize the ethical scientific integrity adopted by the researchers in case of the research study. The concept of plagiarism is defined as using any form of knowledge without giving proper credit to the author of that content. It is established that all the secondary information used by authors in this research study was properly referenced and there is no evidence of unethical inclusion of data in the study.
IRB
IRB is known as an institutional review board, which is an administrative body. It is notable to mention that each social research study needs to be approved and protected by an administrative body. An administrative body ensures that the rights of participants are protected to participate in research activities. It is essential to mention that IRB is a highly reputable administrative body which protects the rights and welfare of participants in a case study. The considered research study was approved by the Institutional Review Board of the University of Washington. The IRB of the University of Washington ensured the protection of participated nurses in this research study. Prior to the initiation of any research study, IRB usually reviews the entire procedure of human participants. It is notable to mention that IRB is charged with the protection of involved participants in any research study. In the considered research study, IRB ensured that individual autonomy of participated nurses is respected. Nurses were given full autonomy in their decision to join this research study. IRB of the University of Washington reviewed ethical and legal consideration regarding this research. It is necessary to mention that the consideration of ethical and legal aspects are of utmost importance to avoid any disciplinary action in the future. Furthermore, institutional, scientific, and social implications are a prominent factor for any institutional review board to ensure the integrity of a research study in terms of federal regulations and institutional policy ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"kVNzDbDb","properties":{"formattedCitation":"(Nurunnabi, 2014)","plainCitation":"(Nurunnabi, 2014)","noteIndex":0},"citationItems":[{"id":2019,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/DBEX9W8J"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/DBEX9W8J"],"itemData":{"id":2019,"type":"article-journal","title":"Institutional Review Board (IRB): its role and responsibility in making research ethical","container-title":"Bangladesh Journal of Bioethics","page":"5-10","volume":"5","issue":"1","author":[{"family":"Nurunnabi","given":"Abu Sadat Mohammad"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nurunnabi, 2014) . Reviewing potential objects of the research study in terms of human participation provides a precise idea about the preference of this research towards participants.
Confidentiality is an important and serious aspect which protects participants in terms of their right to privacy. Every individual has the right to privacy and breaching such right often results in serious enforcement action by law enforcement agencies. Institutional review board ensured that the paradigm of confidentiality is completely fulfilled in this research study. In the considered research study, all personal data of participated nurses kept safe and secure from any outside person. Moreover, the IRB ensured that the process of consent is completely met during this research study.
The entire process of online consent was reviewed by IRB of the University of Washington. They ensured that online consent contained all information including benefits and potential risks of this research study. Thorough information of research study was added in the online consent form to confirm that participants are well aware of the implication of this research study. Researchers of this research study made an approval letter for their research to be approved by the institutional review board of the University of Washington. The approval letter contained all necessary information about this research study including the participation of voluntary nurses. The researchers ensured that the right to privacy and human rights are not violated in this research study. The ethical and legal factors were included in this research approval letter for IRB. The IRB thoroughly reviewed each aspect of this research study, with great emphasis on the protection of participants’ rights and their welfare throughout the research study. Furthermore, institutional review board highly recommends using simple language for informed consent so that participants can easily understand any research study. Use of exculpatory language is needed to avoided as per IRB as it can create certain ambiguities.
HIPAA
HIPAA is a federal law that sets national standards in order to safeguard personal health information and medical records. It is notable to mention that HIPAA privacy rule is designed to protect collected data and personal information in medical records ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ZUhiLaQm","properties":{"formattedCitation":"(Arora, Yttri, & Nilsen, 2014)","plainCitation":"(Arora, Yttri, & Nilsen, 2014)","noteIndex":0},"citationItems":[{"id":2023,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/48FLJIAJ"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/48FLJIAJ"],"itemData":{"id":2023,"type":"article-journal","title":"Privacy and security in mobile health (mHealth) research","container-title":"Alcohol research: current reviews","page":"143","volume":"36","issue":"1","author":[{"family":"Arora","given":"Shifali"},{"family":"Yttri","given":"Jennifer"},{"family":"Nilsen","given":"Wendy"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Arora, Yttri, & Nilsen, 2014). This information is protected through Health Insurance Profitability and Accountability Act. Personal medical information is stored as per the national standard of HIPAA in all offices of doctors and hospitals. It is critical to mention that the individual has complete autonomy to review his/her medical record at any time. Each person has the right to review his/her medical information when needed and he/she can request to change any information if it is not correct.
In the considered research study, the information of registered nurses was not taken from the medical database. There was no need to take medical information from HIPAA, as all the required information was taken through interview. It is notable to mention that there was no need for using database information about registered nurses as it does not deal in depth with their medical history or information. The research study was made to understand the perception of registered nurses regarding evidence-based practices in terms of cancer pain management. Registered nurses were supposed to provide their perspective in this regard to ensure their understanding of the topic. That was the main reason to not use medical information of registered nurses from the database to complete the research study. However, critical actions were taken to ensure the safety of their personal information, which was taken during the interview. The information of registered nurses was protected with the help of assigned numbers in place of their names. They were referred to as registered nurses throughout the research study to protect their personal information such as name and history.
The benefit to Risk Ratio
The benefit to risk ratio is another effective practical measure to achieve the better outcomes of the research study. It is important to assess the research work under the standard of the risk ratio to figure out the actual implications of the research study. A risk ratio is defined as the ratio that is used to determine the actual risk of an action considering the potential benefits ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"MBIe4jP8","properties":{"formattedCitation":"(Chenail, 2011)","plainCitation":"(Chenail, 2011)","noteIndex":0},"citationItems":[{"id":2022,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/UNSLGJBQ"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/UNSLGJBQ"],"itemData":{"id":2022,"type":"article-journal","title":"Interviewing the investigator: Strategies for addressing instrumentation and researcher bias concerns in qualitative research","container-title":"The qualitative report","page":"255-262","volume":"16","issue":"1","author":[{"family":"Chenail","given":"Ronald J."}],"issued":{"date-parts":[["2011"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chenail, 2011). The analysis of the risk-benefit ratio is used by the analyst to correctly quantify the actual risks and benefits in the form of their ratios. Critical analysis of the entire risk can be helpful to figure out the actual effectiveness of the action. The concept of benefit to risk ratio can also use in case of research procedure to figure out the actual opportunities and the risks of the entire research process. It is recommended for the researchers to measure both forms of risks and benefits at the first stage of the research to evaluate the actual effectiveness of the research study. This form of evaluation can be helpful to attain the right track of the research procedure and achieve beneficial outcomes from the entire action of research. The approach of the ratio can be helpful for the researcher to assess the overall feasibility of the research work considering both the perspectives of potential risks and benefits.
There is no evidence that researchers utilized the option of benefit to risk ratio in case of the research study on the topic of EBP specifically in the context of cancer pain management. The risk ratio was not calculated by the researchers to identify the potential risks and opportunities in the form of a ratio. It is established by former research studies that risk ratio is ranked as a suitable method to attain the correct form of estimation. The comprehensive overview of IRB closely linked with the practical domain of the benefit to risk ratio. The outcomes of this particular research study can rank as an effective contribution in the field of nursing when it comes to the approach of EBP. The evaluations of this study can positively impact the individuals and the whole community as it involves the healthcare perspective. The perspectives delivered by the registered nurses in this study can further use to enhance the approach of EBP specifically in case of cancer pain management.
Conclusion
In a nutshell, it is worthy to mention that the research study on the issue of EBP in the context of cancer pain management is effective to form of research work for the nurses. The outcomes of this study can further use to improve the practical domains of the main idea of evidence-based practice in the context of the functioning of registered nurses. The assessment of the research study on ethical grounds is also important to establish the moral standards of the research. Proper application of different principles of ethics in research helps to ensure the desired approach of human rights protection at every stage of the research procedure. A critical assessment of each step of this research study reveals that the standards of ethics are greatly followed by the researchers. Approval of this research study from IRB is the major evidence to define this as the ethical form of research work.
References
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Eaton, L. H., Meins, A. R., Mitchell, P. H., Voss, J., & Doorenbos, A. Z. (2015). Evidence-based practice beliefs and behaviors of nurses providing cancer pain management: A mixed-methods approach. Oncology Nursing Forum, 42, 165. NIH Public Access.
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