NRS465 Applied Evidence-Based Project and Practicum: Clinical vs. Statistical Significance in EBP Projects
Week 8 Discussion
DQ 1
Based on your Topic 7 Capstone Change Project Evaluation Plan, explain the dependent variable that is being measured and the independent variable that is being manipulated. Hypothesize the results of the manipulation of the independent variable and the change you expect to occur in the dependent variable.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN DQ Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
DQ 2
Not all EBP projects result in statistically significant results. Explain the difference between clinical and statistical significance. How can you use clinical significance to support positive outcomes in your project? Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN DQ Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
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Here’s a response for each discussion question for Week 8:
DQ 1: Dependent and Independent Variables in Capstone Change Project
In my Capstone Change Project, the dependent variable being measured is the rate of hand hygiene compliance among nursing staff. This is a critical metric as it directly correlates with the reduction of healthcare-associated infections (HAIs) in clinical settings. The independent variable being manipulated is the implementation of a multi-faceted hand hygiene intervention, which includes educational sessions, visual reminders, and the use of electronic monitoring systems to track compliance.
Hypothesis: I hypothesize that the manipulation of the independent variable—implementing the hand hygiene intervention—will lead to a significant increase in hand hygiene compliance rates among nursing staff. Specifically, I expect that compliance rates will improve from a baseline of 70% to at least 90% within three months post-intervention. This expected change in the dependent variable is based on evidence from previous studies showing that comprehensive hand hygiene programs, which combine education with monitoring and feedback, are effective in improving compliance rates and, subsequently, reducing HAIs (Pfoh et al., 2013).
By systematically manipulating the independent variable (the intervention), we aim to observe a measurable improvement in the dependent variable (compliance rates), which should reflect the effectiveness of the intervention in promoting better hand hygiene practices. If the results align with the hypothesis, it would suggest that the intervention could be adopted more broadly within the healthcare facility to sustain high levels of hand hygiene compliance and improve overall patient safety.
References:
Pfoh, E. R., Dy, S. M., & Engineer, C. (2013). Interventions to improve hand hygiene compliance: A systematic review. Journal of Hospital Infection, 85(4), 270-280.
Yokoe, D. S., Anderson, D. J., Berenholtz, S. M., Calfee, D. P., Dubberke, E. R., Ellingson, K. D., … & Lo, E. (2014). A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates. Infection Control & Hospital Epidemiology, 35(8), 967-977.
DQ 2: Clinical vs. Statistical Significance in EBP Projects
Clinical significance refers to the practical importance of a treatment effect—whether it has a real, tangible impact on patient care and outcomes—while statistical significance pertains to the likelihood that a result is not due to chance, typically assessed through p-values and confidence intervals (Polit & Beck, 2017). An EBP project might yield statistically significant results, indicating that the observed effects are unlikely due to random variation, but these results may not necessarily translate into meaningful clinical changes. Conversely, a project could have clinically significant results, such as improved patient satisfaction or reduced symptoms, even if statistical significance is not achieved.
To support positive outcomes in my project, clinical significance can be demonstrated through improvements in patient care metrics that are directly relevant to practice, such as reductions in infection rates or improved compliance with hand hygiene protocols. For instance, even if the increase in compliance rates does not reach statistical significance, a substantial improvement that leads to fewer HAIs would be considered clinically significant and valuable for patient outcomes.
Highlighting the clinical significance of the results emphasizes the real-world impact of the intervention, which can drive support and buy-in from stakeholders, including healthcare providers and administrators. This focus on practical outcomes ensures that the EBP project remains patient-centered and aligned with the overarching goals of enhancing healthcare quality and safety.
References:
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Wolters Kluwer Health.
Sullivan, L. M. (2012). Essentials of biostatistics in public health. Jones & Bartlett Publishers.
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