Evidence Based Practice Essay Example for Free

Evidence Based Practice Essay To achieve a high quality of healthcare and to keep up with the increasing pace of clinical advances in the field of midwifery, using women’s experiences and statistics within evidence based practice is probably the best research evidence. Evidence based practice is ‘The conscientious and judicious use of current best evidence in conjunction with clinical expertise and patient values to guide health (and social) care decisions’. (Sackett et al 2000). The main aims of this assignment are to outline what qualitative and quantitative data are, how they are used in evidence based practice and to outline the key differences between these two methods. Two research papers, on qualitative and one quantitative will also be compared with respect to the key methodological differences used within the papers. Qualitative research looks to explore a particular subject or question more in depth and is often used to research into a topic where there is unknown information. This type of research is more useful when answers are needed to what, how and why and when in-depth questions need to be answered and they cannot be done numerically. The researcher is looking to develop an in-depth understanding of this topic. Qualitative research uses small sample groups and the methods of collecting the information are often open ended questions in the form of in-depth interviews and focus groups. The participants used have generally had exposure to the phenomenon in the particular study. Qualitative research is less numerically measurable and results are often exposed as themes or trends presented in a narrative. Qualitative research’s aim is subjective. Quantitative research looks to measure data within a study. It is only used when this data can be collected numerically. The sample size with this research is large and the researcher has no involvement with the participant making the research objective. Quantitative research uses structured closed question design and the results are expressed as numbers and statistics in graphs and tables. Within each research problem there is a process which is followed. The research process starts with a general problem, topic or issue. Within quantitative research the aims or objectives are generally associated  between the relationships of two or more variables. In qualitative research the aim is usually to gather a better understanding of the experiences of the subject area, a deeper knowledge so to speak. The research design with qualitative research is non structured, flexible and always non experimental designs. To select the participants within the research a technique called sampling is used. The qualitative sample size is often smaller and non-probability or a non-random sampling approach is used whereas with quantitative a larger more representative sample is used and the probability or the random technique is favoured. The findings are collected in a process called data collection with qualitative research they are typically textual unstructured interviews and open ended questions and with quantitative research the collection is systematic and structured often questionnaires or surveys with closed questions. The data is analysed using thematic analysis techniques for qualitative research and statistical analysis for quantitative research. The results or findings are then presented for qualitative research in a narrative form that is typically supported with direct quotes to illustrate the main points and themes from the data sources and with quantitative research statistics and graphs are presented in tables and graphs. The qualitative research paper is titled ‘Nobody actually tells you: a study of infant feeding’ and it is researching the infant feeding decision making process. The sampling size of the study is 21 and the women have been purposively sampled from a group of women known to have low breast feeding rates. These women were low class, low educational level, living in Tower Hamlets and Hackney in the United Kingdom and expecting their first baby. The women were told the research was about choices women make whilst looking after their first baby but the agenda was later declared. The research design used was a semi structured interview which was developed from four piloted interviews. The women had a choice of where the interview took place, all but three were interviewed in the home and a partner or relative could be present. The women were interviewed on two occasions, once early in pregnancy and then again in six to ten weeks after birth, using the grounded theory which understands and interprets peoples experiences, developing a theory that has been grounded from the data. The framework method of data  analysis was applied systematically using categories and themes identified by reading the transcripts. Nineteen women were reinterviewed at 6-10 weeks as two women had moved away, then the nineteen women remaining were sent a synopsis of their individual case analysis, feedback was received from elven women. The transcripts were analysed and cross checked using data from different sources with the results of the research presented in table form, one with the feeding outcomes and also a box with reasons for women being silent and not seeking help with postnatal difficulties. Also direct quotes from the women are presented in the research outlining some of the main themes of the subject discussed. The quantitative paper is about looking at preconception risks presented when there is a negative pregnancy test. It is a care programme which has been set up to help women who want to become pregnant by giving advice to the women who present with these certain risk factors. The potential to assist women is known as the hypothesis, the risk factors are known as the independent variables with pregnancy being the dependent variable. An experimental method was used with randomised controlled trial which is where the participants are allocated by random allocation into two or more groups. The study was longitudinal because the data was collected over time approximately two years and two months. From the 1570 pregnancy tests 1106 were negative to which 262 women were approached. A registered nurse approached the women who had produced the negative pregnancy tests; the nurse was experienced in family planning and contacted the women within certain hours. The preconception risk assessment w as then offered to 170 women. With a flip of a coin done so by the registered nurse the participants were randomly assigned to an intervention group or a usual care group. The women within the usual care group and the clinician for this group received no feedback. Whereas the women in the intervention group were told of the risks identified and were given an appointment with a clinician. Preconception Risk Surveys (PRS) were given out to all women by a research assistant who was blinded to the group assignment. The PRS was defined as a screening tool to assess being ready for pregnancy and to identify any medical and psychosocial risk factors. The survey took approximately twenty-five minutes to complete. The women in the usual care group were  offered appointments for a family planning visit to discuss the risks and the women in the intervention group received a booklet. Each woman was contacted via a telephone call a year on to ask whether the clinicians had tackled the risks identified and whether the women had become pregnant. The rates of intervention between these two groups were compared and these differences were first analysed using intent to treat design. Subgroup analysis was also conducted which was only done on the women who had visited at least once during the follow up year. The results were presented in numerical tables and pie charts. When the groups were compared when there was at least one risk addressed there were no significant differences. But for the usual care and intervention groups combined the risk categories varied considerably combined with the chance of a risk being addressed. It can be concluded that evidence based practice is an important tool to use when there is a need to achieve a high quality of health care. Evidence based practice enables the researcher to get what they require using the current and best evidence available. Depending on what information is required and from what sample size and the questions needed to be asked then depends on what research method is used, be it qualitative or quantitative research. One criticism of the qualitative research paper could be the sample size used, there were only twenty one women used over a period of time with two dropping out so if any more had dropped out there would have been a low transferability. Also from this small sample it could be difficult to be systematic comparisons as well as some of the feedback could be the researcher’s interpretation. The paper did bring out key points amongst women but it’s the analysing of this data that could be difficult as women use different languages and with the open ended questions asked there will be a lot of talk to bring together into set themes although some common themes were found. In the quantitative research paper there was a very large sample used with different variable which didn’t have a great impact on the end results. In the majority of women the risks were not addressed so if there was further research in the future this should demonstrate some ways to help and motivate both clinicians and women to address the preconception risks and interventions should be initiated to lower the risk status.

The Beauty of Car Rides :: Personal Narrative

When I was six years old, I hated car rides. To a six year old, a car ride was the epitome of boredom. There was nothing to do on a car ride except sit there for hours watching the trees. I would get carsick every single time I was in my mom’s Volvo. If I wasn’t sick or bored, I was waiting painfully in the backseat for the next exit ramp so my mom could turn off the road for a bathroom break. My mom would have to bribe me with candy or some other special treat just to get me in a car everyday. Some six year olds were afraid of monsters and doctor’s visits; I was afraid of the car. About ten years later something happened, a change. When I finally got my driver’s license at age sixteen, I was no longer afraid of the once dreaded car ride.   Ã‚  Ã‚  Ã‚  Ã‚  At first I did not know why or how it happened, I just was not afraid anymore. I did not get bored, I did not get sick, and I did not have to painfully wait to use the bathroom. What was once a time of fear and unease turned to a time of tranquility and delight. I was excited to drive my car, and I felt good while driving. Maybe it was because the music I was listening to calmed me. Perhaps it was the beautiful sights I saw outside my window. It could have been because it was a time when I got to leave my troubles behind me and relax. It may have been that I was driving the car rather someone else, or it could have been a combination of all of these things. All I knew was that I had a 35-minute drive to school everyday, and I enjoyed it.   Ã‚  Ã‚  Ã‚  Ã‚  My drive to and from school everyday became a deep Emersonian experience. It was not so much that I was getting in touch with nature; it was that I was getting in touch with myself.

Shayla Smith

Summer Swimming Incident Shayla Smith stayed a few nights of summer vacation with her friend, Tamara, whose Mom and Dad, Bob and Susan Tuttle, took Shayla and their daughter, Tamara, camping. Shayla’s mom was happy for the break, as Shayla is dyslexic, and that has caused her to have a difficult time at school. Consequently, she acts out, and is a handful for her single mom! The campground is small, but has a fun mini-golf game, hiking trails, and has a pool, but no diving board, and no lifeguard; it is a sand-bottom pool, fed by an artesian well, so it is clean, but murky.The owners, Owen and Dolly Jones, who own and operate the campground, don’t have any security on the premises because they are a ‘mom and pop’ operation, and the campers all come back year after year. The sign out front says, â€Å"Everyone’s family at the O & D Family Campground! † Tamara’s family was looking for a summer spot to which they can return year after year , so they gave the O & D a try this year. The first morning after arriving, the two 10 year-old girls hit the pool at about 9:30, even though it is not supposed to open for another half hour, according to the sign at the entrance.Tamara dove into the pool, and said, â€Å"Ow! It’s shallow here, but it is warm! Come on in! † Shayla yelled, â€Å"What? † and dove in right next to Tamara, but she hit bottom and broke her arm. Tamara saved her from drowning by pulling her to the side of the pool, and then helping her out to the bank. They call out for Tamara’s parents, who came out and immediately called the ambulance. Owen and Dolly returned from breakfast in town, and rushed into the pool area before the ambulance even arrived.Tamara’s mom wondered why the pool was not marked as shallow on that end, but Dolly says they put up the signs every morning when they get ready to officially open the pool, plus the pool is sand bottom and relatively soft anyw ay. Shayla’s family wants to sue Tamara’s parents for negligent supervision, as well as the campground for negligence. Writing Assignment 1: Post-Interview Memorandum This week, you should be working on your Post-Interview Memorandum. In most cases, paralegals are responsible for dictating memoranda to clients' files that summarize information obtained during interviews.Depending on a particular firm's preference, the summary may be in narrative or outline form. Post-interview memoranda should be prepared immediately after an interview, when details and notes remain familiar and fresh in your mind. There are typically five parts to a memorandum: (1) preamble, (2) description of the client's problem (Issue); (3) evaluation of the client; (4) discussion of the relevant facts; (5) conclusions and recommendations about the case. You will be writing a post-interview memorandum and submitting it in Unit 3.The memo will be based primarily on the facts given in the fact scenar io (first introduced in Unit 1) and on your own impression of the case. Additionally, you will â€Å"interview† Shayla and her mom, Mary Smith, in the Unit 2 seminar. Your instructor will play the roles of the witnesses. If you believe you will need additional facts, you should create a section in the memo that describes the other information you will need. See the sample post-interview memorandum below, as well as the description that follows it.Also see the Sample Interview Summary based on your initial interview of Mary Smith, Shayla's mom. The seminar â€Å"interview† will be your initial meeting with Shayla and your follow-up interview of Mary. Client Evaluation (Preamble): Evaluation of Mary Smith Date: 6-1-2008 [Put Issue here] Client Impression: Mary Smith is the mother of the injured child, Shayla. She is Caucasian, weighs approximately 150 lbs. , and is 5'2†³. She has a full head of dark brown hair worn at shoulder length.Mary is a secretary in a small i nsurance agency and is dressed professionally in a black suit. Mary was cooperative during the interview and was very responsive to my questions. However, she did not bring in any documentation though we had requested her medical bills, etc. Mary repeatedly asked me how long the case would take and mentioned her â€Å"large bills† from Shayla's accident several times. Mary is a single mother, and Shayla's father is not really in the picture and provides no financial support for Shayla's care. Mary does not have any kind of insurance.I found Mary to be a nice-looking woman though a bit frazzled. She was articulate but talked a little loudly. I think she would make a good impression on a judge or jury, but she is a little anxious to â€Å"score the big one† for Shayla's injuries. [Put Facts Here] Fact Questions: Where is the campground located? Who was supervising Shayla and Tamara? What is the layout of the pool? How deep and large is it? Were there any signs around the pool? Is there a lifeguard on duty? Have there been previous incidences at this campground pool?I am not sure Mary and Shayla have a viable case, as more investigation is needed. Recommend that we do the following fact development: More contact with client regarding bills and treatment Interviews with all witnesses, including ambulance personnel Obtain information about the campground, the pool, and any warning signs Obtain all medical records [put short conclusion here] Submit your paper to the Dropbox by the end of Unit 3. For additional help, view Power Point Presentation on legal memoranda below.

Belonging Involves Conforming and a Loss of Identity -...

The foundation of belonging is often associated with the loss of a person’s individuality. Indeed, as the construction of one’s identity is highly intricate and ever – changing, several authorities often considers its development to be associated with our relationships. From this, it can be shown that belonging can be associated with the degradation of one’s identity. Such impact can be explained through the reality that in order to belong, we must share similar characteristics or identity with that group however this can involve enhancing character’s identity. Nonetheless, due to its complexities, for some, belonging can threaten a person’s identity and individuality. In order to belong – we must share similar characteristic to a†¦show more content†¦Teenagers however are often ostracized for being different and this results to the conformity of many children and the foreclosing on uniqueness and individuality. In cases of children, belonging is usually not associated with the degradation of identity. This may not be the case with older people as it is a lot more complicated and sometimes conforming may be the only way to belong. We must consider times at which belonging can threaten an individualised identity. For some, the only way to belong is to conform to expectations, losing personal ideologies as a result. In the book The Absolute True Diary of a Part – Time Indian, Junior is a perfect example of conforming in order to belong. Junior is just a poor Indian reservation kid who dreams of a better life and takes action by attending an all – white private school in Reardan. He is considered as a ‘traitor’ by his people and doesn’t find much hope when â€Å"somewhere on the road to Reardan, [he] became something less than Indian. And once [he] arrived at Reardan, [he] became something less than less than less than Indian.† Junior struggle to fit is exacerbated when the Indian people where he once belonged no longer accepts him as he has left them for the white people. The trouble is, he didn’t belong in the all white school either as his â€Å"life [was] a constant struggle between being an individual and being a member of theShow MoreRelatedOrganisational Theory230255 Words   |  922 Pagesdevelop a sense of self in organizations 282 282 284 286 287 288 288 293 294 298 300 301 . Contents xi The self as dramatic artful creation Negotiating the way between the self and the organization’s rules Developing the organizational identity Understanding organization culture through symbols Introduction – two ways of exploring culture Communicating cultures Negotiation of meaning influences organizational design Ideology, rhetoric and negotiation Arenas and games Conclusions 301