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I need to post 6 comments to my peers. Responses to peers or faculty should be 150 min words and include one reference.
Comment 1:
Independent variables are the variables that researchers manipulate or control in an experiment to observe their effects on the dependent variable. Dependent variables are the outcomes or responses that are measured to assess the effects of the independent variable. Extraneous variables are variables other than the independent variable that can affect the dependent variable, potentially leading to confounding and inaccurate results if not controlled. Researchers attempt to control extraneous variables in two main ways: through experimental design and statistical control. Experimental design involves careful planning and manipulation of variables to minimize the influence of extraneous variables. Statistical control involves using statistical techniques to account for the effects of extraneous variables. For example, in a peer-reviewed primary research article titled “The Effects of Music Therapy on Pain in Patients with Cancer: A Meta-Analysis of Randomized Controlled Trials” by Li, et al. (2020), the researchers aimed to investigate the effects of music therapy on pain in cancer patients. In this study, the independent variable is music therapy, the dependent variable is pain levels in cancer patients, and potential extraneous variables could include age, gender, type of cancer, and previous pain management strategies. To control extraneous variables, the researchers likely used randomization to assign participants to the music therapy group or control group, ensuring that any extraneous variables are equally distributed between the groups. By carefully designing their study and controlling for extraneous variables, the researchers aimed to isolate the effects of music therapy on pain in cancer patients, providing more reliable and valid results
Comment 2
As defined by (Falkner, Green, Helbig, et al., 2022) dependent variables are baseline of the study. It’s being compared to the independent variable. Any changes that are observed will be compared to that of the independent variable. The independent variable is the focus of the experiment. It is the one that receives the treatment, procedure, or drug that is being observed for any effects. This variable can stand alone in its use. Lastly, comes the extraneous variable. These are unknown or unpredictable variables that in the beginning of a study. Extraneous variables can lead to inconsistencies and potentially disrupt the study from being accurate. In (Cuttler, 2017) provides example on how to control these disruptive variables. One method is to apply consistency in your study. For example, have the study occur in the same location, all participants have the same instructions, all are treated equally, and so on. A second method is by turning the extraneous variables into confounding variables. This is when an extraneous variable that has an average change across the independent variables. The example the book provides is the averages in IQs of participants. The key is to have IQs of highs and lows to establish an average. Basically, you are turning the extraneous variable and averaging it out, this can be measured separately from the independent variable This can be used to explain the influence it has over independent variable and account for it. An example of extraneous variables in a study is shown in (Hui et al., 2022). They aim to measure the benefits of performing yoga in a heated room. 290 novice participants were used in the 6-week study. It was a qualitative study that used a pre and post intervention questionnaire that focused if performing yoga improved mood. Here the extraneous variables can be age, sex, any mental issues, and current life situation. To help control these extraneous variables, participants were categorized by age, sex, overall health status, mood baseline, and experience to yoga. A randomized controlled trial was applied as well. This the applications of these methods, extraneous variables can now be measured as confounding variables.
Comment 3:
Independent variable is controlled by the type of thing that is being investigated by the researcher. The independent variable could be a disease, treatment, food effects, drugs and ect.
Dependent variable is what is being measured in the research and this can change based on the independent variable and it can be adjusted.
Extraneous Variables are the ones that where not there since the beginning of the study and where not part of the interest. This variable could have a dependent effect on the research.
Researchers attempt to control extraneous variables by using consistency, randomization and conclusion are 3 different ways to control and prevent extraneous variables in researches. When obtaining a conclusion the independent variable and dependent variable are compared on the effect of each other and keep any extraneous variable out. Consistency on the research can avoid any for-seen variable because it maintains the same setting and conditions while avoiding any minimal change that may affect the variables.
When a peer review article is being used the variables are used by providing the defined characteristics of what is being examined and this will later be interpreted to open conclusions regarding the variables used and the effect they cause on each other.
Comment 4:
This study looks at nursing compliance utilizing known best practices to minimize CLABSIs. The primary and 3 secondary goals of the research are clearly stated in the abstract. Results were measured as percentages of known CLABSI rates. Subject randomization was “A stepped wedged cluster-randomized design was used with units clustered into 4 sequences” (Reynolds, 2021). Implementation was systematically approached; results were measured 1 year after implementation to assess sustainability. The stepped wedged cluster disign allows for evaluatio during the implementation phase of a new process, until the entire population has implemented the change. This allows for evaluation between the implemented and non-implemented groups. The randomization was done at a unit level rather than an individual level.
Participants (nurses and nursing units) and researchers were not blind to the intervention. The implementation was “with the evidence-based implementation strategies program” (Reynolds, 2021). The nursing units did not change during the study, and this should not affect the outcome. The groups all received the same training and policy changes.
The results were measured in bathing compliance, charting compliance and CLABSI rates. Results were as expected, increased education, auditing and awareness from nurses should increase compliance. There is a possibility for bias in self-reporting and by project champions over reporting compliance. Results are quantitative in nature and easy to measure. There is no missing data, dropped groups or incomplete results. P values were reported on all datasets. Confidence Interval or CI was not seen in the report. The results of this study did not compromise or change existing nursing care. The only risk present in this study is that the non-implemented units may not have been as aware of policy fallout. Due to the extreme danger and costs associated with CLABSI, cost effectiveness is high.
This study could help locally. If local ICU populations have higher than normal CLABSI rates or poor bathing and/or charting compliance comparable results could be expected using this implementation techniques discussed in this study.
Critical appraisal is that an increased awareness, education and auditing will increase compliance. In this case the intervention is regarding chlorohexidine baths and charting in the ICU areas. This technique should improve compliance using similar techniques regardless of the actual intervention.
Comment 5:
An example of a clinical nursing problem addressed using a randomized controlled trial is the effectiveness of a nursing intervention to reduce hospital-acquired infections (HAIs) in the PICU. In this RCT, the nursing intervention involves implementing a strict hand hygiene protocol, using personal protective equipment, and educating both patients and healthcare workers about infection prevention measures. Other interventions included the use of antibiotics according to the World Health Organization’s guidelines to monitor it’s effectiveness against infection control. The study randomized patients in the PICU to either the intervention group or the control group and then compare the rates of HAIs between the two groups with various instruments that would cause HAI’s such as indwelling catheters and ventilators. By using randomization, the researchers aim to minimize bias and ensure that any differences in infection rates between the groups can be attributed to the nursing intervention. A comprehensive infection control and antibiotic stewardship initiative successfully decreased HAIs and improved healthcare outcomes, notably reducing in-hospital mortality. This research presents a framework for adopting WHO antibiotic guidelines and broader strategies to combat HAIs and antibiotic resistance.
While antibiotics can be effective in preventing infections, their use can also lead to antibiotic resistance, adverse drug reactions, and increased healthcare costs. Therefore, it is essential to consider whether the benefits of using antibiotics to prevent HAIs outweigh these potential harms and costs in the PICU setting. One other ethical consideration applicable to quantitative research studies such as this one is the principle of justice. Justice in research refers to the fair distribution of the benefits and burdens of research participation. In the context of this study, it is important to ensure that the use of antibiotics to prevent HAIs is implemented in a way that is fair and equitable to all patients in the PICU. This includes considering factors such as access to the intervention, potential side effects, and the impact on vulnerable populations.
Comment 6:
Basic Evaluation utilizing the CASP Agenda:
The review was intended to assess the viability and security of corticosteroids in patients with changing levels of coronavirus seriousness. Members were haphazardly relegated to intercessions, a trait of randomized controlled preliminaries (RCTs). The review represented all members throughout its length, including follow-ups and rejections. While the participants’ blinding to interventions was not specified, nor was the blinding of investigators or outcome assessors. The baseline characteristics of the study groups were presented, ensuring their comparability (Pasin et al., 2021). However, details on whether each group received equal levels of care were not provided. The study comprehensively reported outcomes, statistical analyses, and potential biases. Additionally, confidence intervals (CIs) for treatment effects were reported. Regarding the balance of benefits, the study suggests the advantages of corticosteroids in severe COVID-19 cases, yet it also notes potential harms in patients not requiring oxygen. Notably, the study did not mention undertaking a power calculation.
Appraisal Summary:
The study on corticosteroids in COVID-19 patients shows a focused research question, randomized controlled trials, and comprehensive reporting of outcomes. However, the blinding of participants, investigators, and outcome assessors is not clearly stated. The study reports benefits in severe cases but notes harm in less severe cases. It suggests further trials are needed. By and large, this study gives significant bits of knowledge, yet cautious thought of its limits is fundamental before carrying out changes practically speaking
Adjusting Advantages, Damages, and Moral Contemplations in Corticosteroid Use for Coronavirus
The review uncovers the expected advantages of corticosteroids in lessening death rates among serious coronavirus patients, especially those requiring mechanical ventilation. However, these advantages must be weighed against observed harms, notably increased mortality in patients not requiring oxygen therapy. The principle of beneficence, ensuring maximal benefit to patients, is a significant ethical consideration (Cheraghi et al., 2023). Also, the rule of equity highlights the requirement for a fair dispersion of treatment advantages and weights across society. Guaranteeing fair admittance to corticosteroid treatment, particularly in medical care differences, is critical. Accordingly, moral decision-making in coronavirus treatment includes adjusting advantages, damages, and standards of helpfulness and equity.
