Describe the results of this analysis for frequent and moderate ‘treatment and release use’ of the ED.

ASSESSMENT 1 – 40%

Assessment 1 must be completed in 900-1200 words and is worth 40 marks. While references

are not required, where you use other authors’ work, this should be appropriately referenced.

References and in-text citations must not be included in the word count. You are required to

use the Assessment 1 Template (available on the Unit website).

You are required to answer all components of each of the four Parts detailed below. The

Assessment 1 paper should predominantly be written in narrative form. Mark allocations are

shown throughout. Mark allocations provide a guide to the word length for each Part (on

average, 10 marks is equivalent to a maximum of 300 words). Marks include a 20%

component for expression (including spelling and grammar), referencing (if used) and

adherence to the minimum and maximum word count.

Part 1 (10 marks)

The following questions relate to a randomised controlled trial to examine the effects of

applying a tailored delirium preventive protocol to ICU patients. Participants were

randomised to an intervention group or to a control group receiving usual care.

Table 1 shows a comparison of baseline characteristics of participants. Chi-square and t-tests

were used for comparing the demographics and clinical characteristics between the

intervention and the control groups.

9058: Evidence Based Health Care

Semester 2, 2015 2

Assessment items

1.1 In Table 1, the Chi-square test and t-test were used to determine the significance of

differences between categorical and numerical variables of two independent groups (the

intervention and the control group). Which variables would the Chi-square test have

been applied to, and which would the t-test have been applied to? [3 marks]

1.2 Which of these tests is the parametric statistical test and what are the main assumptions

about the data being subjected to that test? [4 marks]

1.3 Describe the results of the baseline comparisons in Table 1. [3 marks]

Part 2 (10 marks)

The following table shows some of results of multinomial logistic regession analyses of

predictor variables associated with 5650 healthy adults’ frequent or moderate ‘treatment and

release’ use of an Emergency Department. The predictor variables are bivariate (Yes/No or

Female/Male) except for the numerical variables ‘Age’ and ‘Number of outpatient visits’.

You are asked to focus just on the odds ratios and confidence intervals (OR and 95% CI).

Assessment items

2.1 Describe the results of this analysis for frequent and moderate ‘treatment and release

use’ of the ED. Report on the strength and direction of the statistically significant

associations. [5 marks]

2.2 Consider the situation where other studies have produced similar results for the main

factors predicting frequent and moderate ‘treatment and release use’ of the ED (NB –

you don’t need to try and find any other studies). What might be the implications of this

evidence for clinical practice when providing nursing services for such patients? [5

marks]

9058: Evidence Based Health Care

Semester 2, 2015 3

Part 3 (10 marks)

The following table shows results of a study that linked hospital facility data with staff nurse

survey data (N = 1024) and surgical patient discharge data (N = 76,036) from 14 teaching

hospitals with 700 or more beds. Logistic regression models that adjusted for a range of

patient and hospital factors were used to estimate the effects of three nursing characteristics

on risk-adjusted patient mortality within 30 days of admission.

The three nursing characteristics were nurse staffing (patients per nurse), nurse work

environment (better vs. mixed or poor) and nurse education (the percentage of nurses with a

Bachelor degree in nursing).

The fully adjusted logistic regression model controlled for patient age, gender, transfer status,

type of admission, major diagnostic category and co-morbidities, as well as hospital location

and number of beds.

Assessment items

3.1 Describe the results of this analysis, focussing on the statistically significant predictors

in the fully adjusted model. Report on the strength and direction of the associations. For

the purposes of this discussion, consider the fully adjusted result for nurse staffing

(patients per nurse) to be statistically significant. [5 marks]

3.2 Consider the situation where other studies have produced similar results for the main

nursing characteristics predicting patient mortality (NB – you don’t need to try and find

any other studies). What might be the implications of the evidence for the health system

in relation to the quality and safety of patient care? [5 marks]

9058: Evidence Based Health Care

Semester 2, 2015 4

Part 4 (10 marks)

You have been asked to work on a research project that has recently been submitted to a

Human Research Ethics Committee for approval. The project aims to investigate the use of

alcohol by underage adolescents (below age 18). Underage drinking, particularly binge

drinking, is an identified public health problem in Australia. The study will explore the

frequency and amount of alcohol use, sources of alcohol, types of alcoholic beverages, cooccuring

other substance use and the consequences of alcohol use. It is hoped that the study

can inform effective public health strategies to reduce underage drinking.

The data will be collected in 2 ways, as follows.

a. By self-reported, online survey – participants will be recruited via advertisements in

secondary schools, which will direct interested volunteers to a secure website.

b. By brief face-to-face interviews at selected events such as music festivals and major

concerts. Potential participants at the nominated events will be identified as:

i. Likely to be in the target age range

ii. Observed to be in possession of alcoholic beverages or appear to be under the

influence of alcohol.

The participants will be asked to answer a few questions, which will include confirming

inclusion criteria (screening for age and alcohol possession), and questions about the

source, type and amount of alcohol.

Assessment items

4.1 What do you believe to be the key risks associated with the research? Who bears those

risks? [3.5 marks]

4.2 What do you believe would be the potential benefits of the research? Who would

potentially benefit? [1.5 marks]

4.3 What additional ethical issues or concerns do you believe there may be? [3.5 marks]

4.4 Do you believe the Human Research Ethics Committee should approve this research

proposal, either in part or in full? Why or why not? [1.5 marks]

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