Ethical Considerations

Throughout this course, you will have explored the importance of research, the impact of research, and the different types of research. During our final week, you will explore the importance of ethical considerations in research.

In this Discussion, you will focus on a specific study to explore ethics in research and consider the importance of the ethics pledge.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Required Resources

Alsan, M., & Wanamaker, M. (2018). Tuskegee and the health of black menLinks to an external site.. The Quarterly Journal of Economics, 133(1), 407–455.
Bates, B. R., & Harris, T. M. (2004). The Tuskegee study of untreated syphilis and public perceptions of biomedical research: A focus group studyLinks to an external site.. Journal of the National Medical Association, 96(8), 1051–1064. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568492/pdf/jnma00177-0047.pdf
Centers for Disease Control and Prevention. (2022, December 5). The USPHS untreated syphilis study at TuskegeeLinks to an external site.. https://www.cdc.gov/tuskegee/index.html
Hunt, D. F., Dunn, M., Harrison, G., & Bailey, J. (2021). Ethical considerations in quality improvement: key questions and a practical guideLinks to an external site.. BMJ Open Quality, 10(3), e001497. https://doi.org/10.1136/bmjoq-2021-001497
Office for Human Research Protections. (n.d.). Quality improvement activities FAQsLinks to an external site.. United States Department of Health and Human Services. https://www.hhs.gov/ohrp/regulations-and-policy/guidance/faq/quality-improvement-activities/index.html
Document:Doctoral Project Ethics Pledge (Word document)Download Doctoral Project Ethics Pledge (Word document)

To prepare:

Read and view the Learning Resources, focusing specifically on the Tuskegee study resources.
Read the ethics pledge.

By Day 3 of Week 11

Post a response including the following:

What are the characteristics of the research study (Tzeng & Yin, 2017), the quality improvement study (Khoja & Moosa, 2023), and the DNP project (Bangura, 2024) in terms of generalizability, sampling, and the nature of ethical protections?
Compare and contrast ethical considerations in research to ethics requirements for QI and/or for a DNP project.

By Day 5 of Week 11

Read a selection of your colleagues’ posts and respond to at least two of your colleagues on two different days by expanding upon their reflections, making connections to your perceptions, and offering additional insights

Reply

CLASS,

In this discussion, you will focus on a specific study to explore ethics in research and consider the importance of the ethics pledge.

Our interactive discussion addresses the following learning objectives:

Analyze ethical considerations in relation to DNP problem statements
Compare and contrast ethical considerations for research vs. quality improvement or any type of DNP project
Compare and contrast a research study, a QI study, and a DNP project with regard to generalizability and protection of human subjects (IRB review)

Post a response to the following prompts:

What are the characteristics of the research study (Tzeng & Yin, 2017), the quality improvement study (Khoja & Moosa, 2023), and the DNP project (Bangura, 2024) in terms of generalizability, sampling, and the nature of ethical protections?
Compare and contrast ethical considerations in research to ethics requirements for QI and/or for a DNP project.

We encourage you to read the question carefully to answer all aspects presented.

RESPOND TO THIS DISCUSSION POST

Charlisa

WK 11 Main Discussion Post – NURS 8211C

Characteristics Comparison

In our exploration of the research study by Tzeng and Yin (2017), we discovered a significant exploratory cross-sectional survey design. Their use of secondary data analysis to investigate the relationship between nurses’ perceptions of preventive fall interventions and their frequency of use in acute care settings was a significant step. They identified over twenty effective interventions that could prevent falls and reduce further patient injuries, a finding of great significance in our field.

Khoja and Moosa’s quality improvement project (2023) aimed to see if tailored interventions for patient safety (TIPS) in a medical-surgical orthopedic unit (MSOU) were as effective in reducing fall rates as the current practice. This study, focusing on improving current workflow processes and enhancing efficiency, provides practical insights that can be applied within a specific organization. The results are intended to identify gaps in practice and enhance the current implementation process, improving healthcare quality.

The Bangura (2024) DNP project aimed to see if intentional rounding would decrease fall rates in a Veterans’ long-term care facility. The project investigated current nursing practice and translated the findings into practice to improve patient outcomes related to fall prevention. The goal is to focus on translating evidence into practice.

Ethical Considerations

Traditional research studies like Tzeng and Yin’s require extensive ethical oversight. They must follow formal protocols to ensure participant protection, including informed consent processes, privacy measures, confidentiality guarantees, and the right to withdraw from the study. This study was approved by each of the different health systems’ institutional review boards (IRBs), ensuring the highest ethical standards were met.

QI projects such as Khoja & Moosa (2023) pose minimal physical, psychological, social, or financial risk to participants; however, the threat to privacy and confidentiality of protected health information remains an important consideration. These projects require different ethical considerations than formal research, but care should be taken to minimize the possibility of patient harm or other moral wrongs and staff burden (Hunt et al., 2021). This study was initiated with the help of the hospital’s Fall Advisory Council.

DNP projects, which commonly incorporate quality improvement methodologies, must consider ethical dimensions even when they may not require formal IRB review. Since many DNP projects are conducted within healthcare organizations and involve patient care processes, they must still adhere to ethical principles of patient protection, confidentiality, and professional conduct.

Conclusion

The three types of studies reviewed differ in their objectives, methods, and ethical requirements. Understanding the specific ethical considerations for each type of study is essential to protect participants and achieve the goals of enhancing healthcare delivery and advancing nursing knowledge.

References

Bangura, F. (2024). Development and evaluation of a nurse practitioner–directed intentional rounding strategy, and its impact on decreasing falls in a veterans long-term care facility (Publication No. 30991997) [Doctoral dissertation, Wilmington University]. ProQuest Dissertations and Theses Global. https://www.proquest.com/dissertations-theses/development-evaluation-nurse-practitioner/docview/2932310765/se-2Links to an external site.

Hunt, D., Dunn, M., Harrison, G., & Bailey, J. (2021). Ethical considerations in quality improvement: Key questions and a practical guide. BMJ Open Quality, 10(3), e001497. https://doi.org/10.1136/bmjoq-2021-001497Links to an external site.

Khoja, A., & Moosa, L. (2023). Impact of tailored interventions for patient safety (tips) to reduce fall rates. MEDSURG Nursing, 32(2), 89. https://doi.org/10.62116/msj.2023.32.2.89Links to an external site.

Tzeng, H.-M., & Yin, C.-Y. (2017). A multihospital survey on effective interventions to prevent hospital falls in adults. Nursing Economics, 35(6), 304–313. https://eds.p.ebscohost.com/eds/pdfviewer/pdfviewer?vid=2&sid=e39128f1-f0e6-471e-b509-b4651a2e535e%40redisLinks to an external site.

Struggling with where to start this assignment? Follow this guide to tackle your assignment easily!

Step-by-Step Guide for Writing Your Ethical Considerations Discussion Post

Step 1: Understand the Different Types of Studies
You need to familiarize yourself with the three types of studies and their ethical characteristics:

Research Study: Tzeng & Yin (2017) conducted a cross-sectional survey to explore the relationship between nurse perceptions and preventive fall interventions in hospitals.
Quality Improvement (QI) Study: Khoja & Moosa (2023) implemented tailored interventions to improve patient safety and reduce falls in a medical-surgical orthopedic unit.
DNP Project: Bangura (2024) examined the effect of intentional rounding on fall rates in a long-term care facility for veterans.

Step 2: Analyze Each Study’s Characteristics

Generalizability:
- Research studies like Tzeng & Yin’s are typically more generalizable because they often use broader sample sizes across multiple institutions.
- QI projects, such as Khoja & Moosa’s, focus on specific organizations, so their results may not be applicable to other settings.
- DNP projects are usually confined to one healthcare facility or setting, making their findings more limited in generalizability.
Sampling:
- In research studies, sampling tends to be random or systematic, aiming for large, diverse groups.
- QI projects may involve a convenience sample from one unit or department.
- DNP projects focus on the population within a specific healthcare facility or patient group, often based on practical constraints.
Ethical Protections:
- Research studies require formal ethical oversight, including Institutional Review Board (IRB) approval, informed consent, and confidentiality.
- QI projects, while important, typically do not need IRB review because they aim to improve existing practices without introducing new interventions.
- DNP projects may not always require IRB review but must adhere to ethical principles, such as patient privacy, informed consent, and confidentiality.

Step 3: Compare Ethical Considerations

Research Ethics:
- Research studies often have stringent ethical requirements because they involve gathering data from participants with a broader purpose of generalizing findings. Ethical concerns, such as informed consent, confidentiality, and risk management, are critical in these studies.
Quality Improvement Ethics:
- QI projects focus on improving existing practices. While they are less invasive, ethical considerations remain, especially concerning patient privacy, confidentiality, and the potential unintended consequences of the interventions. They do not require formal IRB approval but should follow ethical guidelines for patient protection.
DNP Project Ethics:
- DNP projects usually focus on implementing evidence-based practices within specific settings. These projects must consider patient care and confidentiality but may not need IRB approval if they do not involve new interventions or experimental treatments. However, ethical principles must still guide the process, especially regarding patient rights.

Step 4: Integrate Your Insights and Discuss the Ethics Pledge

Reflect on the importance of ethical considerations in these projects and how they align with the Doctoral Project Ethics Pledge.
Ensure that you align your discussion with the commitment to protect human subjects, avoid harm, and maintain professional integrity.

Step 5: Conclusion

Conclude by summarizing how ethical standards vary across research, quality improvement, and DNP projects.
Reinforce that regardless of the type of study, ethical protections are paramount for maintaining trust and ensuring the welfare of participants.

Step 6: Final Review

Proofread your discussion post for clarity and coherence.
Ensure you have cited your resources properly in APA 7th edition style.
Double-check that you’ve answered all parts of the prompt, with detailed comparisons between the studies and their ethical considerations.

By following this guide, you will be able to clearly distinguish between the ethical considerations in research, QI projects, and DNP projects, while providing an insightful reflection on the role of ethics in improving healthcare practices.

Let me know if you need further assistance with any specific part of your response!

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