Deck 13: Outcomes Research

Question 1

A researcher is studying the likely occurrence rate of secondary cancers after a new schedule of chemotherapy for childhood leukemia, using a biochemical marker obtained by blood draw 6 months after the initiation of chemotherapy. What is the rationale for using this biological marker as a proximate outcome, rather than counting the actual rate of secondary cancers?

A)It could be psychologically harmful to children and families to have researchers following up in the future to ask whether the child has had a cancer recurrence.
B)The final end point is not obtainable over a reasonable span of time, since secondary cancers can occur at any age through late adulthood.
C)There is no viable rationale for this decision. Most proximate end points are unreliable variables and should not be used unless there are no final end points.
D)The researcher is not interested in whether children suffer a secondary malignancy; the researcher is merely interested in the biological marker's value.

Answer 1

The final end point is not obtainable over a reasonable span of time, since secondary cancers can occur at any age through late adulthood.

Question 2

Which of the following are processes of care within a hospital that are likely to be scrutinized in research focusing on nursing-sensitive patient outcomes?

A)Cost of hospital insurance
B)The ways nurses perform a certain task of patient care
C)Whether there are policies governing a procedure
D)Educational preparation of nurses
E)Nursing workload
F)Number of hospital beds

Answer 2

The ways nurses perform a certain task of patient care
Whether there are policies governing a procedure
Educational preparation of nurses
Nursing workload

Question 3

Outcomes research in a hospital could address interactions among which of the following general groups of variables?

A)Those that existed prior to treatment, such as narrative health histories
B)Those that reflect surroundings, such as the size of family waiting rooms
C)Those that reflect perceived outcome, such as quality of life
D)Those that pertain to staff, such as levels of education and training
E)Those that reflect physical outcome, such as patient survival

Answer 3

Those that reflect surroundings, such as the size of family waiting rooms
Those that reflect perceived outcome, such as quality of life
Those that pertain to staff, such as levels of education and training
Those that reflect physical outcome, such as patient survival

Question 4

Outcomes research differs from traditional quantitative research in which of the following ways?

A)Its theoretical framework is Donabedian's paradigm.
B)It uses designs that no other methodology uses.
C)Its publications always have "outcomes" in the titles.
D)It focuses on quality.
E)Its dependent variables are measures of outcomes.

Question 5

A nurse manager designs a research study to examine nurse workload stress, work shift, number of years in the nursing profession, number of medication errors, patient falls, and after-shift overtime, as they relate to one another. What is the most likely method the manager will use to study this?

A)Multilevel analysis
B)Analysis of improvement
C)Analysis of variance
D)Analysis of change

Question 6

Why would outcomes research use an entire database, rather than merely selecting a sample?

A)Use of the whole database provides an analysis that addresses the entire patient population.
B)Permission to use an entire database implies that the entire database must be studied.
C)Small effect sizes and multiple variables demand huge samples, if statistical significance is to be achieved.
D)Periodic review of the entire database makes it possible for the researcher to identify patterns related to outcomes that might be missed if only part of the database were used.
E)Cost is not an issue.

Question 7

In nursing, modern outcomes research is likely to focus upon which of the following topics?

A)Variables of the nurse, such as burnout, stress, or factors that affect nursing care
B)Qualitative aspects of the patient experience, such as symptoms and meaning
C)Workplace issues, such as work satisfaction, staffing, skill mix, the physical plant, managerial style, and healthcare team interactions
D)Structures of care, such as educational and specialty preparation of the nurse or the other members of the healthcare team
E)Adverse patient outcomes, and disciplinary actions of the nurse and other members of the healthcare team
F)Measurements of patient illness, wellness, functionality, or safety

Question 8

What are the differences between a cost-effectiveness analysis and a cost-benefit analysis?

A)Cost-effective analysis is prospective, and cost-benefit analysis is retrospective.
B)Cost-effectiveness analysis in outcomes research focuses on health outcomes, whereas cost-benefit analysis may or may not focus on health outcomes.
C)Cost-benefit analysis addresses cost as the opposite of benefit, whereas cost-effectiveness analysis treats cost as a limited resource.
D)Cost-benefit analysis does not consider anything except financial cost, whereas cost-effectiveness analysis considers intangible costs as well.
E)Cost-effectiveness analysis always considers financial cost as one of its variables, whereas cost-benefit analysis may or may not do so.

Question 9

A hospital has recently converted to an "80% BSN staff" policy. In service of this goal, all newly hired nurses are expected to hold at least a bachelor's degree in nursing. Within the area of outcomes research, the variable "educational preparation of nurses" is what kind of a variable?

A)Practice profile
B)Outcome of care
C)Process of care
D)Structure of care

Question 10

What does "a preference for Type I error, as compared with Type II error" in outcomes research mean?

A)The outcomes researcher is not particularly concerned with drawing incorrect conclusions.
B)The outcomes researcher would rather identify a possible connection that doesn't end up being true than miss something.c.The outcomes researcher would rather establish definite causation than an indefinite connection.
D)Patients usually don't recognize what quality of care really is.

Question 11

From what common sources does outcomes research draw its data?

A)Journals kept by clients undergoing treatment for a chronic ailment
B)Nurses' electronic charting within a single hospital
C)A multi-hospital system's morbidity and mortality reports
D)A health insurance company's records
E)A state disability agency's records

Question 12

A complete appraisal of quality of care in an institution is undertaken. It could justifiably be linked with which of the following?

A)The types of insurance the hospital accepts
B)The general safety of the hospital grounds for visitors and family
C)Advertisements for health care in the area
D)Numbers of complaints the hospital administrator receives
E)Nurse: patient staffing ratios
F)National research funding for health care
G)Measures of physiological function, 12 weeks after surgery

Question 13

A study examines the careers of hospital nurses who have opted for retirement before the age of 55, identifying their education, work shift, final work area, and the religion in which they were raised. This is an example of which type of study?

A)Prospective cohort
B)Cost-effectiveness analysis
C)Population-based
D)Retrospective cohort

Question 14

A researcher performs a study in which data are obtained from 10 years of notes made by physicians and nurse practitioners in a large, shared urban obstetrical practice. The researcher collects the following data: primary person providing health care, person attending the delivery, patient's age, patient's parity, patient zip code, baby's Apgar scores, gestational age at first appointment, gestational age at delivery, and maternal complications. What type of research could this be?

A)Geographical analysis
B)Outcomes research
C)Qualitative research
D)Mixed methods research
E)Quantitative research
F)Prospective research
G)Retrospective research
H)Practice pattern profiling

Question 15

How do practice pattern profiling and nursing-sensitive patient outcomes research relate to one another?

A)The identification of nursing-sensitive patient outcomes is a type of practice pattern profiling. The purpose of both is to identify the outlier, so as to improve patient outcomes.
B)Practice pattern profiling scrutinizes an individual in comparison with a group; nursing-sensitive patient outcomes research addresses nurses as a group, rather than as individuals.
C)Both can identify variables that affect patient outcome.
D)Both pose risk to the person who delivers care.
E)Neither can be undertaken without signed consent from the participants.
F)Both are types of outcomes research.

Question 16

Which description indicates research that is a prospective cohort study?

A)All of the children in Toledo, Ohio, are weighed and measured to obtain an accurate statistic for malnutrition occurrence.
B)A physician's records are analyzed to identify how many of the patients have remained in the physician's care for more than 20 years.
C)The citizens of a city experiencing a nuclear accident are tracked for cancer occurrence.
D)A database is accessed to identify mortality rate in patients with sepsis.

Question 17

An advertisement maintains that zip code affects length of life. If outcomes research were designed to explore this geographical difference, what variables would be most useful in understanding the outcome of length of life?

A)Other outcome variables, such as quality of life and consumer perceptions
B)The availability of parking near clinics, a structural variable
C)The time it actually takes in both areas to transport a patient to an emergency room, a structural variable
D)The prevalence of ethnically associated health problems, a structural variable
E)Physicians' clinical judgment, a process variable
F)The presence of standard nursing care plans in the hospitals, a process variable
G)The number of specialist physicians per 1000 population in each area, a structural variable
H)The number of primary care physicians per 1000 population in each area, a structural variable

Question 18

Sampling in outcomes studies differs from that in traditional quantitative research in several ways. Which is true regarding sampling in outcomes studies?

A)A heterogeneous sample is preferred.
B)A random sample is required.
C)A small, focused sample is artificially assembled.
D)The sample is selected before an intervention occurs.

Question 19

In an outcomes study of nurse satisfaction in the workplace, which of the following would be reasonable outcome measures?

A)Lunch relief staffing
B)Formal complaints filed by nurses
C)Nurse satisfaction surveys
D)Manager style
E)Patient survival
F)Nurses' average length of employment
G)Sick calls
H)Reported workload stress