Evidence-Based Practice for Nurses

Epidemiologic designs provide sound methodology for nurses to investigate

patterns of disease to best determine contributing factors to improve health

outcomes and services. Nurses can measure the frequency of disease in clin-

ics, hospitals, and communities and describe diseases by person, place, and

time. They can examine the cost-benefit of screening initiatives by examin-

ing the sensitivity, specificity, and positive predictive value of screening tests.

Outbreaks can be investigated when there appears to be an excess of disease.

By analyzing best practice with case-control and cohort studies, nurses can

evaluate evidence-based practice interventions using epidemiologic designs

and measures.

1. Diseases can be described by all of the following except:
   a. dimension.
   b. person.
   c. place.
   d. time.

TEST YOUR KNOWLEDGE 8-8

How did you do? 1. a

8.9 Keeping It Ethical

At the end of this section, you will be able to:

‹ List ethical concerns related to epidemiology

Ethical concerns in epidemiology are similar to those associated with quan-

titative designs. For ethical reasons, not all exposures can be manipulated in

intervention studies. For example, it would be highly unethical for an inves-

tigator to assign individuals to a smoking intervention knowing the inherent

risks associated with this behavior.

Risk-benefit ratios must be carefully considered while conducting intervention

studies. Investigators must make informed decisions regarding the potential

need to terminate a study if either the risks or benefits become clearer during

the course of the study.

Risk-benefit must also be considered when setting guidelines for screenings.

Screening individuals without the ability to provide follow-up is unethical for

two reasons. First, screening conditions for which there is no treatment is a

216 CHAPTER 8 Epidemiologic Designs: Using Data to Understand Populations