1. Lace tested the effectiveness of alternative types of messages in encouraging the elderly to come forward for a flu vaccination. All members of a senior citizens’ center in a middle-sized community (a total of 504 elderly men and women) were sent a letter advising them a flu epidemic was anticipated and the elderly were especially likely to benefit from an immunization. Half the members were sent a letter stressing the benefits of getting a flu shot (the benefit letter group). The other half were sent a letter stressing the potential dangers of not getting a flu shot (the danger letter group). To avoid any biases, a lottery-type system was used to determine who got which letter. Both letters advised the elders of free immunizations being available at a community health clinic over a 1-week period and free transportation would be made available to them. Rates of coming forward for a flu shot among the two groups of elders were monitored to assess whether one approach of encouragement was more persuasive than the other. Results revealed a higher percentage of elderly in the “benefit letter” group obtained a flu shot than the elders in the “danger letter” group.
   1. Discuss in one paragraph whether and how, this study addressed a research purpose linked to evidence-based practice. (10 points)
   2. In what ways could the researcher have enhanced this study by including a qualitative component? (One paragraph, 10 points)

ANSWER:

1. a. 

1. b.

1. A group of nurses working in a community health center were unsure how to answer questions from patients about appropriate means of cleansing children’s wounds in home settings. Most nurses felt sterile saline should be recommended to minimize the risk of infection, but others believed tap water was adequate for cleansing acute wounds. The nurses decided to examine the evidence and located a systematic review in the Cochrane database. Among the studies conducted, the review concluded there were no differences in rates of infection or healing between the use of tap water and sterile saline in the cleansing of wounds. However, a few of the studies had involved children, and most had been conducted in health care settings. The nurses decided to initiate a new study to gather more focused and informative evidence about the effects of saline solution versus tap water in cleansing children’s wounds.
   1. Discuss which aspects of the Iowa Model of Evidence-Based Practice to Promote Quality Care could be completed as part of this project. (One paragraph, 10 points)
   2. What activities could the nurses undertake to conform to the Iowa Model? (One paragraph, 10 points)

ANSWER:

2. a. 

2. b.

1. In urban ghettos, active participation in the community’s social and economic life for elderly residents is dangerous and potentially life-threatening. This study explored how elders survived in the midst of crime-ridden, inner-city neighborhoods, and how they coped with the social isolation often resulting when public spaces and streets were unsafe. The study was undertaken over a 3-year period in a low-income Baltimore neighborhood known citywide for its “drug warfare.” Data were collected by observing elders in a senior center, by talking with them in-depth in the center and in their homes, by having conversations with the elders’ family members and with staff at the senior center, and by observing life on the streets. The findings indicated fear filled the lives of most elders, who almost never ventured from their homes without a specific (and local) destination. The center served as an important refuge from loneliness and was viewed as a critical ingredient in maintaining positive mental health, especially for elders who had no family living in the neighborhood.
   1. Several of the findings suggested concepts that could be operationalized and measured in a quantitative study.  Identify at least two concepts and explain in broad terms a possible strategy to operationalize them (one paragraph, 10 points).

ANSWER:

3. a.