Preliminary Data: What Am I Learning?

I will be talking with Dr. Pahls by phone on the 19th next week.  I will have more of an idea of how to proceed with the analysis of the data.

I have been working on the revisions within my project paper. As I am sure, the rest of you have as well — several changes. I have added to the literature review. It is looking at things that relate to the survey, which I did, looking at barriers to adhering to guidelines.  It was interesting (one thing new,, I guess).  Clinical inertia ” is the failure of a healthcare provider to initiate or intensify treatment when indicated ” (Cowart, 2018).  This can be seen in people with diabetes; for example, a provider knows there is perhaps a guideline for changing a medication or what is recommended, yet chooses not to follow it.
Because of a lack of knowledge or bias, or disagreement, do not follow guidelines.  This happens with chronic pain management with opioids.  Providers know that there is a CDC Guideline for chronic pain management with opioids; yet, they choose not to follow for reasons mentioned.  I should rephrase, some are not familiar with the guideline, some do not care about the guideline.  The review which I read discussed the need for further research into clinical inertia as it relates to lack of adherence to prescribing opioids for chronic pain, and why there was lack of use of the CDC guideline.  It was very interesting and was the first time that I had seen this term used.  The authors were concerned with “knowledge synthesis” that was related to a lack of adherence for safe prescription of opioid management of chronic pain.  This, of course, their review does not include patients that have chronic pain related to cancer (Rash, et al., 2018).  My survey does go into what might be barriers.  Listed were 1) Lack of knowledge; 2)Not enough time with the patient; and 3) Lack of support from the organization.

I will give a low-down after I have a structured analysis of the data.

References

Cowart, K. (2018). Overcoming clinical inertia in diabetes management: Pharmacist opportunities. U.S. Pharmacist. Retrieved from https://www.uspharmacist.com

Rash, J.A., Buckley, N., Busse, J.W., Campbell, T.S., Corace, K., Cooper, L., Flusk, D., Iorio, A., Lavoie, K.L., and Skidmore, B., (2018).  Healthcare provider knowledge, attitudes, beliefs, and practices were surrounding the prescription of opioids for chronic non-cancer pain in North America: protocol for a mixed-method systematic review. Systematic Reviews, pp. 1-7.  doi: 10.1186/s13643-018-0858-7

UPDATE: 11/23/19

I wanted to let you all know that I did have an appointment with Dr. Pahls last week.  At first, he felt that I would not need statistical analysis, as it was a survey.  I was a little disappointed at first; then I asked him about “comparison” data.  To compare, for example, “those in practice for 1-5 years as compared to those in practice for 10-20 years, etc.” there were differences.  Then he mentions the “Chi-Square” analysis.  Which this would work well for what I wanted to do. This quantitative analysis would also add validity to my project. When looking into “Chi-Square” formulas. I was like, “holy cow, that is not going to be easy.”  But, I am up for that challenge.

Kay

4 thoughts on “Preliminary Data: What Am I Learning?”

  1. Hi Kay,
    I am glad you were able to reach Dr. Pahls. He is such a nice guy and super sweet that he is willing to help so many students who are not enrolled in his class.

    I had never heard of the term “clinical inertia” until I started reviewing for the certification board. It is very interesting. I can see how this would play into your project and the management of opioids. That is a good idea to incorporate it into your project paper.

    I am jealous as I have not really sat down this semester and worked on my project paper. But since my clinical rotation is complete, I will have more time to work on it.

    Good luck. You are doing so well, especially after the rough start you had. I know Dr. Pahls will be a valuable asset when you visit with him. It will be interesting to see if your statistical idea matches his. Mine did not. Thank goodness I got in touch with him.
    Paula

    1. I will appreciate the statistical view he has! This has nothing to do with this blog, may I ask, where do you plan to practice when you are done? Do you live in Wichita? I have not had the opportunity to visit with the BSN/DNP nurses. I would love to find out more about the journey. I have been so impressed with the commitment.
      Kay

  2. Hi Vicki,
    At first he felt since I had a survey in data form, that describing the data would not need statistical analysis. I asked if I were to make comparisons of the data such as “years of practice” 1-5 years in practice compared to 10-15 years in practice, how that would be analyzed? He thought on it a bit, and we discussed “Chi-Square.” It is not a very easy way to measure a comparison, quite tricky formula. However, it does do a great job in comparison to data. Which would be necessary for my survey. It would be so easy to describe the data, however, to be more reliable, I think I am going to try the Chi-Square. If I need help, I can ask him. Does that answer your question?
    Thanks, Kay

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