NRS 445 Rough Draft – Research Critiques and Evidence-Based Practice Proposal
Grand Canyon University NRS 445 Rough Draft – Research Critiques and Evidence-Based Practice Proposal– Step-By-Step Guide
This guide will demonstrate how to complete the Grand Canyon University NRS 445 Rough Draft – Research Critiques and Evidence-Based Practice Proposal assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NRS 445 Rough Draft – Research Critiques and Evidence-Based Practice Proposal
Whether one passes or fails an academic assignment such as the Grand Canyon University NRS 445 Rough Draft – Research Critiques and Evidence-Based Practice Proposal depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NRS 445 Rough Draft – Research Critiques and Evidence-Based Practice Proposal
The introduction for the Grand Canyon University NRS 445 Rough Draft – Research Critiques and Evidence-Based Practice Proposal is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
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How to Write the Body for NRS 445 Rough Draft – Research Critiques and Evidence-Based Practice Proposal
After the introduction, move into the main part of the NRS 445 Rough Draft – Research Critiques and Evidence-Based Practice Proposal assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NRS 445 Rough Draft – Research Critiques and Evidence-Based Practice Proposal
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NRS 445 Rough Draft – Research Critiques and Evidence-Based Practice Proposal
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NRS 445 Rough Draft – Research Critiques and Evidence-Based Practice Proposal
Evidence-based practice in nursing is important for the provision of care that optimizes outcomes. Nurses utilize their experiences in the care process and leadership to identify issues that can be addressed and improved with evidence-based interventions. Organizations strive to create environments that support the use of best practices to enhance safety, quality, and efficiency outcomes. Health problems such as catheter-associated urinary tract infections (CAUTIs) have considerable impacts on the patient’s health, health systems, and nursing care. Specific populations such as those with chronic conditions admitted in long-term care facilities have an increased risk of developing CAUTIs. Nurses should explore and adopt best practices to prevent CAUTIs among this population. Therefore, the purpose of this paper is to review the literature on the use of best practices, including CAUTIs bundles for CAUTIs prevention and rates in long-term care settings.
PICOT Question
In the dilapidated patients admitted to long-term care units and using indwelling catheters, how does the use of CAUTI bundles compared to securing and positioning of catheters affect CAUTI rates within eight weeks?
Quantitative Studies: Methods
Two quantitative studies were used in this literature review. They include the studies by Decker et al. (2021) and Shadle et al. (2021). The study by Shadle et al. (2021) investigated the effectiveness of a bundle-based approach in preventing CAUTIs in the intensive care unit. The increase in the number of CAUTIs above the benchmark data informed this study. Accordingly, the institution reported 13 CAUTIs against the hospital benchmark of 4 or fewer CAUTIs annually. The project targeted a 30% reduction in CAUTIs, a 20% reduction in urinary catheter days, and a 75% compliance rating in catheter-related documentation in the intensive care unit.
The methods used in the research by Shadle et al. (2021) were appropriate. The researchers adopted a pre-post design over 2 consecutive 4-month periods. The intervention targeted critically ill patients aged 18 years and above and admitted to the intensive care unit and catheterized. The bundle interventions included staff education, nurse-driven removal protocol for indwelling urinary catheters, and an electronic daily checklist. The obtained data was analyzed using mixed statistics such as Fisher exact tests and independent sample t-tests. The use of methods such as a pre-post design is appropriate for the project aim because it shows the impact of the bundle interventions on the rate. The selected bundled interventions also support the use of best practices to address CAUTIs.
The other quantitative study selected for the literature review is the research by Decker et al. (2021). Decker et al. (2021) investigated the effect of bundle interventions on CAUTIs in critical care units. Decker et al. (2021) study was conducted in Boston Medical Center to decrease CAUTI rates in the intensive care units using five bundles. The bundles included new processes for catheter insertion and maintenance, indications for catheter insertion, appropriate testing for CAUTIs, alternatives to indwelling devices, and sterilization techniques. Unit nursing supervisors performed daily rounds to determine appropriate catheter use in the unit. The interventions by Decker et al. (2021) are appropriate since they demonstrate the effectiveness of nurse-led bundle interventions in addressing CAUTIs.
Qualitative Studies: Methods
Qualitative studies by Quinn et al. (2020) and Parker et al. (2020) were included in the literature review. The study by Quinn et al. (2020) explored persistent barriers to detecting and removing unnecessary catheters in healthcare settings. The authors adopted a multimethod qualitative study design that included in-person interviews and observations of clinicians working in a large hospital. The observations entailed shadowing nurses during shift changes and when admitting patients and observing doctors during morning rounds. Unstructured field notes were used to gather observational data. Semistructured interviews were conducted, audiotaped, and transcribed. Qualitative content analysis was used to identify the main themes. The methods used in this study were appropriate for the project’s aim. For example, the use of multimethod qualitative approaches enriched the data obtained on the barriers to detecting and removing unnecessary catheters. Unstructured field notes and semistructured interviews ensure the relevance and accuracy of the obtained data.
The study by Parker et al. (2020) provided insights into clinicians’ experiences in implementing multifaceted bundled urinary catheter care interventions in four acute care hospitals in New South Wales, Australia. The researchers adopted a pre and post-intervention study design to implement the catheter care bundle. The intervention was implemented in all adult inpatient wards, operating theatres, inpatient wards, and emergency departments in the four hospitals. The bundle interventions focused on improving clinician’s decision-making on catheter insertion, care, and removal practices. Focus groups were conducted in the four hospitals to understand the implementation process from the clinicians’ perspective, and identify barriers and enablers to successful implementation. The adopted interventions in this study answer the project focus. For example, the use of bundle interventions provides insights into the effectiveness of the proposed project change.
Summary of Findings
The study by Parker et al. (2020) found that the main complexity and challenges associated with the implementation of bundle intervention could be understood from varied themes. They included early and sustained engagement with key stakeholders, good planning but remaining flexible, managing the burden of practice change, and adopting and sustaining practice change. The study by Quinn et al. (2020) found themes that relate to barriers to detecting and removing unnecessary catheters. They include catheters being hard to find, not accurate, or not available, catheter removal is not a priority, confusion about who has the authority to remove catheters, and lack of agreement on and awareness of standard protocols and indications for removal and communication barriers.
The study by Shadle et al. (2021) found that the implementation of the bundle interventions led to no CAUTIs during the intervention period and reduced the rate by 1.33 per 1000 catheter days. There was also a statistically insignificant increase in catheter days by 10.5%. Documentation compliance increased significantly from 50.0% before to 83.3% during the intervention. The study by Decker et al. (2021) found that bundle interventions reduced CAUTIs from 53 in 2013 to 9 in 2017 and a 33.8% reduction in the utilization of indwelling catheters. CAUTIs awareness education, insertion, and removal protocols, and implementation of PureWick female incontinence devices had significant and clear effects on reducing CAUTIs rates.
Anticipated Outcomes for PICOT Question
The PICOT question is associated with some anticipated outcomes. Firstly, the use of bundle interventions is expected to reduce CAUTI rates in long-term care facilities. Evidence obtained from the included studies demonstrates a decrease in CAUTI rate with the use of bundle interventions (Quinn et al., 2020; Shadle et al., 2021). The other anticipated outcome is the increase in the provider’s knowledge about indications, contraindications of indwelling catheters, and indwelling urinary catheter care. Bundle interventions such as education and training increase the provider’s knowledge about the safe use of indwelling urinary catheters. The third anticipated outcome is the reduction in hospital stay and hospitalization costs for patients with indwelling urinary catheters. CAUTIs increase the length of hospital stay and costs incurred in treating hospitalized patients (Ling et al., 2022; Smith et al., 2019). The proposed bundle interventions will reduce and prevent CAUTIs, hence, efficiency in long-term facilities.
Comparison of Outcomes of the Selected Studies to the Anticipated PICOT Outcome
The outcomes of the selected studies align with the anticipated PICOT outcomes. For example, Shadle et al. (2021) found that bundle interventions eliminated CAUTIs, which support the PICOT outcomes. Similarly, Decker et al. (2021) revealed that bundle interventions reduce CAUTIs and increase healthcare provider’s knowledge of the appropriate use of indwelling urinary catheters. Parker et al., (2020) and Quinn et al. (2020) provide insights into the potential barriers that might be experienced when implementing the proposed bundle interventions. Therefore, the outcomes of the selected studies align with those of the PICOT statement.
The Link between the PICOT Question, Research Articles, and Identified Nursing Problem
The identified nursing problem is CAUTI. The existing evidence shows the increased risk of CAUTIs among hospitalized patients with indwelling catheters. CAUTIs have adverse outcomes such as prolonging the length of hospital stay, increasing care costs, predisposing patients to other complications, and premature deaths (Carter et al., 2016; Shadle et al., 2021; Smith et al., 2019). Nurses should adopt best practices to prevent and reduce CAUTIs. The selected research articles provide insights into the effectiveness of bundle interventions in preventing and reducing CAUTIs. They also inform about the barriers that might be encountered in implementing the proposed change in the project. The PICOT question seeks to determine the effectiveness of bundle interventions in reducing and preventing CAUTIs. Therefore, the PICOT question, research articles, and the identified nursing problem are interrelated.
Proposed Evidence-Based Practice Change
The proposed evidence-based practice change based on the reviewed evidence is the implementation of bundle interventions to prevent and reduce CAUTIs in long-term care facility. The bundle interventions include educating nurses on indications, contraindications, evaluation, care, and removal of urinary catheters, the introduction of a daily checklist for indwelling urinary catheters, and nurse-driven protocol for catheter removal. The practice change will address CAUTIs by strengthening the consistent use of best practices in catheter insertion, care, and removal. Staff training will equip them with the required competencies in assessing the need, caring for, and removing indwelling urinary catheters. The proposed change is evidence-based as seen from the evidence from the included studies in this review.
Conclusion
In summary, the reviewed articles support the use of bundle interventions to address CAUTIs in long-term care facilities. Bundle interventions reduce and prevent CAUTIs. The anticipated PICOT outcomes for the project include reduction and prevention of CAUTIs, increase in provider’s knowledge about CAUTIs prevention and reduction, and reduction in the length of hospital stay and costs for patients with indwelling urinary catheters. Therefore, the evidence informs the proposed change, which entails the use of bundle interventions in the project.
References
Carter, E. J., Pallin, D. J., Mandel, L., Sinnette, C., & Schuur, J. D. (2016). A Qualitative Study of Factors Facilitating Clinical Nurse Engagement in Emergency Department Catheter-Associated Urinary Tract Infection Prevention. The Journal of Nursing Administration, 46(10), 495–500.
Decker, S. G. V., Bosch, N., & Murphy, J. (2021). Catheter-associated urinary tract infection reduction in critical care units: A bundled care model. BMJ Open Quality, 10(4), e001534. https://doi.org/10.1136/bmjoq-2021-001534
Ling, R., Giles, M., & Searles, A. (2022). Budget impact analysis of a multifaceted nurse-led intervention to reduce indwelling urinary catheter use in New South Wales Hospitals. BMC Health Services Research, 22(1), 1000. https://doi.org/10.1186/s12913-022-08313-7
Parker, V., Giles, M., King, J., & Bantawa, K. (2020). Barriers and facilitators to implementation of a multifaceted nurse-led intervention in acute care hospitals aimed at reducing indwelling urinary catheter use: A qualitative study. Journal of Clinical Nursing, 29(15–16), 3042–3053. https://doi.org/10.1111/jocn.15337
Quinn, M., Ameling, J. M., Forman, J., Krein, S. L., Manojlovich, M., Fowler, K. E., King, E. A., & Meddings, J. (2020). Persistent Barriers to Timely Catheter Removal Identified from Clinical Observations and Interviews. Joint Commission Journal on Quality and Patient Safety, 46(2), 99–108. https://doi.org/10.1016/j.jcjq.2019.10.004
Shadle, H. N., Sabol, V., Smith, A., Stafford, H., Thompson, J. A., & Bowers, M. (2021). A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit. Critical Care Nurse, 41(2), 62–71. https://doi.org/10.4037/ccn2021934
Smith, D. R. M., Pouwels, K. B., Hopkins, S., Naylor, N. R., Smieszek, T., & Robotham, J. V. (2019). Epidemiology and health-economic burden of urinary-catheter-associated infection in English NHS hospitals: A probabilistic modelling study. Journal of Hospital Infection, 103(1), 44–54. https://doi.org/10.1016/j.jhin.2019.04.010
NRS 445 Benchmark – Ethical Conduct of Scholarly Activities Sample Answer
Benchmark – Ethical Conduct of Scholarly Activities
Application of the Belmont Principles: Case Study 1
Belmont Report principles and the components of each principle | Explain how the case meets the components of each principle. | Explain how the case does not meet the components of each principle. | What steps can the nurse researcher or quality improvement manager take to adhere to the ethical principles identified in the Belmont Report? |
Respect for Person Respect the right to choose, hold views, and act according to personal beliefs. Protect those with decreased capacity to make their own choice. Ensure voluntary participation. Provide informed consent, explaining the harms and benefits. | The patient, who had been diagnosed with lung, colon, and breast cancer, was first given permission to participate in the experimental therapy. This exemplifies the significance of appreciating people’s liberty, self-governance, and capacity to exercise their judgment. In the second scenario, a cancer patient is given the chance to undertake innovative treatment. Nevertheless, the moral quandary arises when considering the resistance of one’s spouse, which raises questions about the principle of honoring an individual’s autonomy (Pritchard, 2021). | When a patient chooses to undertake experimental therapy, even if the likelihood of success is minimal, it may suggest a possible deficiency in their ability to make independent choices. Another instance included a patient who had an abrupt cardiac arrest, maybe attributable to a shortage of detailed information pertaining to the advantages and possible hazards of the experimental therapy. In the scenario above, the spouse’s disregard for the woman’s individuality and autonomy may impede her ability to get experimental treatment (Pritchard, 2021). | Before talking to a patient with aggressive cancer about the potential hazards and advantages of pursuing intensive treatment, nurse researchers should work with the patient to figure out the best way to communicate medical information while also making sure that it is in line with her values for her spouse or family. The patient’s viewpoint might provide vital insights for her spouse and family members to get a more profound comprehension of the medical facts. The authors also discuss the issue of conveying one’s choice to undergo harsh treatment to family members, even if one has a preference for not overtly revealing it (Pritchard, 2021). |
Beneficence Minimize the harm/risks to the greatest extent possible. Maximize the potential benefits. Ensure that the patient’s rights and well-being precede science’s needs. | A female patient with colon, breast, and lung cancers, all of which have a low chance of recovery, voluntarily agreed to take part in an experimental therapy. The medicine had remarkable efficacy in treating her malignancies, resulting in six years of being free from cancer, therefore confirming its favorable effects (Cox et al., 2023). | Researchers have determined that the medication has significant risks and has shown minimal efficacy, as evidenced by the incidence of acute coronary artery disease in specific trials (Cox et al., 2023). | Nurse researchers must meticulously evaluate the risks compared to the benefits of chemotherapy and provide suggestions grounded in robust data to guarantee the patient’s best health and well-being. In order to respect the concept of goodwill, researchers must take steps to minimize the possibility of suffering or harm. Researchers are obligated to protect individuals from being taken advantage of, as stated by the concept of beneficence (Cox et al., 2023). |
Justice Justly distribute the benefits and burdens of the research. Guard against using vulnerable populations. Ensure a fair selection of research participants. Guard against coercion and undue influence. Avoid potential financial or other conflicts of interest. | The original example was a woman who had favorable results from a novel cancer therapy. Surprisingly, she remained cancer-free for six years. This scenario exemplifies the ethical ideal of justice (Siddiqui & Sharp, 2021). | Despite having little chance of life, the patient voluntarily took part in the trial and benefited from the experimental cancer treatment. The patient went into cardiac arrest in the second scenario. But in the end, the patient’s spouse prevented them from receiving experimental cancer treatment (Siddiqui & Sharp, 2021). | Practically speaking, nurse researchers have to make sure that participant suffering is commensurate with any possible advantages that might follow from the study’s findings. It is critical to stress that data from research must be gathered before determining if an experimental therapy is beneficial (Siddiqui & Sharp, 2021). |
Application of the Belmont Principles: Case Study 2
Belmont Report principles and the components of each principle. | Explain how the case meets the components of each principle. | Explain how the case does not meet the components of each principle. | What steps can the nurse researcher or quality improvement manager take to adhere to the ethical principles identified in the Belmont Report? |
Respect for Person Respect the right to choose, hold views, and act according to personal beliefs. Protect those with decreased capacity to make their own choice. Ensure voluntary participation. Provide informed consent, explaining the harms and benefits. | Nurse researchers must take practical factors into account to ensure that the amount of challenge faced by participants is commensurate with the possible advantages that might be obtained from the study’s results. Before determining the effectiveness of the experimental therapy, it is essential to prioritize the collection of thorough information from the research (Nagai et al., 2022). | Technological technologies like GPS monitoring and mobile phone reminders jeopardize people’s privacy and undercut the core premise of upholding human dignity. Furthermore, it may lead to feelings of worry and constant monitoring, a phenomenon known as the “panopticon phenomenon” (Nagai et al., 2022). | Nurse researchers may foster respect for persons by using sophisticated technology methods to ensure comprehension, monitor consent and opt-out options, and distribute study materials. The researcher’s responsibility is to evaluate a candidate’s skill, understanding, and appropriateness for the study (Nagai et al., 2022). |
Beneficence Minimize the harm/risks to the greatest extent possible. Maximize the potential benefits. Ensure that the patient’s rights and well-being precede science’s needs. | Improving compliance with the evaluated treatment method may be accomplished by using technology. This encompasses the transmission of SMS alerts to participants on their research meetings, offering flexibility in the scheduling of visits, and including GPS tracking. Consequently, this leads to the possibility of favorable results (Rivera et al., 2022). | The rural population lacks significant awareness of GPS technology, which might result in the disregard for patients’ and participants’ needs and preferences (Rivera et al., 2022). | Nurse researchers must use contemporary technologies to do various duties. The responsibilities involved in this research include recruiting patients, getting informed permission, retrieving data from medical records, performing follow-up visits, and assuring patient safety. Implementing these strategies is crucial for maintaining the concept of beneficence (Rivera et al., 2022). |
Justice
| One method of adhering to the ethical concept of justice is by obtaining patients’ agreement for GPS monitoring and providing them with text message reminders. By using this methodology, the research may be rendered more pragmatic and advantageous for both the participants and the researcher (Lantos, 2020). | According to Lantos (2020), the use of technology in recruiting and monitoring research volunteers might lead to undeserved stigma, discrimination, and exclusion. | Before enlisting study participants, nurses conducting studies must provide the general public with thorough instructions on the purpose and planned use of technology in the study. It is essential to enact requisite procedures to guarantee the security of the entire system. To ensure that persons have sufficient knowledge regarding the goal and consequences of the study, only those who possess a thorough comprehension should be permitted to participate (Lantos, 2020). |
Personal Reflection
In less than 250 words, discuss how the ethical principles from the Belmont Report align with the Christian worldview. Reflect on your current nursing practice and describe how these ethical principles align with your nursing practice. |
The Christian worldview influences the ethical precepts established in the Belmont Report. The ideals included in this context are the reverence for individuals, fairness, and the promotion of well-being. These principles encourage the acceptance of shared ideals. The ethical standards emphasize the need for caring and displaying compassionate and honest behavior. They also stress the awareness of the intrinsic worth of every individual, regardless of their distinct talents and various situations (White, 2020). The beliefs align with the biblical teachings on empathy, compassion, and the inherent worth of every human being. These values are crucial for delivering patient-centered care in my nursing career. I continuously prioritize the notion of upholding patients’ dignity and safeguarding their autonomy. I have continually placed a high importance on patients’ autonomy by aiding them in making well-informed choices about their health. The idea of benevolence is shown by the commitment to maximizing advantages and minimizing negative consequences. This idea aligns with the Christian virtue of altruism (Kimmelman, 2020). Nurses must follow the concept of justice, which means they must make sure that fairness and impartiality are maintained. The idea also encompasses the advocacy for equitable access to healthcare resources. Within the nursing profession, the Christian worldview emphasizes compassion as a fundamental ethical element for advancing justice. Furthermore, it cultivates a viewpoint that surpasses an individual’s professional responsibilities (Kimmelman, 2020). In my present professional methodology, I include this principle by seeing patients not just in medical situations but as distinct persons worthy of respect and dignity. Furthermore, I always prioritize the compassionate assessment of patients’ holistic requirements, including their mental, emotional, and spiritual well-being. |
References
Cox, D. J., Suarez, V. D., & Marya, V. (2023). Ethical principles and values guiding modern scientific research. In Elsevier eBooks (pp. 35–61). https://doi.org/10.1016/b978-0-323-90969-3.00008-6
Kimmelman, J. (2020). What Is Human Research For? Reflections on the Omission of Scientific Integrity from the Belmont Report. Perspectives in Biology and Medicine, 63(2), 251–261. https://doi.org/10.1353/pbm.2020.0017
Lantos, J. D. (2020). The Belmont Report and innovative clinical research. Perspectives in Biology and Medicine, 63(2), 389–400. https://doi.org/10.1353/pbm.2020.0026
Nagai, H., Nakazawa, E., & Akabayashi, A. (2022). The creation of the Belmont Report and its effect on ethical principles: a historical study. Monash Bioethics Review, 40(2), 157–170. https://doi.org/10.1007/s40592-022-00165-5
Pritchard, I. A. (2021). Framework for the ethical conduct of research: The ethical principles of the Belmont Report. In American Psychological Association eBooks (pp. 3–21). https://doi.org/10.1037/0000258-001
Rivera, S. C., Aiyegbusi, O. L., Ives, J., Draper, H., Mercieca‐Bebber, R., Ells, C., Hunn, A., Scott, J., Fernandez, C. V., Dickens, A., Anderson, N., Bhatnagar, V., Bottomley, A., Campbell, L., Collett, C., Collis, P., Craig, K., Davies, H., Golub, R., . . . Calvert, M. (2022). Ethical Considerations for the Inclusion of Patient-Reported Outcomes in Clinical Research. JAMA, 327(19), 1910. https://doi.org/10.1001/jama.2022.6421
Siddiqui, W., & Sharp, R. R. (2021). Beyond the Belmont report. American Journal of Bioethics, 21(10), 1–4. https://doi.org/10.1080/15265161.2021.1972649
White, M. G. (2020). Why human subjects research protection is important. the Ochsner Journal, 20(1), 16–33. https://doi.org/10.31486/toj.20.5012