Jim Fowler - Practical Statistics for Nursing and Health Care

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Demographic, economic, political and environmental changes have been taking place at a phenomenal pace, nationally and internationally. Many of these changes affect people's needs for health care. At the same time, the demand for health care mounts from a more informed public having access to information from online sources and websites. Campaigns for safe and speedy intervention determine the treatments available and those yet to enter the health care system. The twin axes of patients' safety and the personalized treatment they need require nurses and health care professionals to be confident in the use of statistics, for example, in calculating dosages in oral, liquid, tablet, intravenous, intramuscular and subcutaneous forms. Nurses and health care professionals should be familiar with the meanings and significance of the numbers they encounter in the context of the care they provide.

While it is estimated that there are already approximately 35 million nurses and midwives worldwide contributing to the total health care workforce, there are increasing numbers of other persons seeking to acquire nursing skills at different levels and in a variety of settings, for example, in hospitals, in the community, in the workplace and in people's own homes. One approach to increasing the number of people entering nursing has been to expand the educational programmes. The Long‐Term Plan for the NHS (2019 ) backs six routes into nursing, including a degree course and a pilot accelerated postgraduate programme.

In the United Kingdom, professional regulatory bodies, such as the Nursing and Midwifery Council (2018 ) established evidence‐based proficiency standards of care to underpin pre‐registration nursing education and practice. The proficiency standards of care require, amongst other forms of knowledge and skills, an understanding of relevant research and statistics.

The context of health care is changing, most notably between primary care/home/community‐based services and those provided in acute hospitals. Public expectation of wellness and patterns of disease have also changed, for example, patient referral with symptoms indicative of cancer is more rapid, leading to quicker diagnosis and treatment. At the same time, opportunities created by the development in pharmaceutical services and technological advances combine to increase the pace of change in nursing practice, pointing to the need for nurses to be prepared to respond in knowledgeable and practical ways, and to do so competently every time.

Technological developments in nursing and health, for example, more efficient electronic imaging machines, e‐booking appointments with doctors in the community, patients' e‐records and complex calculations of dosage makes screening for diseases, diagnosis and monitoring much faster and more accurate. The use of hand‐held electronic devices provides an immediate record and instant feedback to the care team. Patients are likely to benefit from these improvements in the methods of data collection and use of technology by which diagnoses are made and, as a consequence, treatment and care will be more effective. Nurses and health care professionals need to know and understand the data they collect individually and collaboratively. Once they comprehend the data and they are converted into information for them, they must critically appraise the information and use it as the evidence base for their patients' care and treatment plans. Chapters 2and 3explain common methods of interpreting data sets with worked examples.

Changes in organizational scale, structure and systems make it essential for nurses to work together in teams to provide an integrated care for patients. A Plan of Care, for example, for patients with diabetes, may include an evaluation response of their response to medication – insulin or tablets – according to their age, gender and ethnicity. It could be extended for purposes of research to a comparative analysis of whether tablets or injections are more effective in controlling the patients' diabetes.

Team working in nursing and health care demands close coordination and collaboration, especially as data are likely to be collected from different sources and to require competent computation and analysis in order to arrive at sound clinical judgements. For example, team members have a responsibility to ensure that data about patients' kidneys obtained by computerized tomography (CT) should be placed in the patients' records, even when the scan shows no abnormality.

Nurses working in specialist clinical areas such as heart, thoracic surgery, intensive care, renal endoscopy clinics and cancer centres/units use skills of a highly technical and statistical nature that are described in specialist medical language that carries precise meanings. Nurses in these settings access, interpret and manage health information, and are required to record clinical changes in patients' conditions. Basic statistical principles enable nurses and health care professionals to decide on suitable treatment.