NSG 3029 Week 4 DQ 2: exempt, expedited or full review

Work the classification from the regulations rather than from instinct. Exempt review covers research with minimal or no risk in defined categories — anonymous surveys, existing de-identified data, ordinary educational practice — and this study fits none of them, because it involves an intervention performed on identifiable, hospitalised patients. Expedited review covers minimal-risk research in listed categories, and here is where the argument gets interesting. Tracheal suctioning and oral care are both routine nursing care that these patients would receive anyway, so the study arguably adds no risk beyond the ordinary care already indicated. But the subjects are critically ill, mechanically ventilated, and cannot communicate verbally, which makes them unable to give contemporaneous consent, and vulnerable populations who cannot consent for themselves are the standard reason a minimal-risk study still goes to full board review. Argue the case both ways and then commit; most defensible answers land on full review.

The second question is separate and posts often merge it into the first. A study can be correctly classified and still be unethical, or be ethical and still need full review, so answer it against the Belmont principles by name. Respect for persons is the pressure point here — these patients cannot consent, so who does, how is assent handled if the patient regains capacity, and is there a plan to re-consent? Beneficence weighs a real benefit against real risk: the whole purpose is to validate a tool that would let clinicians detect pain in patients who cannot report it, which is a substantial good for exactly the group being studied. Justice asks whether the burden falls on people who will benefit, and here it does, which strengthens the case. Note the timing detail too: assessing after suctioning and after oral care means both happen as scheduled care rather than as extra procedures inflicted for the study.