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Chapter 1

Introduction to Nursing Research and Evidence-Based Practice

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Introduction to the Course

Introduction of class members Review of syllabus Presentation of class schedule Questions

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Class Discussion Questions

What was your reaction when you learned you were required to take a research course?

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Class Discussion Questions (cont’d)

What is the value of a research course to you as a nurse?

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What Is Research?

To search again To examine carefully Diligent and systematic inquiry Discovery Goal is to develop an empirical body of

knowledge for a discipline

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Definition of Nursing Research

A scientific process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences nursing practice.

It is the key to building an evidence-based practice for nursing.

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Using Research in Practice

Synthesis of knowledge (research, theory, and clinical experiences)

Effect of philosophy Making a change in practice Evaluation of change for patient, provider,

and health care system

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Integrative Review of Research

Critique of studies on a selected topic or practice problem

Development of evidence-based practice guidelines: Example: safe administration of intramuscular

injections• Summarize the findings.• Draw conclusions about what is known or not known

about the topic.

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Evidence-Based Practice Guidelines

Conscientious integration of best research evidence with clinical expertise and patient values and needs in the delivery of high-quality, cost-effective health care

Synthesis of knowledge for development of guidelines, standards, protocols, or policies to direct nursing interventions and practice

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Why Is Research Important for Evidence-Based Practice?

Develops empirical knowledge base Identifies best practices that are based on

clinical practices Improves outcomes for:

Patient and family Nurse Health care system

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Nursing Research Provides:

Description Explanation Prediction Control

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Description

Identifying and understanding the nature of nursing phenomena and the relationships among the phenomena to: Describe what exists in nursing practice. Discover new information. Promote understanding of situations. Classify information for use in the discipline.

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Explanation

Clarifying the relationships among phenomena and identifying the reasons why certain events occur

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Prediction

Estimating and anticipating the outcomes in a particular situation

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Control

Manipulating a situation so as to achieve a particular outcome

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Research Participation at Various Levels of Educational Preparation

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BSN Researcher Role

Identify research problems. Assist with data collection. Critique research studies. Summarize research findings for use in

practice.

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Class Discussion Question

Why should nurses be excellent consumers of research?

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History of Nursing Research

Nursing research has evolved slowly over the years.

Nursing research began in the 19th century with Florence Nightingale.

Clinical research is the current major focus of nursing research and will continue to be so throughout the 21st century.

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Florence Nightingale

Nightingale focused on the importance of a healthy environment for patients.

Aspects of her research included: Ventilation Cleanliness Purity of water Healthy diet

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Nursing Research: 1900–1940s

American Journal of Nursing first published in 1900.

Case studies reported in the 1920s and 1930s.

Graduate programs in nursing began in the 1920s.

Research conducted by nurses in the 1940s.

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Nursing Research: 1950s

1950—American Nurses Association begins 5-year study of nursing functions and activities.

1952—Nursing Research published BSN and MS nursing programs add research

to their curricula. 1953—Institute for Research and Service in

Nursing Education established by Teacher’s College, Columbia University.

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Nursing Research: 1960s

1963—International Journal of Nursing Studies

1967—Image published by Sigma Theta Tau (now titled The Journal of Nursing Scholarship)

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Nursing Research: 1970s

1970—ANA Commission on Nursing Research

1972—Council of Nurse Researchers 1978—Advances in Nursing Science 1978—Research in Nursing and Health 1979—Western Journal of Nursing Research

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Nursing Research: 1980s

1982–1983—Conduct and Utilization of Research in Nursing project (CURN)

1983—Annual Review of Nursing Research 1985—National Center for Nursing Research

(NCNR) 1987—Scholarly Inquiry for Nursing Practice 1988—Applied Nursing Research and

Nursing Science Quarterly 1989—Agency for Health Care Policy and

Research (AHCPR)

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Nursing Research: 1990s

1992—Clinical Nursing Research 1993—National Institute of Nursing Research

(NINR) 1993—Journal of Nursing Measurement 1994—Qualitative Health Research AHCPR renamed Agency for Healthcare

Research and Quality (AHRQ). 1999—AACN position statement on nursing

research

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Nursing Research: 21st Century

2000—Healthy People 2010 2000—Biological Research for Nursing 2002—Joint Commission revised policies to

support evidence-based care. 2004—Worldviews on Evidence-Based

Nursing

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21st Century

2005—AHRQ guidelines and priorities www.ahrq.gov

2005—NINR priorities www.nih.gov/nin

2006—Revised AACN position statements on nursing research

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Ways of Acquiring Knowledgein Nursing

Traditions Authority Borrowing Trial and error

Personal experience

Role modeling Intuition Reasoning

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Practice Knowledge Base

Identify two common behaviors used in your practice.

Indicate the knowledge base for these behaviors.

Is your practice based mainly on research or on other types of knowledge?

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Nursing Research Methods

Quantitative research Qualitative research Outcomes research

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Quantitative Research Methods

Descriptive research Correlational research Quasi-experimental research Experimental research

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Quantitative Research Characteristics

Philosophical origin: logical positivism Focus: concise, objective, reductionistic Reasoning: logistic, deductive Basis of knowing: cause-and-effect

relationships Theoretical focus: tests theory

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Qualitative Research Methods

Phenomenological research Ground theory research Ethnographic research Historical research Focus groups

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Qualitative Research Characteristics

Philosophical origin: naturalistic, interpretive, humanistic

Focus: broad, subjective, holistic Reasoning: dialectic, inductive Basis of knowing: meaning, discovery,

understanding Theoretical focus: theory development

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Outcomes Research

Focus of outcomes: Patients and families Providers (nurses, physicians) Health care systems

Outcomes used change practice and develop policy.