Development of Nursing Research

Learning Objectives

• Define nursing research• Clinical nursing research• Sources of nursing knowledge• Basic research & applied research• Goals of conducting research• Qualitative & quantitative research• Outcome research• History of nursing research

What is research?• Systematic inquiry using disciplined methods to

solve problems and to develop, refine and expand a body of knowledge (Uses a systematic and objective process

• this knowledge is about issues of importance to the nursing profession.(Analyzes phenomena of importance to nursing)

• The goal of nursing research is to improve patient care

Definitions It includes studies concerning: - nursing practice; -nursing education; - nursing administration, and - nurses themselves • Clinical nursing research: indicates nursing research

that involves clients or studies that have the potential for affecting the care of clients (subjects or animals research).

Features of nursing research1. Systematic search for and validation of knowledge

about issues of importance to the nursing profession (Polit & Hungler)

2. Being concerned with knowledge that directly influences clinical nursing practice (Burns & Grove).

3. Nursing research could be in nursing practice, nursing administration, education.

Features of nursing research Cont.

4. Nursing research (mostly concerned with clinical problems) and research in nursing is the broader study of the nursing profession and includes historical with ethical, historical and political studies.

Clinical Nursing Research

• Focuses on clients/studies• Positively affects care of clients

Clinical Nursing Research

• Consists of patient symptom management• Addresses behavioral interventions• Targets prevention and health promotion

• Variety of sources guide– Nursing practice– Nursing education– Nursing administration

Sources of nursing knowledge

1. Tradition: handing down knowledge from one generation to another and leads to actions that occur because it has been always done that way.

2. Experts or people with authority3. Trial and error4. Disciplined research: objective and reliable

source

Past Knowledge

• Built on Trial and Error Processes• Alternatives tried till one is found• The approach is not systematic• Documentation of success is not existent

The Scientific Research Method

• Best source for research knowledge• Most reliable of all sources• Very objective in its process

Scientific Research methods

• Is a process in which observable, verifiable data are systematically collected from our surroundings through our sense to describe, explain, or predict events.

• Scientific research: involve selecting and defining a problem, formulating research questions or hypothesis or both, collecting data, analyzing data, and reporting results.

Features of Scientific Research Process

• Empirical data• Objective data• Data gathered via senses• Unbiased data and facts• Not influenced by researcher

Scientific Research and Problem Solving Approach

• Similarities– Identify problem areas– Establish plans of action– Collect data and information– Evaluate data results

Purposes are Varied

• Scientific research– Broader in scope– Obtains data for generalization– Applies knowledge to other people/settings

Purposes are Varied

• Problem solving approach– Specific in scope– Seeks a solution to a problem in specific setting– Uses knowledge for people in specific setting

Generalization

• For the research scientific process – An important characteristic– Important for assessing quality of studies

Nursing Research Domains

• Nursing practice• Nursing education• Nursing administration

Type of Research Process

• Basic versus applied• Difference between types– Difficult to determine– Think of two as a continuum

Basic Research

• Pure or fundamental research• Generates new knowledge• Does not solve immediate problems• Major purpose is to obtain empirical data• Develops, tests and refines theories• Uses laboratory animals as subjects

Applied Research

is conducted to gain knowledge that can used in a practical setting.

• Uses the new knowledge• Solves immediate problems• It focused mainly on nursing intervention for

patients and their families.

Goal of applied research

– Solutions to problems– Changes in practice

• Most Nursing Research Studies Use applied research

Goals for Conducting Research

• Promote Evidence-based nursing practice• Credibility of the nursing profession• Accountability for nursing practice• Cost effectiveness of nursing care

Evidence-Based Nursing Practice (EBNP)

• Clinical decisions based upon– Best research evidence– Nurses clinical expertise– Health care preferences of clients

Credibility of Nursing Profession

• Professional vs. vocational• one criteria for a profession is to Establishing

own body of knowledge• The most valid method of developing this

knowledge base is scientific research.

Credibility of Nursing Profession

• Research helps determine– What nurses do– How nurses do it– How knowledge is gathered– What makes nurses different

Accountability for Nursing Practice

• Increase independence ® more accountability

• Promote actions based on sound rationale• Gain knowledge via scientific research• Foster research article critiques• Use findings in everyday practice

Cost-Effectiveness — A Nursing Responsibility

• Gain education in business and finances• Help patients understand the importance of

nursing• Know nursing is large part of institutions

budget• Validate nursing and its activities with

research

• Quantitative research: is concerned with objectivity, tight controls over the research situation, and the ability to generalize findings.

• Qualitative research: is concerned with the subjective meaning of an experience to an individual.

• Outcome research: Focuses on measurable outcomes of interventions with certain patient populations.

Quantitative Research

• Objectivity• Tight controls• Generalization of findings

Qualitative Research

• Subjectivity• No controls• Not able to generalize findings

What Type of Research are Nurses Doing?

• Initially, quantitative• Focus change-qualitative• Qualitative research is increasing

Outcomes Research

• A new “buzzword” in health care• Nursing always concerned with outcomes

Focus of Outcomes Research

• Measurable outcomes• Research addresses interventions• Research uses certain patient populations

Outcomes Research Influences

• High cost of health care• Nursing care that is cost effective• Services purchased that improve client health

Design for Outcomes Research

• Differences– Design– Methods– Sampling Procedures

Specific Research Roles for Nurses

• Principal investigator• Member of research team• Identifier of researchable problems• Evaluator of research findings• User of research findings• Patient client advocate during studies• Subject participant in studies

Principal Investigator

• Beginning nurse researcher– Small-scale surveys

• Independent researcher– Special research preparation

Member of Research Team

• Data collection for study• Administer experimental interventions• Enlist bedside nurses and health care leaders• Makes impact on health care outcomes

Identifier of Researchable Problems

• All levels of nursing preparation• Ideal situation for bedside nurses– Patient related problems– Medication administration– Chronic issues

Evaluator of Research Findings

• Role for all nurses• Read articles on the process– American Journal of Nursing (December, 2006)– Continuing Education Hours

• Review critiques guidelines in the textbook

User of Research Findings

• Tradition, no longer acceptable practice• Evidence-based research (EBR) for changes• Findings change practice• Results to improve client care

User of Research Findings Cont.

• Role of Research Utilization (RU) vs. EBR– RU — findings into practice– EBR — searching for best evidence

Patient/Client Advocate

• Nurses act in both roles• Ethical considerations• Study explanations• Participant support

Nursing Education

• Florence Nightingale (FN)• Tradition and Authority• Statistician and Researcher

Paradigm Shift in Nursing Education

• Education levels of nurse preparation• University school started in 1909

The Start of Research Studies

• Other disciplines– Sociology– Psychology– Education

• Nurses and advanced preparation

The Goldmark Report

• Report started in 1923• A national study

The Goldmark Report

• Studied the educational preparation– Nurse teachers– Nurse administrators– Public health nurses– Clinical Experiences of nursing students– Many inadequacies identified

Nursing Research Studies

• Educators• Focus on students• Address the educational process

Changes in Research Studies

• 1927 — Interest starts in nursing procedures• 1950s — Nursing care studies• 1970s — Practice related issues

A Continuum of Studies

• 1850 — Florence Nightingale• 1900 – 1920– Lavinia Dock– Adelaide Nutting– First university school

Events from 1921–1930

• Goldmark Report– First doctoral program– Procedure vs. nursing activity research

Events from 1921–1930

• 1931–1950– Sigma Theta Tau funds research– Brown Report– Division of Nursing Resources

Events from 1951–1970

• Nursing Research Journal• Institution of Research and Service in Nursing

Education• American Nurses Foundation• Nursing Research Grants and Fellowship

Programs

Events from 1951–1970

• Western Council for Higher Education in Nursing

• Nurse Scientist Graduate Training Grants Program

• Abstract for Action

Events from 1971–1990

• Department of Nursing Research• Guidelines for Research Preparation• Research in Nursing and Health

Events from 1971–1990

• Western Journal of Nursing Research• List of research priorities• First Conference on Research Priorities

Events from 1991–2005

• Clinical Nursing Research• National Institute of Nursing Research• Second Conference on Research Priorities• Qualitative Nursing Research and Biological

Research for Nursing

Events from 1991–2005

• International Council of Nurses-World-wide priorities

• Worldviews in Evidence-Based Nursing• NINR budget increases significantly

Research Priorities

• Our scientific knowledge base for practice• Health promotion and preventive health

practices• All age groups—birth to death• Life satisfaction for individuals and groups• Cost effectiveness in health care

ANA’s Ten Priority Areas

• Promote health and well-being• Ability to care for self among all age, social

and cultural groups• Minimize/prevent behaviorally and

environmentally induced health problems

ANA’s Ten Priority Areas

• Quality of life issues• Productivity issues• Minimize the negative effects of technologies• Acute or chronic health problems

Concerns Relating to Research Studies

• Patient care research • Nursing characteristics• Nursing Education and Administration• Clinical student performances• Education research

Top Five Research Areas

• Patient safety on units vs. RN staffing• Nurse Practitioner–led programs on inner-city

black men and hyper–tension• Gender differences related to symptoms for

heart attacks

Top Five Research Areas

• Role of nursing care in client transition from hospital to community for heart failure clients

• Outcomes relating to hospice care vs. advanced directives

Nurses and the Research Process

• Educate public that nurses do research• Report research findings locally and nationally• Present information on clinical practice issues

Research Dissemination

• Conferences• Research journals• Journals that practicing nurses read

Types of Nursing Research

• Nursing interventions• Medication administration• Chronic disease management

Undergraduate Nursing Curriculum

• Nursing research courses• Research content in all nursing courses• Research threaded throughout the curriculum

Nursing Research and Nursing Knowledge

• Ask the right questions• Search for evidence to support/answer

questions• Implement changes to improve practice• Evaluate results of the changes• Add to our unique body of nursing knowledge

Accountability for Nursing Practice

• Increase independence ® more accountability

• Promote actions based on sound rationale• Gain knowledge via scientific research• Foster research article critiques• Use findings in everyday practice

Funding Opportunities for Nursing Research

• Federal Government• National Institute for Nursing Research• Private Foundation• Organizations and Corporations• Professional Organizations– Sigma Theta Tau

Worldviews on Evidence-Based Nursing

• Quarterly peer-reviewed journal• Sigma Theta Tau International• Blackwell Publishing

Educational Expectations for Nursing Research

• Vary by preparation• All nurses should read research• Advanced practice nurses perform research

Baccalaureate Nurses Research Expectations

• Read research critically• Determine if results are applicable• Identify clinical problems• Gain access to clinical sites• Select appropriate data collection methods• Collect data for the research• Implement findings into practice

Position Statements

• American Association of Colleges of Nursing• American Nurses Association• Internet Sites