18 March Foundations of Nursing Research Fifth Edition Chapter 1 Development of Nursing Research Rose Marie Nieswiadomy

18 March 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

18 March Development of Nursing Research 1.Nursing research concerns nursing and nurses do that are different from other disciplines. 2.Nurses can get involved in none nursing research, but in order to qualify as a nursing research it has to be concerned with a unique area of nursing. 3.It is hard to convince nurses and other professions that nursing research exists. 4.Nurses need to think about the nursing interventions they use in practice, why are we using a certain interventions? Is it based on research findings? Is it based on a tradition?

18 March Learning Objective 1 Define nursing research

18 March What is research? Systematic inquiry using disciplined methods to solve problems and to develop, refine and expand a body of knowledge Nursing research is systematic inquiry to develop knowledge about issues of importance to the nursing profession. The goal of nursing research is to improve patient care

18 March Definitions 1.Nursing research is defined as : the systematic objective process of analyzing phenomena of importance to nursing. This definitions includes all research that concerns with practice, education, and nursing administration. 2.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).

18 March Features of nursing research 1.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.

18 March 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.

18 March Clinical Nursing Research Focuses on clients/studies Positively affects care of clients

18 March Clinical Nursing Research Consists of patient symptom management Addresses behavioral interventions Targets prevention and health promotion

18 March Learning Objective 2 Identify sources of nursing knowledge

18 March Sources of Nursing Knowledge Variety of sources guide –Nursing practice –Nursing education –Nursing administration

18 March 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 authority 3.Trial and error 4.Disciplined research: objective and reliable source

18 March 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

18 March The Scientific Research Method Best source for research knowledge Most reliable of all sources Very objective in its process

18 March Learning Objective 3 Describe scientific research

18 March Traditional Scientific Research Systematic Orderly Objective

18 March Features of Scientific Research Process Empirical data Objective data Data gathered via senses

18 March Features of Scientific Research Process Unbiased data and facts Not influenced by researcher

18 March The Role of Control Measures Process decreases biases Measures decrease confounding factors Researcher controls things not under direct investigation

18 March Scientific Research and Problem Solving Approach Similarities –Identify problem areas –Establish plans of action –Collect data and information –Evaluate data results

18 March Purposes are Varied Scientific research –Broader in scope –Obtains data for generalization –Applies knowledge to other people/settings

18 March 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

18 March Generalization For the research scientific process –An important characteristic –Important for assessing quality of studies

18 March Nursing Research Domains Nursing practice Nursing education Nursing administration

18 March Learning Objective 4 Compare two broad purposes for conducting research

18 March Conducting Nursing Research Two broad purposes –Basic –Applied

18 March Basic Research Pure research Generates new knowledge Does not solve immediate problems

18 March Basic Research Develops, tests and refines theories Uses laboratory animals as subjects

18 March Applied Research Uses the new knowledge Solves immediate problems It focused mainly on nursing intervention for patients and their families.

18 March Most Nursing Research Studies Use applied research Goal of applied research –Solutions to problems –Changes in practice

18 March Type of Research Process Basic versus applied Difference between types –Difficult to determine –Think of two as a continuum

18 March Learning Objective 5 Discuss four goals for conducting nursing research

18 March Goals for Conducting Research Promote Evidence-based nursing practice Credibility of the nursing profession Accountability for nursing practice Cost effectiveness of nursing care

18 March Evidence-Based Nursing Practice (EBNP) Clinical decisions based upon –Best research evidence –Nurses clinical expertise –Health care preferences of clients

18 March 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.

18 March Credibility of Nursing Profession Research helps determine –What nurses do –How nurses do it –How knowledge is gathered –What makes nurses different

18 March 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

18 March 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

18 March Learning Objective 6 Compare qualitative and quantitative research

18 March Quantitative Research Objectivity Tight controls Generalization of findings

18 March Qualitative Research Subjectivity No controls Not able to generalize findings

18 March What Type of Research are Nurses Doing? Initially, quantitative Focus change—qualitative Qualitative research is increasing

18 March Learning Objective 7 Recognize the importance of outcomes research

18 March Outcomes Research A new “buzzword” in health care Nursing always concerned with outcomes

18 March Focus of Outcomes Research Measurable outcomes Research addresses interventions Research uses certain patient populations

18 March Outcomes Research Influences High cost of health care Nursing care that is cost effective Services purchased that improve client health

18 March Design for Outcomes Research Differences –Design –Methods –Sampling Procedures

18 March Learning Objective 8 Contrast the various roles of nurses in research

18 March 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

18 March Principal Investigator Beginning nurse researcher –Small-scale surveys Independent researcher –Special research preparation

18 March Member of Research Team Data collection for study Administer experimental interventions Enlist bedside nurses and health care leaders Makes impact on health care outcomes

18 March Identifier of Researchable Problems All levels of nursing preparation Ideal situation for bedside nurses –Patient related problems –Medication administration –Chronic issues

18 March 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

18 March User of Research Findings Tradition, no longer acceptable practice Evidence-based research (EBR) for changes Findings change practice Results to improve client care

18 March User of Research Findings Cont. Role of Research Utilization (RU) vs. EBR –RU — findings into practice –EBR — searching for best evidence

18 March Patient/Client Advocate Nurses act in both roles Ethical considerations Study explanations Participant support

18 March Learning Objective 9 Recall some of historic events in the development of nursing research

18 March Nursing Education Florence Nightingale (FN) Tradition and Authority Statistician and Researcher

18 March Paradigm Shift in Nursing Education Education levels of nurse preparation University school started in 1909

18 March The Start of Research Studies Other disciplines –Sociology –Psychology –Education Nurses and advanced preparation

18 March The Goldmark Report Report started in 1923 A national study

18 March The Goldmark Report Studied the educational preparation –Nurse teachers –Nurse administrators –Public health nurses –Clinical Experiences of nursing students –Many inadequacies identified

18 March Nursing Research Studies Educators Focus on students Address the educational process

18 March Changes in Research Studies 1927 — Interest starts in nursing procedures 1950s — Nursing care studies 1970s — Practice related issues

18 March A Continuum of Studies 1850 — Florence Nightingale 1900 – 1920 –Lavinia Dock –Adelaide Nutting –First university school

18 March Events from 1921–1930 Goldmark Report –First doctoral program –Procedure vs. nursing activity research

18 March Events from 1921– –1950 –Sigma Theta Tau funds research –Brown Report –Division of Nursing Resources

18 March Events from 1951–1970 Nursing Research Journal Institution of Research and Service in Nursing Education American Nurses Foundation Nursing Research Grants and Fellowship Programs

18 March Events from 1951–1970 Western Council for Higher Education in Nursing Nurse Scientist Graduate Training Grants Program Abstract for Action

18 March Events from 1971–1990 Department of Nursing Research Guidelines for Research Preparation Research in Nursing and Health

18 March Events from 1971–1990 Western Journal of Nursing Research List of research priorities First Conference on Research Priorities

18 March 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

18 March Events from 1991–2005 International Council of Nurses- World-wide priorities Worldviews in Evidence-Based Nursing NINR budget increases significantly

18 March Learning Objective 10 Determine priority areas for nursing research

18 March 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

18 March 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

18 March ANA’s Ten Priority Areas Quality of life issues Productivity issues Minimize the negative effects of technologies Acute or chronic health problems

18 March Concerns Relating to Research Studies Patient care research — “sacred cow” Nursing characteristics Nursing Education and Administration Clinical student performances Education research

18 March 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

18 March 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

18 March Summary 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