2. 18 March 20161 Foundations of Nursing Research Fifth Edition Chapter 1 Development of Nursing Research Rose Marie Nieswiadomy

3. 18 March 20162 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

4. 18 March 2016 3 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?

5. 18 March 20164 Learning Objective 1 Define nursing research

6. 18 March 20165 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

7. 18 March 20166 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).

8. 18 March 20167 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.

9. 18 March 20168 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.

10. 18 March 20169 Clinical Nursing Research Focuses on clients/studies Positively affects care of clients

11. 18 March 201610 Clinical Nursing Research Consists of patient symptom management Addresses behavioral interventions Targets prevention and health promotion

12. 18 March 201611 Learning Objective 2 Identify sources of nursing knowledge

13. 18 March 201612 Sources of Nursing Knowledge Variety of sources guide –Nursing practice –Nursing education –Nursing administration

14. 18 March 201613 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

15. 18 March 201614 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

16. 18 March 201615 The Scientific Research Method Best source for research knowledge Most reliable of all sources Very objective in its process

17. 18 March 201616 Learning Objective 3 Describe scientific research

18. 18 March 201617 Traditional Scientific Research Systematic Orderly Objective

19. 18 March 201618 Features of Scientific Research Process Empirical data Objective data Data gathered via senses

20. 18 March 201619 Features of Scientific Research Process Unbiased data and facts Not influenced by researcher

21. 18 March 201620 The Role of Control Measures Process decreases biases Measures decrease confounding factors Researcher controls things not under direct investigation

22. 18 March 201621 Scientific Research and Problem Solving Approach Similarities –Identify problem areas –Establish plans of action –Collect data and information –Evaluate data results

23. 18 March 201622 Purposes are Varied Scientific research –Broader in scope –Obtains data for generalization –Applies knowledge to other people/settings

24. 18 March 201623 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

25. 18 March 201624 Generalization For the research scientific process –An important characteristic –Important for assessing quality of studies

26. 18 March 201625 Nursing Research Domains Nursing practice Nursing education Nursing administration

27. 18 March 201626 Learning Objective 4 Compare two broad purposes for conducting research

28. 18 March 201627 Conducting Nursing Research Two broad purposes –Basic –Applied

29. 18 March 201628 Basic Research Pure research Generates new knowledge Does not solve immediate problems

30. 18 March 201629 Basic Research Develops, tests and refines theories Uses laboratory animals as subjects

31. 18 March 201630 Applied Research Uses the new knowledge Solves immediate problems It focused mainly on nursing intervention for patients and their families.

32. 18 March 201631 Most Nursing Research Studies Use applied research Goal of applied research –Solutions to problems –Changes in practice

33. 18 March 201632 Type of Research Process Basic versus applied Difference between types –Difficult to determine –Think of two as a continuum

34. 18 March 201633 Learning Objective 5 Discuss four goals for conducting nursing research

35. 18 March 201634 Goals for Conducting Research Promote Evidence-based nursing practice Credibility of the nursing profession Accountability for nursing practice Cost effectiveness of nursing care

36. 18 March 201635 Evidence-Based Nursing Practice (EBNP) Clinical decisions based upon –Best research evidence –Nurses clinical expertise –Health care preferences of clients

37. 18 March 201636 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.

38. 18 March 201637 Credibility of Nursing Profession Research helps determine –What nurses do –How nurses do it –How knowledge is gathered –What makes nurses different

39. 18 March 201638 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

40. 18 March 201639 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

41. 18 March 201640 Learning Objective 6 Compare qualitative and quantitative research

42. 18 March 201641 Quantitative Research Objectivity Tight controls Generalization of findings

43. 18 March 201642 Qualitative Research Subjectivity No controls Not able to generalize findings

44. 18 March 201643 What Type of Research are Nurses Doing? Initially, quantitative Focus change—qualitative Qualitative research is increasing

45. 18 March 201644 Learning Objective 7 Recognize the importance of outcomes research

46. 18 March 201645 Outcomes Research A new “buzzword” in health care Nursing always concerned with outcomes

47. 18 March 201646 Focus of Outcomes Research Measurable outcomes Research addresses interventions Research uses certain patient populations

48. 18 March 201647 Outcomes Research Influences High cost of health care Nursing care that is cost effective Services purchased that improve client health

49. 18 March 201648 Design for Outcomes Research Differences –Design –Methods –Sampling Procedures

50. 18 March 201649 Learning Objective 8 Contrast the various roles of nurses in research

51. 18 March 201650 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

52. 18 March 201651 Principal Investigator Beginning nurse researcher –Small-scale surveys Independent researcher –Special research preparation

53. 18 March 201652 Member of Research Team Data collection for study Administer experimental interventions Enlist bedside nurses and health care leaders Makes impact on health care outcomes

54. 18 March 201653 Identifier of Researchable Problems All levels of nursing preparation Ideal situation for bedside nurses –Patient related problems –Medication administration –Chronic issues

55. 18 March 201654 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

56. 18 March 201655 User of Research Findings Tradition, no longer acceptable practice Evidence-based research (EBR) for changes Findings change practice Results to improve client care

57. 18 March 201656 User of Research Findings Cont. Role of Research Utilization (RU) vs. EBR –RU — findings into practice –EBR — searching for best evidence

58. 18 March 201657 Patient/Client Advocate Nurses act in both roles Ethical considerations Study explanations Participant support

59. 18 March 201658 Learning Objective 9 Recall some of historic events in the development of nursing research

60. 18 March 201659 Nursing Education Florence Nightingale (FN) Tradition and Authority Statistician and Researcher

61. 18 March 201660 Paradigm Shift in Nursing Education Education levels of nurse preparation University school started in 1909

62. 18 March 201661 The Start of Research Studies Other disciplines –Sociology –Psychology –Education Nurses and advanced preparation

63. 18 March 201662 The Goldmark Report Report started in 1923 A national study

64. 18 March 201663 The Goldmark Report Studied the educational preparation –Nurse teachers –Nurse administrators –Public health nurses –Clinical Experiences of nursing students –Many inadequacies identified

65. 18 March 201664 Nursing Research Studies Educators Focus on students Address the educational process

66. 18 March 201665 Changes in Research Studies 1927 — Interest starts in nursing procedures 1950s — Nursing care studies 1970s — Practice related issues

67. 18 March 201666 A Continuum of Studies 1850 — Florence Nightingale 1900 – 1920 –Lavinia Dock –Adelaide Nutting –First university school

68. 18 March 201667 Events from 1921–1930 Goldmark Report –First doctoral program –Procedure vs. nursing activity research

69. 18 March 201668 Events from 1921–1930 1931–1950 –Sigma Theta Tau funds research –Brown Report –Division of Nursing Resources

70. 18 March 201669 Events from 1951–1970 Nursing Research Journal Institution of Research and Service in Nursing Education American Nurses Foundation Nursing Research Grants and Fellowship Programs

71. 18 March 201670 Events from 1951–1970 Western Council for Higher Education in Nursing Nurse Scientist Graduate Training Grants Program Abstract for Action

72. 18 March 201671 Events from 1971–1990 Department of Nursing Research Guidelines for Research Preparation Research in Nursing and Health

73. 18 March 201672 Events from 1971–1990 Western Journal of Nursing Research List of research priorities First Conference on Research Priorities

74. 18 March 201673 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

75. 18 March 201674 Events from 1991–2005 International Council of Nurses- World-wide priorities Worldviews in Evidence-Based Nursing NINR budget increases significantly

76. 18 March 201675 Learning Objective 10 Determine priority areas for nursing research

77. 18 March 201676 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

78. 18 March 201677 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

79. 18 March 201678 ANA’s Ten Priority Areas Quality of life issues Productivity issues Minimize the negative effects of technologies Acute or chronic health problems

80. 18 March 201679 Concerns Relating to Research Studies Patient care research — “sacred cow” Nursing characteristics Nursing Education and Administration Clinical student performances Education research

81. 18 March 201680 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

82. 18 March 201681 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

83. 18 March 201682 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