1. A National Survey of Hospital Nursing Research Requirements and OutcomesA National Survey of Hospital Nursing Research Requirements and Outcomes* 2012 National State of the Science Congress on Nursing Research Session Title: EVIDENCE-BASED PRACTICE Session Date, Time: September 14,2012 8:30 AM-10:00 AM Maureen McLaughlin PhD RN, Medstar Georgetown University Hospital Karen Gabel Speroni PhD RN, Inova Loudoun Hospital Kathy Patterson Kelly PhD RN, Children’s National Medical Center Cathie E. Guzzetta PhD RN AHN-BC FAAN, Children’s National Medical Center Sameer DeSale, MS, Medstar Health Research Institute Annette Turner MSN RN, The Catholic University of America (*Washington Regional Nursing Research Consortium) 1

2. Introduction/Background Noted variable IRB policies regarding whether RNs can be PIs on RN-led research in the metropolitan Washington DC area hospitals Such IRB requirements present a potential barrier to clinical nurses functioning as PIs of their studies in hospitals Study investigators members of the Washington Regional Nursing Research Consortium (WRNRC) 2

3. To identify hospital and/or IRB requirements for RN PIs to conduct RN-led research To describe outcomes of hospital-based nursing research programs What are the hospital/IRB requirements for RN PIs: –RN education level & qualifications? –Nursing research mentoring processes? –Research education programs? –Nursing research review processes? What are the scholarly outcomes of hospital-based research programs? What are the facilitators and/or hindrances of RN-led research studies? Purpose of Study/Research Questions 3

4. Descriptive, comparative national electronic survey of hospitals (purposive, convenience sample) –798 hospitals from 3 groups: 202 Magnet-designated 195 Children’s Hospital Association (CHA) 401 The Joint Commission (TJC) HNRRO Survey: 60-item questionnaire; CVI = 1.0: 1.Educational & qualification requirements for nurse PIs 2.Nursing research mentoring process 3.Nursing research education & training 4.Nursing research peer-review process 5.Scholarly research outcomes 6.Facilitators and hindrances of RN-led research studies & research productivity (2 open-ended questions) Methods 4

5. Quantitative: –Category fields: chi- square test & Fisher’s exact test –Continuous variables: t-test, ANOVA, Wilcoxon rank sum test, & Kruskal-Wallis test –Level of significance set at < 0.05 Qualitative: –Conventional content analysis for 2 open-ended questions –Verbatim comments downloaded from electronic survey –2 co-investigators worked with doctoral student to code data –Responses analyzed together & then divided into Magnet & non-Magnet hospital groups –Coding validated with 10% of dataset Analysis 5

6. 20% response rate Total 160 returned surveys (Magnet & non-Magnet hospitals) –66% (n= 106) Magnet hospitals –34% (n= 54) Non-Magnet hospitals Non-Magnet hospitals = 29 (18%) TJC & 25 (16%) CHA Majority were not-for-profit & in urban areas Magnet hospitals had > number of licensed beds & full-time equivalent RNs compared to non-Magnet hospitals (p<0.0001) Results: Demographic Findings 6

7. Only 8% (n=13) of hospitals had a minimum educational requirement to be a PI –More Magnet than non-Magnet hospitals had no minimum educational requirement (p=0.02) 25% (n=36) of hospitals appointed a PI designee to sign IRB application if a RN did not meet IRB requirements to be a PI Results: Educational Level & Qualifications Requirements for Nurse PIs 7

8. Research mentors/leaders were available to guide nurses throughout the research process at the majority of hospitals (n=131, 83%) More Magnet (n=103, 98%) than non-Magnet (n=28, 53%) hospitals had research mentors (p<0.0001) Results: Nursing Research Mentoring Process 8

9. 23% (n=37) required RN PIs to complete a research education course before conducting research 21% (n=33) had research education classes available to their nurses 20% (n=32) provided a nursing research internship/fellowship –Nearly all (97%) were expected to assume various roles in research at their hospital Results: Nursing Research Education & Training 9

10. Majority had a Nursing Research Committee (NRC) (65%) or interdisciplinary research council (31%) –More Magnet (83%) than non-Magnet hospitals (30%) had a research council (p<0.0001) Majority required NRC or other persons to review (84%) or approve (73%) the nursing research proposal before IRB submission Majority required PI to report progress on study to research mentor (62%) or NRC (68%) Results: Nursing Research Peer-Review Process 10

11. Hospitals reported an annual total of 4 studies initiated, 4 disseminated (podium/poster), 1 published, & 2 funded As hospital bed size increased, so did number of studies initiated (p=.03) – <100 beds = 1.95 studies –101-200 beds = 2.76 studies –201-300 = 2.94 studies –301-500 = 3.61 studies –501-700 = 4.42 studies –701-1000 = 5.63 studies – >1000 = 6.4 studies Results: Research Program Scholarly Outcomes 11

12. Conclusion: 12 Findings from this study provide a prototype & benchmark information for nursing administrators planning to establish, evaluate and/or expand nursing research programs

13. 95% of surveys included written comments 960 units of analysis –Facilitators 477 Magnet, 107 non-Magnet –Hindrances 279 Magnet, 97 non-Magnet Total 24 codes (12 facilitator; 12 hindrance codes) Commonly facilitator codes had mirror hindrance codes representing lack of the underlying construct (n=10 mirror constructs) Qualitative Results: Facilitators & Hindrances 13

14. Facilitator & Hindrance Codes with Magnet & non-Magnet Rank FacilitatorsMagnetNon- Magnet HindrancesMagnetNon- Magnet Nursing research mentor11Lack of time12 Institutional research infrastructure28Lack of research knowledge or research training opportunities 29 Leadership support32Lack of financial resources for nursing research 33 Making research relevant43Lack of experienced nursing research mentors/ academic affiliation 41 Research training54Lack of institutional research infrastructure 55 Nursing Research Committee/Council65Intimidated by research610 Nursing culture that supports research77Lack of leadership support77 Research is part of the job88Nursing culture does not support nursing research 74 Financial & other tangible resources86Nurse educational level86 Magnet99Nursing research is not a priority99 Dedicated time for research95Lack of relevance to nursing practice, lack of interest 108 Impact of higher education108Lack of nursing research committee/ council No report9

15. Findings based on respondent’s familiarity with institutional work Nursing research outcome data collected for years 2004-2008, other data provided in 2009 and/or 2010 Findings likely overestimate influence of Magnet designation on nursing research in hospitals (66% our study vs 7% nation-wide) Limitations 15

16. Expanded prototype for hospital-based nursing research program: Integration of quantitative & qualitative findings 16

17. Nursing leaders need to partner with IRBs to create policies (e.g., mentor guidance, education, peer review) to ensure hospital-based RN researchers can be identified as PI & assume all responsibilities Nursing leaders need to consider their hospital infrastructure, hospital culture, & components necessary for building a hospital-based nursing research program Findings provide prototype for nursing leaders to guide development of a new nursing research program & provide benchmarks to evaluate and/or expand an existing program Implications 17

18. Maureen McLaughlin, PhD, RN mmm116@gunet.georgetown.edu Karen Gabel Speroni, PhD, RN kgabelsperoni@smartneighborhood.net Katherine Patterson Kelly PhD RN kakelly@childrensnational.org Cathie E. Guzzetta, PhD, RN, AHN-BC, FAAN Cguzzett@childrensnational.org Sameer DeSale, MS Sameer.desale@medstar.net Annette Turner, MS, RN 03turner@cardinalmail.cua.edu Contact Information 18