Chapter 1 Introduction to Nursing Research and EvidenceBased

Introduction to the Course Introduction of class members Review of syllabus Presentation of class

Class Discussion Questions What was your reaction when you learned you were required to

Class Discussion Questions (cont’d) What is the value of a research course to you

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 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 5

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. Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 6

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 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 7

Integrative Review of Research Critique of studies on a selected topic or practice problem Development of evidence-based practice guidelines: Ø Example: safe administration of intramuscular injections • Summarize the findings. • Draw conclusions about what is known or not known about the topic. Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 8

Evidence-Based Practice Guidelines Conscientious integration of best research evidence with clinical expertise and patient values and needs in the delivery of highquality, cost-effective health care Synthesis of knowledge for development of guidelines, standards, protocols, or policies to direct nursing interventions and practice Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 9

Why Is Research Important for Evidence-Based Practice? Develops empirical knowledge base Identifies best practices that are based on clinical practices Improves outcomes for: Ø Ø Ø Patient and family Nurse Health care system Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 10

Nursing Research Provides: Description Explanation Prediction Control Copyright © 2011 by Saunders, an imprint

Description Identifying and understanding the nature of nursing phenomena and the relationships among the phenomena to: Ø Ø Describe what exists in nursing practice. Discover new information. Promote understanding of situations. Classify information for use in the discipline. Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 12

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

Prediction Estimating and anticipating the outcomes in a particular situation Copyright © 2011 by

Control Manipulating a situation so as to achieve a particular outcome Copyright © 2011

Research Participation at Various Levels of Educational Preparation Copyright © 2011 by Saunders, an

BSN Researcher Role Identify research problems. Assist with data collection. Critique research studies. Summarize research findings for use in practice. Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 17

Class Discussion Question Why should nurses be excellent consumers of research? Copyright © 2011

History of Nursing Research Nursing research has evolved slowly over the years. Nursing research began in the 19 th century with Florence Nightingale. Clinical research is the current major focus of nursing research and will continue to be so throughout the 21 st century. Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 19

Florence Nightingale focused on the importance of a healthy environment for patients. Aspects of her research included: Ø Ø Ventilation Cleanliness Purity of water Healthy diet Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 20

Nursing Research: 1900– 1940 s American Journal of Nursing first published in 1900. Case studies reported in the 1920 s and 1930 s. Graduate programs in nursing began in the 1920 s. Research conducted by nurses in the 1940 s. Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 21

Nursing Research: 1950 s 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. Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 22

Nursing Research: 1960 s 1963—International Journal of Nursing Studies 1967—Image published by Sigma Theta Tau (now titled The Journal of Nursing Scholarship) Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 23

Nursing Research: 1970 s 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 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 24

Nursing Research: 1980 s 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) Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 25

Nursing Research: 1990 s 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 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 26

Nursing Research: 21 st 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 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 27

21 st Century 2005—AHRQ guidelines and priorities Ø 2005—NINR priorities Ø www. ahrq. gov www. nih. gov/nin 2006—Revised AACN position statements on nursing research Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 28

Ways of Acquiring Knowledge in Nursing Traditions Authority Borrowing Trial and error Personal experience

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? Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 30

Nursing Research Methods Quantitative research Qualitative research Outcomes research Copyright © 2011 by Saunders,

Quantitative Research Methods Descriptive research Correlational research Quasi-experimental research Experimental research Copyright © 2011

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 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 33

Qualitative Research Methods Phenomenological research Ground theory research Ethnographic research Historical research Focus groups

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 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 35

Outcomes Research Focus of outcomes: Ø Ø Ø Patients and families Providers (nurses, physicians) Health care systems Outcomes used change practice and develop policy. Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 36