Introduction of Nursing Research

This is a simple introduction to nursing research and a guide that should help towards understanding the process.

Research Terms	Definitions	Impact on Practice
Empirical Indicators	In clinical practice = the clinical tools used to record observations, results of interventions. Data that’s used to guide practice. How theoretical concepts can be “seen” in reality.	Theoretical Concepts 1. Safe 2. Physical activity 3. Blood pressure Empirical Indicators 1. number of times condoms are used during sexual activity 2. Number of days in a week of 60 minutes of walking 3. Recorded average of (a) two systolic and (b) two diastolic readings
Evidence-Based Practice	Lifelong approach to clinical practice: Integrates a systematic search appraisal and synthesis of relevant research, clinical expertise, and patient preference and values.	Translate knowledge with goal of improving practice.
Qualitative research	a systematic, interactive, subjective, holistic approach used to describe life experiences and give them meaning	observes and interviews; reports findings as a narrative
Quantitative research	a formal, objective, systematic process implemented to obtain numerical data for understanding aspects of the world	counts and measures; reports findings with statistics
Quality Improvement	Combined and unceasing efforts to make changes that lead to better patient outcomes, better system performance, and better professional development	Improve patient care processes and outcomes in specific healthcare settings.
Research	Systematic investigation: Research proposal development; exploring, describing, or testing idea; data analysis and evaluation; develop or contribute knowledge.	Generate new knowledge for practice; adds to professional knowledge base through dissemination
Research Utilization	the process of applying research findings to practice...usually based on a single research study	Component of EBP, research only source of evidence, critical appraisal of a research report

Key Terms in Nursing Theory

Roles of Nurses in Research

Bachelor’s Degree (BSN)

Read and critically appraise studies
Use best research evidence in practice with guidance: apply findings, with supervision
Assist with problem identification and data collection: work with the research team

Master’s Degree (MS or MSN)

Critically appraise research and evidence-based guidelines & synthesize findings
Develop and revise protocols, algorithms, and policies for practice, based on appraisal and synthesis
Implement best research evidence in practice
Lead health care teams to make change based on evidence
Collaborate on research projects and provide clinical expertise for research

Doctorate of Nursing Practice (DNP)

Practice focused & the highest level of clinical expertise
Translate knowledge for use in practice
Advanced research and leadership skills
Develop, implement, evaluate, and revise as needed protocols, policies, and evidence-based guidelines in practice
Conduct clinical studies, usually in collaboration with other nurse researchers

Doctor of Philosophy (Ph.D.)

Research focused
Generate new knowledge
Develop highly funded programs of research
Nurse scientist- lead interdisciplinary teams
Often conduct studies in multiple settings
Considered experts in select areas
Mentor PhD students or new PhD faculty research

–National Inst. of Nursing Research

Research problems may be related to: patients, healthcare worker interactions, healthcare system interface in support of patients, family interactions, teaching, happenings in the healthcare setting…etc

Differences between EPB & Research

Steps of EBP (addresses gaps in PRACTICE)

Step 0: Develop a spirit of inquiry
Step 1. Ask a clinical question in PICOT format
Step 2. Search for the best evidence
Step 3. Critically appraise the evidence
Step 4. Integrate the evidence with clinical expertise and patient preferences and values.

***Implement practice change

Step 5. Evaluate the outcomes of the practice decisions or changes based on evidence.
Step 6. Disseminate EBP results

Steps in Research (addresses gaps in KNOWLEDGE)

Step 0. Develop spirit of inquiry
Step 1. Identify problem of interest/research topic
Step 2. Search for gaps in literature
Step 3. Develop research questions/hypotheses
Step 4. Plan methods (design, sample data collection, analysis procedures)

*** Implement a study

Step 5. Analyze results/draw conclusions
Step 6. Disseminate results

Quantitative Studies	Qualitative Studies	Reviews
Descriptive •Cross sectional •Case control	Phenomenological	Narrative
Correlational •Cross sectional •Cohort	Grounded Theory	Integrative
Quasi- Experimental	Ethnographic	Systemic Review
True Experimental •Randomized control trials	Historical	Meta-Analysis (quantitative)
		Meta synthesis (qualitative)
		Clinical Guidelines

research and PICO

Formulate/Asking the Clinical Question: a picot assists in creating a clinical question and directs the search for obtaining evidence.

P: Population/disease (i.e. age, gender, ethnicity, with a certain disorder)
I: Intervention or Variable of Interest (exposure to a disease, risk behavior, prognostic factor)
C: Comparison: (could be usual care; a placebo or no disease, absence of risk factor, Prognostic factor B )
O: Outcome: (risk of disease, the accuracy of a diagnosis, rate of occurrence of adverse outcome)
T: Time

To Initiate Meaningful Searches

Identify the type of PICOT question.
Determine the level of evidence that best answers the question.
Select relevant databases to search
Use keywords from your PICOT question to search the databases.
Streamline your search with the following strategies:

Additional Help:

Use filters/limits to define parameters (e.g., age, gender, time period, humans, English)
Use database controlled vocabulary (e.g. “MeSH, vocabulary that’s organized into 16 main branches)
Use the words in your PICOT question & synonyms, spelling counts
Nesting – Grouping strategy when using two or more Boolean operators – (herbal remedies)
Truncation (*?#) -allows all words with same root to be searched (e.g. “nurs”)
Wildcards: Example wom?n-searches for both woman and women
Stop words: A, an, for, in , of the, this, to –might lead to failed search
Boolean Operators –relationship among terms:
1. “And” narrows the search –Both words must be found in the record; and is automatically used when two or more keywords are searched
2. “Or” –broadens the search as either term may be found (e.g., anger and anxiety vs. anger or anxiety)
3. “Not” –when only the first search term is to be found and not the second (e.g., anger not anxiety)