Advance nursing research

What is nursing research?
Nursing research is a systematic inquiry that uses rigorous guidelines to produce bias-free, trustworthy answers to questions about nursing practice.

Nurses use research to…
Synthesize findings into practice guidelines
Explore and describe health phenomena
Find solutions to existing or new health problems
Test traditional approaches for relevance and effectiveness

The Goal of Nursing Research
To generate new knowledge to inform the practice of nursing

Evidence-Based Nursing Practice
The use of best scientific evidence integrated with clinical experience, and incorporating patient values and preferences, in the practice of professional nursing care

Triad of evidence-based nursing practice
1. patient preference/vaules
2. clinical experience
3. best scientific evidence

Appraising Research
Author’s credentials are appropriate
No conflict of interest for author or journal
Journal is unbiased
Study is peer reviewed
Study is timely

Levels of Evidence I
Multiple randomized controlled trials
Randomized trials with large sample sizes / large effect sizes

Levels of Evidence II
Evidence from well-designed controlled studies
Randomized or non-randomized

Levels of Evidence III
Studies of intact groups or case/control
Time series studies
Single- or quasi-experimental

Levels of Evidence IV
Evidence from integrative reviews
Qualitative synthesis
Descriptive studies
Theory-based evidence and expert opinion
Peer reviewed professional organization standards

Paradigms in Research
An overall belief system or way of viewing the nature of reality and the basis of knowledge.

Quantitative Study
A traditional approach to research where variables are identified and measured in a reliable and valid way

Qualitative Study
A natural approach to research where the focus is understanding the meaning of an experience from the individual’s perspective

Mixed Methods
Research approach that combines quantitative and qualitative elements; involves the measurable state of a phenomenon and the individual’s subjective response to it

Basic research
Theoretical, pure, fundamental, or bench research done to advance knowledge in a given subject area

Applied research
Research to gain knowledge that has a practical application and contributes in some way to a modification of practice

Retrospective study
Studies that use secondary data that have already been collected about events that have already happened

Prospective study
Studies planned by the researcher for collection of primary data for the specific research study; implemented in the future

Longitudinal study
Studies conducted by following subjects over a period of time with data collection occurring at prescribed intervals

Cross sectional study
Studies conducted by looking at a single phenomenon across multiple populations at a single point in time

Ethical Issues
Concerned with researcher values, individual rights, personal beliefs, and societal norms

Human subjects have the right to:
Be informed about the study
Expect fair treatment
Withdraw from the study at any time

The Nuremburg Code
set of research ethics principles for human experimentation set as a result of the Subsequent Nuremberg Trials at the end of the Second World War.

The Declaration of Helsinki
expanded the TNC to differentiate therapeutic and nontherapeutic research

The Belmont Report
Respect for Persons
Beneficence
Justice

Respect for Persons
Individuals are autonomous human beings capable of making their own decisions

Beneficence
Do no harm and ensure well being

Justice
Subject’s right to fair treatment
Fairness in distribution of benefits

Informed Consent
Information
Comprehension
Voluntariness

Institutional Review Board (IRB)
a. Established by U.S. Department of Health and Human Services
b. Mission is “to ensure that research is ethically acceptable and that the welfare and rights of research participants are protected”
c. Membership includes at least 5 diverse members

Exempt Review
Studies pose no risk for subjects involved
* Surveys
* Noninvasive procedures
*Secondary data or documents

Expedited Review
Studies that pose only minimal risk to participants
*Studies that use drugs not requiring FDA approval
*Probability/Magnitude of discomfort not greater than what is *encountered in daily life

Full IRB Review Required
Direct access to subjects is needed
Human subjects are placed at more than minimal risk
Protected health information is required
Federal funds are received
Publication is anticipated

Identifiable Personal Health Information (PHI)
VIN vehicle identification number
web uniform resource locators
internet protocol address

Sources of Research Problems
Clinical practice observations
Educational experiences
Patient feedback
Theoretical models and frameworks
Professional literature
Performance improvement studies
Research reports and priorities
Social issues

Problem Statements
-Statements of the gap between what is known and unknown
-Articulate the area of concern and provide support for the extent of the problem
-Focus the research process on a known nursing practice problem

Purpose Statements
-Objective statement indicating the general goal of the study
-Describe the direction of the inquiry
-Contain the key variables to be studied, their possible relationships, and the nature of the population of interest

Feasibility of the Study
-Requires resources
-Ethical considerations
-Specific variables to be studied
-Availability of the population
-Potential access to the setting

The Research Question
Specifically identifies the key elements to be studied
Guides the design and methodology
Carefully constructed and refined

PICO
Population:
Intervention:
Comparison:
Outcome:

FINER
Feasible
Interesting
Novel
Ethical
Relevant

Descriptive
Studies a subject of interest in a defined population or setting

Analytic
Studies that compare interventions and outcomes

Prospective
Studies that are planned and carried out in the future under control of the researcher

Retrospective
Studies that use existing secondary data to answer a research question

Hypothesis
Translates the research question into a statistically testable statement
-Null hypothesis
-Directional hypothesis
-Non-directional hypothesis

Literature Review
Adds credence to the importance of the topic
Provides studies that can be replicated
Locates instruments that have already been tested
Reveals appropriate theoretical frameworks
Establishes the basis for the subject under study

concept map
a plan for literature review that identifies all relevant concepts that are pertient to an individual topic or question

secondary source
systematic reviews
meta-analysis
meta-synthesis

primary sources
reports of original research authored by the researcher and published in scholarly source

Information literacy
the competencies necessary to access, retrieve and analyze research evidence

Cochrane Database
the gold standard for evidence-base practice

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One of the primary foundations for evidence-based nursing practice is Medical knowledge. Research results. Everyday health care. Textbook information. Research results Within the process of providing evidence-based nursing care, which types of research results are incorporated to ascertain the plan …

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