I.

Importance of Research in nursing

1. Research is an important tool for the continual development of a relevant body of
knowledge in nursing.
2. Research generates information from nursing investigations which help define the
unique role of nursing as a profession.
3. Professional accountability of nurses to their clients is demonstrated when nurses
incorporate research evidence into their clinical decisions.
4. Research facilitates evaluation of the efficacy of nurses; practice which may
articulate their role in the delivery of health services.
5.Another reason for nurses to engage in research involves the spiraling costs of

health care and the cost-containment practices being instituted in health care facilities. With research,
costly trial-an-error and even unsafe interventions are avoided.

6. Research may allow nurses to make more informed decisions as each phase of the
nursing process is clarified through research.
Research also enables nurses to

7. understand a particular nursing situation about which little is known,

8. assess the need for an intervention,
9. identify factors that must be considered in planning nursing care,
10.predict the probable outcomes of certain nursing decisions,
11.control the occurrence of undesired outcomes,

12.provide advice to enhance client health, and

13.initiate activities to promote appropriate client behavior.

Process

• Identification/formulation of research

o problem anything that requires solution thru scientific

investigation. -

o Sources of problem :
 C – concepts (Ca, PTB, MI)

 L – literature, essays, books, journals

 I – Issues

 E – experience
  N – Nursing problems

 T – theories

o Characteristics of a research problem

 G – general applicability and use

 Re – Researchable

 F – Feasible and measurable

 F – actors of a feasible research :

• time, money, experience of the researcher, instruments,

population

 I – importance to nursing profession

 N – novelty/originality

• Plagiarism/illegal replication – unauthorized use of

another’s literary work without any consent or
permission

 S – significance to nursing

o 2 types of research according to use

 basic/pure research

• only the research benefits the research

• It is only for your personal necessity

• Answers your own question

 Applied research

• problem solving
 • Solving the problems of the patient.

o Variable – subject to change

 Kinds of variable

• Independent variable

o use this to stimulate a target population

• Dependent variable/Effectual variable

o results of the effects of the study

• Intervening Variable

o Comes between dependent and independent

o Example: orghanism variable, internal factor,

sex, gender, color

• Extraneous Variable

o External infuences that can be changed

o Example: citizenship, educational status

• Dichotomous Variable

o 2 choices/ 2 results

o Example: Male/ Female

• Polychotomous Variable

o Multiple choices

o Example: Preferred foods – Chinese, Japanese,

American. . . .

Examples:
“A comparative Study in the Income of Filipino Nurses Employed in P.G.H.
and N.Y.G.H.”

Independent variable : PGH and NYGH (place of work)

Target population : Filipino nurses

Dependent variable : income

Research:

1. Identify the Problem

2. Purpose – objective using SMART (Systematic, Measurable, Attainable,

Realistic, Time Bounded)

3. Define Terms

a. Conceptual Definition – dictionary definition

b. Operational Definition – defined in accordance on how the

researcher used the word

4. Revision of Terms

• Review of related literature

o Purposes :

 to have an update regarding your topic

 to have a basis of theoretical and conceptual framework

o Main sources of literatures

 Conceptual

• Formulated

• Authors

• Can be sold

• Books – general use

  Research

• Researcher

• Research works only

• Future research purpose only

• Formulation of conceptual and theoretical framework

o THEORY – relationship between concepts

O CONCEPTUAL FRAMEWORK

 diagrammatic and structural presentation of the problem

hypothesis

o Paradigm

 actual structural presentation of your conceptual framework

• Formulating hypothesis

o 5 types of hypothesis

 Null/statistical hypothesis

• shows no relationship or difference between an

independent variable and dependent variable.

• ID = DV

• Eg. “There is no difference regarding professional

opportunities of Filipino Nurses working in the
Philippines from those working in USA.”

 Simple/Operational hypothesis/Alternative hypothesis

 • this shows relationship between a single independent
variable from single dependent variable.

• Eg. “Filipinos Nurses working in USA has more

professional opportunities than those working in the
Philippines.

 Complex hypothesis

• this shows a relationship between two or more

independent variable from two or more dependent
variable.

• Eg. “Filipino nurses who worked for 5yrs and passed the
CGFNS, TORFL, TSE, NCLEX has greater
opportunities in NY as compared to those in Manila

 Directional hypothesis

• specifies the direction of the relationship between

variables

• Eg. “Filipino Nurses working in the USA has more

professional opportunities than those working in the
Phils.”

 Non-directional

• only predicts the relationship, but has no specific

direction between variables.

• Eg. “There is a big difference between a Filipino Nurses

working in USA than those working in the Phils.”

• Selecting research design

o Systematic controlled plan for finding the answer to a problem

o Roadmap, blueprint of the study

o Should have a proper resign design

o If improper research design, there will be improper collection of data

o Purpose : key or tool for proper collection of data

o Types

 According to Application

• Basic/ Pure

o For personal knowledge, curiosity

• Applied

o Based on problem solving approach

 According to Methods

• Experimental

o performing active manipulation, observe and

record the result.

o Types of Experimental Reseach

 control

• divide grp into 2.

• Group a – control/comparison grp –

will use the same soap everyday

• Group b – experimental grp – those

who will use the sample soap
  randomization

• using sample by chance.

• Choose randomly to avoid

redundancy of result

 Manipulation

• Performing intervention

 Validation

• comparison of the effects

 Quasi-experimental

• false experiment.

• No control sample.

• Non-experimental

o No manipulation is done. Only observation,

describe and record down the result.

o Types of non-experimental research design

base on time element

 Retrospective (Ex Post Facto)

• Getting actual experience

• Studies a group of people after its

occurrence, experience or facts.

• Experience of people in the past

 Descriptive
 • Observe, describe & record.

• Study of current events.

 Prospective

• Study of research about future

occurrence or future events.

 Historical

• Past that is written, documented,

published and recorded

• Primary Data

o Observe

o 1st hand information

o person himself

• Secondary Data

o 2nd Hand Information

• About the past using records,

journals, books.

• Study of the dead people thru his

written materials, facts

o according to data

 quantitative

• data base on numerical

interpretation, datas that are
measurable, using your senses,
data that are observable.

 qualitative
 • subjective data, feelings,
perception, beliefs, culture,
attitude

o Survey Research Design

 Group

• Small

• Face to face

• Large – not good result

 Methods

• Mailed survey

• Face to face

• Telephone survey

o According to Time Orientation

 Cross Sectional

• Applicable to 2 or more identical

group

• Short term

• For comparison

 Longitudinal

• 1 group only

• with initial and follow up survey

• long term study

• for developmental study

• Selecting your population and samples

o sample

 part of population, data is collected.

 The recipient of the experimental treatment in experimental

design or the individuals to be observed in a non-
experimental design

o Types of sampling

 Probability - equal presentation/ chances in the population.

• Simple random technique

o Used a single/identical group.

o Fish bowl technique

• Stratified random sampling

o You will first going to create a sub population

from the whole population before doing
randomization.

o One population, you divide it.

• Cluster random sampling

o You will first create a sub area in a population

before doing the randomization. In one
population, you make it smaller

• Systematic random sampling

o choosing a sample every nth name in the

population.
 o Multiple of 100 names

o Sampling frame – list of names appearing as

your population

 Non-probability sampling – you are not choosing by

chance.

• Accidental/ convenience sampling

o Base on the accessibility/availability of your

sample.

o Kung sino pinakamalapit syo, yun ang kukunin

mo.

• Purposive/judgmental sampling

o base on the common knowledge or popular

knowledge.

• Snow-ball sampling

o get sampling base on last referral

• Quota Sampling

o Setting criteria and getting samples fitting the

criteria

• Conducting pilot studies

• Collecting data

o types :

 questionnaires – use of pen and paper method

 • dichotomous – divided into two. Eg. true orfalse. Yes
or no

• rating scale – poor 1, good 2, better 3, best 4

• multiple choice

 Interview – use of oral method of collection of data. Use of

active listening

• Structured – with checklist, formal talk, list of question

• Unstructured – informal talk, no pattern, anything

goes

 records – pre existing data

 observation – use of ocular method using your senses

• participant observation

• non-participant observation

• Problems :

o Hawthorne’s effects

 The data you get from your sample is

not accurate.

 The sample has a problem

 Solution : double blind research – they

should not be conscious that they are
being studied

o Halo effect

 The researcher has a problem.

 He is manipulating the data collection.

  It is affected by special
feelings/treatment between the
researcher and the sample.

• Analysis of Data

o part of research when the researcher is forming a body of

knowledge out of data collected for the purpose of affirming or
denying your hypothesis

o Methods

 Nominal method

• get data by means of categories.

• eg. male, female, income

 Ordinal method – base on rank eg. mild, moderate, severe

 Interval

• base on the distance between 2 numerical values

• eg. BP – 150/100 – 120/80, wt, circumference, ht

 ratio – 3:10 children are malnourish

• Interpretation of Data

o 2 Methods

 quantitative method – base on numerical or graphical

standards

 qualitative method – use of narrative words

• Communicating your conclusion

 o Explaining the results of your work to the public

o Conclusion – final answer to your research

o Recommendation – suggestion to others

o Dissemination of Information

 Methods :

• thesis/book – written form

• symposia/symposium – oral presentation

• publish – a lot will be able to read your research

SURGICAL SCRUB, GOWNING AND GLOVING

Surgical Scrub
 Surgical scrub is the removal of as many bacteria as possible from the hands and arms by mechanical
washing and chemical disinfection before taking part in a surgical procedure.
Purpose
 Surgical Scrub helps prevent the possibility of contamination and infection of the operative wound by
bacteria on the hands and arms.
Types
Complete Scrub – it usually takes 10-15 minutes. This time may vary in different hospitals, depending upon

the frequency of the scrubs. This is done:

1. Before the first gowning and gloving.
2. Following a clean case if the gloves have holes in them.
3. Following a clean case if the gloves have been removed inadvertently before the gown.
4. Following a clean case if hands been contaminated in ay other way.
5. Following a contaminated case, before starting the next case.

Short Scrub – it is usually takes 5-10 minutes. This scrub is done following a clean case if the hands and arms
have not been contaminated. It is done to remove bacteria that have emerged from the pores and multiplied
while the gloves were worn.
PREPARATION BEFORE DOING SURGICAL SCRUB:
 Attend to your personal needs.
 Adjusts your cap and mask properly. The hair should be confined inside the cap. The mask should
cover the nose, mouth, cheek and chin.
 Roll up sleeves of the uniform 3 inches above the elbow if sleeves are long

 Check on the liquid soap and brush dispenser.

 Remove your jewelry.

 Check on your fingernails. They must be kept clean and short to reduce the bacteria count and to

prevent the puncturing or tearing of gloves.

SCRUB-UP TECHNIQUE

 Take note of the time you started scrubbing

 Wash hands and arms with soap and water to remove superficial dirt and bacteria.

 Get the sterile brush with the right hand in such a way that it faces up.

 Saturate the brush with soap and water and start scrubbing from the fingertip, to the four corners of

each finger, to the dorsum, palm and wrist. Do this for 2 1/2 minutes, rinse.
 Transfer the brush to your left hand. Saturate it again with soap and water and do the same as in no 3
(5 minute for both hands).
 Transfer the brush to your right hand. Saturate it again with soap and water and brush the left arm from
the wrist up to 2 inches above the elbow. Rinse, Do this for 2 ½ minutes.
 Transfer the brush to your left hand and do the same as in no. 6 (5 minutes for both arms) hence a total
of ten (10) minutes, from the tip of the fingers up to 2 inches above the elbow.
 Drop the brush in a pail provided for used brushes. Rinse both hands and arms well taking care the
flow of water is from the hands down the elbows.
POINTS TO REMEMBER IN SURGICAL SCRUB:
 Rinse as often as possible using one direction only. Start from the hand going to the arm taking care
not to touch the faucet and the sink.
 A person with cut or burn should not scrub because of the high bacterial count.
 The hands and arms can never be rendered sterile no matter how long or how strong the antiseptics
Surgical scrub is most effective when firm motion is applied. Short horizontal or circular
stroke could be
used.
 Use an ample supply of antiseptics
 Since the hands are to be cleaner than any other area, after the initial hand wash,
they are held higher
than the elbows during the rest of the procedure to prevent water from running back the
scrubbed
hands.
Gowning
 The sterile gown is put on immediately following the surgical scrub.
Purpose
 The sterile gown is worn in order to permit the wearer to come within the sterile
field and carry out
sterile technique during an operative procedure.
Parts of a Gown
1. Right Side
6. Neckband
2. Wrong Side
7. Belt
3. Body
8. Hemline
4. Sleeves
9. Back ties
5. Cuffs
PREPARATION FOR STERILIZATION
The gown is folded lengthwise with the wrong side out and facing the wearer
A. Unassisted (Self-service)
•
Grasp the gown at the center or you may receive it from the circulating nurse
•
Step one or two feet away from the sterile field to have an adequate working space.
•
Unfold the gown and expose the hemline portion. Dry your hands and arms with this
small
portion. Use each side of the folded gown in drying each hand and arm.
•
Continue unfolding the gown and locate for the armhole.
•
Slip your hands into each armhole and hold your hands and arms straight and obliquely
upward.
The circulating nurse will fix it.
•
Stop and swing your body to the right, then to the left. The circulating nurse will catch
the belt of
its ends as you swing.
B. Assisted
•
This is done by the scrub nurse when she is already completely sterile, i.e. she has
donned the
gown and the gloves.
•
Pick up the gown directly from the table or receive it from the circulating nurse.
•
Unfold the gown slowly and serve the hemline portion to the surgeon.
•
Continue unfolding the gown while the surgeon is drying his hands and arms
•
When serving the gown, your gloved hands should come in contact with the right side
portion of
the gown under the protecting cuff made.
•
Show the opening and armholes to the surgeon.
•
As soon as the surgeon inserted his hands through the armholes, leave it. The circulating
nurse
will fix it.
RESPONSIBILITY OF THE CIRCULATING NURSE IN THE APPLICATION OF
STERILIZATION
 She places hands inside of the gown near the shoulder of scrub nurse and aids her in
putting on the
gown.
 She grasps ends of the gown’s belt without touching the upper part of sleeves of the
gown

 She ties the belt at the back of the gown, keeping belt ends away from the sterile part of the gown. She
ties the back ties after trying the belt.
POINTS TO REMEMBER IN GOWNING:

 This is done after the surgical scrub.

 Use an oscillating motion pat dry in drying the hands and arms. Start from the hand going to the arms

 Do not dry hand then arms and return to the same hand

 In drying the hand and arms, the hemline portion of the gown or a towel could be used. If a towel is

used, dry one hand and arm on one end of the towel and use the opposite end to dry the other hand
and arm.
 In serving the gown, do not turn your back on the sterile field to prevent contamination.
 In picking the gown from a sterile line pack, be careful not to touch any other articles in the pack with
the bare hands.
GLOVING TECHNIQUE:
This is done after the gowning technique.
PURPOSE:
 Gloves are worn to complete the sterile dress in order that the one who wears them may handle sterile
equipment