NURSING RESEARCH

Gilbert T. Manacmul R.N. Jerome Africa R.N.

RESEARCH

Research means
To

Search Again. To examine carefully.

Research seeks answers to questions in an orderly and systematic way. It is a method of problem solving.

Definition of Research It is diligent (careful), systematic inquiry or study that Validates and refines existing knowledge and develops new knowledge .
2

NURSING RESEARCH
Definitions A scientific process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences clinical nursing practice. Nursing research is systematic inquiry designed to develop knowledge about issues of importance to the nursing profession, including nursing practice, education, administration, and informatics.

WHAT DOES RESEARCH DO?

Research enables nurses to: Describe the characteristics of a particular nursing situation about which little is known. Explain phenomenon that must be considered in planning nursing care. Predict the probable outcome of certain nursing decisions made in relation to client care. Control the occurrence of undesired client outcomes. Initiate, with a fair degree of confidence, activities that will achieve desired client behavior.
4

WHY DO NURSES NEED RESEARCH?

For the continuous growth of nursing profession. Helps nursing to achieve its own professional identity. Helps to identify the boundaries of nursing. To define the parameters of nursing. For cost containment practices.
5

I. STATUS OF RESEARCH IN THE PHILIPPINES

STATUS OF RESEARCH IN THE PHILIPPINES

In the Philippines, nursing research prior to and during the 60s was mostly in nursing administration 51%, and nursing education (33%), while patient care and related studies received minimal attention, with only 13% and 3% respectively. The teaching of research in the undergraduate level was integrated in the curriculum in the mid-sixties. It was aimed at familiarizing the students with skills in scientific investigations, developing a positive attitude toward research, and enhancing interest in their own studies. At this time the only research university in the Philippines is DLSU and the country is lagging behind from other Asian countries in the race of producing research studies.

II. EXAMPLE OF CONTRIBUTION TO CLINICAL IMPROVEMENT

EXAMPLE OF CONTRIBUTION TO CLINICAL IMPROVEMENT

Numerous clinical practice changes over the past 2 decades reflect the impact of research. For example, a recent nursing study documented that Kangaroo care (the holding of diaperclad preterm infants skin-to-skin, chest-to-chest by parents) now widely practiced in neonatal intensive care units (NICUs) in the United States (Engler et al., 2002), but this is new trend. As recently as the early 1990s, only a minority of NICUs offered kangaroo care options. The adoption of this practice reflects the accumulating evidence that early skin-to-skin contact has clinical benefits without any apparent negative side effects (Anderson et al, 2003) some of that accumulated evidence was developed in rigorous studies by nurse researcher in the United States, Australia, Canada, Taiwan, and other countries (Chwo et al, 2002).

III. HISTORY IN NURSING RESEARCH

10

HISTORY IN NURSING RESEARCH

Began with Florence Nightingale over 150 years ago (1850). In (1859) describes her initial research activities which looked at the importance of leading environment in promoting physical and mental well being

Ventilation Cleanliness Purity of water Diet

11

HISTORY IN NURSING RESEARCH

In addition collected the data of morbidity from Crimean War this made the military provide:

Enough food. Clear quarters for the sick. Appropriate medical treatment.

These interventions made impact on public health (military help)

drastically reduces mortality from 43% up-to 2% in the Crimean War. Testing public water Improve sanitation preventing starvation.
12

HISTORY IN NURSING RESEARCH

1900- 20s

First Journal Published American Journal of nursing (1900)

Case

study appeared ( 1920 - 1930)

In-depth analysis and systematic description of one patient or group to promote understanding of nursing Research. Little research done except for a few important educational studies recommending establishing School of nursing in a university. (Gold mark report, 1923)
First doctoral program for nurses was at Teachers college in Colombia. (NYC) in 1924.
13

HISTORY IN NURSING RESEARCH

1950
American

Nurse Association (ANA) initiated a five year study on nursing functions and activities. Clinical Research began Research took on new importance due to vision of Virginian Henderson & Faye Abdullah;
One

could see more nurses with Master's degree and School of Nursing began introducing research as a separate course
14

1952
First Journal Of Nursing Research published. Researches conducted at Baccalaureate and masters level.

1953

The institute of Research and services in Nursing education established at teachers collage Columbia University, New York.
Provided

learning experience in research for Doctoral

studies.

late 60's saw more research being done that imported clinical and quality of care
15

1970's

Saw nursing process as focus for many studies. Saw increase in number of nursing theories and models. Image: Journal of nursing scholarly, first published in 1967 and Advance in nursing science in 1978 ( Including Nursing Theories) by STTI.

To tackle the issue of communication / dissemination of information

Council of Nurse research establish

16

1980's

Clinical research became the important design in research

Saw many new journals being published e.g. Cancer nursing; Pediatric nursing, Dimension of critical care nursing etc.., Applied nursing research.
Clinical research written priority of the 80's

increase funding for nursing research.

The ANA achieved a victory by establishing the National Center for Nursing Research in 1985.
17

Priorities of National Center for Nursing Research 1999 includes:

Community

based nursing models. of nursing interventions in

Effectiveness

HIV/AIDS.
Cognitive Living

impairment.

with chronic illness.

18

IV. IMPORTANCE OF NURSING RESEARCH

19

WHY IS RESEARCH IMPORTANT IN NURSING?

Knowledge generated through research is essential to provide a scientific basis for:-

Description

What exist in N/practice and discover a new knowledge.

Explanation

Explains the existing knowledge in relation to the effect and the outcome

Like bed sore occur in the old people due to lack of mobility

Prediction

A nurse could predict the out come on the bases of interventions

Control

Ability to write a prescription to produce the desire result.

20

THE IMPORTANCE OF RESEARCH IN NURSING

With evidence based practice, research provides the best clinical evidence in making patient care decisions. Nurses are accepting the need to base specific nursing actions and decisions on evidence indicating that the actions are clinically appropriate and cost-effective, and result in positive outcomes for clients. Nurses who incorporate high-quality research evidence into their clinical decisions and advice are being professionally accountable to their clients. 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. nurses need to document the effectiveness of their practice not only to the profession but also to nursing care consumers, health care administrators, third-party payers (e.g., insurance companies), and government agencies.
21

RESEARCH ENABLES NURSES TO

understand a particular nursing situation about which little is known, assess the need for an intervention, identify factors that must be considered in planning nursing care, predict the probable outcomes of certain nursing decisions, control the occurrence of undesired outcomes, provide advice to enhance client health, and initiate activities to promote appropriate client behavior
22

V. ROLES OF NURSES IN RESEARCH

23

ROLE OF NURSE IN RESEARCH PARTICIPATION AT VARIOUS LEVELS OF EDUCATION PREPARATION (ANA-1989)

BSN Degree
Critiquing & synthesizing research findings from nursing profession and other discipline for use in practice. 2. Provide valuable assistance in identifying research problems and collecting data for studies.
1.

Master's degree
1. To lead health care teams

Making essential changes in nursing practice Health care system based on research
24

2. Conduct investigations 3. Initial studies in collaboration with other investigators

CONTINUE

Doctoral Degree 1. Assume a major role in the conduct of research. 2. Generation of nursing knowledge in a selected area of interest.

Extend scientific basis Develop methods to measure nursing phenomena

Post doctoral degree 1. Assumed a full researcher role and has a funded program of research 2. Develop and coordinate funded research
25

ROLES OF NURSES IN RESEARCH

1. 2. 3.

4.
5.

6.
7.

Advocate of client or respondents during study Major/ principal Investigator Evaluator of a research findings Research problem identifier Informants/respondents/subjects/ participants or sample population Consumer of research findings Associate or member of research team
26

NURSES ROLE IN USING RESEARCH

Read widely and critically Attend professional conferences Learn to expect evidence that a procedure is effective Become involved in a journal club Pursue and participate in RU/EBP projects

27

VI. RESEARCH PRIORITY IN THE FUTURE

28

NURSING RESEARCH PRIORITIES

To Improve:

Nursing as a profession Nursing practice Patient outcomes

29

FUTURE DIRECTIONS FOR NURSING RESEARCH

THE FUTURE
1. Future focus is on outcome research assess and document the effectiveness of health care services 2. Future focus is on biophysiologic research 3. Promotion of evidence based practice research findings into research

4.

Development of a stronger knowledge base thru multiple, confirmatory strategies, Replication of studies with different clients in different clinical settings and at different times to ensure that the findings are robust. Trend is from in patient care to ambulatory care.

AREAS OF HIGH PRIORITY FOR NURSE RESEARCHER

Patient focused research The management processes within health care services Cultural issues for nurses and patients The history of nursing Ethical decision making Nursing and professional regulation Education of nurses Nursing workforce skills mix
33

REFERENCES

Polit, D.F., and Bech, C.T. Nursing Research; principles and Methods 7th edition, LWW. Burns, N., and Grove, S.K. (2007). Understanding Nursing Research; building an evidence based practice 4th edition, New Delhi, Elsevier. Anonymous, (n.d). Promoting Research in Clinical Practice: Strategies for Implementing Research Initiatives. Journal of Trauma Nursing, April/June 2009

Acknowledgements

Dr. Fauziya Ali Ph.D Tazeen Saeed Ali RN, RM, BScN, MSc ( Epidemiology)

34