Research Oct 6, 2010 1

Research Oct 6, 2010 1

N105:12Class 8, October 6, 2010

Nursing Research:Asking Questions - Seeking Knowledge


Class Objectives1. Discuss the nature of inquiry-asking question

2. Discuss approaches to knowledge development through nursing research

3. Discuss the importance of using ‘evidenced informed’ practice

4. Identify examples of nursing research


Do any of you have experience related to

research?


Definition of Nursing Research “Research is the primary means by

which new knowledge is discovered and brought into practice to improve the care that nurses provide to their clients. It is a systematic process in which questions that generate knowledge are asked and answered. This knowledge becomes part of the scientific basis for practice and may be used to validate interventions”.

Potter, Perry, Ross-Kerr & Wood (2010, p.80).


Evidence-informed Practice Evidence-informed practice provides a safety

net for nurses and other health professionals because it enables them to make accurate, timely, and appropriate clinical decisions.

Evidence-informed practice is the integration of the most informative research evidence with evidence from experts clinical practice and other sources to produce the best possible care for clients.


Know these terms: Nursing Paradigm: a philosophical or theoretical

framework, a way of thinking about concepts: person, environment, health and nursing care.

Qualitative Nursing Research (subjectivity- personal experience –stress associated with the study of breast lumps?)

Scientific Nursing Research (can be precisely measured and quantified) examples -pain severity, wound healing, body temperature


Types of Nursing Research 1. Quantitative

Research- The investigation of phenomena that lend themselves to precise measurement and quantification, often involving a rigorous and controlled design.


Types of Nursing Research2. Qualitative Research- examines the individual’s viewpoint;

does not use statistical measurement;

Main ways of obtaining data: Observation, interview.

Example: Phenomenology-describes the lived experience of a specific fact or event from the person’s point of view: Study the lived experiences of women who have breastfed their babies exclusively for 6 months.


Purpose of Research Provides answers to questions that are puzzling Builds upon knowledge that is already in existence Issues related to client population and health

concerns can be addressed Some theories are developed and others are tested. Improves nursing practice and education Appropriate utilization of funds


Let’s Review your Research ArticleYour Assignment

1. What is your research article about?

2. What makes it a research article?3. How does it contribute to nursing

knowledge?4. Do you understand how essential

nursing research is?


How do you know if the

journal article is

a true research article?


What Are The Characteristics (elements) Of A Research Article (Paper)? How Do You Know It Is A Research Article?

Evidence informed articles include the following elements:

Must read & study text

“Critique the evidence”

1. Abstract

2. Introduction

3. Literature review

4. Manuscript narrative

5. Purpose statement

6. Method or design

7. Results or conclusion

8. Clinical implications

Potter, Perry, Ross-Kerr & Wood (2010, p. 78-79)


You completed readings related to nursing research and then searched and found a research article that interested you. What did you learn from the research article you selected? -e.g. insight into the methods, findings, usefulness to practice, etc…?


OBSERVE! LISTEN! ASK! There's an art to nursing, but its most basic skills —

observing, listening and asking questions — are also the foundation of scientific inquiry.

Using research to look critically at the "way things have always been done" is an expected role for nurses. Nurses must learn how to ask research questions, aimed at finding care practices, that support the best outcomes for patients (clients) of all ages.


Major Components Of Research-based Practice

1. Investigate a research question

2. Dissemination/sharing of research findings

3. Use of research in practice


Example of Research – Origin & Outcome

Karen Wilkinson, ARNP, an oncology nurse practitioner, repeatedly heard parents wish they could do something for their children during painful procedures. She also saw the anxiety experienced by children anticipating lab visits and treatments.

So she developed a comfort kit for parents and clinicians to use with children who were experiencing fear.

To evaluate the usefulness of this new tool, Wilkinson studied patients and families before and after using the kit. Nurses at Children's Clinical Research Center, experts in obtaining consent and collecting research data, helped her.

Outcome: Patients and parents overwhelmingly rated the distraction props in the comfort kit — pinwheels, bubbles, squish balls, imagery cards and various types of puzzles — as very effective.


Use research: Be accountable

By using evidence from research findings and clinical expertise

and experience to inform their practice,

nurses are (most importantly) demonstrating

accountability for quality patient care


Discuss The Nature Of Inquiry- Asking Questions

Study p. Potter & Perry p. 82-83

Know the difference between the Scientific Paradigm & Qualitative (interpretive) paradigm

What is a researchable question? Why is it important?


Knowledge Development in Nursing Patterns of Knowledge in Nursing

( Carper, 1978 & Chin & Cramer. 2008)

1. Empirics: the Science of Nursing (systematically organized-laws, theories, models)

2. Esthetics: the Art of Nursing (knowing & understanding)

3. Personal knowledge: Nurse Patient Relationship (interpersonal, therapeutic, rapport)

4. Ethics: the Moral Component (what ought to be done –code of ethics, dilemmas, conundrums)

5. Emancipatory knowing: the social, economic & political component (injustice, inequity, need for change)


Reflection Exercise Using Model of Knowing (Carper (i-iv) & Chin & Cramer’s (v)

1. Apply:a) Think of something you have done b) Think about the knowledge you have in each area

i. Empirics ( knowledge/fact to describe what you know)

ii. Esthetics, (knowledge, understanding, interpreting behaviour)iii. Personal knowledge (personal to individual, interpersonal, personalizing

care)iv. Ethics (right, justice, what you should do)v. Emancipatory knowing (recognize problem, injustice, inequity …)

2. Examples could be driving to school or work, babysitting some children, caring for someone in the community, meeting with friends this past weekend, talking to a friend, Anything that gets you thinking about what you know and how you know it and then perhaps what you don’t yet know.


The next class portion is a video clip of an interview with Dr. Judith Shamian, President of CNA who talks about Nursing Research. & Leadership: Listen attentatively (HINT) The value of Nursing Research Importance of Nursing Research to you the

Nurse How to use nursing Research


http://www.viddler.com/explore/rfraser/videos/60/


Development of Research in Nursing Historical Milestones:

Florence Nightingale observed issues concerning nutrition and hygiene practices during the Crimean War

StFXU Nursing BScN (1928) Weir Report (1932) Nursing education transferred to educational settings Nurses started using the scientific process First fully funded PhD Program in Nursing (1992) PhD in Nursing at Dalhousie (2004)

Potter & Perry, 2010, p. 81.


Historical Development: Nursing Research in Canada is Born Cont’d

Masters and PhD programs evolved as well as funding agencies

1956- University of Western Ontario- first MN program 1991-University of Alberta first doctoral program 1964-First nursing research project was funded federally 1969-The first Canadian Journal of Nursing Research was

published at McGill University “Nursing Papers” 1982-First funding agency for Nursing Research-Alberta

(Milestones-Refer to Potter et al. 2010, p.81-82)


Research ProcessResearch Process (Potter & Perry (2010, text p.826-89)

Hypothesis: Hypothetical situation tested to confirm or reject

1. Research Process Researchable question Literature search

2. Purpose

3. Design

4. Sample

5. Method

6. Analysis

7. Answer/Conclusion

Research Designs

1. Quantitative

• Experimental

• Descriptive

• Explorative

• Data analysis

2. Qualitative

3. Ethnography • (observation & description of behaviour)

4. Phenomenology (lived experience)

5. Grounded Theory generates hypothesis inductively


Evidenced-based Decision Making Decisions are made based on the best

possible evidence at that time. Quality patient care is the major focus

when making evidenced- based decisions. Morals and values of the individuals

involved in the decisions play a significant role.


Evidenced-based Decision Making The data collected

through research, needs to be applied to nursing practice once it has been evaluated and processed through the appropriate channels.


Ethical Considerations re Research Institutions need a Research Ethics Board to

review research proposals. The board will decide if the proposed study follows established ethical principles.

An informed consent is required from the participants outlining what is going to be studied. The rights of research subjects must be protected.


Involvement in Research

Nurses need to welcome and be open to research. Each nurse can be involved with research at some

point in their career (understand, interpret, apply, participate, enable, and or lead).

The more advanced the education level, the more involved the person should become.

Advances in research are meaningless unless research reaches nurses at the point of care. “Research utilization” is

very important.


Research Utilization The results of one study are not enough

evidence to change your practice. Must assess multiple studies, consider

systematic reviews “ an examination of all the research on a given topic that critically examines the methods used and provides a summary.”


How You Can Participate In Research

Using research findings to change clinical practice***

Use findings to improving client outcomes Identify researchable questions Collecting data Being on a research team Design studies Maintaining health care costs


Summary1. The nature of inquiry-asking question

2. Approaches to knowledge development through nursing research

3. Importance of using ‘evidenced informed’ practice

4. Your involvement in nursing research

Research Oct 6, 2010 1

Documents

research questions

research data

qualitative research

purpose of research

quantitative research

scientific nursing research

examples of nursing

types of nursing research