1 INTRODUCTION TO NURSING RESEARCH.pdf

INTRODUCTION TO NURSING RESEARCH By : ALEX S. BORROMEO, MN, RN College of Nursing Summary of Lessons DEFINITION, SIGNIFICANCE RESPONSIBILITIES OF A EVOLUTION OF NURSING AND PURPOSES OF THE BEGINNING NURSE RESEARCH NURSING RESEARCH...

INTRODUCTION TO NURSING RESEARCH By : ALEX S. BORROMEO, MN, RN College of Nursing Summary of Lessons DEFINITION, SIGNIFICANCE RESPONSIBILITIES OF A EVOLUTION OF NURSING AND PURPOSES OF THE BEGINNING NURSE RESEARCH NURSING RESEARCH RESEARCHER Summary of Lessons EVIDENCE-BASED USE OF Paradigm OVERVIEW OF THE NURSING TECHNOLOGY IN RESEARCH RESEARCH RESEARCH PROCESS Objectives/Competencies Upon completion of this module, you are expected to: 1. Analyze the importance of research in the nursing profession. 2. Appraise the need for evidence-based nursing research in determining effective best practices and providing high quality care to the patients. 3. Recommend the use of technology in nursing research. 4. Explain the professional standards of ethico-legal conduct in nursing research. DEFINITION, SIGNIFICANCE AND PURPOSES OF THE NURSING RESEARCH  Research It is a systematic investigation that uses a thorough process of collecting, analyzing, and interpreting information to answer questions and solve problems with the goal of gaining knowledge on which we are interested. Goal of Research Answer questions Solve problems, and Contribute to the existing body of knowledge. Nursing research It is a systematic inquiry designed to generate trustworthy evidence about issues of importance to the nursing profession, including nursing practice, education, administration and informatics. Clinical Nursing Research is a kind of research to guide nursing practice and to improve the health and quality of life of nurses’ clients (patients). SIGNIFICANCE OF NURSING 1. Promote Evidence –Based Nursing Practice 2. Ensure credibility of the Nursing Profession 3. Provide accountability for Nursing Practice 4. Document the cost-effectiveness of Nursing Care 5. To develop valid generalizations using a systematized science 6. To provide basis for decision making in business, industry, education, government, and in other undertakings 7. To satisfy researcher’s curiosity 8. To find answers to queries by means of scientific methods 9.To expand or verify existing knowledge Remember: Nurses who base their clinical decisions on scientifically documented information, works in a professionally manner and accountable in their own actions. ROLES OF NURSES IN RESEARCH 1. Principal investigator 2. Member of a research team 3. Identifier of researchable problems 4. Evaluator of research findings 5. User of research findings 6. Patient/client advocate during studies 7. Subject/participant in studies  KINDS AND CLASSIFICATION OF RESEARCH KINDS AND CLASSIFICATION OF RESEARCH: 1. IN TERMS OF GOAL Basic / Pure Research – these are studies that may advance conceptualizations of theory in the topic of interest. Applied Research – It is used to test the effectiveness of the theories and principles. – addressing the research questions that may find solutions to the ongoing problems in the environment. Example: A clinical instructor wants to compare the effectiveness of the different instructional techniques for training the nursing students. KINDS AND CLASSIFICATION OF RESEARCH: 2. IN TERMS OF THE LEVELS OF INVESTIGATION Exploratory Research – it is the study of the variables in relevance to the specific situation. Descriptive Research – It is the study that deals with the relationships between variables. Experimental Research – It is the study that deals with the effects of one variable to the other variables. KINDS AND CLASSIFICATION OF RESEARCH: 3. IN TERMS OF THE TYPE OF ANALYSIS Analytic approach – This approach aims to recognize and separate the research question components. Holistic approach – This approach focuses primarily on the system going to the inner relationships. KINDS AND CLASSIFICATION OF RESEARCH: 4. IN TERMS OF THE CHOICE OF ANSWER TO PROBLEMS. Evaluation Research – This research is used when the researcher wants to find out the most beneficial information. Developmental Research – This research deals with developing the best process or best instrument that exists. KINDS AND CLASSIFICATION OF RESEARCH: 5. IN TERMS OF STATISTICAL CONTENT Qualitative research - It is a non-statistical research. Quantitative research - It is statistical in nature. KINDS AND CLASSIFICATION OF RESEARCH: 6. IN TERMS OF THE ELEMENT Historical - It finds answer to the question “what was..?” Descriptive - It finds answer to the question “what is..?” Experimental - It finds answer to the question “what will be..?” KINDS AND CLASSIFICATION OF RESEARCH: 7. ACCORDING TO SCOPE Action Research – Limited scope will be utilize to give solutions on particular problems. Improving Hand Hygiene Compliance in a Hospital Ward Problem: A hospital ward is facing challenges with maintaining consistent hand hygiene compliance among its nursing staff, leading to increased rates of hospital-acquired infections. Action Research Approach: Nurse researchers, in collaboration with the nursing staff and hospital administration, decide to conduct an action research project to address the hand hygiene issue.  BULSU COLLEGE OF NURSING RESEARCH PRIORITIES 1. GOOD HEALTH AND WELL-BEING 1.1. Disease Prevention 1.2. Diagnosis 1.3. Health Status of Vulnerable Groups 1.4. Functional Foods 1.5. Nutrition and Food safety 1.6. Health Education 1.7. ICT for Health 2. DELIVERY OF SOCIAL SERVICES 3. HAZARDS, VULNERABILITY AND RISK ASSESSMENTS 4. HEALTH RELATED POLICY RESEARCH UNITED NATIONS’ SDG (SUSTAINABLE DEVELOPMENT GOALS)  UNITED NATIONS’ SDG (SUSTAINABLE DEVELOPMENT GOALS) PURPOSE To solve the problem of mankind with the goal of making the world a conducive place for humanity to stay in.  UNITED NATIONS’ SDG (SUSTAINABLE DEVELOPMENT GOALS) RESEARCH ROLE It helps attain the development in any system in the world. Helps in the decision making process of different organizations.  UNITED NATIONS’ SDG (SUSTAINABLE DEVELOPMENT GOALS) Focus of United Nation on SDG: 1. No Poverty 2. Zero Hunger 3. Good Health and well-being 4. Quality Education 5. Gender Equality 6. Clean Water and Sanitation 7. Affordable and clean water 8. Decent work and economic growth  UNITED NATIONS’ SDG (SUSTAINABLE DEVELOPMENT GOALS) Focus of United Nation on SDG: 9. Industry innovation and infrastructure 10. Reduced inequalities 11. Sustainable cities and communities 12. Responsible consumption and production 13. Climate action 14. Life below water 15. Life on land 16. Peace, justice, and strong institutions 17. Partnerships for the goals  RESPONSIBILITIES OF A BEGINNING NURSE RESEARCHER Responsibilities of a Beginning Nurse Researcher 1. Engage in Nursing or Health-Related Research - As a beginning nurse researcher you are likely to engage in one or more activities along a continuum of research participation. - The two end points of nursing research have a variety of research activities in which nurses deal with. On one end of the continuum are nurses that consume research and at the other end are the nurses who conduct research and vigorously participate in the design and implementation of a study. Responsibilities of a Beginning Nurse Researcher – Research consumer – Includes the ability to read and critique research reports. As a nursing student, you are expected to maintain at least in this level of involvement with research. – Conduct research – Conduct research and vigorously participate in the design and implementation of a study. – Conducting a research is one of the most valuable educational experience a student can have. Responsibilities of a Beginning Nurse Researcher 2. Evaluate a Research Study/ Report - Evaluation of a research article requires a process of evaluative appraisal that critically appraises a research report’s content for scientific standard and application to practice. - Evaluating the research of others is a salient skill for any investigator. It is very important to have the ability to evaluate others works focusing on the quality of the methods they used, their findings and of course the conclusions that were made. Responsibilities of a Beginning Nurse Researcher – Find out if the conclusions drawn are congruent to the data presented. The benefits of evaluating a research study are as follows: – It will help you identify which research ideas, findings and conclusions you can focus and which one you may just ignore. – It can help you find out inconsistencies on findings obtained from other authors’ research studies and to be able to reconcile them. – It can give you a hint on how you can improve your own research studies. Responsibilities of a Beginning Nurse Researcher 3. Applies the Research Process in Improving Patient Care - Research utilization is the use of findings from studies in a realistic application. In research utilization, the importance is on translating new knowledge into real-world applications to upgrade the quality of patient care. ROLES OF NURSES IN RESEARCH 1. Main investigator - It also refers to the main researcher. 2. Member of a research team - A member that contributes to the fulfilment of research study. 3. Research problem identifier - You may formulate a problem that is researchable. 4. Research findings evaluator - You may critique research findings to find a solution to the research problem that you have which may help in the improvement of nursing practice. ROLES OF NURSES IN RESEARCH 5. Research finding users - You yourself as a researcher uses the body of knowledge found in literature which may be used in EBP. 6. Advocate of patients during research - While conducting a research with clients or patients, you can serve as their advocate or support. 7. Participant/ subject in research - you may participate in any kind of research by being a subject knowing that it is ethical and morally accepted. EVOLUTION OF NURSING RESEARCH EVOLUTION OF NURSING RESEARCH NR in 1980 The focus of NR= conduct of Clinical Nursing Research 1983: ANNUAL REVIEW OF NURSING RESEARCH 1st volume published 1985: Sigma Theta Tau International was the 1st organization to fund nursing research in US 1986: National Center for Nursing Research (NCNR) at the National Institutes of Health (NIH) – promote and support research projects and trainings related to patient care NR IN 1990 research on health promotion & illness prevention Outcomes Research = came out as important methodology; focus  Future directions of Nursing Research – Promotion of excellence in nursing practice USE OF TECHNOLOGY IN RESEARCH USE OF TECHNOLOGY IN RESEARCH Technology in the context of this lesson refers to the utilization of online or digital resources such as the internet or online library databases to acquire information and plays an essential part in research. The widespread usage of information in electronic formats by the use of internet and article databases has a substantial impact on the way students find and utilize research material. COMPUTER AS A RESEARCH TOOL A. Brainstorming assistance It is software used to organize information and generate data related to the research problem. B. Literature identification assistance Online databases can be used to come up with relevant research studies. C. Materials production assistance Software used to develop useful instructional materials. D. Data collection assistance Software used to monitor responses of participants. E. Graphic production assistance Software used to represent data in a graphic way for the execution of interpretation. F. Statistical assistance statistical and spreadsheet software is used for data sets analysis. G. Dissemination assistance desktop publishing software to produce documents that are professional looking. IT IS SUITABLE AT THIS POINT TO DEFINE A DATABASE AND SPECIFY HOW IT IS DIFFERENT FROM A SEARCH ENGINE. Database is a depository location like a library, where information is stored, categorized, sustained and modernized systematically. To give you an idea, Google and Yahoo are both search engines and MEDLINE is a database. Search engine It is a group of software programs that piles up information from the Web, index it and put it in a database so it can be explored. The task of a search engine is to retrieve the information in a format that is widely accessible and apparent on screen at an on-site library or even in downloadable, readable (full-text) written format. The two most useful databases in Nursing: 1. Medical Literature Analysis and Retrieval System Online (MEDLINE) – This database provides literature related to medicine, nursing and dentistry. Its focus is on information about biomedicine. 1. Cumulative Index to Nursing and Allied Health Literature (CINAHL) – This database comes up with authoritative coverage of the literature related to nursing and allied health. Other examples of Databases: 1. Cochrane Library - this is a regularly updated group of evidence-based medicine databases. 2. Nursing and Health Sciences: A SAGE FullText Collection - this database includes full-text journals. 3. ProQuest (Health Sciences & Nursing Journals) 4. PsycINFO - it is a database that includes journals from the social sciences. 5. Test and measurement databases, theses and dissertations EVIDENCE-BASED NURSING RESEARCH EVIDENCE-BASED NURSING RESEARCH Having best evidence, will come up to the best practice for the best outcome. Let us now define what is evidence-based practice. According to Polit, D. and Beck, C. (2018) evidence-based practice is the integration of best research evidence with clinical expertise and patient values. Kindly refer to figure 1.  Evidence-Based Research Patient Clinical Expertise Preference Figure 1 Evidence-Based Practice EVIDENCE-BASED NURSING RESEARCH Is a process of shared decision-making between practitioner, patient and others significant to them based on research evidence, the patient’s experiences and inclination or preferences, clinical expertise and other mighty sources of information. EVIDENCE-BASED NURSING RESEARCH A core aspect of EBP is recognizing the best available research evidence and merging it with other elements in making clinical decisions. Evidence-based nursing research provides relevant insights about human health and illness and nurses are anticipated to be lifelong learners. The following are the reasons why we need to use evidence-based practice: It leads to highest quality care and patient outcomes. Reduce health care costs. Meet the expectations of an informed public. Institutions that use EBP have better staff contentment and lower turnover rate.  Clinical Scenario: You are a student nurse in a rehabilitation center. One morning while you are having your rounds for vital signs monitoring, patient Peter who had total hip replacement four days ago tells you that she is planning for a very long airplane adventure. You know very well that a lengthy plane ride will elevate her risk of deep vein thrombosis and ponder whether compression stockings are beneficial in- flight treatment. As a student nurse, you have to decide and search for the best possible evidence to answer this question. Clinical Scenario: Remember: In this clinical situation, research evidence can be utilized to improve nursing care. Individual nurses can personally examine evidence to better address specific problems. You can have have a literature review most especially from the nursing research studies for your best possible evidence. PARADIGMS  PARADIGMS A paradigm is a set of basic beliefs or metaphysics that deals with ultimates or first principle. Lincoln and Guba, 1985  PARADIGMS worldview that defines for its holder the nature of the world, the individual’s place in it, and the range of possible relationships to that world and its parts.  PARADIGMS Paradigms for human inquiry are often characterized in terms of the ways in which they respond to basic philosophical questions. Polit and Beck, 2008  PARADIGMS USED IN RESEARCH POSITIVISM – assumes that the laws operate according to strict, logical reasoning. precise quantitative data and often used experiments, surveys, and statistics. Auguste Comte (1798 – 1857)  PARADIGMS USED IN RESEARCH POST POSITIVISM – human knowledge is not based on unchallengeable, rock-solid foundations. Knowledge can be modified or withdrawn in the light of further investigation. Started with Sir Karl Popper (1902 – 1994) Positivist Approach vs Post-Positivist Approach Research Question: Does a specific teaching method improve students' understanding of complex concepts? POSITIVIST APPROACH POST-POSITIVIST APPROACH Experiement with controlled conditions. Experiement but with more varied - Two groups: one group taught using the perspective new method and the other using the - Quantitative might not capture the traditional method. entire picture ; use Qualitative as - CONCLUSION - Effective if the well. statistical analysis shows a significant - New method has both benefits difference in test scores between the and drawbacks, recognizing the two groups. complexities of the educational process Return  PARADIGMS USED IN RESEARCH NATURALISTIC – reality is not a fixed entity but rather a construction of the individuals participating in the research – reality exists within a context, and many constructions are possible. Idea from Thales (624 BC – 546 BC) was carried on with Galileo Galilei (1564 –1642)  Deconstruction is taking apart old ideas and structures. Reconstruction is putting ideas and structures together in new ways.  Naturalistic Approach Deconstruction in Social Science Reconstruction in Social Science Research: Research: A social science researcher wants to Following the deconstruction of gender deconstruct the concept of "gender roles, the researcher engages in roles" within society. They critically reconstruction. They propose a new analyze historical and cultural factors model that recognizes the fluidity and that have shaped traditional gender diversity of gender identities and roles. roles and led to unequal power This reconstructed perspective aims to dynamics. Through deconstruction, they challenge traditional norms and reveal how these roles have limited promote a more inclusive and equitable opportunities for certain groups and society where individuals are free to reinforced harmful stereotypes. express their gender identity without facing discrimination.  PARADIGMS USED IN RESEARCH INTERPRETIVE – access to reality is only through social constructions such as language, consciousness and shared meanings. Schultz, Cicourel, and Garfinkle, and the Chicago School of Sociology are the origins.  Interpretive Approach Example - Patient Experience and The researcher might conduct Communication: interviews with patients to explore their perceptions of effective communication Imagine a nurse researcher interested in and the impact it has on their overall understanding how patients with healthcare experience. chronic illnesses experience communication with healthcare The study might reveal that patients providers. from diverse backgrounds interpret effective communication based on factors such as empathy, clarity, and involvement in decision-making.  PARADIGMS USED IN RESEARCH CRITICAL PARADIGM – aims to critique and transform the social, political, cultural, economic, ethnic, and gender structures that constrain and exploit humankind by engagement in confrontation, even conflict. Developed by Horkeimer, Adorno, and Marcuse at the Frankfurt School of Critical Thinking.  PARADIGMS USED IN RESEARCH FEMINIST PARADIGM – aims to emancipate women and improve their lives. – to elucidate bias and inequity in the way women are treated – to fill-in the gaps in our knowledge about women.  CATEGORIES OF RESEARCH QUANTITATIVE RESEARCH – Allied with positivist tradition – Imposes control mechanisms – Empirical evidence (objective reality) – Data gathered through structured instruments – Numeric information eg. Statistics – generalizability  CATEGORIES OF RESEARCH QUALITATIVE RESEARCH – Associated with naturalistic inquiry – Explores on issues of human complexity Experiences – Interviews and narrations – The researcher synthesizes on the data verbalized by the participants  Think About This Quote “Not everything that counts can be counted, and not everything that can be counted counts” Albert Einstein REFERENCE MATERIALS  Accountability - Challenge in the hospital Medications are administered accurately and at the right new protocols for medication checks, enhance time communication strategies among the nursing team, and create amore conducive environment Design : Investigate the for focused medication administration. factors contributing to medication errors and delays. Contributing Factors: Workload, communication breakdowns, and distractions Return Document the cost-effectiveness of Nursing Care Nurse-Led Fall Prevention Program in a Senior Care Facility Return  Nursing Hand Hygiene Practices in a Hospital Setting Exploratory Research Descriptive Research Experimental Research Variables (insights into their attitudes, Tests the impact of an Uncover initial patterns and perceptions, and barriers related to intervention on hand hygiene potential factors hand hygiene towards Patient compliance Outcomes Return IN TERMS OF THE TYPE OF ANALYSIS Analytic Approach: Holistic Approach: Nurse-patient communication process Overall patient care experience within a healthcare facility verbal cues, nonverbal gestures, and interactions between patients, nurses, patient responses physicians, and the physical environment Return  IN TERMS OF THE CHOICE OF ANSWER TO PROBLEMS Evaluation Research Developmental Research Current pain assessment tool vs design a new pain assessment tool increasing staffing levels on the nursing floor. new electronic health record system Return Evidence-based Nursing Practice Return  Pure / Basic vs Applied Research PURE / BASIC RESEARCH APPLIED RESEARCH hormone levels, heart rate, and given the wrong mood when patients engage in medications due to laughter therapy sessions similar drug names. Curiosity-driven color-coded labels on exploration medication bottles Return