EVIDENCE-BASED PRACTICE

AND

NURSING

RESEARCH

Nursing research

providesthe foundation for evidence-basednursing practice

Evidence-based practice

The process of systematically finding, appraising, and using research findings as the basis for clinical practice - for making decisions about patient care.

Development of Nursing Knowledge

Evidence-Based Practice (research-based practice, best practice)

Integration of best research evidence with clinical expertise and patient values

Evidence-Based Practice

A move toward supporting practice with evidence began in the mid-1980s.

Agency for Healthcare Research and Quality oversees publishing reviews of evidence and clinical guidelines and supports nursing research.

The practice of Evidence-Based Practice includes five fundamental

stepsStep 1: Formulating a well-built question

Step 2: Identifying articles and other evidence-based resources that answer the question

Step 3: Critically appraising the evidence to assess its validity

Step 4: Applying the evidence

Step 5: Re-evaluating the application of evidence and areas for improvement

DEFINITION OF NURSING RESEARCH

Nursing research is a systematic approach used to examine phenomena important to nursing and nurses, that clinical practice be based on scientific knowledge. Research is a process of systematic inquiry or study to build knowledge in a discipline.

NURSING RESEARCH

The purpose of research is to validate and refine existing knowledge and develop new knowledge. The results of research process:

1.provide a foundation on which practice decisions and behaviors are laid

2. create a strong scientific base for nursing practice and application of results demonstrates profes sional accountability to insurers and health care consumers.

NURSING RESEARCHNursing research aimed at

impacting the direct provision of nursing and health care to recipients of nursing care,

nursing research also is needed to generate knowledge in areas

that affect nursing care processes indirectly.

EVIDENCE-BASED PRACTICE

The introduction of evidence-based change into the direct provision of nursing care may occur at the individual level of a particular nurse or at varied organizational or social levels.

Evidence generated by nursing research provides support for the quality and cost-effectiveness of nursing interventions.

RESEARCH PRIORITIES

often set by groups that fund research, encourage nurse researchers to invest effort and money into those areas of research likely to generate the most benefit to recipients of care,the funding opportunities offered by such groups don't hurt the research enterprise either.

Sources of funding for nursing research

The main outcome of research activity for a nurse is to eventually put the knowledge gained to work in health care delivery.In USA there are the National Institute for Nursing Research (NINR) and the Agency for Healthcare Research and Quality (AHRQ). Both of these organizations are funded by federal congressional appropriations.Private foundations and nursing organizations also provide funding for nursing research.

Research is a process that takes place in a series of steps:

1. Formulating the research question or problem2. Defining the purpose of the study3. Reviewing related literature4. Formulating hypotheses and defining

variables5. Selecting the research design6. Selecting the population, sample, and setting7. Conducting a pilot study8. Collecting the data9. Analyzing the data10.Communicating conclusions

STUDY DESIGNS

Are plans that tell a researcher

how data are to be collected,

from whom data are to be collected,

how data will be analyzed to answer specific research questions.

Research studies are classified into two basic methods:

Quantitative research is a formal, objective, systematic process in which numeric data are used.

Qualitative research is a systematic approach used to describe and promote understanding of human experiences such as pain

NURSING RESEARCH DESIGNS

The most common designs used in health care research are case study, survey, needs assessment, experimental, quasiexperimental, methodologic, meta-analysis, and secondary analysis.

Case study designs

Are used to present an in-depth analysis of a single subject, group, institution, or other social unit.

The purpose is to gain insight and provide background information for more controlled broader studies, develop explanations of human processes, and provide rich descriptive anecdotes

Extramural Priority Areas for Nursing research

a. Chronic conditions—arthritis, diabetes, urinary incontinence, long-term care, and care givingb. Health promotion and risk behaviors—women's health, adolescence, menopause,environmental health, exercise, nutrition, and smoking cessation

c. Cardiopulmonary health—prevention and care of persons with cardiac or respiratory conditions, including research in critical care, trauma, wound healing, and organ transplantation

Extramural Priority Areas for Nursing research

d. Neurofunction and sensory conditions—pain management, sleep disorders, and symptom management in persons with cognitive impairment and chronic neurologic conditionse. Immune and neoplastic diseases(oncology)—symptoms primarily associated with cancer andacquired immune deficiency syndrome, such as fatigue, nausea and vomiting, and cachexia, as well as risk-factor prevention researchf. Reproductive and infant health—prevention of premature labor, reduction of health-risk factors during pregnancy, delivery of prenatal care, care of neonates, infant growth and development, and fertility issues

(From the National Institutes of Nursing Research (NINR)

NURSING RESEARCHNursing research (links education, theory, nursing practice) provides the basic for expanding the unique body of scientific knowledge that forms the foundation of nursing practice.

Research studies will emphasize clinical issues, problems, and outcomes. Priority will be given to research studies that focus on promoting health and developing cost-effective health care systems.

RESEARCH UTILIZATION

Through Research Utilization, efforts and knowledge obtained from research is transformed into clinical practice, culminating in nursing practice that is evidence-based, to help understand the importance of evidence-based practice.

Nurse Researcher Roles

Two nursing roles are specifically focused on research: the clinical nurse specialist (CNS) and the clinical nurse researcher (CNR).

CONSUMER OF RESEARCHNurses at all levels of educational preparation have responsibility to participate in the research process.

Nurses become knowledgeable consumers of research through educational processes and practical experience, must have a basic understanding of the research process and critical appraisal skills that provide a standard for evaluating the strengths and weaknesses of research studies before applying them in clinical practice.

CONSUMER OF RESEARCH

A consumer of research uses and applies research in an active manner.

The nurse must be knowledgeable consumer of research, one who can critique research and use existing standards to determine the merit and readiness of research for use in clinical practice.