NURSING

THE OLDEST OF ARTS

The youngest profession

FLORENCE

Nightingale

Encircles the Globe

Early days at Xiangya School of Early days at Xiangya School of NursingNursing

XiangyaNursing

A century of excellence

2121stst Century: Evidence- Century: Evidence-based Practicebased Practice

Use of the Use of the best availablebest available

evidence to guide clinical evidence to guide clinical

decision makingdecision making

Where do we find the “best Where do we find the “best available” evidence?available” evidence?

Clinical knowledgeClinical knowledge Opinions of respected authoritiesOpinions of respected authorities Reports of expert committeesReports of expert committees Guidelines for best practicesGuidelines for best practices Original researchOriginal research

Evidence Based PracticeEvidence Based Practice

Levels of evidenceLevels of evidence Gold standard: Randomized Gold standard: Randomized

controlled trialscontrolled trials Clinical guidelines and pathwaysClinical guidelines and pathways

– Discipline specificDiscipline specific

– Condition specificCondition specific

Implementing Evidence-Implementing Evidence-Based PracticeBased Practice

Search for best evidence for practice problemSearch for best evidence for practice problem Use existing evidence-based guidelineUse existing evidence-based guideline Assess cost/benefit ratio of guidelineAssess cost/benefit ratio of guideline Use guideline in practiceUse guideline in practice Measure outcomes from guidelineMeasure outcomes from guideline Extend use of guideline to other practice settingsExtend use of guideline to other practice settings

Florence NightingaleFlorence NightingaleHer Crimean War Work (1853-Her Crimean War Work (1853-

56)56)

Organized investigationsOrganized investigations Observational studiesObservational studies

InterventionsInterventions EvaluationEvaluation

Reduced mortality from 43% to 2%.Reduced mortality from 43% to 2%.

Compassionate Scientific

Nursing ScholarshipNursing Scholarship

Solving a problem, answering a clinical Solving a problem, answering a clinical question question

– Systematic search for informationSystematic search for information– Critical evaluationCritical evaluation– SynthesisSynthesis

Nursing ResearchNursing Research

A scientific process that validates and refines A scientific process that validates and refines existing knowledge and generates new knowledge existing knowledge and generates new knowledge that directly and indirectly influences nursing that directly and indirectly influences nursing practice.practice.

Solving a problem for a category of patients rather Solving a problem for a category of patients rather than for just one patient.than for just one patient.

A diligent and systematic inquiryA diligent and systematic inquiryAn organized investigationAn organized investigation

Why conduct nursing Why conduct nursing research?research?

““. . . Before one does . . . Before one does any research in any research in nursing practice, he nursing practice, he must believe that must believe that nursing is importantnursing is important… … If nursing has nothing If nursing has nothing to offer patients, why to offer patients, why bother [to study it]?”bother [to study it]?” (Diers, 1970)(Diers, 1970)

ResearchResearch

Is answering a question for many patients Is answering a question for many patients instead of oneinstead of one

Can be transmitted, sharedCan be transmitted, shared Moves knowledge from individual to Moves knowledge from individual to

collectivecollective Describes, explains, predictsDescribes, explains, predicts Allows us to improve practiceAllows us to improve practice

Research contributes to Research contributes to practicepractice

DescribingDescribing ExplainingExplaining PredictingPredicting InterveningIntervening

With Research, we canWith Research, we can::

Improve careImprove care Influence policy (with data)Influence policy (with data) Shape our professionShape our profession Make an impactMake an impact

ResearchResearch

Strengthens your professional voice.Strengthens your professional voice. Allows you to be heardAllows you to be heard Allows you to participate in shaping the Allows you to participate in shaping the

health care systemhealth care system Allows you to influence the environment Allows you to influence the environment

where you deliver carewhere you deliver care

The Research CyclePick Topic

Study design and sampling

Focus research question

Collect Data

Analyze Data

Report Results

Act

Cognitive EffectsCognitive EffectsCognitive EffectsCognitive Effects

Research modifies our way of Research modifies our way of thinking or perception by:thinking or perception by:– improving understanding of a situationimproving understanding of a situation

– allowing analysis of practice dynamicsallowing analysis of practice dynamics

– expanding problem solving skills for expanding problem solving skills for clinical problemsclinical problems

Intervention Intervention ResearchResearch

Study of effectiveness of Study of effectiveness of interventions in achieving desired interventions in achieving desired outcomes in a natural setting.outcomes in a natural setting.

Interventions: treatments, Interventions: treatments, therapies, procedures, or actions therapies, procedures, or actions implemented by the nurse to or with implemented by the nurse to or with patients to achieve positive health patients to achieve positive health outcomesoutcomes

Outcomes ResearchOutcomes ResearchOutcomes ResearchOutcomes Research

Outcomes of Patient, Provider, & Outcomes of Patient, Provider, & Health Care SystemHealth Care System

Outcomes used to develop PolicyOutcomes used to develop Policy

Change Practice based on Change Practice based on ResearchResearch

Knowledge Knowledge UtilizationUtilizationKnowledge Knowledge UtilizationUtilization

The process of The process of disseminatingdisseminating & & using using research-generated research-generated

information to make an impact information to make an impact on or on or changechange in the existing in the existing

practices in society.practices in society.

Time LagTime LagTime LagTime LagDefinitionDefinition: The : The period of time period of time between completing between completing the research & the research & changing practice.changing practice.

MOVING INTO THE 21MOVING INTO THE 21stst CenturyCentury

What are the critical questions for nursing?What are the critical questions for nursing?

Who will answer them?Who will answer them?

Nurses can build the bridge between Nurses can build the bridge between practice and policy.practice and policy.

Collaborations in Collaborations in ResearchResearch

Working together

Answering questionsImproving care

It’s a small world.

Nursing research is relevant around the globe.

ATHENA to Ai Sheng NuoATHENA to Ai Sheng NuoReaching around the GlobeReaching around the Globe

Nurses working together to help patients take lifesaving Nurses working together to help patients take lifesaving medicationmedication

The community will be involved.The community will be involved.

Research teams will be multidisciplinary.Research teams will be multidisciplinary.

谢谢大家 !