NURSING RESEARCH

Recommended Review Preparations

• ANA. Standards of Professional Performance

Standard I. Quality of Care
The nurse systematically evaluates the quality and effectiveness of nursing practice.
Standard II. Performance Appraisal
The nurse evaluates his/her own nursing practice in relation to professional practice standards and
relevant statutes and regulations.
Standard III. Education
The nurse acquires and maintains current knowledge in nursing practice.
Standard V. Ethics
The nurse's decisions and actions on behalf of clients are determined in an ethical manner.
Standard VI. Collaboration
The nurse collaborates with the client, significant others, other criminal justice system personnel,
and health care providers in providing patient care.
Standard VII. Research
The nurse uses research findings in practice.

Rationale
Utilization and practice of research activities promotes the professional development and
knowledge base. The nurse is expected to adhere to research method guidelines.

Measurement Criteria
1. The nurse uses interventions substantiated by research as appropriate to the individual's
position, education, and practice environment.
2. The nurse participates in research activities as appropriate to the individual's position,
education, and practice environment. Such activities may include the following:
a. Identifying clinical problems suitable for nursing research
b. Participating in data collection.
c. Participating in a unit, organization, or community research committee or program.
d. Sharing research activities with others.
e. Conducting research within the guidelines of the individual facility, statutes, and
regulations.
f. Critiquing research for application to practice.
g. Using research findings in the development of policies, procedures, and guidelines for
client care.
Standard VIII. Resource Utilization
The nurse considers factors related to safety, effectiveness, and cost in planning and delivering
client care.

• Roles and Functions of the Nurse

1. Caregiver
2. Agent of change
3. Leader
4. Manager

5. Communicator
6. Advocate of client
7. Research user or consumer
8. Teacher

9. Case Manager
10. Counselor

• Expanded Career Roles for Nurses

1. Nurse Anesthesist
2. Nurse Midwife
3. Nurse Practitioner
4. Clinical Nurse Specialist/ Expert
5. Nurses Researcher- Nurse Researcher investigates nursing problems to improve nursing care and to
refine and expand nursing knowledge. They are employed in academic institutions, teaching hospitals
and research center such as the National Institute for Nursing Research. Nurse-researcher usually has
an advanced education at the doctoral level.

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 6. Nurse Educator

• Criteria of a Profession
A profession is generally distinguished from other kinds of occupation by:
1. Its requirement of prolonged, specialized training to acquire a body of knowledge pertinent to the role to
be performed
2. An orientation of the individual toward service, either to a community or to organizations
3. Ongoing research
4. Code of ethics
5. Autonomy
6. Professional organizations

Development of Nursing Research

• Importance of Nursing Research

1. Purpose: discovery and development of organized body of knowledge.
2. Research is of utmost importance to nursing profession. Research evidence determines nursing
interventions that we are practicing is the optimum one
3. Research knowledge will help nurses to be effective, efficient and excellent.

• Definitions of Nursing Research

1. Research is a collection of data in a rigorously controlled situation for the purpose of prediction
or explanation; a more formal systematic and intensive process of carrying on a scientific
method of analysis. Purpose: discovery and development of organized body of knowledge.
2. Committee on research of the PNA-Research is an honest scientific investigation undertaken
for the purpose of discovering new facts or establishing new relationships among facts already
known which will contribute to the present body of knowledge and can lead to effective
solution of the present problem. It involves careful or critical thinking to revise or to revalidate
accepted conclusions and previously held concepts or established generations or principles.
3. Systematic inquiry using disciplined methods to solve problem
4. Includes the breadth and depth of the discipline of nursing ( preventive, therapeutic and
rehabilitative) as well as the preparations of the practitioners and personnel involved in the total
nursing sphere.
5. Polit and Beck (2004) - systematic inquiry designed to develop knowledge about issues of
importance to the nursing profession, including nursing practice, education, administration and
informatics.
6. Burns and Grove (2005) - have more narrowly defined nursing research as a “scientific process
that validates and refines existing knowledge and generates new knowledge that directly and
indirectly influences clinical nursing practice.
7. Nieswiadomy – systematic objective process of analyzing phenomena of importance to nursing.
Clinical nursing research indicates nursing research involving clients or studies that have the
potential for affecting the care of clients, such as with the studies of animals or the so-called
normal subjects.
8. Nursing research- Systematic inquiry to develop knowledge about issues of importance to the
nursing profession
9.
10.
• Sources of nursing knowledge
1. Customs and tradition- “we’ve always done it that way”. Social and cultural practices have
been the bases for nursing care in the country.
2. Assembled information (e.g., quality improvement data)
3. Scientific research – the most objective and the source of nursing knowledge
4. Trial and error – “if it works, we’ll use it”. If one approach did not work one will be use until
one process is effective that until then the process will be stop.
5. Logical reasoning (inductive & deductive)
6. Experts or authorities- experts and authorities in the given field often provide knowledge for
other people.

Features of Scientific ResearchS

7. Reliability/Generalizations- mean that the research findings can be applied to a situation or
population larger than the one studied
8. Order
9. Control- means the impositions of conditions in research, to minimize bias and maximize the
precision and validity of data gathered.
10. Empiricism-objective methods of seeking information

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 11. Systematic- refers to process that a researcher moves in a systematic fashion from identifying a
problem to conclusions and recommendations

• Purposes of nursing research

1. Identification
2. Description
3. Exploration
4. Explanation
5. Prediction
6. Control
•
1. discover new facts about known phenomena
2. Find answer to the problem that is only partially solved by existing methods and information.
3. improve existing techniques and develop new instruments or products
4. discover previously unrecognized substances or elements
5. discover pathways of action of known substances and elements
6. classify or arrange in order related and valid generalizations into systematized science

• Goals for conducting nursing research

1. Promotion of evidence-based practice
Two models for evidenced- based practice
 The Stetler Model of research utilization to promote evidence-based practice
Five sequential phases of settler model
- Phase I: Preparation
- Phase II:Validation
- Phase III: Comparative Evaluation
and Decision Making
- Phase IV: Translation/Application
- Phase V: Evaluation

 The Iowa Model of evidence-based practice to promote quality care

Steps of individual EVP
- Framing an answerable clinical question
- Searching for relevant research-based evidence
- Appraising and synthesizing the evidence
- Integrating evidence with other factors
- Assessing effectiveness

Appraisal of evidenced
- Validity of study findings
- Clinical importance of findings
- Precision of estimates of effects
- Associated costs and risks
- Utility in a particular clinical situation

1. Increased Future Directions for multidisciplinary collaboration

2. Greater focus on outcomes research
3. Use of multiple, confirmatory strategies
4. Expanded dissemination of research findings
5. Increased visibility of nursing research
 Promote evidenced –based practice means that nurses make clinical decisions based on
the best research evidenced, their clinical expertise, and the health care preferences of
their clients or patients.
 ensure credibility of the nursing professions
 provide accountability for nursing practice
 document the cost effectiveness of nursing care
Paradigm- A world view; a general perspective on the complexities of the real world, with certain assumptions about
reality
Key paradigms for nursing research:
– Positivist paradigm
– Naturalistic paradigm
Nature of reality
• Positivist assumption: Reality exists; there is a real world driven by natural causes
• Naturalistic assumption: Reality is multiple and subjective, constructed by individuals
Relation of Inquirer to those being studied
• Positivist assumption: The inquirer is independent of those being studied

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 • Naturalistic assumption: The inquirer interacts with those being studied; findings reflect the interaction
Roles of Values in Inquiry
• Positivist assumption: Values are held in check; objectivity is sought
• Naturalistic assumption: Subjective values are inevitable, desirable

How knowledge is obtained?

Positivist Naturalistic
Fixed design Flexible design
Discrete, specific concepts Holistic
Deductive processes Inductive processes
Control over context Context-bound
Verification of hunches Emerging interpretations
Quantitative information Qualitative information
Seeks generalizations Seeks patterns

General Classification of research according to purpose:

1. Basic Research
- pure research
- conducted to develop, test and refine theories and generate new knowledge
- “seek knowledge for knowledge’s seek”
- is concerned with generating new knowledge
Ex. Isaac Newton Law of Gravity and Inertia

2. Applied Research
- is concerned with using knowledge to solve immediate problems
- Directed toward generating new knowledge that can be used in the near future. It is often conducted to seek
solutions to existing problem
- received funding than basic research
Ex. study the various methods of cleft lip and palate surgery and the effectiveness of this methods

Classification of research according to design:

1. Quantitative research- is concerned with objectivity, tight controls over the research situation, and the ability
to generalized findings.
- scientific research
- hard science
2. Qualitative research is concerned with the subjective meaning of an experience to the individual.
- not scientific
- soft science
Comparison of Quantitative and Qualitative research
Qualitative
Subjective data
Discovery
Whole is greater than the parts
Multiple truths
Small sample sizes
Participants/informants/respondents
Results presented as narrative data
Researcher part of the study
Quantitative
Objective data
Explanation
Parts are equal to the whole
One truth
Large sample sizes
Subjects
Results presented as statistics
Researcher separate from the study

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 3. Experimental research design

4. Non- Experimental research design

Outcomes research- research that focuses on measurable outcomes of interventions with certain patients
populations.
- include a wide range of patients population

Classification of research according to the level of investigation

a. Exploratory research- is conducted when little is known about the phenomenon of interest. A
flexible approach rather than a structured approach. Hypotheses are generally not appropriate for
these types of studies.
b. Descriptive research- phenomena are described or the relationship between variables is
examined. It is conducted when enough information exists to examine relationships between
variables, descriptive studies maybe conducted in which hypothesis are tested.
c. Explanatory research- search for causal explanations and are much more rigorous than
exploratory or descriptive studies. This type of research is usually experimental.

Classification of Research According to Duration/ Time Element of the study

1. Longitudinal study- follows subject over a period of time in the future.
Cohort study- a special type of longitudinal study wherein a person or persons who have
been born under a particular period of time are being studied.
a. Developmental studies
b. prospective studies- the independent variable or presumed cause is identified at the
present time, and then subjects are followed in the future to observed the dependent
variable. “what is”
2. Cross-sectional study – examines subject at one point in time.
a. Historical studies -the dependent variable is determined in the present and attempt
is made to determine the independent variable that occurred in the past. Data are
collected after the fact.
b. ex post facto study
c. retrospective studies – “what was”
Classification of research according to number of variables used in the study:
1. one variable study/ univariate study
2. two variable studies/ bivariate studies
3. multiple variables study/ multivariate study

Combining qualitative and quantitative methods

Combining both qualitative and quantitative methods increases the researcher’s
ability to rule out the rival explanations for phenomena. Field and Morse asserted that the
strongest research findings are found in studies that use both methods.
Triangulation- is a technique simultaneously using the two methods in research
• Roles of nurses in research
1. Advocate of client or respondents during study
2. Major/ principal Investigator
3. Evaluator of a research findings
4. Research problem identifier
5. Informants/respondents/subjects/ participants or sample population
6. Consumer of research findings
7. Associate or member of research team
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

Barriers to Using Research in Nursing Practice

• Research-related barriers
• Nurse-related barriers
• Organizational barriers
• Barriers related to the nursing profession

• History of nursing research-Increasing research in nursing is contributing to nursing practice. In the

1940’s nursing research is at the very early stage of development. In the 1950s increase in the federal
funding and professional support helped established centers for nursing research. Most early
research was directed to the study of nursing education. In the 1960s, studies were often related to
the nature of the knowledge base underlying nursing practice. Since the 1970s, the nursing research
has focused on practice-related issues.
- Mid 1800’s Florence nightingale recommended clinical nursing research but this type of research
is scarce until 1970’s
- Replication studies are needed in nursing. Replication studies involve repeating a study with all
the essential element of the original study held intact.
- 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.