Running head: PROFESSIONAL DEVELOPMENT ASSIGNMENT 1

Professional Development Assessment

Mallory White

Aspen University

February 2017
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Professional Development Assessment

Nursing is a profession with vast opportunities for personal and professional growth.

Nursing and healthcare, in general, are also areas of frequent change and improvements. One

avenue for nurses to facilitate positive change and growth is through nursing research. Nursing

research can be an expensive and timely process for the researchers, but when the process is

finished, it can help ensure patient care nurses are providing safe and quality care.

Personal Reflection

It was only a few years ago when this nurse transitioned into a Clinical Nurse Educator

role that research was a professional focus. Throughout nursing school and years of practice as a

bedside nurse, some ideas and concepts of nursing research were known, but not fully

understood. Tappen (2011) outlines the five essential phases of nursing research. In the last few

years as a Clinical Nurse Educator, this nurse has performed some essential elements of the

research process, but it was only recently that a full research project was carried out.

Planning phase

The first phase of nursing research is the planning phase. In this phase, researchers must

first identify a research topic. The topic should be interesting to the research team while offering

results that will have a positive impact on the nursing profession. Tappen (2011) explains that

when researchers are making a final selection of a research topic, they must consider if the topic

is innovative, significant, reasonable, ethical, and exciting.

Researchers must ensure the topic is one that is creative and has not been repeated over

and over again. The results must also provide a significant contribution to improving patient

care. Tappen (2011) explains that although few studies are completely insignificant and

worthless, but because they require so much energy and time, researchers must ensure the results
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will make the investment worthwhile. That being said, researchers must also ensure their topic is

reasonable and not too ambitious for one study. Researchers must ask themselves if they have

enough resources like time, money, equipment, and personnel to conduct the entire research

process.

Another important criterion to consider when choosing a research topic is to determine

whether the study is ethical. Researchers must ensure that their study does not put participants in

jeopardy. This idea works at both ends of the spectrum. Researchers must ensure they are not

asking participants to do anything that could put them in danger while also ensuring that if they

are withholding treatment, in a control group, that they are not put in harm's way.

Finally, when choosing a research topic, researchers must ensure that the topic is

exciting. The excitement must be felt be researchers to ensure they have the commitment to stay

involved throughout the entire research process. The research topic must also be exciting to

participants. Participants are also more likely to stay involved in the entire research process

when it is a topic that is of interest to them. Finally, research topics must also be exciting to

nurses. Many times, nurses are saturated with new research, if they find a topic that interests

them, they will be more likely to read the findings and adjust their practices according to the

research.

During the planning phase, after identifying a topic, researchers perform a literature

review. Literature reviews allow researchers to perform a study that builds upon existing

knowledge (Tappen, 2011). In today’s world with nearly everyone having internet access, it is

easier than ever to perform a literature review. It is of utmost importance that when researchers

are performing a review of existing literature that they choose sources that are current and from

reputable sources.
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In the planning phase, researchers must also develop a theory. A theory provides

researchers with a general idea of where they would like their research project to go. Nursing

research can be used to develop a theory, or it can be used to test one. Researchers must ensure

that their theory is specific and related to the research they have been and will be conducting.

Design Phase

The next phase in nursing research involves researchers designing their study.

Researchers determine what type of research they will be conducting and what design elements

they would like to include. Two major types of nursing research are qualitative and quantitative

research. Quantitative research focuses on numbers and statistics. Qualitative research focuses

on innumerable data like feelings and expressions. Nursing research studies can provide results

that are qualitative, quantitative or both.

Researchers can choose to carry out an experimental or quasi-experimental design when

carrying out quantitative projects. These methods involve comparing one group against another.

In nursing, a true experimental design could be a randomized clinical trial. When a completely

randomized trial is not possible, researchers can perform research using a quasi-experimental

design.

For qualitative research projects, researchers can use descriptive, mixed, or meta-

analysis. Meta-analysis and mixed methods can be complex and difficult to execute, but they

allow for researchers to provide more thorough answers to their important questions. Mixed

methods allow researchers to combine the “richness of qualitative data with the precision of

quantitative data” (Tappen, 2011, p. 89).

It is important that researchers choose the design methods that best meet their study.

Tappen (2011) explained that before the study formally begins is the best time to be sure
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researchers choose the type and quality of data that will be needed to achieve the study’s

objective. She also explained that the selecting the right design method is the true test for the

appropriateness for whether or not methods match the purpose of the study and the questions and

theories posed. Designing research helps provide researchers with an idea of how they plan on

getting to their objective.

The design phase also forces researchers to think about samples. The size of sample

groups should be based on the type of research being conducted, the study design, and the

intended outcome. Sample size should be large enough to obtain accurate general

representations, but not too large as to skew the results. A smaller sample size will give results

that may not provide enough support to an accurate conclusion and may lead to a falsely negative

study. If the sample study is too small, results may be inconclusive, which in turn is a waste of

researchers time, money, and other resources. To the contrary, very large sample sizes may also

be detrimental to research studies. It is a waste of available time, money, and other resources

when the same outcome could be achieved with a smaller sample size. Nayak (2010) explained

that in terms of sample groups in split-mouth designs, the researchers must consider their ethical

beliefs. With a larger sample size, more participants are denied treatment and given a placebo.

There would also be a larger number of participants undergoing therapies that may be harmful.

Selecting an appropriate sample size is important for a variety of reasons. Faber and Fonseca

(2014) explained that an appropriate sample renders the research more efficient by generating

data that is reliable. Appropriate sample size also maximizes the time, money, and resources of

the researchers involved.

Other parts of the design phase involve researchers ensuring their study that is reliable,

valid, and trustworthy. Researchers must utilize tools that have a purpose and are appropriate,
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reliable, and have validity. Research studies are most beneficial when the information presented

is valid, reliable, and contributes to the advancement of nursing. As a clinical nurse educator, it is

important to analyze studies and determine whether the study was conducted with reliable and

valid tools and if the results are pertinent to change bedside nursing practices.

Implementation Phase

The first component to the implementation phase involves research ethics. As nurses, we

have a duty to do no harm and to promote the greatest benefits for our patients. Researchers

must be aware and cognizant of the rules and regulations that deal with the ethical conduct of

research studies. There are laws and governing bodies that protect vulnerable populations, like

children or persons with disabilities, in research studies.

Ethics also plays into the next part of the implementation phase, participant recruitment

and retention. Researchers must recruit participants that are suitable for the study and who are

most likely to continue throughout the entire study. Researchers must consider methods to

promote participant retention. Tappen (2011) explained that depending on the type of study,

multiple encounters, treatments, or testing sessions may be required over years or decades. In

order to determine and implement strategies to promote retention, researchers must first identify

the barriers to retention. Methods that work for one study or participant may not work for

another. Researchers can use advertisements, phone calls, newsletters, or emails to reach active

and potential participants.

After participants are selected, next comes the data collection processes. Data can be

collected using many different sources or methods. Researchers can perform a secondary

analysis of existing research to answer their new question. Depending on the research questions

and the depth of data that would need to be collected in order to be considered representative of
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the population of interest, a secondary data analysis can be a very cost-effective way to obtain

large amounts of rich data that would otherwise be unobtainable (Aponte, 2010). In this nurse’s

opinion, there are clear advantages to a secondary analysis, however, a secondary analysis can be

time-consuming, cumbersome, and difficult to ascertain and sort through the vast amount of raw

data (Aponte, 2010). The secondary analysis, however, is clearly helpful when seeking

information about large populations of people, using existing data from state and federal data

sets will allow for wide implications and applications (Aponte, 2010).

Other methods of collecting data involve testing, observations, or interviews.

Observations provide researchers with qualitative data whereas testing offers quantitative data.

Interviews can offer both qualitative and quantitative data. No matter what methods are

employed, researchers must ensure they are appropriate for the study. Researchers must also be

open to the results not matching what they were expecting for their study. Data collection allows

for discovery and the connections between what is already known and new information that can

lead to changes in nursing.

Some research studies offer a period of intervention. Interventions can very greatly

depending on the study. Tappen (2011) gave examples of repainting prison walls to reduce

physical violence or changing the swaddling techniques of newborns to reduce crying. The

intervention phase of research implementation allows researchers to collect more data and test

their theories.

Analysis and Interpretation Phase

Nursing research studies can provide large amounts of data, it is up to researchers to

determine what to do with all of that data. Prompt and reliable management of data will save
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researchers time and energy when analyzing and interpreting it. When analyzing data in nursing

research, it is important to understand that there are different techniques to analyze data. The

method that researchers use depends on the data that was collected and the goal of the

research. Common nursing research data analysis techniques are correlation, dependent t-test,

and independent t-test.

Correlational research is used to determine the relationships among two or more variables

and to forecast events from current knowledge and data. It can be used within the same

population or between the same variables in two populations (Curtis, Comiskey, & Dempsey,

2016). Correlational research is widely used and is useful for novice researchers in nursing

because it is the least complex. Nursing researchers that set out to discover the relationship

between nurse job satisfaction and absenteeism is an example of a correlational study. Dependent

t-test is also referred to as paired t-test. Paired samples t-test compares two means that are from

related groups to determine if there are statistical differences (Munro, 2015). For example, in

nursing, this data analysis can be comparing the percentage of coronary blockage before and

after a cardiac catheterization with stent placement. This data is used to compare statistical

differences between two separate time points. This method can also be applied to different but

related subjects. For example, nurse researchers can use this method for comparing the weight of

first born twins compared to the second born. This method is only used for comparison of two

subjects or units that are related. Independent t-tests are used when there are two or more

independent variables in an analysis (Munro, 2016). To perform an independent t-test study,

researchers must ensure unrelated groups are comprised of participants in each of the groups are

different. Munro (2016) explained that with independent t-testing, an individual in one group

cannot also be a member of the other group. An example of a nursing related independent t-test
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is job satisfaction of male nurses versus female nurses. This fits the independent t-testing model

because researchers are comparing members of different genders.

Researchers may also use database software for the management of their data. Utilizing

database management systems can help researchers store, sort, and analyze data if they are

comfortable using the software. Researchers must ensure the software they are using is easy to

use for research personnel while providing data analysis that meets the needs of the study.

Different software can present data using different methods. Graphs and charts can be useful

visuals for data results. Researchers must ensure they are using the right software and visual

representations for their study while accounting for missing data to ensure a strong conclusion.

Reporting

Presenting and publishing research are the final steps in a long research process. When

nurses begin research projects, they have an end goal in mind. Presenting their data helps them

reach the end goal and allow for changes in nursing. Two main ways of presenting final research

findings are through either poster presentations or podium presentations.

Poster presentations can be especially difficult, in that an abundance of research is

combined and reduced to just a small space, however, this approach allows the researcher the

comforts of not having to stand up in front of a large audience and speak (Tappen, 2011). As

long as the poster is well organized and hits all the major points of the research paper without

overloading the poster with too many details, this can be a very informative way to present

research findings (Tappen, 2011). Various uses of visual aids that represent the data can be used

to show a condensed version of research findings and are often appreciated by readers (Tappen,

2011).
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Podium presentations will allow for a more elaborate explanation of the research

methods, design, and findings; however, these presentations require a public audience and

speaking in front of a group of people (Tappen, 2011). In contrast to a poster presentation, the

podium presentation is organized sequentially one frame at a time (Tappen, 2011). Unlike the

poster presentation where space is limited, the podium presentation is limited on time (Tappen,

2011). There are also many more do’s and don’ts to consider in podium presentations. Some of

the do’s include such things as knowing what to say and how to say it, looking at the audience

and staying on focus, engage the audience, and speak in a normal tone and rate (Tappen,

2011). Some of the don’ts include not reading from note cards or what can be easily seen on the

screen, tell jokes, turn your back to the audience, wonder off topic, go over the allotted time, try

to be too formal or worry about making a good impression (Tappen, 2011).

Conclusion

A graduate level course of advanced nursing research has provided this nurse with more

clear guidelines for carrying out a nursing research project from developing the theory to

positively changing nursing practices. The previous sections are representations of this nurse’s

understanding of course materials. Tappen (2011) explained that her text is by no means an all-

inclusive reference for all of the possibilities of nursing research and the roadblocks that could

occur. For this Clinical Nurse Educator, this course will be most useful for advocating for

change within the nursing orientation process in a hospital setting. The following are examples

of this nurse’s best work throughout the course.

National Institute of Nursing Research

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The National Institute of Nursing Research [NINR] serves to promote and improve the

health of communities, individuals, and families through the support and conduct of basic and

clinical research and research training of illnesses and health. Their research spans multiple

disciplines including behavioral and biological sciences. The work that the NINR helps develop

the “scientific basis for clinical practice” (National Institute of Nursing Research, n.d.). Every

five years, the NINR defines a strategic plan to address the country’s most pressing health care

and health challenges. In 2011, NINR sought out to bring science to life.

In the 2011 Strategic Plan, Director Patricia Grady explained that the NINR felt it was

important to reflect on the discoveries in nursing as a science. Over the 25 years of the NINR,

nursing sciences have had a profound effect on the health over many American’s. She explained

that nursing science has allowed for evidence-based developments to prevent illnesses and

improve lives of countless American’s across the lifespan. It has also enhanced clinical practice

for all nurses. The 2011 Strategic Plan sought to connect the strengths of nursing science and a

determined research program to meet the needs of future and current health care needs while

preparing for future health priorities and challenges (National Institute for Nursing Research

[NINR], 2011). Improvements in nursing science can improve the promotion, management, and

understanding of health from pre-birth until the end of life. NINR stands to support technological

advances and interdisciplinary relationships to provide the best care and treatment to an aging

nation with multiple co-morbidities while suffering from a shortage of health care workers.

In order to advance overall health, the NINR (2011) sought innovative methods to

optimize patient outcomes while maintaining health care costs. They explained that this is best

achieved through interdisciplinary partnerships. Many have said that nurses are a jack of all

trades, knowing information about many different aspects of health care. NINR (2011)
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explained that there is no profession “more integral and essential within every level of the

healthcare delivery system than nursing” (p. 6). New discoveries that have a direct clinical

application add value to health care delivery while keeping nursing relevant in the sciences that

seek to improve the quality of life and benefit clinical practice.

The NINR’s priority goals involved advancing the science of health. To do so, the NINR

invested in research that enhanced health promotion and disease prevention, improved the

quality of life by managing symptoms of chronic and acute illnesses, improved end-of-life and

palliative care, enhanced innovation in practice and science, and developed the next generation

of nurse scientists (National Institute for Nursing Research, 2011). It is the opinion of this writer

that these priorities are in line with the development of nursing as a profession while providing

benefit to patients of all ages and medical conditions. The goals also sought to help develop

future nursing researchers and research projects, which will only continue to benefit nursing as a

profession and the health care patients receive.

These priorities set forth standards for nurse researchers across the country. Because

nursing research can be timely and costly, researchers rely on funding and support from agencies

like the NINR. If researchers truly wish to have the support and resources available from the

NINR, researchers will base their research projects off of the proprieties of the institute.

Evidence-based Practice

Evidence-based practice [EBP] applies the principles and techniques of decision making

to nursing interventions that are intended to improve the health and safety of patients. Evidence-

based practices are formed based on clinical expertise, best research evidence, and patient values.

Academy of Medical-Surgical Nurses (2013) explained that EBP means knowing that nurses do
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is the best practice. EBP helps bridge the gap between research and practice. It strengthens the

evidence base so that nurses know what works and what does not while providing patients with

the best possible outcomes. EBP also translates and consolidates the scientific research into

clinical recommendations.

One main goal of EBP is to allow nurses to provide the safest highest quality care to

patients. EBP provides nurses with the best evidence-based data in research databases, many

available online for reference. Another goal of EBP is to allow clinicians to resolve problems

while in the clinical setting to achieve excellence in the delivery of care. EBP also reduces

variations in nursing care while promoting effective nursing interventions. The final goal of

EBP is to assist nurses with efficient and effective decision-making.

In order for a practice to be evidence-based, it must have three key components. The first

component is research evidence. Research evidence to back EBP’s can come from clinical trials,

qualitative research, laboratory experiments, randomized controlled trials, or many other

research avenues. The second key component to EBP involves clinical expertise. Clinical

expertise is developed over time through knowledge gained from practice and inductive

reasoning. The final component to EBP involves patient values and circumstances. Each patient

has unique preferences, concerns, and expectations about their care. Every patient also has

varying degrees of financial resources and social support. EBP combines all three components

to provide interventions that nurses know are best through clinical practice and previous research

to provide care that meets patient’s health care needs as well as their concerns and expectations

while taking their socioeconomic status into consideration.

One example of an EBP involves indwelling catheters and the patient’s risk of catheter-

associated urinary tract infections [CAUTIs]. The Agency for Healthcare Research and Quality
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[AHRQ] (2012) developed practice guidelines to prevent CAUTIs in geriatric nursing protocols.

The guidelines explained that up to 69% of CAUTIs “are preventable through the application of

evidence-based care strategies” (p. 1). The guidelines recommend nursing care based on

previous research to decrease CAUTIs in patients. One method to reduce CAUTIs is to decrease

the use of indwelling catheters while in the hospital setting. Nurses can intervene by offering

toileting schedules, frequent nursing rounds, and alternative strategies to manage urine output. If

an indwelling catheter is deemed medically necessary, nurses can intervene to reduce the risk of

CAUTIs by choosing the smallest size possible catheter and using aseptic technique and a sterile

product during insertion. Nurses can also decrease CAUTIs by providing frequent cleansing of

the urethral meatus and securing the catheter bag to prevent pulling.

The AHRQ (2012) guidelines also encourage timely removal of the catheter. Many

electronic charting systems provide nurses with a query to determine if the catheter is still

needed. The guidelines also recommend the catheter removal after surgeries on postoperative

day one or two. On-going evaluation, re-education of nursing staff, and the public reporting of

unit-based CAUTIs can not only inform the health care team of current practices, but it can

positively affect patient outcomes and the effectiveness of CAUTI prevention.

Research Proposal

Writing a research proposal for nursing research projects involves outlining many

different steps and aspects to the project. Topics to include are hypothesis, theory, design model,

methods, anticipated results, and potential dissemination avenues. Below is a brief summary of

these topics for this nurse’s research proposal for a standardized nursing orientation program.
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Hypothesis and Theory

After years of nursing school, a nurse’s adventures of practicing as a licensed registered

nurse [RN] begin with nursing orientation. Through discussions with veteran nurses and those

currently going through nursing orientation, it was identified that the current program was not

structured nor did it have clear guidelines for the orientation process. New nurses expressed

frustrations that started with their orientation that ultimately lead to transition job changes before

they reached one year of practice. Veteran nurses expressed dissatisfaction with the program

because they did not have clear guidelines on what their roles as preceptors to the new RNs were.

Therefore, a Masters of Nursing in Education project was developed to provide a structured and

comprehensive nursing orientation program for RNs at a rural medical center in Ohio. A

literature review highlighted the benefits and importance of nursing orientation programs. As a

result of this review, a nursing orientation program was developed to meet the needs of the

nursing staff and the organization as a whole. The outcomes of this project will allow for the

expansion of nursing knowledge while offering an environment that allows new nurses to grow

and become comfortable with independent practice.

Design model

This project was guided by the Competency Outcomes Performance Assessment [COPA]

model and through a literature review to discover evidence-based data for learning strategies,

competencies, and performance evaluations. This review again highlighted the benefits and

importance of having a structured nursing orientation program. This project seeks to address the

gap between literature and the current practices of general nursing orientation programs.

Methodology
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The project began with a literature review of scholarly sources to establish the need for a

structured nursing orientation program. Literature was reviewed and information was obtained

to address the questions and concepts in the COPA model. The medical center’s current nursing

orientation program and processes were also analyzed. After review, using the COPA model,

specific orientation program practices were identified. Based on research findings, a nursing

orientation program was developed that included specific job responsibilities, the verification of

preceptor qualifications, classroom and simulation-based learning opportunities, orientation to

organizational specific procedures and policies including but not limited to infection control,

pain management, and cultural diversity. The orientation program also included mandatory

education and training for novice and veteran nurses as well as in-depth orientation to the

facility’s electronic medical records system and nurse documentation.

Anticipated Results

It is anticipated that this new orientation program will allow for a standardized

orientation process for all new nurses. With that will come better job satisfaction and increase

nurse retention. At an organizational level, this will equate to substantial cost savings. Most

importantly, this program will prepare nurses to comfortably and confidently provide safe quality

care to all patients.

Potential Dissemination Avenues

This project will be disseminated through oral and visual presentations. First, a project

summary will be presented to the facility’s Nursing Senate committee. The Nursing Senate

committee is led by nurses who are seeking to provide positive change to nursing at the medical

center. The project will also be discussed with the Chief Nursing Officer [CNO] to discuss the
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applicability and feasibility of formally accepting a structured nursing orientation program at the

facility. Finally, a project summary can be presented at the facility during a presentation they

call Nursing Grand Rounds [NGR]. NGR is a forum that allows nurses to present information to

their colleagues. At this forum, this nurse would either present with a podium presentation with

an accompanying visual aid or through a poster outlining the changes from the current

orientation process.

Conclusion

Nursing research projects begin with an end goal in mind. Many times, the end goal is to

promote or improve the health of the patients we care for. One wat this can be achieved is

through evidence-based research which then leads to the development of evidence-based

practices. The goal of prudent nurses is to provide the safest highest quality care to all patients

to improve their health status. For nurse researchers, their project goals and outcomes and be

summarized and presented in research proposals.

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References

Academy of Medical-Surgical Nurses. (2013). Evidence-based practice: An independent study

short course for medical-surgical nurses. Retrieved from

https://www.amsn.org/sites/default/files/documents/practice-resources/evidence-based-

practice/Evidence_Based_Practice_Module_I.pdf

Agency for Healthcare Research and Quality [AHRQ]. (2012). Guideline summary: Prevention

of catheter-associated urinary tract infection. In: Evidence-based geriatric nursing

protocols for best practice. Retrieved from

https://www.guideline.gov/summaries/summary/43936/prevention-of-catheterassociated-

urinary-tract-infection-in-evidencebased-geriatric-nursing-protocols-for-best-practice

Aponte, J. (2010). Key elements of large survey data sets. Nursing Economics, 28(1), 27-36.

Retrieved from https://search.proquest.com/docview/236939356?accountid=34574

Curtis, E. A., Comiskey, C., & Dempsey, O. (2015). Correlational research: Importance and use

in nursing and health research. Nurse Researcher, 23(6), 20-25. Retrieved from

http://www.tara.tcd.ie/handle/2262/74298

Faber, J., & Fonseca, L. M. (2014). How sample size influences research outcomes. Dental Press

Journal of Orthodontics, 19(4), 27-29. doi: http://doi.org/10.1590/2176-9451.19.4.027-

029.ebo

Munro, B. (2016). Statistical techniques (2nd ed.). New York: Springer Publishing Company.

Retrieved from https://search.proquest.com/docview/189468475?accountid=34574

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National Institute for Nursing Research. (2011). Bringing science to life: NINR strategic plan.

Retrieved from https://www.ninr.nih.gov/sites/www.ninr.nih.gov/files/ninr-strategic-

plan-2011.pdf

National Institute of Nursing Research. (n.d.). About NINR. Retrieved February 2017, from

https://www.ninr.nih.gov/aboutninr/ninr-mission-and-strategic-plan

Nayak, B. K. (2010). Understanding the relevance of sample size calculation. Indian Journal of

Ophthalmology, 58(6), 469-470. doi:10.4103/0301-4738.71673

Tappen, R. (2011). Advanced nursing research: From theory to practice. Boston: Jones &

Bartlett.