Advanced Practice Nursing and Research


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Advanced Practice Nursing and Research

  1. 1. Nursing Research 1850 - Present
  2. 2. Re*search <ul><li>To search again </li></ul><ul><li>To examine carefully </li></ul><ul><li>Diligent, systematic inquiry or study to validate and refine existing knowledge and develop new knowledge </li></ul><ul><li>Ultimate goal: development of a body of knowledge </li></ul><ul><li>Need knowledge to improve clinical practice </li></ul>
  3. 3. Use of Research in Nursing <ul><li>Nursing is accountable to society for providing high quality care and for seeking ways to improve that care (patient outcomes, health care delivery services, and nursing care) </li></ul><ul><li>Research is used to generate knowledge about nursing education, administration, nursing roles, etc. </li></ul>
  4. 4. Nursing Research Provides a Scientific Base <ul><li>Description (identify nature and attributes of nursing phenomena) </li></ul><ul><li>Explanation (determines relationships) </li></ul><ul><li>Prediction (estimate the probability of a specific outcome) </li></ul><ul><li>Control (manipulate situation to produce the desired outcome) </li></ul>
  5. 5. Historically <ul><li>1850 Nightingale </li></ul><ul><li>1900 AJN (case studies in l920s-1930s) </li></ul><ul><li>1950 Schools had research at BSN level </li></ul><ul><li>1952 Nursing Research </li></ul><ul><li>1967 Image (Sigma Theta Tau Publication) </li></ul><ul><li>1960s-1970s (models, theories) </li></ul><ul><li>1980s clinical research and funding </li></ul>
  6. 6. Acquiring knowledge the old fashioned way <ul><li>Tradition </li></ul><ul><li>Authority </li></ul><ul><li>Borrowing </li></ul><ul><li>Trial and error </li></ul><ul><li>Personal experience </li></ul><ul><li>Role-modeling </li></ul><ul><li>Intuition </li></ul><ul><li>reasoning </li></ul>
  7. 7. Quantitative <ul><li>Formal, objective, systematic process in which numerical data are used to obtain information about the world </li></ul><ul><li>Types: Descriptive, Correlational, Quasi-experimental, and experimental </li></ul><ul><li>Arises from the Positivist view of the world </li></ul>
  8. 8. Qualitative <ul><li>Systematic, subjective approach used to describe life experiences and give them meaning </li></ul><ul><li>Types include: Phenomenological, Grounded Theory, Ethnographic, Philosophical, and Historical </li></ul><ul><li>Arises from the naturalistic world where everything is viewed in context and words are translated into themes. </li></ul><ul><li>In this view there is no absolute truth and things are not quantifiable </li></ul>
  9. 9. Basic vs. Applied <ul><li>Which one would you think is pure research or knowledge for knowledge sake? </li></ul><ul><li>Which one has as its purpose to solve problems, make decisions, or predict or control outcomes in real-life practice situations? </li></ul>
  10. 10. Sampling <ul><li>Probability vs. Nonprobability </li></ul>
  11. 11. Settings <ul><li>Natural </li></ul><ul><li>Partially controlled </li></ul><ul><li>Highly controlled </li></ul>
  12. 12. Research Problem <ul><li>A situation in need of a solution, improvement, or alteration </li></ul><ul><li>E.g. Dyspnea is a symptom that can have a significant impact upon the activities of the school aged child with asthma; however, little is known about the sensation of dyspnea. </li></ul>
  13. 13. Research Purpose <ul><li>Specific goal or aim of the study </li></ul><ul><li>The major purpose of this study is to describe the sensation of dyspnea in school aged children </li></ul>
  14. 14. Review of Literature <ul><li>To discover what is known and not known about a topic </li></ul><ul><li>Usually conducted first with quantitative research; however, with qualitative research this may occur at any time. </li></ul>
  15. 15. Study Framework <ul><li>Abstract theoretical basis for study that enables the researcher to link the findings to nursing’s body of knowledge. </li></ul><ul><li>Theory consists of an integrated set of defined concepts and relational statements that present a view of a phenomena and can be used to describe, explain, predict or control </li></ul>
  16. 16. Research Hypotheses <ul><li>Guesses as to the outcome of the study </li></ul><ul><li>Research Hypothesis: a relationship exists </li></ul><ul><li>Null Hypothesis: a relationship does not exist; used to test statistical outcomes </li></ul>
  17. 17. Hypothesis <ul><li>Simple=2 variables </li></ul><ul><li>Complex=more than 2 variables </li></ul><ul><li>Directional=negative/positive relationship </li></ul><ul><li>Nondirectional=relationship exists </li></ul>
  18. 18. Variables <ul><li>Concepts of various levels of abstraction that can be measured, manipulated, or controlled in a study </li></ul><ul><li>Conceptual Definition: theory definition </li></ul><ul><li>Operational Definition: measurable definition </li></ul>
  19. 19. Assumptions <ul><li>Statements that are taken for granted and are considered true even though they have not been scientifically tested </li></ul>
  20. 20. Limitations <ul><li>Restrictions on the study that may decrease credibility and generalizability of the findings. </li></ul><ul><li>Nonprobability sampling, for example, limits generalizability </li></ul>
  21. 21. Research Design <ul><li>Blueprint for the Study </li></ul><ul><li>Pilot Study often the design of a study. This is conducted to determine feasibility, refine instruments, develop protocols, identify problems with design, try out data collection/analysis techniques, examine reliability and validity of research instruments. </li></ul>
  22. 22. Feasibility <ul><li>Researcher Expertise </li></ul><ul><li>Money Commitment </li></ul><ul><li>Availability of Subjects, Facilities and Equipment </li></ul><ul><li>Ethical Considerations </li></ul>
  23. 23. Population vs. Sample <ul><li>Population: All elements that meet certain criteria </li></ul><ul><li>Sample: Subset of the population </li></ul><ul><li>Who do you think have been underrepresented in studies? </li></ul>
  24. 24. Data Collection and Analysis <ul><li>Data Collection: Precise, systematic gathering of information relevant to the research purpose or specific objectives </li></ul><ul><li>Data Analysis: Process for reducing, organizing, and giving meaning to the data </li></ul>
  25. 25. Research Outcomes <ul><li>Findings </li></ul><ul><li>Conclusions </li></ul><ul><li>Recommendations </li></ul>
  26. 26. Sources of Research in Nursing <ul><li>Advances in Nursing Science </li></ul><ul><li>Applied Nursing Research </li></ul><ul><li>Image: Journal of Nursing Scholarship </li></ul><ul><li>Nursing Research </li></ul><ul><li>Research in Nursing & Health </li></ul><ul><li>Scholarly Inquiry for Nursing Practice: An International Journal </li></ul><ul><li>Western Journal of Nursing Research </li></ul>
  27. 27. Variables <ul><li>Independent: that which is manipulated by the researcher </li></ul><ul><li>Dependent: that which is measured </li></ul><ul><li>Extraneous: may be recognized/unrecognized and controlled/uncontrolled </li></ul><ul><li>Confounding: not recognized until study in progress </li></ul><ul><li>Demographic: attributes of subjects </li></ul>
  28. 28. Bias <ul><li>Who has it? </li></ul>
  29. 29. Progression of Nursing Research <ul><li>1920s-1930s: Case Studies </li></ul><ul><li>1950s: Standards of Care </li></ul><ul><li>1960s-1970s: Studied ourselves with job satisfaction research and studied quality care and measurement of patient outcomes </li></ul><ul><li>1980s: Conducted clinical research </li></ul><ul><li>Qualitative Research </li></ul>
  30. 30. Evidence Based Research <ul><li>Evidence Based Nursing is the process by which nurses make clinical decisions using the best available research evidence, their clinical expertise and patient preferences. </li></ul><ul><li>To carry out EBN must have sufficient research on a topic, skill in critiquing research and ability to implement change </li></ul><ul><li>*see handout Evidence Based Nursing </li></ul>
  31. 31. Participatory Action Research <ul><li>A method of research where creating a positive social change is the predominant driving force </li></ul><ul><li>*see handout Participatory Action Research: Getting the Job Done </li></ul><ul><li>*see handout Announcement of New Rural Action Research Programme and Participatory Action Research as a Methodology of Rural Development </li></ul>
  32. 32. National Institute of Nursing Research <ul><li>1983: Report by Institute of Medicine recommended that nursing research be included in the mainstream of biomedical and behavioral science </li></ul><ul><li>1984: NIH Task Force study found nursing research activities relevant to NIH mission </li></ul><ul><li>1986: National Center for Nursing Research </li></ul><ul><li>1993 NINR </li></ul><ul><li>*see handout A Brief History of NINR </li></ul>
  33. 33. NINR Planning for 21 st Century <ul><li>Special Health Needs: </li></ul><ul><li>Women </li></ul><ul><li>Minorities </li></ul><ul><li>Elderly </li></ul><ul><li>Residents of Rural Areas </li></ul><ul><li>Economically Disadvantaged </li></ul>
  34. 34. Track Record of Research that has Made a Difference <ul><li>Chronic Illnesses </li></ul><ul><li>Quality and Cost Effectiveness of Care </li></ul><ul><li>Health Promotion and Disease Prevention </li></ul><ul><li>Management of Symptoms </li></ul><ul><li>Adaptation to New Technologies </li></ul><ul><li>Health Disparities </li></ul><ul><li>Palliative Care at the End of Life </li></ul><ul><li>* see handout Current RFAs </li></ul>
  35. 35. Challenges for the Future <ul><li>More people will live longer and be subject to diseases and disabilities </li></ul><ul><li>More minorities who experience disparities in the incidence, prevalence and seriousness of disease </li></ul><ul><li>Healthier Lifestyles </li></ul><ul><li>More home care </li></ul><ul><li>More caregivers who need balance </li></ul>
  36. 36. Challenges cont. <ul><li>End of Life Issues </li></ul><ul><li>Genetics </li></ul><ul><li>Better systems in healthcare systems </li></ul><ul><li>Better systems for reporting nursing research </li></ul>
  37. 37. NINR Vision <ul><li>To reshape not only health research and health care, but also the way Americans view the importance of good health in their lives </li></ul>
  38. 38. NINR Mission <ul><li>Reduction of risks for disease and disability </li></ul><ul><li>Promotion of healthy lifestyles </li></ul><ul><li>Promotion of quality of life in those with chronic illness </li></ul><ul><li>Care for individuals at the end of life </li></ul>
  39. 39. Barriers to Nursing Research <ul><li>See handout </li></ul><ul><li>Towards A Strategy for Nursing Research and Development </li></ul>