A program of research involves conducting a series of related studies to address a knowledge gap in a discipline. It is advantageous to have a program of research because it allows researchers to build expertise in an area and make meaningful contributions. To develop a program of research, one should choose an interesting topic of importance, start with small pilot studies, and continue building knowledge through additional studies while disseminating findings through publications and conferences. Launching, conducting, and analyzing patient safety and quality improvement research presents various challenges which must be addressed in an ethical manner.

1. Chapter 27
Developing a Program of Research
Program of Research
A program of research is a sequential “series of related studies
aimed at addressing a particular knowledge gap” of importance
to one’s discipline (Pranulis, 1991)
2
Program of Research
The opposite approach to deliberately building a program of
research would be to conduct a number of discrete, unrelated
studies on various topics
This is a more opportunistic, less planned approach to building
a research portfolio
3
Program of Research
Research trajectory is having a clear path to a long-term goal in
mind

2. This helps to guide your choices and maintain your focus as you
build your research career
4
Advantages of a Program
of Research
Builds expertise in your chosen area of research
Increases the likelihood you will be able to make a substantial
contribution to the nursing practice
5
Advantages of a Program
of Research
Raises the quality of your studies because you will have greater
expertise when concentrating on one subject area you know very
well
Allows you to see new patterns and connections that lead to new
discoveries

3. 6
Launching a Program of Research
Choose an area of great interest to you
Be sure the topic is also important to nursing
Consider focusing on a persistent problem
Be willing to drop a line of research that turns out to be a dead
end
7
Launching a Program of Research
Begin with a small study (this might be a master’s project or
doctoral dissertation)
The goal of your first study is to gain new insights into the
subject of interest
Continue with a second small or medium-size study building on
the first study
8
Launching a Program of Research

4. The second study is often a pilot study used to test your ideas
and procedures before launching a larger study
Begin to form a research team including both colleagues and
research assistants
9
Launching a Program of Research
Become involved in larger, more complex studies, either as the
lead investigator or as a co-investigator
Add “branches” to your research now, increasing breadth as
well as depth
10
Launching a Program of Research
All along, present findings at conferences and publish the
results in professional journals
As an established scholar and researcher you will now mentor
new researchers, serve as a grant reviewer, or become a
consultant

5. 11
Characteristics of an Ethical Organizational Environment
When we speak of ethics, we often focus on underlying values
and principles. Much of that discussion is based on the
individual. As public administrators, we need to be concerned
with creating an ethical agency, not just developing or refining
our own ethics. When we speak of an ethical environment, we
are often looking at the organizational culture. An
organizational culture is that collected of shared values, beliefs,
practices, traditions, jargon, humor, and so much more that
makes the organization unique. Based on your readings and
experiences:
· What do you believe should be the characteristics or
components you need to develop in your organization to have an
ethical organizational culture?
· What do you believe should be the characteristics or
components we need to eliminate from your organization to
avoid having an unethical organizational culture?
For this assignment, you will develop a PowerPoint
presentation:
Create a PowerPoint presentation with detailed presentation
notes section completed. This approach uses a PowerPoint with
detailed notes in the presentation notes area at the bottom of
each slide. The presentation notes are a transcript of the
presentation you would make if showing the presentation to an
audience.
In presenting the information to the new employees, the
PowerPoint must include the following:
1. Title slide.

6. 2. Purpose slide.
3. Content slide(s).
4. Summary slide.
5. References slide.
Based on the guidelines, the presentation must have a minimum
of six slides. With one content slide for each of the bullet points
in the assignment, you will need at least two slides for content,
but you may use as many as you need.
Be sure to appropriately cite and reference your sources in
current APA style.
Chapter 26
Patient Safety and Quality Research
Patient Safety and Quality Research
To Err is Human: Building a Safer Health Systems is a report by
the Institute of Medicine and has been the impetus for a great
increase in research on improving the safety and quality of
patient care
2
Patient Safety and Quality Research
More than 15 years after the Institute of Medicine report was
released, the quality of care provided in the United States is
still uneven and patients are still at risk of harm from
medication errors, healthcare-associated infections, obstetrical

7. adverse effects, and so on (Kronick, 2014)
3
Research Study Versus Quality Improvement Project
Quality improvement projects are institution based and the
ensuing investigation is oriented toward identifying gaps in
safety procedures and policies in that institution and taking
corrective action
4
Research Study Versus Quality Improvement Project
A research study is a systematic investigation of phenomena
that is designed to contribute new knowledge
A research study protocol needs to be reviewed by an
institutional review board (IRB)
5
Research Study Versus Quality Improvement Project

8. Whether a research study or quality improvement project,
attention to the design of the study, adequacy of data collection,
and appropriate data analysis are necessary
6
Examples of Patient
Safety Research
Schoonover and colleagues (2014) conducted a secondary
analysis of data from a study of medication discrepancies found
when patients transition from acute care to home
They found that the odds of unplanned hospital readmission was
5.45 times greater for those with higher medication regimen
complexity
7
Examples of Patient
Safety Research
Taber and colleagues (2014) looked at contributions to a
hospitalization for patients with a transplanted kidney
64% of participants experienced at least one medication error
12% experienced a clinically significant medication error

9. 8
Examples of Patient
Safety Research
Nationwide Children’s Hospital instituted a hospital-wide
culture transformation using the Institute of Healthcare
Improvement (IHI) model of improvement and expanded its
quality improvement program, which lowered the hospital’s
serious safety event rate by 83%
9
Design Challenges in Patient
Safety Research
Placing specific boundaries around the event of concern
Identifying the event in existing patient records, especially in
the qualitative portions of the record
10
Design Challenges in Patient
Safety Research
Noting the sequence of events and the date the event of interest

10. occurred
Comparing populations across different facilities
Measuring the degree of baseline adherence
11
Design Challenges in Patient
Safety Research
Using organization-wide interventions
Encompassing the contextual complexity of system change
Analyzing complex data
12
Ethical Research Considerations
It is often very difficult to obtain the consent of every patient to
be included in the study; however, individual patients need to
be given the opportunity whether they want to be part of the
study or not
13

11. Ethical Research Considerations
The Office for Human Research Protections has issued
guidelines when considering a request for waiver of consent:
Research involves no more than minimal risk
Only the minimum information necessary to conduct the
research will be collected
14
Ethical Research Considerations
The Office for Human Research Protections has issued
guidelines when considering a request for waiver of consent:
Confidentiality must be maintained; particular attention needs
to be paid to collection of any identifying information
15
Ethical Research Considerations
Situations that may qualify for a waiver of consent are:
The research cannot be reasonably carried out unless consent is
waived
Scientific rigor of the research would be threatened by consent
procedures

12. 16
Ethical Research Considerations
Baker and Persell (2015) made a few additional considerations
to waivers:
If consent cannot be obtained from every subject then the
research should only pose minimal risk to the subjects of the
research
Consider if the intervention can ethically be withheld from the
comparison group
17
Ethical Research Considerations
Baker and Persell (2015) made a few additional considerations
to waivers:
Data obtained under waiver of consent should be collected as
part of routine care, but if this cannot be done then consent may
be necessary
18
Guidelines for Publishing Safety and Quality Study Results

13. Indicate in the title that some type of improvement in the
quality of care was the purpose of the study
Be sure the review of the literature is balanced
Provide sufficient detail about implementation of the
improvement intervention
19
Guidelines for Publishing Safety and Quality Study Results
Description of the environment should include organization and
patient characteristics and factors likely to influence the
improvement project
Use appropriate analyses
20
Guidelines for Publishing Safety and Quality Study Results
When analyzing the outcomes, report the strength of the
intervention effect
When reporting outcomes, include both benefits and harms,
successes and failures, and lessons learned
Include estimates of cost factors

14. 21
Guidelines for Publishing Safety and Quality Study Results
Describe the local problem and the intended improvement
Write a description of the individuals or groups involved in the
project and characteristics of the setting in which the study was
done
22