This document discusses clinical nursing research in India. It begins by stating that in 2012, 55% of nursing practices in the USA were based on research findings, and the ANA predicts this will rise to 90% by 2020. In India, key organizations that support nursing research include the Nursing Research Society of India and the Clinical Nursing Research Society. The document defines clinical nursing research and explains why it is important for evidence-based practice and improving patient outcomes. It also discusses the roles of nurses in clinical research, common research designs, and challenges in conducting this type of research.

1. Dr.Latha Venkatesan
Principal, Apollo College of Nursing, Chennai 600 095
Email: latha6901@yahoo.com

5. How do we know in Nursing?

6. What is the Percentage of nursing practices
based on research findings in India?

7. It’s a trend !
• In 2012 USA 55% of all nursing
practices are based on research
findings.
• The American Nurses Association
(ANA) predicts that by 2020, 90% of all
nursing practice will be based on EBP
research findings.

8. Indian perspectives
• Nursing research Society of India
• Clinical Nursing Research Society in India
–Visit www.cnrsi.in
• TamilNadu Nurses and Midwives Council
–Nursing Research Archives

9. What is Clinical Nursing Research
Clinical research is a branch of healthcare science that determines the
safety and effectiveness (efficacy) of medications, devices, diagnostic
products and treatment regimens intended for human use.
These may be used for prevention, treatment, diagnosis or for relieving
symptoms of a disease.
Clinical nursing research is a systematic inquiry into the problems
encountered in nursing practice and into the modalities of patient care.

10. Myths around CNR…..
Clinical research Vs Clinical trials
EBP is not synonymous with research.
• Research focuses on discovery
• EBP focuses on application
Clinical Nursing Research is not synonymous with Nursing
Audit

11. Levels of Evidence

12. Why clinical nursing research is important
to nursing practice?
• It results in better patient outcomes.
• It contributes to the science of nursing.
• It keeps practice current and relevant.
• It increases confidence in decision making.
• Policies and procedures are current and include
the latest research, thus supporting JCAHO-
readiness.

13. Need for clinical nursing research

14. Why Nurses?
• Critical members of the patient care team
• Empathy, sympathy and noble fellow beings.
• Closer to the participants/patients
• Care and research are a continuum .
• Patience and good interpersonal relationships.
• Recognized globally nurses play a important role in emancipating
quality care by research and quality framework.

15. Role of Nurses in Clinical Research

17. Clinical Research Nurses(Scottish Research Nurses Network)

18. Clinical Nurse Researcher in Clinical Research

19. Sources of CNR
Benchmarking data Clinical expertise
Cost-effective analysis Infection control
data

20. Sources of CNR
Medical
record data
National
standards of
care
Quality
Improvement
data
Patient & Family
preferences

21. Clinical Nursing Research Priorities
Effective work force
• Evaluating the competency frameworks
• Nurse :Patient Ratios etc..
• exploration of different models of care delivery
• program development
Effective clinical outcomes/ clinical governance
• Clinical innovation
• Optimising patient outcomes
• Systems & process evaluation
• Integration of evidence into practice
• Quality improvement initiatives eg. Lean six sigma for waste reduction

22. CNR priorities ….contd
Positive experiences/colloborations
• the process of developing of partnerships with consumers
• fostering engagement with patients and families to participate in their own care
• the impact of disease processes and interventions upon the quality of life for
patients and their families.
Patient safety and Zero Harm
• Incident review
• Development of Policies and protocols
• Systems analysis
• Clinical risk management
• Product development

24. Steps in Clinical Research
Formulating the
research question
based on day to
day care
Defining the
purpose of the
study
Reviewing related
literature and
Formulating
hypotheses and
defining variables
Selecting the
research design,
sample setting
Conducting a pilot
study
Collecting and
analyzing the data
Change of
practice towards
quality
improvement.

25. Regulations
• The Clinical Trials Registry- India (CTRI) has been set up
by the ICMR's National Institute of Medical Statistics
(NIMS) and is funded by the Department of Science and
Technology (DST) through the Indian Council of Medical
Research (ICMR).
• Institutional ethics committee – Registration with
CDSCO/DCGI

26. Process of clinical Research

27. Tools of Clinical Research

28. Referenced Rationale & Quality of Evidence Rating Contd-
• The PICOT format
28
Elements
Participants Newborn babies with Vernix Caseosa
Intervention is it really works out the baby’s skin?
Comparison Compared with its properties.
Outcome Protection against infection, Decreased
Skin permeability, Skin cleansing,
Moisturisation the skin Surface
PH Development ,Wound Healing.
Timeframe During Postnatal period

29. Clinical Nursing Research Designs
Qualitative
research
Lean Six
Sigma
Experimental
research
designs
• Pre
experimental,
Quasi
experimental,
RCT
Analytical
studies
• Case control studies
• Cohort studies
• Epidemiological
studies
Descriptive
designs
• Surveys,
• correlational studies

32. Cochrane Database of Systematic
Reviews
• The Cochrane Database of Systematic Reviews (CDSR)
is the leading journal and database for systematic reviews
in health care. CDSR includes Cochrane Reviews
(systematic reviews) and protocols for Cochrane Reviews
as well as editorials and supplements.
• CDSR (ISSN 1469-493X) is owned and produced by
Cochrane, a global, independent network of researchers,
professionals, patients, carers, and people interested in
health.

33. Challenges in Clinical Nursing Research
Navigating
Organizational
restructuring
Managing
with the
uncertainty
Creating
reciprocity
Controlling
Extraneous
variables
Working with
Economic
Constraints

34. Any queries ???