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RESEARCH (Kerlinger) systematic, empirical, controlled & critical investigation of a hypothetical proposition related to natural
phenomenon.
PHENOMENON anything that affects human life
- disease, signs & symptoms, procedures, MD, RNs
HYPOTHESIS educated guess, scientific guess, tentative statement of a supposed answer.
- not known yet if true of false, right or wrong
RESEARCH - must be conducted to affirm or deny a hypothesis.
4 major Characteristics of a Scientific Research
1. Systematic follow step by step process. Fr identification of problem to conclusion.
2. Empirical proper objective. To collect data, facts & evidence to support hypothesis.
3. Controlled proper planning/ direction. Research design.
4. Critical investigation fact finding investigation. (synonym)
PURPOSE OF ASIENTIFIC NURSING RESEARCH
D descriptive purpose. Gain richer familiarity regarding a phenomena. Observation. 100% known to RN.
E exploratory purpose. 50% still unknown to RN.
E experimental purpose. Perform manipulation. Perform intervention. What to find out cause & effect.
D developmental purposes. Fro improvement of system of care.
F Nightingale birthplace. Italy
Training ground: Germany
Greatest contribution: environmental theory & training of RNs in Crimean War
School: St. Thomas School of Nursing
Patient nursing focus on research
10 MAJOR STEPS
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Identification or formulation of research problem

Review of related literature
conceptualization of conceptual/ theoretical framework
Formulation/ Adapting hypothesis
Choosing the appropriate design
Choosing sample from pop
Conducting final study or pilot study
Collection of data base
Analysis & interpretation of data base
Disseminating the conclusion & recommendation.

Problem: in res requires a solution

Sources (CLIENT) of good problem
C concepts
L literatures
I issues
E essays
N nursing problems
T theories
Char of good problem (GRIFINS)
G general applicability result should be helpful or applicable to all.
a.) basic/ Pre for personal knowledge
b.) Applied focus is solving problems of others
Re researchable collectable & abundant data
F feasible or measurable
a.) time

b.)
c.)
d.)
e.)
f.)

money/ cost
participants
instruments
experience
proper ethics of good researcher

I important
N novelty original to avoid plagiarism.
S significant
ETHICS OF A PROPER RESEARCHER: (SCIENTIFIC)
S scientific objective always (good faith)
C consent
I integrity
E equitable (appropriate acknowledgments) liable for
N noble Respect 3 basic rights of research sample
T truthfulness
I importance of topic to nursing profession
C courage to look for data.
Legal owner of chart: Hospital
Legal owner of data in the chart: Patient
Plagiarism illegal replication: no consent & acknowledge
3 rights of sample/ pt
1.) Right not to be harmed
2.) Right to self determination get consent & right to withdraw consent
3.) Right to privacy
a.) anonymity privacy of identity of informant
b.) confidentiality name given but privacy of info/ data
Harm that can happen to sample/pt
1.) right from physical , mental & moral harm
2.) Right to self determination
Negligence
1.) Commission unacceptable in standard of practice
2.) Owrission didnt do anything. No intervention done.
Mental Harm:
1.) Assault threatened. Mental fear
2.) Assault & Battery with mental fear & physical harm
3.) Battery with physical harm.
Moral harm
Slander
Oral defamation
Libel
Restraint dependent with doctors order
- physical vest or jacket
- chemical valium
A study in the difference in the financial income of Filipinos working in NYC & QC (comparative & basic)
Variables anything that is subject t change on manipulation.
1.) Independent variable target population
IV stimulus intervention
2.) Dependent variable response
DV response measured
Independent variable
(stimulus)

Target Population
(Organism)

Place of work

Filipino RNs

Dependent Variable
(Response)
Financial income early review Jan

Reviewers
Pavolovian Theory
(SOR) Stimulus Organism Response
Intervening variables comes between independent & dependent
ex. Organismic variable internal factors age, sex, gender, color.
Extraneous variable ext influences can be changed
Allure, citizenship, educational status
Dichotomus variable 2 choices/ results
Ex. Male or Female
Polychotmus multiple choices/ multi variables
Preferred food Japanese, Chinese, Filipino, American
Research
1.) Identity Problem
2.) Purpose objective (SMART)
3.) Define terms
4.) Revision of terms
S smart
M measurable
A attainable
R realistic
T time bound (limit)
Conceptual definition dictionary meaning
Operational definition based on use of research char of problem
Toxic conceptual waste products
Operational very busy day for RNs
Review of related literature
Purpose: for proper formulation of conceptual & theoretical framework.
Theory relationship bet concepts
Conceptual framework. Illustration showing relationship between variables
Paradigm- diagrammatic presentation / illustration of conceptual framework.
Source of review literature
1. Conceptual Sources authors & conceptualists ( DOH book, Lippincott, Mosbys)
- for general use, can be sold.
2. Research sources researchers cant be sold.
Types of Hypothesis:
1. NULL hypothesis (-) no relationship, no difference bet 1 variable to another
ex. Theres no diff regarding prof Opportunities in US & RP
2. Alterative, simple or operational hypothesis (+) show a relationship bet 1 variable to another
ex. Filipino RNs has more prof opportunities un US
3. complex hypothesis shows a relationship bet 2 or more variables to another.
Ex. Filipino RNs who worked for 5 yrs & passing all CG tests have opportunities to acquire starting salaries, insurance.
4. Directional Hypothesis specifies the direction of relationship bet variables
Ex. Filipino RNs working in USA have more prof opportunities than those in Phil

5. Non directional Hypothesis no specific direction

There is a big difference between all Filipino RNs working in the USA
5 Choosing appropriate design:
- skeletal framework of research
Research Design:
According to application or motive
According to approach
According to data
Method used applicable to quantitative research: survey
Case study focus 1 patient only or 1 family
Research Design
Application motive
Basic / pure

Approach

Data

Applied

Quantitative
(majority answer)
Survey

Qualitative
facts (single pt)
Case study

Non experimental
1.) Observe sample subject, Research has
2.) Massive participation
3.) Describe & record
4.) Natural setting where pop exists
Experimental:
1.) Active manipulation treatment or intervention done
2.) Active participation to sample pop
3.) Controlled setting lab research units
Types of non experimental res design.
1. Historical research design happened in the past
- collect written, published, circulated or archived
- pts chart
ex. Health practices during Crimean War
2. Expost Facto (after facts) (Retrospective)
- Antecedent facts happened
Study a group of people who have naturally experienced a particular phenomena related to a problem & has
something to do with present study
- Interview only, no manipulation! Subject is related to present problem.
3. Prospective focus; future time to look for a data existing subject with future happening
Focus: weekend review in pentagon
Result: of board exam this coming June
Present
future
4. Descriptive no intervention but merely observe & collect data.
Ex. Study on absentism in St Lukes
Study on environmental pollution in Quezon
Types:
a.) comparative study similarity & difference of variables
ex. Environmental pollution between variables

b.) Correlatonal relationship between variables

ex. Environmental pollution & increased TB cases
c.) Evaluative effects/ results
ex. Effects of environmental pollution
d.) Survey type data collection based on majority result
Types or survey research
1.) groups small group
2.) Face to face method
- can get response/ feed back right away
b.) Mailed survey method
Problem; data collection
3.) Time orientation
Cross sectional & longitudinal extend period of time.
2 or more
# of groups 1 core group/ long term study
unidentical groups
- purpose: devt/ study
- purpose: comparison
- initial & fallow up survey
- short term study
# of time
Steps in experimental type of research design
1. controlled stage discipline/ direction
a controlled group will not be subjective
experimental group will be manipulated
2. Randominization choose your sample by chance
3. Manipulation - intervention
4. Measurements of effect determine the result
Quasi experimental- when you lack in steps in experimental
Pop group where you get your sample
Types of sampling
1.) Probability choose sample by chance
Types of probability
Incidental sampling these present in coffee shop
a.) Simple random sampling equal chance/ opportunity to be chosen
- done if identical or equal footing
b.) Stratified random sampling create subdivided population (divide into 4 levels in school) or substrata before
doing randominization
c.) Cluster random sampling create sub areas MNL hospitals UST 3rd floor
d.) Systematic random sampling sampling frame
3,000 HIV patients in Phil write list of names appearing in pop uses multiple number in choosing.
2. Non probability sampling not by chance
- with pre-selected group, with braised group, favoritism
a.) Accidental or convenience sampling.
Criteria immediate availability/ accessibility of sample.
b.) Purposive/ judgmental sampling.
- based on personal knowledge/ info
ex. Research on prostitution
I know location of prostitution Ermita
Prostitution also in Pasay & Makati
I will not choose Pasay & Makati only
Ermita because I have personal info
c.) Snowball sampling based on last referral
d.) Quota sampling setting a certain criteria, with favoritism will choose only who he likes.
Collection of Data Base:
- time & budget consuming 70 80% time
Methods of collection of data
1.) Questionnaire source of collection f data

- pen & paper type of data

3 Major type of Q
a.) Dichotomasis (2) answerable by T/F, Y/N, right or wrong
b.) Checklist style rating scale 1,2,3,4,5 poor, fair, average. . .
c.) Multiple choice a) man b) dog c) cat d) all of the above
2.) Records easiest get pre existing data journals, essays, documents, newspapers
3.) Interviewer use oral communication
1.) Structured with checklist formal
2.) Non structured anything goes answer open ended questions.
The sample will expand on topic researcher will illicit answers their ACTIVE LISTENING.
4.) observation ocular approach
a.) Participant journey
b.) Non-participant passive observer but uses tools to determine results of data.
2 main problems in colleting data
1. Hawthornes effect problem in experimental design inaccurate due to consciously being observed
(PAASCU accreditation management keeps school clean before PAASCUA comes to school.
2. Halo Effect special relationship inaccurate due bias
- solution of researcher to avoid halo effect do double blind res method
Double blind research no bias or prejudice on treatment blind folded
- gives accuracy due not conscious & biased
Analysis & Later pultation of data phase
- research is forming a body of knowledge for the purpose providing an answer
2 Methods in presenting your analysis
1.) Qxuantitative using numerical or graphical presentation of answer
ex. 50% of q 500 Filipinos becomes 75% richer
- or use pie chart, bar graph, line graph
2.) Quantitive narrative approach using words (text) & facts
ex. Majority of all graduating students prefer to nursing course than PT

LEADERSHIP
Dissemination of Finding/ Core/ Recommendations
Importance of core conc is final result of study
How can conc affect others recommendation
Methods of dissemination of Findings/ Result
a.) Book
b.) Symposia oral
c.) Publication
LEADER will influence
LEADERSHIP
S
T
Y

1
L
E

P
R
4
group
Called
Followers

O
C 2
E
S
S

5 goal/ objective patient recipient of care

RNs implementor, assistant to dentist, Not leader

Principles for effective leadership

1. Unity of command all will receive orders, command from nurse manager/ supervisor
2. Unity of direction whole group leader &newborns will have goal towards patient.
3. Subordination of personnel to the general interest
- save patient 1st before self (ex fire in pt room)
R remove/ rescue patients
A alert fire alarm
C confine fire in / area
E extinguish fire
R run
4. Esprit de corps team spirit
fault of one is fault of all
credit of 1 is credit of all
5. Chain of command - hierarchy
Patient reacted to meds given, allergy. Inform MD he will give anti-histamine.
Incident report for purpose of risk management
- Report of sudden occurrence
- Go to Head nurse
Pt has appendicitis. Pain in RLQ who is primarily responsible for patient Head nurse.
HN can delegate to staff nurse pt died. Head Nurse is liable
Command responsibility Respondia Superior
Theories of effective leader.
1. Great man theory to be a good leader, leader must be born. Leaders cant be developed. Some are born a follower.
2. Trait theory behavior/ characteristic
P personality
I intelligence
A ability
Personality
+ attitude/ trait/ knows to adjust to pt adaptability
a.) acceptability can cope, adjust to needs of pt
b.) independent
c.) creative/ assertive
d.) advocate
Char of nurse if you are defender of patient against harm/ negligence advocate
Intelligence proper judgment
Proper decision
Fluency of speech
Ability influence others most effective way to influence pt HI optimum level of is attain OLF
Command of others
Respect others
Participate
Cooperate
3. Charismatic theory charm, charisma, inspirational quality
4. situational theory a person can be a good leader in 1 situation & a follower in another situation.
Case to case
Adv can get best person to the job
Disadvantage theres no continuity of leadership

Styles of leadership:
1. Autocratic authoritarian, dictatorial, bureaucratic traditional or Hard leader
- Unilateral style of nursing
- Leader is only 1 performing without input from other staff.
- Not getting opinion, recommendations
Char unilateral from style of staff leadership leader does decision making without.
A apathy not sensitive
B boisterous speech
C consistent
Demanding
E egoistic
F ferocious
Putting self in shoes of pet recognize & sensitive to pt. empathy
Not good style in leadership but good in emergency cases. Or during acute crisis.
2. Laizzes Faire/ Frierein/ Loose
- excess freedom / or liberates to members
- authority
neglect
control
malpractice
discipline

patients will suffer

3. Democratic / Participative
- gets input from members (decision making)
- Mutual participation
- Members makes mistake member will get notice/ hearing before discipline = due process
Quality/ Skills/ Abilities of good nursing leader:
A authority
B behavior
C Communication skills
D decision making
E ethics
F face conflict
A ability basis of a leader to unsure / demand task, obligation & resp to his subordinates.
2 types
1. Centralized top to bottom for proper management of whole hospital
- to problems of whole institution
2. Declaralized bottom (delegation)
- to manage directly pts or concerns
B. Behavior of good nurse leader:
S specific body of knowledge & skills to do safe care to patient. RN should be competent with scientific rationale
P patient cettered/ client focus
A accountability liable for result of actions
C confidentiality
E ethics
General rule: RN: can be charged with :
Invasion of privacy, breach of confidentiality
Exemption to gen rule (RN cant be charged with breach of confidentiality )
P patients consent
I inform/ report to other members of HC team for precautionary measure
C common dse (report) DOH/ WHO
C crimes within 48h report child abuse
RA 3573 Law on notifiable disease
Within 24h report disease like polio & measles

1 week HIV/ tetanus/ severs acute diarrhea

Priority for child rape sexual abuse, domestic abuse, all kinds of abuse
a.) report to barangay official
b.) report to police
c.) provide safe environment focus on pt 1st reporting can be done within 48h
d.) call med legal
Rule!! (in order)
1. S safety
2. R report
3. R referral DSWD, NGO
C communication skills
- transfer of ideas / info with understanding
Without understanding barrier/ backlog
Sender message (idea/ info which sender would like to transmit
Encoding verbal or non verbal method
Receiver recipient of communication
Decoding manner of interpretation after receiving messages
Feedback response of receiving after interpreting messages
D decision making
E ethics
Principle:
1. Autonomy independent judgment & decision making who should decide for care of patient.
a.) doc
b.) attending pt
c.) pt
d.) relatives
Pt refuses to remove lucky bracelet before surgery Bt due- Jehovahs witness
a.) respect decision of pt respect cultural diversity
b.) refer to doc let doc explain risks involve
c.) let pt sign a waver
Doctrine of assumption or risk
- pt given risks & signed waver
- pt will assume all the risks/ danger
Pills
IUD - string should be checked during & after mens
Diaphragm removed after 6h
Toxic shock syndrome
Vasectomy after 2 negative sperm count, 1st is probable 2nd is confirmatory
BTL can do coitus anytime. When pain & bleeding ceases.
Principles in leadership
Veracity truth dont give false reassurance
- all med prognosis, dx, sex of baby given by MD!
Beneficence doing good to pt
Non malefience do no harm
3 type of harm
1. Physical negligence by commission performed wrong action
negligence by omission neglect of care
2. Mental assault mental threat/ fear
battery physical harm
3. Moral slander verbal
libel written, published pictures
Tolality let pt feel like a whole being even if a part is removed.

- offer wigs, bandana CA pt prosthesis, casts, w/c amputation

Double effect if made to choose between 2 evils, choose the one that will have les bad effect. More good effect
Justice of care priority coz @ pt has unique needs.
Basic char or nursing process
A acceptance universable
B based on pts needs
C client focus
D dynamic update nursing process depending on clients needs
E equitable care
F familiarity
G goal oriented toward solving problem
Inviolability of life respect of life (promote H & prevent disease)
- no abortion!
Conflict clash of ideas resulting to crisis
Methods to solve conflict.
A avoidance putting in one corner dedma not good method
S smoothing appealing to conscience/ kindness
U unilateral force fear, threats correction
N negotiation best method both parties will mutually decide & participate to solve problem.
Nsg management
Mgt MAN+ TASK = GOAL (pts)
Theories:
1. Human relations theory must focus on proper relationship
If needs provided to member (rest day, leave)
Achievement of organization
2. Frederick Taylors scientific mgt theory
4 ts
Tao get rt person/ tao
Training
Tool
Tx
3. Douglas McGregor mgt theory Theory Y
Positive worker
- efficient
diligent
trustworthy
reliable
love their job
= minimal supervision only

Theory X
Negative worker
- inefficient
negligent
non trustworthy
dont love job
for the money only
= increase cases of negligence affecting pts.
= use cozf I d power to discipline workers

4. Max Webers burocaratic (autocratic) theory

- whoever is on top would perform mgt functions
- centralized
- not good style of management
5. Elton Mayos behavioral theory
- overtime pay, rest day, day off
- provide physical needs of worker like rest & recreation
- HAWTHORNES EFFECT if worker knows that they are being observed, workers will have
better output.
6. Henry Fayols principles of mgt
a.) Unity of command one person given instructions to workers
b.) Unity of direction whole team should have one goal, objective, direction towards pt.
c.) Subordination personal general interest pt 1st before self
d.) Esprit de corp team spirit all (-) & (+) output credited to the group
e.) Chain of command heiarchy of command

Get appropriate orders from MD

f.) Channels of communication
MD orders
SN
SN
g.) Respondent supervisor command responsibility
- let master answer for negligence conduct of subordinate
- liable: both
HN
liable for damages due resp supervisor
SN negligence - jail
h.) Security of tenure
i.) Re-numeration of workers compensation
- probationary 6 months
- regular employee
Private RA 4901 40% work 8h a day 5 days a week
Govt RA 7375 magna carta for public HWorker 15k
Overtime = + 25%
Night shift differential = +10%
Special non working holiday + 30%
Legal Holiday= X2 +100%
Occupational Hazard work related disease
Private SSS employees compensation
Govt GSIS
National health Insurance Act PhilHealth
- Provide for unemployed/ employed
- Aesthetic, cosmetic, dental not included
Maternity leave 60 days NSD
78 days C/S
1st 4 pregnancies to legit spouse
th
4. Abortions 5 pregnant - & delivered not entitled to maternity leave
Paternity leave 7 days
Stage/ Steps in nursing management process
P planning
O organizing
S staffing
D directing/ delegating
Co coordinating
Co controlling/ eval
Planning stage conceptualizing/ product of mind/ looking at future/ looking prospectively
Types:
Vision what org likes to achieve in future
Ex. Health for all by 2000
Heath in the hands of the people by 2020
Mission focus in present
- reason why org was established
ex. DOH to five quality health
Philosophy values. Besides org (members)
Goal gen statement of mission
Objective specific statement of mission
Goal- nursing form St. Lukes should provide quality care to pt
Objective nursing from St Lukes should have IV training (specific)
Policies set of rules/ regulation of org

3 types of plan
1.) Short term for every day ordinary activity
ex. NCP
2.) Contingency plan for emergency or acute crisis, stand by plan
3.) Long term plan duration of care is linger for chronic pts. Ex. CVA pts
Budgeting performed in planning stage
- proper allocation of resources
- Money, manpower, machine
1.) Operati0nal budget cheapest everyday ordinary activities (gloves, gown, goggles OR, LR, DR,ER)
2.) Personal/ labor budget used to compensate & re-numerate labor most important
3.) Capital budget long term use equipment
- MRI equipment, beds
Budget asks How
Organizing stage answers the question WHO
Nurse Mgr
RN
Subordinate
Nsg personnel nurse aid
RN will do: (for stable & unstable pt)
A assessment
T health teaching
when best time start discharge
E explain proc to pt
health teaching start during admission of pt
P preparation computation of dosage
A adm give meds or treatment
T treatment oral, IV, ID
E evaluation nursing care plan
J judgment PRN meds nursing will decide when to five
Subordinates can perform: (comfort measures only not VS)
R routine tasks standard procedure, monitor I & O ambulating, bathing bed making
- stable pts predictable outcomes
S stable pts
S supervision of RN
Styles/ method delivery care
1. Primary nursing private duty nurse from admission to d/c!
D direct plan of care to pt
A active participation/ consent of pt.
M mgt of care from basic to complex PD will do
24h from admission t o discharge
tip = answer is primary nurse
2. Functional most useful type
D duty task 1 RN all patients
O one task
H highly recommended
RNS
budget
3. Case Method ICU critical case
resp for: T total care (from basic care to most complex)
O one RN: 1 patient
In extreme cases 1:2 pts
Staffing stage how many
- nurse manager will determine correct # of patients/ RN
Staffing pattern Phil 40h/ wk/ 5d

Traditional 8h/40h/5d
10h shift 10h/ 4d Monday Thursday
On call emergency schedule
Baylor plan M F (traditional)
Sat-Sun (skeletal force)
Directing/ Delegation stage job/ task is done by another pt for you.
Gen rule: RN can delegate any task to another RN
Except: disciplinary task (this is done by higher person)
: confidential task (charting)
: technical task (expertice should be done by same expert)
: official medical task
Coordinating/ collaboration stage
1. canned food highest purine content (uric)
2. Anchovies next highest purine content
1. Interpersonal/ intra departmental collaboration bet 1 nurse to another nurse - under 1 ward
- ex. Endorsement
2. Interdepartmental collaboration between two or more hosp for benefit of pt.
Why RN needs to collaborate to others in HC team?
- pt is entitled to continuous care.
Evaluation stage determine whether, plan goal, objective where met or achieved
Types
1. Nurse rounds 2 x rounds/ day
- short term plan
Psyche ward contraindicated nurse rounds in psych ward
2. Checklist Nurse mgr evaluates/ rates member
3. Gam H chart used to evaluate nurses , multiple plan at same time
4. Peer evaluation co workers poorest type of eval cause might be effected by halo effect due to special relationship.
Performance Appraisal pt or client evaluates most reliable coz --------- or care evaluates.