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Chapter One

Introduction to Nursing Research & Evidence-Based Practice

Research defined:
The term Research consists of two words: Research = Re + Search. Re means again and again and Search means to find out something, the following is the process:

Observes Person Again and again Phenomena

data collection conclusion analysis of data

Therefore, research means to observe the phenomena again and again from different dimensions. elow are some definitions of research: It is systematic inquiry that uses disciplined methods to answer questions or solve problems. It is an honest, scientific investigation undertaken for the purpose of discovering new facts or establishing new

relationship among facts already known which will contribute to the present body of knowledge and can lead to an effective solution of existing The above definitions show that a research stud! ma! simpl! confirm facts which are assumed to e"ist# uncovers or discovers new facts not previousl! $nown# establish relationship between and among facts.


Thus findings of research can confirm, change or e"tend what is alread! $nown about a problem, or ma! suggest new $nowledge about a problem

Nursing research defined

Definition 1: %Nursing research is the systematic inquiry designed to develop knowledge about issues of importance to the nursing profession, including nursing practice, education,

administration, and informatics. informatics. Definition 2: Nursing research is the application of scientific inquiry to the phenomena of concern to nursing. Thus, by these definitions, to be called nursing research, study results must directly or indirectly affect clinical nursing practice and it must include all studies concerning nursing practice, nursing education, and nursing administration.

Examples of Nursing Research

Practice &ssessing patients' $nowledge and fears about ()* infection Education !A "T# Nursing students attitudes toward nursing research course Administration "urse taffing and Patient $ortality in %ntensive #are &nits


Professional #reating a 'ealthy (or)*lace for "e+ Generation Nurses nformatics &se of com*uteri,ed nursing documentation system

mportance of Nursing Research ecause nursing is a practice profession, nurses have in the past placed more emphasis on its practical aspects than on research. Thus, nurses have tended to accept ideas and !no"#edge fro$ authorities "ithout $uch %uestion& 'he i$portance of nursing research cannot (e

stressed enough& )o$e of the goa#s for conducting research are to: a. b. c. d. promote evidence+based nursing practice* ensure credi(i#it+ of the nursing profession* provide accountabilit! for nursing practice, and* document the cost effectiveness of nursing care.

& brief e"planation has been given for each of these points. Pro$oting Evidence-Based Nursing Practice


The ma,or reason for conducting nursing research is to foster optimum care for c#ients& Evidence-(ased nursing

practice ,EBNP- $eans that nurses $a!e c#inica# decisions (ased on the (est research evidence. their c#inica# e/pertise. and the hea#th care preferences of their patients0c#ients& 'he nursing profession e/ists to provide a service to societ+. and this service shou#d (e (ased on accurate !no"#edge& Research has (een deter$ined to (e the $ost re#ia(#e $eans of

o(taining !no"#edge& Ensure Credi(i#it+ of the Nursing Profession )n the past, nursing was fre-uentl! thought of as a vocation rather than a profession. In fact. the strugg#e to gain professiona# status has (een #ong and difficu#t& One of the criteria for a profession is the e/istence of a (od+ of !no"#edge that is distinct fro$ that of other discip#ines& Nursing has traditiona##+ (orro"ed

!no"#edge fro$ the natura# and socia# sciences. and on#+ in recent +ears have nurses concentrated on esta(#ishing a uni%ue (od+ of !no"#edge that "ou#d .


a##o" nursing to (e c#ear#+ identified as a distinct profession& 'he $ost va#id $eans of deve#oping this !no"#edge (ase is scientific research& 'hrough

research. nurses can deter$ine "hat it is that the+ do and ho" the+ do it that distinguishes the$ fro$ other groups in the hea#th care fie#d& Nurses $ust

de$onstrate to the genera# pu(#ic that nursing $a!es a difference& Provide 1ccounta(i#it+ for Nursing Practice &s nurses have become more independent in ma$ing decisions about the care of clients, their independence has brought about a greater need for accountabilit!. &lthough nurses have generall! been glad to achieve some degree of independence from the medical profession, in some wa!s life was easier when ph!sicians were considered to be

responsible for all aspects of health care. &t that time, if a nurse made a medication error, the ph!sician .and some+ times the hospital/ was held responsible. The idea of a lawsuit being brought against a nurse was almost

unthin$able. The general public has gained more $nowledge /










providers of care have increased& 'o (e accounta(#e for their practice. nurses $ust have a sound rationa#e for their actions. (ased on !no"#edge that is gained through scientific research& Nurses have the responsi(i#it+ of !eeping their !no"#edge (ase

current. and one of the (est sources of current !no"#edge is the research #iterature& 'he a(i#it+ to criti%ue research artic#es and deter$ine findings that are appropriate for practice is a s!i## that is needed (+ a## nurses
Practice0evidence based *ractice 123P4 a. 2ducation b. 'ealth care *olicy c. #ost0benefit d. !istinguish nursing as a *rofession %%. 5ole of nurses related to research0%n 1681, the A"A commission on "ursing 5esearch outlined the roles of various levels of nurses related to nursing research. a. 3accalaureate nurses are *rimarily consumers of nursing research7


i. 3e able to evaluate research in terms of its a**licability to nursing *ractice0research utili,ation ii. 3e able to identify *roblems for future investigation iii. Offer clinical e8*ertise to im*rove a *ro*osed research *lan iv. !ata collection v. %nform9assist +ith informed consent9ans+er :uestions vi. To incor*orate research findings into *ractice vii. hare research findings +ith colleagues

viii. Partici*ate in a ;ournal club i8. Attend research *resentations b. $asters *re*ared nurses +ill7 i. #onduct investigations ii. Assist others +ith their research iii. 'el* others a**ly research to *ractice iv. (or) to+ard develo*ing a climate conducive to research c. !octorally *re*ared nurses +ill i. !irect research *ro;ects ii. Provide leadershi* in conducting research and disseminating research findings %%%. 'istory of "ursing 5esearch a. 1<oo) over the Table on *.=4 b. (hat are the *riorities for the future> i. Outcomes research


ii. 2vidence0based *ractice iii. &tili,ation iv. 5e*lication to strengthen the )no+ledge base v. ?reater stress on integrative revie+s vi. $ultidisci*linary collaboration vii. !issemination viii. %ncreasing visibility9a+areness of nursing research %@. ources of )no+ledge a. Tradition b. Authority c. 'uman e8*erience i. $ay be restricted ii. $ay be *re;udiced or sub;ective d. Trial and error e. %ntuition f. <ogical reasoning i. %nductive reasoning ii. !eductive reasoning g. !isci*lined research @. Paradigms 1+orld vie+4 for "ursing 5esearch a. Positivist Paradigm0scientific method0:uantitative research i. Order0systematicA uses a *rocess or ste*s


ii. #ontrol0minimi,es bias and )ee*s unrelated factors from influencing results iii. 2m*iricism0observable +ith the senses iv. ?enerali,ation0results can be a**lied to a broader range of situations than ;ust the research situation itself v. Ob;ectivity0values held in chec) vi. !isadvantages0every study has some fla+s 1. 'umans are com*le8 2. $easurement *roblems0tools do not al+ays e8ist to measure the variable or conce*ts +e +ant -. $ay be vie+ed as overly sim*listic or reductionist .. $oral or ethical issues cannot be em*irically tested /. #ontol0difficult to control all *ossible influencing variables vii. Assum*tions 1. There is an ob;ective reality that is basically orderly. There is some consistency in nature. 2. All *henomena have causes 1!eterminism4. $uch research is the search for cause and effect. -. The researcher is inde*endent from those being studied. viii. Post *ositivist *aradigm0recogni,es the im*ossibility of total ob;ectivity b. "aturalistic Paradigm 1constructivist *aradigm40:ualitative research



ystematic collection and analysis of more sub;ective narrative materials, under conditions using a minimum of researcher im*osed control.


ometimes called BsoftC research

iii. $ore fle8ible than :uantitative research iv. A holistic a**roach v. 5esults in rich in0de*th information vi. ub;ectivity0values are inevitable

vii. 5esearcher interacts +ith those being studied viii. !isadvantages 1. "ot generali,able 2. 'umans are the instrument for gathering :ualitative data0 some are more s)illed than othersD c. $ulti*le *aradigms @%. Pur*oses of "ursing 5esearch a. %dentification0naming or identifying the *henomena b. !escri*tion0(hat are the characteristics of a given grou* c. 28*loration028*loratory studies loo) at *henomenon of interest and factors that influence it d. 28*lanation0focuses on understanding causes. $ay be lin)ed to a theory e. Prediction and control @%%. #ategories of 5esearch a. 3asic



b. A**lied