EVIDENCE-BASED

PRACTICE

AND
NURSING
RESEARCH
Nursing research

provides
the foundation for evidence-
based
nursing practice
Evidence-based practice

The process of systematically

finding, appraising, and using
research findings as the basis
for clinical practice - for
making decisions about patient
care.
 Development of Nursing
Knowledge
Evidence-Based Practice
(research-based practice, best
practice)
Integration of best research
evidence with clinical expertise
and patient values
Evidence-Based Practice
A move toward supporting practice
with evidence began in the mid-
1980s.
Agency for Healthcare Research and
Quality oversees publishing reviews
of evidence and clinical guidelines
and supports nursing research.
 The practice of Evidence-Based
Practice includes five fundamental
steps
Step 1: Formulating a well-built question
Step 2: Identifying articles and other
evidence-based resources that answer the
question
Step 3: Critically appraising the evidence to
assess its validity
Step 4: Applying the evidence
Step 5: Re-evaluating the application of
evidence and areas for improvement
DEFINITION OF NURSING
RESEARCH

Nursing research is a
systematic approach used to
examine phenomena important
to nursing and nurses, that
clinical practice be based on
scientific knowledge.
Research is a process of
systematic inquiry or study to
build knowledge in a discipline.
 NURSING RESEARCH
The purpose of research is to validate and
refine existing knowledge and develop new
knowledge.
The results of research process:
1. provide a foundation on which practice
decisions and behaviors are laid
2. create a strong scientific base for nursing
practice and application of results
demonstrates professional accountability to
insurers and health care consumers.
 NURSING RESEARCH
Nursing research aimed at
impacting the direct provision of
nursing and health care to
recipients of nursing care, nursing
research also is needed to
generate knowledge in areas that
affect nursing care processes
indirectly.
 EVIDENCE-BASED
PRACTICE
The introduction of evidence-based
change into the direct provision of
nursing care may occur at the
individual level of a particular
nurse or at varied organizational or
social levels.
Evidence generated by nursing
research provides support for the
quality and cost-effectiveness of
nursing interventions.
RESEARCH PRIORITIES

often set by groups that fund

research, encourage nurse
researchers to invest effort and
money into those areas of research
likely to generate the most benefit
to recipients of care,
the funding opportunities offered
by such groups don't hurt the
research enterprise either.
Sources of funding for nursing
research
The main outcome of research activity for a
nurse is to eventually put the knowledge
gained to work in health care delivery.
In USA there are the National Institute for
Nursing Research (NINR) and the Agency
for Healthcare Research and Quality
(AHRQ). Both of these organizations are
funded by federal congressional
appropriations.
Private foundations and nursing
organizations also provide funding for
nursing research.
Research is a process that takes
place in a series of steps:

1. Formulating the research question or problem

2. Defining the purpose of the study
3. Reviewing related literature
4. Formulating hypotheses and defining
variables
5. Selecting the research design
6. Selecting the population, sample, and setting
7. Conducting a pilot study
8. Collecting the data
9. Analyzing the data
10. Communicating conclusions
STUDY DESIGNS

Are plans that tell a researcher

how data are to be collected,
from whom data are to be
collected,
how data will be analyzed to
answer specific research
questions.
Research studies are classified
into two basic methods:
Quantitative research is a
formal, objective, systematic
process in which numeric data
are used.
Qualitative research is a
systematic approach used to
describe and promote
understanding of human
experiences such as pain
 NURSING RESEARCH
DESIGNS
The most common designs used in
health care research are case
study, survey, needs assessment,
experimental, quasiexperimental,
methodologic, meta-analysis, and
secondary analysis.
Case study designs
Are used to present an in-depth
analysis of a single subject, group,
institution, or other social unit.

The purpose is to gain insight and

provide background information
for more controlled broader
studies, develop explanations of
human processes, and provide rich
descriptive anecdotes
 Extramural Priority Areas for
Nursing research
a. Chronic conditions—arthritis, diabetes, urinary
incontinence, long-term care, and care giving

b. Health promotion and risk behaviors—

women's health, adolescence, menopause,
environmental health, exercise, nutrition, and
smoking cessation

c. Cardiopulmonary health—prevention and care

of persons with cardiac or respiratory conditions,
including research in critical care, trauma,
wound healing, and organ transplantation
Extramural Priority Areas for
Nursing research
d. Neurofunction and sensory conditions—pain
management, sleep disorders, and symptom
management in persons with cognitive impairment
and chronic neurologic conditions
e. Immune and neoplastic diseases(oncology)—
symptoms primarily associated with cancer and
acquired immune deficiency syndrome, such as
fatigue, nausea and vomiting, and cachexia, as
well as risk-factor prevention research
f. Reproductive and infant health—prevention of
premature labor, reduction of health-risk factors
during pregnancy, delivery of prenatal care, care
of neonates, infant growth and development, and
fertility issues
(From the National Institutes of Nursing Research
(NINR)
 NURSING RESEARCH
Nursing research (links education,
theory, nursing practice) provides the
basic for expanding the unique body
of scientific knowledge that forms the
foundation of nursing practice.
Research studies will emphasize
clinical issues, problems, and
outcomes. Priority will be given to
research studies that focus on
promoting health and developing
cost-effective health care systems.
 RESEARCH UTILIZATION

Through Research Utilization,

efforts and knowledge obtained
from research is transformed into
clinical practice, culminating in
nursing practice that is evidence-
based, to help understand the
importance of evidence-based
practice.
Nurse Researcher Roles

Two nursing roles are

specifically focused on
research: the clinical nurse
specialist (CNS) and the
clinical nurse researcher
(CNR).
CONSUMER OF RESEARCH
Nurses at all levels of educational
preparation have responsibility to
participate in the research process.
Nurses become knowledgeable consumers
of research through educational processes
and practical experience, must have a
basic understanding of the research
process and critical appraisal skills that
provide a standard for evaluating the
strengths and weaknesses of research
studies before applying them in clinical
practice.
CONSUMER OF RESEARCH

A consumer of research uses and

applies research in an active manner.
The nurse must be knowledgeable
consumer of research, one who can
critique research and use existing
standards to determine the merit and
readiness of research for use in
clinical practice.