INTRODUCTION TO NURSING

RESEARCH
Adnan Yaqoob
PhD*, MScN, BScN
Assistant Professor
LSN, UOL
OBJECTIVES

At the end of this session, the learners will be to:

 Define nursing research
 Describe ways of knowing in nursing (tradition, authority, borrowing, trial and error,
intuition, and research)

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NURSING RESEARCH

“Nursing research is a scientific process that validates and defines existing body of

knowledge and generates new knowledge that directly or indirectly influences nursing

practice.”

(Burns & Grooves, 2011, p. 4)

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NURSING RESEARCH
CONT...

 Defining nursing knowledge requires determining the relevant knowledge needed by

nurses.
 Nursing is a practice profession, hence research is essential to develop and refine
knowledge that nurses can use to improve clinical practice.
 Expert researchers have studied many interventions and clinicians have synthesized these
to provide guidelines and protocols for use in practice.
 Practicing nurses need to be able to read research reports and syntheses of research
findings to implement evidence-based intervention for better patient outcome.

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NURSING RESEARCH
CONT..

For example:
 Extensive research has been conducted to determine the most effective technique for
administering medications through an intramuscular (IM) injection. This research was
synthesized and used to develop evidence-based guidelines for administering IM
injections.
 Nursing research is also needed to generate knowledge about nursing education, nursing
administration, healthcare services, characteristics of nurses, and nursing roles.
 The finding of these studies indirectly influence nursing practice and thus add to
nursing’s body of knowledge

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NURSING RESEARCH
CONT..

 Through research, nurses can develop and refine the best methods for delivering distance
nursing education.
 Nursing administration and health services studied are needed to improve the quality and
cost effectives of the health care delivery system.
 Studies of nurses and nursing roles can influence nurses' quality of care, productivity, job
satisfaction, and retention.
 In this era of nursing shortage, additional research is needed to determine the effective
ways to recruit individuals into and retain them in the profession of nursing.
 This type of research could have a major impact on the quality and the number of nurses
providing care to patients and families in the future.

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ACQUIRING KNOWLEDGE IN
NURSING
 Acquiring knowledge in nursing is essential for the delivery of quality patient and family
nurse care.

 Some key questions about knowledge include the following:

 What is knowledge?

 How is knowledge acquired in nursing?

 Is most of nursing’s knowledge based on research?

 Knowledge is essential information acquired in a variety of ways, expected to be an

accurate reflection of reality, an incorporated and used to direct a person's actions

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ACQUIRING KNOWLEDGE IN NURSING
CONT..

 During your nursing education, you acquired an extensive amount of knowledge from
your classroom and clinical experience.
 You had to learn, synthesize, incorporate, apply this knowledge so that you could practice
as a nurse
 The quality of nursing practice depends on the quality of the knowledge that you acquired.
 Thus you need to question the quality and credibility of new information that you hear or
read.

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ACQUIRING KNOWLEDGE IN NURSING
CONT..

For example:  Tradition

 What were the sources of knowledge that  Authority
you acquired during your nursing  Borrowing
education?  Trial and error
 Which interventions were based on  Personal experience
research, and which need further study to  Role modeling
determine their effectiveness?  Intuition and reasoning

 Nursing has historically acquired

knowledge through:
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TRADITION
 Tradition include “truth” or belief that are based on customs and trends.
 Nursing traditions from the past have been transferred to the present by written and oral
communication and role modeling, and they continue to influence the practice of nursing
For example:
 Some of the policies and procedure manuals in hospitals contain traditional ideas.
 Tradition can positively influence nursing practice because they were developed from
effective past experiences.

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TRADITION
CONT..

 However, tradition also can narrow and limit the knowledge sought for nursing practice.
For example:
 Nursing units are frequently organized and run according to set rules or traditions that may
not be efficient or effective.
 Often these traditions are neither questioned nor changed because they have existed for
years and are frequently supported by people with power and authority
 Nursing’s body of knowledge needs to be more evidence based than traditional if nurses
are to have powerful impact on patient outcome

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AUTHORITY

 An authority is a person with expertise and power who is able to influence opinion and
behavior
 A person is given authority because it is thought that she or he knows more in a given area
than others do
 Knowledge acquired from an authority is illustrated when one person credits another as
the source of information

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AUTHORITY
CONT..

 Nurses do publish articles and books or develop theories are frequently considered
authorities
 Students usually view their instructors as authorities
 Clinical nursing experts are considered authorities within the clinical practice setting
 It is important that nurses with authority act based on research evidence versus customs
and traditions

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BORROWING

 Some nursing leaders have described part of nursing’s knowledge as information borrowed from
discipline such as medicine, sociology, psychology, physiology, and education
 Borrowing in nursing involves the appropriation and use of knowledge from other field or
discipline to guide nursing practice
 Nursing ahs borrowed in two ways:
 For years, some nurses have taken information from other discipline and applied it directly to
nursing practice
 This information was not integrated within the unique focus of nursing
For example:
 Some nurses have used the medical model to guide their nursing practice, thus focusing on the
diagnosis and treatment of disease

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BORROWING
CONT..

 This type of borrowing continues today as nurses use advances in technology to become
highly specialized and focused on the detection and treatment of disease
 The second way of borrowing, which is more useful in nursing, involves integrating
information from other disciplines within the focus of nursing
For example:
 Nurses borrow knowledge from other disciplines like medicine but integrate this
knowledge in their holistic care of patients and families experiencing acute and chronic
illness

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TRIAL AND ERROR

 Trial and error is an approach with unknown outcome that is used in a situation of
uncertainty in which other sources of knowledge are unavailable.
 Because, each patient responds uniquely to a situation, there is uncertainty in nursing
practice.
 Hence, nurses must use trial and error in providing nursing care
 However, trial and error frequently involves no formal documentation of effective and
ineffective nursing actions
 With this strategy, knowledge is gained from experience, but often it is not shared with
others

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TRIAL AND ERROR
CONT..

 Trial and error approach to acquire knowledge also can be time consuming because you
may implement multiple interventions before finding one that is effective
 There also is a risk of implementing nursing actions that are detrimental to patients' health
 If studies are conducted on nursing interventions, selection and implementation of
interventions need to be based on scientific knowledge rather than trial and error.

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PERSONAL EXPERIENCE

 Personal experience involves gaining knowledge by being personally involved in an event,

situation, or circumstances.
 Personal experience enables the nurse to gain skills and expertise by providing care to
patients and families in clinical settings.
 Learning that occurs from personal experience enables the nurse to cluster ideas into a
meaningful whole.

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PERSONAL EXPERIENCE
CONT..

For example:
 You may read about giving IM injection or be told how to give an injection in a classroom
setting, but you do not “know” how to give an injection until you observe other nurses
giving injections to patients and actually give several injections yourself.

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PERSONAL EXPERIENCE
CONT..

 The amount of personal experience affects the complexity of a nurse’s knowledge base.
 Benner (1984) conducted a phenomenological qualitative study to identify the levels of
experience in the development of clinical knowledge and expertise and these include:
1. Novice
2. Advanced beginner
3. Competent
4. Proficient
5. Expert

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PERSONAL EXPERIENCE
CONT..

 Novice Nurses: have no personal experience in the work they are to perform, but they have
some preconceptions and expectations about clinical practice that they obtained during their
education.
 These preconceptions and expectations are challenged, refined, confirmed, or refused by
personal experience in a clinical settings.
 Advanced Beginner Nurse: has just enough experience to recognize and intervene in recurrent
situations.
 For example, the advance beginner is able to recognize and intervene in managing patients’
pain.
 Competent Nurses: are able to generate and achieve long-range goals and plans because of
years of personal experience.
 The competent nurse also is able to use personal knowledge to take conscious, deliberate
actions that are efficient and organized.

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PERSONAL EXPERIENCE
CONT..

 The Proficient Nurse: recognizes that each patient and family responds differently to
illness and health.
 The Expert Nurse: has an extensive background of experience and is able to identify
accurately and intervene skillfully in a situation.
 Personal experience increase the ability of the expert nurse to grasp a situation intuitively
with accuracy and speed.
 Benner’s (1984) qualitative research provided an increased understanding of how
knowledge is acquired through personal experience.
 As you gain clinical experience during your educational program and after you graduate,
you will note your movement through these different levels of knowledge

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ROLE MODELING

 Role modeling is learning by imitating the behaviors of an expert.

 In nursing, role modeling enables the novice nurse to learn through interactions with or
examples set by highly competent, expert nurses.
 Role models include admired teachers, experts clinicians, researchers, or persons who
inspire others through their examples.

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ROLE MODELING
CONT..

 An intense form of role modeling is mentorship, in which the expert nurse serves as a
teacher, sponsor, guide, and counselor for the novice nurse.
 The knowledge gained through personal experience is greatly enhanced by a high-quality
relationship with a role model or mentor.
 Many new graduates enter internship programs provided by clinical agencies so that
expert nurses can mentor them during the novices’ first few months of employment.

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INTUITION

 Intuition is an insight into or understanding of a situation or event as a whole that usually

cannot be explained logically
 Intuition is a type of knowing that seems to come unbidden, it may also be described as a
“gut feeling” or a “hunch.”
 Intuition cannot be explained scientifically with ease, therefore, many people are
uncomfortable with it.
 Intuition is not the lack of knowing, rather, it is a result of “deep” knowledge (benner,
1984).

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INTUITION
CONT..

 The knowledge is so deeply incorporated that it is difficult to bring it to the surface

consciously and express it in a logical manner
 Some nurses can intuitively recognized when a patient is experiencing a health crisis
 Using this intuitive knowledge, they can assess the patient’s condition and contact the
physician for medical intervention.

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REASONING

 Reasoning is the processing and organizing of ideas in order to reach conclusions.

 Through reasoning, people are able to make sense of their thoughts, experiences, and
research evidence.
 This type of logical thinking is often evident in the oral presentation of an argument in
which each part is linked to reach a logical conclusion.
 The science of logic includes inductive and deductive reasoning.
 Inductive reasoning moves from the specific to the general; particular instances are
observed and then combined into a larger whole or a general statement.
(Chinn & Kramer, 2008)

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ACQUIRING KNOWLEDGE THROUGH
NURSING RESEARCH
 Acquiring knowledge through traditions, authority, borrowing, trial and error, personal
experience, role modeling, intuition, and reasoning is important in nursing.
 However, these ways of acquiring knowledge are inadequate in providing evidence-based
practice
 The knowledge needed for practice is specific and holistic, as well as process oriented and
outcomes-focused

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CONT..

 Thus, a variety of research methods are needed to generate this knowledge.

 This section introduces quantitative, qualitative, and outcomes research methods that are
used to generate empirical knowledge for nursing practice.
 These research methods are essential to generate research evidence for specific goals of
the nursing profession:
 Promoting an understanding of patients’ and families’ experiences with health and
illness (a common focus of qualitative research)
 Implementing effective nursing interventions to promote patient health (a common
focus of quantitative research)
 Providing high-quality, cost-effective care within the health care system (a common
focus of outcomes research)

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REFERENCE

Burns, N., & Grove, S. K. (2010). Understanding Nursing Research: Building an Evidence-

Based Practice. St. Louis, MO: Elsevier Health Sciences.

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