Chapter 13 Evidence-Based Practice and Nursing Research

Research

Systemic investigation to validate or refine old knowledge or generate new knowledge

Purpose of nursing research

to advance nursing knowledge, Shapes health policy, Impacts the health of individuals, Influences nursing education

Basic Research

Provide explanations for phenomena (generate theories)

Applied research

Tests theories in different situations with different populations

Clinical research

Tests theories about the effectiveness of interventions

 American Nurses Association Research Standards

Use the best available evidence to guide practice decisions. Participate in appropriate research activities

Quantitative

Produces data in the form of numbers

Types of Quantitative research

descriptive, correlational, experimental, quasi-experimental

Descriptive

identifies data and characteristics about the population or phenomenon (a fact, event, or circumstance that can be observed or experienced)

Correlational

research is to find a relationship between two variables

Experimental research

Does one variable have a cause-and-effect relationship with another variable

Quasi-experimental research

Examines a causal relationship between variables but may not meet the strict guidelines of experimental research

Qualitative Research

Usually results in data expressed in words often in narrative form. Focuses on personal beliefs, thoughts, and feelings. Uses inductive reasoning which generalizes from specific facts

Types of Qualitative Research

Phenomenological, grounded theory, ethnography, and historical

Phenomenological

Explores reactions of groups of people who experienced a similar event

Grounded theory

derives theories from the data collected

Ethnography

focuses on sociocultural phenomenon

Historical

studies historical documents to determine an accurate picture of a past event

Literature Review

Determines what is already known on a topic and identifies any gaps in knowledge about the topic. Types is integrative, systematic, and meta-analysis.

Integrative

synthesizes research findings and formulates ideas about future research

Systematic

provides a comprehensive unbiased analysis; uses a strict scientific design to select and assess each of the studies

Meta-analysis

merges statistics from related studies to discover similarities and differences

Confidentiality

assurance that information can be reviewed only by those needing access

Anonymity

subject data is de-identified so subjects cannot be identified in any way.  Often subjects are assigned numbers.

Research utilization

As research is conducted evidence accumulates and then is put into practice

EBP

Applies cost effective and clinically effective evidence to nursing practice

Barriers to evidence-based practice

 Difficulty of communicating how to conduct EBP, Individual skills in determining the quality of research, Cost, and Quantity of research available to review

 PICO(T)

•P – patient, population, or problem

•I – Intervention

•C – Comparison

•O – Outcome

•T – time

Internal validity

determine if the results of a study is reasonable based on how it was conducted

External validity

Validity: can the results be applied to other settings

Result analysis

Results reported in terms of significance. Significance determined by analyzing the size and the precision of the treatment effect

Magnet hospitals:

•Have excellent patient outcomes due to nursing

•High level of nursing job satisfaction with low nursing turnover

•Appropriate resolution of grievances

•Supports an evidence-based environment

•Supports nurse’s autonomy

•Research and EBP are part of the nurses’ care of the patients