Submitted by by Cynthia Gallagher, BSN, RN
During a regular day on a nursing unit, the critical care nurse may ask the question, “Why do we have to change central line dressings everyday and not every 72 hours? or “why do we have to keep the head of the bed up 30 degrees when the patient is intubated?” These types of questions are asked everyday and are at the heart of conducting evidence-based nursing research. Nursing concerns transpire everyday. It is the responsibility of the nurse to answer these profound questions in order to be able to provide the highest quality of care to their patients. It is because of evidence-based research that nursing has played a major role in the advances of medical technology in the past few decades, strengthening the quality of the profession.
Why do Research?
Bedside, practicing nurses is vital to nursing research. We are the ones that know the patients the best; we know what has been working for them and what does not. The findings that we obtain from doing research will provide us with a strong foundation to what we do everyday for our patients. We will have evidence-based data to utilize new ways to assess, evaluate, and deliver nursing care. Research will allow professional growth by supplying us with the most accurate tools and opportunities to advance the specialty where we work. On a personal level, it will create a leadership characteristic for yourself. You are the nurse that co-workers will go to mentor them and find concrete answers. It is not acceptable anymore to just say, “Well, this is the way it has always been done!”
Initiation of a nursing research project can be challenging, but rewarding, to not only the investigator, but nursing staff in a critical care unit. Building a foundation to launch the project must be emphasized to all members involved with specific roles clarified. The role of a primary investigator requires a working knowledge of the nursing research process. She or he has taken the responsibility of being a resource person to other fellow nurses. A commitment has been made to answer any questions, challenges or obstacles encountered throughout research development. They are the front runners in answering questions. Intense education must be done and can be difficult at times due to the high amount of nursing staff that must be educated about the nursing research process. The nurses must complete the study training process which usually includes completion of an institutional research review board 101 and attendance at an educational session on the use of the research methods and data collection tools. Teaching strategies may include videotaping the process for collecting the data from a “real subject.” Reviewing step-by-step instructions will give a visual representation for the adult learner and can increase the accuracy and continuity of assessing the patient. A bulletin board using a presentation format and examples of data collection tools can to enhance the accuracy of obtaining and recording the information correctly.
Selection of Team Members
Developing a subgroup of selective team members to be key personnel will aid in the reliability of gathering research data. If this is the first time a research project is being conducted in a specific nursing unit, it may be easier to seek out particular individuals to help in the process. These members may understand and electively want to participate in the process. Their positive attitudes will be contagious for the next research project! The other nurses will notice what it is like to be part of the team and want to develop their own nursing profession characteristics.
Retaining an advanced practice nurse (APN) as a co-investigator and mentor is a vital part in the nursing process for the project to take shape. This APN should be a mentor that the nursing staff appreciates and respects. Their time may be limited due to their other responsibilities, but will always be accessible for assistance. The expertise and knowledge they possess will promote the value of evidence-based research. Lastly, the APN can also assist in putting the research findings into clinical practice.
Obtaining support from the unit’s management team is essential in a successful nursing research project. Assistance through resources, time, training, energy, and discipline must be advocated to create an environment in which nursing research is accepted and necessary.
Challenges to Nursing Research
One of the major obstacles in conducting nursing research in any nursing unit includes the wide array of educational backgrounds in a particular nursing unit. Each person may possess a different understanding of the nursing process due to the requirements of diverse nursing education. Nurses’ educational backgrounds include graduating from diploma-based programs, or obtaining an associate’s degree or bachelor’s degree, while some are advancing their professional development on the master’s level. The bachelor’s and master’s prepared nurses may have an increased basis of nursing research and may help the other staff members alleviate possible frustrations in the learning process.
Depending on the time frame of a research project, the unit’s interest and participation may be like a roller coaster. Keeping nursing projects in a short time-frame will help maintain interest and attention. Results will be seen faster and self-satisfaction obtained from completing a task and seeing the light at the end of the tunnel. At times, staff may perceive they are doing someone else’s work, instead of having the attitude that they are part of the nursing process.
Encouragement for a job well-done must be expressed to keep everyone on the road to success and achievement.
Repetitive education must be done over and over again so accurate, detailed information can be obtained. Some key personnel may not have cared for a potential research participant for an extended period of time, and may need to be updated and reeducated on the process. This is why it is always good to have a permanent fixture, through bulletin boards and videos, accessible to the key members if needed.
Finding time and energy to review the nursing process becomes an obstacle at times for the investigators. Staffing concerns and providing a safe environment for the patients are top priority. To spend time analyzing data may become second priority in situations where patient care becomes affected.
Recommendations to improve Interest and Participation for Nursing Research
To promote nursing research, a continuous positive attitude must be displayed by all research team participants. Promoting the need to read, critique, and apply research to improve each nurses’ clinical practice. Some activities that can be promoted with fellow nurses include:
1. Participate in a research journal committee that involves meeting, reading and critiquing research articles. This may be part of a specific unit and can discuss future research possibilities that the nursing staff has been questioning.
2. Institutions of nursing education must emphasize the importance of evidenced-based nursing practice. Nursing academies must teach the new era of nurses the importance of research and has it has an impact on the profession.
3. Attend research presentations. Poster presentations are an excellent approach to spread word of the hard work that has been accomplished and the need to apply the evidence-based findings into clinical practice.
4. Assist in the collection of research information. Becoming a co-investigator to a research project will not only increase one’s own knowledge base of the research process, but will increase one’s professional growth and development.
5. Advocate for continuing educational offerings on the nursing research process. It is always helpful to review the process of conducting research to feel more comfortable in implementing the process.
Incorporating Research Findings
Incorporating research findings into nursing practice is the primary reason why research is done - to obtain evidence and validate the nursing care you do! Retaining the nursing findings without integrating them will not only deny the advancement and the quality of nursing care, but will provide an injustice to the nursing profession. You put the time and energy into collecting and analyzing the data, now take the time to integrate them!
At the end of the research project, celebrate, party, and enjoy! Remember to observe the effort the nursing members have taken to advance the nursing profession through all the hard work that has been completed. Lastly, publicize, market, and present the findings; it is of no use to conduct the project if you are not going to spread the word on what was researched!
Cynthia Gallagher, BSN, RN
Geisinger Medical Center
I would like to thank Terri Bickert, MSN, RN, Magnet Coordinator for Geisinger Health System for her mentorship in conducting nursing research. Your hard work and dedication to promote the nursing profession does not get overlooked. To Deb Mensch, MSN, Operations Manager CICU at GHS, for the time provided to conduct and analyze nursing research is appreciated. You have given another nurse professional and personal growth.