Introduction to nursing research and

history
Younas Bhatti
Acting Principal
Bahawalpur College of Nursing, Bahawalpur

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 PURPOSES OF RESEARCH FOR IMPLEMENTING AN
EVIDENCE BASED NURSING PRACTICE
 Through nursing research, experimental knowledge can be
developed to improve nursing care, patient outcomes, and the
healthcare delivery system.
 Nurses need a solid research base to implement and document the
effectiveness of selected nursing interventions in treating
particular patient problems.
 It helps in promoting positive patient and family outcomes.
 Nurses need to use research findings to determine the best way to
deliver healthcare services to ensure that the greatest number of
people receive quality, safe care.

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 Cont…
 Research evidences provide a description, explanation, prediction,
and control of phenomena in clinical practice.
1. Description:
 Description involves identifying and understanding the nature of
nursing phenomena and, sometimes, the relationships among
them.
 Through Nursing research the nurses are able,
(1) Describe what exists in nursing practice;
(2) Discover new information;
(3) Promote understanding of situations;
(4) Classify information for use in the discipline.

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 Cont….
 Examples Include the following
 Identification of the incidence and spread of infection in healthcare
agencies
 Identification of the cluster of symptoms for a particular disease
 Description of the responses of individuals to a variety of health
conditions and aging
 Description of the health promotion and illness prevention
strategies used by a variety of populations
 Determination of the incidence of a disease locally (e.g., incidence
of West Nile virus in Texas), nationally, and internationally (e.g.,
spread of bird flu).

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 Cont….
 Rush, Watts, and Janke (2013, p. 10) have conducted a qualitative
study to describe “rural and urban older adults’ perspectives of
strength in their daily lives.”
 The findings from this study provided nurses with descriptions of
older adults’ perspectives of strength and the strategies that they
use to stay strong.
 The findings from this study to encourage physical, mental, and
social activities to assist older adults in staying strong.

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 Explanation
 Explanation clarifies the relationships among phenomena and identifies
possible reasons why certain events occur.
 Research focused on explanation provides the following types of
evidence essential for practice:
 Determination of assessment data (subjective data from the health
history and objective data from the physical examination) that need to
be gathered to address a patient’s health need
 The link of assessment data to a diagnosis
 The link of causative risk factors or causes to illness, morbidity, and
mortality
 Determination of the relationships among health risks, health
behaviors, and health status
 Determination of links among demographic characteristics, disease
status, psychosocial factors, and patients’ responses to treatment

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 Cont…
Example
 Manojlovich, Sidani, Covell, and Antonakos (2011) conducted an
outcomes study to examine the links or relationships between a “nurse
dose” (nurse characteristics and staffing) and adverse patient outcomes.
 The nurse characteristics examined were education, experience, and
skill . The staffing variables included full-time employees, registered
nurse (RN)-to-patient ratio, and RN hours per patient day.
 The adverse outcomes examined were methicillin-resistant
Staphylococcus aureus (MRSA) infections and reported patient falls for
a sample of inpatient adults in acute care units.
 The researchers found that the nurse characteristics and staffing
variables were significantly correlated with MRSA infections and
reported patient falls.
 Therefore the nursing characteristics and staffing were potential
predictors of the incidence of MRSA infections and patient falls.

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 Prediction
 Through prediction, one can estimate the probability of a specific
outcome in a given situation.
 Predicting an outcome does not necessarily enable one to modify or
control the outcome.
 It is through prediction that the risk of illness or injury is identified and
linked to possible screening methods to identify and prevent health
problems.
 Knowledge generated from research focused on prediction is critical for
EBP and includes the following:
 Prediction of the risk for a disease or injury in different populations
 Prediction of behaviors that promote health and prevent illness
 Prediction of the health care required based on a patient’s need and
values

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 Cont….
 Example
 Lee, Faucett, Gillen, Krause, and Landry (2013) conducted a
quantitative study to examine the factors that were perceived by
critical care nurses (CCNs) to predict the risk of musculoskeletal
(MSK) injury from work.
 They found that greater physical workload, greater job strain,
more frequent patient-handling tasks, and lack of a lifting team or
devices were predictive of the CCNs’ perceptions of risk of MSK
injury.
 The variables identified in predictive studies require additional
research to ensure that their manipulation or control results in
quality outcomes for patients, healthcare professionals, and
healthcare agencies.

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 Control
 The next step is to control or manipulate the situation to produce
the desired outcome.
 Control is the ability to write a prescription to produce the
desired results.
 Testing interventions to improve the health status of individuals,
families, and communities
 Testing interventions to improve healthcare delivery
 Synthesis of research for development into EBP guidelines
 Testing the effectiveness of EBP guideline in clinical agencies.

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 HISTORICAL DEVELOPMENT OF RESEARCH IN NURSING
 In1850, Florence Nightingale is recognized as the first nurse researcher.
 In1900, American Journal of Nursing was published.
 In 1950 American Nurses Association (ANA) published, the study of nursing
functions and activities.
 In1955 American Nurses Foundation (ANF) is established to fund nursing
research.
 In1965 ANA sponsors the first nursing research conferences.
 In1967 Sigma Theta Tau International Honor Society of Nursing publishes
Image, emphasizing nursing scholarship; now Journal of Nursing Scholarship.
 In1970 ANA Commission on Nursing Research is established.
 In1973 First Nursing Diagnosis Conference is held, which evolved into North
American Nursing Diagnosis Association (NANDA).
 In 2002 The Joint Commission revises accreditation policies for hospitals
supporting evidence-based health care and NANDA becomes international—
NANDA-I.

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 Levels of Research Evidence

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 Cont….
 Quantitative studies, especially experimental studies such as the
RCT, provide the strongest research evidence.
 The strength or validity of the best research evidence in an area
depends on the quality and quantity of the studies that have been
conducted in an area.
 The replication or repeating of studies with similar methodology
increases the strength of the research evidence generated.
 The levels of the research evidence are a continuum, with the
highest quality of research evidence at one end and weakest
research evidence at the other.

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 PROCESSES USED TO SYNTHESIZE
RESEARCH EVIDENCE

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 Outcomes Research
 This type of research focuses on examining the results of care and
determining the changes in health status for the patient.
Importance of outcome research:
 Nurses are playing an active role in conducting outcomes research by
participating in multidisciplinary research teams that examine the outcomes
of healthcare services.
 This knowledge provides a basis for improving the quality of care that
nurses deliver in practice.
Areas that require investigation through outcomes research:
(1) Patient responses to nursing and medical interventions;
(2) Functional maintenance or improvement of physical, mental, and social
functioning for the patient;
(3) Financial outcomes achieved with the provision of healthcare services; and
(4)Patient satisfaction with the health outcomes, care received, and healthcare
providers

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