Nursing Research Notes standards of care and enhanced patient

safety.
● Fostering Professional Development:
What Is Nursing Research?
Engaging with research enables nurses
Nursing research is a systematic inquiry to stay current with the latest
designed to develop knowledge about issues advancements in the field, promoting
of importance to the nursing profession, lifelong learning and professional
including clinical practice, education, and growth.
administration. It involves the careful and ● Guiding Policy and Protocols:
rigorous investigation of phenomena related Research provides the evidence needed
to health, illness, and nursing care, with the to develop clinical guidelines, policies,
goal of enhancing patient outcomes, and protocols that ensure consistency
advancing nursing practice, and contributing and quality in patient care.
to the overall body of healthcare knowledge. ● Encouraging Critical Thinking:
Research encourages nurses to critically
Nursing research can be broadly categorized appraise existing knowledge and to
into two main types: question and refine current practices.

● Quantitative Research: Focuses on Roles of Nurses in Research

numerical data and statistical analysis
to answer questions about relationships Nurses can play various roles in research,
among variables or to test hypotheses. depending on their level of education,
● Qualitative Research: Explores human experience, and interest:
experiences, behaviors, and interactions
● Consumer: All nurses are consumers of
through narrative data, often aiming to
research, using findings to inform their
understand phenomena from the
practice. They need to critically
perspectives of those experiencing
appraise research studies and apply
them.
relevant evidence to their clinical
The Importance of Research to decisions.
Evidence-Based Nursing Practice ● Collaborator: Nurses often collaborate
with researchers by participating in
Evidence-Based Practice (EBP) is the data collection, recruitment of
integration of the best available research participants, and implementation of
evidence with clinical expertise and patient research protocols.
values to facilitate clinical decision-making. ● Principal Investigator (PI): Advanced
Nursing research is fundamental to EBP as it practice nurses or nurse researchers
provides the scientific foundation upon which may take on the role of PI, leading
nursing practice is built. The importance of research projects, designing studies,
research to EBP includes: and disseminating findings.
● Educator: Nurse educators incorporate
● Improving Patient Outcomes: research findings into their teaching to
Research findings help nurses prepare students for evidence-based
implement the most effective practice.
interventions, thereby improving ● Advocate: Nurses advocate for the
patient care and health outcomes. ethical conduct of research and the
● Enhancing Healthcare Quality: protection of human subjects, ensuring
Through research, nurses can identify that studies are conducted with respect
best practices, leading to improved for participants’ rights.
NURSING RESEARCH: PAST, ● Growth of Evidence-Based Practice:
PRESENT, AND FUTURE The emphasis on EBP has driven a surge
in research focused on clinical
The Early Years: From Nightingale to the effectiveness, patient safety, and
1970s quality improvement.

Nursing research has its roots in the work of Directions for Nursing Research in the New
Florence Nightingale, who used statistical data Millennium
to improve sanitary conditions in hospitals,
In the 21st century, nursing research continues
reducing mortality rates. Her work laid the
to evolve, with several emerging trends:
foundation for the use of evidence in nursing
practice.
● Precision Health: Research is
increasingly focusing on personalized
● Late 19th and Early 20th Century:
and precision health, tailoring
Nursing research was largely focused
interventions to individual genetic,
on education, with studies aimed at
environmental, and lifestyle factors.
improving nursing education and
● Global Health: Nursing research is
professionalization.
addressing global health challenges,
● 1950s-1970s: The development of
including infectious diseases, health
nursing as a scientific discipline gained
disparities, and the effects of climate
momentum. The establishment of
change on health.
nursing research centers, such as the
● Health Technology: The integration of
National Institute of Nursing Research
digital health technologies, such as
(NINR), and the creation of research
telemedicine, mobile health apps, and
journals, marked significant progress.
electronic health records, is a growing
During this period, nursing research
area of research.
began to focus more on clinical practice
● Patient-Centered Care: Research is
and patient care outcomes.
emphasizing the importance of
Nursing Research Since 1980 patient-centered care, ensuring that
patients’ values and preferences are
Since the 1980s, nursing research has central to decision-making.
expanded significantly: ● Interprofessional Research:
Collaboration across disciplines
● Development of Theoretical
continues to grow, with nurses
Frameworks: Nursing research began
contributing to and leading research in
to be grounded in nursing theories,
diverse healthcare teams.
providing a more structured approach
to studying phenomena.
SOURCES OF EVIDENCE FOR
● Interdisciplinary Collaboration:
NURSING PRACTICE
Nursing research increasingly involved
collaboration with other healthcare
Tradition and Authority
disciplines, leading to more
comprehensive studies on complex Tradition and authority have historically
healthcare issues. played a significant role in shaping nursing
● Technology and Research: Advances in practice. Practices passed down through
technology have transformed nursing generations or advocated by respected
research, enabling more sophisticated authorities were often accepted without
data collection, analysis, and question. However, reliance on tradition and
dissemination methods. authority is increasingly being replaced by
evidence-based approaches, as these sources valid information for informing clinical
may not always be supported by current decisions and is the foundation of
scientific evidence. evidence-based practice.

Clinical Experience, Trial and Error, and PARADIGMS FOR NURSING

Intuition
RESEARCH
● Clinical Experience: Nurses accumulate
The Positivist Paradigm
valuable knowledge through their
clinical experiences. This experiential The positivist paradigm is grounded in the
knowledge, while subjective, is an belief that reality is objective and can be
important complement to research measured and quantified. It is associated with
evidence in clinical decision-making. quantitative research methods, such as
● Trial and Error: In the absence of solid experiments and surveys, which aim to test
evidence, nurses may resort to trial and hypotheses and establish cause-and-effect
error to find solutions to clinical relationships. Positivism is often used in
problems. While this can lead to studies that seek to generalize findings to
practical solutions, it lacks the rigor of broader populations.
research-based evidence.
● Intuition: Intuition, or the "gut feeling" The Naturalistic Paradigm
developed through experience, plays a
role in nursing practice. While it can be The naturalistic paradigm, also known as
valuable, it should be balanced with constructivism, posits that reality is subjective
empirical evidence to avoid biases. and constructed by individuals based on their
experiences and perceptions. This paradigm is
Logical Reasoning associated with qualitative research methods,
such as ethnography, phenomenology, and
Logical reasoning involves the systematic use grounded theory, which aim to explore the
of deductive (general to specific) and meanings and experiences of individuals
inductive (specific to general) reasoning to within their natural contexts.
make clinical decisions. While logical
reasoning is important, it must be supported Paradigms and Methods: Quantitative and
by evidence to ensure that conclusions are Qualitative Research
valid and reliable.
● Quantitative Research: Uses numerical
Assembled Information data and statistical analysis to test
hypotheses and measure variables. It is
Assembled information refers to the use of rooted in the positivist paradigm and is
aggregated data from sources such as clinical often used in experimental,
guidelines, quality improvement reports, and correlational, and survey research.
expert consensus. While these sources provide ● Qualitative Research: Focuses on
valuable insights, they must be critically understanding human experiences and
appraised to ensure that they are based on social phenomena through narrative
robust evidence. data. It is rooted in the naturalistic
paradigm and employs methods like
Disciplined Research
interviews, focus groups, and
Disciplined research, characterized by rigorous observations.
methodology and peer review, is the gold
Multiple Paradigms and Nursing Research
standard for generating evidence in nursing
practice. It provides the most reliable and
Nursing research often embraces multiple guidelines, ensuring they are based on
paradigms to address the complexity of the best available evidence.
healthcare. Mixed-methods research, which ● Improving Patient Care: By translating
combines quantitative and qualitative research findings into practice, nurses
approaches, is increasingly used to provide a can enhance the quality and safety of
more comprehensive understanding of patient care.
research questions. By integrating different
paradigms, nursing research can address Quantitative Research Example
diverse aspects of healthcare phenomena.
Study The study conducted by Badger et al.
PURPOSES OF NURSING RESEARCH (2007) focused on examining depression and
anxiety in women with breast cancer and their
Research to Achieve Various Levels of partners.
Explanation
Study Purpose The purpose of the study was
Nursing research serves multiple purposes, to assess the effectiveness of psychosocial
from describing phenomena to explaining interventions delivered via telephone in
relationships and predicting outcomes: reducing depression and anxiety among
women with breast cancer and their partners.
● Descriptive Research: Aims to describe
characteristics of a population or Study Methods A total of 96 women
phenomenon. It answers the "what" diagnosed with breast cancer and their
questions, such as "What are the most partners participated in the study. The
common symptoms of a disease?" researchers implemented two distinct but
● Exploratory Research: Seeks to explore complementary interventions using a
and clarify relationships among telephone-based delivery method. The first
variables. It often answers the "how" or intervention was a 6-week Telephone
"why" questions, such as "How do Interpersonal Counseling (TIP-C) program,
patients cope with chronic illness?" which combined cancer education with
● Explanatory Research: Focuses on interpersonal counseling aimed at enhancing
understanding the causes of social support behaviors in both the cancer
phenomena. It aims to explain "why" survivors and their partners. The second
something happens, such as "Why do intervention was a 6-week telephone program
certain interventions work better than focused on self-managed exercise (EX).
others?" Participants were randomly assigned to one of
● Predictive Research: Aims to predict the two intervention groups or to a control
outcomes based on certain variables or group (CON) that did not receive either
conditions, helping to forecast the intervention but was provided with printed
effects of interventions or identify information and brief weekly check-in calls. All
at-risk populations. participants, including partners, were assessed
at three time points: before the study began, 6
Research Purposes Linked to EBP weeks later, and again at 10 weeks. The
assessments included measures of depression
● Informing Clinical Practice: Research
and anxiety.
provides the evidence needed to
develop and refine clinical interventions Key Findings The study results indicated that
and protocols. both the TIP-C and EX intervention groups
● Guiding Policy Development: Research experienced reductions in anxiety for both the
informs healthcare policies and women and their partners, while the control
group did not show similar improvements.
Depression levels decreased over time in all Key Terms
three groups.

Conclusions The study concluded that both

Assumption
telephone-delivered interventions were
An assumption in research is a basic principle
effective in enhancing the psychological
or belief that is accepted as true without proof.
quality of life for women with breast cancer
Assumptions form the foundation of the
and their partners when compared to those
study's design, influencing its methods,
who did not receive either intervention.
hypotheses, and interpretation of results. They
are often taken for granted and are necessary
Qualitative Research Example
for the study's framework but are not tested
within the study.
Study The study by Gillespie et al. (2007)
focused on the experiences of mothers raising
a child with food-induced anaphylaxis (FIA).
Cause-Probing Research

Study Purpose The aim of this study was to Cause-probing research is a type of study
create a narrative account that captures the designed to explore the causes of certain
essence of the lived experiences of mothers phenomena, aiming to establish a
who are parenting a child with food-induced cause-and-effect relationship between
anaphylaxis. variables. This type of research often involves
experiments or longitudinal studies to
Study Methods The study involved six mothers determine whether a specific factor leads to a
of children aged 6 to 12 who were considered particular outcome.
at risk for FIA. The children had various food
allergies, with peanut allergy being the most Clinical Nursing Research
common. Each mother participated in two
in-depth interviews, lasting between 1.5 to 2 Clinical nursing research focuses on questions
hours, conducted in their homes. The relevant to nursing practice, particularly within
interviews, which were audiotaped and later a clinical setting. It aims to generate evidence
transcribed, explored the mothers’ experiences that can improve patient care, nursing
of raising a child with a life-threatening food interventions, and health outcomes. This
allergy. research is often applied and practical,
addressing real-world problems encountered in
Key Findings The central theme identified healthcare environments.
from the mothers' experiences was “living with
risk,” which was further broken down into five Deductive Reasoning
supporting themes: (1) living with fear; (2)
worrying about the child’s well-being; (3) Deductive reasoning is a logical process in
seeking control; (4) relying on resources; and which conclusions are drawn from a general
(5) acknowledging that it’s hard, but premise or theory. It involves moving from a
manageable. Each of these themes was broad, general principle to a specific
illustrated with detailed narratives from the conclusion. In research, deductive reasoning is
interviews. often used to test hypotheses derived from
existing theories.
Conclusions The researchers concluded that
the themes reflecting the mothers’ fears and Determinism
concerns could be valuable for nurses in
providing education and support to families Determinism is the philosophical belief that all
dealing with food-induced anaphylaxis. events, including human actions, are
determined by preceding causes. In research,
it suggests that every event or state of affairs, Inductive Reasoning
including human behavior, is the result of
specific, identifiable factors, often leading Inductive reasoning is the process of
researchers to focus on identifying and developing general conclusions based on
understanding these factors. specific observations or data. In research, it
involves moving from detailed, individual
Empirical Evidence instances to broader generalizations or
theories, often used in qualitative research to
Empirical evidence is data and information develop new theories or insights.
obtained through observation,
experimentation, or experience. It is based on Intervention Research
tangible, measurable facts and is considered
the foundation of scientific research, as it Intervention research investigates the effects
allows researchers to verify hypotheses of specific actions or interventions, such as
through objective observation and analysis. medical treatments, educational programs, or
policy changes, on certain outcomes. This type
Evidence-Based Practice (EBP) of research is designed to test the efficacy and
effectiveness of interventions to determine
Evidence-based practice is an approach to their impact on individuals or groups.
healthcare that integrates the best available
research evidence with clinical expertise and Naturalistic Paradigm
patient preferences. EBP aims to provide
high-quality care by applying the most current The naturalistic paradigm is a philosophical
and relevant evidence to clinical framework that assumes reality is subjective
decision-making. and constructed by individuals based on their
experiences. Research within this paradigm
Evidence Hierarchy typically involves qualitative methods that
explore human experiences in natural settings,
An evidence hierarchy is a ranking system focusing on understanding phenomena from
used to categorize the strength and reliability the participants' perspectives.
of research evidence. At the top of the
hierarchy are systematic reviews and Nursing Research
meta-analyses, followed by randomized
controlled trials, cohort studies, case-control Nursing research is the systematic study of
studies, and, at the bottom, expert opinion and issues related to nursing practice, education,
case reports. The hierarchy helps clinicians and administration. It aims to develop
determine the quality of evidence when knowledge that improves patient care,
making decisions. enhances nursing practice, and contributes to
the overall health and well-being of individuals
Generalizability and communities.

Generalizability refers to the extent to which Paradigm

the findings of a study can be applied to
broader populations or different contexts A paradigm is a set of beliefs, values, and
outside the study sample. High generalizability assumptions that guide how research is
means that the study's results are applicable conducted within a particular discipline. It
to a wide range of situations, while low provides the underlying framework for how
generalizability suggests that the findings are researchers understand the world, what they
specific to the study's context. consider valid knowledge, and how they go
about acquiring it. In nursing research, the
positivist and naturalistic paradigms are the on each other, contributing to the development
most common. of a comprehensive understanding of the
research question or problem.
Positivist Paradigm
Scientific Method
The positivist paradigm is a research
framework based on the belief that reality is The scientific method is a systematic, logical
objective and can be measured and approach to discovering how things in the
quantified. Research under this paradigm universe work. It involves making
typically involves quantitative methods, such observations, forming hypotheses, conducting
as experiments and surveys, aimed at experiments, analyzing results, and drawing
identifying generalizable laws and conclusions. The scientific method ensures that
cause-and-effect relationships. research findings are based on empirical
evidence and can be replicated and verified by
Qualitative Research others.

Qualitative research is a methodological Systematic Review

approach focused on understanding human
experiences, behaviors, and social A systematic review is a rigorous, structured
phenomena. It involves collecting approach to synthesizing research evidence on
non-numerical data, such as interviews, a particular topic. It involves a comprehensive
observations, and text, to gain insights into search of the literature, critical appraisal of
the meanings, motivations, and contexts of studies, and a synthesis of findings. Systematic
human actions. reviews often inform evidence-based practice
by summarizing the best available evidence on
Quantitative Research a given question.

Quantitative research is a methodological BACKGROUND OF EVIDENCE-BASED

approach that emphasizes the measurement
NURSING PRACTICE
and analysis of variables using numerical data.
It involves structured data collection methods, Research Utilization
such as surveys and experiments, and employs
statistical analysis to test hypotheses and Research utilization in nursing refers to the
quantify relationships between variables. process of synthesizing, disseminating, and
using research-generated knowledge to make
Research Methods changes in clinical practice. It emphasizes
applying research findings to improve patient
Research methods refer to the specific outcomes, refine clinical procedures, and
strategies, techniques, and procedures used to enhance the quality of care. Research
collect and analyze data in a study. They can utilization is often seen as a precursor to
be qualitative, quantitative, or mixed methods, evidence-based practice (EBP), serving as an
depending on the nature of the research important step in moving from knowledge
question and the goals of the study. generation to practical application in
healthcare settings.
Research Program
● Historical Context: Historically,
A research program is a systematic plan of research utilization in nursing was often
multiple studies designed to explore a specific limited, with a gap between research
research area or topic over time. It often and practice due to various barriers,
involves a series of related projects that build such as a lack of access to research,
 limited training in research appraisal, A systematic review is a type of research
and resistance to change among synthesis that involves a comprehensive,
practitioners. methodical review of all relevant studies on a
● Focus: The focus of research utilization specific topic. Systematic reviews are
is often on specific research findings, considered one of the highest levels of
applying them directly to practice, evidence because they provide a thorough and
typically within the scope of a single unbiased summary of the research evidence
study or a small group of studies. on a particular question.

Evidence-Based Practice in Nursing ● Features:

○ Comprehensive Literature
Evidence-Based Practice (EBP) in nursing is an Search: Systematic reviews
approach to clinical decision-making that involve an exhaustive search of
integrates the best available research the literature to identify all
evidence with clinical expertise and patient studies, published and
values. EBP goes beyond research utilization unpublished, that meet
by considering not only research findings but predefined criteria.
also the context of clinical practice and patient ○ Critical Appraisal: The quality of
preferences. each study included in a
systematic review is critically
● Key Components:
appraised to assess the reliability
○ Best Available Evidence: This
and validity of its findings.
includes high-quality research,
○ Synthesis of Evidence: Data
particularly from systematic
from individual studies are
reviews, randomized controlled
synthesized, often through
trials (RCTs), and other rigorous
meta-analysis, to produce a
studies.
single estimate of the overall
○ Clinical Expertise: Nurses' own
effect of an intervention or
professional experience and skills
treatment.
are crucial in interpreting
● Role in EBP: Systematic reviews are a
evidence and applying it to
cornerstone of EBP because they
individual patient situations.
provide a consolidated, high-quality
○ Patient Preferences: EBP takes
source of evidence that nurses and
into account the patient’s values,
other healthcare professionals can rely
concerns, and expectations,
on when making clinical decisions.
ensuring that care is tailored to
individual needs. Other Preappraised Evidence
● Importance: EBP is crucial in nursing
because it leads to more effective, Preappraised evidence refers to research that
efficient, and patient-centered care. By has already been critically evaluated by
basing practice on the best available experts before being disseminated to
evidence, nurses can improve patient practitioners. This includes evidence
outcomes, reduce variations in care, summaries, clinical practice guidelines, and
and increase healthcare quality. critically appraised topics (CATs).

RESOURCES FOR EVIDENCE-BASED ● Evidence Summaries: These are

concise summaries of research evidence
PRACTICE
on a particular topic, often found in
Systematic Reviews evidence-based resources like
UpToDate or Clinical Evidence.
 ● Clinical Practice Guidelines: These are evaluation of outcomes. It emphasizes
systematically developed statements the cyclical nature of EBP and the need
designed to help practitioners and for continuous improvement.
patients make decisions about ● Role in EBP: These models help nurses
appropriate healthcare for specific and healthcare teams navigate the
clinical circumstances. They are based complexities of implementing evidence
on a comprehensive review of evidence into practice, ensuring a structured
and an assessment of the benefits and approach to improving care.
harms of alternative care options.
● Critically Appraised Topics (CATs): EVIDENCE-BASED PRACTICE IN
These are short summaries of evidence INDIVIDUAL NURSING PRACTICE
on specific clinical questions, based on
the appraisal of the best available Clinical Scenarios and the Need for
research. CATs provide quick, accessible Evidence
information for busy clinicians.
● Role in EBP: Preappraised evidence In individual nursing practice, clinical
helps streamline the EBP process by scenarios often present situations where
providing reliable, ready-to-use evidence is needed to guide decision-making.
information that clinicians can apply These scenarios might involve choosing the
directly to patient care. best intervention for a patient, managing a
complex condition, or optimizing care delivery.
Models of the Evidence-Based Practice The need for evidence arises when there is
Process uncertainty about the best course of action,
when new treatments or protocols become
Several models exist to guide the available, or when patient outcomes need to
implementation of EBP in clinical settings. be improved.
These models provide a framework for
systematically integrating evidence into Asking Well-Worded Clinical Questions
practice.
The first step in EBP is formulating a clear,
● Iowa Model: The Iowa Model focused clinical question that guides the
emphasizes the importance of search for evidence. The PICO(T) framework is
identifying clinical problems that trigger commonly used to structure these questions:
the need for evidence. It involves a
series of steps, including forming a ● P: Patient or Population – Who is the
team, appraising the evidence, and patient or what is the population of
piloting changes before full interest?
implementation. ● I: Intervention – What is the
● Johns Hopkins Nursing intervention being considered?
Evidence-Based Practice Model: This ● C: Comparison – What is the alternative
model focuses on translating evidence to the intervention (if applicable)?
into practice through a process of ● O: Outcome – What are the desired
practice questions, evidence appraisal, outcomes?
and practice change (PET process). It is ● T: Time – Over what time frame is the
particularly strong in fostering a culture intervention and outcome being
of EBP within healthcare institutions. assessed?
● ACE Star Model: The ACE Star Model ● Example: "In elderly patients with
outlines the five stages of knowledge hypertension (P), how does a
transformation, from discovery low-sodium diet (I) compared to no
(research generation) to integration and dietary changes (C) affect blood
 pressure control (O) over six months evidence in the context of their
(T)?" patients’ unique circumstances.
● Considering Patient Preferences: It is
Finding Research Evidence crucial to involve the patient in
decision-making, ensuring that the
After formulating a clinical question, the next
chosen intervention aligns with their
step is to search for the best available
values, preferences, and expectations.
evidence. This involves:
Implementing the Evidence and Evaluating
● Identifying Sources: Utilizing
Outcomes
databases such as PubMed, CINAHL,
Cochrane Library, and other The final step in the EBP process is to
evidence-based resources to find implement the chosen intervention and
relevant research studies. evaluate its impact on patient outcomes.
● Search Strategies: Developing effective
search strategies using keywords, MeSH ● Implementation Strategies: These
terms, and Boolean operators to locate might include staff education, protocol
high-quality studies that address the development, and changes to clinical
clinical question. practice guidelines.
● Outcome Evaluation: Monitor and
Appraising the Evidence assess patient outcomes to determine
whether the evidence-based
Not all evidence is created equal. Appraising
intervention is effective. This could
the quality of evidence is essential to ensure
involve tracking clinical metrics, patient
that it is reliable and applicable to the clinical
satisfaction, or quality of life measures.
scenario.
● Continuous Feedback Loop: EBP is an
● Critical Appraisal Tools: Tools such as ongoing process. Based on the
the CASP (Critical Appraisal Skills evaluation, the intervention may be
Programme) checklists, CONSORT modified, or further research may be
(Consolidated Standards of Reporting conducted to improve outcomes.
Trials) for RCTs, and the PRISMA
(Preferred Reporting Items for EVIDENCE-BASED PRACTICE IN AN
Systematic Reviews and Meta-Analyses) ORGANIZATIONAL CONTEXT
checklist are used to evaluate the
validity, relevance, and applicability of Selecting a Problem for an Institutional
research studies. Evidence-Based Practice Project
● Appraisal Criteria: Consider the study’s
In a healthcare organization, selecting a
methodology, sample size, bias, validity,
problem for an EBP project involves identifying
and generalizability when appraising
areas where patient outcomes could be
the evidence.
improved or where there is variability in
Integrating Evidence practice that could be addressed through
evidence-based interventions.
Once the evidence has been appraised, it must
be integrated into clinical practice. This ● Problem Identification: Problems can
involves: be identified through various means,
including quality improvement data,
● Combining Evidence with Clinical patient safety reports, staff
Expertise: Nurses use their clinical observations, and patient feedback.
judgment to interpret and apply the
 ● Prioritization: Problems are often ● Implementation Strategies: Strategies
prioritized based on their impact on might include pilot testing the changes,
patient outcomes, feasibility of change, using change management techniques
and alignment with organizational to gain buy-in from staff, and gradually
goals. rolling out the intervention.
● Evaluation: The impact of the
Finding and Appraising Evidence: Clinical intervention is evaluated through
Practice Guidelines ongoing monitoring and assessment of
patient outcomes, staff adherence to
Once a problem is selected, finding and
protocols, and overall quality of care.
appraising relevant evidence is crucial. Clinical
● Sustaining Change: To sustain
practice guidelines (CPGs) are valuable
improvements, continuous monitoring,
resources in this process.
feedback, and adaptation of the
● Guideline Sources: Trusted sources for intervention are necessary.
CPGs include organizations like the Organizations may also establish EBP
National Institute for Health and Care committees or champions to promote a
Excellence (NICE), the American culture of evidence-based practice.
Academy of Pediatrics (AAP), and the
Agency for Healthcare Research and Nursing Research Example
Quality (AHRQ).
Study
● Appraisal Tools: Tools like AGREE II
The study by Tracy et al. (2006) focused on
(Appraisal of Guidelines for Research
translating best practices in nondrug
and Evaluation) are used to assess the
postoperative pain management into clinical
quality and applicability of CPGs to
practice.
ensure they are based on the best
available evidence. Background
A group of researchers and clinicians observed
Actions Based on Evidence Appraisals
that many empirically validated nondrug pain
After appraising the evidence, the next step is relief methods were underutilized in standard
to decide on actions to take based on the postoperative pain management in most
findings. This might involve: hospitals. They also highlighted evidence
indicating that nurses often have inadequate
● Developing Protocols: Creating or knowledge about pain and its relief.
revising clinical protocols and guidelines
based on the evidence. Purpose
● Staff Training: Educating staff on new The project's goal was to apply the
protocols and the evidence supporting Collaborative Research Utilization (CRU) Model
them to ensure proper implementation. to translate research into practice at a hospital
● Resource Allocation: Ensuring that the in Rhode Island, using nondrug pain
necessary resources (e.g., equipment, management protocols for postoperative pain
personnel) are available to implement in older adults as a case study.
the evidence-based changes.
Model
Implementing and Evaluating the The CRU Model, a six-step process adapted
Innovation from the Conduct and Utilization of Research
in Nursing (CURN) project, is based on Rogers'
Implementing evidence-based changes in an (1995) Diffusion of Innovation Theory. This
organization requires careful planning and model is unique in involving both student and
evaluation. staff nurses in each step, particularly using
nursing students to evaluate research patients' knowledge, attitudes, and use of the
evidence and help develop best-practice three nondrug interventions for pain
protocols. management. By the time the paper was
written, over 300 patients had utilized the
Method comfort therapy services. Nurses reported that
The first step in the CRU Model involved implementing the protocols did not interfere
identifying a clinical problem and assessing with their other responsibilities, and that each
the evidence base. The team employed both protocol required approximately 15 minutes to
qualitative and quantitative methods to carry out.
determine the need to address the underuse of
nondrug pain management strategies at the Conclusions
study hospital. They selected While hospital administrators had not yet
interventions—massage, music, and decided on the ongoing use of the protocols,
self-guided imagery—based on an evidence hospital volunteers at the study site agreed to
summary from the Agency for Healthcare assist in ensuring that nurses and patients had
Research and Quality (AHRQ), and the necessary supplies to implement the
undergraduate nursing students conducted comfort protocols. The research team
literature reviews on these therapies. In the concluded that the preliminary results were
second step, the team evaluated the relevance promising but noted that further studies
of the research in relation to the identified should be conducted in sites with more diverse
problem, the values of the agency, and the patient populations.
potential costs and benefits. Roundtable
discussions on surgical and rehabilitative care Key Terms
units generated 22 specific recommendations.
Background Question
In the third step, these recommendations were
developed into three best-practice protocols A background question in nursing or clinical
for a tailored teaching intervention by a team research refers to a broad, foundational
of clinicians and researchers. A 12-member question that seeks general knowledge about
Nursing Comfort Therapy Service was then a condition, treatment, or disease. These
established and trained in these protocols. The questions typically address the "who, what,
fourth step involved the implementation and when, where, why, and how" of healthcare
evaluation of the protocols for their feasibility, topics. For example, "What causes
usefulness, and effectiveness. This step hypertension?" or "How does the immune
included a pilot study, which was the primary system work?" Background questions are
focus of the 2006 report, as well as a larger usually answered through textbooks or expert
study that was still ongoing when the paper consensus rather than specific research
was published. The pilot study assessed studies.
changes in knowledge, attitudes, and usage of
the three interventions among 46 surgical Clinical Practice Guideline
patients, from preadmission to the third
postoperative day. A clinical practice guideline is a systematically
developed statement designed to help
In the fifth step, the team presented the pilot practitioners and patients make decisions
study results to nursing staff and about appropriate healthcare for specific
administration for consideration. The final step clinical circumstances. These guidelines are
involved disseminating the project results. based on a thorough review of the evidence
and aim to provide recommendations for the
Findings best practices in diagnosis, treatment, and
The pilot study revealed improvements in management of conditions.
Cochrane Collaboration Evidence-Based Practice (EBP)

The Cochrane Collaboration is an international Evidence-Based Practice (EBP) is an approach

network of researchers, healthcare to healthcare decision-making that integrates
professionals, and patients dedicated to the best available research evidence with
producing high-quality systematic reviews of clinical expertise and patient values. EBP aims
primary research in healthcare and health to provide the highest quality of care by
policy. Cochrane reviews are widely recognized applying the most current and relevant
for their rigorous methodology and are a key evidence to clinical practice, ensuring that
resource in evidence-based practice. patient care is informed by the best possible
information.
Critically Appraised Topic (CAT)
Foreground Question
A Critically Appraised Topic (CAT) is a short
summary of the best available evidence on a A foreground question is a specific, detailed
specific clinical question, usually derived from clinical question that focuses on the
a structured literature review. CATs are often management of a particular patient,
used in clinical settings to provide quick, population, or problem. These questions
accessible information to support typically follow the PICO(T) framework
evidence-based decision-making. They (Patient/Population, Intervention,
typically include an appraisal of the evidence's Comparison, Outcome, Time) and are used to
validity, relevance, and applicability. guide searches for evidence that will directly
inform clinical decision-making. For example,
Diffusion of Innovations Theory "In elderly patients with hypertension (P), how
does a low-sodium diet (I) compared to no
The Diffusion of Innovations Theory, dietary changes (C) affect blood pressure
developed by Everett Rogers, explains how, control (O) over six months (T)?"
why, and at what rate new ideas and
technologies spread within cultures. In Implementation Potential
healthcare, this theory is used to understand
how new treatments, practices, or Implementation potential refers to the
technologies are adopted by healthcare likelihood that a particular intervention or
providers. It emphasizes the importance of evidence-based practice can be successfully
factors like relative advantage, compatibility, implemented in a specific setting. It considers
complexity, trialability, and observability in factors such as the fit between the
the adoption process. intervention and the existing practice
environment, the resources available, and the
Evidence Hierarchy readiness of the staff to adopt new practices.

An evidence hierarchy is a system that ranks Iowa Model

the strength and quality of evidence according
The Iowa Model of Evidence-Based Practice to
to the methodological rigor of the research. At
Promote Quality Care is a framework used to
the top of the hierarchy are systematic reviews
guide the implementation of evidence-based
and meta-analyses of randomized controlled
practice in clinical settings. It emphasizes
trials (RCTs), followed by individual RCTs,
identifying triggering issues or opportunities,
cohort studies, case-control studies, case
forming a team, appraising the evidence,
series/reports, and expert opinion at the
piloting the change, and evaluating outcomes.
bottom. This hierarchy helps clinicians
The model is particularly useful in guiding the
evaluate the reliability and validity of evidence
when making clinical decisions.
systematic incorporation of research findings a particular topic. It involves a comprehensive
into clinical practice. search of the literature, critical appraisal of
studies, and synthesis of findings. Systematic
Meta-Analysis reviews are considered one of the highest
levels of evidence and are crucial in informing
A meta-analysis is a statistical technique that evidence-based practice. They aim to minimize
combines the results of multiple studies on the bias by using explicit, systematic methods to
same topic to produce a single summary identify, select, and critically evaluate relevant
estimate of the overall effect. This method research.
increases the statistical power and precision of
the results, making it one of the highest levels The Building Blocks of Research
of evidence in the evidence hierarchy.
Research is a systematic investigation that
Metasynthesis seeks to establish facts, principles, and
knowledge. The foundational elements of
A metasynthesis is a type of research synthesis research are essential for understanding how
that combines the findings of multiple studies are conducted and interpreted.
qualitative studies to create a comprehensive
interpretation of a particular phenomenon. The Faces and Places of Research
Unlike a meta-analysis, which is quantitative,
metasynthesis involves the synthesis of Research is conducted in diverse settings and
themes, concepts, and insights across studies, involves various stakeholders. The "faces" of
providing a deeper understanding of complex research include researchers, participants, and
human experiences. the broader community. The "places" refer to
the physical or virtual locations where
Pilot Test research occurs, such as laboratories, field
sites, or online platforms. Understanding the
A pilot test is a small-scale preliminary study context of these faces and places helps to
conducted to evaluate the feasibility, time, frame the research questions, methodologies,
cost, risk, and adverse events involved in a and outcomes.
full-scale research project. The purpose of a
Phenomena, Concepts, and Constructs
pilot test is to refine the study's methodology
and procedures before implementing them on
● Phenomena: Observable events or
a larger scale.
occurrences that are studied in
research. For example, in psychology,
Stetler Model phenomena might include behaviors
like anxiety or aggression.
The Stetler Model is a framework for using
● Concepts: Abstract ideas that represent
research in clinical practice. It guides nurses
phenomena. For instance, "stress" is a
and other healthcare professionals through the
concept that can encompass various
process of critically appraising and applying
physiological and psychological
research findings in practice. The model
responses.
includes five phases: preparation, validation,
● Constructs: Complex concepts that are
comparative evaluation/decision-making,
specifically defined for the purpose of
translation/application, and evaluation.
research. Constructs are often not
directly observable, such as intelligence
Systematic Review
or motivation, and require careful
A systematic review is a rigorous, structured operationalization to measure them
approach to synthesizing research evidence on effectively.
Theories and Conceptual Models depends on the research design and the
nature of the variables being studied.
● Theories: Systematic explanations of
phenomena, supported by evidence, Relationships
that help predict outcomes. Theories
provide a framework for understanding In research, relationships refer to the
relationships between different connections or associations between variables.
concepts and constructs. These can be:
● Conceptual Models: Visual or
● Correlational: Where two variables are
theoretical representations of how
related, but one does not necessarily
different concepts and constructs are
cause the other.
related. These models guide research by
● Causal: Where one variable directly
offering hypotheses that can be tested.
affects another, often established
Variables through experimental studies.

Variables are elements of research that can Major Classes of Quantitative and
take on different values. They are classified Qualitative Research
into:
Quantitative Research: Experimental and
● Independent Variables: Variables that Nonexperimental Studies
are manipulated or controlled by the
researcher to observe their effect on ● Experimental Studies: Involve the
other variables. manipulation of one or more
● Dependent Variables: Variables that independent variables to observe their
are measured to assess the impact of effect on dependent variables. These
the independent variables. studies often use control groups and
● Extraneous Variables: Variables that randomization to ensure that results are
are not of primary interest but can due to the manipulation rather than
influence the results if not controlled. other factors.
● Nonexperimental Studies:
Conceptual and Operational Definitions Observational in nature, these studies
do not involve manipulation of
● Conceptual Definitions: Provide a
variables. They include surveys, case
theoretical meaning of a concept or
studies, and correlational studies, which
construct. For instance, defining
explore relationships between variables
"intelligence" in terms of cognitive
without establishing causality.
abilities.
● Operational Definitions: Specify how a Qualitative Research: Disciplinary Traditions
concept or construct will be measured
or manipulated in a study. For example, Qualitative research seeks to understand
intelligence could be operationally phenomena through detailed, contextualized
defined by the score on an IQ test. analysis, often within specific disciplinary
traditions:
Data
● Ethnography: Focuses on the culture
Data are the raw materials of research. They and practices of groups or communities.
can be quantitative (numerical) or qualitative ● Phenomenology: Investigates lived
(descriptive) and are collected to answer experiences and how individuals
research questions. The type of data collected perceive them.
 ● Grounded Theory: Develops theories existing theories and research findings,
based on data collected from serving as a guide for hypothesis formulation
participants. and research design. The framework provides
● Case Studies: Provide in-depth analysis a lens through which the research problem can
of a single case or a few cases within a be viewed and understood.
real-life context.
1.4 Formulation of Hypotheses or Research
Major Steps in a Quantitative Study Questions

A quantitative study involves a systematic and Based on the theoretical framework,

structured approach to investigating researchers formulate hypotheses or research
phenomena, typically involving the collection questions. Hypotheses are specific, testable
and analysis of numerical data. The process is predictions about the relationships between
divided into distinct phases, each with its own variables, often stated in a form that can be
set of activities and objectives. These phases supported or refuted by the data. If the study
are designed to ensure the rigor and reliability is exploratory, research questions may be used
of the research, leading to valid and instead of hypotheses to guide the
generalizable findings. investigation.

1.5 Operational Definitions of Variables

Operational definitions specify how the study's

Phase 1: The Conceptual Phase
variables will be measured or manipulated.
These definitions are critical for ensuring that
1.1 Identification of the Research Problem
the variables are consistently and accurately
The first step in any research study is assessed. For example, a variable like "stress"
identifying a clear and concise research might be operationalized as a score on a
problem. This problem often arises from gaps standardized stress inventory.
in existing knowledge, conflicting results in the
literature, or practical issues that need
addressing. The research problem should be
specific enough to guide the study's focus yet
Phase 2: The Design and Planning
broad enough to allow for comprehensive Phase
exploration.
2.1 Research Design Selection
1.2 Literature Review
The research design is the blueprint for the
A thorough literature review is conducted to study, outlining how data will be collected,
understand the current state of knowledge on measured, and analyzed. It can be
the topic. This involves analyzing existing experimental, where variables are
studies, identifying trends, and noting any manipulated to observe effects, or
inconsistencies or gaps that the new study non-experimental, where variables are
could address. The literature review helps to observed without intervention. The choice of
refine the research problem and provides a design depends on the research problem,
theoretical framework for the study. hypotheses, and practical considerations.

1.3 Development of Theoretical Framework ● Experimental Designs: Include true

experiments with random assignment to
The theoretical framework is a conceptual control and experimental groups, as
model that outlines the relationships between well as quasi-experimental designs
the key variables in the study. It is based on
 where randomization may not be Ethical issues are paramount in research
feasible. involving human participants. Researchers
● Non-Experimental Designs: Include must obtain informed consent, ensuring that
correlational studies, descriptive participants are fully aware of the study's
studies, and case-control studies where purpose, procedures, risks, and benefits. The
the focus is on observing relationships study must be reviewed and approved by an
or describing characteristics without institutional review board (IRB) or ethics
manipulating variables. committee to ensure that it meets ethical
standards.
2.2 Sampling Strategy
● Confidentiality and Anonymity:
Sampling involves selecting a subset of the Researchers must protect participants'
population to participate in the study. The privacy and ensure that data is kept
sampling strategy must ensure that the sample confidential and anonymous where
is representative of the population to possible.
generalize the findings. Researchers decide on ● Informed Consent: Participants must
the sample size, sampling method (e.g., voluntarily agree to participate, with a
random, stratified, convenience), and clear understanding of the study.
inclusion/exclusion criteria.
2.5 Data Collection Plan
● Probability Sampling: Methods like
random sampling, where every member The data collection plan details how data will
of the population has an equal chance be gathered, specifying the procedures,
of being selected, are preferred for timeline, and resources required. This plan
generalizability. ensures that data collection is systematic,
● Non-Probability Sampling: Methods efficient, and consistent across all participants.
like convenience sampling are used
when probability sampling is ● Pilot Testing: A small-scale trial run of
impractical, though they may introduce the data collection procedures is often
bias. conducted to identify potential issues
and refine the process.
2.3 Measurement Tools and Instrumentation

Choosing the appropriate measurement tools

is crucial for collecting reliable and valid data. Phase 3: The Empirical Phase
These tools may include surveys,
questionnaires, tests, or observational 3.1 Data Collection
checklists. Researchers must ensure that these
During this phase, researchers collect data
instruments are standardized, reliable
according to the plan established in the
(consistent results), and valid (measure what
previous phase. Data collection methods vary
they are intended to measure).
depending on the research design and may
● Reliability Testing: Involves pilot include administering surveys, conducting
testing instruments to assess their interviews, or observing participants. It is
consistency over time. critical to follow standardized procedures to
● Validity Testing: Ensures that the minimize bias and error.
instruments accurately capture the
● Consistency: Data must be collected in
constructs of interest.
a consistent manner across all
2.4 Ethical Considerations participants to ensure reliability.
 ● Quality Control: Researchers must determining whether the findings support the
monitor the data collection process to hypotheses and what the implications of the
identify and address any issues that results are for the theoretical framework and
arise, such as missing data or practical applications.
participant non-compliance.
● Significance Testing: Researchers
3.2 Data Management assess whether the observed effects or
relationships are statistically significant,
Once data is collected, it must be organized meaning they are unlikely to have
and prepared for analysis. This involves coding occurred by chance.
responses, entering data into databases, and ● Confidence Intervals: Provide a range
checking for accuracy. Data management is within which the true population
crucial for ensuring that the data is clean, parameter is likely to fall, giving an
complete, and ready for analysis. estimate of the precision of the findings.

● Data Cleaning: Involves identifying and 4.3 Consideration of Limitations

correcting errors in the dataset, such as
outliers or missing values. Researchers must acknowledge the limitations
● Data Storage: Data should be stored of their study, such as sample size, potential
securely to protect it from loss, biases, and generalizability. Understanding the
tampering, or unauthorized access. limitations is crucial for accurately interpreting
the results and for providing a balanced
discussion of the findings.

Phase 4: The Analytic Phase

4.1 Data Analysis Phase 5: The Dissemination Phase

Data analysis involves applying statistical 5.1 Reporting the Findings
techniques to the collected data to test
hypotheses or answer research questions. The The final phase of a quantitative study
type of analysis depends on the nature of the involves sharing the results with the broader
data and the research design. academic and professional community. This is
typically done through writing and publishing
● Descriptive Statistics: Used to research reports, articles, or presentations.
summarize the data, including
measures of central tendency (mean, ● Research Reports: Comprehensive
median, mode) and dispersion (range, documents that detail the entire study,
variance, standard deviation). including the background, methods,
● Inferential Statistics: Techniques such results, and conclusions.
as t-tests, ANOVA, regression analysis, ● Journal Articles: Shorter,
and chi-square tests are used to draw peer-reviewed publications that focus
conclusions about the relationships on specific aspects of the study and are
between variables and to generalize published in academic journals.
findings to the broader population.
5.2 Presenting the Findings
4.2 Interpretation of Results
In addition to written reports, researchers
After analyzing the data, researchers interpret often present their findings at conferences,
the results in the context of the research seminars, or workshops. These presentations
questions or hypotheses. This involves allow for immediate feedback and discussion
with peers, which can be valuable for refining of emerging themes. Researchers immerse
the study's conclusions and identifying future themselves in the data, often using coding
research directions. techniques to identify patterns and develop a
rich, detailed understanding of the phenomena
● Oral Presentations: Typically involve under study. The focus is on generating
summarizing the study and its findings insights that are deeply rooted in the context
in a talk, often accompanied by visual of the research participants.
aids like slides.
● Poster Presentations: Involve creating Qualitative Nursing Research
a visual display that summarizes the
study and its results, allowing for Qualitative research in nursing is focused on
one-on-one interactions with interested understanding the experiences, behaviors, and
colleagues. perceptions of patients, healthcare providers,
and other stakeholders in the healthcare
5.3 Applying the Findings environment. This type of research is
particularly valuable in nursing because it
Finally, the findings of a quantitative study
allows for a deep exploration of complex
can be applied to practice, policy-making, or
phenomena that are difficult to quantify, such
further research. The ultimate goal of research
as patient satisfaction, coping mechanisms,
is not just to generate knowledge but to use
and the nurse-patient relationship. Below is a
that knowledge to make a positive impact.
detailed discussion of the key steps involved in
● Practical Applications: In fields like qualitative nursing research.
medicine, education, or social sciences,
research findings can inform best
practices and improve outcomes.
Planning the Study
● Future Research: The study's results
often lead to new questions and
1.1 Identifying the Research Problem
hypotheses, laying the groundwork for
future research. Identifying a research problem is the first and
most crucial step in qualitative nursing
research. The research problem typically stems
from clinical practice, patient experiences, or
Activities in a Qualitative Study gaps in the existing literature. In nursing, this
problem might involve understanding how
Conceptualizing and Planning a Qualitative
patients experience chronic illness, how nurses
Study
cope with burnout, or how families navigate
Researchers begin by identifying a research end-of-life decisions. The problem should be
problem that is best understood through specific enough to guide the research focus
qualitative methods. They then choose an but broad enough to allow for an in-depth
appropriate qualitative approach (e.g., exploration.
ethnography, phenomenology) and plan how
1.2 Doing a Literature Review
data will be collected, usually through methods
like interviews, observations, or document A literature review in qualitative research helps
analysis. to contextualize the study within existing
knowledge. It involves a critical analysis of
Conducting a Qualitative Study
previous studies related to the research
Data collection in qualitative research is often problem, identifying what is already known
iterative and flexible, allowing for exploration and where there are gaps. The literature
review not only informs the research questions
but also helps to refine the study’s theoretical develop methods to safeguard participants’
framework. In nursing, this might involve rights, privacy, and well-being. This includes
reviewing studies on patient care strategies, obtaining informed consent, ensuring
nurse-patient communication, or the impact of confidentiality, and being sensitive to
healthcare policies on patient outcomes. participants’ vulnerabilities, especially when
dealing with sensitive topics like terminal
1.3 Developing an Overall Approach illness or mental health. Ethical approval from
an institutional review board (IRB) or ethics
The overall approach to qualitative research is
committee is typically required before data
determined by the nature of the research
collection begins.
problem and the goals of the study. Common
approaches in nursing include:

● Phenomenology: Exploring the lived

Developing Data Collection
experiences of patients or nurses to
understand their perspectives. Strategies
● Ethnography: Examining the culture
2.1 Deciding What Type of Data to Gather
and practices within a specific nursing
and How to Gather Them
or patient community.
● Grounded Theory: Developing a theory In qualitative research, the type of data
based on data collected from collected is typically rich, descriptive, and
participants, often used to understand contextual. Common data collection methods
processes like decision-making in in nursing research include:
clinical settings.
● Case Study: An in-depth examination of ● Interviews: Semi-structured or
a particular case or cases, such as a unstructured interviews allow
specific patient population or a nursing participants to share their experiences
unit. in their own words. This method is
particularly useful for exploring
1.4 Selecting and Gaining Entrée into personal experiences, beliefs, and
Research Sites emotions.
● Focus Groups: Group discussions
Gaining access to research sites is a critical
provide insights into shared experiences
step that involves selecting appropriate
and group dynamics. This method is
settings for data collection and obtaining
useful for understanding collective
permission to conduct research there. In
perspectives, such as those of a nursing
nursing research, these sites could be
team.
hospitals, clinics, community health centers, or
● Observations: Direct observation
patients' homes. Researchers must build
allows the researcher to capture
relationships with gatekeepers, such as
real-time behaviors and interactions
hospital administrators or department heads,
within a healthcare setting, providing
to gain entry. It is important to ensure that the
insights into the context of care.
selected sites are relevant to the research
● Document Analysis: Reviewing patient
problem and will allow the researcher to
records, nursing notes, or policy
gather rich, meaningful data.
documents can provide additional
1.5 Developing Methods to Safeguard context or corroborate findings from
Participants interviews and observations.

Ethical considerations are paramount in 2.2 Deciding From Whom to Collect the Data
qualitative nursing research. Researchers must
Sampling in qualitative research is typically environment where participants feel
purposive, meaning participants are selected comfortable sharing their experiences.
based on specific criteria relevant to the
research problem. In nursing research, this 3.2 Organizing and Analyzing Data
might involve selecting patients with a
Once data is collected, it must be
particular condition, nurses with a certain level
systematically organized and analyzed. Data
of experience, or families who have navigated
analysis in qualitative research typically
similar healthcare challenges. The goal is not
involves coding, where the researcher
to achieve a statistically representative sample
identifies patterns, themes, and categories
but to gather data that is rich and informative.
within the data. In nursing research, this might
2.3 Deciding How to Enhance involve identifying common experiences
Trustworthiness among patients with a chronic condition or
exploring the challenges faced by nurses in a
Trustworthiness in qualitative research refers particular setting. Software programs like
to the credibility, dependability, confirmability, NVivo or [Link] can assist in managing and
and transferability of the findings. To enhance analyzing large amounts of qualitative data.
trustworthiness in nursing research:
● Thematic Analysis: A common
● Triangulation: Using multiple data approach in qualitative research,
sources, methods, or researchers to thematic analysis involves identifying
verify findings and reduce bias. and analyzing patterns or themes within
● Member Checking: Involving the data. These themes help to explain
participants in the verification of the the underlying meaning of the data and
data or interpretations to ensure are used to answer the research
accuracy. questions.
● Audit Trail: Keeping detailed records of
the research process, including 3.3 Evaluating Data: Making Modifications
decisions made and data collected, to to Data Collection Strategies, if Necessary
allow others to follow and understand
Qualitative research is flexible and allows for
the researcher’s process.
modifications to the data collection process as
● Reflexivity: Researchers must reflect on
the study progresses. If initial data suggests
their own biases and how these might
new directions or reveals unexpected findings,
influence the research process and
researchers might adjust their data collection
findings.
methods or focus on new areas. For example,
if a study on nurse-patient communication
reveals issues with healthcare technology, the
Gathering and Analyzing Data researcher might begin to explore this area in
more detail.
3.1 Collecting Data
3.4 Evaluating Data: Determining If
Data collection in qualitative nursing research Saturation Has Been Achieved
is often an iterative process, where data
collection and analysis occur simultaneously. Data saturation is the point at which no new
Researchers may conduct interviews, observe information or themes are emerging from the
interactions, or review documents in a way data, indicating that the research has fully
that allows them to explore emerging themes explored the research problem. In qualitative
and adjust their focus as needed. The nursing research, determining saturation
researcher’s role is to create a safe, trusting involves continually assessing the data and
considering whether additional data collection
would yield new insights. Once saturation is Quantitative Example: Further
reached, data collection can conclude. Validation of the Postpartum
Depression Screening Scale

Study Purpose:
Disseminating Findings
The purpose of this study was to further assess
4.1 Communicating Findings the Postpartum Depression Screening Scale
(PDSS), an instrument developed for screening
Communicating the findings of qualitative mothers for postpartum depression by
nursing research involves writing detailed clinicians and researchers.
reports, journal articles, or presentations that
convey the study’s insights. These
communications should be clear,
well-organized, and accessible to a broad Phase 1: Conceptual Phase (Duration:
audience, including healthcare professionals, 1 Month)
policymakers, and researchers. The findings
should be presented in a way that highlights ● Overview:
their relevance to nursing practice and patient This phase was relatively brief, lasting
care. only one month. The foundational
conceptual work had largely been
● Narrative Reporting: Given the completed in a previous study by Beck
descriptive nature of qualitative data, and Gable (2000), where the PDSS was
findings are often presented as initially developed.
narratives, incorporating quotes and ● Key Activities:
examples from participants to illustrate ○ Updated the literature review, as
key points. most of the groundwork had
already been laid in the earlier
4.2 Utilizing (or Making Recommendations study.
for Utilizing) Findings in Practice and Future ○ Reaffirmed the use of the same
Research theoretical framework and
conceptual definitions from the
The ultimate goal of qualitative nursing
initial study.
research is to improve nursing practice and
patient outcomes. Researchers should make
specific recommendations for how their
findings can be applied in clinical practice, Phase 2: Design and Planning Phase
education, or policy. Additionally, they should
(Duration: 6 Months)
identify areas for future research, especially
where their findings have revealed new ● Overview:
questions or highlighted gaps in knowledge. This phase required significant time and
effort, extending over six months, and
● Practice Recommendations: These
involved meticulous planning and
may include changes to nursing
logistical coordination.
protocols, patient education strategies,
● Key Activities:
or healthcare policies.
○ Refined the research design,
● Future Research: Recommendations
ensuring it was appropriate for
might involve further exploration of
the study objectives.
themes that emerged during the study
or studies that build on the current
research to address new questions.
 ○ Secured access to the hospital effectiveness of the PDSS in identifying
from which the study postpartum depression.
participants were to be recruited. ● Key Activities:
○ Obtained ethical approval from ○ Performed statistical analyses to
the hospital’s human subjects determine the PDSS cut-off score
review committee. for identifying mothers at risk of
○ Engaged in multiple postpartum depression.
consultations with statistical ○ Assessed the accuracy of the
experts and Gable, who PDSS in predicting diagnosed
specialized in instrument postpartum depression cases.
development, to finalize the ○ Collaborative interpretation of
study design. results through meetings with
Gable and statistical consultants.

Phase 3: Empirical Phase (Duration:

11 Months) Phase 5: Dissemination Phase
(Duration: 18 Months)
● Overview:
The empirical phase took approximately ● Overview:
11 months, focusing on data collection This final phase, lasting 18 months,
and participant recruitment. involved disseminating the study
● Key Activities: findings through various channels.
○ Recruitment of 150 postpartum ● Key Activities:
women, 6 weeks after delivery, ○ Prepared and submitted the
during childbirth preparation research report to the journal
classes. Nursing Research. The
○ Administered the PDSS and manuscript was accepted within
scheduled psychiatric diagnostic 4 months, but the publication
interviews to confirm postpartum was delayed by 14 months while
depression diagnoses. it was "in press."
○ Recruitment began 4 months ○ Presented study findings at both
prior to data collection, requiring regional and international
a wait of 6 weeks post-delivery conferences.
to begin data collection. ○ Prepared and submitted a
○ Conducted diagnostic interviews summary report to the agency
by a nurse psychotherapist who that funded the research.
was available only one day per
week, contributing to the
extended data collection
Overall Timeline: The entire study took
timeline.
approximately three years to complete, from
conceptualization to the dissemination of
findings.
Phase 4: Analytic Phase (Duration: 3
Qualitative Study: Birth Trauma – A
Months)
Mother's Perspective
● Overview:
Data analysis was conducted over three Study Purpose:
months, focusing on evaluating the This study aimed to explore and understand
the experience of birth trauma from the Watson, who, along with other
perspectives of the mothers who lived through TABS founders, approved Beck's
it. study.

Phase 1: Conceptual Phase (Duration: Phase 2: Design and Planning Phase

3 Months) (Duration: 3 Months)

● Overview: ● Overview:
The conceptual phase, lasting three The design and planning phase, also
months, marked the beginning of Beck’s three months long, involved selecting
exploration into the topic of birth the research design and organizing the
trauma, which was inspired by her logistics for data collection.
background in postpartum depression ● Key Activities:
research and an impactful event at a ○ Beck chose a phenomenological
conference. design for the study, aiming to
● Key Activities: deeply explore the lived
○ Beck’s interest in birth trauma experiences of the mothers.
was sparked during her ○ She collaborated with Sue
preparation for a keynote Watson via email to develop a
address on perinatal anxiety recruitment strategy. This
disorders at the September 2001 included crafting an introductory
Australasian Marce Society letter from Beck explaining the
Biennial Scientific Meeting in study, accompanied by a letter
New Zealand. from Watson endorsing the
○ A review of the literature research.
revealed a scarcity of studies on ○ These letters were sent to the
birth trauma and its connection mothers in the TABS network,
to post-traumatic stress disorder inviting their participation in the
(PTSD). study.
○ After delivering her keynote, ○ Once the study design was
Beck was profoundly moved by a finalized, Beck obtained approval
presentation from Sue Watson, a from her university’s human
mother who shared her subjects committee.
experience with PTSD following a
traumatic birth. Watson was a
co-founder of Trauma and Birth
Stress (TABS), a New Phase 3: Empirical and Analytic
Zealand-based charitable trust. Phases (Duration: 24 Months)
○ Inspired by Watson's story, Beck
decided to pursue research on ● Overview:
birth trauma. Later that day, she The empirical and analytic phases
and Watson discussed the spanned 24 months, with data collection
possibility of conducting a taking 18 months and analysis taking an
qualitative study with the additional 6 months.
mothers who were members of ● Key Activities:
TABS. ○ Data collection involved 40
○ Gaining access to the TABS mothers sharing their personal
community was facilitated by stories of birth trauma with Beck
 via email over an 18-month findings at numerous national
period. and international research
○ Following data collection, Beck conferences.
spent six months analyzing the
stories. Through her analysis, she
identified four central themes:
Overall Timeline: The entire study took nearly
1. To care for me: Was that
three years to complete, from initial
too much to ask?
conceptualization to the dissemination of
2. To communicate with
results.
me: Why was this
neglected?
3. To provide safe care: You
Key Terms
betrayed my trust and I
Cause-and-effect (causal) relationship
felt powerless.
4. The end justifies the A relationship where one variable (the cause)
means: At whose directly influences another variable (the
expense? At what price? effect). In causal relationships, changes in the
independent variable lead to changes in the
dependent variable.

Phase 4: Dissemination Phase Clinical trial

(Duration: 5+ Months)
A research study that tests the safety,
● Overview: efficacy, or effectiveness of a medical
The dissemination phase focused on treatment, intervention, or drug in human
publishing and sharing the study’s participants. Clinical trials are often used to
findings, lasting a little over five gather evidence needed for regulatory
months. approval of new therapies.
● Key Activities:
○ In April 2003, Beck submitted a Concept
manuscript detailing the study to
An abstract idea or general notion that
the journal Nursing Research.
represents something in research. Concepts
○ In June 2003, she received
are the basic building blocks for developing
feedback from the journal’s
theories and hypotheses.
editor, who recommended
revisions based on reviewers' Conceptual definition
comments.
○ Beck revised the manuscript, The explanation of a concept in theoretical
incorporating the reviewers' terms, providing a clear and detailed
suggestions, and resubmitted it understanding of what the concept means
six weeks later. within the context of a study.
○ In September 2003, Beck was
notified that her revised Construct
manuscript had been accepted
A complex concept that is deliberately
for publication, and the article
invented or adopted for a specific scientific
was published in the
purpose. Constructs are often not directly
January/February 2004 issue of
observable but are inferred from related
Nursing Research.
behaviors or outcomes, such as intelligence or
○ Beyond the publication, Beck
satisfaction.
also presented the study’s
Data Grounded theory

Information collected during a study, which A qualitative research approach that involves
can be qualitative (descriptive) or quantitative generating a theory based on data collected
(numerical). Data are used to answer research from participants, often used to understand
questions or test hypotheses. processes or actions from the ground up.

Dependent variable Hypothesis

The variable in a study that is affected by A testable prediction about the relationship
changes in the independent variable. It is the between two or more variables. It is a
outcome or effect that researchers measure to statement that can be supported or refuted
determine the impact of the independent through empirical evidence.
variable.
Independent variable
Emergent design
The variable that is manipulated or controlled
A flexible research design that evolves during by the researcher to determine its effect on
the research process, particularly common in the dependent variable. It is the presumed
qualitative research, allowing the study to cause in a cause-and-effect relationship.
adapt to new insights or data as they emerge.
Intervention protocol
Ethnography
A detailed plan that outlines the procedures
A qualitative research method that involves and processes for implementing an
studying cultures or communities by observing intervention in a study, including how it will be
and interacting with people in their natural delivered, monitored, and assessed.
environment to understand their customs,
behaviors, and social interactions. Literature review

Experimental research A comprehensive analysis of existing research

and publications on a particular topic. It helps
A type of research where the researcher to identify gaps in knowledge, inform the
manipulates one or more independent study design, and situate the research within
variables to observe their effect on one or the broader academic context.
more dependent variables, often involving
random assignment to control and Nonexperimental research
experimental groups.
A type of research where the researcher
Fieldwork observes variables without manipulating them,
often used to study correlations or descriptive
The process of collecting data in the natural relationships between variables.
environment of the subjects being studied,
often used in ethnographic and observational Observational research
research.
A research method where the researcher
Gaining entrée systematically observes and records behaviors
or events as they occur naturally, without
The process of gaining access to a research intervening or manipulating the environment.
site or population, often involving establishing
trust and obtaining permission from Operational definition
gatekeepers or key individuals.
A precise definition of how a concept or measured, and analyzed to answer the
construct will be measured or manipulated in a research questions or test hypotheses.
specific study. It translates abstract concepts
into measurable variables. Sample

Outcome variable A subset of the population selected for

participation in a study. The sample is
Another term for the dependent variable, intended to represent the population, allowing
which represents the outcome that the researchers to make inferences about the
research is designed to measure or explain. broader group.

Phenomenology Sampling plan

A qualitative research approach focused on The strategy used to select the sample from
exploring and understanding the lived the population, including the method of
experiences of individuals, often involving selection (e.g., random, stratified) and the
in-depth interviews and analysis to uncover criteria for inclusion or exclusion.
the essence of those experiences.
Saturation
Population
The point in qualitative research when no new
The entire group of individuals or elements information or themes are emerging from the
that the research is interested in studying. The data, indicating that data collection can be
population is the group from which the sample concluded.
is drawn.
Statistical analysis
Qualitative data
The process of applying mathematical
Non-numerical data that provides descriptive techniques to analyze and interpret
information, such as words, images, or quantitative data, allowing researchers to
observations, often used to understand determine relationships, differences, and
complex phenomena, experiences, or social patterns in the data.
processes.
Study participant
Quantitative data
An individual who takes part in a research
Numerical data that can be measured and study, providing data through various means
analyzed statistically, often used to identify such as surveys, interviews, or experiments.
patterns, test hypotheses, and make
generalizations about a population. Subject

Relationship Another term for a study participant,

particularly in experimental research, where
The connection or association between two or the individual is subjected to various
more variables, which can be positive, conditions or treatments.
negative, or neutral, and may or may not
imply causation. Variable

Research design Any characteristic or factor that can vary or

change within a study. Variables can be
The overall strategy or plan for conducting a independent, dependent, control, or
study, including how data will be collected, extraneous, depending on their role in the
research.
50 Sample Quantitative ● Overview: This study assesses the
effectiveness of nurse-led education
Research Titles programs in improving diabetes
self-management among patients.
1. The Impact of Nurse-Patient ● Purpose: To determine whether
Ratios on Patient Outcomes in Acute nurse-led education can enhance
patient knowledge and control of
Care Settings
diabetes, leading to better health
● Overview: This study examines the outcomes.
relationship between nurse-patient
ratios and patient outcomes, such as 5. The Effect of Nurse-Led Early
recovery rates and complication Mobility Programs on Recovery
incidences in acute care settings. Outcomes in ICU Patients
● Purpose: To determine the optimal
nurse-patient ratio that minimizes ● Overview: This research examines the
patient complications and improves impact of early mobility programs led
recovery times. by nurses on the recovery outcomes of
patients in intensive care units.
2. Assessing the Effectiveness of Pain ● Purpose: To establish the benefits of
Management Protocols in early mobility interventions in reducing
ICU stay duration and improving overall
Post-Surgical Patients
patient recovery.
● Overview: This research evaluates the
effectiveness of standardized pain 6. Exploring the Relationship Between
management protocols on Nurse Burnout and Patient Safety in
post-operative pain levels in surgical Pediatric Care
patients.
● Purpose: To identify the most effective ● Overview: This study explores how
pain management strategies that nurse burnout affects patient safety
improve patient comfort and reduce and care quality in pediatric units.
recovery time. ● Purpose: To identify strategies to
reduce nurse burnout and enhance
3. The Role of Nursing Interventions patient safety in pediatric care settings.
in Reducing Hospital Readmission
7. The Impact of Telehealth Nursing
Rates for Heart Failure Patients
on Chronic Disease Management in
● Overview: This study investigates how Rural Populations
specific nursing interventions influence
the readmission rates of patients with ● Overview: This study investigates the
heart failure. effectiveness of telehealth nursing in
● Purpose: To develop targeted nursing managing chronic diseases in rural
interventions that reduce hospital communities.
readmissions and improve patient ● Purpose: To assess whether telehealth
outcomes in heart failure care. interventions can improve health
outcomes for patients with chronic
4. Evaluating the Impact of conditions in underserved areas.
Nurse-Led Education Programs on
Diabetes Management
8. The Influence of Nurse 1. Assessing the Impact of Nurse-Led
Communication Training on Patient Breastfeeding Education on Lactation
Success Rates
Satisfaction in Oncology Care
● Overview: This study evaluates the
● Overview: This research evaluates the
effectiveness of nurse-led breastfeeding
effect of enhanced communication
education programs on breastfeeding
training for nurses on patient
initiation and continuation rates among
satisfaction in oncology settings.
new mothers in the OB ward.
● Purpose: To determine if
● Purpose: To determine whether
communication training for nurses leads
breastfeeding education provided by
to higher patient satisfaction scores in
nurses improves lactation success and
oncology care.
to identify the most effective teaching
methods.
9. Assessing the Effectiveness of
Infection Control Measures in 2. The Effectiveness of Skin-to-Skin Contact
Preventing Healthcare-Associated on Neonatal Outcomes in Cesarean
Infections Deliveries

● Overview: This research investigates

● Overview: This study examines the
the impact of immediate skin-to-skin
effectiveness of infection control
contact between mothers and newborns
protocols in reducing the incidence of
on neonatal outcomes following
healthcare-associated infections in
cesarean deliveries.
hospitals.
● Purpose: To determine whether
● Purpose: To identify the most effective
skin-to-skin contact improves neonatal
infection control practices that minimize
health indicators such as temperature
the risk of hospital-acquired infections.
regulation, heart rate, and
breastfeeding initiation.
10. The Impact of Shift Work on
Nurse Fatigue and Patient Care 3. The Role of Prenatal Classes in Reducing
Quality Anxiety Levels in Expectant Mothers

● Overview: This study investigates how ● Overview: This study examines the
shift work patterns affect nurse fatigue impact of prenatal classes on reducing
levels and the quality of patient care anxiety levels among expectant
provided. mothers in the OB ward.
● Purpose: To explore ways to optimize ● Purpose: To assess whether
shift scheduling to reduce nurse fatigue participation in prenatal classes
and improve patient care quality. reduces anxiety and improves
psychological well-being in pregnant
End of sample…. women.

End of sample..
Quantitative Nursing Research Titles
in the OB Ward
Quantitative Nursing Research Titles
in the Medical-Surgical Setting
1. Assessing the Impact of Early ● Overview: This study investigates the
Mobilization on Postoperative Recovery in emotional and psychological
Medical-Surgical Patients experiences of parents caring for
children with chronic illnesses in the
● Overview: This study evaluates the pediatrics ward.
effect of early mobilization protocols on ● Purpose: To understand the challenges
the recovery outcomes of patients in faced by parents and to develop
the medical-surgical unit. supportive interventions that address
● Purpose: To determine whether early their emotional and practical needs
mobilization reduces the length of during their child’s hospitalization.
hospital stay and improves functional
outcomes after surgery. 2. Understanding the Impact of Long-Term
Hospitalization on Pediatric Patients’
2. The Effectiveness of Multimodal Pain Emotional Well-Being
Management Strategies in Reducing Opioid
Use in Surgical Patients ● Overview: This research explores how
long-term hospitalization affects the
● Overview: This research examines the emotional and psychological well-being
effectiveness of multimodal pain of pediatric patients.
management strategies in reducing the ● Purpose: To identify the emotional
need for opioids in postoperative challenges faced by children during
patients. extended hospital stays and to develop
● Purpose: To identify the most effective strategies to improve their mental
pain management approaches that health and overall experience.
minimize opioid consumption and
related side effects. 3. The Role of Play Therapy in Reducing
Anxiety Among Hospitalized Children
3. Evaluating the Impact of Nurse-Led
Discharge Planning on Readmission Rates in ● Overview: This study examines the
the Medical-Surgical Unit experiences of pediatric patients who
participate in play therapy during their
● Overview: This study investigates the hospitalization.
effectiveness of nurse-led discharge ● Purpose: To explore the effectiveness of
planning interventions in reducing play therapy in reducing anxiety and to
30-day hospital readmission rates. inform nursing practices that support
● Purpose: To determine whether the emotional needs of hospitalized
comprehensive discharge planning led children.
by nurses improves post-discharge
outcomes and reduces readmissions. Full notes at 250+ Pages With more samples
of research studies, titles and more!
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Qualitative Nursing Research Titles in LSdc-RNoMOme5XvyhEAtY7Y2rv8KMmsYnK
the Pediatrics Ward EM5xkDoXAddeQzOg/viewform

1. Exploring the Lived Experiences of

Parents Caring for Hospitalized Children
with Chronic Illnesses