NR 449 Week 2 The Research Process
Student Name
Chamberlain University
NR-449 Evidence-Based Practice
Prof. Name
Date
NR449 Week 2 The Research Process
The Research Process
The nursing research process parallels the nursing process in that both follow a systematic, logical sequence. However, the nursing process typically applies to the care of individual clients, whereas research aims to create generalizable knowledge for broader application. The ultimate purpose of nursing research is to enhance patient outcomes and advance nursing practice through evidence-based findings.
A problem statement articulates the gap between what is known and what is unknown in a specific area. Once the problem is identified, researchers develop a research question, which precedes the selection of a research design. Literature reviews serve as a foundation for understanding existing work, identifying opportunities for replication, and determining methodological approaches.
Match the research design to the description
| Research Design | Description |
|---|---|
| Quantitative | A structured, scientific approach assuming that events are caused and measurable, emphasizing numerical data. |
| Qualitative | A naturalistic method focusing on understanding individuals’ constructed realities, often through interviews and observations. |
| Mixed Methods | Combines quantitative measurements with qualitative insights to address both numerical and experiential aspects of a phenomenon. |
Steps of the Research Process
Nursing research follows a systematic order that ensures reliability and validity of results. The correct sequence is:
- Determine the problem
- Review the literature
- Design the study
- Collect the data
- Analyze the data
- Communicate the results
- Implement practice change
Characteristics of Quantitative and Qualitative Research
| Quantitative Characteristics | Qualitative Characteristics |
|---|---|
| Objective, measurable data | Reality is subjective and constructed by individuals |
| Uses representative samples | Individual cases are explored through informants |
| Employs descriptive and inferential statistics | Identifies and analyzes themes for meaning |
| Allows generalization to a larger population | Transfers findings to similar cases |
| Researcher remains detached and objective | Researcher is actively engaged and involved |
Prospective, Retrospective, and Time-Based Designs
Prospective studies involve collecting primary data directly from participants moving forward in time. Retrospective studies use secondary data already gathered. Longitudinal studies span extended periods to examine changes, while cross-sectional studies collect data at a single point from multiple populations.
Question: A nurse researcher is testing whether an intervention for fall prevention is effective. Which evidence is best for this type of problem?
Answer: An experimental, prospective, quantitative study offers the highest level of rigor for determining intervention effectiveness.
Question: The nurse researcher wants to determine obstacles to compliance with a pressure ulcer prevention regimen. Which evidence is best for this type of problem?
Answer: A qualitative study using focus groups of nurses can provide rich insights into barriers and perceptions.
Question: Quantitative research provides some of the strongest evidence for nursing practice. Which best describes the rationale for this statement?
Answer: Quantitative research enables confidence in the causal relationship between interventions and outcomes through statistical validation.
Question: Which research question is best answered with a quantitative design?
Answer: “Does the use of chair alarms impact fall rates over time?”
Match the research design to the study described
| Research Design | Example |
|---|---|
| Quasi-experimental | A nurse introduces a new stress reduction technique to a convenience sample. |
| Quantitative | A nurse seeks to improve clinical interventions for heart failure patients. |
| Qualitative | A nurse explores older adults’ perceptions of a fall prevention program. |
| Nonexperimental | A nurse examines the relationship between substance abuse and sexual experimentation in teenagers. |
Question: A researcher plans to collect data from participants over one year to describe changes in attitudes about smoking cessation. Which type of study best describes this plan?
Answer: Longitudinal study.
Descriptive, Correlational, and Predictive Nonexperimental Studies
Descriptive studies classify and summarize data without manipulation of variables. Correlational studies examine relationships between variables, and predictive studies use existing data to forecast outcomes.
Question: When reading and analyzing a research study, what is the nurse’s primary reason to question the link between the treatment and the outcome?
Answer: Threats to validity suggest alternative explanations for the observed outcome.
Question: Which research provides the best evidence for nursing practice?
Answer: Research that demonstrates the effectiveness or ineffectiveness of an intervention in improving patient care.
Identifying Practice Problems
In nursing, identifying a practice problem is often the first step toward initiating a research project. A research problem statement outlines the knowledge gap, while a purpose statement expresses the researcher’s intent. Curiosity, combined with professional observation, drives the recognition of these issues.
Question: As a staff nurse on a medical-surgical unit, which role is appropriate related to nursing research?
Answer: Evaluate research studies and apply relevant findings to clinical practice.
Question: What is the first step in the research process?
Answer: Identify a gap in knowledge related to nursing practice.
Sources for Researchable Nursing Problems
| Source | Example |
|---|---|
| Practice observations | Noticing increased patient falls during night shifts |
| Quality improvement data | Reports showing rising rates of hospital-acquired infections |
| Personal experiences | Difficulty following outdated wound care protocols |
| Customer surveys | Patient dissatisfaction with discharge teaching |
| Nursing frustrations | Limited time for patient education |
| Nurse-sensitive indicators | Data on pressure ulcer rates directly linked to nursing care |
Nurse-Sensitive Indicators
Nurse-sensitive indicators reflect elements of patient care that are directly influenced by nursing actions. Examples include patient falls, pressure ulcer rates, and catheter-associated urinary tract infections (CAUTIs). Non-nurse-sensitive indicators are outcomes not directly attributable to nursing care, such as hospital food quality.
Case Study: Medication Error
Question 1/6: The nurse begins to wonder why the medication error occurred. Identify the sources of researchable questions about this medication error.
Answer: Personal experience, client feedback, poor client outcome, and new interventions can all serve as sources.
Question 2/6: The nurse learns that medication errors may occur at any point in a multistep process. Identify which research topics are nursing-sensitive and which are not nursing-sensitive.
Answer: Errors related to medication administration techniques are nurse-sensitive; factors like drug manufacturing defects are not nurse-sensitive.
Question 3/6: After consulting with the nurse manager and quality improvement department, the nurse discovers medication errors have increased by 10% in the past year, primarily due to distractions during administration. The nurse has identified a general topic of interest and a problem. What is the next step?
Answer: Review current literature to assess what is already known and identify gaps.
Question 4/6: The nurse reviews Relihan et al. (2010) and identifies the study design.
Answer: Quantitative research design.
Question 5/6: After reviewing literature, a problem statement should be developed, followed by a purpose statement.
Answer: A problem statement identifies the issue; a purpose statement defines the goal of the research.
Question 6/6: After reviewing Relihan et al. (2010), which conclusions could be made?
Answer:
- Future research should evaluate time lost due to interruptions.
- Multifaceted interventions are likely most effective.
- Single interventions may not be sufficient.
- Interventions aimed at minimizing interruptions should be implemented.
The PICOT Question
The PICOT framework ensures a research question is comprehensive.
| PICOT Element | Description |
|---|---|
| P (Population) | Target group or problem |
| I (Intervention) | Treatment or exposure |
| C (Comparison) | Standard or alternative intervention |
| O (Outcome) | Desired result |
| T (Time) | Time frame for the study |
Question: Which type of hypothesis states there is no difference between two groups?
Answer: Null hypothesis.
Question: Which element of the PICOT question is missing in this example? “In overweight adults with hypertension, does changing the diet and exercise result in weight loss and reduced blood pressure within a three-month time period?”
Answer: Comparison.
Question: Amy, a nurse researcher, skipped which step when forming a research question about medication errors?
Answer: Performing a literature review.
Sources and Levels of Evidence
Different types of evidence vary in strength. Randomized controlled trials and systematic reviews are considered high-level evidence, while anecdotal reports are low-level.
| Rank | Type of Evidence |
|---|---|
| 1 | Clinical practice guidelines |
| 2 | Meta-analyses |
| 3 | Randomized clinical trials |
| 4 | Case-controlled studies |
| 5 | Expert opinion |
| 6 | Social media posts |
Aggregated evidence synthesizes results from multiple studies, while non-aggregated evidence comes from a single study.
Grading Research Evidence
| Scenario | Level of Evidence |
|---|---|
| Consulting a clinical nurse specialist for wound care advice | Level 5 |
| Using a drug handbook for side effect information | Level 5 |
| Chart review comparing medication classes for blood pressure control | Level 3 |
| Descriptive study on preceptor impact on retention | Level 4 |
| Program evaluation with statistical comparisons for HIV medication adherence | Level 2 |
| Practice guideline recommending chlorhexidine dressings | Level 1 |
Literature Review in Nursing Research
A literature review helps researchers find, evaluate, and synthesize previous studies related to a research topic.
Databases relevant to nursing practice include: CINAHL, PubMed, ProQuest, Cochrane Library, and Latin America & Iberia Database.
Benefits of a literature review:
- Supports evidence-based practice changes
- Establishes credibility for the practice problem
- Expands the body of nursing knowledge
Common mistakes in literature searches:
- Limiting to full-text only
- Searching irrelevant databases
- Setting overly restrictive filters
Example: For the PICOT “In adults with anxiety disorder, is meditation as effective as exercise in reducing stress?” relevant search terms include meditation, exercise, anxiety disorder, and adults.
Boolean operators improve searches:
- AND narrows the search (e.g., “Chinese” AND “Native American heritage”).
- OR broadens it (e.g., “white potato” OR “sweet potato starch”).
- NOT excludes terms (e.g., “wound dressings” NOT “gauze”).
References
Alsulami, Z., Conroy, S., & Choonara, I. (2014). Double checking the administration of medicines: What is the evidence? A systematic review. Archives of Disease in Childhood, 99(9), 833–838. https://doi.org/10.1136/archdischild-2013-304888
Nelissen, E., et al. (2017). Effects of a wearable patient sensor on clinical care. Journal of Advanced Nursing, 73(6), 1380–1391. https://doi.org/10.1111/jan.13200
Parker, V., Giles, M., Graham, L., Suthers, B., Watts, W., O’Brien, T., & Mitchell, R. (2017). Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): A pre–post control intervention study. BMC Health Services Research, 17(1), 314. https://doi.org/10.1186/s12913-017-2250-1
NR 449 Week 2 The Research Process
Pickham, D., et al. (2018). Effect of a wearable patient sensor on care delivery for preventing pressure injuries. International Journal of Nursing Studies, 80, 12–19. https://doi.org/10.1016/j.ijnurstu.2018.01.005
Relihan, E., O’Brien, V., O’Hara, S., & Silke, B. (2010). The impact of a set of interventions to reduce interruptions and distractions to nurses during medication administration. BMJ Quality & Safety, 19(5), e52. https://doi.org/10.1136/qshc.2009.036871
Tan, C., et al. (2020). Nurses’ perceptions and experiences with medical device–related pressure injuries. Journal of Clinical Nursing, 29(9–10), 1725–1736. https://doi.org/10.1111/jocn.15222