Principles of Research and Evidence-Based Practice - Essay Example

Instruction: Principles of Research & Evidence Based Practice Table of Contents Principles of Research & Evidence Based Practice2 Nursing Research 5 Evidence-Based Practice Implications for Nurses 7 Quantitative Research 9 Qualitative Research 11 Conclusion 12 Works Cited 14 Principles of Research & Evidence Based Practice Evidence-based nursing practice is a form of nursing approach that integrates the use of scholarly theories and concepts to diagnose medical issues with regards to evidence used to diagnose the problem. For example, nurse assisted euthanasia is a practice which has been termed by critics as nurse assisted suicide whereby patients look forward to taking their lives as a remedy to their long and intense suffering. In such a situation, evidence-based practice would allow the nurse to identify whether the pain of the patient is intense enough to warrant the assistance. In addition, concepts and theories of nursing allege that a nurse is bound to his/her practice policies as well as personal choices. Therefore, for nurses to undertake any course of actions, evidence is supposed to lead the decisions while concepts and information enabling such decisions is required prior to implementing decisions and deemed solutions. For the nursing career, care is the major responsibility which the nurse is entrusted with as it involves of use of interventions aiming at providing care for patients with differing and a wide range of personal and medical needs (Burns, & Grove, 20). Evidence in nursing is a function of both research and analysis of data regarding medical problems that the nurse may be presented with. This means that a nurse is entitled to provide diagnosis of illness through researching on symptoms, medical tests, and information on the best practices available. However, while nurses are categorized as care givers, their welfare in terms of performance and attachment with the work they do has been identified as problematic at personal development level. For example, the nurses are care givers and therefore are classified as the service deliverers but their welfare hangs on the balance as they do not have bodies or entities that care for them. This is according to a research conducted by Burtson and Stichler (2010) in which they allege that satisfaction of nurses is a function of how they are treated, both in compensation and how they are developed to adapt and deal with personal issues while at the same time providing the best care to their patients. According to the results from Burtson and Stichler’s research, nurses get their satisfaction from the work they do. The responsibility of providing care to patients is one among a cluster of factors that ensure that a nurse is satisfied. The level of satisfaction enables the nurse to conduct research and employ cohesiveness in their duties. In this case, a nurse with personal issues and unsatisfied needs is unable to provide substantial evidence-based care. In this case, the quantitative research article ‘nursing work environment and nurse caring: relationship among motivational factors’ gives an account of the various factors that influence nurse satisfaction and the possible outcomes when caring is considered. The purpose and aim of this document is to analyze the various factors of consideration that connect nursing research with best practice. In addition, a critique to two articles, quantitative and qualitative research methods, will show the different types of research methods, designs, and approaches used by the nurses before they implement their interventions. Research methods and designs are used to determine the variables and factors that affect a group of patients, individual patients, or the relevance of using treatment and control groups in a research-based intervention. Nursing therefore includes research whose purpose is to provide evidence which in turn is used to implement interventions. A background study on evidence-based practice shows that during the 1980s, evidence-based medicine was the term used for today’s evidence-based practice and emerged to describe an approach that used evidence from scientific study to define the best drill. After some while, the term evidence-based medicine shifted to evidence-based practice as clinicians and physicians understood that within the health care sector, scientific research was essential to decision making. Through this knowledge, various definitions of evidence-based research where created such that “evidence-based practice is the meticulous, categorical, and thoughtful of the present best-practice to make choices about care of different patients (Sacket et al, 1996)”. In addition, experts began to identify evidence-based practice with evidence-based healthcare taking it as a process that took research into consideration prior to making decisions and making decisions based on evidence. Evidence-based practice and healthcare assume that patients’ preferences and desires, the clinical setting, and the clinician’s expertise are factors that call for evidence. An interpretation of existing evidence-based practices within the clinical practice, reading, critiquing, and synthesizing research findings are factors that experts associate with evidence-based healthcare. With consideration to the care givers, it is seen that nurses ask various question when intending on assimilating evidence-based practice into their medical setting. Such questions, which will be considered the research questions for this essay include: What evidence-based practice really is Whether evidence-based practice is similar to nursing research What the difference between evidence-based practice and eminence enhancement is Whether evidence-based is applicable to nursing drill (Polit, & Beck, 345) The above questions help the nurse to determine the options that he/she has to take with regards to offering the best care to a patient. Hence fore, the ability to answer these questions shows an understanding of what evidence-based practice is and how it affects the nursing fraternity with regards to patient reviews and application of ethical procedures. To the nurse, there are different levels and types of evidence that can be achieved from a nursing research aimed at influencing decision making processes. There is a substantial difference between evidence-based research and quality improvement, or research utilization, or nursing research. However, there is a relationship between evidence-based research and the rest of the processes. For instance, quality improvements may be based on evidence and may contribute to evidence-based practice or initiatives involving research. In addition, the consideration of evidence-based practice has the potential to lead to research studies or improvement of quality (Polit, & Beck, 74) Research utilization with reference to evidence-based practice is the process through which nurses are able to analyze various research findings and then making a decision or a conclusion on how such findings can be integrated into the clinical practice. The assimilation of appropriate study conclusions into clinical practice aids in closing the gap between research and practice. However, recent findings show that research utilization has been replaced with evidence-based practice as nurses are more concerned with evolving healthcare sector and the number of options available at their disposal. Hence fore, rather than using the findings of existing research to implement interventional measures, nurses burden themselves with the task of venturing into research considering two factors, timing and the patient preferences and desires. In this case, the gap between research and practice is closed in a cohesive manner as technology and interventional measures differ from period to period (Berwick, 1972-75). Nursing Research Normally, there exists a difference between nursing research and evidence-based practice. While the latter uses research to determine patient issues and to offer assistance in decision making process, the former is specific in developing nurse’s knowledge through systematic inquiry leading to development and refinement. Researchers within the nursing fraternity use research to scrutinize hitches of explicit concerns to nurses and the patients, kinfolks, and the civilization they attend to (Centers for Disease Control and Prevention, 33). Nursing research methods include quantitative, qualitative, and/or mixed. In quantitative research, nurse researchers use intentions, computable data or use study apparatuses to test familiarity, outlooks, dogmas, and/or proficiencies. Qualitative research on the other hand, uses methods such as the analysis of chronicles and interviews to aid in accepting a precise phenomenon. Triangulated research method uses both quantitative and qualitative methods. This means that computable variables can be determined from interviews and analysis of narratives to determine the factors affecting a certain specific group of patients, families, and the community in general (Clifford, & Murray, 46-89). Regardless of the method used in nursing research, researchers follow a set of approaches that ensure quality and accuracy of data and the associated analyses. The purpose of any precise approach used to provide answers to questions and develop knowledge using scientific methods. Below is a set of areas that nursing research is applicable: Randomization of clinical trial that examines best drill for orthopedic-pin location care. The efficacy of gloves used for examination for modest dressing modifications. The level of reliability of the approaches that are used to control nasogastric tube allocation Properties of relaxation and channeled imagery on preoperative fretfulness Value of being in patients with long-lasting discomfort The affiliation of a preoperative training package for joint replacement operation and patient results. The use of scientific method involving the collection of observable, computable, and demonstrable records in a recommended style so as to designate, explain or forecast outcomes is a common practice in nursing research (Fink et al., 122). Within the nursing fraternity, nursing research is an undertaking that paves way to evidence-based practice and therefore various principles of research are used. For example, while conducting nursing research data collecting methods demand that the data collected is as objective as possible to avoid bias of the researcher in hypothesis development, personal beliefs, and/or values (Funk, 94). A research is capable of biasing results from the data collected or from the instruments of collecting the data. In qualitative research methods where instruments such as interviews are used, it is possible that hypotheses, values, and personal beliefs may affect the setting of research questions and recording of data that conflict with the values and beliefs. The use of certain approaches such as treatment and control groups may involve the use of recruitment, performing of faculty, and the lack of control for other confounding variables may invite bias in the research findings. In this case, nursing research calls for study proposals that take into consideration a plan to minimize these risks and to support the development of reliable and viable information and results respectively (Madsen et al., 43). The consideration of researching within the nursing setting involves variables such as extensive knowledge of research methods and processes. Hence fore, the research process must involve the expertise of experienced researcher or the use of own skills through the consideration of statistics and research methods (Silverman, & Altman, 173). While nursing research involves theoretical and practical considerations, nurses are required to learn about getting involved within aspirations associated with evidence-based practices. Nursing fraternities have databases with which nurses can be members of to subscribe to the theoretical and informative resources developed by experts within the field. This serves the nurse in a manner that is likely to help him/her in the processes of critiquing, analyzing, and evaluating existing published research as it is a necessary and essential step in research activity (Newhouse at al., 35). Evidence-Based Practice Implications for Nurses The roles served by nurses are instrumental in nature as they provide and ensure evidence-based practice is integrated in the decision making practice. Before the implementation of any intervention, nurses are required to ask themselves whether the evidence to such intervention is available or how best practice can be provided. In addition, the nurse is required to determine whether the set objectives for every intervention will provide the highest results for each case or any group of patients (Madsen et al., 2005). Nurses are obligated to work with other experts within the field to ensure their practice is ethical and that it uses substantial evidence-based approaches to deliver interventions. Opportunities are abundant for nurses to question current practices within their field and therefore they use evidence to make care much effective (Pravikoff et al., 47-51). Evidence –based practice helps nurses to provide service that is quality in nature, substantially effective to the patient problem at hand, and one that does not involve ideologies such as ‘it has always been done in a particular manner’. The use of evidence-based practice is to eliminate traditional, mythical, hunches, colleague advice, and/or the use of outdated resources. With regards to current best practices, current research provides interventional solutions and options1 by the consideration of evidence. However, current research and evidence on various areas of concern, for example chronic pain, will not be needed in the future as various other means of providing care will be available and new evidence will be available (Thompson, 376). For instance, if new questions regarding the best practice and intervention for a certain problem emerge, the nurse should not look for answers from textbooks as these books are not published yearly and therefore vital information might be missing. In this case, evidence-based practice involves the consideration of current and vital data that coincides with patient needs and nurse resourcefulness (Sackett, 71). Quantitative Research According to Burtson and Stichler’s (2010) Nursing work environment and nurse caring: relationship among motivational factors, it is observed that quantitative research method is one of the ways of gathering evidence from research using computable data. In this research analysis document, a quantitative method of data collection is employed to bring forth quantifiable data from which the variable for testing can be analyzed and rated with regards to their effects on the problem statement. The purpose of the quantitative research method was to identify how many, out the total sample size, of nurses are satisfied with regards to their work. The variables for testing include compassion satisfaction, nurse job satisfaction, compassion fatigue, stress, and how all these relate to care nursing. The sample size for this research was 450 nurses randomly selected from 9 different district hospitals. This study was experimental in nature as the randomization strategy does not apply to quasi-experimental tests. Hence fore, pretests and posttests are applicable for this study. With the theoretical model adapted being the Watson’s theory of caring, the objectives of the study required the development of hypotheses from which the research results can confirm the acceptability or deniability of the research and/or null hypotheses. The hypotheses for the Burtson and Stichler’s research include the combination of hypotheses 1 and 2 as well as combining hypotheses 3, 4, and 5 as some of the variables for testing affect the same system or pattern of planning (Department Of Health, 56). The following hypotheses were developed for the quantitative research: “Hypotheses 1 and 2: Compassion satisfaction (H1) and nurse job satisfaction (H2) are positively correlated with nurse caring. Hypotheses 3, 4 and 5: compassion fatigue (H5), burnout (H4), and Stress (H3) are damagingly interrelated with nurse caring. Hypothesis 6: Nurse job satisfaction, stress burnout, and compassion fatigue, and Empathy satisfaction are related to nurse caring (H6) Burtson and Stichler’s 2010)” Using the Maslow’s theory of hierarchy the researchers aimed to understand the needs of a caring personnel in order to guarantee satisfaction. Psychological motivations are the main reason that the Maslow theory of hierarchy is applicable in the research process. The first measure of authentic research is to ensure that the expected results and purpose of research has a theoretical footing to ensure relevance and purposefulness. The design of the study was correlational study carried out in a 450-bed academic medical center. The 450-bed allowed a sample size of 450 nurses from 9 medical institutions. Collection of data took 14 days in 2008 where six variables were considered using four reliable research instruments. The validity of the research instruments was confirmed to ensure relevance of the data collected with the purpose of the study. In design and structuring, the quantitative research in this case almost resembles nursing research except of the fact that published researches aren’t the sources of information. The four research instruments include (1) the (CBI-24), SIG, ProQOL, and MMSS standing for Caring Behaviors Inventory, Stress in General Scale, Professional Quality of Life Scale, Mueller McCloskey Satisfaction Scale respectively (Stantonet al. 2001; Mueller & McCloskey 1990; Wu et al. 2006; Stamm 2005). Data collection involved the use of research instruments that enable the respondents to respond using numerically represented answered. For job and nurse satisfaction, respondents were expected to respond with answers such as ‘very unsatisfied’ to ‘very satisfied’. Data analysis was carried out using the statistics software SPSS. Through the processes and instruments used a conclusion was drawn for the quantitative research indicating that there was substantial connection among the variables and therefore if nurses were motivated in their field of work, their performance in rendering care would improve. The evidence gathered in this research is the very first reason the researchers were able to come up with a conclusion. Qualitative Research According to Ilifee, Wilcock, and Haworth (2006) Obstacles to Shared Care for Patients with Dementia: A qualitative study it is observed that qualitative research method is another way of gathering evidence from research using descriptive data (Valcour et al., 2965). In this analysis, a qualitative method of data collection is employed to bring forth descriptive information from which the variable for testing can be analyzed and rated with regards to its effects on the problem statement. The purpose of the qualitative research method is to identify the perceptions of generalists and specialists about shared care among people with dementia. The variables for investigation include qualitative research, primary care, shared care, and how all these relate to caring of dementia patients (Tzeng, & Ketefian, 102). The sample size for this research was 69 as it comprised of 39 generalists and 30 specialists. This study was not experimental in nature and no randomization was applied in this case as the selection of the sample could not use quantitative research design’s sampling methods. With guidelines from the National Service Framework (2001), elderly people with mental problems are entitled to interventions from any integrated healthcare facility. With this directive issued by the government and given that practice and theory differ remarkable, the rationale for conducting this qualitative research is to make sure that nurses are able to deliver quality service through shared care to dementia patients (Camicioli, 88). The selection of the sample size included specialists and generalists at the ratio of 10:13 for specialists to generalists. The scope of the research was to include all potential participants within urban, rural, and the subsections of both. The data collection instrument used was interview as this offered a better elevation in gathering descriptive data. The interview involved open and closed-ended questions discussing diagnosis and management of dementia. An exclusion criterion was used to eliminate primary care nurses as their relevance in the early implementation of care was deemed limited and this could have risked the accuracy of the research results. The results the study shows that most of the generalists did not have substantial skills in the diagnosis and management of dementia under shared care (Boise, 475). The conclusion of the study shows that collaborative and dedicated engagement in the diagnosis and management of dementia can only thrive if specialists cater for such quality of service. From the interviews, responses which are compared to current theoretical footing provide the evidence that generalists misunderstand what it takes to diagnose and manage dementia. The purpose and essence of research in evidence-based practice is to draw conclusions from observed results or collected data regarding specific areas of concern. Conclusion The use of evidence-based practice is to eliminate traditional, mythical, hunches, colleague advice, and/or the use of outdated resources. Evidence in nursing is a function of both research and analysis of data regarding medical problems that the nurse may be presented with. This means that a nurse is entitled to provide diagnosis of illness through researching on symptoms, medical tests, and information on the best practices available. Nursing research methods include quantitative, qualitative, and/or mixed. In quantitative research, nurse researchers use intentions, computable data or use study apparatuses to test familiarity, outlooks, dogmas, and/or proficiencies. Qualitative research on the other hand, uses methods such as the analysis of chronicles and interviews to aid in accepting a precise phenomenon. Triangulated research method uses both quantitative and qualitative methods. This means that computable variables can be determined from interviews and analysis of narratives to determine the factors affecting a certain specific group of patients, families, and the community in general. The consideration of researching within the nursing setting involves variables such as extensive knowledge of research methods and processes. Hence fore, the research process must involve the expertise of experienced researcher or the use of own skills through the consideration of statistics and research methods. The roles served by nurses are instrumental in nature as they provide and ensure evidence-based practice is integrated in the decision making practice. Nurses are obligated to work with other experts within the field to ensure their practice is ethical and that it uses substantial evidence-based approaches to deliver interventions. Opportunities are abundant for nurses to question current practices within their field and therefore they use evidence to make care much effective. In addition, concepts and theories of nursing allege that a nurse is bound to his/her practice policies as well as personal choices. Therefore, for nurses to undertake any course of actions, evidence is supposed to lead the decisions while concepts and information enabling such decisions is required prior to implementing decisions and deemed solutions. With consideration to the two researches for analysis in this writing, it is observed that processes and instruments within the research lead to a conclusion being drawn. These include the observation that substantial connection among the variables exists and therefore if nurses were motivated in their field of work, their performance in rendering care would improve. From the interviews of the qualitative research, responses were compared to current theoretical footing to provide the evidence that generalists misunderstand what it takes to diagnose and manage dementia. The purpose and essence of research in evidence-based practice is to draw conclusions from observed results or collected data regarding specific areas of concern. 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