1 NURS 320 Nursing Research Research and Evidence-Based Nursing Practice

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NURS 320NURS 320Nursing ResearchNursing Research

Research and Evidence-Based Nursing PracticeResearch and Evidence-Based Nursing Practice

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Research and Research and Evidence-Based Nursing PracticeEvidence-Based Nursing Practice

Read Fawcett and Garity, Chapter 1Read Fawcett and Garity, Chapter 1

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What is Research?What is Research?

Research is a formal, systematic, and rigorous Research is a formal, systematic, and rigorous process of inquiry used to generate new theories process of inquiry used to generate new theories and test existing theoriesand test existing theories

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What is Research?What is Research?

A project that is NOT designed to generate or test A project that is NOT designed to generate or test a theory is, at best, a hobby, not research! a theory is, at best, a hobby, not research!

Thus, research is no more or less than the vehicle Thus, research is no more or less than the vehicle for THEORY DEVELOPMENTfor THEORY DEVELOPMENT

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What is a Theory?What is a Theory?

A theory is one or more relatively concrete and A theory is one or more relatively concrete and specific concepts, the propositions that narrowly specific concepts, the propositions that narrowly describe those concepts, and the propositions describe those concepts, and the propositions that state relatively concrete and specific that state relatively concrete and specific relations between two or more of the concepts relations between two or more of the concepts

• A concept is an idea expressed in wordsA concept is an idea expressed in words

• A proposition is a statement about one or more A proposition is a statement about one or more conceptsconcepts

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What is NURSING Research?What is NURSING Research?

Nursing research is a formal, systematic, and Nursing research is a formal, systematic, and rigorous process of inquiry used to generate new rigorous process of inquiry used to generate new theories and test existing theories about the theories and test existing theories about the health-related experiences of human beings health-related experiences of human beings within their environments and about the actions within their environments and about the actions and processes that nurses use in practiceand processes that nurses use in practice

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Why Should Nursing Research Why Should Nursing Research Be Conducted?Be Conducted?

Why do YOU think nursing research should be Why do YOU think nursing research should be conducted?conducted?

• ““So what?” topicsSo what?” topics

• Great topicsGreat topics

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What is Evidence-BasedWhat is Evidence-BasedNursing Practice?Nursing Practice?

Evidence-based nursing practice is the deliberate Evidence-based nursing practice is the deliberate and critical use of theories about human beings’ and critical use of theories about human beings’ health-related experiences to guide actions health-related experiences to guide actions associated with each step of the nursing process associated with each step of the nursing process

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Nursing Practice Process and Nursing Practice Process and Nursing Research ProcessNursing Research Process

Practice is researchPractice is research

Research is practiceResearch is practice

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Parallel Between the Nursing Practice Process Parallel Between the Nursing Practice Process and the Nursing Research Processand the Nursing Research Process

Nursing Practice Process

Nursing Research Process

Assessment Statement of the problem

Planning Research methods

Implementation Conduct of the research

Evaluation

Documentation

Interpretation of results

Research report

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Evidence-Based Nursing PracticeEvidence-Based Nursing Practice

Theories are the BEST evidence for Theories are the BEST evidence for practicepractice

• However, other sources of knowledge However, other sources of knowledge sometimes are used as evidencesometimes are used as evidence

Four methods of knowing Four methods of knowing

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Methods of Knowing Used as Evidence: Methods of Knowing Used as Evidence: TenacityTenacity

Method andDescription

Limitations

Tenacity

“We’ve always done it that way; it’s the custom.”

“It’s the traditional way to do it here.”

Ignores contradictory evidence and opinions

No way to decide between conflicting opinions.

Unanticipated negative outcomes.

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Methods of Knowing Used as Evidence: Methods of Knowing Used as Evidence: AuthorityAuthority


Limitations

Authority

“The textbook tells us to do it that way.”

“My teacher told me to do it this way.”

Authoritative sources are not infallible.

No way to decide which authoritative source is correct.

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Methods of Knowing Used as Evidence: Methods of Knowing Used as Evidence: A PrioriA Priori


Limitations

A priori

“It seems reasonable.”

One person’s idea of reasonable is not the same as another’s.

No way to decide whether reasonableness depends on the current way of thinking or previous education.

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Theory is the BEST EvidenceTheory is the BEST Evidence


Limitations

Theory

“The theory guides me to do it.”

Must be developed through Must be developed through rigorous inquiry. rigorous inquiry.

Theories can be false.Theories can be false.

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Theory is the BEST EvidenceTheory is the BEST Evidence

Five types of nursing theories have been Five types of nursing theories have been identifiedidentified

• CarperCarper

Chinn and KramerChinn and Kramer

• WhiteWhite

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Five Types of Theory for Five Types of Theory for Evidence-Based Nursing Practice:Evidence-Based Nursing Practice:

Empirical TheoriesEmpirical Theories

DescriptionDescription Mode of InquiryMode of Inquiry ExamplesExamples

The science of nursingThe science of nursing

Publicly verifiable, factual Publicly verifiable, factual descriptions, descriptions, explanations, or explanations, or predictions based on predictions based on subjective or objective subjective or objective groupgroup data data

Empirical researchEmpirical research

Scientific dataScientific data

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Three Types ofThree Types of Empirical Theories and ResearchEmpirical Theories and Research


Descriptive theoriesDescriptive theories Descriptive researchDescriptive research

Descriptions Descriptions of people’s of people’s health health experiencesexperiences

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Three Types of Empirical Theories and ResearchThree Types of Empirical Theories and Research


Explanatory theoriesExplanatory theories Correlational researchCorrelational research

Explanations Explanations of factors that of factors that influence influence health health experiencesexperiences

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Three Types of Empirical Theories and ResearchThree Types of Empirical Theories and Research


Predictive theoriesPredictive theories Experimental researchExperimental research

Outcomes of Outcomes of nursing nursing interventionsinterventions

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Empirical TheoriesEmpirical Theories

Think about your own nursing practiceThink about your own nursing practice

• How do you know what to expect in a clinical How do you know what to expect in a clinical situation?situation?

• How do you know how a nursing intervention How do you know how a nursing intervention

“works”?“works”?

• How do you know what your own best practices How do you know what your own best practices

are?are?

• How do you know how to get desired How do you know how to get desired outcomes? outcomes?

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Aesthetic TheoriesAesthetic Theories


The art of nursingThe art of nursing

Expressions of the Expressions of the nurse’s perception of nurse’s perception of what is significant in the what is significant in the individualindividual patient’s patient’s behaviorbehavior

Performance of nursing Performance of nursing actions in an artful actions in an artful mannermanner

Envisioning Envisioning possibilitiespossibilities

Rehearsing nursing Rehearsing nursing art and acts and art and acts and observing or observing or performing nursing performing nursing artart

Philosophical Philosophical essaysessays

Works of artWorks of art

Aesthetic Aesthetic criticismcriticism

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Aesthetic TheoriesAesthetic Theories


• How do How do youyou express your aesthetic knowing? express your aesthetic knowing?

• Have you ever written a poem or story that Have you ever written a poem or story that expressed your aesthetic knowing about a expressed your aesthetic knowing about a particular situation with a patient?particular situation with a patient?

• Have you ever danced in a way that expressed Have you ever danced in a way that expressed your aesthetic knowing about a particular your aesthetic knowing about a particular situation with a patient?situation with a patient?

• Have you ever made a painting or drawing that Have you ever made a painting or drawing that expressed your aesthetic knowing about a expressed your aesthetic knowing about a particular situation with a patient?particular situation with a patient?

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Ethical TheoriesEthical Theories


The ethics of nursingThe ethics of nursing

Descriptions of moral Descriptions of moral obligations, moral and obligations, moral and nonmoral values, and nonmoral values, and desired endsdesired ends

Identification, Identification, analysis, and analysis, and clarification of clarification of beliefs and valuesbeliefs and values

Dialogue about and Dialogue about and justification of justification of beliefs and valuesbeliefs and values

Standards of Standards of practicepractice

Codes of ethicsCodes of ethics

Philosophies of Philosophies of nursingnursing

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Ethical TheoriesEthical Theories


• How do you know what is the right thing to do How do you know what is the right thing to do in nursing practice?in nursing practice?

• How do you know what is the right thing to do How do you know what is the right thing to do in nursing research?in nursing research?

• How do you know when you are acting How do you know when you are acting responsibly?responsibly?

• How do you know what you should do in How do you know what you should do in nursing practice?nursing practice?

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Five Types of Theory for Five Types of Theory for Evidence-Based Nursing Practice:Evidence-Based Nursing Practice:Theories of Personal KnowingTheories of Personal Knowing


The interpersonal The interpersonal relationships of nursingrelationships of nursing

Expressions of the quality and Expressions of the quality and authenticity of the authenticity of the interpersonal process interpersonal process between each nurse and each between each nurse and each patientpatient

Opening, Opening, centering, thinking, centering, thinking, listening, and listening, and reflectingreflecting

EssaysEssays

Nurses’ Nurses’ autobiographicautobiographical storiesal stories

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Theories of Personal KnowingTheories of Personal Knowing


• How do you express yourself in an authentic How do you express yourself in an authentic manner to patients?manner to patients?

• How do you let patients know that you care How do you let patients know that you care about them as individuals?about them as individuals?

• What strategies do you use to engage in What strategies do you use to engage in therapeutic relationships with patients?therapeutic relationships with patients?

• How do How do youyou know that your relationship with a know that your relationship with a particular patient is therapeutic? particular patient is therapeutic?

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Sociopolitical TheoriesSociopolitical Theories


The politics and The politics and policies of nursingpolicies of nursing

Descriptions and Descriptions and expressions of expressions of the context or the context or cultural location cultural location for nurse-patient for nurse-patient interactions and interactions and the broader the broader context in which context in which nursing and nursing and healthcare take healthcare take place place

Critiques of situationsCritiques of situations

Critiques of alternate Critiques of alternate constructions of realityconstructions of reality

Hearing and attending Hearing and attending to all relevant voicesto all relevant voices

Written or oral Written or oral criticismcriticism

Written or oral Written or oral criticismcriticism

Written or oral Written or oral documentation of documentation of voices heard and voices heard and acknowledgedacknowledged

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• Who are the stakeholders in Who are the stakeholders in youryour particular work particular work environment?environment?

• Who are the stakeholders for nursing practice as a Who are the stakeholders for nursing practice as a whole?whole?

• Who are the stakeholders in the educational program Who are the stakeholders in the educational program in which you currently are enrolled?in which you currently are enrolled?

• Who are the stakeholders for the entire discipline of Who are the stakeholders for the entire discipline of nursing?nursing?

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• How do you, as a nurse, hear and attend to all How do you, as a nurse, hear and attend to all relevant voices? relevant voices?

What strategies do you use to encourage What strategies do you use to encourage stakeholders to express their views?stakeholders to express their views?

What strategies do you use to share diverse What strategies do you use to share diverse views among stakeholders?views among stakeholders?

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Contributions of Five Types of Theories to Contributions of Five Types of Theories to Evidence-Based Nursing PracticeEvidence-Based Nursing Practice

Each type of theory is needed as evidence for Each type of theory is needed as evidence for practicepractice

Inquiry addressing each type of theory Inquiry addressing each type of theory contributes different but equally valuable contributes different but equally valuable evidence for nursing practiceevidence for nursing practice

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Evidence-Based Nursing PracticeEvidence-Based Nursing Practice

Evidence is needed to support actions associated Evidence is needed to support actions associated with each step of the nursing processwith each step of the nursing process

• AssessmentAssessment• PlanningPlanning• ImplementationImplementation• EvaluationEvaluation

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NURS 320 Nursing Research:NURS 320 Nursing Research:Major Points for this SessionMajor Points for this Session

Research = Theory DevelopmentResearch = Theory Development

Theory = EvidenceTheory = Evidence

Practice = ResearchPractice = Research

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Definition of researchDefinition of research

Definition of theoryDefinition of theory

Definition of nursing researchDefinition of nursing research

Definition of evidence-based nursing practiceDefinition of evidence-based nursing practice

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Sources of evidence for evidence-basedSources of evidence for evidence-based

nursing practicenursing practice

• TenacityTenacity• AuthorityAuthority• A prioriA priori • TheoryTheory

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Theory is the best source of evidence forTheory is the best source of evidence for evidence-based nursing practiceevidence-based nursing practice

• Five types of theoriesFive types of theories

EmpiricalEmpirical AestheticAesthetic EthicalEthical Personal knowingPersonal knowing Sociopolitical knowingSociopolitical knowing

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Research and Evidence-Based Nursing PracticeResearch and Evidence-Based Nursing Practice

Questions?Questions?

Comments?Comments?

Concerns?Concerns?

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NURS 320 Nursing Research: NURS 320 Nursing Research: Next SessionNext Session

Conceptual-theoretical-empirical (C-T-E) Conceptual-theoretical-empirical (C-T-E) structures for nursing researchstructures for nursing research

Contents of research report Contents of research report

Framework for evaluating C-T-E structures for Framework for evaluating C-T-E structures for researchresearch

Documents

1 NURS 320 Nursing Research Research and Evidence-Based Nursing Practice