Critical Appraisal of Nursing Research

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Critical Appraisal of Nursing Research

• Nursing 503
• Session 1-
• September 7, 2005

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Overview

• Knowledge ? Research
• What is Research?
• What is Nursing Research?
• Does Nursing research differ from research in
  other disciplines?
• Is nursing research necessary to the profession
  of nursing?
• What is evidence-based nursing practice why is
  it important?

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Ways of Obtaining Knowledge

• Traditional ways
• Authority
• Borrowing
• Trial and Error
• Intuition
• Personal experience

• Role Modeling
• Reasoning/ problem solving
• Research
• Other??

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What is Research?

• Dictionary Meanings
• To search or explore for answers
• Diligent Systematic Inquiry
• Discovery
• Investigation

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Why is Research Necessary?

• Generate a knowledge base
• Develop and Test theories
• Answers questions with more than speculation
• Use of scientific approach vs. tradition or
  knowing/sensing/intuition

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Knowledge Developed from Research can be used for

• Description
• Explanation
• Prediction
• Control
• Proof in Principle
• Argument
• Decision Making

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What is Nursing Research?

• Nursing Research is a scientific process that
  validates old knowledge and generates new
  knowledge that directly and indirectly influences
  clinical nursing practice.
• Burns Grove, 1987 The Practice of Nursing
  Research
• Research that answers difficult clinical health
  related problems in nursing practice

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The World of Nursing
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Why do We Need Nursing Research?

• Promotes professional practice based on a
  systematic body of knowledge
• Defines the unique contribution
• of nursing to health
• Demonstrates the difference
• that nursing makes

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What is evidence-based nursing practice why is
it important?

• Evidence research findings, knowledge from
  basic science, clinical knowledge, expert opinion
• Why is it important?
• Facilitates nursing care
• Defines best practices
• Enhances nursing efficiency
• Nursing care keeps pace with latest advances
• Takes advantage of new knowledge developments
• Improves patient outcomes and satisfaction

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Types of Nursing Studies

• Pure or Basic Research
• Generates theories ?
• state of knowledge

• Applied Research
• Solves problems/ makes decisions for practical
  purposes
• Includes clinical trials
• 3 properties for nursing consequences in patient
  care, contributes to theory development, nurses
  have access/control over phenomenon studied

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Is Nursing Research Different from Research in
Other Disciplines?

• YES?

• NO?

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Comparison of Nursing Process Research Process

• NURSING PROCESS
• Assessment Data collection interpretation
• Nursing Diagnosis
• Plan goal identified planned interventions
• Implementation
• 5. Evaluation Modification

• RESEARCH PROCESS
• Knowledge of the World of Nursing
• Problem Identification
• Design- Methodology
• Data Collection Analysis
• 5. Outcomes

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Phases of the Research Process

• Stating the Study Problem
• Defining the Purpose of the Research
• Reviewing the Literature to Develop a Theoretical
  Framework
• Selecting the Research Design
• Selecting the Population and Sample
• Conducting a Pilot Study
• Collecting the Data
• Analyzing the Data
• Communicating Findings and Recommendations

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Steps involved in the practice of Evidence-Based
Nursing

• formulation of an answerable question
• systematic searching for the research evidence
• appraisal of the validity, relevance and
  applicability of the research evidence
• integration of the research evidence with other
  information that might influence the management
  of the patient's problems
• clinical expertise,
• patient preference for alternative forms of care,
  and
• available resources
• implementation of the evidence-based practice
  decision
• evaluation of the outcome of the decision.

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The evidence

• Research findings
• Preference RCT (gold standard)
• Knowledge from the basic sciences
• Bench research
• Clinical knowledge Judgment
• (rarely included in formal rating systems)
• Experience
• Anecdotal accounts
• Case histories
• Expert opinion

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Rating system for levels of evidence
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Sources of EBP

• Systematic reviews
• Cochrane Collaboration (www.cochrane.org)
• Evidence-Based Journals
• Evidence-Based Nursing
• Evidence-Based Mental Health
• Centres for Evidence-Based Nursing
• Joanna Briggs Institute for Evidence Based
  Nursing Midwifery (www.joannabriggs.edu.au)
• Evidence-based practice guidelines
• National Guidelines clearinghouse
  (www.guidelines.gov)

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DISCUSSION

• QUESTION
• What makes Nursing Research Unique and Important?
• Other questions?