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Have you ever asked yourself why? Why is it that a certain procedure is done this way or that, or why is it that we do things in a certain manner, or why does something work the way it does? If you have, then without knowing it, you have initiated the nursing research process.
Nursing research is the cornerstone of nursing practice. It is what binds together the Theory-Education-Practice triad that forms the foundation of the nursing profession.
Historically, research began with Florence Nightingale. She observed and noted the high rate of mortality among the British forces as compared to the low mortality rate of the French forces fighting in the Crimean War. Nightingale believed she could reduce the mortality rates and, as a result, enhance the recovery of soldiers. Her work was not readily accepted and she faced many roadblocks. In the end, she demonstrated that infection control measures significantly reduced the mortality rates within a short period of time.
As nurses, we make many observations each day. We observe our patients, their families, the delivery of nursing care, and patient outcomes within an interdisciplinary health care delivery system. When we begin to question these observations, we begin formulating ideas about cause and effect. More importantly, we begin forming ideas about how best to make an observation work for us. We begin to rearrange our ideas and create mental images as we identify a research question.
In the research process, the problem to be studied arises from your clinical observations and expressed as a statement of purpose. Having a clearly defined purpose helps to focus your intent and identifies what you hope to achieve through your inquiry. It can be hard to narrow down your focus, but taking the next step, which is doing a literature review, will help you see what is already known about the topic and what new knowledge you may be able to contribute through your investigation. Once you have reviewed the literature on your topic you may be able to identify and aspect that needs further clarification. You can access the Treadwell Library from every desk top at MGH and the medical librarian is simply an email away!
The next phase of the process is to develop your hypothesis, or statement about the relationship between variables that you plan to study. For example, if you want to understand the impact of a new wound care product on healing, your hypothesis might be that using Product A vs. Product B will decrease the amount of time for wound healing.
In other words, when you decide to conduct research after thinking about the “whys”, you also think about the answers to the “whys”. Many studies where you have a hypothesis are quantitative studies or studies where you can measure your results.
If your literature review reveals very little about the topic you are interested in you need to ask broader questions such as “what”. Research questions on topics where there is little information are typically qualitative studies and can be conducted asking broad open-ended questions in an interview format where the answer can be explored and themes identified.
In a quantitative study a theoretical framework may guide your research. Conversely, qualitative studies may generate new theory. Theories come from both nursing and other disciplines. When looking at theoretical frameworks think about your own world view. Think about how you see the ideas put together and you will soon be able to identify a theory base if your question is quantitative.
Now that you have this section completed its time to really have fun! Fun is developing a research design. In the design you describe in detail the way you will obtain data to answer your research questions. You will describe your sample, your instruments (if any), address ethical-legal principles and data collection procedure methods. The design is dictated by the type of research you are interested in conducting (qualitative or quantitative). Data collection can be as simple as a single question or a questionnaire or as complex as comparison between groups. It can take a few hours to complete or it can be carried out over several years such as a longitudinal study, which may follow research participants for decades. Think of quantitative research as a collection of numbers and facts and qualitative research as a collection of descriptions of experiences.
Before proceeding with data collection you will need to determine if your proposed research study requires approval by the Institutional Review Board (IRB). Be sure to plan ahead to complete CITI training (Course in the Protection of Human Research Subjects) before submitting your IRB package.
Once data is collected, it is time to compile the results. This process includes an analysis of your findings. You will be able to draw conclusions, make recommendations and most importantly, contribute new knowledge to the science of nursing. It is essential to communicate your findings via various forums, such as poster and oral presentations, and writing for nursing journals for publication for the benefit of the nursing community and most of all improve patient care.
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