Improving Patient Care Through Research

By | 2022-02-07T18:00:34-05:00 June 16th, 2008|0 Comments

Nursing blends the art of caring and investigating scientific best practices to discover new techniques that improve patient care.

“Everything a nurse does must be grounded in evidence,” says Fran Roberts, RN, PhD, vice president of the College of Nursing and Health Sciences at Grand Canyon University in Phoenix. “We must have a proven reason for why we are doing what we are doing.”

Long the purview of academia, nursing research presents opportunities for bedside nurses to discover answers to vexing questions in their daily practice.

“The best research comes out of day-to-day issues we face as we care for patients,” Roberts says.

Nurses may turn to nursing literature or guidelines from specialty organizations to check for completed studies that have already addressed the situation, but they often find a lack of information and decide to tackle a project to find an answer that will let them enhance the quality of care, says Nicolette Estrada, RN, FNP, PhD, nurse researcher at the Phoenix VA Health Care System.

“We cannot improve patient outcomes and give the best care without it being research based,” says Barbara F. Piper, RN, DNSc, AOCN, FAAN, professor and chair of nursing research at Scottsdale Healthcare/University of Arizona College of Nursing.

Nurses, typically, develop an area of expertise and build the scientific knowledge in that domain, whether end-of-life care, pressure ulcers, or another topic. Roberts considers it a good idea to follow one’s passion and start exploring within that area of special interest. She says a place exists for both quantitative research, data driven studies, or qualitative research. She suggests investigating and exploring issues from the patients’ perspective.

Research differs from quality improvement (QI) initiatives in that QI projects typically look at internal improvements within the hospital or health system while research involves an investigation that will contribute to the general knowledge.

Overcoming Barriers

Time, money, attitudes, and educational preparation present barriers to nursing research.

Nurses busy with high-acuity patients may find it hard to conceive taking on a research project, which involves designing the study, collecting the data, and writing the paper.

A mentor, within or outside the hospital system, often proves helpful to nurses new to the research process.

“Nurses can get together with doctorally prepared nurses to develop projects they can implement together,” Piper says. She is working with an advanced practice nurse at the hospital on a study addressing cancer patients’ fatigue.

Karen Cizek, RN, a staff nurse on a surgical unit at the Phoenix VA is collaborating with Estrada on a study evaluating the use of colored wristbands to warn caregivers about allergies or other conditions.

Cizek says that fear of the unknown, failure to recognize the benefit of research, and the perception that only university-educated nurses can conduct research often prevent nurses from tackling a research project. She thinks change must begin in nursing schools to spark students’ interest in research, Hospitals could also do more to educate nurses about the process and reward initiatives in tangible and intangible ways, such as pay incentives offered by the VA and praise from the nurse manager or a mention in the hospital newsletter.

Colleen Keller, RN, FNP, PhD, director of the Hartford Center of Excellence in Geriatric Nursing at Arizona State University in Phoenix, says nursing must overcome the stereotype that research is borimg and help nurses discover the excitement of asking the right questions and finding answers.

Money also often serves as a barrier to nursing research. However, Roberts says research need not be costly, but it does require time and support from the institution.

Publishing

Expanding the knowledge base requires informing fellow nurses of research results.

“You need to share with the world and get the evidence out there, so changes can be made,” Roberts says. “As professionals, we have an ethical responsibility [to publish] for the greater good of all.”

Keller agrees, saying that nurses must report results from all studies, even those that failed. She said analyzing the results and the reasons the expected outcome did not occur is an important part of furthering the knowledge base.

“A research project is not done until it is published, until we disseminate it to our colleagues,” Keller adds. “The next person doing a study based on this work or like work can push the science further. It adds another piece to a puzzle.”

Publishing typically requires obtaining approval of the study from the Institutional Review Board (IRB), which aims to protect human subjects. Cizek obtained IRB approval for her study, even though it did not require any interaction with patients. Hoping to advance the theory that uniform colors on the bands will improve patient safety, Cizek plans to publish her findings.

“You don’t have to be a master’s degree nurse or an administrator; staff nurses can do this and should be doing this,” Cizek says. “Nursing research can have a direct, positive impact on patient care.”

Debra Anscombe Wood, RN, is a freelance writer. To comment on this article e-mail [email protected]

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