nursing research paper writing

nursing research paper writing

The Importance of Evidence-Based Practice in Nursing

1. Introduction

The significance of nursing research and the importance of evidence-based practice is discussed in the introduction. Providing high-quality patient care has always been a goal for nurses across the globe. To achieve this goal, experts and scholars argue that utilizing evidence-based practice is the most effective strategy. As such, this article seeks to critically analyze the concept of evidence-based practice in nursing. It will be essential for nurse scholars, students, and practitioners to critically think about the content and information they are reading, who conducted the study, how conclusions were reached, and the implications for changes in their practice. By critically evaluating and utilizing the best current evidence, we can improve the quality of patient care. Also, better outcomes can be achieved and the burden on the healthcare system can be minimized. But what is evidence-based practice? According to Sackett and his colleagues, evidence-based practice is the “conscientious, explicit, and judicious use of the current best evidence in making decisions about the care of individual patients”. As it is stated, evidence-based practice indeed is a process of making an informed decision for a particular clinical judgment. It involves the use of the best scientific evidence in making decisions in practice, providing care that is most effective for the patient, and searching for the best clinical opinion while focusing on assessment skills that are learned from different academic studies. By carefully examining critically appraised topics and articles, some clinicians can increase their knowledge on medical treatments and ultimately improve the quality of patient care. However, registering the professional care that healthcare professionals could provide in the existing clinical environment is not a simple task. Bayea and Sminkey pointed out that there are various barriers to the utilization of evidence-based practice. They found the attitude of health professionals and lack of the demanded resources are the most important factors that hinder the promotion of evidence-based practice. Yet, Grant showed that evidence-based practice has been taught successfully in class. He suggested that the best way to foster evidence-based practice is to start the teaching in basic level, like what we are learning in this class.

2. Benefits of Nursing Research

Nursing researchers are given the opportunity to make a difference in the lives of patients every day. Whether that comes through creating an evidence-based protocol for the best practices of patient care, improving medical devices, or developing alternative practices, nursing research has a profound effect on all areas of health care. The first and most obvious advantage of conducting nursing research is the opportunity to improve patient care. For instance, a study conducted by Julia Snethen and her team on children with asthma was aimed at improving the health of these children and minimizing the suffering and costs from their illness. The results from this study underscore that children with asthma have a better quality of life when their care is managed by their parents and that nursing interventions to involve parental management of the child’s care have a positive and significant outcome in relation to the child’s welfare. Such research and subsequent findings are what move health care and nursing as a profession forward. Improved patient outcomes indicate success both for the individual and the nurse who works with an evidence-based approach. Further, research studies in the area of nursing offer an opportunity for proven, scientific professional growth. Research is an opportunity for the nurse to better her practice. The American Association of Colleges of Nursing recognizes that nursing research falls into 2 main categories. First, there is the research that takes place in the academy and is led by qualified and professional nurse scholars who also encourage and teach the next generation of nurses. On the other hand, there exists research that is based on direct patient care by clinical nurse scientists, who work with patients directly in the provision of medical services. Both types of research are important in advancing the knowledge and evidence that is used in nursing to provide patient care. Lastly, nursing research offers an opportunity for continued professional development for both the individual and the discipline as a whole. Individually, participating in the research process and in subsequent dissemination of the results allows for growth as a professional. For instance, Beauchamp and Childress highlight a ‘four principle’ approach to medical ethics that includes ‘respect for autonomy’, ‘non-maleficence’, ‘beneficence’, and ‘justice’. By establishing a professional code of research conduct, like the ‘Mental Capacity Act’ and the more detailed ‘Good Clinical Guidance’, research nurses offer the opportunity to act out beneficence with the application of new nursing knowledge from completed research. Such implementation may serve to benefit the individual nursing researcher and the disciplines of the profession as a whole.

3. Steps in Conducting Nursing Research

The first step is to identify a research question. This is a clear, focused question that will help to direct the research. In identifying a question, nurses should reflect on what their area of interest is and how this can be turned into a question that will seek to generate knowledge. There are three types of research questions that can be developed, namely background, foreground and investigative queries, and a good research question will include all three of these. Background questions concern underlying conditions or an understanding of a condition or fact, for example, “What is the underlying cause of pressure sore development?” Foreground questions are more specific and are typically linked to evidence-based practice decisions, for example, “In elderly patients, does the use of a specific type of pressure-relieving mattress reduce the risk of developing pressure sores?” Finally, investigative queries concern a very specific part of care and its delivery and normally are structured in the PICO way, that is, considering patients or problem, intervention, comparison, and outcome, such as “For critical care patients with central venous catheters, does the use of dressing with chlorhexidine and alcohol compared to povidone-iodine reduce the risk of central line infection?”. Once the question has been agreed upon, the next step is to create a systematic, organized plan, keeping a record of all the searches and decisions that are made – this is often referred to as PROSPERO.

Secondly, review of the literature is essential in the generation of a top quality piece of nursing research. This is because the Research Governance Framework (Department of Health 2005) states that nurses should develop a thorough knowledge base through literature review and the research project should be part of the ongoing learning and development. Not only does a thorough search of the literature aid in the building of background knowledge, it enables nurses to identify their place in the current field of knowledge and understanding and whether their research could add to existing literature. By identifying what is already known, the nurse can then justify the relevance of their work, it will help in the development of the research question and the formulation of the objectives and also provides an opportunity for criticism of the literature, forming an important part of both a literature review and critical discussion, something that is essential in a high-quality research study. Lastly, a literature review can often help in the process of refining the research question. For example, difficulties in obtaining specific information about a certain research query will ultimately highlight troubles that are present within the specific area of healthcare and this can help to justify the importance of the research question.

Next, researchers need to have a good understanding of approaches to research, including primary and secondary research and quantitative and qualitative methods. Primary research is a type of research where the researcher interacts with patients or service users and gathers new information. In primary research, the researcher has a choice of whether to gather methods that are quantitative (concerning numerical data and the wider community or population) or qualitative (concerning the opinions and behaviors of individuals in solitary). Data can then be collected in a wide range of different forms, such as case studies, surveys, experiments, interviews, and observations, and each is specific for a certain method of data collection. On the other hand, secondary data or methods involve the use of data, findings, or research that has already been carried out by another party and may either be necessary to help support or make evidence-based decisions or used to provide a critique or evaluate a piece of literature. By understanding the different forms that research can take, nurses can ensure that the research undertaken will provide valid and meaningful results.

4. Challenges in Nursing Research

To find the time, resources, and energy to direct such activity into an area that may not have immediately evident impacts on patient outcomes can be daunting. Such cultural and psycho-social factors, the so-called “research aversion” found by Wells and Pluym at the turn of the century, can thus act as a potent barrier to the effective execution of research by nurses in a wide range of environments and levels of experience. Indeed, the specific patient contact involved in nursing work, the bureaucratic demands on nurses and nursing time, and the fear of fostering principles of care which may be inimical to research objectives, serve to lump all nursing research under the umbrella, and in doing so seriously restrict the attempts of any nurse to make a productive, unique contribution to the field.

The demands of the profession may also present direct barriers to the execution of research. For example, many nurses feel a moral responsibility to provide optimal, attentive care to patients who may be acutely unwell or require time-intensive rehabilitation. This does not simply create a dearth of hours in the day for nurses to find somewhere comfortable to participate in research; at a deeper level, it can create an ethical barrier to nurses who feel that the focus of their attention should be directed towards immediate practice. Such pressures can be particularly profound for those working in critical care environments like Intensive Therapy Units (ITUs), where split-second decisions can be a reality of the job.

Another crucial challenge to nursing research can be shown in the different environments in which nurses work. For instance, those nurses in administrative positions such as Directors of Nursing or Quality Assurance Coordinators may find themselves without sufficient time to engage in the production of research. This is also true for those nurses who are on regular shifts. While off-duty nurses may be able to find the time necessary for research, many work long or odd hours, often struggling to balance family and work commitments.

Despite the many advantages that research provides, conducting nursing research can be difficult in many ways. First, many nurses perceive that they lack the expertise required to carry out meaningful research. This makes sense; while a nurse might have years of experience in bedside care, this does not automatically translate to a profound understanding of quantitative and qualitative research methodology. More extensive and ongoing educational strategies, like those laid out by the Institute of Medicine, could help to bridge this gap by providing nurses at all levels with a better understanding of research and more opportunities to actively engage with the production of knowledge.

5. Conclusion

Thirdly, evidence-based practice provides opportunities for nursing care to be more individualized, effective, streamlined, and dynamic. By taking into account evidence-based practice, which includes reliable and valuable research findings, nurses can critically evaluate the best research with the most clinical expertise and the most patient value. It also encourages nursing professionals to use the best evidence as a foundation of the professional practice to enhance the patient’s health and well-being. As for the future of nursing, research which originated from evidence-based practice will continue to generate and reshape the knowledge in our discipline. Nurses of the next generations will continue to learn and provide the best care possible, but the spirit of inquiry as well as the drive to generate and integrate readily-available, reliable evidence into day-to-day professional activities must be instilled into the minds of the healthcare environment now. Finally, by promoting engagement in both individual and collaborative efforts at solving clinical issues and generating new knowledge, the entire profession benefits and will continue to advance. For the new graduates, they are expected to have the necessary skills and knowledge in computer and information literacy to support evidence-based practice. Nevertheless, many seasoned and well-experienced professional nurses are slow in accepting and integrating new information, research, and evidence-based practices, probably due to a lack of exposure to these in their academic experience and limited access to computer and information literacy resources. Well-informed and professional nurses who are proficient in clinical work and scientifically based research, who are able to demonstrate the essential competencies of information literacy, continuously expand the provision of the professional field, which is nursing. All in all, evidence-based practice essentially provides the stepping-stone for nurses to guide the best clinical decisions and promote the health of the patients. It also creates the urge for lifelong learning for professional nurses in order to keep their knowledge up-to-date. Hopefully, in the near future, more enhanced programs will be offered to many more professional nurses, showing them the importance of research and evidence-based practice in the nursing profession, in order to bring it to the next level of success.