Nursing Research: Principles, Process and Issues

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Sullivan-Bolyai S., Bova C., Harper D. (2005). Developing and refining interventions in persons with health disparities: The use of qualitative description. Nursing Outlook, 53, 127–133. [ PubMed] [ Google Scholar] An inductive process (describes a picture of the phenomenon that is being studied, and can add to knowledge and develop a conceptual and/or theoretical framework).

The next stage is to generate ideas for changes that will result in improvement, using quality improvement tools. It is beneficial to involve other team members in these activities. Danby S., Farrell A. (2004). Accounting for young children’s competence in educational research: New perspectives on research ethics. The Australian Educational Researcher, 31( 3), 35–49. [ Google Scholar] LoBiondo-Wood G., Haber J. (2014). Nursing research, methods and critical appraisal for evidence-based practice (8th ed.). St. Louis, MI: Mosby. [ Google Scholar] Ironside P. M. (2006). Using narrative pedagogy: Learning and practising interpretive thinking. Issues and Innovations in Nursing Education, 55, 478–486. doi: 10.1111/j.1365-2648.2006.03938.x [ PubMed] [ CrossRef] [ Google Scholar]

Footnotes

Driver diagrams are used to generate as many potential solutions as possible. One or two of these, termed change projects, are chosen to be implemented as part of the QIP. Dowling, R., Lloyd, K. and Suchet-Pearson, S. (2017) ‘Qualitative methods III’, Progress in Human Geography, 42(5), pp.779-788.

The second quantitative study is a Randomised Control Trial conducted by Kalowes, Messina and Li (2016). They compared the difference in the incidence rate of hospital-acquired PUs (HAPUs) in critically ill patients in the intensive care unit (ICU). Unlike Charalambus et al. (2019) study which has only one objective, this study has three objectives which were first to determine the difference in the incidence rate of sacral HAPU formation between two groups of critically ill patients. Secondly to examine the risk factors for the development of HAPU. Thirdly, to explicate the cost with regards to the use of foam dressing in the prevention of PUs. A convenient sampling was also used to select 366 participants, 184 were randomised to have a 5-layered soft silicone foam dressing applied to their sacrum (intervention group) and 182 received the usual PU care (control group). The result suggests that the rate of HAPU was considerably less with patients in the intervention group than those in the control group with (0.7% vs 5.9%) and is statistically significant (P=0.01). Consent was gained from the University, prior to the research commencing. As such, the research will have been reviewed by the University in line with the Ethical Research Standards (WHO, 2011). The researchers kept all data anonymised in line with the protection of human rights, protecting confidentiality and anonymity (Lo-Biondo Wood and Haber, 2017). Quantitative research is underpinned by positivism, based on scientific laws and truths which emerge from research that is observed and measured (Gerrish and Lathlean, 2015). Findings from research with minimal or no bias hold greater validity (Gerrish and Lathlean, 2015). Coughlan, M., Cronin, P. and Ryan, F. (2013). Doing a Literature Review in Health and Social Care. London: Sage.QIP ideas [Internet]. Royal College of General Practitioners. [cited 17 May 2021]. Available from: https://www.rcgp.org.uk/training-exams/training/new-wpba/qip.aspx

When conducting quality improvement in healthcare, a useful framework is the Model for Improvement. This considers what the QIP is trying to achieve, how it will be known if a change resulted in an improvement, and what changes are necessary to satisfy the objective. An emic stance (an insider view which takes the perspectives and words of research participants as its starting point) but is influenced by the researcher not only because of subjectivity but also when a degree of interpretation occurs.

This section appraised the two quantitative papers selected for this assignment; these include Charalambus et al. (2019) which explored the knowledge and attitude of nurses in a major public hospital in Cyprus towards PU prevention. This descriptive cross-sectional study used convenient sampling to select the nurses. Harvey and Land (2017) viewed convenient sampling as a non-probability type of sampling method where participants are selected because of their easier accessibility. The participants were employed by paraplegic, ICU, orthopaedic, neurological and medical wards because of their daily interactions with patients at risk of developing PU. Data collection was done from December 2014 to February 2015, and there were 60% of the participants who returned their questionnaire giving the 102 number of nurses who participated in this study. Two separate questionnaires were used, these consist of Piper pressure knowledge text (PUKT) and a Likert scale question which allows the participants to answer the questions ranging from agree to strongly disagree thereby granting them the flexibility of answers compared to a yes or no questions. The study was approved by the ethics committee of Cyprus. Pearson test was applied for data correlation and the statistical correlation was set at P=0.05. The result of the study showed that knowledge and attitude of nurses correlated positively (Pearson R=0,223) and is statistically significant (P=0.019). This suggests that nurses have a positive attitude towards PU prevention. Walby, K. and Luscombe, A. (2018) ‘Ethics review and freedom of information requests in qualitative research’, Research Ethics, 14(4), pp.1-15. Siepmann, T., Spieth, P., Kubasch, A., Penzlin, A., Illigens, B. and Barlinn, K. (2016) ‘Randomized controlled trials – a matter of design’, Neuropsychiatric Disease and Treatment, 8(2), pp.1341-1355. Fusch P. I., Ness L. R. (2015). Are we there yet? Data saturation in qualitative research. The Qualitative Report, 20, 1408–1416. [ Google Scholar] The goal of the researcher is to provide an account of the “experiences, events and process that most people (researchers and participants) would agree are accurate” ( Sullivan-Bolyai et al., 2005, p. 128). The focus on producing rich description about the phenomenon from those who have the experience offers a unique opportunity to gain inside or emic knowledge and learn how they see their world.