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An overview of the evolution of nursing research and practice from the 1900s to the present day. It covers topics such as nursing education, teaching, administration, curriculum issues, health care reform, and barriers to evidence-based practice. It also discusses the roles of various nursing professionals, such as Clinical Nurse Leaders, Clinical Nurse Researchers, and Clinical Nurse Specialists. The document concludes with a discussion of clinical practice guidelines and computerized databases.
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1900-1940's nursing research - ansNursing education Student characteristics Student satisfaction 1950-1970's nursing research - ansteaching, administration, curriculum issues 1980's nursing research - ansMore qualified researchers Widespread availability of computers for data collection and analysis Qualitative studies 1990's nursing research - ansHealth care reform Medicare and Medicaid health care delivery issues such as cost, quality, and access Agency for Health care research and quality (AHRQ) - ansImprove the health care outcomes/reduce the risk of harm Transform research into practice/ promote use of EBP Advance use of information technology for coordinating patient care and conducting quality and outcomes research Include priority populations health care needs in their research. "Improving the quality, safety, efficiency and effectiveness of health care for all Americans" Barriers to EBP - ans-Lack of time, competency, knowledge -Lack of electronic search skills -Overwhelming patient loads -Lack of value for research in practice -Lack of administrative support, incentives, mentors -Resistance to change Clinical Nurse Leader (CNL) - ansuse quality improvement methods in evaluating individual and aggregate client care and for self-improvement. Major contributions to the advancement of nursing research and EBP. Clinical Nurse Researcher (CNR) - ans>focuses on the care of research participants
assures patient safety maintenance of informed consent integrity of protocol implementation accuracy of data collection, data recording and follow up Doctoral degree
Clinical Nurse Specialist (CNS) - ansa registered nurse with graduate preparation in a specialized area of nursing practice and an expert clinician with additional responsibility for education and research. Ideal position to Link research to practice by assessing an agency's readiness for research utilization, consulting with staff to identify clinical problems, and helping staff to discover, implement and evaluate findings that improve health care delivery. Clinical Nurse Specialist (CNS) - ansAn advanced practice nurse who provides direct care to clients and participates in health education and research. Masters degree. Carries out the study. clinical practice guidelines - ansan evidence-based guide to clinical practice developed by experts in a particular field for direct application in clinical environments. clinical practice guidelines as standards of care - ansAn evidence-based guide to clinical practice developed by experts in a particular field for direct application in clinical environments. ~Gather, appraise, and combine evidence ~Make explicit recommendations ~Often define the "standard of care" ~Important role in guiding health care practices clinical practice guidelines standards of care - ansan evidence-based guide to clinical practice developed by experts in a particular field for direct application in clinical environments. Gather, appraise, and combine evidence Make explicit recommendations Often define the stand of care Important role in guiding health care practices computerized databases - ans~CINAHL (Cumulative Index to Nursing and Allied Health Literature) Information Systems-an index of selected journal articles about nursing, allied health, biomedicine, and healthcare. ~MEDLINE (Medical Literature Analysis and Retrieval System Online)- The most comprehensive online resource for national and international medical literature. -Aid the process of locating research relevant to current practice. List article information provide a short summary identify key words and provide links to similar articles. Doctor of Nursing Practice (DNP) - ans>provides leadership for evidence-based practice in nursing and translate evidence-based research into their own practice
disseminate and integrate new knowledge May be called upon to lead and contribute to collaborative research and EBP initiatives at the health care agency level.
Clinical Nurse Researcher [CNR]-doctoral degree, conduct/ design studies Clinical Nurse Leader [CNL]-doctoral degree, quality improvement methods Doctor of Nursing Practice [DNP]-doctoral degree, EBP Overcoming Barriers to EBP - ans-Time to critically appraise studies & implement their findings -Support and encouragement from leadership/administration -Integrating EBP into health care curricula -EBP clinical practice policies & procedures -Journal clubs, EBP rounds, promotion systems PICOT question - ansP- patient population of interest I- intervention of interest C- comparison of interest O- outcome T- time practice guidelines - ansresearch-based recommendations stated as standards of practice, procedures, or decision algorithms private funding for research - ansRobert Wood Johnson W.K. Kellogg Foundation Offer program funding for health related research. research utilization - ansSubset of evidence based practice that focuses on the application of research findings. A single study The use of research knowledge, often based on a SINGLE study in clinical practice. Seven Steps of Evidence-Based Practice - ansa. Step 0: cultivate a spirit of inquiry b. Step 1: ask clinical questions in PICOT form c. Step 2: search for the best evidence, Literature review d. Step 3: critically appraise the evidence, evaluating the evidence e. Step 4: integrate the evidence with clinical expertise and patient preferences and values f. Step 5: evaluate the outcomes of the practice decisions or changes based on evidence g. Step 6: disseminate EBP result, make it known Twenty first Century nursing research. - ansContinues with health care delivery issues such as cost, quality and access Evidence base for practice