An ethnography: four public health nurses' perspectives of nursing

This paper examines one study of nursing practice that utilized ethnography as a research approach. The general overview of the ethnographic method and the symbolic interaction framework used are described. An overview of the specific approach is included. The findings of the study are presented. The strengths and problems of the approach for nursing research are then reviewed. Some potential uses of an ethnographic approach for clinical nursing research are outlined.     

From models to measures in assessment of mature families

Although assessment of families as guided by nursing conceptual models is gaining impetus in the field of nursing, the incorporation of psychometrically sound clinical research measures into assessment protocols is a relatively recent phenomenon in family health nursing. Therefore, the purpose of this article is to describe an educational approach for students enrolled in a graduate nursing course focusing on mature and aging families. In this course, valid and reliable clinical research measures were incorporated into assessment protocols for practice based on nursing models. Criteria for selection of clinical research measures emphasized appropriateness for nursing assessment of families, age and ethnic relevancy of the measures, strength of psychometric properties, ease of administration and understandability, and potential for delineating nursing diagnoses and nursing intervention foci. The methods used to incorporate this approach into a graduate-level family nurse clinician course are presented. Theoretical issues include (1) the fit between the selected measures and the nursing conceptual model of choice and (2) the use of individual-focused versus family-focused paradigms. Clinical issues include student involvement in instrument selection, ethical implications of use of the measures, interpretation of data, and sharing of results with families.     

The Centre for Psychiatric Nursing Research and Practice: an innovative approach to enhancing clinical nursing research in the psychiatric/mental health field

The available nursing literature suggests that nurses engaged in clinical practice hold a somewhat ambivalent attitude towards nursing research. On the one hand, its value is acknowledged, but on the other, its relevance to clinical practice is questioned. This situation poses a significant barrier to the involvement of clinicians in research and the utilisation of findings in practice. This paper describes the implementation of a model to facilitate the development of a systematic research approach at the Centre for Psychiatric Nursing Research and Practice in Victoria, Australia. The development of strong relationships between the Centre and the clinical field was considered crucial in determining the success of this initiative. The introduction of a number of programs to foster the conduct and utilisation of clinical research are described, including: The Nursing Clinical Development Unit Program, the Clinical Research Fellowship Program, clinical research projects, the Collaborative Psychiatric Nursing Conference and strategies to encourage the dissemination of research information. In combination, these initiatives are expected to contribute to a systematic approach to engendering a research culture within psychiatric nursing in Victoria, Australia.     

THE CENTRE FOR PSYCHIATRIC NURSING RESEARCH AND PRACTICE: AN INNOVATIVE APPROACH TO ENHANCING CLINICAL NURSING RESEARCH IN THE PSYCHIATRIC/MENTAL HEALTH FIELD

The available nursing literature suggests that nurses engaged in clinical practice hold a somewhat ambivalent attitude towards nursing research. On the one hand, its value is acknowledged, but on the other, its relevance to clinical practice is questioned. This situation poses a significant barrier to the involvement of clinicians in research and the utilisation of findings in practice. This paper describes the implementation of a model to facilitate the development of a systematic research approach at the Centre for Psychiatric Nursing Research and Practice in Victoria, Australia. The development of strong relationships between the Centre and the clinical field was considered crucial in determining the success of this initiative. The introduction of a number of programs to foster the conduct and utilisation of clinical research are described, including: The Nursing Clinical Development Unit Program, the Clinical Research Fellowship Program, clinical research projects, the Collaborative Psychiatric Nursing Conference and strategies to encourage the dissemination of research information. In combination, these initiatives are expected to contribute to a systematic approach to engendering a research culture within psychiatric nursing in Victoria, Australia.     

Evidence-based nursing in clinical practice: implications for nurse educators

To improve patient outcomes currently and in the future, it is important that an evidence-based approach to nursing care be incorporated into clinical practice settings. Nurse educators and clinical nurse educators have a mandate to model and facilitate evidence-based nursing through learning activities. Unfortunately, issues present within clinical practice settings have made this approach difficult for registered nurses to fully incorporate into practice. This article outlines issues inhibiting evidence-based nursing, such as time factors, access to information and resources, nurses' research knowledge, skills, and learning opportunities, and the current nursing culture. Strategies for change that can be used by clinical nurse educators to enhance the use of evidence-based nursing in clinical practice areas are also described.     

Clinical intervention research in nursing

As a healthcare profession nursing has a duty to develop practices that contribute to the health and well being of patients. The aim of this paper is to discuss current issues in clinical research within nursing. The paper defines clinical interventions research as a theoretically based, integrated and sequential approach to clinical knowledge generation. The paper provides specific criteria for defining a clinical intervention together with an overview of the stages involved in clinical research from problem identification to implementing knowledge in practice. The paper also explored the extent to which nursing research was focussed on clinical issues, through a snapshot review of all the original research papers in Europe’s three leading nursing research journals. In total of 517 different papers were included and classified in the review. Of these 88% (n = 455) were classified as non-clinical intervention and 12% (n = 62) as clinical intervention studies. The paper examined the intervention studies in detail examining: the underpinning theory; linkage to previous (pre-clinical) work; evidence of granularity; protocol clarity (generalisable and parsimonious); the phase of knowledge development; and evidence of safety (adverse event reporting). The paper discusses some of the shortcomings of interventions research in nursing and suggests a number of ideas to help address these problems, including: a consensus statement on interventions research in nursing; a register of nursing intervention studies; the need for nursing to develop clinical research areas in which to develop potential interventions (nursing laboratories); and a call for nursing researchers to publish more research in nursing specific journals.     

Cooperation and collaboration for clinical nursing research. The Akron-Canton Clinical Nursing Research Network.

Nursing research suffers from an image of being an academic exercise even though it is essential for the growth and improvement of professional practice. With the current emphasis on redesign and cost containment, nurses need to come to the planning table with information and data to assist in decision making and to keep the nursing perspective in patient care. There are barriers to conducting nursing research, but a group approach, through a regional clinical nursing research network, provides the support and resources for an active research program.     

Nurse teachers' attitudes to research: a phenomenological study

This research project looks at nurse teachers' attitudes to research. It addresses the question of how nurse teachers view their responsibilities and abilities to promote nursing research. The requirement for nursing practice to be founded upon a firm basis of research is increasing. It may be argued that nurse teachers are highly influential and may provide the linchpin to the future of nursing research in the clinical environment. This research, using a phenomenological approach, attempts to reveal what nurse teachers think and feel about their role in research.     

Dissemination of Nursing Knowledge: The Application of the Model of Change

Despite the dramatic growth of nursing research and the development of nursing theory over the last 25 years, concern remains that nurses frequently fail to base their practice on the findings and recommendations of research. It is through research conducted by nurses that new knowledge can be obtained in order to implement good quality care in clinical practice. However, even when new knowledge is gained, its dissemination remains low. Several barriers to the dissemination of nursing knowledge in clinical practice have been identified. These include: lack of awareness of nursing research, lack of knowledge of the research process and the inability to understand research reports. These factors may contribute to negative attitudes among nurses regarding the use of nursing research in their clinical practice. However, research must filter down from academia to practicing nurses at all levels but it cannot make practicing nurses use research. One of the main priorities in the dissemination of nursing knowledge in clinical practice is to make research findings more “user friendly.” The use of a clinical nurse specialist or research nurse (that is a nurse with a defined role within research), combined with an action research approach, could increase the utilization of research findings in clinical nursing. The use of Journal club, research seminars, research workshops and nursing conferences are some of the enabling process in order to increase the dissemination of knowledge. The use of the model of change would enable us to understand whether nurses have the readiness to change and implement new nursing knowledge in to practice.     

What nurse faculty have to say about clinical grading

Clinical grading is one approach to assure that future nurses have the knowledge and skills to provide safe patient care. The phenomenon being explored for this study was the experience of clinical grading for clinical nurse faculty. Through the use of a qualitative phenomenological method, the lived experience of grading nursing student clinical performance for experienced clinical nurse faculty in prelicensure programs is described. Recommendations for future research and implications for nursing are identified.     

Expert clinician to clinical teacher: Developing a faculty academy and mentoring initiative

The lack of sufficient numbers of qualified nursing faculty to prepare nursing students for entry into the field of nursing is of national and international concern. Recruiting expert clinicians and preparing them as clinical teachers is one approach to addressing the faculty shortage. Adequate training for the new role is paramount to promote job satisfaction and reduce attrition. Various models for orienting and preparing expert nurse clinicians as clinical educators are reported in the literature with little consensus or research to support a single approach. This paper describes a collaborative effort to prepare experienced registered nurse clinicians for new roles as part-time clinical faculty. Using a blend of learning strategies (face-to-face, online, simulation, and group mentoring sessions), this training experience was designed to cover content while promoting discussion of issues and challenges and providing much-needed mentorship. Outcomes include 12 new clinical faculty, 25% from groups underrepresented in nursing, with nine newly employed as part-time clinical teachers.     

Designing a data and safety monitoring plan

Evidence-based nursing practice is now the expected standard of care intensifying the need to conduct clinical research studies to investigate the efficacy of nursing interventions. To ensure that the urgency to document such efficacy does not compromise human participant safety, government research funding agencies are advocating special procedures to protect individuals who voluntarily participate in research studies. The National Institutes of Health application for clinical trial funding requires a data and safety monitoring plan (DSMP) to enhance human participant safety and clinical research integrity. This article describes an approach to developing a DSMP that includes a study risk assessment and a monitoring design based on that assessment.     

NCLEX-RN success: evidence-based strategies

Evidence-based nursing requires that students think reflectively and use clinical inquiry to develop clinical reasoning and decision-making skills. Likewise, nursing students need a strategy to be successful in passing the NCLEX-RN. The authors identify strategies based on nursing research to facilitate student success. While learning the evidence-based nursing process, the student must begin to think like a nurse while answering clinical practice questions. Using the skills taught for evidence-based nursing can be a powerful tool to approach the NCLEX-RN and succeed.     

Clinical nurse specialist: a facilitator for clinical research

The role of the clinical nurse specialist is continuing to expand to include participation in clinical research. There is, however, a lack of clinical researchers available to conduct nursing research. A clinical nurse specialist with a joint appointment between a clinical and an academic setting can facilitate clinical research through collaboration. Such collaborative efforts can result in improved patient care and nursing practice. This article describes several major collaborative models used to join the academic and practice settings and discusses their strengths and weaknesses. It also describes in detail a collaborative approach in which the clinical nurse specialist play a more pivotal role by acting as a facilitator for the collaboration. We discuss the formation of the collaborative team, the roles of the participants, and the research plan of the team. Suggestions for implementing this model in other settings are offered.     

Ineffective airway clearance and ineffective breathing patterns: theoretical and research base for nursing diagnosis

This article addresses the conceptual approach to nursing diagnosis in general and the theoretical and research base for these two nursing diagnoses. Pertinent issues concerning the use of nursing diagnoses in clinical practice are presented within the framework of the nursing process. This is followed by a review of mechanisms of airway clearance and normal breathing patterns which form the theoretical basis for the subsequent articles on alterations in airway clearance and breathing patterns.     

Cultivating a culture of research in nursing through a journal club for leaders: A pilot study

Aim

To describe whether an action learning‐inspired journal club for nurse leaders can develop the leaders' self‐perceived competences to support a research culture in clinical nursing practice.

Background

Development of clinical research capacity and nurse leaders with the requisite competences are key factors in evidence‐based health care practice. This study describes how nurse leaders at a large regional hospital took part in a journal club for nurse leaders, with a view to developing their competences to support a nursing research culture in their departments.

Methods

A pilot study using a multimethod approach to evaluate the journal club for nurse leaders. Four nurse leaders participated in the journal club for nurse leaders. Content analysis on the data was performed.

Results

Data revealed that participation in journal club for nurse leaders gave the leaders a feeling of increased competences to support nursing research culture in their departments. They stated that the action learning approach and the competences of the facilitator were key factors in this outcome.

Conclusions

An action learning‐inspired journal club for nurse leaders can be useful and meaningful to nurse leaders in developing leadership competences.

Implications for nursing management

As an approach in journal club for nurse leaders, action learning can develop nurse leaders' competence to support a research culture, and thus ensure evidence‐based nursing is practised.     

The genesis of a phenomenological approach to advanced nursing practice

This paper describes how participation, as a co-investigator, in a phenomenological study of the high-risk perinatal experience led to the development of a new approach to advanced nursing practice for a maternity clinical nurse specialist Prior to implementation of the study, nursing was practised based in a structured, conceptual framework, but, as a result of conducting interviews with study subjects, analysing data with a research team and gaining a better understanding of the high-risk perinatal experience, a new style of nursing practice based in a phenomenological approach emerged, which permeated all aspects of clinical nurse specialist practice     

Addressing bullying and incivility in clinical nursing education

Despite ongoing research, incivility and bullying are rampant in nursing education. This paper explores the concepts of bullying and incivility in clinical nursing education. Students are particularly vulnerable to bullying at the hands of clinical instructors and nurses in the clinical setting. Bullying and incivility have detrimental effects on students psychologically, physiologically, and professionally. When these behaviors are normalized, they become a part of nursing culture and continue on long after nursing school. Social dominance theory helps to explain some of the factors contributing to the presence of bullying and incivility, but more research is needed to understand how minoritized students are affected. While a holistic approach to bullying acknowledges that all stakeholders have a responsibility to reduce bullying and incivility, this paper will focus on the ways that instructors can address and reduce these behaviors, empower students and advocate for meaningful change.