Research priorities for australian critical care nurses: do we need them?

The development of research priorities for critical care nurses has been previously examined from the perspective of both Australian and international critical care nursing experts. A variety of techniques have been used to determine research priorities for critical care nursing, however, a clear articulation of research priorities for Australian critical care nurses, which are both timely and encompass all aspects of critical care nursing practice, is lacking. Research priorities previously determined in Australia and elsewhere identify similar clinical research priorities such as nutritional support, infection control, supporting respiratory and cardiac function, and follow-up of critically ill patients. However, differences between the few available studies exist, possibly because of the changing nature of critical care nursing practice. Despite the identification of research priorities for critical care nursing in the past, there is little evidence to demonstrate a direct effect on research output in these areas. Future development of research priorities for Australian critical care nurses needs to be carefully considered. It is essential that identification of such research priorities be done within the context of their intended use.     

Nursing Research Priorities for Ireland

PURPOSE: The purpose of the study was to identify and rate clinical, managerial, and educational nursing research priorities in Ireland. DESIGN: The study design was a three-round, decision Delphi survey to identify and rate the importance of clinical, managerial, and educational research issues. A discussion group workshop was also undertaken to identify timeframes within which research on the issues identified should be conducted. A total of 1,695 nurses from all divisions of the nursing register in Ireland were initially surveyed. Response rates varied over the three rounds of the Delphi survey. A total of 122 nurses attended the discussion group workshop. This is the largest known survey of nurses to identify research priorities reported in the literature. RESULTS: Twenty-four nursing research priorities were identified. The five highest priorities were three clinical issues: outcomes of care delivery, staffing issues in practice, communication in clinical practice; and two managerial issues: recruitment and retention of nurses, and nursing input into health policy and decision-making. CONCLUSIONS: These research priorities identified for nursing in Ireland indicate, to an extent, the nursing research priorities identified in other European countries and in North America. The research priorities identified in this survey indicate that outcomes of care and the need to make nursing visible are attaining a higher priority than seen in previous studies. Also evident is that nursing shortages and increasing skill-mix in the clinical area have indicated a need for research into nurse recruitment, staff turnover, and staffing levels and how these issues affect patient outcomes. The priorities suggest research programmes that target the health service concerns identified in the national health agenda, such as the need to identify protocols and procedures that improve patient and client care outcomes and to examine and test solutions to workforce problems.     

A Delphi study on the research priorities of European oncology nurses.

The importance of establishing priorities for cancer nursing research has been repeatedly acknowledged (Corner 1993, Hunt 2001). A Delphi survey designed to capture research priorities of European cancer nurses was undertaken to document issues perceived as important to European Oncology Nursing Society (EONS) members and to set priorities to underpin an evolving research strategy. The survey comprised three phases, beginning at the second EONS Spring Convention (2000) when European cancer nurses were approached to complete a phase 1 questionnaire. In phase 2, research priority categories generated from responses to the phase 1 questionnaire were reviewed by a group of European cancer nurses. The categories and the placement of all the research questions within these categories were comprehensively reviewed. The final phase involved the distribution of the second questionnaire. Two hundred and twenty three nurses responded to the first questionnaire and 117 responded to the second questionnaire. Prioritisation of research categories reflected diverse views between respondents, with many categories receiving similar overall scores, of almost equal priority. Nonetheless, a number of categories demonstrated high priority throughout Europe namely needs of patients related to communication, information and education; symptom management; experiences of disease and its treatment; cancer nursing research issues (e.g. research facilitation) and cancer nursing education issues. It is recommended that future research examines clusters of research questions around the highest ranked priorities. This may provide both direction and focus to European-wide cancer nursing research, whilst ensuring clinically relevant investigation.     

Clinical nursing research priorities in Australian critical care: a pilot study

The aims of this research project were to identify areas for research in Australian critical care nursing with potential for improvement in patient care, and to advise nursing research policy and priorities with relevance to areas of patients'needs Research participants represented a national sample of clinical nurse specialists (CNSs) and clinical nurse consultants (CNCs) The Delphi method was used to obtain the most reliable consensus of the specialist nurses, and over 238 research priorities were identified initially In the final phase of the research nine high priorities were identified The findings of this study suggest directions for clinical nursing research in critical care     

Nursing Research Priorities in the Pediatric Emergency Care Applied Research Network (PECARN): Reaching Consensus Through the Delphi Method

IntroductionPediatric emergency nurses who are directly involved in clinical care are in key positions to identify the needs and concerns of patients and their families. The 2010 Institute of Medicine report on the future of nursing supports the active participation of nurses in the design and implementation of solutions to improve health outcomes. Although prior efforts have assessed the need for research education within the Pediatric Emergency Care Applied Research Network (PECARN), no systematic efforts have assessed nursing priorities for research in the pediatric ED setting.MethodsThe Delphi technique was used to reach consensus among emergency nurses in the PECARN network regarding research priorities for pediatric emergency care. The Delphi technique uses an iterative process by offering multiple rounds of data collection. Participants had the opportunity to provide feedback during each round of data collection with the goal of reaching consensus about clinical and workforce priorities.ResultsA total of 131 nurses participated in all 3 rounds of the survey. The participants represented the majority of the PECARN sites and all 4 regions of the United States. Through consensus 10 clinical and 8 workforce priorities were identified.DiscussionThe PECARN network provided an infrastructure to gain expert consensus from nurses on the most current priories that researchers should focus their efforts and resources. The results of the study will help inform further nursing research studies (for PECARN and otherwise) that address patient care and nursing practice issues for pediatric ED patients.     

Cancer nursing research priorities: a Norwegian perspective

The purpose of the study was to determine research priorities among Norwegian nurses in cancer care, and to investigate implications that these priorities might have for future planning of nursing research. Differences between specialists in cancer nursing and other nurses working in cancer care, and between the current results and earlier findings in this area also were evaluated. Half the members of The Norwegian Society of Nurses in Cancer Care (n = 197) were mailed a questionnaire used in a similar Canadian study. The nurses were asked to select the five topics they perceived as most important from a list of 80 items, and to rank them in order of research priority. The response rate was 43% (197/464), and 75 respondents were specialists in cancer nursing. Quality of life was given the highest research priority in the total sample. Psychosocial support/counseling, communication between patient and nurse, patient participation in decision making, nurse burnout, and ethics also were ranked highly. In contrast to the others, cancer nursing specialists ranked ethics as their number one priority. Except for symptom management, the priorities given in Norway and other Western countries were found to be similar. These results might suggest topics for future research tailored to the needs of cancer nursing.     

Patients' and nurses' perceptions of nursing problems in an acute care setting

AIM: This paper reports a study to determine the degree of agreement or disagreement between nurses and patients in their perceptions of the presence, severity, and importance of nursing problems. BACKGROUND: Patient experiences, values and preferences are increasingly acknowledged as important factors underpinning healthcare decision-making. The ability to identify patient problems accurately is an important prerequisite for planning and implementing individualized high quality care. METHODS: A convenience sample of patients (n = 80) and Registered Nurses (n = 30) in an acute care setting responded to a 43-item questionnaire. Findings. Nurses identified patients' problems with a sensitivity of 0.53 and a positive predictive value of 0.50. Patients identified several severe problems that were not identified by nurses, particularly problems with nutrition, sleep, pain, and emotions/spirituality. Nurses underestimated the severity in 47% of mutually-identified problems. An overall level of agreement of 44% was found on the importance of patient problems. Low levels of agreement on severity and importance were related more to individual differences than to systematic differences. CONCLUSIONS: Nurses need to be more aware that patients and nurses often hold disparate views of the priorities in nursing care. To plan individualized nursing care effectively, nurses need to elicit and use individual patients' preferences more systematically in care planning.     

Critical care nursing research priorities in Hong Kong

BACKGROUND: Research is vital to nursing practice especially in an area such as critical care, where nursing practice continues to increase in complexity and nurses assume greater responsibility and accountability for patient care. However, without knowledge of what are the most significant problems or questions affecting the welfare of critically ill patients in Hong Kong, nurses' research efforts may be directed to areas that are not of highest priority in today's climate of decreasing health care resources and changing health care provision. AIM: To identify and prioritize research questions of importance to Hong Kong critical care nurses. METHOD: A three-round Delphi technique was used to solicit, identify and prioritize problems for critical care nursing research. RESULTS: Respondents who completed the third round had a mean of 6.25 years of critical care nursing experience. Ninety-one research topics were ranked important or extremely important. Twenty-seven research priorities ranked as extremely important included topics relating to patient care, family care, nursing, technology, alternative interventions, and illness prevention/health promotion research domains. Thirteen research topics were ranked as least important. None of the participants ranked research topics as not important. STUDY LIMITATIONS: Only full-time active members of the Hong Kong Association of Critical Care Nurses participated in this study and they may not necessarily represent the views of all critical care nurses in Hong Kong. In addition, no attempts were made to compare research priorities between specialty groups of nurses. CONCLUSION: With the re-structuring of Hong Kong's health care system, critical care nurses are expected to take an active role in advancing the profession, and to be accountable for improving patient outcomes by use of effective, evidence-based interventions. The research priorities identified in this study may provide impetus and direction for critical care nursing research initiatives.     

Priority areas for clinical research in palliative care nursing

This report highlights a number of current research issues and concerns in palliative care nursing. The aim of the study was to identify high clinical nursing research priorities in palliative care, drawing on the expertise of nine (n = 9) clinical nurse consultants currently working in this specialty. The Delphi method was used to collect and process data in the study. Thirteen high research priorities emerged which have relevance for nursing practice, patient and family care in the hospice and community care setting. In the context of this study, the concept of high priority relates to research participant consensus on the most pressing nursing research problems which require investigation to improve clinical practice. Study findings provide direction for clinical research and continuing education in palliative care which may benefit expert nurses and their patients.     

A Delphi survey of evidence-based nursing priorities in Hong Kong

The purpose of this study was to inform an evidence-based nursing development project within the Hospital Authority, Hong Kong. It considered the specific question of: what are the nursing practice issues which need to be addressed as a matter of priority in order to improve nursing practice, the quality of care or develop some aspect of nursing practice. A three round Delphi survey was adopted. The methodological problems associated with the use of the Delphi method are addressed. An expert panel consisting of 190 Department Operations Managers (nurses) was identified. The data collection focused on issues related to nursing skills and client care and excluded management or educational issues. Agreed categories were prioritized in the final round by utilizing a 11-point rating scale. The group mean score for each category was calculated and rank ordered. The results provided 45 categories that reflected the nursing practice priorities that required more research evidence to guide practice. The top five ranked items were: nurse patient communication, resuscitation, administration of medicines, counselling and nursing documentation. The top 10 items were used to inform the advisory and selection processes for the evidence-based practice development project.     

Cancer nursing--a problem-finding survey. The London Nursing Research Consortium

A survey was conducted to identify the most difficult patient-care problems encountered by nurses who care for patients with cancer and the most difficult problems personally experienced by nurses as a consequence of caring for these patients. Nurses who provided care to patients with cancer in two community health agencies, one cancer treatment center, one chronic care hospital, and three acute care hospitals were invited to participate. A total of 566 nurses responded (43% response rate). Results are presented by total sample for 15 top-ranked patient care problems, 10 top-ranked physical care problems, and 5 top-ranked personally experienced problems. Results are also presented as a qualitative analysis of 1,052 comments made by respondents. For all groups of nurses within the total sample, coping with diagnosis, disease progression, and emotional response comprised the top-ranked patient care problems. Nutrition and pain management were top-ranked physical care problems. Top-ranked personally experienced problems paralleled patient care problems. A comparison of study findings with two previous surveys to identify research problems indicated high consensus about important areas for cancer nursing research. Scott, Oberst, and Dropkin's Stress-Coping model will be used to guide development of the research program that began with this problem-finding survey.     

Establishing nursing research priorities on a paediatric haematology, oncology, immunology and infectious diseases unit: involving doctors and parents.

Following a Delphi survey undertaken with nurses on a specialist children's unit to identify priorities for nursing research, this paper outlines the results of a survey to ascertain the views of doctors and parents regarding the results of the Delphi. This approach was in keeping with national guidance on multi-professional working in paediatric oncology and the importance of service-user involvement in planning and evaluating care. Convenience samples of doctors (n=16) and parents (n=10) were asked to rank the priorities previously identified by nurses. Results highlighted that in the main, nurses, doctors and parents agreed on the key areas that should take priority for research. Nurse's knowledge of day-to-day symptom management, children's quality of life, negotiation and communication in relation to care provision were identified by all three groups as high priorities. There were some areas where the views varied: this was generally in relation to the different primary focus of the individual groups-parents being very concerned with the effect of daily ward routines and procedures and their child's overall hospital experience, nurses with issues such as staff retention and morale, whereas doctors were more concerned with issues around information giving and consent to treatment. Limitations of the study, including sample selection and the transient nature of the population involved are discussed within the paper. The paper concludes that all three groups shared similar views, being focused on issues directly related to patient care. Consensus between the groups should result in future research initiatives reflecting a shared focus and responding to an identified need.     

Research directions for specialist practice

Emergency nursing is a specialist area of practice that demands particular knowledge and skills. This paper reports on a study to identify the research directions necessary to advance emergency nursing as a specialist area of practice. Nurses working in nine Australian hospital emergency departments responded to questions about current research practices, and the research priorities necessary to inform the development of knowledge and practice in the evolving specialty of emergency nursing. Forty-four core topics considered relevant to the knowledge base of emergency nursing were identified by nurses who were directly involved in providing patient care. The highest ranked topics were clustered into four priority areas for further research. The key areas for further research are education needs and opportunities, specialist roles of triage, trauma and practitioner, and nurses' coping mechanisms. Discussion of these topics is framed by the increasing specialisation of nursing practice, thus this paper aims to encourage consideration and debate about the research based development of the specialty of emergency nursing.     

Ethical elements in priority setting in nursing care: A scoping review

BackgroundNurses are often responsible for the care of many patients at the same time and have to prioritise their daily nursing care activities. Prioritising the different assessed care needs and managing consequential conflicting expectations, challenges nurses’ professional and moral values.ObjectiveTo explore and illustrate the key aspects of the ethical elements of the prioritisation of nursing care and its consequences for nurses.Design, data sources and methodsA scoping review was used to analyse existing empirical research on the topics of priority setting, prioritisation and rationing in nursing care, including the related ethical issues. The selection of material was conducted in three stages: research identification using two data bases, CINAHL and MEDLINE. Out of 2024 citations 25 empirical research articles were analysed using inductive content analysis.ResultsNurses prioritised patient care or participated in the decision-making at the bedside and at unit, organisational and at societal levels. Bedside priority setting, the main concern of nurses, focused on patients’ daily care needs, prioritising work by essential tasks and participating in priority setting for patients’ access to care. Unit level priority setting focused on processes and decisions about bed allocation and fairness. Nurses participated in organisational and societal level priority setting through discussion about the priorities. Studies revealed priorities set by nurses include prioritisation between patient groups, patients having specific diseases, the severity of the patient’s situation, age, and the perceived good that treatment and care brings to patients. The negative consequences of priority setting activity were nurses’ moral distress, missed care, which impacts on both patient outcomes and nursing professional practice and quality of care compromise.ConclusionsAnalysis of the ethical elements, the causes, concerns and consequences of priority setting, need to be studied further to reveal the underlying causes of priority setting for nursing staff. Prioritising has been reported to be difficult for nurses. Therefore there is a need to study the elements and processes involved in order to determine what type of education and support nurses require to assist them in priority setting.     

Establishing pediatric cancer nursing research priorities: a Delphi study

The purpose of this study was to have pediatric oncology nurses identify and rate topic priorities for clinical nursing research in the specialty and to determine if nurses in a pediatric cancer center identified different priorities than did nursing colleagues in other settings. The sample consisted of 44 nurses from a comprehensive pediatric cancer center and 43 nurses attending the 12th Annual APON Conference. A decision-making method, the classical Delphi technique, was used. Three rounds of soliciting opinions by questionnaires were completed, and data from each round were reviewed and categorized by a research team of six nurses until group consensus was achieved. The majority of priorities identified by both groups concerned nursing procedures, the pediatric oncology patient, and the specialty itself. The least number of priorities were in the categories of care delivery systems and families. One difference between the two groups was that professional issues dominated the cancer center sample, whereas psychosocial issues were more prominent in the APON sample.     

Identifying cancer nursing research priorities using the Delphi technique

BACKGROUND: Nursing research is an integral component of improving the care of people with cancer. However, for research to be successfully integrated and applied to practice, ownership and identification must come from those in practice. The need for local and national strategies for cancer nursing research and the importance of establishing priorities for cancer nursing research have been repeatedly acknowledged. STUDY AIM: The aim of the study was to facilitate a strategic approach to cancer nursing research by identifying the research priorities of cancer nurses. RESEARCH METHOD: A three-round Delphi survey was administered to nurses (n = 112) attending a cancer nursing research conference in Northern Ireland. Participants were asked to identify five research questions that they considered a high priority for cancer nursing. A response rate of 54% (60 delegates) was obtained for round one and this generated 117 statements. These statements were content analysed. Two subsequent quantitative rounds followed this. RESULTS: The top priority areas identified were psychosocial issues, for example communication and information needs; professional issues relating to nurse burnout, stress and nurse-led care; and context of care issues including continuity of care. LIMITATIONS: A potential limitation of the study is the use of conference delegates. However, it is argued that these are the people we wanted to target as they could be considered as experts who already had an interest and clinical background in both cancer research and practice. CONCLUSION: These priorities have helped to provide both direction and focus for the development of a cancer nursing research strategy for Northern Ireland. It is recommended that future research questions should be focused around the highest ranked priorities.     

Measuring the outputs of Australian nursing research published 1995-2000

AIMS: To analyse the research published in refereed nursing journals by Australian authors from 1995 to 2000. BACKGROUND: Analysis of the research topics and types of methodologies used by Australian nurse researchers has not been recently undertaken. The study was similar to an analysis of United Kingdom (UK) nursing research between 1988 and 1995 to allow comparison between the two countries. DESIGN: A quantitative approach analysed the research abstracts for the topic researched, source of data, location of data collection, paradigm and methodology used and funding source. RESULTS: A total of 509 articles from 11 generalist Australian and UK nursing journals were analysed. The highest numbers of articles were published in Australian Journal of Advanced Nursing and Journal of Advanced Nursing. The most popular topics were education of nurses (18.7%, n=95) and practice issues relating to patient care (15.3%, n=78). However, scant attention was paid to major Australian health issues. Most research was undertaken in the hospital setting (55.8%, n=247). Data were most often drawn from nurses themselves (40.7%, n=206), followed by patients (25.5%, n=129). Both quantitative (41%, n=203) and qualitative approaches (47%, n=230) were employed. A minority of studies acknowledged any funding (14.9%, n=76). CONCLUSIONS: Research findings need to be applied in practice to improve patient care. Nurse researchers need to publish their findings and align their research interests to meet national health priorities. They need to be involved in setting these health priorities to ensure that nursing has a place in health research.