Developing a culture of nursing research through clinical-academic partnership

Evidence based practice is essential to advanced practice nursing, enabling the delivery of quality care and improved patient outcomes. As the name suggests, it requires healthcare decisions to be based on the best available and current evidence. Advanced practice nurses need astute critical analysis skills to appraise the evolving literature, and require research skills to lead on scientific inquiry and develop the profession. Yet, advanced practice nurses may not recognize themselves as research leaders. Participation in a journal club can promote evidence-based practice, improve clinician's critical thinking skills, and expose members to different research methodologies, however, nurses continue to face barriers to participation in these clubs. Establishing a clinical-academic partnership appears to be both mutually beneficial for clinicians and academics and is a significant enabler in the sustainability and functioning of the club through sharing expertise and experience. A supportive workplace culture is favourable to research utilization and knowledge translation. This paper outlines the role, practicalities, challenges, and benefits of setting up a hybrid urology journal and research club for advanced practice nurses in a clinical-academic partnership.     

The lived experience of clinical development unit (nursing) leadership in Western Sydney, Australia

BACKGROUND: A network of nine Clinical Development Units (Nursing) (CDU(N)) were recently created in the Western Sydney Area Health Service. These units are designed to develop patient-focused nursing practice through group process and action research, based on principles of transformational leadership. AIMS OF THE STUDY: Although there is documented evidence from Australia and the United Kingdom (UK) that CDUs and Nursing Development Units (NDUs) are very successful in improving both patient and staff satisfaction, there is also growing evidence that the stressors experienced by nurse leaders are threatening the survival of some of these units. This study set out to develop an understanding of the phenomena of Clinical Development Unit (Nursing) leadership when these stressors were likely to impinge. STUDY DESIGN: Hermeneutic phenomenology was employed in order to identify how these experiences changed over time. Two rounds of interviews were conducted: approximately 4--6 months after the launch and, again, 12 months later. FINDINGS: The Clinical Development Unit (Nursing) philosophy provided a framework on which these very motivated leaders began to enhance nursing accountability in their units through reflective practice and participatory governance. While reinforcing many previously published positive and negative aspects of Clinical Development Units and Nursing Development Units, this paper also highlights how the expectations and experiences of these leaders changed over time with unanticipated pressures of work, a high turnover of clinical leaders, a perceived diminution of management support and unrealistic self-expectations. A significant theme that emerged as these stressors began to impinge was the leaders' own need for leadership in order to sustain their confidence and motivation. IMPLICATIONS FOR NURSING: Insights harvested from this study have since been incorporated into a revised leadership preparation programme and support mechanisms for the leaders of eight new Clinical Development Units (Nursing) in the Western Sydney Area Health Service.     

Developing nursing and midwifery research capacity in a university department: case study

AIM: This paper reports a case study which examined the selection, implementation and outcomes of one university department's approach to building research capacity in nursing and midwifery. BACKGROUND: The literature identifies building nursing research capacity as an important challenge. In countries such as Australia and the United Kingdom it is taking place in the context of the move of nurse education into the university sector. Structural and cultural barriers to building academic nursing research capacity exist. Previous studies highlight the strategies that academic departments adopt to build nursing research capacity. METHODS: Using case study methodology, data were collected using documentary analysis and semi-structured interviews with a purposive sample of 27 academic and related staff and a focus group with seven staff. The data were collected between 2003 and 2005. FINDINGS: The department had adopted an inclusive approach to capacity development (allowing all teaching staff to develop their research capability), but is now moving towards a more focused path and the cultivation of "leading edge" research. Neophyte researchers described lacking confidence in undertaking research, and expressed a need for more formal support structures. The importance of effective management of capacity building was highlighted, including transparent communication and mapping of existing capacity. Key external influences included the lack of core research funding, and divergence between the university's emphasis on research and the department's desire to develop an interface between teaching, research and clinical practice. CONCLUSION: Academic leadership and educational management should work in tandem. Staff development and the provision of time and support are crucial aspects of research capacity development. The effectiveness of "inclusive" and "exclusive" approaches to research capacity development depends on the nature of each department, and they are not mutually exclusive.     

Priorities for paediatric cancer nursing research in Western Australia: a Delphi study

A Delphi study was undertaken to identify paediatric cancer nursing research priorities at the sole paediatric tertiary referral centre in Western Australia. Thirty one responses were received from the first Delphi round and 22 from the second round. The top 10 priorities identified were different from those identified in prior North American Delphi studies. The top ranked research topic was 'To effective methods of communication in a multi-disciplinary identify health care team'. The findings will provide a research agenda for cancer nursing at the study setting and may stimulate discussion and re-assessment of research priorities in other paediatric cancer settings.     

Developing research priorities for nurses working in the gynaecology setting in Western Australia

Background

Nurses working in clinical settings are instrumental to translating research into practice. The Delphi approach has been used by clinicians worldwide to set research agendas relevant to their clinical work.

Articulation of pre-registration nursing courses in Western Sydney

This paper will describe a project, undertaken in 1996-1997, which sought to develop formal articulation arrangements between nursing education courses provided by Technical and Further Education (TAFE) institutions in Greater Western Sydney and the University of Western Sydney (UWS). The project sought to facilitate the access of TAFE-trained Enrolled Nurses (ENs) to UWS's Bachelor of Nursing (BN) courses and eliminate costly duplication in programs of study. Although conducted in Australia, the project generated insights of utility to colleagues in the UK, the USA and New Zealand, in particular, who are dealing with the effects of the 'knowledge explosion' and reductions in government funding to universities. The project comprised two stages. Stage 1 involved a statewide survey of all stakeholders, using individual telephone interviews and focus groups, of practices and perceptions with respect to formal articulation arrangements. The findings demonstrated an overwhelming consensus with respect to both the benefits of and barriers to formal articulation arrangements. These benefits and barriers will be described. Stage 2 involved the TAFE-UWS collaborative design and implementation of 2 EN-BN bridging programs which allow, differentially, ENs to access UWS's BN programs with 1 and 2 semesters block credit. This paper includes details of the project's background, survey methods and findings, bridging courses' contents and courses' implementation evaluative data.     

A Delphi survey of clinical nursing research priorities in Western Australia.

In 1989-1990 an investigation was undertaken to ascertain which problems WA nurses considered required researching. A modified Delphi technique was employed to obtain data from nurses in hospitals and health care agencies throughout the metropolitan and rural regions in the state. Participants worked in areas of acute care, mental health, paediatrics, gerontology, community health and domiciliary services and addictions. Problems identified were categorised into three streams; clinical, management and staff development. Respondents were required to assign a value to items according to their importance to nurses and to patients. They were also asked to indicate whether they considered there was an adequate research base relevant to each item. Results reported here are based on the 10 priority items identified in the clinical stream.     

Developing a hospital nursing research program

Including nursing research as a stream in the nursing career structure in Western Australia paved the way for development of the Nursing Research Department at Sir Charles Gairdner Hospital. Over the last two years a program of research activities has been introduced to assist nurses to evaluate their practice, to critique the research and apply its results in patient care.     

Creating a research culture in a nursing school

BACKGROUND: Research in nursing schools still falls behind that in other disciplines. Schools need to develop a good research culture, in which those undertaking and supervising research are supported and guided. This requires commitment from management and effective leadership. CONCLUSION: To raise awareness the authors explore some of the ways in which a nursing school can foster a positive research environment.     

Palliative care nursing in rural Western Australia

This article presents the findings of a study of rural palliative care nurses in Western Australia. The number of rural centres in Western Australia offering palliative care services is increasing; however, at present there is little empirical data available about the roles of the nurses involved. This study was undertaken to begin to correct this deficit. The study examined basic social processes associated with the role of rural palliative care nurses, and identifies issues that affect the nurses' professional practice. A modified grounded theory approach was used to form a conceptual framework that describes rural palliative care nursing. Theoretical sampling techniques were used to identify the six palliative care nurses working in rural Western Australia who participated in the study. Data were generated using in-depth interview and participant observation techniques. Constant comparative analysis of the data was employed to allow concepts to emerge from the data. The central theme that developed is the all-consuming nature of the rural palliative care nurse's role. Three subthemes relating to multiple roles, expectations of nurses, and coping strategies are also discussed. This research explored issues that rural palliative care nurses feel are relevant to their professional practice, and it describes the basic social processes inherent in the rural palliative care nurse's role. Recommendations for nursing research, education, administration and clinical practice are presented.