We need from nursing research!!

llg, PhD, RN · Jul 25, 2003

See my response in the other thread you posted to nurse educators on the same topic.

Also, remember research costs money. If you raise the money to conduct the research, I'm sure you will be able to find a skilled researcher to conduct the research for you.

So far, nursing has funded very little research itself -- or done much to raise money for research -- and nurses themselves donate very little money for research. Nurses usually go to the government looking for funds for research -- and the taxpayers aren't particularly interested in the topics you would like to see addressed.

Until individual nurses are willing to pay for research on those subjects -- or willing to raise money for that type of research -- it won't be done.

llg

WashYaHands · Jul 25, 2003

The National Association of Clinical Nurse Specialists publishes a Journal which has many of these types of articles. Here's a sampling:

The Role of Nebulized Opioids in Managing Terminal Dyspnea. Implications for the CNS.

Acknowledging Postraumatic Stress Effects on Health. A Nursing Intervention Model.

Using self-regulation theory to develop an intervention for Cancer-related fatigue.

A CNS managed Diabetes Foot-care Clnic: A Descriptive Survey of characteristics and foot-care behaviors for the Patient Population.

Advance Practice Nurses - Influencing Practice through research.

Activities of the APN to enhance unpartnered elders self-efficacy after Myocardial Infarction.

Exercise Program effects on Women with Fibromyalgia Syndrome.

Nurses As Scientists.

A practical approach to the process of measurement in Nursing

Pharmacologic management of Agitation in the Older Adult with Dementia.

Developing an Evidenced-based Procedure: Maintenance of Central Venous Catheters.

Understanding Staff Nurse Responses to Change: Utilization of a Grief-Change Framework to facilitate Innovation.

Content validation of the medication error worksheet

Outcome Evaluation: An essential component for CNS practice.

Outcomes Research: An essential compenent of the Advanced Practice Nurse Role.

Music Therapy: A healing Art.

Can We Talk? Developing a social support nursing intervention for couples.

Nurse Staffing Levels and Prevention of Adverse Events.

This is just a sampling of one journal. There are many other nursing journals that publish research specific to nursing. The research is being done. And, it's being done by nurses. The challenge is to disseminate the information to make other disciplines aware of it.

Go to CINAHL, do a literature search on the topic, the research is out there.

Linda

llg, PhD, RN · Jul 25, 2003

Originally posted by WashYaHands
The National Association of Clinical Nurse Specialists publishes a Journal which has many of these types of articles. Here's a sampling: .... Linda

You're absolutely right, Linda. The clinical journals publish articles about nursing practices that help people all the time. Perhaps it's just that people like ainz need to learn how to use that knowledge better.

I wish I had thought of that and added it to my recent posts on this topic.

Thank you,

llg

WashYaHands · Jul 25, 2003

Thanks, llg. There is one other thing that I'd like to add. My peers in research have had a few experiences where they go to units to conduct research on a specific intervention. They are met with flak from floor nurses who deem this research a waste of time. Some refuse to participate because they believe it is cumbersome for them to follow the research protocol. They want nothing to do with it.

Without a research protocol, you cant establish reliability, validity, or credibility of the research study. Without the help of the nurses, you can't do the research at all. It's important for nurses at all levels to value not only the outcomes of the research, but the process of research as well.

llg, PhD, RN · Jul 25, 2003

Once again ... Well said, WashYaHands.

llg

ainz · Jul 25, 2003

Maybe its just that people like me can use the knowledge that is pertinent to the problem---it is finding the information that is challenging!! Again, the people that are in positions of power in our hospitals understand finance, not clinical issues. It is going to be up to us to translate that information about clinical issues into financial data that makes sense to the business people. I need studies that are designed to just that. Can't find them because they are not there, not what I need. I understand why and appreciate your comments and assistance.

Also, in my role I am more of a consumer of research, not a generator of research. I will gladly support research in my hospital. I will gladly help in any way I can a researcher design and conduct a study to address the things I am looking for. The taxpayers may not support research such as I have mentioned because perhaps they do not understand, or are not aware, of how important it is to them when they or a loved one are in the hospital.

Whose responsibility is it to let the public know how important research concerning nursing is?? Perhaps the nurses should start. I also fully agree, understand, and have seen the uncooperativeness of staff nurses with anything that interferes with their ability to get their job done as quickly and efficiently as they can possibly get it done. Maybe studies can be designed to take this into account. I don't know.

WashYaHands · Jul 25, 2003

Whose responsibility is it to let the public know how important research concerning nursing is?? Perhaps the nurses should start.

Nurses already have started. Perhaps administrators should listen to nurses and change their attitudes about the value of their employees. I've seen many times the efforts of nurses to present quality cost saving measures and interventions to higher ups. The sad thing is that these ideas get lost in the bureaucratic process. I suppose I'm fortunate in that I have many friends who seek to advance nursing as a profession through research and obtaining administrative positions where they can make a difference. One of my friends is the CEO of the local hospital. She is also a nurse. Sure, she has to consider the financial bottom line, but she also advocates for her nursing staff and nursing managers. Moreso than a non-nurse administrator would.

I do not want to sound argumentative about this topic, but I noticed on another topic that you stated you're an administrator. Are you a nurse? If you're not a nurse, let me ask you this....if you went to the floor tomorrow, would the staff nurses recongize your face and know your name?

Linda

ainz · Jul 26, 2003

Linda--thanks for your dialogue with me here. If I sound argumentative, sarcastic, or anything else negative, please accept my apology. I have been pretty upset lately over what I see, hear, and read about the situation in nursing.

Yes I am an administrator, I have been a COO and a CEO. Yes I am a registered nurse and have been for 18 years. My degree is an MSN. I worked as a staff nurse in direct patient care for many years. Then became a nurse manager, nursing supervisor, department director, and so on.

Yes the staff nurses know my face and name. Yes I advocate daily for nurses and good patient care. But yes, I have to answer to my bosses who are expecting increasing profits and decreasing operating cost every year. It is really sickening to me to see the financial report and know how much profit my hospital is making every month and to hear and see what administrators and corporate bosses are doing around the country to cut costs and create the impression that things are "fiscally tight" as one nurse put it. The only thing fiscally tight is the increase in revenue that is expected from CEOs every year by their bosses and/or stockholders in their companies.

I pursued and obtained an administrative position so that I could be in position to advance the profession and improve care for the patients. So my comments and ranting and raving is not just all talk, I have taken action, spent many days, nights, hours working on issues, and worked my way into a position to be a decision maker.

I have watched the attempts of nurses to make proposals to improve things, reduce costs, for improvements in their compensation package, new ideas for enhancing services and so on. As I sit in the meetings with my associate administrators, chief financial officer, and other assistants, it is very apparent that the nurses lack the knowledge and skill to "sell" administrator-types on ideas they have. I know that is a broad statement, but, nurses in general don't have the financial knowledge to do all of their homework and present quantitative data that links nursing interventions to patient outcomes to improved operating margins. Administrators will listen to that kind of presentation and take action.

I go about, on a daily basis, the business of encouraging nurses to continue their education, to enhance their knowledge of the healthcare system, to know more about the environment we are working in, to learn about the people that are actually running the healthcare system, to arm themselves with information that will make them more effective in promoting their ideas. Reality is that most are so busy at work that when they get off from work they are exhausted, burned out, and the last thing they want to do is read about healthcare finance and corporate structure etc.

I interface daily with corporate executives and other hospital executives and I am extremely concerned and alarmed with what I hear, what I see, and the decisions that are made concerning the nursing workforce. I don't think that most staff nurses out there working for a living from shift-to-shift realize the forces that are at work and how that could impact their job as a nurse. No other discipline in healthcare is going to advocate for us. As a matter of fact, other disciplines (collectively speaking) have been chipping away at nursing for a while and continue to do so by absorbing things nurses used to do. Many other departments find nurses very difficult to deal with and are not really supportive of nursing. Administrators are not going to advocate, doctors aren't, pharmacists, physical therapist, etc. Nurses are going to have to do it for themselves and are going to need to learn how to do it effectively. We need some help with good, credible studies that can be put together with reliable financial data that can demonstrate that nurses help hospitals generate revenue, not simply consume resources.

Thanks for your comments and forgive my lengthy and sometimes heated/emotional posts. I am just very passionate about this.

WashYaHands · Jul 27, 2003

I was recently reading an article related to your original post. The article had to do with the identification of Nursing-sensitive and Multidisciplinary quality indicator sets. I skimmed over the references included with the article and this is what I found that might be of interest to you:

Reed L, Blegan, M, Goode C, et al. Assessing patient occurrences as a measure of nursing care quality. Journal of Nursing Administration. 1998; 28 (5) 62-69.

Joint Commission on Accreditation of Healthcare Organizations. The Measurement Mandate. Oakbrook Terrace, Ill: JCAHO; 1993.

Hegyvary ST. issues in outcomes research. Journal of Nursing Quality Assurance. 1991: 5(2) 1-6.

American Nurses Association. Nursing Care Report Card for Acute Care. Washington, DC; ANA, 1995.

Irvine D, Sidani, S. Hall LM, et al. Linking outcomes to nurses' roles in health care. Nursing Economics. 1998: 16(2): 58-64.

Aiken L, Smith H, Lake ET. Lower medicare mortality among a set of hospitals known for good nursing care. Medical Care. 1994, 32: 771-787.

Blegen MA, Vaughn T. A multisite study of nurse staffing and patient occurrences. Nursing Economics. 1998. 16(4) 196-203.

Kovner C, Gergren PJ. Nurse staffing levels and adverse events following surgery in US hospitals. Image: Journal of Nursing Scholarship. 1998. 30(4) 315-321.

Jastremski, C. Caught between the rock and the hard place: proving the worth of nursing. Journal of Trauma Nursing. 1999. 6(1) 3-4.

Johnson M, Maas M, Moorhead S. Nursing Outcomes Classification. St. Louis, MO: Mosby. 2000.

Maas, M. Nursing's role in interdisciplinary accountability for patient outcomes. Outcomes Management in Nursing Practice. 2000. 2(3) 92-94.

These are reference for one article. I'm sure there are more like these published, but you'll have to find them yourself. There are also internet references, such as the ANA Nursing Quality Indicators, Nursing Outcomes Classification (NOC), Nursing Intervention Classification (NIC), and nursing outcomes measurement studies.

glascow · Jul 28, 2003

Check out

National Institute nursing reseach (NINR)

http://www.nih.gov/ninr/

All the latest on nursing research.

llg, PhD, RN · Jul 28, 2003

After being away from my office for the weekend, I am happy to see that this thread has not deteriorated to a bunch of ugly, bitter arguing.

I don't have all that much new to add, but here is one idea that might help you a bit, ainz:

Do you have anyone in your in institution who can help you personally with these issues at your institution? An increasing number of hopsitals are hiring doctorally prepared nurses to help the administrators with things like gathering and analyzing informationp pertinent to their institution, establish relationships with academics who might help them conduct research, translate existing research so that it is more useful to the particular institution, etc.

That's what my boss did. She hired me to help her with issues that she was personally struggling with. She saw that some things needed to be done and that no one in our hospital had those functions as their primary job. Her issues were a little different than the ones you have, but they are not so dissimilar that the same solution might not work for you.

llg