Uploadfiles HLTEN514B Assessment Porfolio V2 Apr 2104 1 - Assessment 1

HLTEN514B Apply research within a contemporary health environment

GCIT 2014 Page 1 of 37 Nursing

Portfolio of Learning activities Research Activity Book

HLT51607 Diploma of Nursing (Enrolled / Division 2 Nursing)

HLT61107 Advanced Diploma of Nursing

HLTEN514B

Apply research skills within a contemporary health environment

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Student Number:____________________________________



Acknowledgments:

Teaching Team: Nursing First Published: 2013, Version 1 Revised Date: March, 2014

Published by: Nursing

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Contents Instructional symbols ......................................................................................................... 4

Assessment Instructions .................................................................................................... 5

Introduction ....................................................................................................................... 6

What is research? .......................................................................................................... 6

Evidence-based practice ................................................................................................ 6

Accessing Sources ............................................................................................................ 8

Electronic databases ...................................................................................................... 8

Develop a Research Proposal ......................................................................................... 11

Research problem ........................................................................................................ 11

Literature Review ............................................................................................................ 14

Primary and Secondary sources .................................................................................. 15

Writing a literature review ............................................................................................. 17

Research Design ............................................................................................................. 19

Quantitative and qualitative approaches ....................................................................... 19

Population Sample .......................................................................................................... 23

Inclusion and Exclusion Criteria ................................................................................... 23

Data Collection ................................................................................................................ 26

Ethics and Data Storage .................................................................................................. 28

Accessing Participants .................................................................................................... 30

Valid Consent .................................................................................................................. 31

Outcomes and Recommendations .................................................................................. 32

Conclusion ...................................................................................................................... 33

Bibliography .................................................................................................................... 34

Appendix A ...................................................................................................................... 35

Example Literature review (using five [5] primary sources) ........................................... 35



Instructional symbols

This workbook uses a variety of instructional symbols or icons to represent the following activities and tasks.

Assessment

Reflect

Discuss

Research

Important

Tip

Listen

Watch

Practice

Weblink

Reading

Written Activity



Assessment Instructions

Assessment Details

This workbook is designed to assist you to meet the unit requirements for HLTEN514B

Apply research skills within a contemporary health environment. The workbook provides

you with summarised information related to key research concepts, and suggestions for

further investigation of these concepts.

The purpose of this workbook is to guide you through a process of developing a research

proposal. By completing this workbook successfully you will create a portfolio of activities

through which you will demonstrate an understanding of the research process. The

overall outcome is that you will have developed a research proposal based on a Focus

Topic, which will be provided.

All twelve (12) activities in this book must be completed to demonstrate competence.

Please read the instructions below carefully before commencing the tasks.

Throughout this workbook, you will see the following icon:

Written Activity

These are your assessment items for this unit and you will need to complete all the written

activities in this workbook. Once you have completed the activities in this workbook,

submit the whole workbook as one document to your teacher.

Refer to your Student Study Guide for the assessment due date, and review the marking

criteria which is uploaded in the Assessment Instruction section in my.TAFE.

Required Resources

To complete this workbook, you will need to access:

1. GCIT my.TAFE: online learning resource for HLTEN514B Apply research skills

within a contemporary health environment

2. Borbasi, S., & Jackson, D. (2012). Navigating the maze of research: Enhancing

nursing and midwifery practice. (3rd ed.). Sydney, Australia: Elsevier.

******PLEASE ENSURE******

When asked to provide a reference, use the APA referencing style guide which you can view on my.TAFE, or the GCIT Library website.

Please ensure you include your name and student number on the front of the work book.

Complete ALL activities for a satisfactory grade



Introduction

What is research?

Nurses today actively produce, publish and apply nursing research in their practice to improve patient care and enhance the nursing professions knowledge base.

Research is defined by Burns and Grove (2007, p. 20) as diligent, systematic inquiry to validate and refine existing knowledge and generate new knowledge.

Please refer to the following:

my.TAFE online learning resource - Topic 1: Identify a need for research into health issues

Navigating the maze of research: Enhancing nursing and midwifery practice.

Chapter 1: Introduction to Nursing and Midwifery Research

Evidence-based practice

Evidence based practice (EBP) is the process by which nurses make clinical decisions using the best available research evidence.

The key steps in the EBP process are:

1. Framing the question

2. Finding the evidence

3. Assessing the evidence

4. Making the clinical decision

Like any new skill, the process of EBP initially takes time and practise.

Understanding research concepts will assist you to develop the skills to integrate EBP into

your own nursing practice.



Written Activity One: Evidence-Based Practice

Make a list of all the tasks that are routinely done by nurses during a typical clinical day. Think about what evidence you have used as the foundation for these tasks. Is your practice based on research, personal preferences, clinical guidelines or traditions?

Complete the following table:

Task Research Personal

preferences Clinical

Guidelines Traditions

Example: Hand washing



Accessing Sources

Practise Guide to accessing the GCIT Library Nursing databases

Electronic databases

1. Click the link below to login to the Library electronic resources

GCIT electronic resource log in page

2. Enter your Borrower ID this is your 10 digit student number

3. Enter your PIN this is your date of birth in this format: ddmmyyyy (no

slashes, gaps or dashes)

Nursing databases

1. Click Library Subject Guides in the left-hand panel

2. Choose Nursing from the subject guides list

3. Click the Online databases tab

4. Choose CINAHL (best for Nursing journals)

5. Scroll down to the Holdings section and click the View Resource Online

6. Click the Nursing Research link

7. Select CINAHL Plus with Full Text

8. Enter search descriptors and titles in the search fields

9. Enter dates (just the years) in the date section (this will ensure current

articles)

10. Click Search and review the results

Joanna Briggs Institute database

1. Follow steps 1 -3 above

2. Choose Joanna Briggs Institute (from the Evidence Based practice

section)

3. Scroll down to the Holdings section and click the View Resource Online

4. Type a descriptor in the Search field

5. Click Search and review the results



Written Activity Two: Evidence-Based Practice

This brief YouTube clip gives you tips to understand how to find credible information on the Internet:

Critically Evaluating Websites

This activity has two (2) parts.

Part A

Based on the readings and video above, answer the following questions:

1. When accessing reports and other sources of information from organisations which publish on the Internet, what are three (3) things you should look for to verify the credibility of the website?

2. Give two (2) reasons why websites such as Wikipedia and About.com are not considered suitable for academic research?

3. Name four (4) organisations/information systems you can use to access EBP journals and articles.

The following readings will help you to find appropriate and relevant research articles:


Chapter 2: Using library resources: what, when and how!

Chapter 3: Navigating the net



Part B

Scenario

You are concerned about the likelihood that an older, immobilised patient will develop pressure ulcers.

Instructions

Follow the guide on p. 8 of this activity book and use the Joanna Briggs Institute database to find current Best Practice guidelines for the care of pressure ulcers. DO NOT Google Joanna Briggs Institute or Best Practice for Pressure Ulcers. You must retrieve an Evidence Summary from the JBI database for this task.

Write a brief summary (100-150 words) on the best practice guidelines you found. Do not copy a bullet point list of the recommendations from the Evidence Summary; write in a narrative form, and include a citation and a correct reference list entry. Here is an example on a different topic (Mastitis in breastfeeding).

Mastitis in breastfeeding is inflammation of the breast which occurs generally because of reduced milk flow. The breast milk accumulates in the milk ducts causing localised areas of the breast to become tender and hardened. If these signs are accompanied by flu-like symptoms and swelling of the affected breast, it can be an indication that an infection has developed (infective-mastitis) (Pamaiahgari, 2014). According the best practice recommendations from the Joanna Briggs Institute (Pamaiahgari, 2014), nurses should check the attachment of the baby during feeding, and encourage and support the mother to continue breastfeeding. Hot packs prior to feeding are recommended to induce milk flow, and cold packs should be used after to reduce pain and oedema. Analgesics can also be administered to help manage symptoms. There is currently no evidence suggesting a definitive choice of antibiotic for the treatment of infective mastitis. Pamaiahgari, P. (2013). Mastitis [Evidence Summary]. Retrieved from

http://connect.jbiconnectplus.org

Write your summary here:



Develop a Research Proposal

Research problem


my.TAFE online learning resource - Topic 4 Develop a Research Proposal

Sample research questions and hypotheses


Chapter 9: Bringing it all together (pp. 217-219).

Chapter 5: Qualitative research: The whole picture (pp.132-134).

Chapter 8: Using research evidence (pp.196-198).

Research aims to investigate problems and to do that researchers need to ask questions about the perceived or observed problem. As you will have read in the readings above, this process of questioning and thinking about different aspects of the problem culminates in a research proposal. As Borbasi and Jackson (2012, p. 87) suggest, the research process involves an orderly series of steps that allow the researcher to move from asking a question to finding an answer. In this next section of the workbook you will be guided through the initial part of that series of steps to design a research proposal. For this unit, you will not be conducting research. This is a theoretical exercise only which is designed to meet the outcomes of this unit of competency. To begin, you will be asked to think about a problem in nursing practice and to start to ask questions about one particular aspect of that problem. The focus topic for the problem will be provided and once you have identified the aspect of the research problem that you would like to explore, you need to create a research question which is searchable with your literature review. Step One Defining the problem To define the problem researchers often break the questions down into smaller components. One technique that can help with this is referred to using the acronyms PICO and PEO. These are explained in more detail on the following page.



The following article provides some additional reading: Applying the PICO and PEO formats to your research question

Predominantly used for Quantitative research

P I C O

Population

Patient

Problem

Intervention or exposure

Comparison Outcome

Who are the patients? What is the problem?

What do we do with them? What are they exposed to?

What do we compare the intervention with?

What happens? What is the outcome?

P Patient type or population Who will you be investigating? Will it be

patients, nurses, students? What gender or age will they be? For example, if you were investigating pain management in post-surgical

patients, your population could be patients over the age of 18 following orthopaedic surgery.

I Intervention For example, a particular intervention might be carried out. This could be a treatment such as administration of a particular medication, a diagnostic test, or how the patient feels i.e. their perception.

C Comparison this could be a comparison of another treatment, a control or a placebo.

O Outcome The measurable outcome that is expected.

Predominantly used for qualitative research

P E O

Population

Patient

Problem

Exposure Outcome

Who are the patients/community? What is the problem?

What have they been exposed to?

What happens? What are the expected outcomes?



Written Activity Three: Develop a research question

Using the PICO or PEO acronym, develop a research question from an identified problem in Nursing practice. The focus topic is provided below.

Focus Topic The focus topic is: The impact of horizontal violence in nursing ..

The areas to choose from which could be related to the above topic are:

staff morale

staff retention

physical or psychological health of staff

student nurse clinical experiences

effects on patient care

the organisation

Your question should relate to this focus topic above. Please choose one area only from the dot point list above to investigate.

Tip: Keep the aim of your research and the question simple. Do not try to do too much in your proposed study.

Use the PICO or PEO method to start exploring your ideas about the area of the focus topic you would like to investigate (you do not need to include your notes here).

Then, formulate a Research Question or Statement (it can be a working/draft question or statement to begin with). E.g. The impact of horizontal violence in nursing: Understanding student nurses experiences.

Research Question or Statement



Literature Review


my.TAFE online learning resource - Topic 4 Develop a research proposal:

Conducting a literature review

Critiquing a research report

Critiquing qualitative research


Chapter 3: Factors affecting information quality (pp. 6772)

Chapter 9: Conducting a literature review (pp. 219220)

A literature review is a survey of information and research that has been written about a particular topic, theory, or research question. It requires critical thinking, reading, and writing.

In a literature review section of a research proposal you need to take the information that you have gathered through your questioning, compare and evaluate it by showing important ideas and trends in the literature, and explain their significance to your research question.

Tip: Whatever you read or write should have a clear connection to your question.

Once you have found the relevant literature, it is important for you to analyse (critique) the literature. Critiquing is a process of assessing the literature to evaluate its good and bad points, or strengths and weaknesses. It assists you to decide if the findings are credible, and whether they should be used in practice.

Overall, a literature review seeks to answer the following questions:

What does the literature tell you?

What does the literature not tell you?

Why is this important?



Primary and Secondary sources

The materials, evidence, or data used in your research proposal are known as sources. As foundations of your research, these sources of information are typically classified into two broad categories: primary and secondary.

For some research project it may be a requirement to use primary sources, instead of, or in addition to, secondary sources. So what's the difference?

A primary source is a first-hand account of research findings from the source or the person who conducted the research. Therefore, it is an original article or book created by an individual. A secondary source refers to, writes or talks about the primary source. You can think of secondary sources as second-hand information.

Tip: If I tell you something, I am the primary source. If you tell someone else what I told you, you are the secondary source.

Primary research articles can be identified by a commonly used format. Look for sections titled:

Abstract at the beginning which will summarise the research findings. If there is no abstract at all, that in itself may be a sign that it is not a primary resource

Methods (sometimes with variations, such as Materials and Methods)

Results (usually followed with charts and statistical tables)

Discussion

Bibliography or Reference list, and/or a Works Cited section at the end of the article

Short research articles may not include all or any of those elements. In those cases look at the words the authors use; phrases such as "we tested" and "in our study, we measured" will tell you that the article is reporting on an original research project.

This brief You Tube be clip gives a great summary of primary and secondary sources:

Primary vs Secondary Sources

Go to the CINAHL database at the GCIT library (follow the steps on p. 8 of this

book). Download and read the following article:

Ditmer, D, (2010). A Safe Environment for Nurses and Patients: Halting Horizontal Violence. Journal of Nursing Regulation, 1(3), 9-14. Retrieved from CINAHL database http://web.ebscohost.com

Answer the questions related to the article on the following page.

Written Activity Four: Literature Review



1. Is this article a primary or secondary source? Provide a rationale for your answer (min 50 words)

2. Are the aims and objectives clear? Does the article address the aims and objectives given by the author? (min. 50 words)

3. Is the information presented still valid and applicable today? Provide a rationale for your answer (min 50 words)

4. What does the author suggest as the main reason why horizontal violence exists?

5. What are the effects of horizontal violence?

6. The author suggests that an educational process is essential to break the cycle of horizontal violence. What are the three (3) main aspects that should be included in this educational program?



Writing a literature review

A review of literature can be presented in a number of ways, including:

Book Review Annotated Bibliography Literature Review

Analyzes and evaluates a particular book.

Summarises relevant sources and explains the significance of that source to the research question.

Surveys the relevant literature to determine what is known and not known about a particular topic.

Steps to writing an effective review of literature:

1. Gathering sources

Focus your topic:

A literature review should cover a variety of the research on a given topic. If the topic is too large, there will be too much material to cover it adequately.

Read with a purpose:

Although you will need to summarise sources briefly, a good literature review requires that you find the key themes or issues related to your own research interests.

2. Evaluating sources

For each book or article consider:

Credentials: Is the author an expert?

Argument/Evidence: Does the evidence support the conclusion? Is the argument or evidence complete?

When comparing sources, consider:

Conclusions: Does all research arrive at the same conclusion or are there differing opinions? What evidence or reasoning are the differences based on?

Gaps or omissions: What questions are raised by the literature?

Written Activity Five: Write a Literature Review

Consider the research question or problem statement you developed earlier (Activity 3) and find four (4) primary research articles related to your chosen focus area. Write a literature review based on these articles. Your articles should be no more than five (5) years old. However, if it is applicable for your focus area, older articles can be used to demonstrate how perspectives have changed through the years.

The literature review for four (4) articles should be approximately, 300-500 words, written in a narrative form using cohesive sequenced paragraphs.

Tip: An example of a Literature Review is available in Appendix A of this workbook.



Write your Literature Review here:



Research Design

Quantitative and qualitative approaches Once you have chosen your research question/statement and reviewed the literature on your chosen area of investigation, you need to plan how you would design or collect the data for a proposed study (REMEMBER: you are not going to conduct research for this assessment task this is a theoretical exercise only).

There are many types of designs which you will read about in your textbook and my.TAFE topics. These designs fall under the main headings of quantitative, qualitative or mixed method research methodologies.


my.TAFE online learning resource - Topic 3b The research process:

Quantitative, qualitative and mixed method:


Chapter 4: Quantitative Research: Summing it up

Chapter 5: Qualitative Research: The Whole Picture

Tip: the research design you choose will be determined by the research problem/question you have selected.

As you start to read more research articles, you will see patterns in the types of problem statements/questions. You will also see how the problem statement and research question relates to the title of the research article.

Look at the three research problem examples below and you will see that the problem statement itself leads you to a logical way of collecting data. The problem statement can also suggest a suitable title for a project.

Example 1

Problem Statement:

To determine whether using alternate sites is effective in reducing bruising when administering low-dose heparin via the subcutaneous route.

This statement suggests that the project will involve a measure (of bruising) on a patient using instruments and tools, and an intervention (use of an alternate site). Therefore, this research problem must be guided by quantitative research approaches.

A title for this project might be:

Reducing bruising during the administration of heparin via the subcutaneous route: Measuring the effect of using alternate sites.



Example 2

Problem Statement:

To describe the experience of being a nurse with a substance abuse problem.

This statement requires the investigator to find nurses who have lived the phenomenon of abusing substances during their nursing careers. When participants are required to describe their experiences, it suggests that they will need to be interviewed so that the researcher can explore their perceptions. Thus, this problem statement would be designed around qualitative research approaches and, in particular, a phenomenological design.


Nurses with substance abuse problems: Understanding the issues. Example 3

Problem Statement:

To evaluate nurses knowledge and experience of stroke rehabilitation

This statement requires the investigator to gather information of both knowledge and experience. Depending on the scope of a proposed study, this problem statement could be designed around either quantitative or qualitative methods, or could use a mixed method approach to evaluate knowledge (quantitative) and experiences of (qualitative).


The complexities of stroke rehabilitation: What do nurses know?

When selecting your own research question and research design consider the following to determine how you would like to focus your study:

WHAT QUANTITATIVE RESEARCHERS THINK ABOUT

I want to know what causes something

I spend a lot of time wondering how to measure things

I wonder how small patterns link to big patterns

I want to make sure others can repeat my findings

WHAT QUALITATIVE RESEARCHERS THINK ABOUT

I want to see the world through the eyes of my respondents

I want to describe the context in a lot of detail

I want to show how social change occurs

I really want my research approach to be flexible and able to change



Written Activity Six: Research Design

This activity has three (3) parts:

Part A

Match the following terms with their correct definition:

Term Definition Matching definition

letter

Examples of qualitative research designs

A) Statistical results displayed in table form

Phenomenology is the study of

B) Focuses on scientific descriptions of cultural groups

An example of a Quantitative design data collection method

C) ethnography, grounded theory, case study

Ethnographic method

D) Lived experiences

Characteristics of quantitative design

E) Numerical behaviour data, measuring instruments, reliability, validity

Part B

Read the following research study:

Nichols, P., Copeland, T.S., Craib, I., Hopkins, P. & Bruce, D. (2008). Learning from error: Identifying contributory causes of medication errors in an Australian hospital. Medical Journal of Australia, 188(5), 276279. Available at: https://www.mja.com.au/journal/2008/188/5/learning-error-identifying-contributory-causes-medication-errors-australian

Identify the following:

1. The type of research design used for the study

2. The rationale for using the research design



Part C

Review your research question then complete the section below related to your research design. This activity must be written in essay format and referenced throughout using APA 6th edition referencing. A reference list is required.

1. Choose a research design/method that will support your chosen research question/statement AND give a rationale for your choice (min. 70 words)

2. In a short paragraph, write a definition of your chosen research method (min 50 words)

3. Provide a reference list for the citations you used above



Population Sample

Populations are generally very large so the investigator will need to find a sample of the population so that the study is more feasible.

The process involves selecting a number of individuals for a study in such a way that the individuals are representative of the larger group from which they were selected. The people selected possess certain common characteristics or traits that identify them as a part of a particular population.

If your study was investigating The lived experience of schizophrenia then your population would be people diagnosed with schizophrenia and you would select a sample from that large group.

Review the information on samples in your text book. Identify the different categories of population samples as you will be quizzed on this later.


Chapter 4: Identify Sample and Setting (pp. 99-102)

Inclusion and Exclusion Criteria

Inclusion criteria are the characteristics that the prospective participants in a research study must have to be included in the study. Exclusion criteria are those characteristics that would disqualify a prospective participant from being included in the study.

There are many criteria that could be used for inclusion/exclusion and these may range from age, gender, ethnicity, race, stage of disease, prior treatments, current medications and many other medical, psychological or emotional conditions.

Clearly defined inclusion and exclusion criteria can assist in designing a study that is reliable and valid. It also minimizes the chance of harm to a vulnerable subject/participant and guards against exploitation.

An example of inclusion criteria for a study of Diabetes in juvenile subjects might include all children between the ages of 10 and 17 who have been diagnosed with Diabetes Type 1. Other inclusion criteria could be that they have been diagnosed for at least one year and have attended an outpatient clinic in a public hospital. Exclusion criteria for this study may include children who live in remote areas, or children who suffer with a psychological or emotional condition.



Written Activity Seven: Population Sample

This activity has three (3) parts

Part A

Complete the following True/False and Multiple Choice Questions:

Highlight the correct answer for the following True or False questions.

a. In a nonprobability sample the subjects are chosen at random.

TRUE / FALSE

b. In a probability sample the results can be generalised to the population.

TRUE / FALSE

c. The larger the sample the more representative it is of the population.

TRUE / FALSE

Highlight the correct answer for the following multiple choice questions.

A stratified random sample is:

a. The most basic form of probability sampling in which all subjects in a population

are numbered and selected randomly

b. A multistage sampling in which larger groups are randomly selected first (eg.

Hospitals) followed by smaller groups (e.g. Patients)

c. A sample subdivided into groups according to some characteristic.

d. A sample which selects subjects via an allocated number from a randomised list.

A quota sample is:

a. A convenience sample which selects the most convenient subjects.

b. A sample conveniently selected according to pre-specified characteristics.

c. A sample which is handpicked by the researcher

d. A sample which selects subjects via an allocated number from a non-randomised

list.



Part B

Read the following study on horizontal violence:

McKenna, B.G., Smith, N.A., Poole, S.J. and Coverdale, J .H. (2003). Horizontal violence:

Experiences of Registered Nurses in their first year of practice. Journal of

Advanced Nursing 42(1), 9096. Available at:

http://www.mc.vanderbilt.edu/root/pdfs/nursing/HorizontalViolenceArticle.pdf

Outline the population sample and inclusion/exclusion criteria that the authors used.

Part C

Consider your research question and design and complete the following section on your

target population sample and inclusion/exclusion criteria. This activity must be written in

essay format and referenced where appropriate using APA 6th edition referencing style. A

reference list is required at the end of this section.

a. Population sample (min. 50 words)[reference required]

b. Inclusion criteria (min. 50 words)

c. Exclusion criteria (min. 50 words)

d. Provide a reference list



Data Collection

Data Collection is an important aspect of any type of research study. Inaccurate data collection can impact on the results of a study and ultimately lead to invalid results.

As discussed in the Research design section, data is usually collected through qualitative and quantitative methods, or by a mixture of these methods.

One way to grasp the difference between these two approaches is to think about the difference between numbers (quantitative) and words (qualitative).

Surveys and document analysis, for instance, are typically used to collect information that is easily quantifiable, such as the number of nurses who improve their score on a test of content knowledge.

Interviews and focus groups, on the other hand, are ideal for gathering qualitative data, such as rich, descriptive information regarding how or why nurses incorporate what they have learned into their practice.

Quantitative methods use instruments that can be administered to a large number of respondents at once, therefore making collecting data from many respondents more reasonable.

Qualitative methods, such as interviews and observations, are often time-intensive, making them difficult to use with a very large number

Read the following information from your online resource on data collection methods:

Topic 4: Data collection process

Written Activity Eight: Data Collection Methods

This activity has two (2) parts

Part A

Listed below are some examples of research focus areas. After reading the question, highlight which of the data collection techniques suggested would be most appropriate for answering the question.

1. Why are some youth more likely to drop out of school than others?

a. Documents/Records

b. Ethnographies/Case Studies

c. Observations

d. All of the above



2. What is the dynamic between staff members during a conflict resolution workshop?

a. Observations

b. Documents/Records

c. Ethnographies/Case Studies

d. None of the above

3. Did the education program succeed in giving participating parents more confidence

with parenting skills?

a. Surveys/Questionnaires

b. Focus Groups

c. Interviews

d. All of the above

Part B

Consider your research question and your research design, and complete the following section on your data collection methods. This activity must be written in essay format and referenced throughout using APA 6th edition referencing. A reference list is required.

a. What data collection methods would best fit your research design? (min. 50 words)

b. Provide a reference list



Ethics and Data Storage

When conducting research, researchers must be mindful of ethical and data protection issues. Ethical guidelines seek to work towards protecting the individuals, communities and environments involved in research studies against any form of harm, manipulation or malpractice.

Read the following information from your online resources on data storage and ethical considerations:

Topic 3A: Undertake Critical Analysis

Navigating the maze of research: Enhancing nursing and midwifery practice

Chapter 4 Get Approval to use Human Subjects (pp. 108-110)

Chapter 9 Other Important Considerations: Ethics(pp. 229-230)

In Australia, the National Health and Medical Research Council (NHMRC) is the peak body for supporting health and medical research, and for providing advice on ethical behaviour in health care and in the conduct of health and medical research.

Written Activity Nine: Ethics and Data Storage

Access the following publications to answer the questions on the following page.

Data Storage

National Health and Medical Research Council, the Australian Research Council and Universities Australia. (2007) Australian code for the responsible conduct of research. Available at: http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/r39.pdf

Ethical Guidelines

National Health and Medical Research Council, the Australian Research Council and the Australian Vice-Chancellors Committee. (2013). National statement on ethical conduct in human research 2007 (Updated December 2013), Canberra: Australia: Commonwealth of Australia. Available at: https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/e72_national_statement_140130.pdf



a. What are the data storage requirements for researchers? (min 50 words)

b. Human research may be conducted only with ethical approval. Outline the responsibility of researchers in gaining ethics committee approval. (min 50 words)

c. Specific issues arise in the design, conduct and ethical review of research involving the categories of participants. Define these participants. (min 50 words)

d. Provide a reference list



Accessing Participants

After obtaining ethics approval for human research, researchers need to access to their research field and research participants.

Unfortunately, one of greatest drawbacks in conducting successful research is the ability to obtain access to the research field and research participants. In fact, researchers often spend a considerable amount of time on obtaining access, but many researchers do not even describe their access to the research field and participants in their research reports.

Obtaining access to the research field and research participants can vary to a considerable extent, depending on the kind of data being investigated. For example, obtaining access to participants in large profit organisations can be more difficult as their managers would value the cost of time. In these situations completion of questionnaires are often considered to be more achievable, rather than interviews and observations.

Additionally, researchers who are considered outsiders of an organisation are often not welcomed, especially if they ask questions that are considered to be sensitive and awkward.

There are two main goals of recruitment of research participants:

to recruit a sample that adequately represents the target population

to recruit sufficient participants to meet the sample size and ensure the research outcomes and findings are valid

Written Activity Ten: Accessing Participants

Consider your proposed research study.

a. What pitfalls do you think you might have in accessing participants?

b. What methods would you use to recruit sufficient participants for your study?



Valid Consent


my.TAFE online learning resource -

Topic 3A The ethics application process Consent

Navigating the maze of research: Enhancing nursing and midwifery practice

Chapter 4 Elements of Informed Consent (p.111 Box 4.10)

Written Activity Eleven: Valid Consent

For a researcher to obtain valid consent from any potential research participant there is essential information that must be discussed with each participant. Summarise the elements of valid consent.



Outcomes and Recommendations


my.TAFE online learning resource -

Topic 4: Barriers to research utilisation

Written Activity Twelve: Outcomes & Recommendations

From your reading and your literature review of your chosen area related to horizontal violence in nursing, list two recommendations for clinical practice which would help to address this problem. Include an in-text citation and a reference list.



Conclusion

This workbook of activities and assessment tasks forms a portfolio of work through which it is hoped you have developed an understanding of the research process. Many nurses do not get the opportunity to conduct research themselves. However, all nurses have a responsibility to be consumers of research so that they can keep informed about developments in health and disease treatments, and so that they can use research findings to improve nursing practice.

In successfully completing and submitting this portfolio of work you have participated in the nursing research process in a simulated environment by:

Identifying a need for research into health issues

Identifying client-related issues in participating in research

Reviewing and critiquing the literature related to a problem area in nursing practice

Identifying an appropriate methodology in response to a research problem

Developing a research proposal based on a research problem

Considering relevant methods of data collection

Demonstrating an understanding of the ethical guidelines for research, and the principles of valid consent

Well done!



Bibliography

Borbasi, S. and Jackson, D. (2012) Navigating the maze of research: Enhancing nursing

and midwifery practice. (3rd ed.). Australia: Elsevier.

Burns, N., & Grove, S.K. (2007). Understanding nursing research: Building an evidence-

based practice (4th ed.). St. Louis, MO: Saunders Elsevier.

The Hartness Library (2012, August 1). Primary vs secondary sources [Video file].

Retrieved from http://www.youtube.com/watch?v=g0plq2E9ZjQ

Holmes, K. (2013). Applying the PICO and PEO formats to your research question.

Retrieved April 2, 2014 from https://my.ucs.ac.uk/Library/Subject-Guides/Nursing,-

Midwifery--ODP/PICO-Searching2.pdf

McCormack, J.R. (2013). Acute stroke research: Challenges and opportunities for nurses.

Nursing Standard 27(32), 39- 45. Available at

http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=4&sid=62b4dbe9-6444-

4ca5-9772-f067c70fd7f7%40sessionmgr4003&hid=4112

McKenna, B. G., Smith, N. A., Poole, S.J. & Coverdale, J .H. (2003). Horizontal violence:

Experiences of Registered Nurses in their first year of practice. Journal of

Advanced Nursing 42(1), 9096. Available at

http://www.mc.vanderbilt.edu/root/pdfs/nursing/HorizontalViolenceArticle.pdf

National Health and Medical Research Council. (2007). Australian code for the

responsible conduct of research. Available at

http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/r39.pdf

National Health and Medical Research Council, the Australian Research Council and the

Australian Vice-Chancellors Committee. (2013). National statement on ethical

conduct in human research 2007 (Updated December 2013), Canberra: Australia:

Commonwealth of Australia. Available at:

https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/e72_national_sta

tement_140130.pdf

Nichols, P., Copeland, T. S., Craib, I., Hopkins, P. & Bruce, D. (2008). Learning from

error: identifying contributory causes of medication errors in an Australian hospital.

Medical Journal of Australia 188(5), 276 279. Available at

https://www.mja.com.au/journal/2008/188/5/learning-error-identifying-contributory-

causes-medication-errors-australian

Nieswiadomy, R. (2012). Foundations of nursing research (6th ed.). Upper Saddle River,

NJ: Pearson Education.

Reynolds, G., Kelly, S., & Singh-Carlson, S. (2014). Horizontal hostility and verbal

violence between nurses in the perinatal arena of health care. Nursing

Management 20(9), 24- 30. Available at http://web.a.ebscohost.com/

Vessey, J. A., Demarco, R., & DiFazio, R. (2010). Bullying, harassment, and horizontal

violence in the nursing workforce: the state of the science. Annual Review of

Nursing Research 28, 133-157. Available at http://web.a.ebscohost.com/

Virginia Commonwealth University (2011, January 11). Critically evaluating websites

[Video file]. Retrieved from

http://www.youtube.com/watch?v=9ig20cOGQYU&feature=related

Appendix A


Appendix A

Example Literature review (using five [5] primary sources)

Topic: Stroke

Focus area - Nurses knowledge and experience of stroke rehabilitation

Working title/question How much do nurses know about stroke rehabilitation?

It is generally acknowledged that survivors of a cerebrovascular accident (CVA),

commonly referred to as stroke, often require intense and long-term rehabilitation, including

physical, occupational and speech therapy, psychological support, nutritional advice, and

general education about the possible ongoing effects of stroke (Andersson & Hansebo, 2009;

Barreca & Wilkins, 2008). Nurses are often at the forefront of stroke rehabilitation and care

programs, especially in the initial phases of recovery, and they can play a pivotal role in

improving outcomes for stroke victims (Hill, Middleton, OBrien & Lalor, 2009). Nevertheless,

Hill et al maintain that their research revealed a lack of information in some hospitals about

how the guidelines on stroke rehabilitation and management should be implemented, and

confusion amongst the multidisciplinary healthcare teams about should take a lead role in this

regard.

Senevirante, Mather and Then (2009) examined this aspect of stroke care further by

exploring the workplace culture of a stroke unit. In their ethnographic study they conducted

interviews with a range of healthcare professionals, including nurses, and made observations

of the participants practice throughout their daily interactions and activities. The results

suggested that, in the culture of the particular setting observed, the contribution of nurses to

stroke rehabilitation was under-valued, despite their role in providing 24-hour care for

patients, and that the multidisciplinary teams of health professionals did not work

collaboratively. Similarly, Barreca and Wilkins (2008) found that nurses understand their role

to be vital in assisting patients with stroke rehabilitation, but are often frustrated by the time

Appendix A


constraints they work under, and the lack of support received from other members of the

multidisciplinary care teams.

The importance of assessing nurses knowledge about stroke rehabilitation cannot be

understated because the complex needs of patients following a CVA are not limited to

physical impairment. The challenge of recovery and stroke rehabilitation can leave patients

feeling extremely isolated and vulnerable, leading to mental health complications, with

depression, in particular, said to be common after a CVA (Andersson & Hansebo, 2009).

Despite these complexities, Andersson and Hansebo assert that their research into elderly

peoples experiences following stroke suggested that there are varying perceptions amongst

health professionals of what the patients needs are, and how best to manage them.

Similarly, a survey conducted with stroke nurses in the United Kingdom found that nurses

knowledge of the incidence of recurrent strokes, and the lifestyle risk factors which can

contribute to this, may be limited (Lawrence, Kerr, Watson, Jackson & Brownlee, 2009).

Accordingly, Lawrence et al concluded that nurses could benefit from professional

development on secondary prevention of stroke and improved access to evidence-based

research in this regard.

Overall, the literature reviewed relating to nursing care in stroke recovery and

management suggests that stroke patients experience a range of complex issues which

require the involvement of a variety of health practitioners and therapists. Although nurses are

predominantly responsible for providing care in these settings, they may be unaware of the

extent of the issues that stroke survivors face, may be unsure of their specific role within the

healthcare team, and may lack the necessary knowledge of best practice guidelines

recommended for achieving optimal patient outcomes.

Appendix A


References

Andersson, A., & Hansebo, G. (2009). Elderly peoples experience of nursing care after a

stroke from a gender perspective. Journal of Advanced Nursing 65(10), 2038-2045.

doi: 10.1111/j.1365-2648.2009.05060.x

Barreca, S., & Wilkins, S. (2008). Experiences of nurses working in a stroke rehabilitation

unit. Journal of Advanced Nursing 63(1), 36-44. doi: 10.1111/j.1365-

2648.2008.04648.x

Hill, K., Middleton, S., OBrien, E., & Lalor, E. (2009). Implementing clinical guidelines for

acute stroke management: Do nurses have a lead role? Australian Journal of

Advanced Nursing 26(3), 53-57. Retrieved from the CINAHL database

http://web.ebscohost.com

Lawrence, M., Kerr, S., Watson, H.E., Jackson, J., & Brownlee, M.G. (2009). A survey of

stroke nurses knowledge of secondary prevention lifestyle issues. British Journal of

Neuroscience Nursing 5(11), 518-523. Retrieved from the CINAHL database

http://web.ebscohost.com

Seneviratne, C. C., Mather, C. M., & Then, K. L. (2009). Understanding nursing on an acute

stroke unit: Perceptions of space, time and interpersonal practice. Journal of

Advanced Nursing 65(9), 1872-1881. doi: 10.1111/j.1365-2648.2009.05053.x

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