1) Explore the National Institute of Nursing Research (NINR) website: http://wwww.ninr.nih.gov/ Review their publication Bringing science to life: NINR strategic plan (2011,p.7)to identify the current priorities for nursing research. Do you agree with the priorities or would you recommend addition or elimination of some of the priorities? What effect do the nursing research priorities have on nursing research?
2) What criteria must be met in order to consider a practice, evidence-based? Provide examples. Explain the role quality plays in evidence-based practice. Nursing Research and Evidence Based Practice Essay
3) Based on the information you\’ve learned to this point, write a research proposal that relates to the topics you chose for a previous assignment. Be sure to include the following information in your proposal:
Hypothesis
Theory
Design Model
Method
Anticipated results
Potential dissemination avenues
Nursing Research and Evidence-Based Practice
Introduction
The National Institute of Nursing Research (NINR) focuses on promoting and improving the health of people, families, and communities. NINR achieves this by supporting and conducting basic and clinical research as well as prompting training of training health research while integrating the biological and behavioral sciences to form the foundation for clinical practice (NINR, 2011). Research is imperative for nurses as it aids nurses to stay updated about the latest evidence, helps nurses to advance their career, and more importantly, research is important in ensuring nursing provides high-quality and better patient care. Nursing Research and Evidence Based Practice Essay
Current Priorities for Nursing Research
According to NINR the priorities include promoting health and preventing disease; improving scientific innovations; improving the quality of life through self-management and symptom management; developing nurse scientists; and improving the provision of palliative care (NINR, 2011). Whereas I am in agreement with the current priorities, my opinion is that some priorities should be added. For example, research in the management of pandemics, epidemics, and similar disasters should also be prioritized. This is because disasters and pandemics lead to massive injuries and fatalities and thus nurses need to have adequate knowledge on how to handle and manage such disasters. Nursing priorities also need to focus on the determinants of health. Such research would address the collective and individual needs of health within the micro and macro social settings. Nursing research also needs to focus on the social structure that generates disease or health, while integrating the subjective actors. The nursing research priorities ensure that nursing research focuses on the most pressing health aspects to promote optimal nursing care, promote patient safety, and improve the quality of life (Curtis et al., 2017).
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Criteria for Evidence-Based Practices
For a practice to be considered as evidence-based, the practice should be informed by the most accurate, relevant, and current research. Evidence-based practice involves the integration of clinical expertise, external scientific evidence, as well as the integration of perspectives of the patients. The integration of these elements of evidence-based practice allows nurses to make decisions that are informed by the latest evidence and provide high-quality care that reflects the values, interests, needs, and choices of people (Black et al., 2015). An example of evidence-based practice in a hospital is infection control measures within healthcare organizations. Nurses are critical in the prevention of infections by following the implemented evidence-based infection-control protocols in a healthcare organization. This can be achieved by practicing hand hygiene techniques, donning PPEs, and utilizing barrier precautions. Observing the evidence-based infection-control procedures has been shown to prevent hospital-acquired infections. Another example is oxygen administration in patients with COPD. Providing oxygen to patients with COPD improves the quality of life and increases life expectancy. Quality is important in evidence-based practice. High-quality evidence leads to improved quality of care and better patient outcomes (Mathieson et al., 2019).
Research Proposal
The impact of nurse workload on Missed Care in Neonatal Intensive Care Units (NICU)
Hypothesis
Heavy workload among nurses working in NICU leads to a high rate of missed care in NICUs
Theory
Studies show that bedside nursing care significantly impacts the safety and clinical outcomes in NICUs. Nurse workload refers to the level of performance needed to conduct the nursing activities and is normally represented by metrics such as nurse-patient ratio and poor health outcomes. Nurse workload has been associated with infant health outcomes within NICUs. On the other hand, missed nursing care refers to the omitted or significantly delayed patient care. Evidence indicates that nurse workload leads to missed care in nursing wards with adult patients. This is because increased workload among nurses as indicated by staffing adequacy, nurse care hours, and staffing ratio are allied to increased missed care. Evidence shows the occurrence of neonatal nurses misses in providing essential care to the patients. A study conducted by Tubbs-Cooley et al (2015) on missed care among nurses working in the NICU found out that the most missed nursing care activities include oral care for mechanically ventilated infants; attending team rounds, and parental involvement in care. This indicates the existence of missed care in NICUs. The missed care for infants within NICUs is highly associated with heavy workload among the nursing staff. A study conducted by Lake et al (2018) found out inadequate staffing for nurses working in NICUs significantly contributed to missed care events in the NICU. Missed care within NICUs is allied to poor infant outcomes, including a prolonged stay in the NICU and prolonged time to attain full feedings. Nursing Research and Evidence Based Practice Essay
Design Model
The quantitative design will be used as the research design. Quantitative research aims to answer the research question and the methods are normally predetermined and structured. The quantitative research design involves researches such as treatment administration to examine its efficacy; or observing study participants (Regnault et al., 2017). There are different methods of quantitative studies and the study design should be selected depending on its ability to answer the research question. It is important to take into account the cost-efficiency and ethical considerations when choosing a research design.
Method
A prospective research method will be performed from June 1, 2020, through December 31, 2020. The data will be collected in four cycles. After the end of each shift, data about subjective workload, staffing ration, and missed care for each allocated infant will be collected. Infant acuity data will also be collected from the EHR corresponding to every infant-specific report of missed care.
The study will be conducted in the NICU in my current organization. Nurses who will be eligible to participate in this study are the ones provide care to the infants and were permanently working in the NICU. All data of infants who had missed care will also be recorded.
Nurses participating in the study will report subjective workload during the shift, infant-to-nurse ratio, as well as missed care for allocated infants at the end of every shift. Infant acuity data will be obtained from the EHRs and combined with the missed care data. The completed forms will be reviewed and the data entered in a secure database. The data will be analyzed using SPSS software.
Before the study begins, approval will be sought from the appropriate institutional review board. Written informed consent will also be sought from the participating nurses. The data will be kept in a secure file that will only be accessed by authorized parties. A Certificate of Confidentiality was gotten as an additional protentional measure.
Anticipated Results
The expected results from the proposed study are that the nurse-patient ratio significantly influenced the missed nursing care for the infants. Inadequate nurse-patient ratio leads to heavy workload and this is associated with a high likelihood of missed nursing care (Lake et al., 2018). This is because previous studies indicate that have shown that heavy workload is associated with missed care in adult patients. The findings from the proposed study about nurse workload and missed care will, therefore, be vital in designing interventions to change NICU and shift contexts and assigning of nursing staff in the unit.
Potential Dissemination Avenues
Findings from the proposed study will be published on the organization’s website. This will enable all the organizational stakeholders to access the findings. A copy of the final report will also be submitted to the head of the NICU and the organizational management as well. Moreover, the final report will be presented during a workshop and conference meeting where all relevant organizational stakeholders will be required to attend. Finally, the final report will be published in a peer-reviewed journal.
Conclusion
NINR focuses on promoting and improving the health of people, families, and communities by supporting and conducting basic and clinical research as well as prompting training of training health research. The current priorities in research include promoting health and preventing disease; improving scientific innovations; improving the quality of life through self-management and symptom management; developing nurse scientists; and improving the provision of palliative care. However, pandemic outbreaks need to be prioritized. Evidence-based practices need to be informed by the most accurate, relevant, and current research. the proposed study is about the impact of nurse workload on missed care in NICUs.
References
Black, A. T., Balneaves, L. G., Garossino, C., Puyat, J. H., & Qian, H. (2015). Promoting evidence-based practice through a research training program for point-of-care clinicians. The Journal of nursing administration, 45(1), 14–20. https://doi.org/10.1097/NNA.0000000000000151
Curtis, K., Fry, M., Shaban, R. Z., & Considine, J. (2017). Translating research findings to clinical nursing practice. Journal of clinical nursing, 26(5-6), 862–872. https://doi.org/10.1111/jocn.13586.
Lake, E. T., Staiger, D., Edwards, E. M., Smith, J. G., & Rogowski, J. A. (2018). Nursing Care Disparities in Neonatal Intensive Care Units. Health services research, 53 Suppl 1(Suppl Suppl 1), 3007–3026. https://doi.org/10.1111/1475-6773.12762.
Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators, and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Primary health care research & development, 20, e6. https://doi.org/10.1017/S1463423618000488.
NINR. (2011). Bringing Science to Life NINR STRATEGIC PLAN. https://www.ninr.nih.gov/sites/files/docs/ninr-strategic-plan-2011.pdf
Regnault, A., Willgoss, T., Barbic, S., & International Society for Quality of Life Research (ISOQOL) Mixed Methods Special Interest Group (SIG) (2017). Towards the use of mixed methods inquiry as best practice in health outcomes research. Journal of patient-reported outcomes, 2(1), 19. https://doi.org/10.1186/s41687-018-0043-8.
Tubbs-Cooley HL, Pickler RH, Meinzen-Derr JK. Missed oral feeding opportunities and preterm infants’ time to achieve full oral feedings and neonatal intensive care unit discharge. Am J Perinatol. 2015;32(1):1-8. doi:10.1055/s-0034-1372426.
Nursing Research and Evidence Based Practice Essay