Category Archives: research

Write Away!

Want to know the standardized format for writing up your research study, QI report, Writing1case study, systematic review, or clinical practice guideline?    Check out these standardized reporting guidelines: http://www.equator-network.org/reporting-guidelines/

Of course you should always give priority to the author instructions for the particular journal in which you want to publish, but most adhere generally or fully to these standardized guides.

Write away!

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“Please answer….” (cont.)

What do people HATE about online surveys?   If you want to improve your response rates, check out SurveyMonkey Eric V’s (May Mail2017)  Eliminate survey fatigue: Fix 3 things your respondents hate 

For more info: Check out my earlier post “Please Answer!”

Missing in Action: The Pyramid foundation

Last post I commented on the potentially misleading terms of Filtered & Unfiltered Filtered Unfiltered jpgresearch.  My key point?  Much so-called “unfiltered research” has been screened (filtered) carefully through peer-review before publication; while some “filtered research”  may have been ‘filtered’ only by a single expert & be out of date. If we use the terms filtered and unfiltered we should not be naive about their meanings. (Pyramid source:  Wikimedia Commons )

This week, I address what I see as a 2nd problem with this evidence based medicine pyramid.  That is, missing in action from it are descriptive, correlation, & in-depth qualitative research are not mentioned.  Where are they?  This undercuts the EBM pyramid as a teaching tool and also (intentionally or not) denigrates the necessary basic type of research on which stronger levels of evidence are built.  That foundation of the pyramid, called loosely “background information,” includes such basic, essential research.

Ask an ExpertYou may have heard of Benner’s Novice to Expert  theory.  Benner used in-depth, qualitative interview descriptions as data to generate her theory.  Yet that type of research evidence is missing from medicine’s pyramid!  Without a clear foundation the pyramid will just topple over.  Better be clear!

I recommend substituting (or at least adding to your repertoire) an Evidence Based NURSING (EBN) pyramid.  Several versions exist & one is below that includes some of the previously missing research!  This one includes EBP & QI projects, too! Notice the explicit addition of detail to the below pyramid as described at https://www.youtube.com/watch?v=MfRbuzzKjcM.EBN

Critical thinking:  #1List some EBM & EBN pyramid differences.  #2 Figure out where on the hierarchy this project would go: Crowell, J., OʼNeil, K., & Drager, L. (2017). Project HANDS: A bundled approach to increase short peripheral catheter dwell time. Journal of Infusion Nursing, 40(5), 274-280. doi: 10.1097/NAN.0000000000000237.   1st use medicine’s EBM pyramid; & then 2nd use nursing’s EBN pyramid.  #3 Label Crowell et al.’s study as filtered or unfiltered and explain what you mean by that.

For more info:  Watch the YouTube video at the link above.

33,000 foot view isn’t enough! Get down on the Ground To See What’s Really Happening!

My last blog post listed the usual sections of a research report (title, abstract, introduction, methods, results, & discussion/conclusion); and I illustrated the amazing things you can learn from only an article title!Its not enough

This week? Abstracts.   Abstracts are great; abstracts are not enough!

An abstract gives us only enough info to INaccurately apply the study findings to practice.

An abstract typically summarizes all the other sections of the article, such as  the question the researcher wanted to answer, how the researcher collected data to answer it, and what that data showed.  This is great when you are trying to get the general picture, but you should Never assume that the abstract tells you what you need to know.

Wrong WayAbstracts can mislead you IF you do not read the rest of the article.  They are only a short 100-200 words and so they leave out key information.   You may misunderstand study results if you read only the abstract.   An abstract’s 33,000 foot level description of a study, cannot reveal the same things that can be revealed in the up-close & personal description of the full article.

So…what is the takeaway?  Definitely read the abstract to get the general idea.  Then read the full article beginning to end to get the full & beautiful picture of the study.  Davies & Logan (2012) Butterflyencourage us,  Don’t give up reading the full article just because some parts of the study may be hard to understand.  Just read and get what you can, then re-read the difficult-to-understand parts.  Get some help with those PRN.

 

Critical thinking:   What info is missing from the below abstract that you might want to know?

J Nurses Prof Dev. 2016 May-Jun;32(3):130-6. doi: 10.1097/NND.0000000000000227.    Partnering to Promote Evidence-Based Practice in a Community Hospital: Implications for Nursing Professional Development Specialists. Highfield ME1, Collier A, Collins M, Crowley M.

ABSTRACT: Nursing professional development specialists working in community hospitals face significant barriers to evidence-based practice that academic medical centers do not. This article describes 7 years of a multifaceted, service academic partnership in a large, urban, community hospital. The partnership has strengthened the nursing professional development role in promoting evidence-based practice across the scope of practice and serves as a model for others.

More info on abstracts & other components of research articles?  Check out Davies & Logan (2012) Reading Research published by Elsevier.

Nightingale: Avante garde in meaningful data

In honor of Nurse Week, I offer this tribute to the avante garde research work of Florence Nightingale in the Crimea that saved lives and set a precedent worth following.

Nightingale was a “passionate statistician” knowing that outcome data are convincing when one wants to change the world.  She did not merely collect the data, but also documented it in a way that revealed its critical meaning for care.

As noted by John H. Lienhard (1998-2002): Nightingale coxcombchart“Once you see Nightingale’s graph, the terrible picture is clear. The Russians were a minor enemy. The real enemies were cholera, typhus, and dysentery. Once the military looked at that eloquent graph, the modern army hospital system was inevitable.  You and I are shown graphs every day. Some are honest; many are misleading….So you and I could use a Florence Nightingale today, as we drown in more undifferentiated data than anyone could’ve imagined during the Crimean War.” (Source: Leinhard, 1998-2002)

As McDonald (2001) writes in the BMJ free, full-text,  Nightingale was “a systemic thinker and a “passionate statistician.”  She insisted on improving care by making policy & care decisions based on “the best available government statistics and expertise, and the collection of new material where the existing stock was inadequate.”(p.68)

Moreover, her display of the data brought its message home through visual clarity!

Thus while Nightingale adhered to some well-accepted, but mistaken, scientific theories of the time (e.g., miasma) her work was superb and scientific in the best sense of the word.   We could all learn from Florence.

CRITICAL THINKING:   What issue in your own practice could be solved by more data?  How could you collect that data?   If you have data already, how can you display it so that it it meaningful to others and “brings the point home”?

FOR MORE INFO:

HAPPY NURSE WEEK TO ALL MY COLLEAGUES.  

MAY YOU GO WHERE THE DATA TAKES YOU!

 

 

So you want to do a research study…..

So you want to do a research study?   Wonderful!

Here are 5  bits of advice to get started:

  1. If you haven’t done a scientific research study before or don’t have a PhD, then realize that your project will go much more smoothly if you consult with a PhD or someone with experience.

You bring the great clinical ideas, & the experienced researcher will bring research design expertise.  The design is the overall research plan for getting and analyzing the data to answer your question or to find out how well your new ideas work.  That person resiliencewill know the technical things you need to plan into your study in order to make the study ‘sparkle’ and to get approval from human subjects review committees.  The person doesn’t have to be an expert on your topic.  You fill that role, or soon will!

  1. If you have access to a librarian who is good at helping you look for current literature, s/he is one of your Best friends in getting a project done.

Searching for on-target literature from the millions of publications out there takes some special skills.  Of course you can learn these on your own, but how much nicer to talk with a librarian about the key ideas in your project and allow them to use their special skills to help you.  As an experience researcher, I can tell you that good Heart Bookslibrarians are worth their weight in gold!  Librarians can help you find what others have learned about your topic already, and then you can build on that knowledge.  [note: check out Finding the Needles in the Haystacks: Evidence Hunting Efficiently & Effectively for more]

  1. Because it’s your first foray into research, you might want to stick with a descriptive study.

What does that mean?  It means that you will collect data about what the current situation is.  For example, you might measure the average days to return of bowels sounds on your unit, OR the number of minutes it takes to do some task, OR the interruptions of patient sleep during the night.  describeThis will help you to establish whether or not there really is a problem to be solved.  Descriptive studies are much simpler to conduct and analyze than experimental studies in which you measure something, make an improvement, and then see if the improvement improved things. For example, you would measure sleep interruptions, institute a quiet time, and then measure sleep interruptions again to see if there were fewer.  [check out “What it is.” – a primer on descriptive studies for more]

  1. Pick a topic you are really jazzed about!

jazzEvery researcher from time to time can feel ‘bogged down’ or bored with what they are doing, & one of the best protections against that is making sure you think the topic is super-interesting in the first place.  If you get a little bored or stuck later don’t be surprised; it just means you’re pretty normal.  Those stuck times might even feel like “hitting the wall” in a long race, and once you get past it things get better.   Remind yourself why you loved the topic in the first place.  Talk to your PhD friend or a mentor for encouragement.  Take a little break.  Read something really interesting about your topic.

  1. Have fun!

While not every step of the research study process will make you want to jump up, sing, and dance, the process as a whole is really rewarding and great fun.  You will be empowered by new learning—not just about your topic, but about how to do research!

Critical thinking:  What’s a topic of interest to YOU?   Write a descriptive question that you could answer with research.  (Check out You Got A Problem With That? Try PICO*for more help.)

“Here Comes Santa Claus?” What IS the Evidence?

How strong is the evidence regarding our holiday Santa Claus (SC) practices? And what are the opportunities on this SC topic for new descriptive, correlation, or experimental research?  Although existing evidence generally supports SC, in the end we may conclude, “the most real things in the world are those that neither children nor men can see” (Church, as cited in Newseum, n.d.).santa3

If you want to know the answers, check out: Highfield, M.E.F. (2011).  Here comes Santa Claus: What’s the evidence? Advanced Emergency Nursing Journal, 33(4), 354-6. doi: http://dx.doi.org.libproxy.csun.edu/10.1097/TME.0b013e318234ead3   Using bona fide published work, the article shows you how to evaluate the strength of evidence and how to apply it to practice.   You can request a full-text for your personal use from your library or from the author via www.researchgate.net/home .  

Critical thinking: Check out this related research study with fulltext available through PubMed: Black Pete through the eyes of Dutch children
(https://www.ncbi.nlm.nih.gov/pubmed/27322583 ).   Write a follow-up research question based on the findings of this study & post in comments below.

For more info: For those unfamiliar with ResearchGate, it is a site where you can track authors who publish in your area of interest, and you can set up your own profile so that people can track your work.  Take a look.