Chapter 1

Chapter 1
Integrating Research,
Evidence-Based Practice, and
Quality Improvement Processes
Copyright 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc.
What Is Nursing Research?
Research is the systematic, rigorous, critical

investigation that aims to answer questions about
nursing phenomena.
Researchers follow the steps of the scientific
process.
There are two types of research quantitative
and qualitative.
The methods used by nurse researchers are the
same methods used by other disciplines; the
difference is that nurses study questions relevant
to nursing practice.
Copyright 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc. 2
Research vs.
Evidence-Based Practice
Research is systematic, rigorous, logical
investigation that aims to answer questions
about nursing phenomena.
Evidence-based practice is the collection,
interpretation, and integration of valid
research evidence, combined with clinical
expertise and an understanding of patient and
family values and preferences to inform
clinical decision making.
Quality Improvement
QI is the systematic use of data to monitor the

outcomes of care processes as well as the
use of improvement methods to design and
test changes in practice, the aim of which is to
continuously improve the quality and safety of
health care systems.
Nurse as
Knowledgeable Consumer
Nurses must be knowledgeable consumers of
research and should be able to appraise
research evidence and use existing
standards to determine the merit and
readiness of research for use in clinical
practice.
Types of Nursing Research
Qualitative Quantitative
Seeks to understand Seeks to test
the meaning of relationships or
answer a question
human experience
Explains cause-and-
Usually conducted in
effect relationships
natural settings
Seeks to DESCRIBE
Seeks to DESCRIBE phenomena
experiences Objectivity is
Subjective approach important
Theory generating Theory testing
Critical Reading
A critical reader actively looks for

assumptions, key concepts and ideas,
reasons, justifications, supporting examples,
implications and consequences, and any
other structural features of the written text, to
interpret and assess it accurately and fairly.
Critical Reading Strategies
What Is a Research Critique?
A research critique is the process of critical

appraisal that objectively and critically
evaluates a research reports content for
scientific merit and application to practice.
A research critique requires some knowledge
of the subject matter and knowledge of how
to critically read and use critiquing criteria.
Evidence-Based Practice and
Research
Evidence-based practice allows one to
systematically use the best available
evidence from research with the integration of
individual clinical expertise, as well as the
patients values and preferences, to make
clinical decisions.
Levels of Evidence: Study Design
Grading the Strength of a Body of
Evidence
Quality: the extent to which a studys design,
implementation, and analysis minimizes bias
Quantity: the number of studies that have
evaluated the research question, including
overall sample size across studies, as well as the
strength of the findings from data analyses
Consistency: the degree to which other studies,
with similar or different designs, investigating the
same research question report similar findings
Research Articles: Format and Style
Abstract
Introduction
Definition of purpose
Literature review and theoretical framework
Hypothesis/research question
Research design
Sampling
Research Articles: Format and Style
Reliability and validity

Procedures and data collection measures
Data analysis results
Discussion
Recommendations and implications
References
Communicating results
Types of Journal Articles
Research: qualitative, quantitative, or mixed

Systematic review: summation and assessment
of a group of research studies that test a similar
research question. If statistical techniques are
used to summarize and assess the studies, the
systematic review is labeled meta-analysis.
Meta-analysis: summary of a number of studies
focused on a question/topic using a specific
statistical methodology to synthesize the findings
in order to draw conclusions about the area of
focus
Types of Journal Articles
Integrative review: a focused review and

synthesis of either research or theoretical
literature on a particular area that follows
specific steps of literature integration and
synthesis without statistical analysis and can
include both quantitative and qualitative
articles.
Meta-synthesis and meta-summary: synthesis
of a number of qualitative research studies on
a focused topic using specific qualitative
methodology
Clinical Guidelines
Consensus or expert-based guidelines are

developed by expert panels.
Evidence-based guidelines are those
developed using research findings.
Guidelines have been developed to assist in
bridging practice and research. Guidelines
provide clinicians with an algorithm for clinical
management, or decision making, for specific
diseases (e.g., colon cancer) or treatments
(e.g., pain management).
Quality Improvement
Conducting an assessment
Setting specific goals for improvement
Identifying ideas for changing current practice
Deciding how improvements in care will be
measured
Rapidly testing practice changes
Measuring improvements in care
Adopting the practice change as a new
standard of care
Critical reading requires four stages
of understanding. What is the last
stage?
A. Analysis
B. Preliminary (skimming)
C. Synthesis
D. Comprehensive
What is the most common first step
in the quality improvement process?
A. Deciding how improvements will be

measured
B. Adopting the practice change as a new
standard of care
C. Conducting an assessment
D. Measuring improvements in care
What is an assessment of a group of
research studies that test a similar
research question?
A. Systematic review
B. Meta-analysis
C. Integrative review
D. Meta-synthesis

Chapter 1 - Intergrating Research EBP and Quality Mprovement

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Chapter 1 - Intergrating Research EBP and Quality Mprovement

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Research is the systematic, rigorous, critical

QI is the systematic use of data to monitor the

A critical reader actively looks for

A research critique is the process of critical

Reliability and validity

Research: qualitative, quantitative, or mixed

Integrative review: a focused review and

Consensus or expert-based guidelines are

A. Deciding how improvements will be

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