Kozier & Erb's
Fundamentals of Nursing
Concepts, Process, and
Practice
Eleventh Edition
Chapter 2
Evidence-Based
Practice and Research
in Nursing
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Learning Outcomes (1 of 2)
2.1 Explain the relationship between research and evidence-based nursing practice.
2.2 Apply the steps of change used in implementing evidence-based practice.
2.3 Describe limitations in relying on research as the primary source of evidence for
practice.
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Learning Outcomes (2 of 2)
2.4 Differentiate the quantitative approach from the qualitative approach in nursing
research.
2.5 Outline the steps of the research process.
2.6 Describe research-related roles and responsibilities for nurses.
2.7 Describe the nurse's role in protecting the rights of human participants in research.
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Evidence-Based Practice
Evidence-Based Practice (EBP) in Nursing is the process of using the best available
research, clinical expertise, and patient preferences to guide nursing care and decision-making. It
ensures that nurses provide the most effective care to improve patient outcomes.
• Seven steps of evidence-based practice (EBP)
⚬ Cultivate a spirit of inquiry.
⚬ Ask clinical questions.
⚬ Search for the best evidence.
⚬ Critically appraise evidence.
⚬ Integrate the evidence with clinical expertise and client/family preferences and values.
⚬ Implement and evaluate outcomes of the intervention.
⚬ Disseminate the outcomes.
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Evidence-Based Practice
• Importance of EBP in Nursing:
⚬ Improves Patient Outcomes: Ensures care is based on proven methods, leading
to better health results.
⚬ Enhances Safety: Reduces the chances of errors by following established protocols
and guidelines.
⚬ Promotes Efficiency: Saves time and resources by avoiding outdated or ineffective
practices.
⚬ Encourages Lifelong Learning: Nurses stay informed about new research and
advancements in healthcare.
⚬ Boosts Professionalism: Demonstrates that nursing care is rooted in science and
critical thinking.
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Evidence-Based Practice
• Research
⚬ Formal and systematic process of inquiry to address problems or develop knowledge
about issues of importance to the nursing profession.
• Concerns of reliance on research
⚬ Controlled circumstances different from real world of health care delivery
⚬ One-size-fits-all solution
⚬ May ignore significance of life events to individual
⚬ Not all research robust and flawless
⚬ EBP should promote cost-effective care, but this is often not included in traditional
studies.
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Nursing
Research
Nursing research is a systematic process of studying and investigating issues related to
health, illness, and nursing practice to develop new knowledge and improve patient care. It
involves gathering evidence through observations, experiments, and analysis to answer specific
questions or solve problems in nursing.
• Accrediting organizations require all baccalaureate and higher programs to include
research and EBP.
• Journal Nursing Research
⚬ First published in 1952
⚬ Vehicle for communicating findings
• National Institute of Nursing Research (NINR)
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Approaches to Nursing
Research
• Quantitative Research
⚬ Systematic collection
⚬ Statistical analysis (focuses on numerical data/measurable outcomes)
⚬ Utilizes deductive reasoning (general to specific)
⚬ Objective data measurement
⚬ Large sample size
￭ e.g. Measuring the effectiveness of a new drug
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Approaches to Nursing
Research
• Qualitative Research
⚬ Systematic collection
⚬ Thematic analysis of narrative data
⚬ Explores human experiences, feelings, and perspectives
⚬ Utilizes inductive reasoning (specific to general)
⚬ Reality is relative
⚬ Subjective data measurement
⚬ Sample size: until saturation point is satisfied
￭ e.g., The lived experiences of cancer patients throughout their chemotherapy.
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Approaches to Nursing
Research
Qualitative Research
￭ Phenomenology
• Expoloers the respondents’ lived experiences to understand how they perceive
and make sense of their experiences.
⚬ e.g., Exploring what it feels like to be a patient living with chronic pain.
￭ Ethnography
• Studies cultural patterns of thoughts, and social interactions within specific
groups to understand how culture shapes people's actions and beliefs.
⚬ e.g., Observing how nurses in a busy emergency room communicate during
a crisis.
￭ Grounded theory
• It is a research method concerned with the generation of a theory based on data
collected from participants.
⚬ e.g., Studying how patients heal with a clean environment vs a dirty
environment.
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Approaches to Nursing
Research
Qualitative Research
￭ Case Study
• Studies a specific individual, event, or situation in-depth to gain a deep
understanding of a unique case to draw insights.
⚬ e.g., Studying an HIV patient who have been cured via bone marrow
transplant.
￭ Action Research
• A problem-solving method in a specific setting through collaboration to address
an issue while involving participants in creating solutions.
⚬ e.g., Working with a community to improve healthcare practices and
knowledge in a rural place.
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Overview of Research
Process
Research process
The research process is the series of steps taken to conduct a study and find answers to specific
questions or problems. Think of it as a roadmap to gather and analyze information in a structured way.
• Formulating the Research Problem and
Purpose
⚬ Narrow into specific problem significant to
nursing
￭ Must be feasible to study with resources
⚬ Purpose of study
⚬ PICO format -D, -S, or -T can be added.
⚬ Dependent variable
⚬ Independent variable
⚬ Hypothesis - creating a goal or statement that
guides your study. (prediction) Example: "What is the effect of stress on
nursing students' academic performance?"
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Overview of Research
Process
Review of Related Literature
• Check what is already known about the topic by reading relevant existing studies and
articles. It helps avoid repeating studies and identifies gaps in knowledge.
Research Design
• It is a strategy for answering your research question using empirical data.
Experimental/Non-experimental
⚬ Descriptive, Correlational, Causal-Comparative, Quasi-Experimental
Target population
• the group of individuals that the intervention intends to conduct research in
Sample
• The number of target population that has been selected to be respondents of the research
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Overview of Research
Process
Collecting Research Data
• Protocols
⚬ Surveys, questionnaires, observations, focus group discussions, interviews, etc.
• Reliability
⚬ Refers to whether research methods can reproduce the same results consistently.
• Validity
⚬ Refers to whether a test measures what it aims to measure.
• Authenticity
⚬ implies that the conduct and evaluation of research are genuine and credible
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Overview of Research
Process
Collecting Research Data
• Objectivity
⚬ refers to proceeding of a test without being influenced by any bias or personal opinions.
• Specificity
⚬ refers to a test’s ability to designate an individual who does not have a trait as negative.
• Sensitivity
⚬ refers to a test's ability to designate an individual with a trait as positive.
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Overview of Research
Process
• Analyzing Data
⚬ Descriptive statistics
⚬ Measures of central tendency
⚬ Measures of variability
⚬ Inferential statistics
⚬ Statistically significant result
⚬ Content analysis
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Overview of Research
Process
• Communicating Research Findings
⚬ Must be made public
⚬ Publication in journals, conferences
⚬ Small-scale projects
• Using Research Findings in Practice
⚬ Scientific validation
⚬ Comparative analysis
⚬ Cost–benefit analysis
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Research-Related Roles and Responsibilities for
Nurses
• Research Consumer
⚬ Locating Research Literatures
￭ Most conducted through key terms
￭ Cumulated Index in Nursing and Allied Health Literature (CINAHL)
is the most comprehensive nursing research database.
￭ Move toward open-access from fee based
⚬ Critiquing Research Reports
￭ Reading and evaluating articles
￭ Allows nurse to determine whether findings are of sufficient quality
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Research-Related Roles and Responsibilities for
Nurses
• Research Consumer
⚬ Writing a Review of the Literature
￭ Length depends on purpose.
￭ Introductions includes issue and method of obtaining document(s).
￭ Main section includes critique.
￭ Conclusion summarizes findings, identifies gaps, and provides direction for further
research.
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Research-Related Roles and Responsibilities for
Nurses
• Research Team Member
￭ Important in hospitals seeking magnet recognition status
￭ Working directly with clients can allow valuable contribution to research.
￭ Historical instances of failure to advocate for ethical treatment of clients in conduct of
research.
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Research-Related Roles and Responsibilities for
Nurses
• Research Team Member
⚬ Protecting the Rights of Study Participants
￭ Right not to be harmed
￭ Right to full disclosure
￭ Right to self-determination
￭ Right to privacy
￭ Confidentiality
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