Mary a nursing college student does not understand why she had to take a research class when all she wanted to do was be a staff nurse in a critical care unit. Research? Evidence-based practice? Why are these topics in the nursing program? She thought. She has enough to do just learning all the content in her clinical courses. She wondered what research and evidence have to do with developing her nursing abilities? She trusts the faculty, the textbooks, and clinical experience to prepare her for nursing. She is already getting what she needs to know. That was Mary’s earlier attitude. Now Mary is practicing, She has a new appreciation for nursing research and the evidence it provides for application to practice. She has an entirely different way of addressing clinical questions. She is starting to ask questions about how she can improve the care she gives to patients and how she can be involved in her workplace’s efforts to improve care for the patients it serves. She has discovered by purposeful reading in her practice area that research reports and research summaries contain many implications that apply to practice in the critical care unit. After practicing for a while Mary went back to school for her masters and PHD degree. Upon completion Mary is now working as a clinical research nurse (CNR) in a medical center. Mary now a CNR in a medical center asks the staff nurses on a pediatric oncology unit to identify patient care problems that need to be investigated. The nurses identify pain control as a major problem for the children admitted to the unit. In talking with the nurses on the unit, Mary discovers that the nurses routinely use physiologic measures, such as heart rate and blood pressure, as indicators of pain. Occasionally the nurses rely on parents’ reports, but rarely do they consult the child. Mary conducts a review of the literature to determine proven ways to assess pain in children. In the Western Journal of Nursing Research, Mary discovers a meta-analysis of pediatric pain assessment techniques. Findings from this study indicate that self-report tools are appropriate for most children 4 years and older and provide the most accurate measure of children’s pain. Mary discovers a pediatric pain interview tool in the literature that she thinks would be practical and feasible for use on the unit. She then writes a utilization memo to the nurse manager citing the problem (inadequate pain control), the research findings documented in the literature, and a suggestion for change in practice (use of the self-report pain assessment) on the pediatric oncology unit. Next Mary organizes a meeting with the nurses to discuss conducting a pilot study on the unit for the purpose of comparing the effectiveness of the pediatric pain assessment interview tool and their usual procedures for assessing pain in the pediatric oncology patients. Findings from this study are incorporated into practice by documenting the preferred method of pain assessment in the unit’s protocol. The change instituted by the pediatric oncology unit is cited in the medical center’s accreditation report as an example of how the medical center is meeting standards of care in pain management. Questions1. How can faculty encourage BSN students to read research journals and to consider being a CNR in the future?
2. How can nurses motivate and encourage colleagues to base their practice on research? 3. What are some of the challenges that nurses in research face?
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