By Susan Kreimer, MS, contributor
March 10, 2010 - From pediatrics to geriatrics, nursing researchers explore some of the most important issues affecting our health. Their findings may lead to major changes in clinical practice, elevating patient care at the bedside and beyond.
While medicine may discover "a magic pill," nursing science guides patients and caregivers in how to take it for the best outcome, said Margaret Grey, DrPH, RN, FAAN, dean and Annie Goodrich Professor at Yale University School of Nursing.
"For the most part, our science deals with caring rather than curing," she said. "We help individuals, families and communities promote health, prevent disease and manage chronic conditions."
The translation of study results into practice takes time. Clinical studies often test an ideal application, and further evaluation is usually necessary to expand it to real situations. "Changing notions about practice that are dearly held is as difficult in nursing as in other fields," Grey said.
Nonetheless, nursing researchers are hard at work in many clinical centers across the country, designing and carrying out initiatives with the scientific method in mind.
Uncovering new evidence or refining established knowledge can improve the quality of care, increase safety, enhance patient satisfaction and decrease cost, said Dorothy A. Jones, EdD, RN, FAAN, director of the Yvonne L. Munn Center for Nursing Research at Massachusetts General Hospital and a professor of nursing at Boston College.
A doctoral degree is typically required for a nurse to serve as principal or co-investigator of a study, and to qualify for funding from the National Institutes of Health or other sponsoring agencies. Nurses with master’s degrees often assist as study coordinators and research assistants.
Meanwhile, all registered nurses can benefit by applying research findings in clinical practice, said Gail L. Ingersoll, EdD, RN, FAAN, director of the Clinical Nursing Research Center at University of Rochester Medical Center in Rochester, N.Y.
To pursue a doctoral degree, it’s wise to consider nursing schools with faculty members who are actively engaged in intensive research.
"They are the best mentors," said Adey Nyamathi, Ph.D., ANP, FAAN, associate dean for international research and scholarly activities at the UCLA School of Nursing. In 2009, the school was approved to receive nearly $18 million in nursing research grants for initiatives such as HIV prevention among paroles and the homeless.
At Mayo Clinic in Rochester, Minn., funding from the King Hussein Scholars (KHS) Program has provided research training opportunities for Mayo nurses enrolled in Ph.D. programs at affiliated universities since 1999.
"We gradually have built a cadre of doctorally-prepared nurses," said Sharon J. Tucker, Ph.D., RN, Mayo’s administrator of nursing research and evidence-based practice.
One of the KHS Program scholars, Diane E. Holland, Ph.D., RN, developed a screening method for discharge-planning decisions, which identifies patients at higher risk for problems. A number of variables assessed early in the hospitalization result in an automated score that targets interventions.
"We’re strategically going to further look at what they need when they’re discharged," Tucker said. Fostering a continuum of care, the objective is "to help them in their recovery journey and to keep them out of the hospital."
At least two East Coast medical centers are testing the application to see if it will meet their needs, Tucker said. A study involving multiple U.S. hospitals is also in the planning stages.
In her own research, Tucker has partnered with physicians and nurses who are tracking children’s body-mass index during well-care visits. They are studying the effects of a six-month healthy habits intervention--delivered through onsite and phone-based nurse counseling sessions--to those with a BMI in the 85th to 95th percentile of the overweight category.
Based on preliminary results, "it looks very promising," she said. "Conversations with well-child care staff indicate that the probability of rolling this out as a standard of practice is high."
There are fewer large-scale investigations involving children, but studies are definitely underway, said Sharon Barton, Ph.D., RN, PCNS-BC, a pediatric clinical nurse specialist who directs nursing research and evidence-based practice at Children’s Hospital of Philadelphia.
"Neonatal intensive care is a very productive area," she said. Researchers examine how to better position tiny babies in an isolette - and how lighting, sound and touch may affect their development.
Researchers also know that children experience pain differently than adults and have developed responsive methods to assess and manage it. Blowing bubbles and listening to music may decrease pain and reduce reliance on pain medicine, Barton said.
"Nursing research is really moving into using knowledge and science to change care," she said. "That’s something I say all the time, and I see it happening."
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