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Engaging nurses in scholarly work

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By: Besa Rocel, PhD, RN, CV-BC, NPD-BC, CNE, CPPS, and Dawn Williams, MSN, RN, CV-BC
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Motivate nurses by making the connection to patient care.

Takeaways:

  • The American Nurses Association Code of Ethics for Nurses with Interpretive Statements identifies engaging in scholarly inquiry to advance the nursing profession and practice as every nurse’s ethical and professional responsibility.
  • Engaging nurses in scholarly work requires helping them understand its value and how research findings can ensure that their current practice reflects the best and most current approach to safe patient care.
  • Equipping nurses with the knowledge and skills to conduct scholarly work requires understanding their varying levels of education, exposure, and experience.

The American Nurses Association (ANA) Code of Ethics for Nurses with Interpretive Statements identifies engaging in scholarly inquiry to advance the nursing profession and practice as every nurse’s ethical and professional responsibility. Provision 7 states, “The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.” ANA further emphasizes incorporating evidence-based practice, which requires reviewing, assessing, and implementing recent research rather than relying on traditional methods, advice from colleagues, or personal beliefs.

When nurses engage in scholarly work, they can identify more efficient and effective patient care options, address practice gaps, and influence patient outcomes and experiences. The mission and strategic priorities of the American Nurses Credentialing Center’s Research Council include shaping the future of nursing and healthcare by building the capacity for a culture of inquiry to advance interprofessional, practice-based research.

As the largest segment of the healthcare workforce on the frontlines of patient care in various settings, nurses can influence positive change that impacts patient outcomes and the practice environment. Based in this premise, the Institute of Medicine’s 2010 The Future of Nursing Leading Change, Advancing Health identified nurses as the driving force to help realize the objectives set forth in the 2010 Affordable Care Act. The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity also identifies nurses as key players in achieving this vision.

Nursing’s challenge

Getting nurses involved in scholarly work and incorporating evidence-based principles and findings into daily practice present two key challenges: achieving nurse buy-in and equipping them with the knowledge and skills to conduct scholarly work. Nurses’ work hours typically are consumed by direct patient care, coordination, teaching, and documentation. To get their buy-in, nurses must understand the value of scholarly work and how research findings can help ensure that their current practice reflects the best and most current approach to safe patient care.

Establishing this connection engages nurses and helps them see the worth of scholarly work. ANA’s Commission on Nursing Research mapped out this connection, stating that nursing research aims to develop knowledge about health and the promotion of health over the full lifespan, care of patients with health conditions and disabilities, and actions to enhance the ability of individuals to respond effectively to actual or potential health concerns.

The Magnet Recognition Program®, considered the gold standard and a road map for nursing excellence, also provides an avenue for helping nurses realize the connection between scholarly work, nursing practice, and patient outcomes. The program emphasizes promoting quality in a setting that supports professional practice, identifying excellence in nursing care, and disseminating nursing best practices. Its core concepts highlight the empowerment of nurses’ voices and influence over anything that impacts their practice, including patient outcomes and the practice environment. The fourth component of the Magnet model—New Knowledge, Innovations, and Improvements—encourages organizations to support nurses’ pursuit of scholarly work by providing education and resources, encouraging participation in research projects, and incorporating evidence-based practice into their workflows.

Gallagher stated that research findings can provide nurses with the foundation of daily patient care. Everyday practice questions (“Why do we change central line dressings every day and not every 72 hours?”) and concerns (“Why do patients continue to develop infection when we follow strict aseptic technique?”) are at the heart of research. Altman described research as demonstrating nursing’s contribution to health and wellness, answering questions about nursing practice, and confirming nurses’ knowledge.

Equipping nurses with the knowledge and skills to conduct scholarly work requires understanding their varying levels of education, exposure, and experience. For most nurses, their involvement in research is limited to nursing school and satisfying degree requirements. In addition, many nurses believe that scholarly work is difficult, which makes the process intimidating for some. Altman identified nurses’ common perceptions about nursing research, which includes lack of time and the belief that the work is boring or too complicated. For nurses to acquire the knowledge and skills necessary for scholarly work, they require education and support that will help break down the concepts into an easy-to-follow process. (See Practical tips.)

Practical tips

Gallagher offers several practical tips to help engage nurses in scholarly work, including the following:

  • Participate in a research journal committee.
  • Provide nursing education that emphasizes evidence-based nursing practice.
  • Attend research presentations.
  • Assist with the collection of research data.
  • Offer continuing education related to the nursing research process and integrate research findings into practice.

Incorporating nursing research into the RN job description also may contribute to increasing nurse inquiry and interest.

Chipps and colleagues offer a simplified step-by-step guide to conducting a research study on a clinical nursing unit, which includes the following:

  • Identify a clinical question.
  • Conduct a literature review.
  • Identify administrative support by reviewing the organization’s strategic plan, organizational chart, and policies/procedures regarding research in the clinical setting.
  • Review potential study settings/nursing units and target participants.
  • Form the research team.
  • Write and present the research proposal.
  • Once approved, conduct the study (including data collection and analysis).
  • Disseminate research findings and their implications for nursing and healthcare in general.

One organization’s journey

With the support of the chief nursing officer (CNO), our organization established a scholarly work committee. Initially, the committee members comprised three nursing directors and the Magnet program director. They began by brainstorming how to advance the committee, create a structure, and recruit members. Next, they developed the committee’s goals, objectives, and guidelines, which they presented to nursing leaders and at council meetings. The presentation, which received a lot of interest, led to the recruitment of six nurse managers and five clinical nurses.

The first committee meeting focused on gathering member input on barriers to engaging in scholarly work. The identified barriers included lack of knowledge related to conducting research, performing literature searches, following the institutional research board (IRB) process, and preparing abstracts for presentation and publication.

The committee members also identified fear of writing as a challenge. This finding led to further discussion among published peers. The nurses found comfort in knowing that even those who’ve published multiple articles also initially feared writing.

These open discussions helped alleviate some of the participant’s trepidation. The group felt they were on this journey together and leaned on each other for support as they moved forward.

Based on their discussions, the committee implemented three strategies to overcome barriers to nursing research: address knowledge, support, and infrastructure needs; provide organizational assistance; and engage nurses through recognition and dissemination.

Knowledge, support, and infrastructure needs

Our organization has a center that promotes nursing and allied health excellence via education and research. A pool doctorally prepared nurse scientists offers educational counseling and enrichment programs to help promote evidence-based practice as well as coordinate and conduct research. Biostatisticians help with data collation and statistical analysis. A hospital-based nursing research council (NRC) serves as a forum for presenting research proposals for review and endorsement to the IRB for final approval. Three council members (a nurse scientist and two nurses) review projects to help strengthen the research protocol and ensure that all IRB requirements are met. This assistance makes the IRB and approval process less intimidating, shortens the review timeline, and prevents multiple resubmissions. In addition, the New Knowledge & Innovation Council, composed of hospital-based NRC chairs and the nurse scientists, also serves as a resource for nurses pursuing research and scholarly work.

To address the need for resources and infrastructure, the scholarly work committee chairs contacted nurse scientists to plan education and training; the nurse scientists served as speakers. (See Scholarly work education.)

Scholarly work education

Our scholarly work committee offers education as a workshop to aid audience participation and engagement. The speaker (typically a nurse scientist) describes the steps involved in research, starting with asking and forming clinical questions. They use examples to help participants understand how to apply the concepts. In addition, the librarian explains how to conduct literature reviews and searches using the organization’s library services and resources.

In the first session, the speaker describes the internal review board (IRB) research protocol and requirements. This includes discussion of application templates, electronic application submission, other required documents (license verification, signed and dated resume, intellectual property forms, conflict-of-interest forms), and completing Collaborative Institutional Training Initiative (CITI) modules. The CITI Program serves the training needs of colleges and universities, healthcare institutions, technology and research organizations, and governmental agencies as they foster learners’ integrity and professional advancement.

The speaker also explains the process of presenting a research proposal to the nursing research council (NRC). They highlight the value of getting feedback from NRC members to enrich the study and ensure it meets IRB requirements.

In addition to education about conducting research studies, the session also addresses quality-improvement knowledge. Participants receive unit metric graphs, which guide them through the Plan-Do-Check-Act steps.

The second session focuses on preparing abstracts for conference presentations, using available poster templates, and publishing steps (for example, writing a query letter, citing references, making revisions, following author guidelines, and submitting for open access publication).

Suggested educational topics
The following topics can aid nurse education related to scholarly work:

Organizational assistance

Most nurses list time as a top challenge to scholarly work. With the CNO’s support, nurses in our organization who engage in scholarly work receive compensation for the time spent on any related activities, including conducting a literature review, writing the proposal, collecting data, attending committee meetings, and completing Collaborative Institutional Training Initiative (CITI) modules. Nurses also receive support to attend conferences for poster or podium presentations, including expenses for printing posters and handouts, transportation, hotels, conference registration fees, and meals.

Recognition and dissemination

To celebrate completed scholarly work, organization and network newsletters feature podium talks, poster presentations, and publications. In addition, a 65-inch TV near the hospital’s entrance displays a slideshow of all the organization’s research. Scholarly work also is shared in leadership and council meetings and highlighted at several research conferences within our network. This recognition and dissemination has generated additional nurse interest and engagement, which has led to the recruitment of five more clinical nurses who completed their CITI training and started attending NRC meetings.

Outcomes and next steps

Our journey began near the end of 2022. By the end of the year, the organization had nine poster presentations at local, national, and international conferences and two articles submitted to peer-reviewed journals for publication. By mid-2023, the organization exceeded the total completed in 2022 with 12 presentations, eight published articles in peer-reviewed journals, and three articles currently undergoing peer review.

With the support of our CNO, we propose allocating a dedicated budget for scholarly work. We created a flyer with a QR code and link for nurses to share their project ideas. Based on the topic or specialty, we refer the project to a nurse scientist who will contact the nurse to help develop the idea.

We also plan to expand our organization’s infrastructure by using the scholarly work committee as a forum to brainstorm ideas and projects. It will be open to any nurse with clinical questions they’d like to explore. The committee might refer the nurse to a nurse scientist or subject matter expert to identify variables and determine how the idea should be developed or to the librarian to help facilitate a literature review. Regardless of the next step, the committee intends to ignite and sustain our nurses’ spirit of inquiry so they can contribute to the body of knowledge that advances nursing excellence and patient outcomes.

Make the connection, provide the support

Engaging in scholarly work may be a nursing ethical and professional responsibility, but making the connection with positive patient care outcomes may prove a stronger motivation for nurse participation. Combining this intention with resources and organizational support and guidance helps to create a culture where scholarly work is an inherent part of an institution’s nursing practice.

The authors work at Hackensack Meridian Jersey Shore University Medical Center in Neptune, New Jersey. Rocel Besa is Magnet program director. Dawn Williams is director of patient care.

American Nurse Journal. 2024; 19(1). Doi: 10.51256/ANJ012450

References

American Nurses Association. Code of Ethics for Nurses with Interpretive Statements. 2015. nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses

Altman M. Why should I participate in nursing research? July 14, 2020. aacn.org/blog/why-should-i-participate-in-nursing-research

Chipps E, Nash M, Buck J, Vermillion B. Demystifying nursing research at the bedside. Nurs Manage. 2017;48(4):28-35. doi:10.1097/01.NUMA.0000514063.45819.c1

CITI Program. Get to know CITI program. about.citiprogram.org/get-to-know-citi-program

Erickson JI, Pappas S. The value of nursing research. J Nurs Adm. 2020;50(5):243-4. doi:10.1097/NNA.0000000000000876

Gallagher C. Conducting nursing research. RN Journal. rn-journal.com/journal-of-nursing/conducting-nursing-research

Institute of Medicine Division of Health Care Services. Nursing research: Definitions and directions. In: Nursing and Nursing Education: Public Policies and Private Actions. Washington, DC: National Academies Press; 1983. ncbi.nlm.nih.gov/books/NBK218540

Institute of Medicine (US) Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press; 2011.

Kreil S. Operationalizing new knowledge, innovations, and improvement. Am Nurse J. 2021;16(3):34-8.

Wolters Kluwer. At the core of Magnet: Innovations and outcome. October 12, 2017. wolterskluwer.com/en/expert-insights/at-the-core-of-magnet-innovations-and-outcomes

Mason TM, Patterson AE. The ABCs of nursing research. Am Nurse J. 2022;17(6):30-4.

Wakefield MK, Williams DR, Le Menestrel S, Flaubert JL. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: National Academies Press; 2021. nap.nationalacademies.org/read/25982/chapter/1

Key words: nurse research, scholarly work, Magnet

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