Action research: A mechanism for active engagement of clinical nurses in a program of research.

This study aimed to explore the outcomes of active participation in an action research project on building the research capacity of clinical nurses. In this qualitative research study, six registered nurses volunteered to participate in the action research team. None of the nurses reported having any prior research experience. This study was part of a larger three-phase project. The nurses were required to reflect on the data about their medication practice of phase 1, develop and implement a bundle of interventions in phase 2 to improve medication safety, and evaluate the effectiveness of these interventions in phase 3. We report the nurses' participation in Action Research during phase 2. Meeting minutes and six semistructured interviews were thematically analyzed. The results showed that after receiving support to enhance their research skills from the research team, the nurses were empowered to perform and lead clinical nursing research project. Nurses were able to take ownership of the research process and outcomes and were then able to translate their new research knowledge and skills into their clinical practice by building their own research capacity.

Emerging Trends in Clinical Research: With Implications for Population Health and Health Policy.

Policy Points: Significant advances in clinical medicine that have broader societal relevance may be less accessible to population health researchers and policymakers because of increased specialization within fields. We describe important recent clinical advances and discuss their broader societal impact. These advances include more expansive strategies for disease prevention, the rise of precision medicine, applications of human microbiome research, and new and highly successful treatments for hepatitis C infection. These recent developments in clinical research raise important issues surrounding health care costs and equitable resource allocation that necessitate an ongoing dialogue among the fields of clinical medicine, population health, and health policy. CONTEXT: Developments in clinical medicine have important implications for population health, and there is a need for interdisciplinary engagement among clinical medicine, the social sciences, and public health research. The aim of this article is to help bridge the divide between these fields by exploring major recent advances in clinical medicine that have important implications for population health. METHODS: We reviewed the most cited articles published from 2010 to 2015 in 5 high-impact clinical journals and selected 5 randomized controlled trials and 2 related clinical practice guidelines that are broadly relevant to population health and policy. FINDINGS: We discuss the following themes: (1) expanding indications for drug therapy and the inherent medicalization of the population as highlighted by studies and clinical guidelines supporting lower blood pressure targets or widespread statin use; (2) the tension in nutritional research between quantifying the impact of isolated nutrients and studying specific foods and dietary patterns, for example, the role of the Mediterranean diet in the primary prevention of cardiovascular disease; (3) the issue of high medication costs and the challenge of providing equitable access raised by the development of new and effective treatments for hepatitis C infection; (4) emerging clinical applications of research on the human microbiome as illustrated by fecal transplant to treat Clostridium difficile infections; and (5) the promise and limitations of precision medicine as demonstrated by the rise of novel targeted therapies in oncology. CONCLUSIONS: These developments in clinical science hold promise for improving individual and population health and raise important questions about resource allocation, the role of prevention, and health disparities.

Advancing a Culture of Clinical Nursing Research Through Collaborative Partnership Between Practice and Academia.

Engaging in clinical inquiry is a natural foundation for a nurse's critical thinking strategy and application to practice. Transforming clinical inquiry into a formal research question designed to improve patient care and/or the practice environment can, however, sometimes seem overwhelming to clinical nurses. It may even be seen as out of scope for their daily practice. As a result, aligning the trifold mission of service, education, and research at an Academic Health Sciences Center can be challenging unless there exists a purposeful strategy to achieve this goal. Since the publication of the Institute of Medicine "Future of Nursing Report" in 2010, Emory Healthcare Nursing and the Emory University Nell Hodgson Woodruff School of Nursing (SON) have sought to advance the vision and mission of strengthening and sustaining a culture of clinical inquiry to advance nursing science through nurse-led research. This vision also aligns with the American Association of Colleges of Nursing to identify paths for achieving enhanced partnerships between academic nursing and academic health centers. This goal has been conceptually important since then. In the last 2 years, there has been a renewed and invigorated commitment between Emory Healthcare Nursing and the Emory School of Nursing to forge a path for improving and sustaining a rigorous culture of collaborative and interprofessional research. This article describes the journey of the "One Emory Nursing" initiative, which spans from bedside/chairside to bench and back again. This work is built on a foundation of clinical nurses engaged in leading research that is designed to transform care in partnership with SON.

State of the research on credentialing: the Institute of Medicine Standing Committee on Credentialing Research in Nursing.

This column is presented to report an update on the status of research on credentialing in nursing by the director of the Institute for Credentialing Research at the American Nurses Credentialing Center. The author presents an overview of the 5 meetings held to explore this topic and recommendations for further study.

Promoting the place of the allied health professions in clinical research.

Clinical research is of major importance to today's society, as scientific evidence is increasingly demanded as a basis for progress, whether this involves developing new healthcare products, improving clinical practice and care protocols or progress in prevention. Clinical research therefore requires professionals who are both experienced and increasingly well trained. Against this background, allied health professionals are becoming involved more and more, both as team members supporting clinical research projects and as managers or coordinators of projects in their own field. Clinical research activities provide an ideal opportunity for continuing professional development. All of this means that the professional skills of the allied health professions and clinical research support professions must be enhanced, their role promoted in the context of lecturer status and in the longer term, their status recognised by the supervisory authorities.

The state of European nursing research: dead, alive, or chronically diseased? A systematic literature review.

BACKGROUND: Reviews of nursing research have suggested that most is descriptive; with no more than 15% providing strong evidence for practice. No studies have examined this from the perspective of nursing research conducted in Europe. OBJECTIVE: The aim of this study was to review reports of European clinical nursing research in the top 20 nursing journals in 2010 to establish a baseline of nursing research activity in the year immediately prior to the launch of a European Science Foundation network to increase the proportion of intervention research in Europe. METHODS: We identified eligible reports that were then data-extracted by two independent reviewers. Disagreements were resolved through pair discussion and independent arbitration. We appraised and synthesized topics, methods, and the extent to which studies were programmatic. We synthesized data as proportions of study reports meeting our a priori categorization criteria. RESULTS: We identified 1995 published reports and included 223 from 21 European countries, of which 193 (86.6%) reported studies of primary research only, 30 (13.5%) secondary research, and three (1.4%) a mix of primary and secondary. Methodological description was often poor, misleading, or even absent. One hundred (44.8%) articles reported observational studies, 87 (39.0%) qualitative studies. We found 26 (11.7%) articles reporting experimental studies, 10 (4.5%) of which were randomized controlled trials. We found 29 (13.0%) reports located within a larger program of research. Seventy-six (34.1%) articles reported studies of nursing interventions. LINKING EVIDENCE TO ACTION: European research in nursing reported in the leading nursing journals remains descriptive and poorly described. Only a third of research reports concerned nursing interventions, and a tiny proportion were part of a programmatic endeavor. Researchers in nursing must become better educated and skilled in developing, testing, evaluating, and reporting complex nursing interventions. Editors of nursing journals should insist on systematic reporting of research designs and methods in published articles.

[Ethnography and fieldwork: the crisis of representation and beyond]. / Ethnografie und Forschen im Feld: diesseits und jenseits der Krise der Repräsentation.

Writing as a nursing researcher about the subjects that comprise the nursing profession means writing about oneself. Conducting ethnographic research on subjects within one's own professional culture and interacting with these subjects in the field poses a challenge. Ethnographic research analyses and opens out the horizon of one's own professional culture for the benefit of the potential reader. However, at the same time, the researcher's self within an ethnographic framework is called into question. In anthropology the researcher-subject relationship is deemed a special relationship, and in this article both authors reveal the precarious status of their research object. In this article an attempt is made to let the nursing subjects speak for themselves, while at the same time the authors write about their subjects' social practices an communication processes. To date there has hardly been any German research work within nursing dealing with this critical area of interest. The authors seek to provide an introduction to the constitutive parts of ethnography and the crisis of representation and beyond. In addition, they present two reflexive accounts.

Intimate partner violence: a global health perspective.

Intimate partner violence is a serious violation of human rights and a significant global health problem. As the largest health workforce worldwide, nurses are well positioned to address this health issue. Based on literature from various countries, this article presents a summary of the literature on health consequences, costs, prevalence, risk factors, perceptions, and manifestations of intimate partner violence, and women's responses to it. Next, building on the author's program of research on intimate partner violence, the article highlights a number of implications for nursing: intersectionality; micro, meso, and macro levels; social violence; violence throughout a woman's lifespan; and the migration context and process. Finally, the article presents research and practice recommendations for nurses and proposes North-South collaborations and capacity-building to address the complex nature of this global health problem.

Palliative and end-of-life care research: embracing new opportunities.

The past two decades have witnessed dramatic advances in palliative and end-of-life care research with increased understanding of the burden of life-limiting diseases on patients, families, clinicians, and our healthcare system; and researchers have documented palliative care interventions that improve patient and family outcomes and reduce the costs of care (Detering, Hancock, Reade, & Silvester, 2010). These advances have led to a new era of palliative and end-of-life care research and practice with widespread recognition of its accomplishments and successes. Consequently, we now have an important opportunity to reassess our recent successes and challenges and to identify the goals and benchmarks that will ensure ongoing robust advances in this now-recognized and critical scientific area. High-quality palliative and end-of-life care will be best informed by methodologically strong research efforts that generate a body of evidence with the capacity to support and direct care and effect changes in practice. It is in this context that the National Institute of Nursing Research conceptualized and led a Summit titled The Science of Compassion: Future Directions in End-of-Life and Palliative Care Research in August, 2011. In this summary article, we present brief overviews of the six articles chosen for this Special Issue of Nursing Outlook, examine their key conclusions, articulate gaps and needs, and discuss next steps in palliative and end-of-life care research through the lens of these six topics.

Nurse educators and the future of nursing.

Calls for transformation in nursing education and practice abound. Nurses are part of a trusted profession, but they have been under-represented in conversations about health care compared with other, more vocal professionals. Nurses may not consider that they already have many leadership skills, and nurse educators in staff development roles are positioned to foster growth in other nurses. The relationship between nurse educators and their constituents provides the context for support that can motivate staff nurses to move beyond their concerns and accept challenges that may cause them some discomfort, such as writing for publication or public speaking. The leadership of nurse educators is essential to support colleagues who will shape the future of nursing.

Developing clinical research nurses.

Clinical research nurses have a unique role in developing and contributing to high-quality care. This article discusses key policy recommendations on their support and development, and outlines a local project exploring the issues that research nurses face. It also makes recommendations to improve these nurses' training and profile.

[Too busy to think?]. / Essay über die spärliche Theoriebildung der deutschen Pflegewissenschaft.

A synthesis of current nursing knowledge by means of nursing theory construction is missing in German speaking countries. Unfortunately, due to this the nursing discipline cannot counterbalance the influence of other scientific disciplines with a self-created nursing specific theory. The level of theory construction in a discipline serves as sensitive indicator of intellectual state in this discipline. After the fruitful period from 1980 to 1990, the theoretical discourse in nursing almost disrupted while the number of empirical studies is increasing. This deserves to be discussed thoroughly with respect to further development of nursing theory. The theoretical discourse in nursing should generalise research findings in order to develop nursing theory in an inductive way - combined with a focus on patient's perspective in research and theory construction. New aspects and themes in health care as the demographical development and its epidemiological consequences, the increase and transformation of chronic illness as well as the changing role of the patient (participation, self-management) should be considered. The reanimation of a culture of discussion is only possible if scholars can dedicate time to it. Only under this condition reading and discussing research findings of other disciplines will be again on the agenda of scientific working and will - last but not least - inspire the construction of a nursing specific theory.

[Development of research competence]. / Developpement de compétences par la recherche.

The implementation of the new reference system of training in nursing care requires from trainers to develop new educational skills. These allow to help students to transfer their experience in new situations of care. The study is based on the experience of two training institutes in nursing care which participated in programmes of European exchanges. In this presentation, we shall be interested in the one that participated in the Leonardo daVinci programme. The analysis shows that the confrontation with a new reference field, Europe, leads the trainers to modify their position by developing reflexive analysis and by using interactive educational methods. Therefore, they move from the "teaching" to the "training" process. The reference to concepts enhances the status of trainers who then become aware of their skills. Upstream to the project, it falls under IFSI head's responsibility to implement the conditions favourable to its success. This project integrated into that of the institution then becomes a training-action.

Nurses' perceptions of the barriers to and the facilitators of research utilization in Turkey.

The aim of this study was to determine nurses' perceptions of the barriers to and facilitators of research utilization in Turkey. Barriers Scale was utilized in the research, and the population was 631 nurses. According to the research results, the first three important barriers were inadequate authority (63.6%), lack of time (54.0%), and insufficient facilities (52.8%). Nurses have perceived the organizational management support as the most important easing factor in their applications (n = 156). It is highly recommended that nurses be trained in research methods and evidence-based practice, that research articles be written more clearly, and that Research and Development centers where nurses could get consultation services be established.