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A National Survey of Hospital Nursing Research Requirements and Outcomes *
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A National Survey of Hospital Nursing Research Requirements and Outcomes* 2012 National State of the Science Congress on Nursing Research Session Title: EVIDENCE-BASED PRACTICESession Date, Time: September 14,2012 8:30 AM-10:00 AM Maureen McLaughlin PhD RN, Medstar Georgetown University HospitalKaren Gabel Speroni PhD RN, Inova Loudoun HospitalKathy Patterson Kelly PhD RN, Children’s National Medical CenterCathie E. Guzzetta PhD RN AHN-BC FAAN, Children’s National Medical CenterSameer DeSale, MS, Medstar Health Research InstituteAnnette Turner MSN RN, The Catholic University of America(*Washington Regional Nursing Research Consortium)
Introduction/Background • Noted variable IRB policies regarding whether RNs can be PIs on RN-led research in the metropolitan Washington DC area hospitals • Such IRB requirements present a potential barrier to clinical nurses functioning as PIs of their studies in hospitals • Study investigators members of the Washington Regional Nursing Research Consortium (WRNRC)
Purpose of Study/Research Questions • What are the hospital/IRB requirements for RN PIs: • RN education level & qualifications? • Nursing research mentoring processes? • Research education programs? • Nursing research review processes? • What are the scholarly outcomes of hospital-based research programs? • What are the facilitators and/or hindrances of RN-led research studies? • To identify hospital and/or IRB requirements for RN PIs to conduct RN-led research • To describe outcomes of hospital-based nursing research programs
Methods • Descriptive, comparative national electronic survey of hospitals (purposive, convenience sample) • 798 hospitals from 3 groups: • 202 Magnet-designated • 195 Children’s Hospital Association (CHA) • 401 The Joint Commission (TJC) • HNRRO Survey: 60-item questionnaire; CVI = 1.0: • Educational & qualification requirements for nurse PIs • Nursing research mentoring process • Nursing research education & training • Nursing research peer-review process • Scholarly research outcomes • Facilitators and hindrances of RN-led research studies & research productivity (2 open-ended questions)
Analysis • Quantitative: • Category fields: chi- square test & Fisher’s exact test • Continuous variables: t-test, ANOVA, Wilcoxon rank sum test, & Kruskal-Wallis test • Level of significance set at < 0.05 • Qualitative: • Conventional content analysis for 2 open-ended questions • Verbatim comments downloaded from electronic survey • 2 co-investigators worked with doctoral student to code data • Responses analyzed together & then divided into Magnet & non-Magnet hospital groups • Coding validated with 10% of dataset
Results: Demographic Findings • 20% response rate • Total 160 returned surveys (Magnet & non-Magnet hospitals) • 66% (n= 106) Magnet hospitals • 34% (n= 54) Non-Magnet hospitals • Non-Magnet hospitals = 29 (18%) TJC & 25 (16%) CHA • Majority were not-for-profit & in urban areas • Magnet hospitals had > number of licensed beds & full-time equivalent RNs compared to non-Magnet hospitals (p<0.0001)
Results: Educational Level & Qualifications Requirements for Nurse PIs • Only 8% (n=13) of hospitals had a minimum educational requirement to be a PI • More Magnet than non-Magnet hospitals had no minimum educational requirement (p=0.02) • 25% (n=36) of hospitals appointed a PI designee to sign IRB application if a RN did not meet IRB requirements to be a PI
Results: Nursing Research Mentoring Process • Research mentors/leaders were available to guide nurses throughout the research process at the majority of hospitals (n=131, 83%) • More Magnet (n=103, 98%) than non-Magnet (n=28, 53%) hospitals had research mentors (p<0.0001)
Results: Nursing Research Education & Training • 23% (n=37) required RN PIs to complete a research education course before conducting research • 21% (n=33) had research education classes available to their nurses • 20% (n=32) provided a nursing research internship/fellowship • Nearly all (97%) were expected to assume various roles in research at their hospital
Results: Nursing Research Peer-Review Process • Majority had a Nursing Research Committee (NRC) (65%) or interdisciplinary research council (31%) • More Magnet (83%) than non-Magnet hospitals (30%) had a research council (p<0.0001) • Majority required NRC or other persons to review (84%) or approve (73%) the nursing research proposal before IRB submission • Majority required PI to report progress on study to research mentor (62%) or NRC (68%)
Results:Research Program Scholarly Outcomes • Hospitals reported an annual total of 4 studies initiated, 4 disseminated (podium/poster), 1 published, & 2 funded • As hospital bed size increased, so did number of studies initiated (p=.03) • <100 beds = 1.95 studies • 101-200 beds = 2.76 studies • 201-300 = 2.94 studies • 301-500 = 3.61 studies • 501-700 = 4.42 studies • 701-1000 = 5.63 studies • >1000 = 6.4 studies
Conclusion: Findings from this study provide a prototype & benchmark information for nursing administrators planning to establish, evaluate and/or expand nursing research programs
Qualitative Results:Facilitators & Hindrances • 95% of surveys included written comments • 960 units of analysis • Facilitators • 477 Magnet, 107 non-Magnet • Hindrances • 279 Magnet, 97 non-Magnet • Total 24 codes (12 facilitator; 12 hindrance codes) • Commonly facilitator codes had mirror hindrance codes representing lack of the underlying construct (n=10 mirror constructs)
Limitations • Findings based on respondent’s familiarity with institutional work • Nursing research outcome data collected for years 2004-2008, other data provided in 2009 and/or 2010 • Findings likely overestimate influence of Magnet designation on nursing research in hospitals (66% our study vs 7% nation-wide)
Expanded prototype forhospital-based nursing research program: Integration of quantitative & qualitative findings
Implications • Nursing leaders need to partner with IRBs to create policies (e.g., mentor guidance, education, peer review) to ensure hospital-based RN researchers can be identified as PI & assume all responsibilities • Nursing leaders need to consider their hospital infrastructure, hospital culture, & components necessary for building a hospital-based nursing research program • Findings provide prototype for nursing leaders to guide development of a new nursing research program & provide benchmarks to evaluate and/or expand an existing program
Contact Information Maureen McLaughlin, PhD, RN mmm116@gunet.georgetown.edu Karen Gabel Speroni, PhD, RN kgabelsperoni@smartneighborhood.net Katherine Patterson Kelly PhD RN kakelly@childrensnational.org Cathie E. Guzzetta, PhD, RN, AHN-BC, FAAN Cguzzett@childrensnational.org Sameer DeSale, MS Sameer.desale@medstar.net Annette Turner, MS, RN 03turner@cardinalmail.cua.edu