FOUNDATIONS OF NURSING RESEARCH

FOUNDATIONS OF NURSING RESEARCH
FOUNDATIONS OF NURSING RESEARCH
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NSG 3029 FOUNDATIONS OF NURSING RESEARCH
POWERPOINT PRESENTATION RUBRIC
FOUNDATIONS OF NURSING RESEARCH
CRITERIA POSSIBLE POINTS EARNED POINTS
Introduction to the research articles
· States authors, title, publication of the articles
10
Article #1
· Purpose
· Background and significance of the problem
· Methodology
· Interpretation of findings
20
Article #2
· Purpose
· Background and significance of the problem
· Methodology
· Interpretation of findings
20
Synthesis of information
· Compares and contrasts both articles and their components
· Synthesize information in both articles to develop and present a unique perspective on the topics
40
Recommendation for the future research
· Summary of recommendations from both articles
30
Application of research articles in nursing practice
· Outlines the research findings for the use in nursing practice
30
PowerPoint presentation quality
· PowerPoint presentation is organized, well-constructed, legible, and directed to RNs (classmates)
· Presentation is not more than 15 min at length with a maximum of 15 slides
· Slides are easy to understand with catchy design and graphics
· Reference slide is done per APA guidelines
· Slide references are correctly cited on the slide
FOUNDATIONS OF NURSING RESEARCH
50
TOTAL:
200
Feedback:
NSG 3029 FOUNDATIONS OF NURSING RESEARCH POWERPOINT PRESENTATION RUBRIC CRITERIA
FOUNDATIONS OF NURSING RESEARCH
Introduction to the research articles • 10 States authors, title, publication of the articles Article #1 • Purpose • Background and significance of the problem • Methodology • Interpretation of findings Article #2 • Purpose • Background and significance of the problem • Methodology • Interpretation of findings Synthesis of information • Compares and contrasts both articles and their components • Synthesize information in both articles to develop and present a unique perspective on the topics Recommendation for the future research • POSSIBLE POINTS Summary of recommendations from both articles 20 20 40 30 EARNED POINTS Application of research articles in nursing practice • 30 Outlines the research findings for the use in nursing practice PowerPoint presentation quality • PowerPoint presentation is organized, wellconstructed, legible, and directed to RNs (classmates) • Presentation is not more than 15 min at length with a maximum of 15 slides • Slides are easy to understand with catchy design and graphics • Reference slide is done per APA guidelines • Slide references are correctly cited on the slide 50 200 TOTAL: Feedback: Critical Analysis of Two Peer-Reviewed Research Articles [Students’ Names] Articles Reviewed •[Article #1 = must be APA format] •[Article #2= must be APA format] Article #1: Purpose •[type purpose here] Article #1: Background and Significance of the Problem •[bullets only] •[bullets only] •[bullets only] •[bullets only] •[bullets only] •[bullets only] •[bullets only] Article #1: Methodology •Sampling Technique –[type here] •Sample Characteristics –[type here] •Setting –[type here] Article #1: Interpretation of Findings •[BULLETS only = type answer here] •[BULLETS only = type answer here] •[BULLETS only = type answer here] •[BULLETS only = type answer here] •[BULLETS only = type answer here] •[BULLETS only = type answer here] •[BULLETS only = type answer here] Article #2: Purpose •[type purpose here] Article #2: Background and Significance of the Problem •[bullets only] •[bullets only] •[bullets only] •[bullets only] •[bullets only] •[bullets only] •[bullets only] Article #2: Methodology •Sampling Technique –[type here] •Sample Characteristics –[type here] •Setting –[type here] Article #2: Interpretation of Findings •[BULLETS only = type answer here] •[BULLETS only = type answer here] •[BULLETS only = type answer here] •[BULLETS only = type answer here] •[BULLETS only = type answer here] •[BULLETS only = type answer here] •[BULLETS only = type answer here] Synthesis of Information •[Compare and contrast both articles = i.e. compare & contrast the methodology used, between these articles, which research utilized better research technique?; is Article #1’s results similar or different from Article #2’s results; etc.] Synthesis of Information •[Combine, “synthesize,” the information in the research articles to develop an argument or a unique perspective on a topic] Recommendations for Future Research •[recommendations MUST be a summary from BOTH research articles] •Bullets ONLY •Bullets ONLY •Bullets ONLY •Bullets ONLY •Bullets ONLY Application of Research Articles in Nursing Practice 1.[text here] 2.[text here] 3.[text here] 4.[text here] 5.[text here] 6.[text here] 7.[text here] References •Your texts here MUST be written in an APA, 6th ed format. Please refer to your notes and visit the library. Research Stress in hospice at home nurses: a quahtative study of their experiences of their work and wellbeing Karen Tunnah, Angela Jones, Rosalynde Johnstone P alliative care nursing can be a rewarding but emotionally stressful specialty in which to work, and therefore stress and burnout may contribute to issues of staff sickness and retention. Studies have shown that although staff perceive themselves as coping, many nurses do experience compassion fatigue and burnout (Abendroth and Flannery, 2006; Edmunds, 2010). The purpose of this study was to undertake an assessment of hospice at home nurses’ experiences and wellbeing while caring for palliative and dying patients. Anecdotal evidence identified a lack of education and training regarding self-help strategies in the local nursing team. Clinical supervision is available for the team but uptake had been poor. The literature includes studies undertaken with palliative care nurses working in a hospice environment, but few published studies have looked specifically at hospice nurses working out in the community. Background Nursing has been described in many studies as a demanding and stressful profession, particularly for those working in direct clinical care (Hawkins et al, 2007; Edmunds, 2010). Compassion fatigue may be triggered by becoming overly empathetic with patients, having unreal expectations of outcomes, and experiencing personal crises (Abendroth and Flannery, 2006). It may affect an individual caring for someone who is experiencing a traumatic event such as dying. A nurse may experience helplessness and react by turning off his or her emotions. Compassion fatigue is also often linked to burnout, which can be defined as: emotional exhaustion, sometimes accompanied by a cynical approach, that can be experienced by individuals in a caring role (Maslach and Jackson, 1991). Burnout may affect the mental and physical health of the nurse, which could ultimately affect the quality of their nursing care (Maslach and Jackson, 1991). Some have also suggested that burnout is contagious International Journal of Palliative Nursing 2012, Voi 18, No 6 Abstract The literature has evaluated studies of hospice nurses and stress but very few studies have focused on community hospice nurses. This study explored hospice at home nurses’ experiences of caring for palliative and dying patients. Hospice at home nurses working in the community across North West Wales were interviewed and a grounded theory approach was used to categorise the data into the following themes: job satisfaction, Stressors, coping strategies, and support. Recommendations arising from the study include encouraging the use of clinical supervision, attendance at multidisciplinary meetings, and the provision of stress-awareness training, and raising awareness of the role of hospice at home nurses in primary care. Implementation of these recommendations might be beneficial for staff wellbeing. Further work would identify whether such recommendations can help to prevent sickness and promote staff retention. Key words: Hospice at home nurses # Stress and coping • Dying patients • Qualitative methods and can be communicated from one nurse to another (Bakker et al, 2005). Palliative care nursing is often viewed as a psychologically distressing and stressful specialty (Gambles et al, 2003). Palliative care nurses are fully aware that all the patients in their care have an incurable illness with a life-limiting prognosis and are expected to die. Furthermore, national strategies such as the UK’s End of Life Care Strategy (Department of Health, 2008) promote high-quality care for all adults at the end of life, which includes conditions with complex needs. This may pose further challenges and stresses for palliative care staff. However, it is now recognised that the benefits of early intervention and symptom control in the palliative patient help to maintain quality of life (World Health Organization, 2002). Also, studies suggest that palliative care staff report lower levels of burnout than other specialties, including oncology and intensive care nursing (Vachon, 1995). Lower levels of distress have also been reported for hospice nurses than for staff Karen Tunnah is Hospice at Home Nurse; Angela Jones is Clinical Nurse Manager; Rosalynde Johnstone is Project Manager, Betsi Cadwalader University Health Board, Palliative Care Department, Bodfan Eryri Hospital, Caernarfon, Gwynedd LL55 2YE, Wales Correspondence to: Rosalynde Johnstone FOUNDATIONS OF NURSING RESEARCH Rosalynde.johnstone® wales.nhs.uk 283 Research ^Studies have shown that although staff perceive themselves as coping, many nurses do experience compassion fatigue and burnout…* working in other areas, whicb implies that hospices are positive environments in which to work (Payne, 2001). The same study examined Stressors, coping, and demographics in relation to burnout and hospice nurses. It found that Stressors such as conflict with staff made the greatest contribution to burnout. The importance of not labelling an individual as coping ‘well’ or ‘badly’ in relation to burnout has also been highlighted, as this can oversimplify the coping/burnout relationship (Payne, 2001). The participants in the study reported here were hospice at home nurses working in the community setting, which is not compatible with the nurses in Payne (2001). The role of the hospice at home nurse embraces the biopsychosocial approach to human functioning, particularly in relation to illness or disease (Engel, 1977). The importance of psychosocial factors in nursing is recognised, and tbe development of a close, holistic relationship with patients is encouraged (Aldridge, 1994; Luker, 1997). This can take a considerable amount of time (Skilbeck and Payne, 2003).
FOUNDATIONS OF NURSING RESEARCH
Hospice at home nurses can spend between 1 and 2 hours with the patient and their family on a first visit. Subsequent visits may be shorter or longer depending on the needs of the patient and tbe disease progression. Toward the end of life the hospice at home nurse may need to make multiple extended visits on one day. The emotional element of ‘getting to know’ patients and their families is difficult to define, not least because of the lack of clarity surrounding the terminology. The phrase ’emotional care and support’ is used interchangeably with ‘psychological care and support’ or ‘psychosocial care’ (Skilbeck and Payne, 2003). However, different meanings can be attributed to each term depending on the contexts and theoretical backgrounds. The term ’emotional labour’ draws on a sociological background and is used to represent hard work, and indeed the difficulty of caring for patients at tbe end of life has been acknowledged (Froggatt, 1998; Jones, 2001a). Emotional labour places demands on the individual as tbey are constantly creating and sustaining relationships with patients who subsequently die. Tbe nurse tben has the continuous task of assimilating the loss of the patient and of the relationship. Dealing with the demands of this emotional ‘yo-yo’ may gradually erode one’s resilience and result in stress-related issues for the nurse. However, tbe emotional labour involved in palliative care is often underestimated and undervalued (Henderson, 2001). Mechanisms for coping with this aspect of nursing dying patients are varied and well 284 documented (James, 1993; McNamara et al, 1995; Froggatt, 1998; Jones, 2001b). The benefit of staff training in self-care tbrough counselling sessions and stress inoculation training is recognised (Ablett and Jones, 2007; Desbiens and Fillion, 2007). It bas been suggested that the opportunity for reflective practice in end-of-life care may help staff come to terms with the emotional impact of tbe work (Jones, 2001b). Some researchers suggest that a stress-resistant personality type and personal factors such as hardiness and a sense of stability and structure may enable hospice nurses to be buffered from the stressful effects of palliative care nursing (Ablett and Jones, 2007). Factors that promote resilience and wellbeing in nurses could be developed through training and supervision (Ablett and Jones, 2007). Clinical supervision and reflection are recognised as viable mechanisms for supporting palliative care nurses (Jones, 2001b). However, there is a lack of agreement concerning definitions, models, and use of clinical supervision. Known variously as ‘mentorship’, ‘supervision by manager’, and ‘reflective practice’, clinical supervision was very popular in the late 1990s; however, little is known about how or wbetber it is used by clinical nurse specialists (Yegdicb and Cusbing, 1998; Skilbeck and Payne, 2003; Jones, 2006). Aim The aim of the study was to explore the feelings and experiences of hospice at home nurses when providing palliative nursing care for patients in tbe community. Tbe study sought to identify key issues that contribute toward stress in hospice at home nurses working in primary care. Method Qualitative methodology was used as this is more suited to exploratory studies of people in their natural settings. The potential participants were a team of hospice at bome nurses working in the community across a large rural area in North West Wales. Ethics The study was presented to the North Wales Research Ethics Committee-West and a favourable opinion was awarded subject to management permission being granted. The study was given full management permission in accordance with NHS research governance arrangements. Research team The research team comprised the nursing team leader (with management, clinical, and research International Journal of Palliative Nursing 2012, Voi 18, No 6 Research experience), the project manager (with management and research experience), and a hospice at home nurse (with clinical experience). Items in i-jlics were used as prompts for the inier^iewer in the event that the intervie’Vre had dfficulty responding to th= question. Participants The hospice at home nursing team in North West Wales comprises ten qualified nurses and one health-care assistant. All had worked in the palliatiye care setting for a minimum of 12 months. The nurses deliver ‘hands on’ nursing care in collaboration with various community nursing teams, providing symptom control and advice for patients and their carers in the community. Their work sometimes necessitates travelling distances between 10 and 110 miles per day. The nurses were informed of the study and invited to participate at the regular nurses’ meeting by their colleage, the first listed author. It was made clear that they were under no obligation to take part and that they could withdraw at any time during or after the study without having to provide a reason and without fear of compromising their working relationships. Confidentiality was assured both verbally and in writing, with the usual exception of disclosure of any unsafe, unethical, or illegal practice. Age: Gencer General nursing experience: Hospice njrsing experience: QualificitJDns: Area of v^ork: I a) Can you tell m 2 about a good working day as a. hcspice nurse? /) What wojtd yoL say contributed towards mating it c good day? I b) Can >ou tell me about your worst working day as a hospice nurse? i) Whatwojtd yoL say contributed towards mailing it your worst doy? 2) How do you leel your work affects y /) Woutd yoj soy iz affects you physicatly? In what na/? ii) WouHycu soy i effects you mentally? In what wa/? 3) Hov» do you cope with an emotionally d^mandng day? Data collection /) Woutd yoj soy you totk to work colleagues? Each nurse was asked to participate in a taperecorded semi-structured interview lasting a maximum of 45 minutes. The interviews were conducted by the palliative care project manager. This position has no professional responsibility for tbe nursing team (managerial or otherwise) and is external to the hospice at home nursing service. The interviews all took place in the palliative care department in a quiet designated room at times convenient for the nurses and fitting in with their clinical duties. As the interviews could prove to be emotional or distressing, the nurses were offered the opportunity of counselling. There is currently an arrangement between an independent counselling service and the Health Board to provide free counselling sessions for Health Board employees. ii) Would ycu say »oo talk to family? Tbe interview schedule is provided in Box 1. The interview comprised a list of open-ended questions, guided by tbe interviewer. Interviewer prompts were included to avoid long silences during the interview process. Leading questions were avoided. The questions were managed in a conversational style to maximiseflexibilityand versatility. Data analysis The transcripts of each interview were analysed using the grounded theory approach initially developed by Glaser and Strauss (1967). Tbis International journal of Palliative Nursing 2012, Vol 18, No 6 Hi) VVou.’c jau soy you talk to your marager? iv) VVou.’c jou soy you totk to friends? 4) Hov» w o u l d youi say you cope w i t h t h e p i y s i i a l demands of y o u r w o r k i n g day? /) Woutd yoj soy ycu exercise, watk, cycle or gc to the g/m’ ii) Would ycu say »ou relox m a warm both? Hi) Wou.c jrou say yoj switch off in front of the TV? iv) Would ycu soy .”ou catch up with outstandhg househo/d /obs such os ckoning or gardening? 5) Hov” would youi say you cope with the psychological demands oí your working day? i) Would you soy you browse the internet? it) Would ycu say rou discuss your day with others? Hi) Wou,c you say yo j meditate or use any other form z-fmentol exercise.’ iv) WOU.Û you soy yoj hove on eorly night? approach :s favoured in nursing and the isodal sciences >wing tc the systematic and structured way that the data are collected and analysed. The term ‘grounded theory’ refers to the idea that the data are not obtained from tl-.e researchers’ preconceived hypothesis but are discovered or derived!. Themes that are repeatedly present or notably ¿bsent in the data are deemed significant enough to be categorised and each aisce oJ data 285 Research 6) How would you say you oope ./vith the demands: put on you by other health professionals? 7) How do you feel your job impacts on your famil/ life? 8) How does continually nursing dying patients affect your daily life? 9) During your time as a hospice at home nurse ha/e there been any training or support events that you felt »vere beneficie ? 10) Is there anything further that you wou d like t o discuss? i) Do you have any suggestions ttiat would improve yoir daily work experience? 11) Is there anything you would ‘/f:e to see put n place to improve your daily work experience? Thank you for participating in thi; study. is constantly compared with another until no further new data aie discovered. Data analysis was carried out following transcription of all of the interviews. The transcripts were typed verbatim with the exception of participant names, which were omitted. The transcripts v/ere independently read and re-read for familiarity b^ individual members of the research teair, who were blmd to each others’ critique of the data until the^ met to discuss the content of the transcripts. The ckta were analysed by an open coding procedure in which the first step of the analysis is conceptúalisaticn of the data. Concepts are identified through analytical procedures such as isking quest.ons about the data and looking for differences £.nd sirüilarities between phenomena, events, and incidents through constant comparison. The common themes that emerged from the data were tl’.en grouped together for identification and labelled with an abstract name to produce categories. Meticulous reccrds of the research process were mainiained with the aim that other researchers would be able to analyse the data and reach the sam; conclusions. Analysis triangularion by the different members of the team was intended to ensure reliability and reduce bias and error. Results and discussion Of the ten registered nurses in the hospice at home nursing team, seven participated in the study. One nurse ‘^as excluded because she had a rcle in tiie research team, one nurse was 286 absent on mate …
FOUNDATIONS OF NURSING RESEARCH