Becoming a Research Nurse: Analytical Capacity and Interest in Advances in Health Sciences - Essay Sample

Introduction

Research is often considered as a highly sophisticated and complex activity, which requires numerous material and human resources for its realization, and which is developed in the elite of certain environments, exclusively by people belonging to this elite (Boswell & Cannon, 2018). The main requirement that each nurse professional must have as a starting motor to become a research nurse is to have an analytical capacity and interest in advances in health sciences research. The starting point of the investigation is the formulation of a research question. This must be well planned in the construction of its basic structure to maximize the search and retrieval of the evidence in the various databases by focusing on the purpose of the investigation and avoiding performing unnecessary searches. A good investigation question is the pillar of the excellence of nursing based on evidence.

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Nursing research develops mixed research studies, assessing both quantitative and qualitative research, which places it at high levels of evidence for its holistic view of the process. The findings of the qualitative and quantitative research are complementary to each other and are a powerful means to transform the Nursing practice in Evidence-Based Nursing (EBN) (Black, Balneaves, Garossino, Puyat & Qian, 2015; Atkinson & Cipriani, 2018). The objective of EBN in Applied Clinical Research in Health Sciences is to guide and train solvent research nurses capable of developing and carrying out research projects linked to their clinical trajectory.

Formulating the Investigation Question

In health sciences generally, research begins with the observation of some facts or ideas, which constitute the object of study, to which you want to better understand or which you want to find an explanation. For this, the hypothetical-deductive method is generally used, which consists of a series of steps or steps.

These stages of the investigation are:

1. Formulation of the research question
2. Research study design
3. The collection, analysis, and interpretation of the obtained data
4. Preparation of the research report and dissemination of the results

The appropriate research question must be well-posed and the construction of its basic structure must allow for the correct definition of necessary information or evidence required to answer the investigation. It must also maximize the evidence recovery within the databases by focusing on the purpose of the investigation and avoiding unnecessary searches (Atkinson et al., 2018).

The question will help to write the objective of the study (what is intended to know, in what population and in what context), what possible relationship may exist between the variables studied (hypothesis) and, at least a priori, what type of study that must be performed to solve the problem. Before starting to look for answers, it is convenient that the question is formulated in such a way that allows delimiting the information needs as much as possible, and that facilitates the elaboration of the most efficient information search strategy, through a list of terms key to use. Starting the search for information without this initial effort usually leads to spending more time than would be necessary for the search, increasing the probability of not finding the information applicable to the investigation and wasting time in the immensity of existing knowledge.

The fundamental advantages of the ideal preparation of research questions are:

• Helps focus on the problem of interest.
• Develop the best information search strategy with the available resources.
• Choose the study design correctly.
• Save time and resources in the planning of the research study.

The formulation or construction of the question is done in two phases. The first phase is formulating the question that needs to be solved, derived from the problem, uncertainty or doubt. The question's structure must clearly identify the person or population. It must also have a normal intervention against such a problem, and third, the proposed and, finally, the expected outcome or result (Boswell & Cannon, 2018).

The question must be posed correctly to translate into a search strategy that leads to finding a quick and adequate response. For this phase, there is a facilitating strategy. The EBN proposes that the clinical problems that arise during the healthcare, educational and/or research practice be decomposed and then organized, using the PICOT strategy (Black, Balneaves, Garossino, Puyat & Qian, 2015). This supposes to divide the structure of the clinical question into 4 well-differentiated parts that are gathered in the acronym PICOT as shown below.

• P Patient or Problem of interest
• I Main intervention to consider (therapeutic, diagnostic, educational, etc.)
• C Comparison of interventions (while comparing with another intervention)
• O Outcome that interests to value.
• T Timeframe for the intervention to achieve the outcome

An example of a PICOT question browser is hosted within the TRIP Database search engine that can be useful to train the use of the PICOT strategy (http://www.tripdatabase.com). Its objective is to provide health professionals with the easy search for the highest quality material accessible on the Internet, and it is an attempt to unite all the sources based on the high-quality evidence available on the Internet. The contents of its website are reviewed monthly and usually, about 300-400 new articles are added. Since September 2006, access is free (Kalu & Bwalya, 2017).

The PICOT strategy can be applied in constructing the research question in very different contexts, clinical situation, management of human and material resources, search for instruments for symptom evaluation, etc.

Once the research question is identified, a literature review is conducted to search for scientific studies that offered an answer to the proposed research question. Currently, there are multiple resources for the search for information. Retrieving efficient and specific information is imperative for developing the skills necessary to apply effective strategies in evidence-based research. The search is done in medical databases which include Pubmed, Cochrane Library and CINAHL. PubMed, for instance, is a search engine that allows queries in the MEDLINE database, which is the most important related to publications on biomedical research. MEDLINE, through PubMed, offers access to a large amount of current and quality biomedical literature to search and retrieve information for research in health sciences. Unlike Google scholar which offers limited search limits (eg, date, age, publication type), PubMed provides extensive filters that limit searches to specific clinical studies or subject matter (eg, Topic-Specific Queries and Clinical Queries). It is currently the most used tool in the search for biomedical information and one of the most effective in the search for relevant information (Demner-Fushman et al., 2006). The databases contain scientific documents published both nationally and internationally, concerning the research question. The search uses a set of key terms or descriptors to limit the articles in terms of relevancy and to save time.

The relevance or appropriateness of retrieved articles is determined by various factors including the nature of trials, number of participants and sampling methodology (appropriate statistical methods), and ethical considerations (devoid of bias). The most appropriate or recommended articles are scientific evidence derived from, systematic reviews, randomized and controlled clinical trials, as well as the Meta-analyses derived from them, preferably with a large group of participants. These sources provide the best clinical evidence essential for nursing practice. The studies should also be valid, peer-reviewed and contain appropriate conclusions (Nassehi, Esmaeili & Varaei, 2017; Kalu et al., 2017).

A Specific Research Problem Example

Health setting: In the hemodynamics laboratory.

Background: Catheterization was performed radially in a 60-year-old man under treatment with Sintrom. Arterial introducer carrier on its exit to the recovery room. For the removal of the radial catheter, a nurse thinks it is better to do it manually, another nurse questions it, believes that it is better to use a mechanical device to perform vascular hemostasis.

Generic question: Is it convenient to start manual vascular hemostasis in patients' anticoagulated with Sintrom?

As a starting point, the components of the question are broken down following the PICO strategy:

P (Population) I (Intervention) C (Comparison) O (Outcome/Expected Results) T (Timeframe)

Patients anticoagulants with Sintrom subjected to catheterization radial route

Hemostasis: vascular

manual compared to: hemostasis vascular mechanics

• Does the appearance of a hematoma decrease?
• Does post-intervention pain decrease?
• Does it reduce complications?

Structured and specific research question:

In adults undergoing cardiac catheterization via the anticoagulated radial route with Sintrom, is manual vascular hemostasis more effective than mechanical vascular hemostasis in reducing post-intervention local complications?

The importance of taking time to elaborate the research question in a structured way (a careful definition of the question, which includes the specification of the population, the intervention and the measurement of the result), can help to develop a search strategy for feasible and rapid information that allows to obtain results with maximum precision and completeness (Melnyk, GallagherFord, Long & FineoutOverholt, 2014). In other words, by translating the structured PICO question into an "indexed" language, a search strategy is elaborated that provides the maximum number of documents relevant to the topic in the chosen database.

In the second phase of the formulation of the question, the Deductive Method can be used to analyze the relevance, magnitude, and suitability of the research question, or what is the same, to reflect on the feasibility and usefulness of the evidence intended to contribute to the rest of the scientific community.

The stages of the Deductive Method in the valuation of the applicability of the question involve:

• Identifying the clinical problem or population
• Formulating a relevant and specific clinical problem
• Searching for scientific evidence
• Evaluating the available evidence
• Evaluating the clinical application of the evidence
• Implementing the evidence in nursing practice

Evaluating the Results Versus the Change

The researchers must be able to justify, from a review of the knowledge situation on the subject and the establishment of the appropriate theoretical framework, the realization of the study, assessing its relevance and feasibility. The question conditions the objectives of the study and implies, in the first phase, the selection of the most appropriate type of study to answer the question. Therefore, the basis of good research is to have a good question. If the question has not been correctly defined, it will be difficult for the research objectives to be well-posed and for the hypothesis or potential response to be so. Even the choice of design may be erroneous because as already indicated, both the conceptual and the methodological and empirical phases are articulated according to the research question that the study intends to answer.

Conclusion

Biomedical research contributes to improving the quality of care provided to patients, providing the necessary information to help choose the most appropriate therapeutic and care option in each case. Given the important benefits it provides, it is obvious that research must be considered a moral obligation of the health sciences. Research provides the b...