Monday, September 7, 2009

Evidence Hodges' model #1: Research in Nursing

Mind the gapWhen as a nurse (OT, physio, medic....) you are on a course, especially one about research you may be required to complete a study or more significant piece of research. Courses at graduate and post graduate level invariably include such demands and stress the hope that this course will spur you to continue the research effort in the work place. The ideal is of course to routinise research in clinical settings. Whatever the debate regarding the merits of evidence-based nursing, medicine and so on, this still needs to happen in part to help bridge the theory - practice gap.


In the same way all nurses have a professional responsibility to educate their student peers, (patients and carers...) there is an expectation that nurses are like embedded media commentators in a war zone. Part of your time in practice will be devoted to research, audit and governance.

While there are audit and governance teams there willing to help, many people multi-task in their work and nurses are seasoned practitioners. Many just want to do what they were trained for and nurse. They recognize this as they hear the expectations of the course leaders, lecturers and yet they are aware of the constraints. The scope for research is weighed against other commitments, notably:
  • direct(ing) patient care and safety
  • management and supervision
  • audit duties for management information
There are of course a host of psychosocial influences that come into play. What is my personal interest in research? Where do I prefer to be at work: office, ward, or home or retired? Cynical? No! Just being realistic. The information systems frequently in place can assist as a research tool, but their chief role is to provide management information through the collation of aggregated data. This is done by-and-large transparently in the background ('back-end'), and that is the problem. Nurses need to get their feet wet. The option must be there, and not just when on courses. Nurses need to immerse themselves in the data and information streams they help to create and source.

As the list above suggests nurses and not just senior nurses need direct access to the icon labelled 'reports'. There should be ways for nursing work to be captured in-situ, but how? Many clinical information system vendors have their solutions to this, but as regular readers know for a long time I've been wondering about -
  1. How can the balance between management data and intelligence needs and clinical needs be supported and bridged?*
  2. What is the evidence base to support Hodges' model in theory, practice, management and policy?
  3. What is the state, characteristics, access and usability of nursing terminology, taxonomy, classification systems in informatics - information and communication systems?
  4. If I am individually compelled (nuts!) to create a new website could I ally this aim with a course?
More to follow - including some of the sessions at Drupalcon Paris.....

*To this list we also need to add other stakeholders - members of the public.

Additional links:
http://www.icn.ch/icnp.htm


Image sources:
Mind the gap: http://ci.coe.uni.edu/facstaff/zeitz/web/itag/mindthegap/
Report icon:
http://artistsvalley.deviantart.com/art/Free-Task-Icons-Reports-Icons-89509953