SUPPLEMENT NURSING RESEARCH
Challenges for nursing Alison Tierney offers a personal view of the role of national nurses’ associations in an era of challenge for nursing research world-wide. Throughout the world, research-based knowledge about nursing has never been so much in demand. Recent changes in the NHS, and the politico-economic climate in the United Kingdom, exert an urgency on British nursing to justify its worth and cost. From past research we have learned about the need for improvement. We know that patients’ pain is not always managed effectively; that our commu nications with patients and relatives are not as clear as they could be; and that many routine nursing activities are per petuated in spite of evidence that they are neither beneficial to, nor easily tolerated by, patients. What we have not done enough of is research that demonstrates how to im prove the quality and effectiveness of nursing, and provides evidence to con vince others of the things which we, as nurses, believe we do well. The fact that there has been ‘little research into the effectiveness of nursing practice’ was noted in a recent Audit Commission report (1). The greatest challenge for nursing research, both nationally and internationally, lies in the development of methods and measures which demonstrate the effectiveness of nursing and its impact on outcomes of health care for patients, families and communities. Patient-outcomes research (as it is now known) is notoriously difficult. Making headway is not going to be easy, given the limited research skills and resources at our disposal. Although the profession’s research capability has increased over the past 20
years, it is still limited. We need a stronger cadre of nurse researchers with the ability to win the resources to gener ate the findings which justify urilisation in practice and policy by virtue of their kind, quality and scale. There has been little research of that order. Individual small-scale studies have a place in the overall development of research and research expertise, but we have been slow to recognise the limitations of allowing what I call ‘one-person, one-off studies’ to dominate the profession. There is an urgent need for large-scale, long-term research and for our national endeavour to be focused and co-ordinated. Given this need, I regret that each of the four countries in the UK is to have its own individual strategy for nursing research. But for bureaucracy -we might have had what we really need at this critical time - a national strategy for nursing research.
Systematic targeting In the United States, for example, a National Nursing Research Agenda (NNRA) has been formulated to ‘provide structure for selecting scientific oppor tunities and initiatives, to promote depth in developing a knowledge base for nurs ing practice, and to provide direction for nursing research within the discipline’. Its purpose is to achieve 'systematic targeting of the endeavours of the profes sion's researchers and resources’ (2). The evolution of the NNRA has been facil itated by the National Center for Nurs ing Research (NCNR). The NCNR, which is sited on the
huge campus of the National Institutes of Health in Bethesda in Maryland, was established about five years ago. Its annual budget has increased from 16 to 40 million dollars over that period. The achievements of the Center in that relatively short time are evident and impressive. The establishment of the Center was a feat of determined and concerted effort, and at the heart was the American Nurses’ Association (ANA), led by its equivalent of the RCN’s Research Advisory Group the ANA’s Council of Nurse Researchers. The ANA is by no means the only nurses’ association to have made an impact on the development of nursing research at national level. There are examples closer to home, as I have learned from my participation as the RCN’s representative in the Workgroup of European Nurse Researchers. The Finnish Federation of Nurses and the Danish Nurses’ Organisation arc two examples of national nurses’ associations in Europe which have provided leader ship, facilities and funding for research and research education. There are other countries, particularly (but not exclus ively) those in Eastern Europe, where economic and political difficulties and low professional status are hampering the development of research. Nevertheless, their national nurses' associations are fighting for a research base for the future. The International Council of Nurses (ICN) has recognised that its members can, and should, play a role in the development of research. The ICN (act ing in partnership with the US National Center for Nursing Research) organised a Taskforce on International Nursing Research in 1990 in Geneva, and I was privileged to be the British participant in that landmark event. The Taskforce report will be distributed to ICN mem ber associations and I hope it will stimulate the RCN to review its position with regard to support for, and leadership of, research in nursing at national and inter national levels. The RCN has a good track record in this respect. Its Research Society (now RAG) has been in existence for some 30 years. Throughout that time, it has played an important role in the pro motion and dissemination of research, and in supporting nurses involved in research, through its meetings, conferen ces and other activities.
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54 Nursing Standard
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Participants at the 14th Annual Meeting of the Workgroup of Nurse Researchers, held in Copenhagen. September 1991. Extreme right: Alison Tierney; extreme left. Jane Salvage, an invited W HO observer.
The RCN has also facilitated the undertaking of research. Between 1967 and 1975, the RCN 'Study of Nursing Care Project' was carried out. It involved 12 individual projects and collectively represents the first of this country's long-term, practice-focused research endeavours. And there is the RCN's 'Standards of Care Project’ which, as 'ODySSSy', is undergoing research evalu ation supported by DoH funding. Continuing contribution Another significant contribution is the RCN's collection of theses in the College Library, the Steinberg Collection. This offers a unique research archive for the profession. The RCN Nursing Research Monograph series, with more than 70 titles, provides a continuing contri bution to the dissemination of research. So too, on a smaller scale, does the annual Winifred Raphael Memorial Lecture
which is held in the College and is needed if the College generally, and the arranged by the Research Advisory Research Advisory Group specifically, Group, which ensures the later publica are to give leadership and support in tion of the lecture. tackling the challenges for nursing The first Chair in Nursing Research in research, both nationally and interna the UK, established at the University of tionally, in the 1990s and beyond. Wales in 1987, was endowed with funds raised by the RCN. And, within the Alison Turney Bsc, PhD. RCN. is Director College itself, there is the Daphne Hcald of the Nursing Research Unit. University of Research Unit, a Director of Policy and Edinburgh, and Chair of the Research Advis Research, a full-time research adviser and ory Group. other staff with a research remit. Yes, the RCN does have a good record in its References development of research in nursing. 1. Audit Commission. The Virtue of Pat But, mirroring what has happened in ients: Making Best Use of Ward Nursing the profession at large, the College's Resources. The Audit Commission for contribution in support of research devel Local Authorities and the NHS in En opment has been largely ad hoc and gland and Wales. London, HMSO. opportunistic. There has been no explicit 1991. full-blown research strategy, either 2. Hinshaw AS et al. Evolving clinical within RCN headquarters or for College nursing research priorities; national endeavour. Journal of Professional Nursing. activities as a whole. A RCN Research Strategy is urgently 1988. 4, 6, 458-459.
February 5/VoIumc 1992 Nursing Standard 55 Downloaded from RCNi.com by ${individualUser.displayName} on Sep 13, 2016. For personal use only.6/Number No other 20 uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
Challenges for nursing Alison Tierney offers a personal view of the role of national nurses’ associations in an era of challenge for nursing research world-wide. Throughout the world, research-based knowledge about nursing has never been so much in demand. Recent changes in the NHS, and the politico-economic climate in the United Kingdom, exert an urgency on British nursing to justify its worth and cost. From past research we have learned about the need for improvement. We know that patients’ pain is not always managed effectively; that our commu nications with patients and relatives are not as clear as they could be; and that many routine nursing activities are per petuated in spite of evidence that they are neither beneficial to, nor easily tolerated by, patients. What we have not done enough of is research that demonstrates how to im prove the quality and effectiveness of nursing, and provides evidence to con vince others of the things which we, as nurses, believe we do well. The fact that there has been ‘little research into the effectiveness of nursing practice’ was noted in a recent Audit Commission report (1). The greatest challenge for nursing research, both nationally and internationally, lies in the development of methods and measures which demonstrate the effectiveness of nursing and its impact on outcomes of health care for patients, families and communities. Patient-outcomes research (as it is now known) is notoriously difficult. Making headway is not going to be easy, given the limited research skills and resources at our disposal. Although the profession’s research capability has increased over the past 20
years, it is still limited. We need a stronger cadre of nurse researchers with the ability to win the resources to gener ate the findings which justify urilisation in practice and policy by virtue of their kind, quality and scale. There has been little research of that order. Individual small-scale studies have a place in the overall development of research and research expertise, but we have been slow to recognise the limitations of allowing what I call ‘one-person, one-off studies’ to dominate the profession. There is an urgent need for large-scale, long-term research and for our national endeavour to be focused and co-ordinated. Given this need, I regret that each of the four countries in the UK is to have its own individual strategy for nursing research. But for bureaucracy -we might have had what we really need at this critical time - a national strategy for nursing research.
Systematic targeting In the United States, for example, a National Nursing Research Agenda (NNRA) has been formulated to ‘provide structure for selecting scientific oppor tunities and initiatives, to promote depth in developing a knowledge base for nurs ing practice, and to provide direction for nursing research within the discipline’. Its purpose is to achieve 'systematic targeting of the endeavours of the profes sion's researchers and resources’ (2). The evolution of the NNRA has been facil itated by the National Center for Nurs ing Research (NCNR). The NCNR, which is sited on the
huge campus of the National Institutes of Health in Bethesda in Maryland, was established about five years ago. Its annual budget has increased from 16 to 40 million dollars over that period. The achievements of the Center in that relatively short time are evident and impressive. The establishment of the Center was a feat of determined and concerted effort, and at the heart was the American Nurses’ Association (ANA), led by its equivalent of the RCN’s Research Advisory Group the ANA’s Council of Nurse Researchers. The ANA is by no means the only nurses’ association to have made an impact on the development of nursing research at national level. There are examples closer to home, as I have learned from my participation as the RCN’s representative in the Workgroup of European Nurse Researchers. The Finnish Federation of Nurses and the Danish Nurses’ Organisation arc two examples of national nurses’ associations in Europe which have provided leader ship, facilities and funding for research and research education. There are other countries, particularly (but not exclus ively) those in Eastern Europe, where economic and political difficulties and low professional status are hampering the development of research. Nevertheless, their national nurses' associations are fighting for a research base for the future. The International Council of Nurses (ICN) has recognised that its members can, and should, play a role in the development of research. The ICN (act ing in partnership with the US National Center for Nursing Research) organised a Taskforce on International Nursing Research in 1990 in Geneva, and I was privileged to be the British participant in that landmark event. The Taskforce report will be distributed to ICN mem ber associations and I hope it will stimulate the RCN to review its position with regard to support for, and leadership of, research in nursing at national and inter national levels. The RCN has a good track record in this respect. Its Research Society (now RAG) has been in existence for some 30 years. Throughout that time, it has played an important role in the pro motion and dissemination of research, and in supporting nurses involved in research, through its meetings, conferen ces and other activities.
Downloaded from RCNi.com by ${individualUser.displayName} on Sep 13, 2016. For personal use only. No other uses without permission. February 5/Volume 6/Number 20 1992Copyright © 2016 RCNi Ltd. All rights reserved.
54 Nursing Standard
|
1
j i
I
■
%
u' , Ki it
■ V
a?
1JK .
I
Participants at the 14th Annual Meeting of the Workgroup of Nurse Researchers, held in Copenhagen. September 1991. Extreme right: Alison Tierney; extreme left. Jane Salvage, an invited W HO observer.
The RCN has also facilitated the undertaking of research. Between 1967 and 1975, the RCN 'Study of Nursing Care Project' was carried out. It involved 12 individual projects and collectively represents the first of this country's long-term, practice-focused research endeavours. And there is the RCN's 'Standards of Care Project’ which, as 'ODySSSy', is undergoing research evalu ation supported by DoH funding. Continuing contribution Another significant contribution is the RCN's collection of theses in the College Library, the Steinberg Collection. This offers a unique research archive for the profession. The RCN Nursing Research Monograph series, with more than 70 titles, provides a continuing contri bution to the dissemination of research. So too, on a smaller scale, does the annual Winifred Raphael Memorial Lecture
which is held in the College and is needed if the College generally, and the arranged by the Research Advisory Research Advisory Group specifically, Group, which ensures the later publica are to give leadership and support in tion of the lecture. tackling the challenges for nursing The first Chair in Nursing Research in research, both nationally and interna the UK, established at the University of tionally, in the 1990s and beyond. Wales in 1987, was endowed with funds raised by the RCN. And, within the Alison Turney Bsc, PhD. RCN. is Director College itself, there is the Daphne Hcald of the Nursing Research Unit. University of Research Unit, a Director of Policy and Edinburgh, and Chair of the Research Advis Research, a full-time research adviser and ory Group. other staff with a research remit. Yes, the RCN does have a good record in its References development of research in nursing. 1. Audit Commission. The Virtue of Pat But, mirroring what has happened in ients: Making Best Use of Ward Nursing the profession at large, the College's Resources. The Audit Commission for contribution in support of research devel Local Authorities and the NHS in En opment has been largely ad hoc and gland and Wales. London, HMSO. opportunistic. There has been no explicit 1991. full-blown research strategy, either 2. Hinshaw AS et al. Evolving clinical within RCN headquarters or for College nursing research priorities; national endeavour. Journal of Professional Nursing. activities as a whole. A RCN Research Strategy is urgently 1988. 4, 6, 458-459.
February 5/VoIumc 1992 Nursing Standard 55 Downloaded from RCNi.com by ${individualUser.displayName} on Sep 13, 2016. For personal use only.6/Number No other 20 uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
