Research in Nursing
by Dr. Nancyruth Leibold
Nurses should always check a source to determine if it is credible before using. To determine if a source is credible or not, there are several factors to consider. The Department of Nursing at Southwest Minnesota State University (SMSU) recommends the criteria in the CRAAP Test. The CRAAP Test resource (California State University, 2010) is in the Nursing Research Guides at the SMSU Library is at http://libguides.smsu.edu/c.php?g=432710&p=2951108
The CRAAP Test includes five criteria:
- Currency
- Relevance
- Authority
- Accuracy
- Purpose
Currency
In nursing, a source is best if it is current within five years. Since the basis for nursing practice is research findings, it is best practice to use the most recent evidence to improve patient/family care. There are times when it is appropriate to use older sources. For example, an author may cite original work such as Notes on Nursing, written by Florence Nightingale or an original source of a theory. Another time that it is appropriate to cite old sources are when describing the history of a topic or issue. Some reports or documents may be older but are the most current ones available. For example the most recent Essentials for Baccalaureate Nursing Education document was published in 2008 by the American Association of Colleges of Nursing. Another instance when it is appropriate to cite older sources is if very little on the topic is published. A source less than ten years is okay to use, but the more current, the better.
Relevance
Is the information relevant to the topic? Is the level of information appropriate for the intended audience (California State University, 2010)? Nurses must always consider how practical and practical since nursing is an applied discipline (Dexter, 2000).
Authority
The most reliable publication of information in nursing is peer-reviewed, scientific journals. The publisher should have a credible reputation. Some U.S. Government sources list the agency but not the individual person as the author. Some internet sources are credible, such as The Centers for Disease Control and the National Institutes of Health. Most U.S. Government agencies, such as the U.S. Department of Health and Human Services are credible internet sources written by experts in the field.
Accuracy
Besides the authority, examine the author’s credentials, qualifications, and place of work. Another area to consider is replication of data. When five journal articles offer the same research findings, it lends credibility to the sources. Nurses should look for the credentials and expertise of the author to determine the accuracy of the source.
Purpose
In healthcare, another point to consider is the purpose of the information. Nurses should consider whether the information provided is educational, or if it is part of a sale pitch. A source that was funded by a party or agency with an agenda may not be credible. For example, a research study that was paid for by a pharmacy company may publish findings that favor the medication. Sources independent of funding are more reliable, because they do not have a conflict of interest.
Scholarly journals
The discipline of nursing has many outstanding scholarly journals. There are too many to list but some major journals are below. The list includes numerous specialty journals listed since most nursing practice is in specialty areas. The nursing practice within an operating room is very different from the nursing practice in a psychiatric hospital.
These publications are key because they are peer-reviewed, double-blinded publications. That means that an author submits the manuscript for publication and an editor reviews if the manuscript fits the mission of the journal. If so, the manuscript has all author identification removed and two or more expects on the topic review it for accuracy and scholarship. The reviewers comment on if the manuscript is accurate and make any writing recommendations for improvement. Sometimes the reviewers vote no to publish and the editor sends a rejection letter to the author. The intent of this process is to make certain that only credible, accurate, and well-written manuscripts appear in the journal.
Major Scholarly Journals in the Nursing Discipline:
- American Journal of Nursing
- American Journal of Public Health
- Holistic Nursing Practice
- Journal of Advanced Nursing
- Journal of Professional Nursing
- OJIN: The Online Journal of Issues in Nursing
- International Journal of Nursing Knowledge
- International Journal of Nursing Practice
- MEDSURG Nursing
- Critical Care Nurse
- Rehabilitation Nursing
- Nephrology Nursing Journal
- Nursing Education Perspectives
- Journal of Clinical Nursing
- Journal of Trauma Nursing
- Journal of Nursing Management
- Journal of Nursing Scholarship
- Journal of Neurological & Neurosurgical Nursing
- Journal of Nursing Care Quality
- Issues in Mental Health Nursing
- Journal of Nursing & Healthcare Research
- JOGNN: Journal of Obstetric, Gynecologic & Neonatal Nursing
- Journal of Perioperative Practice
- Journal of Gerontological Nursing
- The Journal of School Nursing
- Worldviews on Evidence-Based Nursing
Trade publications
Examples of trade publications in nursing include American Nurse Today, Independent Nurse, Med-Surg Matters, Minnesota Nursing Accent, and Reflections on Nursing Leadership. The main difference between a scholarly journal and a trade publication is that scholarly journals include research evidence and are evidence based, whereas trade publications include news stories, legislative updates, and some include advertisements aimed at nurses. A trade publication is helpful when reading about legislative news or current events. However, a trade publication may not have evidence-based practice information.
Open Internet resources
Credible sources can provide a wealth of information for nurses. The concern with using internet resources is that the information may not be factual or evidence-based. The nurse must use critical thinking to appraise an internet source for credibility. The CRAAP test is one tool that nurses can use to determine how reliable and credible an internet source is and the tool is available at http://libguides.smsu.edu/c.php?g=432710&p=2951108
There are credible internet resources, such as government agencies that publish population data, mortality, and morbidity data. For example, the Minnesota Department of Health, Health Statistics Portal at https://www.health.state.mn.us/data/mndataportal/index.html is a credible source of birth, death, and population queries, county health data tables, Minnesota Health Statistics Annual Summary, and tobacco use data. The Minnesota Department of Human Services (2016) is a credible website that houses income and asset limits that provides information about qualifying for Minnesota Health Care Programs. There are some good examples, but nurses must analyze each source for value.
Government agencies
Government agencies are credible sources of health information in nursing. Many health statistics and epidemiology data are published at government agency websites, such as the Centers for Disease Control. For example, the Centers for Disease Control monitor rates of infections and publish this data on their website. Public health data, such as demographics, vital statistics, economics, and community context is available on government agency websites. Nurses use this data to assess, plan, write community health nursing diagnoses, implement, and evaluate health care.
Statement of ethics and research in Nursing
Nursing research includes specific standards for nurses to follow. Informed consent is required in all human subject research. This is commonly required in nursing research, unless the research is of literature (such as a literature review that does not include human subjects). In the United States, there is a federal mandate to protect the rights of human research participants. Nursing research falls under the Code of Federal Regulations, Title 45, Public Welfare through the Department of Health and Human Services, Part 46, Protection of Human Subjects. Nurses must follow this code under federal law. Nursing also follows The Belmont Report—Ethical Principles and Guidelines for the Protection of Human Subjects of Research. In the course, NURS 430, Evidence-Based Practice, learners complete the National Institutes of Health (2011) Protecting Human Research Participants Institutional Research Board Training. The National Institutes of Health institutional research board course prepares nurses with the information and skills necessary for ethical research practice. Institutional Review Board Approval is required at all facilities related to the research involving human subjects.
While there may not be any widely-known corruptions of research in nursing today, the past is responsible for several significant violations of the protection of human subjects in research (National Institutes of Health, 2011), such as Nazi Medical War Crimes or The Tuskegee Syphilis Study. In the Tuskegee Study, African American male participants did not receive treatment for syphilis, despite the cure of penicillin that was readily available (Godshall, 2016). For over forty years, participants in the study were tracked and the stages of syphilis progression were recorded. No information was given to the Tuskegee military pilots that the treatment for syphilis was intentionally withheld to study the progression of the disease. The airman were not provided with information about treatment options or the effects of not receiving antibiotic therapy. Many of the men died from the lack of treatment (Godshall, 2016). This intentional and unethical violation of human rights is not acceptable. Today, an explanation of the risks is given to every participant of every study before any research is started and informed consent is a requirement. All research studies that include humans must receive institutional review board approval before implementation. Legal guardians or parents give informed consent for children (Godshall, 2016). Nurses have an ethical responsibility to follow the ethical guidelines for protection of human subjects in research.
Presenters or authors are required to disclose any financial incentives when disseminating research through presentations or publications because of the potential for conflict of interest (Hutchinson & Rubinfeld, 2008). For example, if a researcher is presenting research about how well a new heart medication works, they must disclose if they receive money from the pharmaceutical company that manufactures the heart medication. Presenters and authors in nursing are often required to complete a disclosure form and sign it, even if there are no disclosures to make.
View a video on research in the field of nursing here.