NK - New Knowledge, Innovation, and Improvements

NK 4 The structure(s) and process(es) used by the organization to develop, expand and/or advance nursing research

Nursing Research Council

The Nursing research Council is instrumental in expanding and advancing nursing research at JCMC. This is accomplished through the integration of research into practice, fostering staff member knowledge and skill in research and promoting evidence based practice (EBP). The Nursing Research Council establishes a process by which nursing research project are designed and conducted for the purpose of:

  • Enhancing the professional practice of nursing
  • Improving patient care interventions and/or outcomes of care
  • Utilizing research as a strategy for developing evidence-based practice and practice standards
  • Developing collaborative and interdisciplinary research to improve patient care

The nursing research council serves as a forum for approval of all studies involving nurses as investigators, participants, or subjects. All nursing research studies move through two levels of review. The first step is to obtain approval by the Nursing Research council, comprised of staff nurses from every nursing unit. As part of this process, the nurse investigator submits a letter of intent and presents the proposal to the research council. Council members evaluate the aims, methodology, and data collection procedures to determine the following:

  • The problem is relevant and timely
  • The research design is appropriate and logical
  • The rights and safety of patients, staff nurses and the nursing profession are maintained and protected
  • The study does not interfere with or compromise existing nursing care
  • The study is feasible in terms of staff time, space and/or materials required
  • Results will be disseminated amongst Nursing Research council members, nursing staff and nursing leadership

Once the nursing research council approves the study, a letter of approval is provided to the investigator and the IRB. The IRB will not accept any nursing protocols without approval provided by the Nursing research council. A sample letter of approval can be seen in Appendix NK4-A

In addition, Council members serve as mentors and resources for peers who are interested in conducting nursing research. All nurses interested in developing a research proposal are assigned a nurse mentor to assist with the IRB proposal and presentation as indicated in the “Nursing Research Approval Process” guideline (Reference NK4-A). The research council members also support the advancement of research projects by assisting and facilitating the study. For example council members have participated in subject recruitment, and obtaining consent for various nursing research projects.

North Jersey Research and Evidence Based Practice Consortium

One of the goals for 2010 was to partner with other facilities on shared research activity and mentorship to advance nursing knowledge and expertise in research activities. Joining the Northern New Jersey Research and Evidence Based Practice consortium (NJREBPC) in 2010 has proven valuable in accomplishing this goal. The mission of the consortium is the expansion of nursing research and evidence-based practice within the region through a collaborative center of excellence. Currently, the consortium provides a forum for collaboration among six local magnet hospitals. Two main goals are to initiate collaborative research projects across institutions and provide continuing education programs that enhance the knowledge base of nurses at all levels. The Consortium was divided into two subgroups, Mabel LaForgia MSN, RN, CNL attends the Research Subgroup and Nicole Sardinas MSN, RN, attends the education subgroup. During this past year both groups have been working diligently to accomplish these goals.

The Research Subgroup has developed and implemented a collaborative research study (Reference NK4-B). A multi-site retrospective chart review of heart Failure (HF) patients readmitted within 30 days of discharge was performed. The purpose was to determine the demographic, physiologic and psychosocial differences, among the six hospitals in HF patients. An evidence based tool was developed and guided the data abstraction. Of the total CHF readmissions in 2010 every fourth medical record was selected. Results show that 25% of total readmission rates for HF patients for all hospitals ranged from 18 to 79 patients. Similarity and differences identified among HF patients were: Gender: males 52%, females 48%; Average age: 41% of population 80-89 years; 57% admitted from home; 55% live with spouse/partner/extended family; 52% are readmitted with cardiovascular ICD codes. An abstract for a poster presentation of this study was submitted to the National Magnet Conference for dissemination of study finings. Currently the nursing leaders from the consortium are in the process of reviewing the data analysis and planning further research activities to identify and implement nursing interventions aimed at reducing heart failure readmission rates.

JCMC Joins North Jersey Nursing EBP/Research Consortium

The goal of the education subgroup has been to collaborate on the development of an original series of learning modules to be shared across the member Magnet facilities. These learning modules are divided into the topics of research, evidence-based practice, and performance improvement. Each topic is further sub-divided into three progressing lessons based on Patricia Benner’s theoretical model of From Novice to Expert. The ultimate objective is to provide the tools necessary to differentiate between the topics, and prepare nurses with varied levels of comfort to implement ideas of best practice within their institutions and communities. To date, the novice-level lesions for each topic have been completed and are waiting pilot testing at each facility. By the end of the first quarter 2012, the completed lessons will be available to all member hospitals for staff use.

The Northern New Jersey Evidence Based Practice Consortium provides a unique collaborative opportunity for regional nurse leaders to share ideas and resources. Both subgroups meet regularly to plan, implement, and evaluate projects that impact quality nursing practice.

Research Budget

Economic Support is necessary to develop, expand, and advance nursing research at JCMC. Financial support is available to advance staff nurses’ knowledge in the nursing research process, promote use of evidence based practice, and promote resources for the nursing staff at the point of care. $20,000 is allocated yearly to fund research projects, poster presentations, consortium fees, and research/EBP educational activities. Costs such as poster materials, printing, laminating, copying cost, development of tools, and speaker honorariums are funded. JCMC sponsors two annual nursing research events the “Nursing Symposium” and the “Nursing Research fun fair”. Furthermore, nurses who attend outside conferences or participate in research activities are compensated for their time. An additional $20,000 (Appendix NK4-B) is budgeted each year to fund electronic point of care evidence based resources and electronic databases such as CINAHL and “The Nurse Reference Center” as explained further in NK6. The focus on nursing research is an ongoing developing process. Budgeting for each of these activities is done prospectively during the budget preparation. Consideration is given when allocating resources to ensure sufficient funds are available to support the advancement of nursing research at JCMC.

Research Consultation and Mentoring in Nursing Research

Since 2007, Sue Salmond EdD RN Dean of UMDNJ School of Nursing has been contracted to serve as nursing research consultant for JCMC. She has played a tremendous role in establishing a process whereby nursing research projects are designed and implemented. Because of her extensive expertise and knowledge in research she works closely with the chairperson of the Research Council in approval, monitoring and evaluation of nursing research project at JCMC. Some of her functions include:

  • Identifying areas suitable for nursing research
  • Provide input on current projects
  • Provide guidance on how to structure nursing research projects
  • Assist staff nurses with IRB proposals and Grant applications
  • Provides guidance and resources to nurse researchers as needed
  • Provides education to staff nurses, nurse managers, and Research council members as needed

When a staff nurse is interested in proposing a research project, the idea is presented to the Research Council for review using the “Application of Intent to Conduct Nursing Research at JCMC” (Appendix NK4-C) The following information is proposed and submitted to Dr. Salmond for review:

  • Title of research project and question
  • Literature review on the topic
  • Project setting
  • Study procedure
  • Anticipated sample size and estimated time frame
  • Human subject requirements and consent requirements
  • Enhancement of research finding to nursing practice

Mabel LaForgia MSN, RN, CNL Chair of the Research Council communicates with Dr. Salmond on a monthly basis to update and review current and ongoing projects, research issues and questions which may arise. Dr. Salmond offers advise and suggestions as needed through email and meeting participations.

One of her most valuable contributions to the council is her ability to embrace staff nurses’ interests and ideas and guide them through the process of developing well designed research protocols. This is done through on-going mentoring and support during the research design and development process. For example in September of 2010, Dr. Salmond spent an evening at JCMC meeting with 5 staff nurses who were interested in developing research proposals based on their specific topics of interest (Appendix NK4-D). Isabel Pitao BSN, RN and Vinnie Gelicame BSN, RN presented Dr. Salmond with an idea to study the quality of life among dialysis patients with hemoglobin less than 12g/dl in outpatient settings. Dr. Salmond brainstormed ideas with the nurses and provided direction on how this project could be structured and analyzed. Her advice included suggestions on how to recruit participants, appropriate sample sizes, literature review, ethical obligations, and financial considerations. Vinnie and Isabel full time nurses in the renal department, worked on their research during their off shifts with the support of the Nursing Research Council and Dr. Salmond. On March 17th, 2011 a research proposal was submitted to the JCMC IRB and was approved pending revisions to the consent form (Appendix NK4-E). Dr. Salmond continues to be an essential resource to this team and is available to assist with the execution and completion of their project when needed.

Many additional mentors are available to nursing staff in order to encourage inquiry and participation in research projects. The Clinical Nurse Leaders (CNL) at JCMC provide mentorship in many forums. They are available to any staff nurse as resources regarding clinical research. In addition they offer recommendations and guidance on clinical problems and unresolved clinical questions that often lead to research inquiry. For example a telemetry RN emailed Mabel LaForgia MSN, RN, CNL, for assistance on a proposed project regarding alarm fatigue and nurse desensitization to different alarm sounds (Appendix NK4-F). The Clinical Nurse leaders are very knowledgeable regarding the research process and frequently review and disseminate research findings regarding identified clinical problems amongst the staff. Staff nurses do not hesitate to approach the CNLs regularly with their questions and proposed projects.

Educational offerings on Nursing Research and Evidence Based Practice

The key to advancing nursing research initiatives depend on ongoing education of the nursing research and evidence based practice process. JCMC has embraced a strong commitment to promote nursing research and evidence based practice through educational activities. The Nursing Research Council plans two main events per year to foster staff member knowledge and skills in evidence based practice through formal and informal interactive educational offerings. These events provide nursing staff:

Alegria Lim BSN, RN, CCRN, Regina O’Donnel BSN, RN, CCRN and Vinnie Gelicame BSN, RN
 Alegria Lim BSN, RN, CCRN, Regina O’Donnel BSN, RN, CCRN and Vinnie Gelicame BSN, RN  
  • Two all day events dedicated to nursing research and evidence based practice
  • Exposure to ongoing research and evidence based practice activity
  • Opportunity to share impact of their research and hear new perspectives from others
  • Form collaborative relationships with fellow nursing colleagues, academic partners, and other healthcare institutions
  • Community involvement

Since 2010, The Nursing Research Council recognizes that a formal educational event is necessary to provide staff nurses and nursing students the opportunity to show case their research projects and expose JCMC nurses to research activity from other academic and healthcare organizations. The Nursing Research Council members plan the event, select themes, speakers, designs flyers, and brochures. A call for abstracts (Appendix NK4-G) is distributed amongst various neighboring healthcare organizations and academic settings. A blind peer review process is employed to guarantee objectivity when selecting the most qualified poster and podium presenters. The symposium is offered without charge to any JCMC nursing employee or nurse resident.

On October 25, 2011, JCMC sponsored its 2nd Annual Nursing Research Symposium (Appendix NK4-H). The theme selected by the council was “Improving Quality at the bedside. This daylong event featured nationally recognized speaker Dr. Dula Pacquiao ED, RN, CTN as the keynote speaker. She presented the latest best practices and research evidence in addressing health care disparities. Other highlights of the event included four featured speakers, decoding a research article workshop, and break out poster sessions. Nearly 15 poster presentations developed by staff nurses form JCMC, other Magnet designated healthcare organizations, and academic settings were showcased at this event. In attendance were 60 nurses, nursing students and faculty members from neighboring academic center, North New Jersey EBP consortium hospitals, Magnet designated facilities, and other healthcare organizations. The Nursing symposium successfully demonstrated how knowledge translation and implementation could impact patient outcomes

Marie Jean staff nurse on 7W states “I learned so much at the Nursing Research Symposium. My favorite speaker was Dr. Caldwell PHD, from UMDNJ who discussed her observational study regarding sleep patterns and psychological distress in women who live in inner cities. Until this day I remember the importance of sleep for my patients and myself. I look forward to working with Dr. Caldwell on a future study regarding sleep patterns and nurses who work 12 hour shifts”

The following were poster presentation presented at the Symposium:

NK4-Table 1

Christina Simeone BSN, RN & Maria Benardo BSN, RN
 Christina Simeone BSN, RN &
Maria Benardo BSN, RN

Since 2010, the Nursing Research Council elected to enhance learning of the research and evidence based process by sponsoring a yearly “Nursing Research Fun Fair” Event. This event promotes research activity and evidence based practices with fun filled games and interactive methods. Staff members creatively present research findings and demonstrate how they influenced nursing practice on their individual units using games, prizes, and give-a-ways.

Vivian Chang RN & Laura Alves RN
 Vivian Chang RN & Laura Alves RN  

The goal of this event is to increase awareness and knowledge regarding the integration of research, best evidence, clinical practice guidelines and patient values into daily practice. The enthusiasm and dedication of the nursing staff is impressive as they build on their knowledge and engage in learning the research process. Yearly themes used include:

  • 2010 - Nursing Research Made Incredibly Easy! (Appendix NK4-I)
  • 2011 - “Teaching our patient using evidence based Practice” (Appendix NK4-J)

In 2011, the council invited visitors and community member to join in on the fun and learn about the different evidence based topics in healthcare. The event was a success with over 150 JCMC employees and community members in attendance.

In 2012, conference room space was scarce due to EMR training, the Nursing Research Council decided to be innovative and take the show on the road. The research fun fair was presented daily on each unit’s solarium. This allowed the opportunity for participation of nursing staff members and visitors. Over 200 Nursing employees and visitors attended the fun fair.

Pamela Santiago APN-C
 Pamela Santiago APN-C  

During the last three years the nursing research fun fair has successfully engaged staff nurses, hospital employees, and the JCMC community in the nursing research process and evidence based practice.

Pamela Santiago APN-C staff nurse on 5West states “I had the opportunity to present an evidence based poster on the reduction in the use of seclusion and restraints on 5W-Behavioral Health. I enjoyed sharing the unit’s successes with other nurses and learning about all of the other evidence based and research projects nurses from other units participating in. It’s so nice to see how evidence based practice can have such great outcomes on patient care”