Known the world over for its strong basic science and its fundamental mission as a clinical research hospital, Cleveland Clinic is placing renewed emphasis on the importance of research by nurses. Although nurses have long been involved in clinical research efforts, nurses at all levels of nursing practice—bedside, clinical nurse specialists, educators, managers—are being encouraged to engage in scientific inquiry. Cleveland Clinic nurses have the opportunity to raise a question about nursing practice, and through the research process, investigate that question with the goal of promoting and assuring evidence-based nursing practice and optimum patient care.

To encourage research by nurses, Nursing Research assigns a PhD trained nurse researcher to each Cleveland Clinic Institute who serves as a mentor to clinical nurses. A mentor stimulates and supports the development of research questions or generates ideas regarding nursing practice changes that will prompt evaluation of current practices and foster improved standards for patient care. Mentors assist nurses in every step of research, as needed; from identifying clinical problems, initiating research questions, completing paperwork for Institutional Review Board approval and grant funding groups, conducting and analyzing research, and presenting and disseminating findings. Research findings will determine how nurses deliver care, educate each other, and manage their practice. When nursing practice is evidence-based, patients are more likely to receive nursing care that is safe and effective, promotes comfort and facilitates the best outcomes.

Additionally, each PhD nurse researcher has her own program of research that is actively pursued. In this way, researchers are always current with governing rules of research, are aware of grant and other opportunities open to those they mentor and can include staff nurses in their projects, to aid in general nursing research growth.

How the Research Process Works

Staffed by registered nurses with a Ph.D. Research by nurses helps generate new knowledge to firmly establish nursing practice that is evidence-based. Nurses may initiate projects that broaden the scope of nursing practice, utilize new methods to assess, plan, deliver or evaluate nursing care or work collaboratively with other Clinic teams to manage patient populations more effectively. In addition, nurses who learn the research process can become mentors to other clinical nurse peers who are inexperienced in research, with the goals of:

• improving the confidence of clinical nurses in their ability to conduct basic research
• aiding clinical nurses in the processes of conducting research
• guiding clinical nurses in anticipating results and promoting practice changes based on results and
• supporting dissemination of research through presentation at a national meeting and publication in a peer-reviewed journal.

Research findings will help determine how nurses deliver care, educate each other and manage their practice. Nursing research may be descriptive /correlational (e.g., noise levels on a unit) or quasi-experimental / experimental (e.g., assessing the effect of a new patient intervention); it may be qualitative (understanding complexity of nursing care) or quantitative; or it may be retrospective, prospective or longitudinal in design. Nurse researcher mentors assist nurses in instrument development (when needed) and assure content validity and reliability of new tools when doing so. For example, a clinical nurse specialist and a team of nurses on the medical intensive care unit at the Clinic developed an algorithm for sedation for patients on respirators and breathing tubes. The goal was to improve patient rest, reduce anxiety and decrease irritation in the throat. After conducting a fully researched and documented trial, with data collection and analysis, the team determined that the new sedation algorithm was safe and effective. Their research led to a sedation protocol that became the standard of practice.

Overcoming the Time Factor

Although many nurses do not consider research a part of their scope of practice and currently do not make time to undertake a research project, Cleveland Clinic believes the future of nursing practice will be strongly influenced by the findings from ongoing nursing research. In placing emphasis on the importance of nursing research, the Clinic is studying ways to make time for nurses to conduct research projects; time that does not negatively impact patient care.

Professional Growth

By participating in research projects, nurses become leaders in their own departments by working to improve nursing practice and patient care. Nursing researchers can mentor a clinical nurse through the entire research process, as needed. We also provide opportunities to share completed research among peers internally, through oral and poster presentations at our annual Research Day, held in May each year (during Nurses Week) and oral presentations at our fall workshops.

Prior to publication, nurses have the opportunity to present their findings at national meetings, thereby influencing patient care and nursing practice at a national level. Research provides the opportunity to further knowledge, to gain recognition and prominence in setting standards for patient care and nursing practice, and to grow personally and professionally. Nursing research activities can be used to clinical ladder activities.

Department Description

In addition to roles as a nurse consultant, mentor, and educator to nurses, the Nursing Research and Innovation department provides other resources to aid the research process. Our Intranet website provides templates and forms to assist nurses and links to other departmental resources. We maintain a database of current, completed and abandoned research projects so we have up-to-date information on nursing research activities. We offer a Nursing Research Day educational program annually (1 day) and up to 12 workshops every fall on a variety of topics. Workshops provide an opportunity for nurses to learn in smaller groups and receive hands-on experiences. Examples of workshop themes are: developing an instrument; writing an abstract; developing a poster; developing research questions and differentiating quality improvement from quality research, to name a few. We also offer a Nursing Innovation Summit to encourage nurses to be creative and innovative in problem solving.

We encourage students wishing to complete clinical practice hours in research to utilize our department team as preceptors. PhD team members also assist doctorate students by joining the thesis or dissertation teams for DNP and PhD degree work, as clinical experts. .

Director

Nancy Albert, Ph.D., RN, CCNS, CCRN, NE-BC, FAHA, FCCM

Researchers

RNs with a Ph.D. and a master prepared RN with research experience

Nursing Awards

The Cleveland Clinic Nursing Research Fund (NURF) is a privately supported internal grant- making system that supports nursing research. Annually, multiple awards are approved to nurses working in any capacity on the Main campus of Cleveland Clinic or in one of the regional ambulatory practices. Internal grant funds are encouraged and sought to overcome costs associated with the research process.

Cleveland Clinic nurse researchers are widely published in leading medical and scientific journals. They present research papers at national symposia and conferences. Nursing staff have received external grant awards from private, governmental, corporate and professional organizations.

Staffed by registered nurses with a Ph.D. Research by nurses helps generate new knowledge to firmly establish nursing practice that is evidence-based. Nurses may initiate projects that broaden the scope of nursing practice, utilize new methods to assess, plan, deliver or evaluate nursing care or work collaboratively with other Clinic teams to manage patient populations more effectively. In addition, nurses who learn the research process can become mentors to other clinical nurse peers who are inexperienced in research.