Developing a Culture of Inquiry through Nursing Research: A New Hospitals' 3-Year Journey to Magnet® Designation

Background: The American Nurses Credential Center (ANCC) Magnet Recognition Program® and its key components are considered a driving force for building professional practice environments that are healthy and supportive of nurses (Sherman & Pross, 2010).  Magnet® designation helps to promote nursing professional development, resulting in positive work environments and increased nurse satisfaction (Renter & Thallas, 2014).  Part of professional development is the engagement of nurses in a culture of nursing inquiry which is showcased in the New Knowledge and Innovation, and Improvements portions of the Magnet® designation application.  When developing a culture of nursing inquiry through a nursing research program it is important to keep nursing research visible through its integration into nursing staff meetings and organization meetings (Steele-Moses, 2010).  In addition, the initiation and utilization of a nursing research council, with a clearly defined purpose, along with a step by step process for obtaining approval for research is essential for sustaining a productive nursing research program (Steele-Moses, 2010).    

Objective:  The overall objective was to create a culture of nursing inquiry through the development of a strong nursing research program.  Secondary objectives included: (1) developing inter professional research lead by clinical staff; and (2) providing exemplar nursing research to support Magnet® designation in three years.

Implementation:   From the conception of West Kendall Baptist Hospital (WKBH), a non-replacement hospital which opened in 2011, a culture of inquiry through nursing research was created by employing a Nurse Scientist to develop the program from the ground up.  The Nurse Scientist was added as a standing voting member of the Nurse Governance Council which further anchored WKBH’s support in recognizing the value of research and assisted in hardwiring the culture of inquiry.  Not only did this include the Nurse Scientist’s consistent outreach during staff meetings and membership on hospitals councils, but also the development of an inter professional Evidence-based Practice (EBP)/Research Council.  The purpose of the council is to support evidence-based nursing and allied health practice while providing a forum for the facilitative review process of all WKBH research protocols.  Therefore, during monthly council meetings the Nurse Scientist and EBP/Research Nurse Educator provide mini research educational sessions to the direct patient care nurses and allied health professionals with the expectation that they will disseminate to their respected units/ departments to assist in supporting and maintaining the culture of inquiry.  In addition, the council is tasked with reviewing all nursing and allied health research based on four components: clinical significance, professional significance, logistics, and human protection in research.  This focused review format helps all council members, especially those with less research experience but strong clinical expertise, to successfully participate and provide essential clinical input.  This facilitative review helps to expedite the Institutional Review Board (IRB) approval resulting in more active studies progressing toward answering important clinical questions.  Furthermore, once the research studies are complete, the Nurse Scientist continues to support the nursing and allied health research studies through the dissemination process.  For example, the Nurse Scientist maintains an ongoing abstract book for all research studies so that researchers can easily adapt their abstracts for submission to conferences.  Finally, the Nurse Scientist assists the research team in navigating through the publication process and team writing.  

Outcomes:  During the first year of opening there were 9 active research studies that included WKBH nurses as Principal Investigators (PIs) or members of the research team.  One of these studies is assessing the effects of nighttime use of earplugs on delirium onset and sleep perception of patients in the Intensive Care Unit (ICU) which is funded by the Neuroscience Nursing Foundation and the PI is a direct patient care nurse working in the ICU.  By the end of 2014, there were 23 active research studies that include WKBH nurses as PIs or members of the research team.  Of these studies a second grant was awarded to a Medical/Surgical direct patient care nurse from the Academy of Medical/Surgical nurses for the first PI-initiated randomized controlled trial assessing the impact of 4% sodium bicarbonate additive during intravenous Potassium Chloride replacement on pain and incidence of phlebitis.  In addition, to the development of research there have been over 30 accepted abstracts for posters or podium presentations at local, national, and international conferences.  There have also been 3 publications in peer-reviewed journals.         

Implications: Developing and implementing a culture of inquiry through a nursing research program can be successful and sustainable in the clinical setting by integrating the concept into staff and organizational meetings along with the utilization of an EBP/Research council.  In addition, having a Nurse Scientist assists with the management of the research program along with promoting direct patient care nurses in developing research through research mentorship.    

References:

Renter, M., Thallas, A. (2014). How Magnet® designation affects nurse retention: An evidence-based research project. American Nurse Today, 9(3). Retrieved from http://www.americannursetoday.com/how-magnet-designation-affects-nurse-retention-an-evidence-based-research-project/.

Sherman, R. & Pross, E. (2010). Growing future nurse leaders to build and sustain healthy work environments at the unit level. Online Journal of Issues in Nursing, 15. Retrieved from http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol152010/No1Jan2010/Growing-Nurse-Leaders.html.

Steele-Moses, S.K. (2010). The journey to Magnet®: Establishing a research infrastructure. Clinical Journal of Oncology Nursing, 14(2), 237-239.