A Delphi study on National PICU nursing research priorities in Australia and New Zealand
Introduction
Research is the cornerstone of generation of new knowledge and evidence to support improved practice and optimal patient outcomes.1 However barriers to both undertaking clinical research and implementing evidence into practice still exist.2 Nursing research is relatively young compared to other professions particularly in subspecialties such as paediatric intensive care (PIC). The systematic development of a knowledge base to direct and support PIC nursing is essential and the development of national PIC nursing research priorities may facilitate the process of undertaking clinical research and translating evidence into clinical practice.
Section snippets
Background
The available evidence to guide PIC nursing practice is limited. A search of the Cumulative Index of Nursing and Allied Health Literature (EBSCO) database from January 1992 to March 2011 using paediatric critical care as subject heading, revealed 756 research articles, 47 of which were from Australia and/or New Zealand. The topics addressed in this small number of Australian studies included parenting, decision-making, communication, nurses’ education, weaning from ventilation, feeding, pain
Design
The classic Delphi technique was used as a practical and valid approach to identify and prioritise clinical nursing research questions.4, 6, 7, 8, 9, 13 The structured process for collecting and condensing knowledge from a group of experts by means of a series of questionnaires interspersed with controlled opinion feedback was described by the RAND Corporation in the 1950s.14, 15 The process consists of response–analysis–feedback–response repeated two or three times16, 17. Advantages of the
Demographic profile
Nearly half (46%) of the participants were aged between 41 and 50 years. The median of professional experience was 15 years for general nursing and 9.5 years for paediatric intensive care nursing. Just over a third of the nurses who participated in the study had completed a postgraduate qualification and another third completed graduate studies (bachelor level). The majority (55%) were employed on a full time, permanent basis. Table 1 presents the demographic characteristics of participants in
Discussion
This study reports on research priorities as identified by specialist level registered nurses working in PIC units in Australia and New Zealand at the time of the study. The response rate in this study indicates a good representativeness of the study population and that the findings reflect the views of PIC nurses. Because the panel of respondents was constituted of nurses working in PIC at specialist level at the time study, it is likely that the results are truly relevant to their clinical
Conclusion
This study reports on research priorities as identified by specialist level registered nurses working in PIC units in Australia and New Zealand at the time of the study. The results reflect important current issues related to critically ill children and their families as well as the nurses caring for them. More specifically, these issues include assessment and management of patient comfort and pain, neurological protection following cerebral insult, weaning from mechanical ventilation and two
Recommendations
ACCCN established a Paediatric Advisory Panel in 2009. The research priorities highlighted in this study can now inform the Advisory Panel in guiding ACCCN's paediatric research agenda and to use the research priorities as a guide for future funding of nursing research. ACCCN may also take a leadership role by recommending in a position statement that all PICUs provide a Nurse Researcher position to facilitate nursing research. To really move forward with PIC nursing research in Australia and
Acknowledgements
We wish to thank the PIC nurse coordinators for their sustained interest and support of this study over the three rounds of data collection, namely Debbie Long, Amanda Ullman, Di McKinley, Marion Dempster, Elaine McCall, and Tina Kendrick, as well as all nurses who participated in this study. We also acknowledge the study endorsement by the ACCCN National Board on behalf of the ACCCN Paediatric Special Interest Group.
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