1. Mueller, Dale EdD, RN, CNAA, BC

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As nurse leaders seek ways to base practice on evidence and involve staff nurses in the process, a new book provides a tool for your nurses. "Clinical Research in Practice: A Guide for the Bedside Scientist"1 is a thoughtfully compiled guide to research essentials presented in less than 300 pages. Positioned somewhere between a pocket guide, a reference manual, and an introductory level textbook, this handy paperback promotes a niche opportunity for nurses in clinical settings to bloom as "bedside scientists."


Abundant, thoughtful suggestions are provided for busy nurses in clinical roles to engage their knowledge as frontline nurses more visibly and purposefully in the research discipline of identifying a care-related question or need, then locating, sorting, and evaluating existing research as "consumers" of information. Furthermore, this guide provides practical and well-illustrated step-by-step actions and accompanying considerations to assist the bedside scientist in initiating, implementing, and disseminating practice-based research by identifying what might be feasible in their own scope of work and where collaboration or enlistment of experts might be needed.


Bedside scientists have a somewhat unique role in the broad continuum of care wherein salient research questions and observations of unmet needs may surface quite often in the course of an already busy day. The potential for nurses in clinical practice to contribute evidence through the scientific rigor of research that ultimately leads to research-based changes or improvements in practice is a strong message throughout this book, whether the nurse's contribution is as a consumer or as an innovator.


The book contains 11 chapters, which are then organized into four parts. Part I introduces the role of research in nursing clinical practice and argues quite well that practice-based research, including how nurses can use a relevant clinical question to begin the process of a bedside research project, is a needed and valued contribution in healthcare today. Parts II, III, and IV contain a methodical and informative "walk" through the steps involved in conceptualizing a research study, including formulating research questions, performing a review of the literature, designing the methods including sampling and statistical analysis, and dissemination of findings. There is a glossary and 5 appendices where examples of useful forms and flow sheets are included.


So what differentiates this guide from existing research textbooks? Each chapter includes practical examples and ready-to-use checklists, along with actions that bedside nurses might need to take to establish organizational support, including locating and enlisting any additional expertise that might be needed for a valid and meaningful research project. This guide confronts the possibility that additional expertise might be needed to ensure that a bedside research project is feasible and well designed and that such expertise for assistance probably already exists within the organization. The research endeavor should be a collaborative effort, such that bedside clinicians would not be expected to design and evaluate the entire study unaided.


Seeking guidance from others in the organization might include locating statisticians or other analysts perhaps in risk management or process improvement roles, advanced practice nurses, nurse managers, nurse researchers, or even physicians who are trained in research methods and analysis. This guide thus encourages the stellar contributions from bedside nurses who have valuable and unique contributions to make in the research process, yet who may not be experts in the realm of designing a research study.


Enlisting assistance in the organization in this way thus enables bedside nurses to fulfill a valued niche contribution by engaging in identifying questions, participating in data collection, and collaborating with others in the organization to provide evidence that would support a research-based practice. Herein lies the charm and utility of this book. Detailed information is provided to position the bedside research project for success and to be carried out with inherent rigor by drawing upon existing resources within the organization. Examples of such information include locating expertise for study design and statistical analysis, working with the institutional review board, and getting buy-in from managers and administrators to support the endeavor and to assist with review and dissemination of findings. In addition, illustrations are provided to create a poster to disseminate findings, given that the outcome of the study might not be published in the literature but would be of value to share with other staff.


Even a little coaching to prepare for anticipated barriers is provided, such as an encounter with someone in the organization who may have the erroneous impression that if bedside nurses have the time to engage in research, then they must not have enough to do in their daily patient care assignment. Practical ways to explain and justify the value of the study, the uniqueness of bedside nurse involvements, and the aspects of time and costs that may be of concern to others within the organization are provided.


Although this guide is not a likely replacement for the textbooks on nursing research that are used in both undergraduate and graduate programs, it could very well be a useful supplement at either level and a helpful text in nonacademic settings. The guide should not be used as the sole source for academic preparation about research, given its brevity and singularity of examples. In addition, the guide is intended for bedside nursing roles within an organization such as acute care, extended care, or rehabilitation settings and is therefore limited in breadth of examples for community or public health nursing, nurse educator roles, or other settings. The principles contained in the guide are just as applicable for nursing roles in other settings, as it is likely that nurses in any setting will often become aware of needs for research-based practice, but the guide itself was written expressly for bedside practice. This intended context for applications should be kept in mind.


The guide covers a lot of information, yet it is not intended to wholly supplant academic preparation in research design, methods, implementation, or evaluation. For administrators or educators who have ever had staff or students express frustration at the plethora of new information and terms in a nursing research or express feelings of becoming "lost," thinking that research is not relevant to their current or future role, use of this reference as supplemental reading or reference may be helpful. This guide may provide a clarity of focus and purpose about practice-based research such that staff nurses and students will more fully appreciate their own potential contributions even if a career in research is not their goal.


This guide has great practical application outside the academic setting wherein it could be used to stimulate nourishing discussion for projects in nursing research councils, quality circles, staff meetings, or inservice education in a variety of ways. Because the guide includes step-by-step procedures, checklists, and evaluation tools, selective sections of the book could be used to promote specific activities designed for team problem solving. Such an example might be where a team collaborates to gather a compendium of literature on a particularly complex problem or issue. A collaborative effort for a large project at once leverages the time and labor to perform the search, whereas this approach also promotes an opportunity to establish skills for everyone on the team concerning methodical searches of the literature, including the process of evaluation of published research findings.


For preceptors or managers who may have forgotten the rigors of research, this guide provides an excellent overview such that support can be provided for nursing colleagues who wish to pursue bedside research. For any nurse who may be in need of a quick refresher on important but sometimes esoteric knowledge about research, such as what the differences are between "alpha," an "alpha coefficient," and a "correlation coefficient," this guide is a convenient shelf reference for such detail.


The contents of this guide provide helpful and easily accessible reminders about research process and protocols for just about any nurse, but especially for those nurses at the bedside who have the potential to discover what needs to be researched to contribute to the growing body of knowledge about research-based practice. Any nurse who is engaged in promoting nursing knowledge and action through reading, designing, conducting, or evaluating research can benefit from this book in some way. The easy-to-read, clearly illustrated, logical, and conveniently presented contents can be useful in providing guidance, models, and suggestions for research processes in the course of an otherwise very busy day in just about any setting or role where nurses make reasoned and informed contributions in healthcare today.




1. Houser J, Bokovoy J. Clinical Research in Practice: A Guide for the Bedside Scientist. Sudbury, Mass: Jones and Bartlett, 2006. [Context Link]