Evaluating Quality And Methods In Clinical Practice Discussion Paper

ith the increase in complexity of illness and the increase in demand for quality care, the emphasis on evidence-based practise (EBP) has increased. Scientific research is considered a vital factor for quality care and medical care cost. The utilisation of research in clinical practice takes place by adopting the EBP approach. It involves using knowledge from research and nursing experiences, preferences, and personal values to influence the quality of care (Aljezawi et al., 2019). Currently, it is a professional expectation that all health care workers should have research knowledge and the ability to apply evidence in practice. Evidence shows that patient outcome improves when nurses practice in an evidence-based manner. EBP is also associated with increased patient safety, reduction in healthcare costs and no challenges in care delivery (Black et al., 2015). However, a lack of knowledge of the research process often acts as a barrier in research utilisation. As research is one of the keys to addressing clinical problems and promoting practice change, it is recommended that all health professionals be given training on research skills and knowledge of basic research methodologies (Aljezawi et al., 2019). This report aims to discuss about the utility of research in clinical practice by giving a background discussion on the topic and discussing how the quality of research is evaluated. In addition, the report will discuss qualitative, quantitative and mixed methods and how it is used to address clinical problems in health care. The application of the research methods in different nursing practice areas such as mental health, geriatrics, community health, and emergency care will be discussed.

Currently, research in health care has achieved great importance because it has become a source to improve health and address clinical problems in health care settings. The value of research has further increased because of the emphasis on evidence-based practice (EBP). Evaluating Quality And Methods In Clinical Practice Discussion Paper EBP is defined as the appropriate use of best evidence to make decisions about the care of patients. EBP ensures that recent research evidence is used in treatment and decision making and ensures that clinical problems are addressed by considering patient situations and values (Szajewska, 2018). The use of research in clinical practice is one approach to strengthening nursing practice. However, the issue is that many nurses still rely on their peers to make decisions for patients. Their involvement in using research evidence in practice can be improved by providing education about research in pre-licensure programs. The utilisation of research cannot be done independently and nursing needs to collaborate with the multidisciplinary team for research utilisation (Aljezawi et al., 2019).

According to Portney (2020), recent research evidence is useful as the ultimate goal of such research is to promote practice change and change care delivery. Such application of research plays a role in enhancing patient outcomes and provides the most effective care to patients. However, all research is not of good quality. Health care professionals have the skills to critically appraise the research and determine which is good quality research to inform clinical decision-making.

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Before applying research into clinical practice, it is essential for health care professionals to have skills in evaluating the quality of a research paper. Based on the quality assessment, whether the research is good or reliable can be determined. This overall process is briefly known as critical appraisal. It systematically evaluates research evidence to determine its trustworthiness, value, and relevance in a specific context (Pianta et al., 2018). Similarly, Al-Jundi and Sakka (2017) argued that critical appraisal is useful for eliminating information overload and ensuring the papers chosen are clinically meaningful. By applying the research in clinical decision-making, critical appraisal plays a role in skill development and continuing professional development. The critical appraisal can be done based on any checklist or by using common questions to analyse the quality of the study. The focus is mainly on the completeness of information, consideration of bias, the validity of the findings and clinical implications of the finding. In addition, there are separate checklists for different research designs too, and one can also evaluate using the specific checklist. For example, the RCT trial checklist mostly focuses on allocation, blinding, follow-up of participants, bias, sample size, presentation of findings, and application to the local population (LoBiondo-Wood & Haber, 2021).

During the critical appraisal, the three main aspects critically reviewed are validity, impact and applicability. Validity refers to the presence of the most relevant content in the research paper. It can be applied to different types of research such as prevalence studies, intervention studies or association based studies. Validity is categorised into two domains, namely internal and external validity. Internal validity is the extent to which the results in a study represent the truth and are free from any methodological errors. While assessing a research paper for internal validity, health care workers will have to check if the participant’s selection is appropriate or identify any error in measurement (Al-Jundi & Sakka, 2017). After evaluating the internal validity of the study, the researchers will have to evaluate the external validity of the findings. External validity is evaluated by asking if the study results can be applied to a similar population group in a different setting or not. In brief, it is useful in evaluating whether the research findings can be generalised in daily practice or not. If any research lacks internal validity, the study deviates from the actual truth, and a proper conclusion cannot be made. Moreover, external validity eventually becomes irrelevant if the trial is not internally valid (Kamper, 2020).

The second element that is important during the analysis of the quality of the research paper is the reliability of the finding. The other term for this is consistency or repeatability. It refers to the consistency of any measure. It can be evaluated by checking the quality of the research instruments used and looking for the internal validity of the findings. Schünemann et al. (2020) argue that many factors decrease the quality of evidence. It includes study limitation, inconsistency of findings, publication bias and imprecision. In addition, the factors influencing the quality of research are large treatment-effect and dose-response gradient. Moreover, the study design used in a study is also useful in determining the quality of a research paper. For example, a rigorous observation study provides stronger evidence than uncontrolled case series. In addition, a systematic review is considered high-quality research compared to cross-sectional studies. If any observational studies do not have any special strength, it is considered low-quality evidence. Therefore, study designs and any special strengths or limitations can also modify the quality of the research.

There are many important frameworks or tools that guide reviewers in appraising a research paper. According to Huguet et al. (2013), the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework is also an important tool in judging the quality of evidence. It mostly considers five factors: study design and limitation, inconsistent results, indirectness of the evidence, imprecision, and publication bias. It is also a useful framework for prognostic studies. The Critical Appraisal Skills Programme (CASP) is another generic tool for quality appraisal of health-related research. It consists of 10 questions, with each focusing on different types of methodological aspects. The tool mostly asks the researchers to interpret if the method used in the research were appropriate and whether the findings are well-presented. The advantage of CASP in the quality appraisal of the article is that it is a user-friendly tool for novice researchers. It can be useful for health care professionals who are new in evaluating research papers. It provides a good measure of research reporting standards and transparency (Long, French & Brooks, 2020).

Understanding of research methodology to ensure rigour and validity in research

As discussed above, it has been found that the appraisal of the quality of research depends on evaluating the validity, reliability and rigour of the research process. However, any researcher cannot maintain all the three criteria unless they understand different research paradigms and methodologies. This is said because each research methodology has a different scope of focus. Depending on the knowledge of the key features of each methodology, researchers can maintain rigour in the research proces. Research methodology is defined as a way of carrying out research. It consists of two common research methodologies as qualitative and quantitative research. Qualitative research is a nature of inquiry where a non-numerical data set is used to investigate a research phenomenon. It aims to look at explanatory factors or discover reasons for observed patterns in any research. The steps of sampling, data collection, analysis and interpretation are interconnected to each other (Busetto, Wick & Gumbinger, 2020). To maintain rigour, they need to be concerned about the reliability and validity of each of the steps. Without rigor, qualitative research can lose its clinical significance (Cypress, 2017).

The purpose of qualitative research is to answer the how, where, and why questions. Understanding research methodology can help plan research appropriately and maintain rigour and biases accordingly. For instance, the main difference between quantitative and qualitative research investigation is that quantitative research emphasize on numerical data, whereas qualitative research deals with non-numerical data and phenomenological interpretation. Hence, before considering the validity and reliability of findings, it is important to maintain the issue of subjectivity and contextual relevance. The element of subjectivity measures the quality and trustworthiness of qualitative research. The overall quality of qualitative research depends on clarification and justification, procedural rigour, sample representativeness, interpretive rigour, reflexive rigour and transferability (Leung, 2015). The meaning of validity in qualitative research differs too. It means appropriateness of the processes, tools and data. However, the validity of qualitative research may be challenged by the ontology and epistemology of the findings. The validity of data extraction and analysis also depends on triangulation and multidimensional analysis (Busetto, Wick & Gumbinger, 2020).

Quantitative research methodology deals with objective measurement or numerical data analysis using methods such as surveys. Reliability implies stability of the measured outcomes in repeated measurements under different circumstances, whereas validity refers to the appropriate of the measuring instrument in measuring what it is intended to measure. In quantitative research, it is paramount to consider that the research tool measures exactly what it claims. It can be done by considering the validity of the research tool from previous research and analysing how the research instrument produces valid findings. It may involve looking at each item of the tool and finding out how each item serves the purpose of taking the main measurement. This concept is known as content validity. Another type of measurement of validity is constructed validity. It involves the degree to which a research instrument measures the concepts it is supposed to measure. In addition to this, the reliability of the research instrument depends on evaluating the test-retest reliability of the research instrument. Test-retest reliability refers to the consistency of the results when the research tool is applied to the same population groups at different time intervals. For example, a high correlation between survey data in two different periods will implement good reliability of the tool (Heale & Twycross, 2015).

Research paradigm is defined as beliefs and arguments about how a research problem should be addressed. It is a belief system with different assumptions about ontology, epistemology, methodology and methods. Ontology is defined as the nature of our beliefs related to reality. In addition, epistemology refers to the branch or philosophy that deals with the way knowledge are acquired or validated. Moreover, the difference between methodology and methods is that methodology refers to a theoretically linked approach to data production, whereas method refers to collecting and evaluating data through interviews and questionnaires (Rehman & Alharthi, 2016). Through good knowledge of the research paradigm, one can identify the philosophical orientation of different research and have useful implications for decisions related to the research process. Different research paradigms and the criteria used to validate research located within each paradigm differ. The three common research paradigms are positivist, interpretivism or critical paradigms. The positivism paradigm is based on the belief that observation and experimentation should be the basis for evaluating human behaviour. This paradigm is validated by four internal validity, external validity, reliability, and objectivity criteria. In contrast, the interpretivist paradigm believes in the subjective world of human experience. The validity of research in the interpretivist paradigm is done using credibility, dependability, confirmability and transferability (Kivunja and Kuyini 2017).

For example, one research question that can be answered using qualitative methodology is:

What is the perspective of mental health nurses regarding views about death and dying?

In addition, one research question that can be explored using quantitative research methodology is:

In patients with diabetes, what is the effectiveness of a nurse-led educational program in increasing patients’ self-management skills compared to no education?

Different research methodology serves a different purpose in research. The qualitative research methodology is useful when the purpose is to interpret the full description of a research event. Qualitative research believes in providing a rich and detailed description of the research phenomenon and illuminates the interpretation of events by different stakeholders. This research contributes to health practice by translating a patient’s beliefs or preferences into desired actions. Overall, it can broaden the scope of evidence-based medicine (Green & Thorogood, 2018).

Similarly, Eyisi (2016) argues that qualitative research is that relying on the words of participants to make it well-suited for getting factual information. Thirdly, qualitative research supports the generation of theory from the data. Human thoughts and perceptions are used in a social context and help in shaping the research process. In contrast, quantitative research methodology aims to find patterns, make predictions, and test causal relationships between two research variables. In addition, the use of statistical data in qualitative research is useful in saving time and resources. It minimises the time involved in interpreting research findings. The second advantage of using quantitative methodology is that it promotes the generalizability of the findings by using scientific methods. Furthermore, the replicability of this research is high because of its clear objectives (Eyisi, 2016).

Qualitative research is a descriptive method of inquiry where the aim is to answer questions on the how and why of a research phenomenon. It believes that reality is socially constructed, and the interpretation of the views, opinions or perception of a research phenomenon may determine the how and why of any phenomenon. The examples of qualitative methods in nursing research are ethnography, grounded theory, phenomenology and ethnography (Miller 2010). According to Hammarberg, Kirkman and de Lacey (2016), qualitative research is used when there is a need to seek the research participant’s values, beliefs, or preferences. It involves non-numerical data using small group discussions or semi-structured interview methods. It allows researchers to analyse any intervention or condition from a personal perspective. It can be used to solve different clinical problems. For example, the qualitative research method can explore parents’ views about vaccination and why they avoid or go for vaccination. It has been used to explore the cause behind nurses’ non-adherence to hand hygiene and use an amended approach to solve the problem.

There are three main approaches to qualitative research: ethnography, phenomenology, and grounded theory. Ethnography is defined as the study of social interactions and cultural groups. The key features of ethnographic investigation are that it is done in natural setting, it is inductive in nature and provides an accurate reflection of perspectives and behaviours (Reeves et al., 2013). In contrast, phenomenology involves studying or exploring people’s lived experiences. The main characteristics of phenomenology are subjectivity, interpretation of the lived experience and focusing on ways people construct meaning of a research phenomenon. In addition, grounded theory is a qualitative approach that helps generate theories. It is a naturalistic form of research, and it believes in the construction of codes from the data (Tarozzi, 2020). Each of these has been used to address clinical problems.

There are diverse nursing care fields, and nurses in each field are confronted with different research problems. For instance, one of the problems in clinical nursing is the barrier to the patient-centred communication process. The study by Miller (2010) revealed that qualitative findings have resulted in instrumental changes in clinical communication practices. One such finding from a qualitative study recommended that active listening and social support should become patient-centred communication. The execution of such changes in practice has enhanced the outcomes of the patient.

Another example is that a clinical nurse specialist (CNS) is often confronted with challenges in communication with the end of life patients. By reading a qualitative research paper on a similar issue, they can identify what such patients prefer communication style and modify their communication process accordingly. Furthermore, qualitative findings are useful in identifying the impact of different contextual factors on an intervention. It can help to interpret why an intervention is successful or not successful in practice. A qualitative study by Piyasena et al.  (2019) investigated the barriers and enablers to uptake diabetic retinopathy screening by people with diabetes. Through focus group discussions with the patient with diabetic retinopathy, several factors such as the family environment, institutional factors and economic factors acted as a barrier to the uptake of the screening process. Some of the socio-cultural factors reported in the study were family responsibility, domestic work and the influence of patriarchal roles in the family. Organisational factors included crowding, long waiting times, and limited seating in the waiting area. This finding had implications for service improvement initiatives and improved capacity limitations in clinical settings.

The main purpose of qualitative research is to better understand a social phenomenon and emphasise the participants’ meanings and experiences. Hence, it is suitable to use a qualitative approach when the research focuses on interpreting the people’s lived experiences and locating the meaning of any events or processes on the people’s lives. Qualitative research is mostly inductive compared to quantitative research, which is deductive. There is an argument that quantitative findings have instrumental and conceptual utility along with the use of participants’ experience to improve the nursing process and patient outcome. Instrumental utilisation involves the application of the findings into clinical guidelines, appraisal tools and standards of care.

Similarly, conceptual utility involves how a user plans to provide care (Dodgson, 2019). In nursing, qualitative findings support conceptually by promoting nurses’ understanding of the patient experience and implementing a tailored intervention in care. The study by Eldal et al. (2019) used a qualitative research design to explore in-patient experiences in mental health. The rationale for research in this area was to identify the expectations of patients towards nurses and use it to enhance nurse-patient interaction in mental health. Through interpretive phenomenological analysis, it was found that patients were excluded or turned away because of their mental status. In addition, patients are expected to be emotionally and physically close to someone in their treatment context. They talk about some staff who help them in recovery. The findings consisted of directed narratives of research participants. By reading these narratives, mental health nurses can get an idea of what type of care in-patients in mental health services expect. The data on patient experiences can act as a rich data source for learning and reflecting on their communication style with patients. It would foster patient participation in care.

Research evidence shows the wide application of qualitative methods in mental health. The primary reason is that it provides an in-depth description of the research phenomenon of interest. Through qualitative data, one can elicit the perspective of others. It allows participants to speak in their voice without being influenced by others. Through this mean, the validity of the research data improved too, as it enables the investigator to compare their perception with that of the research participant (Gabriel et al., 2018; Palinkas, 2014). For instance, the study by Schofield et al. (2011) aimed to evaluate patients’ experience regarding taking. The study was done using a qualitative interview method in London, North East England and East Lancashire.

The findings revealed the first experiences with the use of antidepressants. Participants reported fear of addiction and reluctance to any drugs during the first consultation. With time, their experiences changed. Through the analysis of qualitative data, it was found that many people could not cope with the side effects of antidepressants. They either stopped taking those medications or altered their doses. The trial and error process helped some participants learn more about their illness and take conscious decisions about the dose. The advantage of such findings for novice nurses working in the mental health setting is that they can interpret different factors influencing concordance with an antidepressant. From the patient’s story, they can change their way of communication with such patients. It will encourage them to provide more education on the challenges linked to antidepressant use and its use. Open discussion at regular intervals is the lesson a mental health nurse may take by reviewing the above study.

Quantitative research focuses on objective measurement of data through numerical analysis and collection of data through surveys, questionnaires and polls. The main goal of conducting quantitative research is to identify the relationship between one research variable and another variable within a population. Depending on the situation, quantitative research can be descriptive or experimental. Unlike qualitative research, which focuses on subjective data such as patient narratives and experiences, quantitative research deals with numbers and logic. The advantage of quantitative research design is that it can be done on a large sample group, and thus, it can increase the generalizability of findings. Data in quantitative research is collected using a structured research tool and it is analysed using the statistical analysis method. A quantitative research method is used when the purpose is to test or evaluate any theory or assumptions. It quantifies the problem and helps to understand the prevalence or burden of any health issue (Mohajan, 2020). According to Hammarberg, Kirkman and de Lacey (2016), qualitative research is used when there is a need for factual data to answer the research question or when the problem is clear and unambiguous. It can be used to solve different clinical problems.

There are many ways to carry out a quantitative investigation. The three main types of quantitative research are experimental, correlational and descriptive. Descriptive research involves evaluating the current status of any identified variable and providing systematic information about a research phenomenon. It can be useful in interpreting the current status of any condition or event. Unlike other quantitative research, there is no hypothesis at the beginning of the research. Instead, a hypothesis is developed after collecting the data (Siedlecki, 2020). One example of descriptive research is a research on the attitude of scientist towards global warming or an investigation on the tobacco use habits of a teenager. In contrast, correlational research is an approach that believes in exploring the relationship between two or more variables using different statistical tools. The utility of correlation research is that it can identify patterns within data. The variables are not manipulated during the study. The use of correlational research design is appropriate when there is a need to clarify relationships or to achieve a degree of prediction (Seeram, 2019).Thus, researcher can gain an insight into how variables operate in a system. The example of correlational research design may include a study that explores relationship between lung disease and smoking.

The third category of quantitative research is experimental research. It is a scientific approach to establish the cause and effect relationship between two or more variables. The key features of experimental research design are the presence of experimental and control groups, independent and dependent variables and pretesting and post-testing. It is said because in experimental research design, the effect of any intervention is evaluated by comparing two groups. It involves consciously manipulating a treatment or variable of interest and randomising control and treatment groups. The strength of experimental research design are that it provides a specific conclusion, and the study results can be duplicated. However, the disadvantages of experimental research design are that it is a time-consuming process and may be prone to ethical problems (Bloomfield & Fisher, 2019). Thus, the research design is useful in evaluating the effect of any intervention. An example of an experimental study is the investigation of a new screening therapy to detect breast cancer.

Quantitative research design finds use in addressing different research problems too. The main rationale behind using quantitative research in health care or clinical problem is that it provides reliable outcome data. By analysing the effect of any treatment using statistical analysis, it provides objective results that can be generalised to the larger population group. The second benefit of the quantitative approach is the use of the reductionism approach. By reducing a large set of data to a set of numbers, it statistically represents an entire population (Bloomfield & Fisher, 2019). Hence, it is easier to use quantitative research for practice change and evidence-based practice. Some examples of quantitative research design are quasi-experimental study, randomised controlled trials and correlational studies.

The utility of different types of quantitative research in addressing research problems can be explained through different examples. For instance, a quasi-experimental study by Janse, Huijsman and Fabbricotti (2014) investigated the effects of an integrated care intervention for the frail elderly on caregivers’ satisfaction with care. A 62-item instrument was applied to collect research data, and regression analyses were performed. The study results revealed that after implementing the intervention, the satisfaction with the degree to which care was provided decreased, and no appropriate outcome could be obtained. It was because of gaps in the study, such as the small sample size.

In contrast, Lucas et al. (2018) reported a quantitative population-based study where screening risk factors for type 2 diabetes (T2D) in overweight and obese individuals were explored. Through the analysis of the screening risk factors, preterm birth and living in rural areas were found to be some of the risk factors. The study gave insight into the number of adolescent groups at risk of T2D and included around 13% of the group. This quantitative study had implications for school nurse. By reading this article, the nurses can understand the extent of risk for the adolescent group and their role in influencing students and parents in health prevention programs.

Mixed method research design is an approach where quantitative and qualitative data are collected and analysed on the same day. The advantage of the mixed-method approach is that it draws on strength from both qualitative and quantitative research methods and allows researchers to explore multiple perspectives simultaneously. There is a growth in the mixed method research approach with the increase in complexity in the health care system (Schoonenboom & Johnson, 2017). It allows for a holistic view of the research process through diverse research lenses. The main goal of mixed-method research is to strengthen a researcher’s conclusion by combining qualitative and quantitative research processes. It is suitable to use this research when quantitative or qualitative data alone cannot answer the research question. It is often known as mixed-method or multiple method research.

A mixed-method research design has good overall validity too. The process of mixing mixed-method research serves five purposes. Firstly, the use of triangulation supports the convergence of results from different sources. It promotes complementarity through the elaboration, illustration and clarification of the results using both research designs. It enables the discovery of paradox and contradiction and seeks to extend the breadth and range of inquiry (Schoonenboom & Johnson, 2017). The explanation by Tariq and Woodman (2013) regarding the use of the mixed method approach can address some research questions more comprehensively. A research question that suits mixed method design is mostly broad and complex in nature. Some examples of research questions where mixed-method approaches are used are:

• How GPs record child maltreatment concerns in the electronic health record?
• What is the impact of migration on pregnancy in women living with HIV in the UK?

For the second question, the quantitative phase helped identify disparities in health outcomes, whereas the qualitative phase helped identify different types of disparities during health care access. Overall, it can be said that mixed-method research design is utilised when the purpose is to get reliable findings. It incorporates the strength of both qualitative and quantitative research design. Quantitative research has a positive stance and believes in objective measurement. The strength of this research design is that the research process minimises the chances of confounding factors in research. However, this research design is not suitable while generating hypotheses about how and why things are happening.

In contrast, qualitative research has an interpretive stance, and it is based on the belief that diverse viewpoints shape multiple realities. High-quality qualitative research is useful for policymakers in bringing change in care delivery. But the disadvantage of this method is that the small sample size may limit the results. In this situation, the benefit that mixed-method research provides is that it balances the weakness of both designs and adapts the strength when addressing complex health issues (Tariq & Woodman, 2013). To conclude, the mixed-method research design is used for complementarity, development, initiation, expansion and triangulation.

Mixed method research design is categorised into four types: triangulation, embedded, explanatory, and exploratory. The most common approach to the mixing method is the triangulation design. It is a design where the qualitative and quantitative approach is applied in the same time frame. The strengths of triangulation design are it is a design that makes intuitive sense, and it involves the collection of both types of data independently. However, there are challenges in implementing the design because it requires a lot of time and expertise. The second type is embedded design, where one research design plays a supportive role in place of other data types. The design can be used when there is a need to embed the two types of data in a large study. This research approach is implemented in experimental or correlational research design. The strength of this research design is that it can be used when there are not enough resources to commit to a single qualitative and quantitative data. In addition, the design is most likely to appeal to all because of its quantitative nature (Asenahabi, 2019).

The other two types of mixed method design are explanatory and exploratory designs. The aim of explanatory design is to build upon quantitative results. It is suited for that type of research where qualitative data is needed to explain any results. It consists of two phases and the quantitative phase follows the qualitative phase. The two variants of this design are the follow-up explanation model and the participant selection model. The strengths of the explanatory research design are that the two-way structure makes it easier for implementation and design appeals to researchers with quantitative orientation. In contrast, explanatory design is a type of mixed method approach where qualitative method can inform the quantitative method. The use of this research design is useful when there is a need to develop and test an instrument. Some of the major strengths of explanatory design are that it is easy to implement and can be easily applied in multi-phase studies. However, time constraint can be a barrier to implementation of the too (Schrauf, 2018).

The above discussion makes it clear how many ways mixed-method research design can be implemented. It is suitable to be used when comprehensive conclusions needed to be made, and there is a need to get detailed data. Evaluating Quality And Methods In Clinical Practice Discussion Paper The use of this design in addressing clinical problems can be seen from the following example. The study by Surr et al. (2020) investigated the barriers and facilitators to implementing dementia education in health and social care settings. The study was based on the notion that health and social workers need appropriate training to provide quality care, and success depends on behavioural change. In the research, a mixed-method design was used to provide training to participants and the audit of care implemented was done using an online survey. The study revealed that interactive face-to-face training enhanced staff’s capability.

In contrast, staff motivation was enhanced by providing incentives and training. These studies addressed the clinical problem in two ways. Firstly, it gave an idea about the training method that would be effective. Secondly, it reported different ways in behavior change for staff. The above study clearly defines why a mixed-method research design should be used in the clinical context.

Similar to the application of the mixed-method approach in solving clinical problems, it has been utilised to address challenges in specific fields. For example, pediatric nursing is a challenging role, and the use of mixed-method studies have modified different care practices. One good example of this is the mixed-method study by Beckett et al. (2015), which investigated the pain management practice in a UK children’s hospital. The study aimed to identify barriers to in-patient pediatric pain management. A case note review was done, and seven semi-structured interviews were conducted with staff. The quantitative data gave an idea about the average pain score and staff workload, whereas the qualitative data revealed three themes. The first theme identified unresolved pain as a distressing situation for staff, requiring specialised skills. The second theme discussed how the complexity of a child’s condition affects pain management and how developing competencies affected practice. The third theme realised pain as expert skills which required broader experience. Hospital staff can use this study’s findings to provide ongoing training to junior pediatric nurses and develop mentoring capacity for senior staff.

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Conclusion:

The report summarised the importance of research in addressing clinical problems. Through the analysis of recent research evidence, it was found that the utilisation of research evidence is an important part of evidence-based practice. With the increase in emphasis on evidence-based practice, nurses are often expected to have good research skills. To utilise research in clinical practice, nurses need to know how to analyse the quality of the study. Some of the important criteria discussed for evaluating a research paper were validity, reliability and applicability of the research findings. In addition, the importance of several frameworks such as GRADE and CASP tool in evaluating different research designs were discussed. In addition, the essay discussed the purpose of different research methodologies and the reason behind their use in addressing clinical problems. Qualitative research was useful in interpreting the opinion or lived experience of a phenomenon from research participants. The study reported several nursing fields where qualitative research has been used to promote practice change or improve the nursing communication process. Examples of recent research evidence were provided to show how qualitative research has informed nursing care plans or modified nursing communication methods.

Similarly, quantitative research methods were found to improve understanding about the effectiveness of any intervention or the burden of any disease condition. In addition, the utility of the mixed method in identifying comprehensive conclusions for a study was identified. Overall, the report implies that research has an important role in improving nursing skills and resolving different clinical problems. It is recommended that all nursing students be given training on research methodology and interpreting research papers during their pre-licensure training program. It can further increase the utilisation of research in health care practice. By knowledge of different research designs, nurses can decide which types of papers to be used for addressing a research problem. Knowledge of research can provide the foundation for high quality and evidence-based care. The report gives the implication to increase research skill interest in all nurses. The process should start with training during the nursing education program and it should continue during practice too. During practice, current research tools and techniques can be used to identify how effective are updated research process in handling the problem. All types of changes such as reform in communication process, service delivery related change, health system or patient experience related concern can be resolved using the research process. The utilization of research evidence enriched practice and decrease the stress associated with negative outcomes too.

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Evaluating Quality And Methods In Clinical Practice Discussion Paper