Katie Davenport and the other nurses on the surgical unit at Seattle Children’s Hospital generally use oral or underarm thermometers to take patients’ temperatures. But in other areas of the hospital, clinicians use temporal thermometers, which take readings with a simple forehead swipe.
Parents who have seen the temporal thermometers in action often ask Katie and her colleagues why they can’t use this tool on the unit, since it can take a temperature without even waking a child.
The question got Davenport and her colleagues thinking.
“We were curious about whether readings from temporal thermometers are consistent with oral and axillary readings, but when we searched the literature we found a lot of inconsistent evidence and studies sponsored by thermometer manufacturers,” says Davenport. “So, a group of nurses on our unit designed a study to find our own evidence.”
Last month, Katie’s group received a two-year, $10,000 grant from Seattle Children’s to pursue their research. The award is part of a new nursing research program that provides funding, technical support, mentorship and other resources to make scientific inquiry accessible to nurses who want to tackle research questions.
The program is a collaboration between the Nursing Department and the Center for Clinical and Translational Research (CCTR) at Seattle Children’s Research Institute.
“This is the right time for Seattle Children’s to invest in a robust nursing research program,” says Susan Heath, chief nursing officer. “It’s our goal to offer every patient the opportunity to benefit from research, directly or indirectly. Since nurses spend so much time with patients and families, getting them involved with research is vitally important to the success of this effort.”
Building a foundation for better care
“In pediatric nursing, there’s not always clear evidence for why we do what we do,” says Debra Ridling, senior director and associate chief nurse for clinical practice and research. “Asking and answering research questions helps us build the foundation for better, evidence-based nursing care.”
Although nurses have always been involved in facets of clinical research, the new program is Seattle Children’s first organized effort to empower nurses to follow where their curiosity leads them, and to do so with scientific rigor.
The program has several components:
- Nursing research committee: This group, made up of nursing leaders, nurses with research experience and experts from the research institute, started meeting last summer. In September, the committee sent out a general call to nurses, inviting them to submit study proposals for funding.
- Research funding: Starting in fiscal year 2014, Seattle Children’s has made at least a five-year commitment to financially supporting nurse research. The first round of funding will support seven studies seeking answers to a wide range of nursing questions. The principal investigators are staff nurses, educators, directors and nurse practitioners.
- Mentorship: In September, Karen Thomas, a professor and nurse researcher at the University of Washington, started working at Children’s part-time as an advisor, cheerleader and sounding board for nurses interested in pursuing research.
- Technical support: Experts from CCTR – including Bonnie Ramsey, MD, the center’s director, and Dedra Schendzielos, its director for administration and finance – are on the nursing research committee. The center also administers the research grants and provides a wide range of logistical and analytical support.
- Education: The initiative incudes a way to share what nurse researchers learn. Seattle Children’s first will be May 1 in Wright Auditorium, preceded by a training session on protecting human subjects. All seven teams of nursing research grant recipients will report on their projects and progress at the event.
Questions raise more questions
“Nursing research is different from other disciplines because it focuses on nursing science, which is largely about caregiving,” says Thomas.
That doesn’t mean that all nursing research takes place at the bedside; in fact, nurse-led projects can be anywhere on the bench-to-bedside spectrum, she says.
“The common denominator is that nursing research ultimately helps us create care plans for patients that are built on solid evidence,” she says.
The program at Seattle Children’s, she says, “is focused on nurse-generated, nurse-led small projects that answer questions nurses have right now.” The answers, she adds, will raise more questions. And as nurses start to answer these, “some of these small projects will grow into more complex avenues of research around more refined questions.”
It starts with an idea
Melinda Garberich, a nurse in the Sleep Clinic, and her co-investigator, nurse practitioner Jennifer Patano, are using their nursing research grant to explore whether taking iron supplements improves quality of life for kids with sleep problems.
“I’ve been interested in research for a long time, but it didn’t seem practical to pursue it until the nursing research program started,” says Garberich. “I’m excited to learn from this, and to potentially present what I learn at a national sleep medicine conference.”
Garberich and the other principal investigators were required to include plans for disseminating their findings when they submitted their funding proposals, says Thomas.
“Nursing research is judged with the same scientific parameters and the same level of rigor as any other area of research,” says Thomas. “The peer review process that precedes publishing or presenting your findings is an important part of that.”
For Ridling, who chairs the nursing research committee and has long led the charge for a formal nursing research program at Children’s, watching it come together has been exciting and gratifying.
She’s looking forward to the next round of nursing research funding this summer. And in the long run, she sees a future in which research is part of every nurse’s job description, and Seattle Children’s retains and recruits the best and brightest nurses to pursue it.
“Our goal for now is to build support for inquiry,” she says. “Some day, I hope inquiry is completely integrated into nursing, and that we’ll have nursing scientist positions. Many physicians do clinical work part-time and research part-time – I don’t see why we can’t have that model for nurses, too.”