research question nursing

Best Nursing Research Topics for Students

What is a nursing research paper.

• What They Include
• Choosing a Topic
• Best Nursing Research Topics
• Research Paper Writing Tips

Writing a research paper is a massive task that involves careful organization, critical analysis, and a lot of time. Some nursing students are natural writers, while others struggle to select a nursing research topic, let alone write about it.

If you're a nursing student who dreads writing research papers, this article may help ease your anxiety. We'll cover everything you need to know about writing nursing school research papers and the top topics for nursing research.  

Continue reading to make your paper-writing jitters a thing of the past.

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A nursing research paper is a work of academic writing composed by a nurse or nursing student. The paper may present information on a specific topic or answer a question.

During LPN/LVN and RN programs, most papers you write focus on learning to use research databases, evaluate appropriate resources, and format your writing with APA style. You'll then synthesize your research information to answer a question or analyze a topic.

BSN , MSN , Ph.D., and DNP programs also write nursing research papers. Students in these programs may also participate in conducting original research studies.

Writing papers during your academic program improves and develops many skills, including the ability to:

• Select nursing topics for research
• Conduct effective research
• Analyze published academic literature
• Format and cite sources
• Synthesize data
• Organize and articulate findings

About Nursing Research Papers

When do nursing students write research papers.

You may need to write a research paper for any of the nursing courses you take. Research papers help develop critical thinking and communication skills. They allow you to learn how to conduct research and critically review publications.

That said, not every class will require in-depth, 10-20-page papers. The more advanced your degree path, the more you can expect to write and conduct research. If you're in an associate or bachelor's program, you'll probably write a few papers each semester or term.

Do Nursing Students Conduct Original Research?

Most of the time, you won't be designing, conducting, and evaluating new research. Instead, your projects will focus on learning the research process and the scientific method. You'll achieve these objectives by evaluating existing nursing literature and sources and defending a thesis.

However, many nursing faculty members do conduct original research. So, you may get opportunities to participate in, and publish, research articles.

Example Research Project Scenario:

In your maternal child nursing class, the professor assigns the class a research paper regarding developmentally appropriate nursing interventions for the pediatric population. While that may sound specific, you have almost endless opportunities to narrow down the focus of your writing. 

You could choose pain intervention measures in toddlers. Conversely, you can research the effects of prolonged hospitalization on adolescents' social-emotional development.

What Does a Nursing Research Paper Include?

Your professor should provide a thorough guideline of the scope of the paper. In general, an undergraduate nursing research paper will consist of:

Introduction : A brief overview of the research question/thesis statement your paper will discuss. You can include why the topic is relevant.

Body : This section presents your research findings and allows you to synthesize the information and data you collected. You'll have a chance to articulate your evaluation and answer your research question. The length of this section depends on your assignment.

Conclusion : A brief review of the information and analysis you presented throughout the body of the paper. This section is a recap of your paper and another chance to reassert your thesis.

The best advice is to follow your instructor's rubric and guidelines. Remember to ask for help whenever needed, and avoid overcomplicating the assignment!

How to Choose a Nursing Research Topic

The sheer volume of prospective nursing research topics can become overwhelming for students. Additionally, you may get the misconception that all the 'good' research ideas are exhausted. However, a personal approach may help you narrow down a research topic and find a unique angle.

Writing your research paper about a topic you value or connect with makes the task easier. Additionally, you should consider the material's breadth. Topics with plenty of existing literature will make developing a research question and thesis smoother.

Finally, feel free to shift gears if necessary, especially if you're still early in the research process. If you start down one path and have trouble finding published information, ask your professor if you can choose another topic.

The Best Research Topics for Nursing Students

You have endless subject choices for nursing research papers. This non-exhaustive list just scratches the surface of some of the best nursing research topics.

1. Clinical Nursing Research Topics

• Analyze the use of telehealth/virtual nursing to reduce inpatient nurse duties.
• Discuss the impact of evidence-based respiratory interventions on patient outcomes in critical care settings.
• Explore the effectiveness of pain management protocols in pediatric patients.

2. Community Health Nursing Research Topics

• Assess the impact of nurse-led diabetes education in Type II Diabetics.
• Analyze the relationship between socioeconomic status and access to healthcare services.

3. Nurse Education Research Topics

• Review the effectiveness of simulation-based learning to improve nursing students' clinical skills.
• Identify methods that best prepare pre-licensure students for clinical practice.
• Investigate factors that influence nurses to pursue advanced degrees.
• Evaluate education methods that enhance cultural competence among nurses.
• Describe the role of mindfulness interventions in reducing stress and burnout among nurses.

4. Mental Health Nursing Research Topics

• Explore patient outcomes related to nurse staffing levels in acute behavioral health settings.
• Assess the effectiveness of mental health education among emergency room nurses .
• Explore de-escalation techniques that result in improved patient outcomes.
• Review the effectiveness of therapeutic communication in improving patient outcomes.

5. Pediatric Nursing Research Topics

• Assess the impact of parental involvement in pediatric asthma treatment adherence.
• Explore challenges related to chronic illness management in pediatric patients.
• Review the role of play therapy and other therapeutic interventions that alleviate anxiety among hospitalized children.

6. The Nursing Profession Research Topics

• Analyze the effects of short staffing on nurse burnout .
• Evaluate factors that facilitate resiliency among nursing professionals.
• Examine predictors of nurse dissatisfaction and burnout.
• Posit how nursing theories influence modern nursing practice.

Tips for Writing a Nursing Research Paper

The best nursing research advice we can provide is to follow your professor's rubric and instructions. However, here are a few study tips for nursing students to make paper writing less painful:

Avoid procrastination: Everyone says it, but few follow this advice. You can significantly lower your stress levels if you avoid procrastinating and start working on your project immediately.

Plan Ahead: Break down the writing process into smaller sections, especially if it seems overwhelming. Give yourself time for each step in the process.

Research: Use your resources and ask for help from the librarian or instructor. The rest should come together quickly once you find high-quality studies to analyze.

Outline: Create an outline to help you organize your thoughts. Then, you can plug in information throughout the research process. 

Clear Language: Use plain language as much as possible to get your point across. Jargon is inevitable when writing academic nursing papers, but keep it to a minimum.

Cite Properly: Accurately cite all sources using the appropriate citation style. Nursing research papers will almost always implement APA style. Check out the resources below for some excellent reference management options.

Revise and Edit: Once you finish your first draft, put it away for one to two hours or, preferably, a whole day. Once you've placed some space between you and your paper, read through and edit for clarity, coherence, and grammatical errors. Reading your essay out loud is an excellent way to check for the 'flow' of the paper.

Helpful Nursing Research Writing Resources:

Purdue OWL (Online writing lab) has a robust APA guide covering everything you need about APA style and rules.

Grammarly helps you edit grammar, spelling, and punctuation. Upgrading to a paid plan will get you plagiarism detection, formatting, and engagement suggestions. This tool is excellent to help you simplify complicated sentences.

Mendeley is a free reference management software. It stores, organizes, and cites references. It has a Microsoft plug-in that inserts and correctly formats APA citations.

Don't let nursing research papers scare you away from starting nursing school or furthering your education. Their purpose is to develop skills you'll need to be an effective nurse: critical thinking, communication, and the ability to review published information critically.

Choose a great topic and follow your teacher's instructions; you'll finish that paper in no time.

Joleen Sams is a certified Family Nurse Practitioner based in the Kansas City metro area. During her 10-year RN career, Joleen worked in NICU, inpatient pediatrics, and regulatory compliance. Since graduating with her MSN-FNP in 2019, she has worked in urgent care and nursing administration. Connect with Joleen on LinkedIn or see more of her writing on her website.

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PICOT Question Examples for Nursing Research

Are you looking for examples of nursing PICOT questions to inspire your creativity as you research for a perfect nursing topic for your paper? You came to the right place.

We have a comprehensive guide on how to write a good PICO Question for your case study, research paper, white paper, term paper, project, or capstone paper. Therefore, we will not go into the details in this post. A good PICOT question possesses the following qualities:

• A clinical-based question addresses the nursing research areas or topics.
• It is specific, concise, and clear.
• Patient, problem, or population.
• Intervention.
• Comparison.
• Includes medical, clinical, and nursing terms where necessary.
• It is not ambiguous.

For more information, read our comprehensive PICOT Question guide . You can use these questions to inspire your PICOT choice for your evidence-based papers , reports, or nursing research papers.

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List of 180 Plus Best PICOT Questions to Get Inspiration From

Here is a list of nursing PICO questions to inspire you when developing yours. Some PICOT questions might be suitable for BSN and MSN but not DNP. If you are writing a change project for your DNP, try to focus on PICOT questions that align to process changes. 

• Among healthy newborn infants in low- and middle-income countries (P), does early skin-to-skin contact of the baby with the mother in the first hour of life (I) compared with drying and wrapping (C) have an impact on neonatal mortality, hypothermia or initiation/exclusivity/ duration of breastfeeding (O)?
• Is it necessary to test blood glucose levels 4 times daily for a patient suffering from Type 1 diabetes?
• Does raising the head of the bed of a mechanically ventilated patient reduce the chances of pneumonia?
• Does music therapy is an effective mode of PACU pain management for patients who are slowly coming out from their anesthesia?
• For all neonates (P), should vitamin K prophylaxis (I) be given for the prevention of vitamin K deficiency bleeding (O)?
• For young infants (0-2 months) with suspected sepsis managed in health facilities (P), should third generation cephalosporin monotherapy (I) replace currently recommended ampicillin-gentamicin combination (C) as first line empiric treatment for preventing death and sequelae (O)?
• In low-birth-weight/pre-term neonates in health facilities (P), is skin-to-skin contact immediately after birth (I) more effective than conventional care (C) in preventing hypothermia (O)?
• In children aged 2–59 months (P), what is the most effective antibiotic therapy (I, C) for severe pneumonia (O)?
• Is skin-to-skin contact of the infant with the mother a more assured way of ensuring neonatal mortality compared to drying and wrapping?
• Are oral contraceptives effective in stopping pregnancy for women above 30 years?
• Is spironolactone a better drug for reducing the blood pressure of teenagers when compared to clonidine?
• What is the usefulness of an LP/spinal tap after the beginning of antivirals for a pediatric population suffering from fever?
• In children aged 2–59 months in developing countries (P), which parenteral antibiotic or combination of antibiotics (I), at what dose and duration, is effective for the treatment of suspected bacterial meningitis in hospital in reducing mortality and sequelae (O)?
• Does the habit of washing hands third-generation workers decrease the events of infections in hospitals?
• Is the intake of zinc pills more effective than Vitamin C for preventing cold during winter for middle-aged women?
• In children with acute severe malnutrition (P), are antibiotics (I) effective in preventing death and sequelae (O)?
• Among, children with lower respiratory tract infection (P), what are the best cut off oxygen saturation levels (D), at different altitudes that will determine hypoxaemia requiring oxygen therapy (O)?
• In infants and children in low-resource settings (P), what is the most appropriate method (D) of detecting hypoxaemia in hospitals (O)?
• In children with shock (P), what is the most appropriate choice of intravenous fluid therapy (I) to prevent death and sequelae (O)?
• In fully conscious children with hypoglycaemia (P) what is the effectiveness of administering sublingual sugar (I)?
• Is using toys as distractions during giving needle vaccinations to toddlers an effective pain response management?
• What is the result of a higher amount of potassium intake among children with low blood pressure?
• Is cup feeding an infant better than feeding through tubes in a NICU setup?
• Does the intervention of flushing the heroin via lines a more effective way of treating patients with CVLs/PICCs?
• Is the use of intravenous fluid intervention a better remedy for infants under fatal conditions?
• Do bedside shift reports help in the overall patient care for nurses?
• Is home visitation a better way of dealing with teen pregnancy when compared to regular school visits in rural areas?
• Is fentanyl more effective than morphine in dealing with the pain of adults over the age of 50 years?
• What are the health outcomes of having a high amount of potassium for adults over the age of 21 years?
• Does the use of continuous feed during emesis a more effective way of intervention when compared to the process of stopping the feed for a short period?
• Does controlling the amount of sublingual sugar help completely conscious children suffering from hypoglycemia?
• Is the lithotomy position an ideal position for giving birth to women in labor?
• Does group therapy help patients with schizophrenia to help their conversational skills?
• What are the probable after-effects, in the form of bruises and other injuries, of heparin injection therapy for COPD patients?
• Would standardized discharge medication education improve home medication adherence in adults age 65 and older compared to-standardized discharge medication education?
• In patients with psychiatric disorders is medication non-compliance a greater risk compared with adults experiencing chronic illness?
• Is the use of beta-blockers for lowering blood pressure for adult men over the age of 70 years effective?
• Nasal swab or nasal aspirate? Which one is more effective for children suffering from seasonal flu?
• What are the effects of adding beta-blockers for lowering blood pressure for adult men over the age of 70 years?
• Does the process of stopping lipids for 4 hours an effective measure of obtaining the desired TG level for patients who are about to receive TPN?
• Is medical intervention a proper way of dealing with childhood obesity among school-going children?
• Can nurse-led presentations of mental health associated with bullying help in combating such tendencies in public schools?
• What are the impacts of managing Prevacid before a pH probe study for pediatric patients with GERD?
• What are the measurable effects of extending ICU stays and antibiotic consumption amongst children with sepsis?
• Does the use of infrared skin thermometers justified when compared to the tympanic thermometers for a pediatric population?
• What are the roles of a pre-surgery cardiac nurse in order to prevent depression among patients awaiting cardiac operation?
• Does the increase in the habit of smoking marijuana among Dutch students increase the chances of depression?
• What is the direct connection between VAP and NGT?
• Is psychological intervention for people suffering from dementia a more effective measure than giving them a placebo?
• Are alarm sensors effective in preventing accidents in hospitals for patients over the age of 65 years?
• Is the sudden change of temperature harmful for patients who are neurologically devastated?
• Is it necessary to test blood glucose levels, 4 times a day, for a patient suffering from Type 1 diabetes?
• Is the use of MDI derive better results, when compared to regular nebulizers, for pediatric patients suffering from asthma?
• What are the effects of IVF bolus in controlling the amount of Magnesium Sulfate for patients who are suffering from asthma?
• Is the process of stopping lipids for 4 hours an effective measure of obtaining the desired TG level for patients who are about to receive TPN?
• What are the standards of vital signs for a pediatric population?
• Is daily blood pressure monitoring help in addressing the triggers of hypertension among males over 65 years?
• Does receiving phone tweets lower blood sugar levels for people suffering from Type 1 diabetes?
• Are males over the age of 30 years who have smoked for more than 1 year exposed to a greater risk of esophageal cancer when compared to the same age group of men who have no history of smoking?
• Does the increase in the use of mosquito nets in Uganda help in the reduction of malaria among the infants?
• Does the increase in the intake of oral contraceptives increase the chances of breast cancer among 20-30 years old women in the UK?
• In postpartum women with postnatal depression (P), does group therapy (I) compared to individual therapy (C) improve maternal-infant bonding (O) after eight weeks (T)?
• In patients with chronic pain (P), does mindfulness-based cognitive therapy (I) compared to pharmacotherapy (C) improve quality of life (O) after 12 weeks (T)?
• In patients with type 2 diabetes (P), does continuous glucose monitoring (I) compared to self-monitoring of blood glucose (C) improve glycemic control (O) over a period of three months (T)?
• In patients with chronic kidney disease (P), does a vegetarian diet (I) compared to a regular diet (C) slow the decline in renal function (O) after one year (T)?
• In pediatric patients with acute otitis media (P), does delayed antibiotic prescribing (I) compared to immediate antibiotic prescribing (C) reduce antibiotic use (O) within one week (T)?
• In older adults with dementia (P), does pet therapy (I) compared to no pet therapy (C) decrease agitation (O) after three months (T)?
• In patients with chronic heart failure (P), does telemonitoring of vital signs (I) compared to standard care (C) reduce hospital readmissions (O) within six months (T)?
• In patients with anxiety disorders (P), does exposure therapy (I) compared to cognitive therapy (C) reduce anxiety symptoms (O) after 12 weeks (T)?
• In postpartum women with breastfeeding difficulties (P), does lactation consultation (I) compared to standard care (C) increase breastfeeding rates (O) after four weeks (T)?
• In patients with chronic obstructive pulmonary disease (P), does long-acting bronchodilator therapy (I) compared to short-acting bronchodilator therapy (C) improve lung function (O) after three months (T)?
• In patients with major depressive disorder (P), does bright light therapy (I) compared to placebo (C) reduce depressive symptoms (O) after six weeks (T)?
• In patients with diabetes (P), does telemedicine-based diabetes management (I) compared to standard care (C) improve glycemic control (O) over a period of six months (T)?
• In patients with chronic kidney disease (P), does a low-phosphorus diet (I) compared to a regular diet (C) decrease serum phosphate levels (O) after one year (T)?
• In pediatric patients with acute gastroenteritis (P), does probiotic supplementation (I) compared to placebo (C) reduce the duration of diarrhea (O) within 48 hours (T)?
• In patients with chronic pain (P), does acupuncture (I) compared to sham acupuncture (C) reduce pain intensity (O) after eight weeks (T)?
• In older adults at risk of falls (P), does a home modification program (I) compared to no intervention (C) reduce the incidence of falls (O) over a period of six months (T)?
• In patients with schizophrenia (P), does cognitive remediation therapy (I) compared to standard therapy (C) improve cognitive function (O) after one year (T)?
• In patients with chronic kidney disease (P), does angiotensin-converting enzyme inhibitors (I) compared to angiotensin receptor blockers (C) slow the progression of renal disease (O) over a period of two years (T)?
• In postoperative patients (P), does chlorhexidine bathing (I) compared to regular bathing (C) reduce the risk of surgical site infections (O) within 30 days (T)?
• In patients with type 2 diabetes (P), does a low-carbohydrate, high-fat diet (I) compared to a low-fat diet (C) improve glycemic control (O) over a period of six months (T)?
• In patients with chronic obstructive pulmonary disease (P), does pulmonary rehabilitation combined with telemonitoring (I) compared to standard pulmonary rehabilitation (C) improve exercise capacity (O) after three months (T)?
• In patients with heart failure (P), does a nurse-led heart failure clinic (I) compared to usual care (C) improve self-care behaviors (O) after six months (T)?
• In postpartum women with postnatal depression (P), does telephone-based counseling (I) compared to face-to-face counseling (C) reduce depressive symptoms (O) after eight weeks (T)?
• In patients with chronic migraine (P), does prophylactic treatment with topiramate (I) compared to amitriptyline (C) reduce the frequency of migraines (O) after three months (T)?
• In pediatric patients with acute otitis media (P), does watchful waiting (I) compared to immediate antibiotic treatment (C) reduce the duration of symptoms (O) within seven days (T)?
• In older adults with dementia (P), does reminiscence therapy (I) compared to usual care (C) improve cognitive function (O) after three months (T)?
• In patients with chronic heart failure (P), does telemonitoring combined with a medication reminder system (I) compared to telemonitoring alone (C) reduce hospital readmissions (O) within six months (T)?
• In patients with asthma (P), does self-management education (I) compared to standard care (C) reduce asthma exacerbations (O) over a period of one year (T)?
• In postoperative patients (P), does the use of wound dressings with antimicrobial properties (I) compared to standard dressings (C) reduce the incidence of surgical site infections (O) within 30 days (T)?
• In patients with chronic kidney disease (P), does mindfulness-based stress reduction (I) compared to usual care (C) improve psychological well-being (O) over a period of three months (T)?
• In adult patients with chronic pain (P), does biofeedback therapy (I) compared to relaxation techniques (C) reduce pain intensity (O) after eight weeks (T)?
• In patients with type 2 diabetes (P), does a low-glycemic index diet (I) compared to a high-glycemic-index diet (C) improve glycemic control (O) over a period of six months (T)?
• In patients with chronic obstructive pulmonary disease (P), does regular physical activity (I) compared to no physical activity (C) improve health-related quality of life (O) after three months (T)?
• In patients with major depressive disorder (P), does mindfulness-based cognitive therapy (I) compared to antidepressant medication (C) reduce depressive symptoms (O) after eight weeks (T)?
• In postpartum women (P), does perineal warm compresses (I) compared to standard perineal care (C) reduce perineal pain (O) after vaginal delivery (T)?
• In patients with chronic kidney disease (P), does a low-protein, low-phosphorus diet (I) compared to a low-protein diet alone (C) slow the progression of renal disease(O) after two years (T)?
• In pediatric patients with attention-deficit/hyperactivity disorder (P), does mindfulness-based interventions (I) compared to medication alone (C) improve attention and behavior (O) after six months (T)?
• In patients with chronic pain (P), does cognitive-behavioral therapy (I) compared to physical therapy (C) reduce pain interference (O) after 12 weeks (T)?
• In elderly patients with osteoarthritis (P), does aquatic exercise (I) compared to land-based exercise (C) improve joint flexibility and reduce pain (O) after eight weeks (T)?
• In patients with multiple sclerosis (P), does high-intensity interval training (I) compared to moderate-intensity continuous training (C) improve physical function (O) after three months (T)?
• In postoperative patients (P), does preoperative carbohydrate loading (I) compared to fasting (C) reduce postoperative insulin resistance (O) within 24 hours (T)?
• In patients with chronic obstructive pulmonary disease (P), does home-based tele-rehabilitation (I) compared to center-based rehabilitation (C) improve exercise capacity (O) after six months (T)?
• In patients with rheumatoid arthritis (P), does tai chi (I) compared to pharmacological treatment (C) reduce joint pain and improve physical function (O) after six months (T)?
• In postpartum women with postpartum hemorrhage (P), does early administration of tranexamic acid (I) compared to standard administration (C) reduce blood loss (O) within two hours (T)?
• In patients with hypertension (P), does mindfulness meditation (I) compared to relaxation techniques (C) reduce blood pressure (O) after eight weeks (T)?
• In elderly patients with hip fractures (P), does multidisciplinary geriatric care (I) compared to standard care (C) improve functional outcomes (O) after three months (T)?
• In patients with chronic kidney disease (P), does aerobic exercise (I) compared to resistance exercise (C) improve renal function (O) after six months (T)?
• In patients with major depressive disorder (P), does add-on treatment with omega-3 fatty acids (I) compared to placebo (C) reduce depressive symptoms (O) after 12 weeks (T)?
• In postoperative patients (P), does preoperative education using multimedia materials (I) compared to standard education (C) improve patient satisfaction (O) after surgery (T)?
• In patients with type 2 diabetes (P), does a plant-based diet (I) compared to a standard diet (C) improve glycemic control (O) after three months (T)?
• In patients with chronic obstructive pulmonary disease (P), does high-flow oxygen therapy (I) compared to standard oxygen therapy (C) improve exercise tolerance (O) after three months (T)?
• In patients with heart failure (P), does nurse-led telephone follow-up (I) compared to standard care (C) reduce hospital readmissions (O) within six months (T)?
• In postpartum women with postnatal depression (P), does online cognitive-behavioral therapy (I) compared to face-to-face therapy (C) reduce depressive symptoms (O) after eight weeks (T)?
• In patients with chronic migraine (P), does mindfulness-based stress reduction (I) compared to medication alone (C) reduce the frequency and severity of migraines (O) after three months (T)?
• In older adults with delirium (P), does structured music intervention (I) compared to standard care (C) reduce the duration of delirium episodes (O) during hospitalization (T)?
• In patients with chronic low back pain (P), does yoga (I) compared to physical therapy (C) reduce pain intensity (O) after six weeks (T)?
• In pediatric patients with acute otitis media (P), does watchful waiting with pain management (I) compared to immediate antibiotic treatment (C) reduce the need for antibiotics (O) within one week (T)?
• In patients with schizophrenia (P), does family psychoeducation (I) compared to standard treatment (C) improve medication adherence (O) over a period of six months (T)?
• In patients with chronic kidney disease (P), does a low-phosphorus diet (I) compared to a regular diet (C) slow the progression of renal disease (O) after one year (T)?
• In postoperative patients (P), does wound irrigation with saline solution (I) compared to povidone-iodine solution (C) reduce the incidence of surgical site infections (O) within 30 days (T)?
• In patients with type 1 diabetes (P), does continuous subcutaneous insulin infusion (I) compared to multiple daily injections (C) improve glycemic control (O) over a period of six months (T)?
• In postoperative patients (P), does the use of prophylactic antibiotics (I) compared to no antibiotics (C) reduce the incidence of surgical site infections (O) within 30 days (T)?
• In patients with chronic obstructive pulmonary disease (P), does smoking cessation counseling (I) compared to no counseling (C) decrease the frequency of exacerbations (O) over a period of six months (T)?
• In patients with diabetes (P), does a multidisciplinary team approach (I) compared to standard care (C) improve self-management behaviors (O) over a period of one year (T)?
• In pregnant women with gestational hypertension (P), does bed rest (I) compared to regular activity (C) reduce the risk of developing preeclampsia (O) before delivery (T)?
• In patients with chronic kidney disease (P), does angiotensin-converting enzyme inhibitors (I) compared to placebo (C) slow the progression of renal disease (O) over a period of two years (T)?
• In older adults with hip fractures (P), does early surgical intervention (I) compared to delayed surgery (C) improve functional outcomes (O) after six months (T)?
• In patients with major depressive disorder (P), does exercise (I) compared to antidepressant medication (C) reduce depressive symptoms (O) after eight weeks (T)?
• In children with autism spectrum disorder (P), does applied behavior analysis (I) compared to standard therapy (C) improve social communication skills (O) over a period of one year (T)?
• In postoperative patients (P), does the use of incentive spirometry (I) compared to no spirometry (C) decrease the incidence of postoperative pulmonary complications (O) within seven days (T)?
• In patients with hypertension (P), does a combination of diet modification and exercise (I) compared to medication alone (C) lower blood pressure (O) after six months (T)?
• In patients with chronic obstructive pulmonary disease (P), does home oxygen therapy (I) compared to no oxygen therapy (C) improve exercise capacity (O) after threemonths (T)?
• In patients with heart failure (P), does a multidisciplinary heart failure management program (I) compared to standard care (C) reduce hospital readmissions (O) within six months (T)?
• In postpartum women with postnatal depression (P), does mindfulness meditation (I) compared to relaxation techniques (C) reduce depressive symptoms (O) after eight weeks (T)?
• In patients with chronic kidney disease (P), does a low-sodium diet (I) compared to a regular diet (C) lower blood pressure (O) after six months (T)?
• In pediatric patients with attention-deficit/hyperactivity disorder (P), does neurofeedback training (I) compared to medication (C) improve attention and behavior (O) after six months (T)?
• In patients with chronic pain (P), does transcranial direct current stimulation (I) compared to sham stimulation (C) reduce pain intensity (O) after eight weeks (T)?
• In older adults with osteoporosis (P), does a structured exercise program (I) compared to no exercise (C) improve bone mineral density (O) after six months (T)?
• In patients with type 2 diabetes (P), does a low-carbohydrate, high-protein diet (I) compared to a standard diet (C) improve glycemic control (O) over a period of six months (T)?
• In patients with chronic obstructive pulmonary disease (P), does mindfulness-based stress reduction (I) compared to usual care (C) improve dyspnea symptoms (O) after three months (T)?
• In postpartum women with postnatal depression (P), does online peer support (I) compared to individual therapy (C) reduce depressive symptoms (O) after eight weeks (T)?
• In patients with chronic kidney disease (P), does resistance training (I) compared to aerobic training (C) improve muscle strength (O) after six months (T)?
• In pediatric patients with asthma (P), does a written asthma action plan (I) compared to verbal instructions (C) reduce emergency department visits (O) within six months (T)?
• In patients with chronic pain (P), does yoga (I) compared to pharmacological treatment (C) reduce pain interference (O) after eight weeks (T)?
• In older adults at risk of falls (P), does a multifactorial falls prevention program (I) compared to no intervention (C) reduce the rate of falls (O) over a period of six months (T)?
• In patients with schizophrenia (P), does cognitive-behavioral therapy (I) compared to medication alone (C) reduce positive symptom severity (O) after six months (T)?
• In postpartum women with breastfeeding difficulties (P), does breast massage (I) compared to no massage (C) improve milk flow (O) after four weeks (T)?
• In patients with chronic obstructive pulmonary disease (P), does long-term oxygen therapy (I) compared to short-term oxygen therapy (C) improve survival rates (O) after one year (T)?
• In patients with major depressive disorder (P), does repetitive transcranial magnetic stimulation (I) compared to sham treatment (C) reduce depressive symptoms (O) after six weeks (T)?
• In patients with diabetes (P), does a digital health app (I) compared to standard care (C) improve medication adherence (O) over a period of six months (T)?
• In patients with chronic kidney disease (P), does a low-potassium diet (I) compared to a regular diet (C) lower serum potassium levels (O) after one year (T)?
• In pediatric patients with acute gastroenteritis (P), does oral rehydration solution (I) compared to intravenous fluid therapy (C) reduce hospital admissions (O) within 48 hours (T)?
• In patients with chronic pain (P), does hypnotherapy (I) compared to no hypnotherapy (C) reduce pain intensity (O) after eight weeks (T)?
• In older adults at risk of falls (P), does a tai chi program (I) compared to no exercise program (C) improve balance and stability (O) after six months (T)?
• In patients with chronic heart failure (P), does a home-based self-care intervention (I) compared to standard care (C) reduce hospital readmissions (O) within six months (T)?
• In patients with anxiety disorders (P), does acceptance and commitment therapy (I) compared to cognitive-behavioral therapy (C) reduce anxiety symptoms (O) after 12 weeks (T)?
• In postpartum women with breastfeeding difficulties (P), does the use of nipple shields (I) compared to no nipple shields (C) improve breastfeeding success (O) after four weeks (T)?
• In patients with chronic obstructive pulmonary disease (P), does a comprehensive self-management program (I) compared to usual care (C) improve health-related quality of life (O) after three months (T)?
• In patients with major depressive disorder (P), does internet-based cognitive-behavioral therapy (I) compared to face-to-face therapy (C) reduce depressive symptoms (O) after eight weeks (T)?
• Does the increase in the habit of smoking marijuana among Dutch students increase the likelihood of depression?
• Does the use of pain relief medication during surgery provide more effective pain reduction compared to the same medication given post-surgery?
• Does the increase in the intake of oral contraceptives increase the risk of breast cancer among women aged 20-30 in the UK?
• Does the habit of washing hands among healthcare workers decrease the rate of infections in hospitals?
• Does the use of modern syringes help in reducing needle injuries among healthcare workers in America?
• Does encouraging male work colleagues to talk about sexual harassment decrease the rate of depression in the workplace?
• Does bullying in boarding schools in Scotland increase the likelihood of domestic violence within a 20-year timeframe?
• Does breastfeeding among toddlers in urban United States decrease their chances of obesity as pre-schoolers?
• Does the increase in the intake of antidepressants among urban women aged 30 years and older affect their maternal health?
• Does forming work groups to discuss domestic violence among the rural population of the United States reduce stress and depression among women?
• Does the increased use of mosquito nets in Uganda help in reducing malaria cases among infants?
• Can colon cancer be more effectively detected when colonoscopy is supported by an occult blood test compared to colonoscopy alone?
• Does regular usage of low-dose aspirin effectively reduce the risk of heart attacks and stroke for women above the age of 80 years?
• Is yoga an effective medical therapy for reducing lymphedema in patients recovering from neck cancer?
• Does daily blood pressure monitoring help in addressing the triggers of hypertension among males over 65 years?
• Does a regular 30-minute exercise regimen effectively reduce the risk of heart disease in adults over 65 years?
• Does prolonged exposure to chemotherapy increase the risk of cardiovascular diseases among teenagers suffering from cancer?
• Does breastfeeding among toddlers in the urban United States decrease their chances of obesity as pre-schoolers?
• Are first-time mothers giving birth to premature babies more prone to postpartum depression compared to second or third-time mothers in the same condition?
• For women under the age of 50 years, is a yearly mammogram more effective in preventing breast cancer compared to a mammogram done every 3 years?
• After being diagnosed with blood sugar levels, is a four-times-a-day blood glucose monitoring process more effective in controlling the onset of Type 1 diabetes?

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Formulating a good research question: Pearls and pitfalls

Wilson fandino.

Guys' and St Thomas' Hospital National Health Service Foundation Trust, London, United Kingdom

The process of formulating a good research question can be challenging and frustrating. While a comprehensive literature review is compulsory, the researcher usually encounters methodological difficulties in the conduct of the study, particularly if the primary study question has not been adequately selected in accordance with the clinical dilemma that needs to be addressed. Therefore, optimising time and resources before embarking in the design of a clinical protocol can make an impact on the final results of the research project. Researchers have developed effective ways to convey the message of how to build a good research question that can be easily recalled under the acronyms of PICOT (population, intervention, comparator, outcome, and time frame) and FINER (feasible, interesting, novel, ethical, and relevant). In line with these concepts, this article highlights the main issues faced by clinicians, when developing a research question.

INTRODUCTION

What is your research question? This is very often one of the first queries made by statisticians, when researchers come up with an interesting idea. In fact, the findings of a study may only acquire relevance if they provide an accurate and unbiased answer to a specific question,[ 1 , 2 ] and it has been suggested that up to one-third of the time spent in the whole process—from the conception of an idea to the publication of the manuscript—could be invested in finding the right primary study question.[ 3 ] Furthermore, selecting a good research question can be a time-consuming and challenging task: in one retrospective study, Mayo et al . reported that 3 out of 10 articles published would have needed a major rewording of the question.[ 1 ] This paper explores some recommendations to consider before starting any research project, and outlines the main difficulties faced by young and experienced clinicians, when it comes time to turn an exciting idea into a valuable and feasible research question.

OPTIMISATION OF TIME AND RESOURCES

Focusing on the primary research question.

The process of developing a new idea usually stems from a dilemma inherent to the clinical practice.[ 2 , 3 , 4 ] However, once the problem has been identified, it is tempting to formulate multiple research questions. Conducting a clinical trial with more than one primary study question would not be feasible. First, because each question may require a different research design, and second, because the necessary statistical power of the study would demand unaffordable sample sizes. It is the duty of editors and reviewers to make sure that authors clearly identify the primary research question, and as a consequence, studies approaching more than one primary research question may not be suitable for publication.

Working in the right environment

Teamwork is essential to find the appropriate research question. Working in the right environment will enable the investigator to interact with colleagues with different backgrounds, and create opportunities to exchange experiences in a collaborative way between clinicians and researchers. Likewise, it is of paramount importance to get involved colleagues with expertise in the field (lead clinicians, education supervisors, research mentors, department chairs, epidemiologists, biostatisticians, and ethical consultants, among others), and ask for their guidance.[ 5 , 6 , 7 , 8 ]

Evaluating the pertinence of the study

The researcher should wonder if, on the basis of the research question formulated, there is a need for a study to address the problem, as clinical research usually entails a large investment of resources and workforce involvement. Thus, if the answer to the posed clinical question seems to be evident before starting the study, investing in research to address the problem would become superfluous. For example, in a clinical trial, Herzog-Niescery et al . compared laryngeal masks with cuffed and uncuffed tracheal tubes, in the context of surgeons' exposure to sevoflurane, in infants undergoing adenoidectomy. However, it appears obvious that cuffed tracheal tubes are preferred to minimise surgeons' exposure to volatile gases, as authors concluded after recruiting 60 patients.[ 9 ]

Conducting a thorough literature review

Any research project requires the identification of at least one of three problems: the evidence is scarce, the existing literature yields conflicting results, or the results could be improved. Hence, a comprehensive review of the topic is imperative, as it allows the researcher to identify this gap in the literature, formulate a hypothesis and develop a research question.[ 2 ] To this end, it is crucial to be attentive to new ideas, keep the imagination roaming with reflective attitude, and remain sceptical to the new-gained information.[ 4 , 7 ]

Narrowing the research question

A broad research question may encompass an unaffordable extensive topic. For instance, do supraglottic devices provide similar conditions for the visualization of the glottis aperture in a German hospital? Such a general research question usually needs to be narrowed, not only by cutting away unnecessary components (a German hospital is irrelevant in this context), but also by defining a target population, a specific intervention, an alternative treatment or procedure to be compared with the intervention, a measurable primary outcome, and a time frame of the study. In contrast, an example of a good research question would be: among children younger than 1 year of age undergoing elective minor procedures, to what extent the insertion times are different, comparing the Supreme™ laryngeal mask airway (LMA) to Proseal™ LMA, when placed after reaching a BIS index <60?[ 10 ] In this example, the core ingredients of the research question can be easily identified as: children <1 year of age undergoing minor elective procedures, Supreme™ LMA, Proseal™ LMA and insertion times at anaesthetic induction when reaching a BIS index <60. These components are usually gathered in the literature under the acronym of PICOT (population, intervention, comparator, outcome and time frame, respectively).[ 1 , 3 , 5 ]

PICOT FRAMEWORK

Table 1 summarises the foremost questions likely to be addressed when working on PICOT frame.[ 1 , 6 , 8 ] These components are also applicable to observational studies, where the exposure takes place of the intervention.[ 1 , 11 ] Remarkably, if after browsing the title and the abstract of a paper, the reader is not able to clearly identify the PICOT parameters, and elucidate the question posed by the authors, there should be reasonable scepticism regarding the scientific rigor of the work.[ 12 , 13 ] All these elements are crucial in the design and methodology of a clinical trial, as they can affect the feasibility and reliability of results. Having formulated the primary study question in the context of the PICOT framework [ Table 1 ],[ 1 , 6 , 8 ] the researcher should be able to elucidate which design is most suitable for their work, determine what type of data needs to be collected, and write a structured introduction tailored to what they want to know, explicitly mentioning the primary study hypothesis, which should lead to formulate the main research question.[ 1 , 2 , 6 , 8 ]

Key questions to be answered when working with the PICOT framework (population, intervention, comparator, outcome, and time frame) in a clinical research design

Occasionally, the intended population of the study needs to be modified, in order to overcome any potential ethical issues, and/or for the sake of convenience and feasibility of the project. Yet, the researcher must be aware that the external validity of the results may be compromised. As an illustration, in a randomised clinical trial, authors compared the ease of tracheal tube insertion between C-MAC video laryngoscope and direct laryngoscopy, in patients presenting to the emergency department with an indication of rapid sequence intubation. However, owing to the existence of ethical concerns, a substantial amount of patients requiring emergency tracheal intubation, including patients with major maxillofacial trauma and ongoing cardiopulmonary resuscitation, had to be excluded from the trial.[ 14 ] In fact, the design of prospective studies to explore this subset of patients can be challenging, not only because of ethical considerations, but because of the low incidence of these cases. In another study, Metterlein et al . compared the glottis visualisation among five different supraglottic airway devices, using fibreroptic-guided tracheal intubation in an adult population. Despite that the study was aimed to explore the ease of intubation in patients with anticipated difficult airway (thus requiring fibreoptic tracheal intubation), authors decided to enrol patients undergoing elective laser treatment for genital condylomas, as a strategy to hasten the recruitment process and optimise resources.[ 15 ]

Intervention

Anaesthetic interventions can be classified into pharmacological (experimental treatment) and nonpharmacological. Among nonpharmacological interventions, the most common include anaesthetic techniques, monitoring instruments and airway devices. For example, it would be appropriate to examine the ease of insertion of Supreme™ LMA, when compared with ProSeal™ LMA. Notwithstanding, a common mistake is the tendency to be focused on the data aimed to be collected (the “stated” objective), rather than the question that needs to be answered (the “latent” objective).[ 1 , 4 ] In one clinical trial, authors stated: “we compared the Supreme™ and ProSeal™ LMAs in infants by measuring their performance characteristics, including insertion features, ventilation parameters, induced changes in haemodynamics, and rates of postoperative complications”.[ 10 ] Here, the research question has been centered on the measurements (insertion characteristics, haemodynamic variables, LMA insertion characteristics, ventilation parameters) rather than the clinical problem that needs to be addressed (is Supreme™ LMA easier to insert than ProSeal™ LMA?).

Comparators in clinical research can also be pharmacological (e.g., gold standard or placebo) or nonpharmacological. Typically, not more than two comparator groups are included in a clinical trial. Multiple comparisons should be generally avoided, unless there is enough statistical power to address the end points of interest, and statistical analyses have been adjusted for multiple testing. For instance, in the aforementioned study of Metterlein et al .,[ 15 ] authors compared five supraglottic airway devices by recruiting only 10--12 participants per group. In spite of the authors' recommendation of using two supraglottic devices based on the results of the study, there was no mention of statistical adjustments for multiple comparisons, and given the small sample size, larger clinical trials will undoubtedly be needed to confirm or refute these findings.[ 15 ]

A clear formulation of the primary outcome results of vital importance in clinical research, as the primary statistical analyses, including the sample size calculation (and therefore, the estimation of the effect size and statistical power), will be derived from the main outcome of interest. While it is clear that using more than one primary outcome would not be appropriate, it would be equally inadequate to include multiple point measurements of the same variable as the primary outcome (e.g., visual analogue scale for pain at 1, 2, 6, and 12 h postoperatively).

Composite outcomes, in which multiple primary endpoints are combined, may make it difficult to draw any conclusions based on the study findings. For example, in a clinical trial, 200 children undergoing ophthalmic surgery were recruited to explore the incidence of respiratory adverse events, when comparing desflurane with sevoflurane, following the removal of flexible LMA during the emergence of the anaesthesia. The primary outcome was the number of respiratory events, including breath holding, coughing, secretions requiring suction, laryngospasm, bronchospasm, and mild desaturation.[ 16 ] Should authors had claimed a significant difference between these anaesthetic volatiles, it would have been important to elucidate whether those differences were due to serious adverse events, like laryngospasm or bronchospasm, or the results were explained by any of the other events (e.g., secretions requiring suction). While it is true that clinical trials evaluating the occurrence of adverse events like laryngospasm/bronchospasm,[ 16 , 17 ] or life-threating complications following a tracheal intubation (e.g., inadvertent oesophageal placement, dental damage or injury of the larynx/pharynx)[ 14 ] are almost invariably underpowered, because the incidence of such events is expected to be low, subjective outcomes like coughing or secretions requiring suction should be avoided, as they are highly dependent on the examiner's criteria.[ 16 ]

Secondary outcomes are useful to document potential side effects (e.g., gastric insufflation after placing a supraglottic device), and evaluate the adherence (say, airway leak pressure) and safety of the intervention (for instance, occurrence, or laryngospasm/bronchospasm).[ 17 ] Nevertheless, the problem of addressing multiple secondary outcomes without the adequate statistical power is habitual in medical literature. A good illustration of this issue can be found in a study evaluating the performance of two supraglottic devices in 50 anaesthetised infants and neonates, whereby authors could not draw any conclusions in regard to potential differences in the occurrence of complications, because the sample size calculated made the study underpowered to explore those differences.[ 17 ]

Among PICOT components, the time frame is the most likely to be omitted or inappropriate.[ 1 , 12 ] There are two key aspects of the time component that need to be clearly specified in the research question: the time of measuring the outcome variables (e.g. visual analogue scale for pain at 1, 2, 6, and 12 h postoperatively), and the duration of each measurement (when indicated). The omission of these details in the study protocol might lead to substantial differences in the methodology used. For instance, if a study is designed to compare the insertion times of three different supraglottic devices, and researchers do not specify the exact moment of LMA insertion in the clinical trial protocol (i.e., at the anaesthetic induction after reaching a BIS index < 60), placing an LMA with insufficient depth of anaesthesia would have compromised the internal validity of the results, because inserting a supraglottic device in those patients would have resulted in failed attempts and longer insertion times.[ 10 ]

FINER CRITERIA

A well-elaborated research question may not necessarily be a good question. The proposed study also requires being achievable from both ethical and realistic perspectives, interesting and useful to the clinical practice, and capable to formulate new hypotheses, that may contribute to the generation of knowledge. Researchers have developed an effective way to convey the message of how to build a good research question, that is usually recalled under the acronym of FINER (feasible, interesting, novel, ethical and relevant).[ 5 , 6 , 7 ] Table 2 highlights the main characteristics of FINER criteria.[ 7 ]

Main features of FINER criteria (Feasibility, interest, novelty, ethics, and relevance) to formulate a good research question. Adapted from Cummings et al .[ 7 ]

Novelty and relevance

Although it is clear that any research project should commence with an accurate literature interpretation, in many instances it represents the start and the end of the research: the reader will soon realise that the answer to several questions can be easily found in the published literature.[ 5 ] When the question overcomes the test of a thorough literature review, the project may become novel (there is a gap in the knowledge, and therefore, there is a need for new evidence on the topic) and relevant (the paper may contribute to change the clinical practice). In this context, it is important to distinguish the difference between statistical significance and clinical relevance: in the aforementioned study of Oba et al .,[ 10 ] despite the means of insertion times were reported as significant for the Supreme™ LMA, as compared with ProSeal™ LMA, the difference found in the insertion times (528 vs. 486 sec, respectively), although reported as significant, had little or no clinical relevance.[ 10 ] Conversely, a statistically significant difference of 12 sec might be of clinical relevance in neonates weighing <5 kg.[ 17 ] Thus, statistical tests must be interpreted in the context of a clinically meaningful effect size, which should be previously defined by the researcher.

Feasibility and ethical aspects

Among FINER criteria, there are two potential barriers that may prevent the successful conduct of the project and publication of the manuscript: feasibility and ethical aspects. These obstacles are usually related to the target population, as discussed above. Feasibility refers not only to the budget but also to the complexity of the design, recruitment strategy, blinding, adequacy of the sample size, measurement of the outcome, time of follow-up of participants, and commitment of clinicians, among others.[ 3 , 7 ] Funding, as a component of feasibility, may also be implicated in the ethical principles of clinical research, because the choice of the primary study question may be markedly influenced by the specific criteria demanded in the interest of potential funders.

Discussing ethical issues with local committees is compulsory, as rules applied might vary among countries.[ 18 ] Potential risks and benefits need to be carefully weighed, based upon the four principles of respect for autonomy, beneficence, non-maleficence, and justice.[ 19 ] Although many of these issues may be related to the population target (e.g., conducting a clinical trial in patients with ongoing cardiopulmonary resuscitation would be inappropriate, as would be anaesthetising patients undergoing elective LASER treatment for condylomas, to examine the performance of supraglottic airway devices),[ 14 , 15 ] ethical conflicts may also arise from the intervention (particularly those involving the occurrence of side effects or complications, and their potential for reversibility), comparison (e.g., use of placebo or sham procedures),[ 19 ] outcome (surrogate outcomes should be considered in lieu of long term outcomes), or time frame (e.g., unnecessary longer exposition to an intervention). Thus, FINER criteria should not be conceived without a concomitant examination of the PICOT checklist, and consequently, PICOT framework and FINER criteria should not be seen as separated components, but rather complementary ingredients of a good research question.

Undoubtedly, no research project can be conducted if it is deemed unfeasible, and most institutional review boards would not be in a position to approve a work with major ethical problems. Nonetheless, whether or not the findings are interesting, is a subjective matter. Engaging the attention of readers also depends upon a number of factors, including the manner of presenting the problem, the background of the topic, the intended audience, and the reader's expectations. Furthermore, the interest is usually linked to the novelty and relevance of the topic, and it is worth nothing that editors and peer reviewers of high-impact medical journals are usually reluctant to accept any publication, if there is no novelty inherent to the research hypothesis, or there is a lack of relevance in the results.[ 11 ] Nevertheless, a considerable number of papers have been published without any novelty or relevance in the topic addressed. This is probably reflected in a recent survey, according to which only a third of respondents declared to have read thoroughly the most recent papers downloaded, and at least half of those manuscripts remained unread.[ 20 ] The same study reported that up to one-third of papers examined remained uncited after 5 years of publication, and only 20% of papers accounted for 80% of the citations.[ 20 ]

Formulating a good research question can be fascinating, albeit challenging, even for experienced investigators. While it is clear that clinical experience in combination with the accurate interpretation of literature and teamwork are essential to develop new ideas, the formulation of a clinical problem usually requires the compliance with PICOT framework in conjunction with FINER criteria, in order to translate a clinical dilemma into a researchable question. Working in the right environment with the adequate support of experienced researchers, will certainly make a difference in the generation of knowledge. By doing this, a lot of time will be saved in the search of the primary study question, and undoubtedly, there will be more chances to become a successful researcher.

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Before You Start Searching

Clinical and epidemiological question frameworks.

• Basic Literature Searching
• Advanced Literature Searching
• Searching for Evidence with ABCDE
• Citation Management
• Citing Sources: APA and Other Styles

Step One: Start to formulate a research question or topic.

Aiming for clarity at the beginning of the project can help you get started right. It can be helpful to use one of the question frameworks detailed below.

Step Two: Do some background searching on the topic.

Taking a look in relevant resources to see what's already been written about your topic will help you understand how you can best contribute to the body of literature. It will also help you grasp the terminology around the topic, so that you'll be more prepared to do an effective literature search.

Step Three: Narrow down the question or topic if needed.

You may find that your original topic is too broad. After you have taken the time to evaluate what's already been written about your topic, you'll have a better understanding of what you're interested in.

Step Four: Meet with your librarian.

Step five: create a search for your topic in an appropriate database..

Try one of these tried and true clinical or quantitative research question frameworks. Not sure where to start? PICO is the most common clinical question framework. and PEO works well for public health and epidemiology.

• Condition, Context, Population
• Aromataris, E., & Munn, Z. (2017). Joanna Briggs Institute reviewer's manual. The Joanna Briggs Institute. Available from JBI Manual for Evidence Synthesis .
• Population, Exposure of Interest, Outcome or Response
• Population or Problem, Intervention or Exposure, Comparison or Control, Outcome
• Heneghan, C., & Badenoch, D. (2002). Evidence-based medicine toolkit. London: BMJ Books. https://www.worldcat.org/title/evidence-based-medicine-toolkit/oclc/62307845
• Population or Problem, Intervention or Exposure, Comparison or Control, Outcome, Study Type
• Methley, A. M., Campbell, S., Chew-Graham, C., McNally, R., & Cheraghi-Sohi, S. (2014). PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC health services research, 14, 579. https://doi.org/10.1186/s12913-014-0579-0 .
• Population or Problem, Intervention or Exposure, Comparison or Control, Outcome, Time
• Richardson, W. S., Wilson, M. C., Nishikawa, J., & Hayward, R. S. (1995). The well-built clinical question: A key to evidence-based decisions. ACP Journal Club, 123(3), A12-A12. https://pubmed.ncbi.nlm.nih.gov/7582737/
• Population, Index Test, Reference Test, Diagnosis of Interest
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‘Efforts to tackle discrimination are laudable but more is needed’

STEVE FORD, EDITOR

• You are here: Nurse educators

Identifying and defining research questions

25 January, 2016

Successful clinical research depends on a properly constructed research question on a topic that is relevant for study. Discover the best process of developing one

Research is vital to improving nursing practice and patient outcomes, and therefore a key aspect of nursing degree programmes. All student nurses must show they can undertake an independent learning project before they can graduate and become registered nurses. This article outlines processes that can be followed to select a research area and narrow it down to generate a specific research question. Methodologies and models can then be used to compile a list of search terms that can be used to get the research underway.

Citation: Khodabux R  (2015) Identifying and defining research questions.  Nursing Times ; 112: 3/4, 16-19

Author:  Raouf Khodabux is senior lecturer, module leader for Approaches to Health and Social Care Research, Middlesex University, London.

• This article has been double-blind peer reviewed
• Scroll down to read the article or  download a print-friendly PDF here

Introduction

In 2011, pre-registration education in England became an all-degree programme (Nursing and Midwifery Council, 2010), so student nurses in their final year must carry out an independent learning project. In addition, many qualified nurses are returning to university to do their dissertation and complete their degree (Aveyard, 2014). These projects vary in scope and nature, from literature reviews or extended essays to small research projects.

For many students, the dissertation is a “nightmare” they have to endure to gain a degree (Lundgren and Halvarsson, 2009). This module can be challenging for a number of reasons such as:

• The requirement to be on placement;
• Long days and/or night duty;
• Working part-time to make ends meet;
• Family commitments.

However, perhaps the biggest challenge is the fact that this is an independent module in which a lot depends on students’ motivation and willingness – they have to determine the focus and direction of their work. This is usually carried out on an individual basis, although some tutor support, supervision and direction is provided.

The module is also demanding because there is typically a substantial research component to the project requiring primary data to be collected and secondary or existing data to be analysed. Furthermore, students are expected to have a more prolonged engagement with the chosen subject than they do with standard coursework, such as essays or reports; the work is consequently required to be more in-depth than students are accustomed to (Todd et al, 2004).

Many students struggle to start their project because they simply do not know where to begin. The most critical question for many is “What should I study?” Deciding between a research project and a literature review depends on the type of degree course being undertaken. However, for most undergraduate nursing courses, students are required to carry out a literature review.

Pole and Lampard (2002) stated that curiosity is, or at least should be, the driving force behind the conduct of any research. Research questions are an attempt to “tame” curiosity, so they are not asked in a haphazard manner but in relation to what is already known about the topic of interest (White 2013). The process of framing, developing and refining these questions allows researchers to make connections with existing theories and previous empirical findings; this helps avoid unnecessary repetition of, or overlap with, previous work (White, 2009). In the final analysis, a researchable question is an uncertainty about a problem that can be challenged, examined and analysed to provide useful information (Ellis, 2013). A clearly defined research problem is the fuel that drives the scientific process, and is the foundation of any research method and experimental design, from true experiment to case study (Shuttleworth 2008).

Framework for a literature review

Formulation of a research-focused question underpins any type of literature review, whether it is for a:

• Dissertation for a systematic or traditional/narrative review;
• Primary research project;
• Research proposal.

A literature review is an account of what has been published on a topic by accredited scholars and researchers. It is an objective, thorough summary and critical analysis of the relevant available research and non-research literature on the topic being studied (Hart 2012).

Conducting a literature review can be a daunting and confusing prospect. Wakefield (2015) identifies seven steps in the process (Box 1), at the top of which is formulating a research question. Aveyard (2010) argued that in order to write a robust evaluative literature review, it is essential to start with a sound research question. Even in the context of the research process, Gelling (2015) identified the development of a research question as the first stage, while Offredy and Vickers (2010) said the first step in writing a research proposal is to choose a topic and then to develop research questions.

Ionesco (1969) stated that it is not the answer that enlightens, but the question. According to Graziano and Raulin (2004): “Questions are everywhere; all you have to do is observe and be curious”.

To carry out a literature review, it is necessary to:

• Have a basic knowledge of research processes and methodologies;
• Understand the origins of the evidence, primary and secondary sources;
• Understand the terminology used;
• Know how the various types of literature reviews vary (Conner, 2014).

It is well documented that student nurses tend to disengage with the research module (Ax and Kincade, 2001). Undergraduates find research boring, and may have difficulty understanding the language and experience cognitive shutdown (Porter et al, 2006); this may come back to haunt them in the final year when they attempt the literature review for their dissertation. Since the literature review is an integral part of the research process, it is crucial for students to engage with the research module.

Box 1. Conducting a literature review

There are seven steps to follow when conducting a literature review:

• Formulate a research question
• Identify a term/terms that will be used to search the literature
• Create robust inclusion and exclusion criteria to select the most appropriate literature
• Select the most relevant databases to interrogate the literature
• Search the literature from a global perspective
• Analyse, synthesise and critique the research articles
• Present the findings

Source: Wakefield (2015)

Choosing a research topic

The starting point for any research project begins with the choice of topic. This should be a subject the student finds interesting, stimulating and worthwhile, as this will make the process more enjoyable and, ultimately, more rewarding. While the initial topic selected may be broad, it must be narrowed down to a focused question (Playle, 2000).

The topic should already have been researched by others so it is possible to search for relevant literature to review. The most interesting topic in the world will not create a successful literature review if nothing has previously been written about it. Sometimes it is a good idea to come up with a few alternative ideas and carry out some preliminary research on each – that way, if there has only been limited exploration of the first choice, there is an alternative to fall back on.

Most research projects start with an idea that arises from clinical practice (Gelling, 2015). However, it is generally agreed that research topics narrowed into focused questions arise from three basic sources:

• The literature;
• Experience (Springett and Campbell, 2006).

Using the literature

Sometimes studies raise far more questions than they answer so, when reading the literature on a particular topic, you may find new ideas are recommended for further investigation. For example, there may be observational studies that explain what is happening but not necessarily why. When reading the literature it is useful to bear in mind that:

• It is possible to replicate a study – this not only ensures its reliability but also provides additional information;
• Any recommendations made at the end of research articles may be followed up with another investigation;
• Sometimes there may be flaws in the original method used in a study, and the same question can be asked in a different way – this may then reinforce or challenge the findings of the earlier study.

Theoretical concepts that may be tested in practice are the second major source of research questions. Theories such as the promotion of continence and self-care as a framework for nursing or mentorship, and student nurses’ performance, can be tested in practice. An example of a theory is: “Promotion of continence will result in better quality of life for patients”. Like many other theories in nursing, this can be investigated inductively or deductively. A quantitative experimental design uses deductive reasoning to arrive at a testable hypothesis. According to Coates (2011), this approach focuses on replicability, objectivity, prediction and control; the distinguishing feature is a collection of numerical data that can be subjected to statistical analysis. Qualitative research designs use inductive reasoning to propose a research statement about how people interpret and structure their lives. This kind of research is used to explore, understand and interpret experiences, feelings and beliefs (Gelling, 2015).

Research ideas can also stem from experience in clinical areas where nurses observe practice that may be a source of concern or simply “interest”. The research question need not be about something that is “wrong” but something that could be done better or has not been thought about before. Student nurses are taught critical analysis to encourage them to ask:

• Why is this being done in this particular way?
• What will happen if this is done differently?

These are important ways to explore more about nursing inductively as they stem from the real world of nursing.

From a clinical practice perspective, when a research question is carefully composed it aims to close the gaps between what is known and what needs to be known about nursing care, and resolve the discrepancy between the way things are and how they ought to be to result in better patient care. However, research does not always lead to definitive answers.

Composing the research question

Deciding on the research question is challenging, but is one of the most critical aspects of the research process. A carefully constructed research question helps to guide the project to hit its scholarly target. Research is only as good as the question and plan on which it is based; this is relevant to healthcare research because new knowledge comes from having asked answerable questions (Haynes, 2006).

Beitz (2006) defined research questions as “an explicit query about a problem or issue that can be challenged, examined and analysed, and that will yield useful new information”.

The question is the fundamental core of a research project, study or literature review. It focuses the study, determines the methodology and guides all stages of inquiry, analysis and reporting. It also acts as an aide memoire, and helps keep the researcher focused on the specific area of enquiry, which is particularly helpful when searching the literature (Lahlafi, 2007).

Blaikie (2007) argued that the use of research questions in the design and conduct of research is often neglected. The key to defining a research question is focus. If it is too broad (for example, “Does regular exercise prevent heart disease in adult men?”), the search strategy will become unstructured and many important articles may be overlooked (Wakefield, 2015). The end product should be a specific query that is explicit in what it is looking for. However, Denney and Tewksbury (2013) have also argued against having a research question that is too narrow (for example, “Do daily 30-minute exercise sessions reduce the incidence of myocardial infarction in 40-60-year-old Asian men?”) as it can limit the search strategy. An appropriate question on the topic in the examples above might be, “Does daily exercise reduce the incidence of myocardial infarction in men over 40 years of age?”

Framing the research question

The development of the research question is important as it sets the parameters of the research. It provides opportunities for a wide range of research methodologies as well as a structure and direction for the student. Hanson (2006) argued that there are three important phases of developing a study question destined for success:

• Defining the research question(s);
• Refining the research question(s);
• Converting the research question(s) into a specific aim(s).

Similarly, Lipowski (2008) proposed three steps in the formulation of a great research question:

• Ask interesting questions;
• Select the best question for research;
• Transform the research question into a testable hypothesis.

There are three types of research question:

• Descriptive: describing something, using a descriptive approach that can simply be an observation of something, with the researcher taking the role of the “witness” and answering the basic question of “what happened?”;
• Relational: a relational or correlational study exploring relationships between two or more variables using statistical analysis, and asking the question: “how are these linked?”;
• Causal: exploring cause and effect to determine whether one or more variables causes or affects one or more outcomes using an experimental approach (Trochim, 2006).

Table 1 (attached) indicates some broad research topics and specific research questions; students should be able to identify which type of question each one is. Research questions should be:

• Manageable in terms of research and in terms of the individual’s own academic abilities;
• Substantial and with originality: rather than previously addressed topics, students should use their imagination and come up with ground-breaking ideas that can be turned into research issues or developed into a dissertation;
• Able to confirm or refute previous findings, extend or build on previous findings or provide new findings;
• Consistent with the requirements of the assessment;
• Clear and simple;
• Interesting and worthwhile;
• Feasible or able to be answered.

Framing models

Having selected a broad topic, the next step is to narrow it down. There are several frameworks that can be used to structure a sound research question in a strategic manner (Bettany-Saltikov, 2010); two models are PICO and SPICE (Box 2). Offredy and Vickers (2010) mentioned four stages in the research question formulation process, illustrating the process of narrowing the topic by focusing on surgery.

• Broad topic area – surgery;
• Narrow broad topic area – surgery and pain relief;
• Focused topic area – surgery, pain relief and patient-controlled analgesia;
• Research question.

In the fourth stage, when the focused topic area is converted into a research question, PICO or SPICE is used. According to Ellis (2013), PICO is useful when generating quantitative questions, whereas SPICE is most commonly applied to research aimed at exploring qualitative phenomena. However, not all components may be relevant when formulating a question.

Box 2. Framing models for research questions

P – Population I – Intervention C – Comparison O – Outcome

S – Setting P – Perspective I – Intervention C – Comparison E – Evaluation

Generating search terms

Once the question has been composed, it is essential to generate several key search terms or words, from which synonyms are identified, that can be entered into one or more databases. These key terms are combined using Boolean Operators such as “OR”, “AND” and “NOT”.

Fig 1 (attached) indicates the process by which search terms have been generated from the research question using the PICO model. These terms are entered in the databases for a comprehensive literature search and a number of articles will be found. Wakefield (2014) suggests that establishing and adhering to inclusion and exclusion criteria will ensure the most appropriate literature is selected, which addresses the research question.

Clinical practice is the main arena from which nurses can seek ideas for research, but those ideas can stem from experience, theories and the literature. With the advent of the internet and the increasing volume of articles being published, students can spend a lot of time sifting through the resources. Developing a research question, therefore, is an important systematic activity that provides a “road map” for a successful literature search.

Tools such as PICO or SPICE can be used to structure a sound research question. Not only is valuable time saved but the most appropriate articles are selected for review. Formulating a focused question is a disciplined method to beginning a research project.

• Students must complete an independent learning project as part of their nursing degree
• Before conducting research, students must have some knowledge of research process and methodologies
• Many issues encountered in clinical practice form the basis of research projects
• Once a broad topic has been selected, it should be narrowed down until a specific research question has been framed
• Research models can help generate relevant search terms from a research question

Related files

270116_identifying-and-defining-research-questions.pdf, table 1 research question types.pdf, fig 1 generating search terms from a research question.pdf.

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Examples of Research Questions

Phd in nursing science program, examples of broad clinical research questions include:.

• Does the administration of pain medication at time of surgical incision reduce the need for pain medication twenty-four hours after surgery?
• What maternal factors are associated with obesity in toddlers?
• What elements of a peer support intervention prevent suicide in high school females?
• What is the most accurate and comprehensive way to determine men’s experience of physical assault?
• Is yoga as effective as traditional physical therapy in reducing lymphedema in patients who have had head and neck cancer treatment?
• In the third stage of labor, what is the effect of cord cutting within the first three minutes on placenta separation?
• Do teenagers with Type 1 diabetes who receive phone tweet reminders maintain lower blood sugars than those who do not?
• Do the elderly diagnosed with dementia experience pain?
•  How can siblings’ risk of depression be predicted after the death of a child?
•  How can cachexia be prevented in cancer patients receiving aggressive protocols involving radiation and chemotherapy?

Examples of some general health services research questions are:

• Does the organization of renal transplant nurse coordinators’ responsibilities influence live donor rates?
• What activities of nurse managers are associated with nurse turnover?  30 day readmission rates?
• What effect does the Nurse Faculty Loan program have on the nurse researcher workforce?  What effect would a 20% decrease in funds have?
• How do psychiatric hospital unit designs influence the incidence of patients’ aggression?
• What are Native American patient preferences regarding the timing, location and costs for weight management counseling and how will meeting these preferences influence participation?
•  What predicts registered nurse retention in the US Army?
• How, if at all, are the timing and location of suicide prevention appointments linked to veterans‘ suicide rates?
• What predicts the sustainability of quality improvement programs in operating rooms?
• Do integrated computerized nursing records across points of care improve patient outcomes?
• How many nurse practitioners will the US need in 2020?

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Narrowing a Clinical Question

Two types of clinical questions, what is pico anyway, picott alternatives and additions, pico process in action, using pico to form the research question, tips and tricks.

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To begin to develop and narrow a clinical research question it is advisable to craft an answerable question that begins and ends with a patient, population, or problem. These are the beginnings of not only developing an answerable EBP question, but also using the PICO process  for developing well-built searchable and answerable clinical questions. 

There are many elements to developing a good clinical question. Clinical questions can be further divided into two major areas: Background Questions and Foreground Questions .

Background Questions refer to general knowledge and facts. The majority of the information that can be used to inform answers to background questions are found in reference resources like Encyclopedias, Dictionaries, Textbooks, Atlases, Almanacs, Government Publications & Statistical Information, and Indexes.

Foreground Questions are generally more precise and usually revolve around patient/s, populations, or a specific problem. Crafting an appropriate EBP question will not only inform your search strategy which you will apply to the medical literature but will also create a framework for how to maintain and develop your investigative process.

What are some examples of P ?

• Diabetes mellitus, Type 2 (problem) Obese
• elderly (population)

What are some examples of I ?

• Chlorpropamide

What are some examples of C ?

What are some examples of O ?

• Management of glucose levels

Using the example from the bottom-center we can start forming a research question: 

Is Chlorpropamide (intevention) more efficient than Metformin (comparator) in managing Diabetes Mellitus Type 2 (problem) for obese elderly patients (population)?

*Note: It is not necessary to use every element in PICO or to have both a problem and population in your question. PICO is a tool that helps researchers frame an answerable EBP question. 

Synonyms can very helpful throughout your investigative and research process. Using synonyms with boolean operators can potentially expand your search. Databases with subject headings or controlled vocabularies like MeSH in PubMed often have a thesaurus that can match you with appropriate terms.

Boolean operators allow you to manipulate your search.

Use AND to narrow your search

  eg. elderly AND diabetes  

Use OR to broaden your search

  eg. myocardial infarction OR heart attack

Use NOT to exclude terms from your search

  eg. children NOT infants  

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Defining the Question: Foreground & Background Questions

In order to most appropriately choose an information resource and craft a search strategy, it is necessary to consider what  kind  of question you are asking: a specific, narrow "foreground" question, or a broader background question that will help give context to your research?

Foreground Questions

A "foreground" question in health research is one that is relatively specific, and is usually best addressed by locating primary research evidence. 

Using a structured question framework can help you clearly define the concepts or variables that make up the specific research question. 

 Across most frameworks, you’ll often be considering:

• a who (who was studied - a population or sample)
• a what (what was done or examined - an intervention, an exposure, a policy, a program, a phenomenon)
• a how ([how] did the [what] affect the [who] - an outcome, an effect). 

PICO is the most common framework for developing a clinical research question, but multiple question frameworks exist.

PICO (Problem/Population, Intervention, Comparison, Outcome)

Appropriate for : clinical questions, often addressing the effect of an intervention/therapy/treatment

Example : For adolescents with type II diabetes (P) does the use of telehealth consultations (I) compared to in-person consultations  (C) improve blood sugar control  (O)?

Framing Different Types of Clinical Questions with PICO

Different types of clinical questions are suited to different syntaxes and phrasings, but all will clearly define the PICO elements.  The definitions and frames below may be helpful for organizing your question:

Intervention/Therapy

Questions addressing how a clinical issue, illness, or disability is treated.

"In__________________(P), how does__________________(I) compared to_________________(C) affect______________(O)?"

Questions that address the causes or origin of disease, the factors which produce or predispose toward a certain disease or disorder.

"Are_________________(P), who have_________________(I) compared with those without_________________(C) at_________________risk for/of_________________(O) over_________________(T)?" 

Questions addressing the act or process of identifying or determining the nature and cause of a disease or injury through evaluation.

In_________________(P) are/is_________________(I) compared with_________________(C) more accurate in diagnosing_________________(O)?

Prognosis/Prediction:

Questions addressing the prediction of the course of a disease.

In_________________(P), how does_________________(I) compared to_________________ (C) influence_________________(O)?

Questions addressing how one experiences a phenomenon or why we need to approach practice differently.

"How do_________________(P) with_________________(I) perceive_________________(O)?" 

Adapted from: Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Beyond PICO: Other Types of Question Frameworks

PICO is a useful framework for clinical research questions, but may not be appropriate for all kinds of reviews.  Also consider:

PEO (Population, Exposure, Outcome)

Appropriate for : describing association between particular exposures/risk factors and outcomes

Example : How do  preparation programs (E) influence the development of teaching competence  (O) among novice nurse educators  (P)?

SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research Type)

Appropriate for : questions of experience or perspectives (questions that may be addressed by qualitative or mixed methods research)

Example : What are the experiences and perspectives (E) of  undergraduate nursing students  (S)  in clinical placements within prison healthcare settings (PI)?

SPICE (Setting, Perspective, Intervention/phenomenon of Interest, Comparison, Evaluation)

Appropriate for : evaluating the outcomes of a service, project, or intervention

Example : What are the impacts and best practices for workplace (S) transition support programs (I) for the retention (E) of newly-hired, new graduate nurses (P)?

PCC (Problem/population, Concept, Context)

Appropriate for : broader (scoping) questions

Example : How do nursing schools  (Context) teach, measure, and maintain nursing students ' (P)  technological literacy  (Concept))throughout their educational programs?

Background Questions

To craft a strong and reasonable foreground research question, it is important to have a firm understanding of the concepts of interest.  As such, it is often necessary to ask background questions, which ask for more general, foundational knowledge about a disorder, disease, patient population, policy issue, etc. 

For example, consider the PICO question outlined above:

"For adolescents with type II diabetes does the use of telehealth consultations compared to in-person consultations  improve blood sugar control ?

To best make sense of the literature that might address this PICO question, you would also need a deep understanding of background questions like:

• What are the unique barriers or challenges related to blood sugar management in adolescents with TII diabetes?
• What are the measures of effective blood sugar control?
• What kinds of interventions would fall under the umbrella of 'telehealth'?
• What are the qualitative differences in patient experience in telehealth versus in-person interactions with healthcare providers?
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A.R. Dykes Library

Nursing research guide.

• Introduction
• Scholarly vs Non-Scholarly
• Primary, Secondary, & Tertiary Research
• Qualitative & Quantitative Data
• Evidence-Based Practice
• Types of Study Designs
• Types of Reviews
• Searching Tips
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• Finding Guidelines
• PICO Questions
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What is PICO?

PICO is a formula used to develop a researchable clinical question. 

The purpose of a PICO question is to help breakdown a research question into smaller parts, making the evaluation of evidence more straightforward.

Note: Not every question will have a time frame or a comparison. Outcomes should be a measure of clinical well being/quality of life.

Forming Focused Question with PICO: Case Study

Case: patient education.

• You are a nurse working in a busy inpatient medical surgical unit. The patients on your unit are admitted for a wide variety of conditions: renal, GI, dermatologic, etc.
• All patients admitted that are chronic smokers are given brief counseling by an RN and a self-help brochure about smoking cessation, but no follow up counseling after that.
• You hear your coworkers complaining that they feel like they are wasting their time because they think the patients will resume smoking after discharge.
• You decide you want to find out if this minimal contact intervention works in the long term.

P: Consider when choosing your Patient/Problem/Population

• What are the most important characteristics?
• Relevant demographic factors
• The setting

I: Consider for your Intervention

• What is the main intervention, treatment, diagnostic test, procedure, or exposure?
• Think of dosage, frequency, duration, and mode of delivery

C: Consider for your Comparison

• Inactive control intervention: Placebo, standard care, no treatment
• Active control intervention: A different drug, dose, or kind of therapy

O: Consider for your Outcome

• Be specific and make it measurable
• It can be something objective or subjective

PICO: Putting It Together

Your full PICO question is:

"Among hospitalized chronic smokers, does a brief educational nursing intervention lead to long term smoking cessation [when compared with no intervention]?"

PICO Question Examples

• Infection Control
• Labor & Delivery

Patients on coronary artery bypass graft (CABG) waiting lists often experience anxiety and depression and your nurse manager wants to know if it would be a good idea to reach out to these patients with presurgical home visits and follow-up calls from a specialist cardiac nurse.

P: patients on CABG waiting lists I: program consisting of presurgical home visit and follow-up calls form a specialist cardiac nurse C: no intervention O: decreased patient anxiety and depression  

For patients on CABG waiting lists, does an intervention program consisting of presurgical home visits and follow-up calls from a specialist cardiac nurse lead to decreased patient anxiety and depression [when compared with no intervention]?

You work in the Big City Hospital ICU. Your mechanically ventilated patients sometimes contract nosocomial pneumonia, which leads to costly complications. You want to know if raising the head of the bed lowers the chance of the patient contracting pneumonia compared to letting the patient lie flat on their back.

P: mechanically ventilated ICU patients I: semi-fowlers position C: supine position O: lower incidence of nosocomial pneumonia In mechanically ventilated ICU patients, does positioning the patient in semi-fowlers result in a lower incidence of nosocomial pneumonia when compared to the supine position?

In the past few years, your hospital has installed antibacterial foam dispensers on all the nursing units. You’ve had nurses asking you if the foam is just as effective as washing their hands with water and soap.

P: hospital nurses I: using antibacterial foam C: hand washing with soap and water O: decreased bacteria count In hospital nurses, does antibacterial foam decrease bacteria count on hands as much as hand washing with soap and water?

You’re a new nurse on a labor and delivery unit. You’ve noticed that most women give birth in the lithotomy position at the encouragement of their doctors. However, you’re sure you heard in nursing school that other positions are less likely to lead to deliveries with forceps or a vacuum...or did you? You want to find some literature to back up your claim.

P: laboring women delivering in a hospital I: positions other than the lithotomy position C: lithotomy position O: decreased incidence of assisted deliveries In laboring women delivering in the hospital, do positions other than lithotomy position lead to a decreased incidence of assisted deliveries?

You’re the nurse manager of a NICU unit. One concern of parents of infants receiving tube feedings is being able to successfully breastfeed their child upon discharge. One of your staff nurses asks if it would be helpful to give the infants cup feedings instead of tube feedings during their NICU stay.

P: Infants in the NICU I: cup feeding throughout the hospital stay C: tube feedings throughout the hospital stay O: greater reported success with breastfeeding post-discharge In infants in the NICU, will cup feeding throughout the hospital stay lead to greater success with breastfeeding post-discharge when compared to tube feedings?

You work with patients with advanced cancer and have been taught to suggest pain diaries for your patients as a form of pain management. You’ve been wondering for a while now if these diaries actually improve pain control or make pain worse by making patients more aware of their pain.

P: patients with advanced cancer I: keeping a pain journal C: no intervention O: lower reported pain scores In patients with advanced cancer, does keeping a pain journal result in lower reported pain scores when compared to no intervention?

You work in a pediatrician’s office and give patients their routine vaccinations. The younger children are often fearful of needles, and some of the RNs use toys to distract the patients. You want to know if this technique actually has an effect on the children's pain response.

P: young children I: distraction techniques during immunization C: no intervention O: lower pain scores rated by the Faces pain scale In young children, do distraction techniques during immunization administration using toys result in lower pain scores when compared to no intervention?

You work on an inpatient psychiatric unit. One of your patients with chronic schizophrenia, Joe, normally mumbles to himself, but will occasionally speak to others when residents play games together. Noticing this, you say to a coworker that maybe social skills group training sessions would bring out Joe’s conversational skills. Your coworker shakes her head and says "I don’t think so. Joe is in and out of this hospital, he’s a lost cause."

P: Inpatient chronic schizophrenia patients I: social skills group training sessions C: standard care O: increased conversational skills as evidenced by greater number of interactions with peers In inpatient chronic schizophrenia patients, do social skills group training sessions increase conversational skills when compared to standard care?

A diabetic patient from a nursing home has recently been admitted with a stage III pressure ulcers on his heels. The unit nurses have called you in for a wound consult. You have to choose between standard moist wound therapy and using a wound vac.

P: elderly diabetic with stage III foot ulcers I: negative pressure wound therapy C: standard moist wound therapy O: improved wound healing as measured by pressure ulcer grading system guidelines In elderly diabetic patients with stage III foot ulcers, does negative pressure wound therapy lead to improved wound healing when compared to standard moist wound therapy?

The main concern for most of your patients coming out of anesthesia in your PACU is pain. You want to explore nursing interventions you can use on top of medication administration to decrease pain. One coworker mentions trying to make the PACU feel less clinical by playing soft music to relax patients.

P: PACU patients I: soft music as an adjunct to standard care C: standard care alone O: lower reported pain scores In PACU patients, will playing soft music in the PACU as an adjunct to standard care result in lower reported pain scores when compared to standard care alone?

Example Sources:

• UNC-Chapel Hill Health Sciences Library PICO Examples
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• Clinical Information Sources

How to Develop a Question

Developing a project.

• Evaluating Sources
• Qualitative vs Quantitative Studies
• Summarize Evidence
• Create Quick Citations
• Organize Your Research
• Writing Guides
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• For Faculty
• The PICO Format Simple tool to help focus your research question on a specific issue (from the Evidence Analysis Manual)
• Template for Asking PICO(T) Questions handout This template can help you figure out how parts of your research question fit into the PICO(T) format.
• Tips for Writing a Good PICO What is a bad PICO vs a good PICO? From Meyer, M.N. (2017). Evidence-based practice: Success of practice change depends on the question. In T.L. Christenbery, ed., Evidence-Based Practice in Nursing: Foundations, Skills, and Roles. Springer: New York, NY.
• Question Formulation Template Factors to consider when developing a research question (from the Evidence Analysis Manual)

• SRM Project Planner This tool is designed to guide you through your research project. First, think about what stage you're at in your research. If you've already gotten started, click on the stage below that best describes where you are. If you're just starting out, it might be helpful to read more about why we do research before getting started.
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Develop your research question

• Search for your assignment
• Find books and journal articles
• Find evidence (Government and organisation information)
• Data & statistics
• Forgotten Australians
• Clinical skills
• Aged care & mental health
• Mental health resources: 0-65 years
• Finding resources for your assignment
• HLTH 1036: Global and National Health – A1 Task 2 & A2
• HLTH 1047: First Peoples' Health – A1
• NURS 1072: Foundations of Nursing Practice
• NURS 2023: Health of Adults - Nursing Case Study Report
• NURS 2024: Health of Older Adults
• NURS 5164: Best Practice in Adolescent Mental Health
• NURS 3055: Evidence Based Nursing Practice
• NURS 3045: Nursing Context of Practice: Primary Health Care
• UniSA Online - NURS 1066: Living Skills and Life Routines in Aged Care

STEP 1: Understand your research objective

Before you start developing your research question, think about your research objectives:

• What are you trying to do? (compare, analyse)
• What do you need to know about the topic?
• What type of research are you doing?
• What types of information/studies do you need? (e.g. randomised controlled trial, case study, guideline, protocol?)
• Does the information need to be current?

Watch the following video (6:26) to get you started:

Key points from the video

• All good academic research starts with a research question.
• A research question is an actual question you want to answer about a particular topic.
• Developing a question helps you focus on an aspect of your topic, which will streamline your research and writing.
• Pick a topic you are interested in.
• Narrow the topic to a particular aspect.
• Brainstorm some questions around your topic aspect.
• Select a question to work with.
• Focus the question by making it more specific. Make sure your question clearly states who, what, when, where, and why.
• A good research question focuses on one issue only and requires analysis.
• Your search for information should be directed by your research question.
• Your thesis or hypothesis should be a direct answer to your research question, summarised into one sentence.

STEP 2: Search before you research

The benefits of doing a background search :

• You can gather more background knowledge on a subject
• explore different aspects of your topic
• identify additional keywords and terminology

STEP 3: Choose a topic

The resources linked below are a good place to start: 

• UpToDate It covers thousands of clinical topics grouped into specialties with links to articles, drugs and drug interaction databases, medical calculators and guidelines.
• An@tomedia This online anatomy resource features images, videos, and slides together with interactive, educational text and quiz questions.
• Anatomy.tv Find 3D anatomical images; functional anatomy animations and videos, and MRI, anatomy, and clinical slides. Test your knowledge through interactive activities and quizzes.

STEP 4: Brainstorm your questions

Now you have explored different aspects of your topic, you may construct more focused questions (you can create a few questions and pick one later).

Learn more: 

• Clear and present questions: formulating questions for evidence based practice (Booth 2006) This article provides an overview of thinking in relation to the theory and practice of formulating answerable research questions.

STEP 5: Pick a question and focus

Once you have a few questions to choose from, pick one and refine it even further.

Are you required to use "PICO"?

• PICO worksheet
• Other frameworks

The PICO framework (or other variations) can be useful for developing an answerable clinical question. 

The example question used in this guide is a PICO question:   How does speech therapy compare to cognitive behavioural therapy in improving speech fluency in adolescents?

Use the interactive PICO worksheet to get started with your question, or you can download the worksheet document.

• Building your question with PICO

Here are some different frameworks you may want to use:

There are a number of PICO variations which can be used for different types of questions, such as qualitative, and background and foreground questions. Visit the Evidence-Based Practice (EBP) Guide to learn more:

• Evidence Based Practice guide
• << Previous: Plan your search
• Next: Search for your assignment >>
• Last Updated: Jun 5, 2024 12:31 PM
• URL: https://guides.library.unisa.edu.au/Nursing

The text within this Guide is licensed CC BY 4.0 . Image licenses can be found within the image attributions document on the last page of the Guide. Ask the Library for information about reuse rights for other content within this Guide.

School of Nursing

• What is EBP?

Background vs. Foreground

Pico examples, asking different types of questions, pico resources & worksheet.

• Evidence Appraisal
• Clinical Tools and Databases
• Other Resources

Evidence based practice requires that clinicians make use of the best research they can find to help them in decision-making. To find that research efficiently, the clinician must ask a well-designed clinical question with all the elements that will lead to finding relevant research literature.

The first step in doing this is to determine the type of question: background or foreground. The type of question helps to determine the resource to access to answer the question.

Background questions ask for general knowledge about a condition or thing.

• Broaden the scope - "The Forest"
• Provides basics for a a greater grasp of concepts
• Typically found in textbooks, guidelines, point-of-care monographs, encyclopedias, or topic reviews
• A question root (who, what, when, etc.) with a verb
• A disorder, test, treatment, or other aspect of healthcare

The background question is usually asked because of the need for basic information. It is not normally asked because of a need to make a clinical decision about a specific patient.

Foreground questions ask for specific knowledge to inform clinical decisions or actions.

• Focused in scope - "The Trees"
• Requires a grasp of basic concepts to fully comprehend
• Typically found in journals and conference proceedings
• Have 3 or 4 essential components (see PICO below)

PICO is a mnemonic used to describe the four elements of a good clinical foreground question:

P = Population/Patient/Problem - How would I describe the problem or a group of patients similar to mine?

I = Intervention - What main intervention, prognostic factor or exposure am I considering?

C = Comparison - Is there an alternative to compare with the intervention?

O = Outcome - What do I hope to accomplish, measure, improve or affect?

 Fill in the blanks with information from your clinical scenario: THERAPY In_______________, what is the effect of ________________on _______________ compared with _________________?

PREVENTION For ___________ does the use of _________________ reduce the future risk of ____________ compared with ______________? DIAGNOSIS OR DIAGNOSTIC TEST Are (Is) ________________ more accurate in diagnosing _______________ compared with ____________? PROGNOSIS Does ____________ influence ______________ in patients who have _____________? ETIOLOGY Are ______________ who have _______________ at ______________ risk for/of ____________ compared with _____________ with/without______________? MEANING How do _______________ diagnosed with _______________ perceive __________________? Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice . Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

• PubMed PICO Tool
• TRIP Database PICO Builder
• PICO Worksheet
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• Last Updated: Apr 15, 2024 9:34 AM
• URL: https://libguides.ohsu.edu/nursing

50+ useful PICO questions for nursing research

DNP Capstone Project Help

Ever wonder how nurses figure out the best ways to care for people? It all starts with asking good questions . And that’s where PICO comes in! PICO helps you turn your “hmm, I wonder…” into powerful questions that can lead to real change in patient care.

This guide is packed with over 50 PICO question examples across tons of different nursing areas. Whether you’re interested in helping people after surgery, fighting chronic diseases, or making healthcare more accessible in your community, there’s something here for you.

Get PICO Writing services from www. dnpcapstoneproject.help

Think of these examples as jumping-off points to fuel your own curiosity:

P (Population)

I (Intervention)

C (Comparison)

O (Outcome)

T (Timeframe)

General Nursing

Adult ICU patients with sepsis

Early goal-directed therapy protocol

Standard care

Mortality rates, long-term outcomes

Hemodialysis patients

Mindfulness-based meditation

Anxiety, quality of life

Elderly in long-term care

Individualized music therapy

Group music therapy

Cognitive function, depression symptoms

Children undergoing tonsillectomy

Distraction techniques

No intervention

Anxiety, pain

Pregnant women with morning sickness

Ginger supplementation

Nausea, vomiting severity

1st trimester

Critically ill ventilated patients

Early mobility protocols

Standard practice

Ventilator weaning success, length of stay

Acute coronary syndrome patients

Interactive multimedia education

Traditional pamphlets

Medication adherence, risk factor control

Surgical patients with post-operative pain

Patient-controlled analgesia (PCA)

Traditional pain medication

Pain levels, patient satisfaction

Diabetic foot ulcer patients

Negative pressure wound therapy

Standard dressing techniques

Healing rate, amputation rate

Stroke patients undergoing rehab

Virtual reality therapy

Traditional physical therapy

Motor function, functional independence

Chronic Care

Adults with chronic heart failure

Telemonitoring program

Usual follow-up care

Medication adherence, clinical outcomes

Diabetes mellitus type 2 patients

Carbohydrate counting education

Standard dietary advice

Glycemic control, HbA1c levels

Individuals with asthma

Smartphone app-based self-management education

Paper-based materials

Asthma control, healthcare utilization

Chronic pain patients

Mindfulness-based stress reduction (MBSR)

Traditional pain management

Pain intensity, quality of life

Older adults experiencing social isolation

Senior citizen social programs

Mental well-being, depression symptoms

Mental Health Pico Question Examples

Area of Focus

Depressed adolescents

Cognitive-behavioral therapy (CBT)

Medication alone

Depression symptoms, functional improvement

Adults with anxiety disorders

Acceptance and commitment therapy (ACT)

Traditional CBT

Anxiety levels, quality of life

Survivors of trauma

Art therapy

Talk therapy alone

Post-traumatic stress symptoms, emotional processing

Patients with eating disorders

Family-based therapy

Individual therapy

Eating disorder symptoms, relapse prevention

Maternal and Child Health PICO Examples

Pregnant women with gestational diabetes

Personalized dietary counseling

Standard gestational diabetes education

Glycemic control, pregnancy outcomes

Throughout pregnancy

Newborns with jaundice

Skin-to-skin contact (kangaroo care)

Traditional phototherapy

Bilirubin levels, breastfeeding rates

Children with developmental delays

Early intervention programs

Developmental milestones, communication skills

Adolescents facing peer pressure

Social-emotional learning (SEL) interventions

Standard health education

Risk-taking behaviors, self-esteem

Geriatrics PICO Examples

Older adults with falls risk

Exercise programs focused on balance and strength

Falls incidence, functional mobility

Elderly patients with dementia

Music therapy interventions

Cognitive function, mood and engagement

Homebound seniors

Telehealth-based chronic disease management

Traditional in-person visits

Patient satisfaction, health outcomes

Older adults experiencing caregiver burden

Support groups for caregivers

Caregiver stress, well-being

Public Health PICO Examples

Communities with high smoking rates

Smoking cessation programs with incentives

Standard smoking cessation counseling

Smoking quit rates, public health costs

Individuals with vaccine hesitancy

Educational campaigns addressing misinformation

No campaign

Vaccination rates, knowledge about vaccines

People experiencing homelessness

Mobile healthcare clinics

Traditional healthcare facilities

Access to care, health outcomes

Rural communities with limited access to mental health services

Telepsychiatry consultations

No access to mental health services

Mental health outcomes, patient satisfaction

Oncology PICO Question Examples

Cancer patients experiencing fatigue

Mindfulness meditation app

Traditional relaxation techniques

Fatigue levels, quality of life

Breast cancer survivors

Personalized exercise programs

Standard rehabilitation program

Physical function, quality of life

Children with leukemia undergoing chemotherapy

Video game-based distraction techniques

Standard pain management approaches

Pain and anxiety levels, procedural anxiety

During treatment

Patients with advanced cancer

Palliative care interventions focused on symptom management

Standard care without a specific focus on symptom management

Quality of life, symptom burden

Critical Care PICO Question Examples

Septic patients requiring mechanical ventilation

Early administration of specific antibiotics

Standard antibiotic protocol

Mortality rates, length of stay in ICU

Burn patients

Early implementation of skin substitutes

Traditional wound dressings

Healing time, infection rates

Patients with traumatic brain injuries

Early mobilization protocols

Standard bed rest protocols

Neurological outcomes, functional recovery

Patients undergoing cardiac surgery

Continuous intraoperative neuromonitoring

Standard anesthesia monitoring

Neurological outcomes, cognitive function

Emergency Nursing PICO Examples

Patients presenting with chest pain

Point-of-care ultrasound for diagnosis

ECG and standard diagnostic tests

Diagnostic accuracy, time to definitive diagnosis

During emergency department stay

Stroke patients in prehospital setting

Telemedicine consultations with neurologists

Standard prehospital assessment and transport

Time to thrombolysis, functional outcomes

Within 6 hours of symptom onset

Victims of mass casualty events

Standardized triage protocols

Non-standardized triage approaches

Efficiency of patient care, mortality rates

During event and immediate aftermath

Patients with suspected opioid overdose

Early administration of naloxone

Delayed administration of naloxone

Survival rates, time to regain consciousness

During emergency care

Community and Public Health PICO Questions

Low-income communities with food insecurity

Mobile food pantries

Traditional food pantries with limited accessibility

Access to healthy food, nutritional intake

Adolescents engaging in risky sexual behavior

Comprehensive sex education programs

Abstinence-only education programs

Knowledge of safe sex practices, rates of sexually transmitted infections

Adults with chronic respiratory illnesses

Air pollution reduction interventions

Hospitalization rates, lung function

Rural communities with limited access to dental care

Teledentistry consultations

No access to dental care

Access to preventive care, oral health outcomes

Pediatric Nursing PICO Question Examples

Children with autism spectrum disorder

Standard behavioral therapy

Social communication skills, engagement in therapy

Children with obesity

Family-based weight management programs

Individual interventions focused on the child

Weight loss, healthy lifestyle habits

Premature infants

Kangaroo care provided by fathers

Kangaroo care provided by mothers only

Growth and development, parent-infant bonding

Children with chronic pain

Relaxation techniques training

Pain levels, coping skills

Written by DNP Capstone Project Help

Text to speech

Nursing Research Nursing Test Bank and Practice Questions (60 Items)

Welcome to your nursing test bank and practice questions for nursing research.

Nursing Research Test Bank

Nursing research has a great significance on the contemporary and future professional nursing practice , thus rendering it an essential component of the educational process. Research is typically not among the traditional responsibilities of an entry-level  nurse . Many nurses are involved in either direct patient care or administrative aspects of health care. However, nursing research is a growing field in which individuals within the profession can contribute a variety of skills and experiences to the science of nursing care. Nursing research is critical to the nursing profession and is necessary for continuing advancements that promote optimal nursing care. Test your knowledge about nursing research in this 60-item nursing test bank .

Quiz Guidelines

Before you start, here are some examination guidelines and reminders you must read:

• Practice Exams : Engage with our Practice Exams to hone your skills in a supportive, low-pressure environment. These exams provide immediate feedback and explanations, helping you grasp core concepts, identify improvement areas, and build confidence in your knowledge and abilities.
• You’re given 2 minutes per item.
• For Challenge Exams, click on the “Start Quiz” button to start the quiz.
• Complete the quiz : Ensure that you answer the entire quiz. Only after you’ve answered every item will the score and rationales be shown.
• Learn from the rationales : After each quiz, click on the “View Questions” button to understand the explanation for each answer.
• Free access : Guess what? Our test banks are 100% FREE. Skip the hassle – no sign-ups or registrations here. A sincere promise from Nurseslabs: we have not and won’t ever request your credit card details or personal info for our practice questions. We’re dedicated to keeping this service accessible and cost-free, especially for our amazing students and nurses. So, take the leap and elevate your career hassle-free!
• Share your thoughts : We’d love your feedback, scores, and questions! Please share them in the comments below.

Quizzes included in this guide are:

Recommended Resources

Recommended books and resources for your NCLEX success:

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy .

Saunders Comprehensive Review for the NCLEX-RN Saunders Comprehensive Review for the NCLEX-RN Examination is often referred to as the best nursing exam review book ever. More than 5,700 practice questions are available in the text. Detailed test-taking strategies are provided for each question, with hints for analyzing and uncovering the correct answer option.

Strategies for Student Success on the Next Generation NCLEX® (NGN) Test Items Next Generation NCLEX®-style practice questions of all types are illustrated through stand-alone case studies and unfolding case studies. NCSBN Clinical Judgment Measurement Model (NCJMM) is included throughout with case scenarios that integrate the six clinical judgment cognitive skills.

Saunders Q & A Review for the NCLEX-RN® Examination This edition contains over 6,000 practice questions with each question containing a test-taking strategy and justifications for correct and incorrect answers to enhance review. Questions are organized according to the most recent NCLEX-RN test blueprint Client Needs and Integrated Processes. Questions are written at higher cognitive levels (applying, analyzing, synthesizing, evaluating, and creating) than those on the test itself.

NCLEX-RN Prep Plus by Kaplan The NCLEX-RN Prep Plus from Kaplan employs expert critical thinking techniques and targeted sample questions. This edition identifies seven types of NGN questions and explains in detail how to approach and answer each type. In addition, it provides 10 critical thinking pathways for analyzing exam questions.

Illustrated Study Guide for the NCLEX-RN® Exam The 10th edition of the Illustrated Study Guide for the NCLEX-RN Exam, 10th Edition. This study guide gives you a robust, visual, less-intimidating way to remember key facts. 2,500 review questions are now included on the Evolve companion website. 25 additional illustrations and mnemonics make the book more appealing than ever.

NCLEX RN Examination Prep Flashcards (2023 Edition) NCLEX RN Exam Review FlashCards Study Guide with Practice Test Questions [Full-Color Cards] from Test Prep Books. These flashcards are ready for use, allowing you to begin studying immediately. Each flash card is color-coded for easy subject identification.

Recommended Links

If you need more information or practice quizzes, please do visit the following links:

An investment in knowledge pays the best interest. Keep up the pace and continue learning with these practice quizzes:

• Nursing Test Bank: Free Practice Questions UPDATED ! Our most comprehenisve and updated nursing test bank that includes over 3,500 practice questions covering a wide range of nursing topics that are absolutely free!
• NCLEX Questions Nursing Test Bank and Review UPDATED! Over 1,000+ comprehensive NCLEX practice questions covering different nursing topics. We’ve made a significant effort to provide you with the most challenging questions along with insightful rationales for each question to reinforce learning.

4 thoughts on “Nursing Research Nursing Test Bank and Practice Questions (60 Items)”

Thanks for the well prepared questions and answers. It will be of a great help for those who look up your contributions.

Hi Zac, we’re having some performance issues with the quizzes so we’re forced to change their settings in the meantime. We are working on a solution and will revert the changes once we’re sure that the problem is resolved. Thanks for the understanding!

I need pass question and answer on nursing research

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Nursing Research: Creating a Research Question

• Creating a Research Question
• Search Terms
• Search Strategies
• Recording Your Research
• Research Tips
• Reading and Understanding Research
• Finding Sources
• Health Statistics
• Grey Literature and Clinical Guidelines
• Research Sites
• Journal Articles
• Books & Other Sources
• Publisher URL
• Interlibrary Loan

Choosing a Topic

Sometimes the most difficult part of the research process is choosing a topic.  Here are some tips for selecting a research question that you will enjoy learning about and will ultimately lead to a good grade.

• Read through your assignment.   Professors design an assignment outline for a reason.  Make sure your topic can and will adhere to their requirements and guidelines.
• Choose a topic you are interested in.   If you don't like what you're researching, chances are you won't learn a whole lot or enjoy the process.  And really, what's the point of that?  
• Browse resources that relate to your course work.  Look through a newspaper, magazine, or database for current events or hot topics.  Browsing can spark a lot of great ideas and can help you refine your topic.
• Ask for help!   There is nothing wrong with asking your professor or a librarian to help you brainstorm ideas.

Where to Start

The links below are great places to start in developing a research question.  Browsing current events and hot topics can spark your interest and inspire a topic.

• Alvernia's "Opposing Viewpoints" Collection
• Alvernia's Reference Collection
• Anatomy & Physiology
• Athletic Training Websites
• Google Trends
• Health & Medicine
• Hot Paper Topics
• Hot Topics for Research Papers
• Human Diseases
• National Library of Medicine
• New York Times
• NPR Research News
• Pew Research Center
• Public Agenda's Programs and Reports
• MedLinePlus This link opens in a new window
• Opposing Viewpoints in Context This link opens in a new window

Subject Terms to Consider

Below is a list of subjects that often  relate to nursing issues .  Considering these subject terms can help you  develop a topic  or  focus your search .

• Nursing research
• Evidence-based nursing

How to Formulate an Answerable Clinical Question

P opulation/patients

I ntervention/indicator

C omparator/control

• P I C O: Formulate an Answerable Question
• Formulating Answerable Clinical Questions

Developing your Research Question

• Creating a Research Question Helps you to write a narrow, focused research question.

Try asking yourself these questions to help develop a research question:

Topic:  Obesity

Who?  teenagers

What?  consumption of high fat foods

Where?  school cafeterias

Question :  How does the consumption of high fat foods in school cafeterias contribute to teenager obesity?

Topic: Smoke Exposure

Who?   children exposed to smoke

What?   developmental abilities

Question :  How does smoke exposure alter the developmental abilities of children?

Below is worksheet which will help illustrate how a research question develops from a broad topic to a focused question.  This could be a helpful resource for you during the process of creating your research question.

Helpful Tools

• bubbl.us - Brainstorming Made Simple
• Critical Thinking Model
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• Next: Search Terms >>
• Last Updated: Jan 18, 2024 1:19 PM
• URL: https://alvernia.libguides.com/nursing_research

• McMaster University Health Sciences Library
• Forming Questions

Nursing: Forming Questions

• Getting Started
• Background Info
• 6S/Foreground Info
• Further Research
• Clinical Practice
• Nursing Theory

A Good Question...

• Focuses your information needs
• Identifies key seach concepts
• Points you in the direction of potential resources

Background Questions

These questions are general in nature and provide foundational information on a single concept.  Background questions cover:

• Terminology
• General Pathology
• Patient Education Resources
• General Drug Information
• Examination/Assessment Procedures

What is the pathology of asthma ?

What drugs are used to treat hypertension ?

How do I perform a psychological assessment ?

What education resources exist for patients with gestational diabetes ?

How is hepatitis b diagnosed?

What does a normal heartbeat sound like?

These questions are best answered using the resources found in the Background Info page of this guide.

Foreground Questions

These questions bring together multiple concepts related to a specific clinical situation or research topic.  They may be divided into two  broad categories:

• Qualitative Questions  aim to discover meaning or gain an understanding of a phenomena or experience.  They ask about an individual's or population's experience of certain situations or circumstances
• Quantitative Questions  aim to discover cause and effect relationships, often through comparison. Comparison may occur between two or more individuals or groups based on outcomes associated with differences in exposures or interventions. Comparison may also be made to 'no intervention', standard care or standard practice, 'no exposure'.

These questions are best answered using the resources found in the 6S/Foreground Info page of this guide.

Forming Foreground Questions

Building an effective foreground question can be challenging.  The following models will help:

Qualitative Questions: The PS Model

P - Patient/Population

S - Situation

How do/does ___ [P] ____ experience _____ [S] _____?

What is the experience of ____ [P] ___ [S] ____?

Ex. How do  caregiver- spouses of Alzheimer patients  experience  placing their spouse in a nursing home ?

___________________________________________________________________________

Quantitative Questions: The PICO(T) Model

A quantitative approach can answer many different types of questions, but all can be formatted by following the  PICO(T) Model  outlined below:     

PICO(T) Templates

In ___ [ P ]___,  do/does ___[ I ]___ result in ___[ O ]____ when compared with ___[ C ]___ over ___[ T ]____?

E.g.) In nursing home residents with osteoporosis , do hip protectors result in fewer injuries from slips, trips, and falls when compared with standard osteoporosis drug therapy over the course of their stay ?

Are ___[ P ]___  with  ___[ I ]___  over ____[ T ]____ more likely to ___[ O ]____ when compared with ___[ C ]___ ?

E.g.) Are   female non-smokers   with  daily exposure to second-hand smoke  over  a period of ten years or greater  more likely to  develop breast cancer  when compared with  female non-smokers without daily exposure to second-hand smoke ?

Is/are ___[ I ]___ performed on ___[ P ]___   more effective than ___[ C ]___  over ___[ T ]____in ___[ O ]____?

E.g.) Are   self-reporting interviews and parent reports  performed on   children aged 5-10   more effective than  parent reports alone  over a  four-week consultation process  in  diagnosing depression ?

In ___[ P ]___,  do/does ___[ I ]___ result in ___[ O ]____ when compared with ___[ C ]___ over ___[ T ]____?

E.g.) In  emergency room visitors , do   hand sanitizing stations  result in   fewer in-hospital infections  when compared  with no hand sanitizing stations  over  a year-long pilot period ?

Do/does ___[ I ]___ performed on ___[ P ]___   lead to  ___[ O ]___  over ___[ T ]____compared with ___[ C ]____?

E.g.) Do  regular text message reminders  performed on  patients recently diagnosed with diabetes  lead to  a lower occurrence of forgotten insulin doses  over  the first six months of treatment  compared with  no reminders ?

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Curse of a Nurse

Exposed to the golden wind in awakening there is limitless life, liberation, and love in holy harmony, health, and happiness, writing a nursing research question – undergraduate nursing.

Most undergraduate BSN students take a Research and Evidence-Based Practice course. Students are often assigned a small research project or review paper. The assignment begins with writing either a research question, or a clinical question. Usually, the student is given a range of topics, but let’s assume the student is starting from scratch. A good research question is essential to good research and not only answering a question but filling the gaps. I suggest you start my thinking of a research paper as a “who done it” story. Who killed X. What is your method going to be for figuring out who the killer is. Then you apply methods to the facts. Next you identify the killer using for example fingerprints, interrogations, and ballistic testing of the bullet. After you have the evidence, your results, you discuss the results. Finally, discuss the effectiveness of the methods. You conclude by saying in the future you can use these methods to do X, Y, and Z.

STEP 1: Review Variables

Before you start thinking about writing a research question it is good to review the difference between independent and dependent variables.

• Independent variable – a variable that is presumed to influence another variable. It is the variable the researcher can manipulate.
• Dependent variable –the effect. Its value depends on changes in the independent variable. It is what is being measured.

You will also need an operational definition, so it is possible to measure and manipulate the variable. The operational definition is essentially your measure.

STEP 2: Find a Topic and then Narrow

What is your research problem? It should be an area of concern where there is a gap in knowledge necessary for good nursing practice.

STEP 3: Narrow the Topic

Even if a broad area is given, you still need to narrow the topic. Some ways to do that include:

• Choose an interesting topic from within the scope of your assignment.
• Start with general references sources. Most universities have a search engine such as WorldCat for books, journals, articles, and more. Another place to start may be GoogleScholar. You only need a few articles to see what scholars in the area are doing and to help narrow your topic.
• Are there subtopics?
• Do the subtopics raise any specific questions?
• What is of specific interest to you?
• Are there how and why questions about this topic I should ask?
• Consider who your intended audience is for your research. There may be a tendency to think it is your class or your professor, but I suggest you think broader and decide who you want to be your audience, not who the class requires.
• Identify a theory or research finding within the assignment that needs further testing.
• Consider a patient care experience that impacted on the nurse’s or the patient’s experience.
• Talk to your colleagues and classmates. Be willing to question authority. Too much of what we do results from the way it has always been.
• Identify a knowledge gap.
• Apply personal experience and take the time to consider what is important to you. The research question should be more than a class assignment. It is an opportunity to express your concern about what matters and your commitment to taking responsibility for what happens to patients and nurses.
• Make a final research question selection by considering whether the idea is innovative, significant, reasonable, ethical, and will promote health equity.

STEP 3: Write Your Research Question

The FINER criteria are one way to write a good question (Hulley et al., 2007).

• The question should be feasible . Focus on one problem that can be accomplished within the semester and the time allotted for the assignment and is within your ability. Try not to have more than one or two variables.
• The question should be interesting to you. Even within limited topic made available to you choose what is most interesting and tweak it. If you are interested in the topic you will be more motivated.
• The question should be novel . You should bring new insights to the chosen topic. This may include confirming or expanding on prior research. There must be primary and secondary sources available to help answer your question.
• The question must be ethical and avoid any deceptive practices, such as only including articles that support your conclusion. Your research question and study must be able to be approved by appropriate review boards or authorities.
• The questions should be relevant to the assignment and of interest to nursing. It should also be relevant to public interest.

Ratan et al. (2019) add to FINER in their research question guide. They suggested the purpose of your paper and should be feasible, interesting, novel, ethical, relevant, manageable, appropriate, have potential value and publishability, and be systematic (Read more: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322175/ ).

• A manageable question can be managed by the researcher.
• The research question should be appropriate logically and scientifically.
• The research should have significant health impact and be of value and publishable .

Draft your research question based on what you hope to achieve. You can have primary and secondary research questions but remember that more questions generally mean more time and resources. McCombes (2019) suggest the table below as a way to consider drafting your research question.

Many nurses use the PICOT framework to construct research questions. If you prefer the PICOT format then follow this format.

• P – patient or population (age, gender, location, characteristics)
• I – intervention (diagnostic test, exposure, management strategy)
• C – comparison group (a comparison to the intervention or indicator)
• O – outcome (what are the consequences of the intervention)
• T – timeframe or type of the study (time periods that should be considered or study types most likely to have relevant information)

STEP 4: Evaluate Your Question

• Can you identify the relationship between the variables?
• Did you indicate the population to be studied?
• Did you identify a problem that can be addressed (in the time available)?

STEP 5: Making your research question strong

Focused, clear, feasible, specific, and researchable.

Complex and arguable

Relevant, original, and clear

Burns, N. and Grove, S.K. (2001) The Practice of Nursing Research: Conduct, Critique, and Utilization, 5 th ed. Elsevier Saunders.

Hulley, S.B., Summings, S.R., Browner, W.S., Grady, D.G., Newman, T.B. (2007) Desiging Clinical Research. Lippincott Williams & Wilkins.

Kerlinger, F.N. (1979) Behavioral Research: A Conceptual Approach. Holt, Rinehart and Winston.

McCombes, S. (2021) Developing strong research questions. Scribbr. https://www.scribbr.com/research-process/research-questions/

Polit, D. and Beck. C.T. (2022) Essential of Nursing Research: Appraising Evidence for Nursing Practice, 10 th Ed. Wolters Kluwer.

Ratan, S. K., Anand, T., & Ratan, J. (2019). Formulation of Research Question – Stepwise Approach.  Journal of Indian Association of Pediatric Surgeons ,  24 (1), 15–20. https://doi.org/10.4103/jiaps.JIAPS_76_18 .

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Nursing Students' Guide to Evidence Based Research: Asking Research Questions

• Introduction to Evidence-Based Practice
• Asking Research Questions
• Reading and Evaluating Research
• Six Steps of the Scientific Method
• Quality of Evidence Pyramid
• Encyclopedias
• Handbooks and Guides
• Study Guides and Test Prep
• Books-eBooks-Media
• Nursing Journal Databases
• Online Magazines and Journals
• Nursing Theories
• Study Skills
• Social Media Dos and Don'ts
• Best Nursing Apps

Getting Started with Nursing Research

This guide will help you improve your nursing research skills by helping you:

• develop a focused research question
• search  nursing and allied health databases   for articles, reports and other publications to gather evidence
• evaluate evidence for credibility and usefulness
• apply evidence to clinical practice

First Steps

If your research is taking you into unfamiliar territory (it usually does), one of the best ways to gain a working knowledge of your topic is to check out introductory articles and chapters of reference sources, like special encyclopedias and handbooks. Check out the  Reference Tools  tab for a selection of our print and online reference sources for nursing.

Planning Your Research

One of the keys to effective database searching is to ask focused, specific questions. You also need to choose your search terms carefully, and combine them in ways that give you control over your search results. The PICO model, described below, provides a framework for constructing questions and search strategies for clinical research questions.

Research Process Overview

The research process can be broken down into four simple steps:

• Evidence-Based Practice: PICO
• Example PICO Worksheet
• Blank PICO Worksheet

PICO: How Nurses Plan Their Research

Organizing the issue into four simple parts helps to identify the main concepts. 

PICO in Action

There are several variations of the PICO method. In the video below, the T in PICOT refers to TIME.

PICO Example

Scenario: A 64 year old obese male who has tried many ways to lose weight presents with a newspaper article about ‘fat-blazer’ (chitosan). He asks for your advice. Begin by identifying the main concepts: obese, adult, chitosan, weight loss

Your research question might be: I n obese patients, does chitosan, compared to a placebo, decrease weight?

Use these keywords when searching nursing databases such as CiNAHL . 

From PICO to Search Strategy

• Search Strategies with PICO
• 7 STEPS TO THE PERFECT PICO SEARCH
• << Previous: Introduction to Evidence-Based Practice
• Next: Reading and Evaluating Research >>
• Last Updated: Jun 13, 2024 6:18 PM
• URL: https://library.atlanticcape.edu/nursing

200+ Quantitative Research Topics for Nursing Students [Updated 2023]

Quantitative research plays an important role in the field of nursing education. It empowers nursing students to develop critical thinking skills, fosters evidence-based practice, and paves the way for career growth in the nursing profession. However, the journey of a nursing student in selecting the right quantitative research topic can be daunting. In this blog, we’ll delve into the world of quantitative research topics for nursing students. 

We’ll discuss why these topics matter, offer tips on choosing them, and provide a comprehensive list of intriguing research ideas across various nursing subfields.

Benefits of Quantitative Research for Nursing Students

Table of Contents

Before we dive into the world of quantitative research topics for nursing students, let’s understand why quantitative research is so crucial for nursing students:

• Enhancing Critical Thinking Skills: Nursing students often find themselves in situations where they must assess, analyze, and make decisions that directly impact patient care. Engaging in quantitative research hone these critical thinking skills, enabling students to approach complex problems methodically.
• Contributing to Evidence-Based Nursing Practice: Evidence-based practice is the cornerstone of modern healthcare. Quantitative research empowers nursing students to explore and apply the latest evidence in their clinical practice, ensuring the best possible care for patients.
• Career Advancement: As nursing professionals progress in their careers, research experience becomes increasingly valuable. Nurses who can conduct and interpret quantitative research are more likely to secure leadership roles, contribute to policy development, and influence positive change in healthcare systems.

How to Choose Quantitative Research Topics

Selecting suitable quantitative research topics for nursing students is the first and often the most critical step in the research process. Here are some tips for nursing students on how to choose the right quantitative research topic:

Opt for a topic that aligns with your interests and career goals. Research is a long journey, and enthusiasm for your topic will sustain your motivation.

Feasibility

Consider the resources available to you. Assess the feasibility of data collection, analysis, and the overall research process. A well-planned study within your means is more likely to succeed.

Literature Review

Conduct a thorough literature review to identify gaps in existing research. Your topic should address an unanswered question or provide a fresh perspective on an existing issue.

Consult with Advisors

Seek guidance from your professors or mentors. They can help you refine your research question and provide valuable insights based on their experience.

200+ Quantitative Research Topics for Nursing Students

Now, let’s explore a range of quantitative research topics that nursing students can consider across different subfields:

Nursing Workforce and Patient Outcomes

• The Impact of Nurse-Patient Ratios on Patient Outcomes in Critical Care Units.
• Assessing the Relationship Between Nurse Staffing Levels and Falls Among Hospitalized Patients.
• The Effect of Nursing Workload on Medication Errors in Acute Care Settings.
• Investigating the Influence of Nurse Experience on Surgical Site Infections.
• Nurse Burnout and Its Consequences on Patient Safety and Satisfaction.
• Examining the Link Between Nurse-to-Patient Ratios and Pressure Ulcer Development.
• The Role of Nurse Education and Certification in Reducing Hospital Readmissions.
• Assessing the Impact of Nursing Leadership Styles on Patient Outcomes.
• Investigating the Association Between Nurse Retention Rates and Patient Mortality.
• The Effect of Multidisciplinary Team Collaboration on Patient Care in Oncology Units.
• Nurse-Patient Communication and Its Effect on Pain Management in Postoperative Patients.
• The Influence of Nurse Staffing on the Length of Hospital Stay for Surgical Patients.
• Examining the Relationship Between Nurse-Patient Ratios and Delirium in Elderly Patients.
• The Impact of Shift Length and Overtime on Nurse Performance and Patient Safety.
• Assessing the Effectiveness of Nurse-Managed Early Warning Systems in Identifying Deteriorating Patients.
• Investigating the Link Between Nurse Workforce Diversity and Cultural Competence in Patient Care.
• Nurse-to-Patient Ratios and the Incidence of Healthcare-Associated Infections in Long-Term Care Facilities.
• The Role of Nursing Workforce Development Programs in Enhancing Patient-Centered Care.
• Exploring the Effect of Nurse Staffing Levels on Patient Satisfaction and Hospital Ratings.
• Nurse Burnout and Its Influence on Discharge Planning and Patient Education.

Telehealth and Remote Monitoring

• The Effectiveness of Telehealth in Improving Access to Mental Health Services in Rural Areas.
• Assessing the Impact of Remote Monitoring on Medication Adherence Among Chronic Disease Patients.
• Telehealth for Pediatric Care: Examining Parental Satisfaction and Child Outcomes.
• Investigating the Use of Telehealth in Post-Operative Care and Its Effect on Recovery Rates.
• Telehealth and Diabetes Management: A Comparative Analysis of Telemedicine vs. Traditional Care.
• The Role of Telehealth in Preventive Care: Evaluating its Effectiveness in Promoting Healthier Lifestyles.
• Telehealth for Stroke Rehabilitation: A Study on Functional Outcomes and Cost Savings.
• Telemedicine in Mental Health Crisis Intervention: Assessing Crisis Resolution and Patient Satisfaction.
• Exploring the Use of Wearable Devices and Remote Monitoring in Monitoring Elderly Patients’ Health.
• Telehealth and Chronic Pain Management: A Comparative Study of Virtual vs. In-Person Consultations.
• The Impact of Telehealth on Reducing Hospital Readmissions Among Heart Failure Patients.
• Telehealth and Maternal Care: Investigating its Role in Prenatal Monitoring and Postpartum Support.
• Telemedicine in Emergency Medical Services: Evaluating its Effectiveness in Triage and Decision-Making.
• Telehealth and Home-Based Palliative Care: A Study on Patient Comfort and Quality of Life.
• Remote Monitoring of COVID-19 Patients: Assessing its Role in Early Detection of Complications.
• Telehealth for Geriatric Care: Analyzing its Impact on Aging-in-Place and Independence.
• Investigating the Cost-Effectiveness of Telehealth Interventions in Managing Obesity and Weight Loss.
• Telemedicine in Speech Therapy for Children with Speech Disorders: Evaluating Speech Outcomes.
• Telehealth for Dermatology Consultations: A Comparative Analysis of Diagnostic Accuracy.
• The Use of Telehealth in Mental Health Crisis Intervention for Veterans: Assessing PTSD Symptom Reduction.

Mental Health Nursing

• The Efficacy of Telehealth Interventions in Providing Mental Health Support to Remote or Underserved Populations.
• Assessing the Impact of Peer Support Programs on the Recovery of Individuals with Severe Mental Illness.
• Exploring the Relationship Between Childhood Trauma and the Development of Mental Health Disorders in Adulthood.
• The Role of Mindfulness-Based Interventions in Reducing Anxiety and Depression Among College Students.
• Investigating the Effectiveness of Art Therapy in Improving Emotional Regulation in Adolescents with Behavioral Disorders.
• Assessing the Impact of Music Therapy on Agitation Levels in Dementia Patients in Long-Term Care Facilities.
• The Influence of Nurse-Administered Cognitive Behavioral Therapy on Depression Remission Rates.
• Exploring the Use of Digital Mental Health Apps in Improving Treatment Adherence Among Individuals with Bipolar Disorder.
• Investigating the Association Between Sleep Patterns and Mental Health Outcomes in Adolescents.
• The Effect of Family Involvement in Therapy on the Outcomes of Schizophrenia Patients.
• Evaluating the Role of Mental Health Nurses in Suicide Prevention and Postvention Strategies.
• Assessing the Effectiveness of School-Based Mental Health Programs in Reducing Bullying and Its Impact on Mental Health.
• Exploring the Use of Animal-Assisted Therapy in Reducing Anxiety and Depression in Psychiatric Patients.
• Investigating the Relationship Between Social Media Use and Mental Health in Young Adults.
• The Impact of Cultural Competence Training on Mental Health Care Delivery for Diverse Populations.
• Assessing the Effect of Physical Activity and Exercise Programs on the Mental Health of Individuals with Schizophrenia.
• Exploring the Role of Gender Identity and Sexual Orientation in Mental Health Disparities and Access to Care.
• Investigating the Influence of Stigma on Help-Seeking Behavior Among Individuals with Mental Health Disorders.
• The Effectiveness of Psychoeducation Programs in Reducing Relapse Rates in Individuals with Bipolar Disorder.
• Assessing the Impact of Trauma-Informed Care in Mental Health Settings on Patient Outcomes and Staff Well-being.

Pediatric Nursing

• The Impact of Parental Involvement in Pediatric Pain Management.
• The Effectiveness of Child Life Specialists in Reducing Pediatric Anxiety During Medical Procedures.
• Assessing the Role of Pediatric Nurse Practitioners in Early Childhood Development Screening.
• Investigating the Relationship Between Pediatric Obesity and Long-Term Health Outcomes.
• Exploring the Use of Play Therapy in Pediatric Pain Management.
• The Impact of Pediatric Palliative Care on Quality of Life for Seriously Ill Children and Their Families.
• The Role of School Nurses in Promoting Mental Health Awareness Among School-Aged Children.
• Investigating the Efficacy of Pediatric Vaccination Education Programs in Increasing Immunization Rates.
• The Effect of Parenting Styles on Pediatric Asthma Management and Control.
• Assessing the Impact of Pediatric Sickle Cell Disease Management Programs on Disease Outcomes.
• Exploring the Influence of Family-Centered Care on Pediatric Hospitalization Experiences.
• The Relationship Between Childhood Trauma and Mental Health Outcomes in Adolescents.
• Investigating the Effectiveness of Pediatric Telehealth Services for Rural and Underserved Populations.
• The Impact of Pediatric Nursing Interventions on Neonatal Abstinence Syndrome in Infants Born to Substance-Using Mothers.
• Assessing the Efficacy of Pediatric Nutrition Education Programs in Reducing Childhood Obesity Rates.
• Exploring the Use of Technology and Apps for Pediatric Diabetes Management.
• The Role of Pediatric Nurses in Early Detection and Intervention for Developmental Delays.
• Investigating the Relationship Between Childhood Vaccination Rates and School Immunization Policies.
• The Effect of Child Abuse Prevention Programs on Reducing Child Maltreatment Incidents.
• Assessing the Impact of Pediatric Pain Assessment Tools on Pain Management Practices in Pediatric Settings.

Gerontological Nursing

• The Impact of Comprehensive Geriatric Assessment on Hospital Readmission Rates in Elderly Patients with Multiple Comorbidities.
• Evaluating the Effectiveness of Fall Prevention Interventions in Nursing Homes for Older Adults with Dementia.
• The Role of Family Caregivers in Managing Chronic Illnesses and Maintaining Quality of Life for Elderly Patients.
• Investigating the Relationship Between Social Isolation and Cognitive Decline in the Aging Population.
• Assessing the Effectiveness of Palliative Care Services in Improving End-of-Life Quality for Elderly Patients.
• The Influence of Nutrition and Diet on Functional Independence in Older Adults.
• Examining the Impact of Gerontological Nursing Education on the Competence and Confidence of Nursing Students in Caring for Older Adults.
• Exploring the Role of Exercise and Physical Activity in Preventing Falls and Fractures in Elderly Individuals.
• The Effect of Medication Management Programs on Medication Adherence and Health Outcomes in Older Adults.
• Investigating the Prevalence and Risk Factors of Elder Abuse in Long-Term Care Facilities.
• Assessing the Impact of Cognitive Training Programs on Delaying the Onset of Alzheimer’s Disease in Older Adults.
• Exploring the Relationship Between Sleep Quality and Cognitive Function in the Aging Population.
• The Role of Gerontological Nurses in Promoting Advance Care Planning and End-of-Life Decision-Making in Older Adults.
• Evaluating the Effectiveness of Home-Based Telehealth Services in Managing Chronic Conditions for Elderly Patients Living Alone.
• Investigating the Influence of Multimorbidity on Healthcare Utilization and Quality of Life in Older Adults.
• The Impact of Music Therapy on Emotional Well-Being and Quality of Life in Nursing Home Residents with Dementia.
• Assessing the Effectiveness of Interventions to Reduce Polypharmacy in Older Adults.
• Exploring the Role of Gerontological Nurses in Addressing Loneliness and Social Isolation in Older Adults.
• The Relationship Between Oral Health and Overall Health in the Aging Population: Implications for Nursing Care.
• Investigating the Use of Robotics and Assistive Technologies in Promoting Independence and Quality of Life for Older Adults.

Women’s Health Nursing

• The Impact of Midwife-Led Care on Maternal and Neonatal Outcomes.
• Assessing the Effectiveness of Prenatal Education Programs in Reducing Maternal Anxiety and Stress.
• Investigating the Relationship Between Maternal Nutrition and Birth Weight in Low-Income Communities.
• The Role of Postpartum Support in Preventing Postpartum Depression.
• Exploring the Barriers to Accessing Reproductive Health Services Among Underserved Women.
• Evaluating the Effectiveness of Intimate Partner Violence Screening and Intervention in Obstetric Care.
• The Association Between Breastfeeding Duration and Postpartum Weight Loss in Mothers.
• Assessing the Impact of Menopause Education Programs on Women’s Quality of Life.
• Investigating the Role of Nurse Practitioners in Providing Comprehensive Menopausal Care.
• The Effect of Body Image and Self-Esteem on Women’s Health Behaviors.
• Exploring Factors Influencing Women’s Decision-Making Regarding Contraceptive Methods.
• Evaluating the Efficacy of Sex Education Programs in Preventing Teenage Pregnancy.
• The Relationship Between Fertility Awareness-Based Methods and Contraceptive Efficacy.
• Assessing the Effect of Pelvic Floor Muscle Training in Managing Urinary Incontinence in Women.
• Investigating the Impact of Hormone Replacement Therapy on Cardiovascular Health in Postmenopausal Women.
• The Role of Preconception Health Promotion in Reducing Adverse Pregnancy Outcomes.
• Exploring the Use of Telehealth for Gynecological Consultations and Follow-Up.
• The Association Between Body Mass Index (BMI) and Infertility in Women.
• Assessing the Effectiveness of Nurse-Led Support Groups for Women with Polycystic Ovary Syndrome (PCOS).
• Investigating the Influence of Cultural and Socioeconomic Factors on Maternal Health Disparities in Minority Populations.

Community Health Nursing

• The Impact of Community Health Education Programs on Smoking Cessation Rates in High-Risk Populations.
• Evaluating the Effectiveness of School-Based Nutrition Interventions in Reducing Childhood Obesity.
• Assessing the Role of Community Health Nurses in Promoting Vaccination Compliance and Preventing Infectious Disease Outbreaks.
• Investigating the Relationship Between Access to Green Spaces and Mental Health in Urban Communities.
• The Effect of Community-Based Diabetes Management Programs on Glycemic Control and Health Outcomes.
• Exploring the Challenges and Strategies in Providing Culturally Competent Care in Diverse Community Settings.
• The Influence of Social Determinants of Health on Health Disparities in Underserved Communities.
• Assessing the Impact of Mobile Health (mHealth) Apps in Promoting Healthy Lifestyles in Rural Areas.
• Investigating the Role of Community Health Nurses in Disaster Preparedness and Response.
• The Effectiveness of Community Health Worker (CHW) Programs in Reducing Healthcare Costs and Hospital Readmissions.
• Exploring the Relationship Between Community Health Nursing Interventions and Reductions in Substance Abuse Rates.
• Evaluating the Impact of Maternal and Child Health Programs on Infant Mortality Rates in Low-Income Communities.
• Assessing the Effectiveness of Community-Based Mental Health Support Services in Preventing Hospitalizations.
• Investigating the Influence of Community Health Promotion Campaigns on Immunization Rates.
• The Role of Community Health Nurses in Addressing the Opioid Epidemic Through Harm Reduction Strategies.
• Exploring the Impact of Community Health Initiatives on Improving Access to Healthcare Services in Rural Areas.
• Assessing the Effect of Home Visiting Programs on Maternal and Child Health Outcomes.
• Investigating the Relationship Between Food Insecurity and Chronic Disease Management in Urban Communities.
• The Effectiveness of Telehealth Services in Providing Mental Health Support to Underserved Populations.
• Exploring the Implementation of Community-Based Palliative Care Programs and Their Impact on Quality of Life for Terminally Ill Patients.

Nursing Education and Training

• The Impact of Simulation-Based Training on Nursing Student Competency.
• Evaluating the Effectiveness of Blended Learning Models in Nursing Education.
• Assessing the Integration of Cultural Competence Training in Nursing Curricula.
• Investigating the Role of Interprofessional Education in Preparing Nursing Students for Collaborative Practice.
• The Influence of Emotional Intelligence Training on Nursing Students’ Interpersonal Skills.
• Exploring the Use of Virtual Reality (VR) and Augmented Reality (AR) in Nursing Education.
• The Effect of Peer Mentoring Programs on Retention and Success Rates of Nursing Students.
• Analyzing the Efficacy of Team-Based Learning in Nursing Curriculum.
• Investigating the Impact of Preceptorship Programs on Transition to Practice for New Graduates.
• Assessing the Role of Reflective Practice in Developing Clinical Decision-Making Skills in Nursing Students.
• The Influence of Evidence-Based Practice (EBP) Training on Nursing Student’s EBP Implementation.
• Exploring the Integration of Mindfulness and Resilience Training in Nursing Education.
• Investigating the Use of Social Media and Technology in Enhancing Nursing Education.
• Assessing the Role of Nursing Simulation Centers in Improving Clinical Competence.
• The Effect of Cultural Immersion Experiences on Cultural Competency Development in Nursing Students.
• Analyzing the Impact of High-Fidelity Patient Simulators on Critical Thinking Skills in Nursing Education.
• Investigating the Use of Competency-Based Education in Nursing Programs.
• Assessing the Role of Clinical Reasoning Development in Nursing Education.
• The Influence of Team-Based Care Training on Nursing Students’ Understanding of Collaborative Healthcare Models.
• Exploring Strategies to Enhance Clinical Placement Experiences for Nursing Students.

Healthcare Quality and Patient Safety

• The Impact of Electronic Health Records (EHRs) on Patient Safety and Data Accuracy.
• Strategies to Reduce Medication Errors in Hospital Settings.
• The Role of Nurse Staffing Levels in Preventing Adverse Patient Outcomes.
• Assessing the Effectiveness of Rapid Response Teams in Hospitals.
• Investigating the Relationship Between Hospital Accreditation and Patient Safety.
• The Use of Human Factors Engineering to Enhance Healthcare Quality and Patient Safety.
• Evaluating the Implementation of Surgical Safety Checklists and Their Impact on Surgical Complications.
• Analyzing the Link Between Hand Hygiene Compliance and Hospital-Acquired Infections.
• The Role of Patient and Family Engagement in Promoting Healthcare Quality and Safety.
• Investigating the Effect of Healthcare Provider Burnout on Patient Safety.
• Assessing the Impact of Telemedicine on Patient Safety and Care Quality.
• Strategies for Reducing Diagnostic Errors in Healthcare.
• The Role of Artificial Intelligence (AI) and Machine Learning in Predicting and Preventing Patient Safety Incidents.
• Examining the Influence of Organizational Culture on Patient Safety Practices.
• The Effectiveness of Team-Based Training in Enhancing Communication and Reducing Errors in Healthcare.
• Investigating the Relationship Between Nurse Leadership Styles and Patient Safety Culture.
• Assessing the Impact of Patient Safety Initiatives on Healthcare Costs.
• Strategies for Improving Patient Handoff Communication to Enhance Continuity of Care.
• Analyzing the Effect of Healthcare Policy Changes on Patient Safety Outcomes.
• The Role of Interdisciplinary Collaboration in Enhancing Healthcare Quality and Patient Safety.

Cultural Competence in Nursing

• The Impact of Cultural Competence Training on Nurses’ Knowledge, Attitudes, and Practices in Diverse Healthcare Settings.
• Exploring the Role of Cultural Competence in Reducing Health Disparities Among Minority Populations.
• Assessing the Influence of Cultural Competence on Patient-Centered Care and Patient Satisfaction.
• The Relationship Between Language Proficiency and Effective Communication in Cross-Cultural Nursing Care.
• Investigating the Effect of Cultural Competence on Nursing Student Preparedness for Providing Culturally Sensitive Care.
• The Influence of Cultural Competence on Nurse-Patient Trust and Rapport Building in Multicultural Healthcare Settings.
• Evaluating the Impact of Cultural Competence Education on Nursing Curricula and Program Outcomes.
• Exploring the Challenges and Barriers Faced by Nurses in Providing Culturally Competent Care.
• The Effect of Cultural Competence on Medication Adherence and Health Outcomes Among Diverse Patient Groups.
• Assessing the Cultural Competence of Healthcare Organizations and Its Relationship to Quality of Care.
• Investigating the Influence of Cultural Competence on Ethical Decision-Making in Nursing Practice.
• The Role of Cultural Competence in Reducing Healthcare Misdiagnoses and Medical Errors.
• Exploring the Effectiveness of Cultural Competence Models and Frameworks in Nursing Education.
• Assessing the Cultural Competence of Nursing Leadership and Its Impact on Staff Morale and Retention.
• Investigating the Influence of Cultural Competence on End-of-Life Care Preferences and Decision-Making in Diverse Populations.
• The Relationship Between Cultural Competence and the Delivery of Culturally Tailored Health Promotion Programs.
• Evaluating the Role of Cultural Competence in Shaping Nursing Practice Guidelines and Protocols.
• Exploring the Impact of Cultural Competence on the Management of Chronic Diseases in Culturally Diverse Patient Populations.
• Assessing the Effectiveness of Culturally Competent Care in Reducing Hospital Readmission Rates.
• Investigating the Link Between Cultural Competence and Health Equity Initiatives in Healthcare Systems.

Tips for Conducting Quantitative Nursing Research

Now that you have a glimpse of potential research topics, it’s essential to understand the key steps involved in conducting quantitative nursing research:

• Research Design and Methodology: Choose the most appropriate research design (e.g., cross-sectional, longitudinal, experimental) and methodology (e.g., surveys, experiments) for your research question.
• Data Collection Methods: Determine how you’ll collect data. Will it involve surveys, observations, or analysis of existing datasets? Ensure your data collection methods align with your research design.
• Data Analysis Techniques: Familiarize yourself with statistical analysis tools and techniques (e.g., regression analysis , t-tests) to analyze your data accurately.
• Data Management: Develop a robust data management plan to organize, store, and protect your research data. Adherence to ethical data handling is crucial.
• Ethical Considerations: Always prioritize ethical principles in your research. Obtain informed consent from participants, maintain confidentiality, and seek ethical approval if required.

Resources for Nursing Students

To support your journey in quantitative research topics for nursing students, here are some recommended resources:

• “Nursing Research: Generating and Assessing Evidence” by Denise F. Polit and Cheryl Tatano Beck.
• “Quantitative Research in Nursing and Healthcare” by Immy Holloway and Stephanie Wheeler.
• “Journal of Nursing Scholarship”
• “Research in Nursing & Health”

Online Resources

• The National Institute of Nursing Research (NINR) offers valuable research resources and funding opportunities.
• Online courses and webinars on research methods and statistical analysis (e.g., Coursera, edX).

Quantitative research is an indispensable tool for nursing students looking to make a meaningful impact in their field. By choosing the right quantitative research topics for nursing students and following ethical research practices, nursing students can contribute to the body of nursing knowledge, improve patient care, and advance their careers. 

So, don’t hesitate to embark on your quantitative research journey, and let your curiosity and passion drive you toward excellence in nursing practice.

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Research questions from nursing practice.

• Fri, 21 Oct 2011

ICU Management & Practice, ICU Volume 5 - Issue 4 - Winter 2005

Julie Benbenishty RN BA

ICU, Hadassah Medical Organization

Jerusalem, Israel

C orrespondence

[email protected]

Nursing research can improve patient care and outcome, promote professional growth and help avoid staff burnout. In this article, Julie Benbenishty describes the steps from asking a research question to completing research. Also in this issue of ICU Management (page 34), you can read an article co-authored by Julie Benbenishty, Maureen BenNun and colleagues, describing a research project, which was awarded the 2003 Professor Bergman prize for Creativity in Nursing by Tel Aviv University.

Research provides the opportunity to further knowledge, to gain recognition in setting standards for patient care and nursing practice, and to grow personally and professionally. By participating in research projects, nurses improve nursing practice and patient care and become leaders in their own departments. Nurses can lead the entire research process from developing a research question through to data collection and analysis, and the publication process. Once published, nurses have the opportunity to present their findings at national and international meetings, thereby influencing patient care and nursing practice at a global level. Completing research can also improve the quality of life for the working team. With the promotion of nursing research, the burnout rate is greatly reduced and nursing staff tend to stay in the unit (Burtt 1999).

Approaching Nursing Research

The main requirements for nursing researchers are an enquiring mind and interest in looking for ways to improve patient care. Nurses, above all other healthcare providers, have the best opportunity to identify problems and patterns of patient behaviours and to observe patient responses to therapy. Although there is much professional literature to support provision of patient care, too often there are gaps in the literature for the specific problems that nurses are dealing with, and for which better procedures are required. (The article opposite in this issue of ICU Management describes how to appraise evidence from the literature.)

Recognized patterns and problems allows us to ask questions about how care can be improved. Nurses, regardless of academic background, must be able to identify what needs to be changed and what we don’t know about the patterns observed with patients. This is the first step towards developing a research question.

The next step is to understand the resources available to explore the research question and help find the answers. Nurses approaching research need to believe that what they have to say is important and to identify the key contacts to progress their ideas. They need to invite collaborators who are also interested in the topic or issue, and who have been actively involved in developing research, and have the academic credentials to develop a study. The prospect of developing research may be frightening for nurses who are not familiar with the process. However, the best research is most often a group effort; research cannot be achieved alone. The ICU nurse who is motivated to perform research must involve his or her nursing team and other staff members sharing the same goal. Table 1 lists all the steps as a checklist for nurses to progress towards completing research.

Nursing research investigates topics that relate directly or indirectly to nursing, affect nursing practice and influence the lives of patients and practitioners. Nursing research can be descriptive, quasi-experimental or experimental. It can be conducted through quantitative or qualitative methodologies and may be retrospective, prospective or longitudinal in design. Research findings determine how nurses deliver care, educate each other, and manage their practice. With evidence-based nursing practice, patients are more likely to receive nursing care that is safe and effective, promotes comfort and the best outcomes.

The Nightingale Legacy – Research and Practice

In Nightingale's view, nursing should be a search for truth. She believed that the ability to collect accurate information and make correct observations was essential. "If you cannot get the habit of observation one way or other, you had better give up being a nurse, for it is not your calling, however kind and anxious you might be" (Nightingale 1969). Nursing research gathers evidence for good practice to improve healthcare and can also promote team spirit and professional development.

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Nursing Research Questions and Answers

This is a comprehensive examination in order to serve as a reviewer for the upcoming Nursing Board Examination for Nurses. Read the questions carefully before answering them. Please choose the best answer.

This test covers nursing research topics in easy to difficult questions. Each question is designed in order to equip the nursing student with the testing skills needed for the comprehensive examination. Nursing Research is an essential part of the core concepts in Nursing. In this examination, the nursing student is expected to be equipped with information about Nursing Research and Nursing Process , Ethics in Nursing Research, the Research Process, and Essentials of Statistics.

Nursing Research Questions

1. Nursing Research can be classified according to the time frame the research study has been made. As a nurse, you know that the study entitled “Knowledge and practice of Staff Nurses in preventing needle prick injuries in a private hospital in Manila is classified as:

A. Basic Research B. Historical Research C. Descriptive Research D. Experimental Research

2. Nursing Research has a lot of purposes. Which of the following category do the study about the sociodemographic profile of nursing students and their risk for depression belong?

A. Prescription B. Exploration C. Prediction and control D. Explanation

3. In experimental research, as a nurse there must be an essential activity wherein the participants of the study will be able to understand the whole experimental design. This term is called:

A. Desensitization B. Experimental Proper C. Research Proper D. Debriefing

4. Ethics in Nursing Research has always been an issue when it comes to the identity of the respondents. When the topics of research are very sensitive, which of the following rights of individual participants must be ensured when the researcher cannot link the information given by the respondent from the source of the information?

A. Confidentiality B. Anonymity C. Virility D. Volunteerism

5. In starting a focused group discussion, Nurse Dina wants to stress out the confidentiality of the topics that they will be discussing. Which of the following instruction convey confidentiality?

A. “This discussion should not only be confined within this group of people. Any information discussed should be told publicly.” B. “This discussion should only be confined within this group of people. Any information discussed should not be told publicly.” C. “This discussion should not be confined within this group of people. Any information discussed should not be told publicly.” D. “This discussion should only be confined within this group of people. Any information discussed should be told publicly.”

No. 6 – 10. Situation No.1 – “Knowledge and practice of prevention of needle prick injuries of Staff Nurses in a certain private hospital in Metro Manila”

6. Based on the research title which of the following will be the general objective?

A. This study aims to determine the level of knowledge and practice of prevention of needle prick injuries of Staff Nurses in a certain private hospital. B. This study aims to determine if there is a significant relationship between levels of knowledge regarding prevention of needle prick injuries and sociodemographic of Staff Nurses in a certain private hospital. C. The study aims to determine the levels of knowledge regarding the prevention of needle prick injuries of Staff Nurses in a certain private hospital. D. This study aims to determine the sociodemographic of Staff Nurses in a certain private hospital.

7. All of these are specific objectives except:

A. This study is for nursing researchers in the future. B. This study aims to determine if there is a significant relationship between levels of knowledge regarding prevention of needle prick injuries and sociodemographic of Staff Nurses in a certain private hospital. C. The study aims to determine the levels of knowledge regarding the prevention of needle prick injuries of Staff Nurses in a certain private hospital. D. This study aims to determine the sociodemographic of Staff Nurses in a certain private hospital.

8. As a nurse, you know the appropriate data-gathering tool, this is? A. Survey B. Questionnaire C. Structured Discussion D. Interview Method

9. As a nurse, these are the following topics in the scope and limitations except:

A. Limited to the hospital personnel of a private hospital B. Limited only to the practice of preventing needle prick injuries of nursing personnel C. The scope of the study involves the knowledge about prevention of needle prick injuries D. The scope of the study involves the sociodemographic profile of nursing personnel

10. Which of the following is not a null hypothesis?

A. There is no relationship between the level of knowledge and practice of prevention of needle prick injuries B. There is no relationship between the practice of prevention of needle prick injuries and the sociodemographic profile of staff nurses C. There is a significant relationship between the knowledge and sociodemographic profile of staff nurses D. All of the above.

11. Which of the following would correspond to Intervene in Nursing Process? A. Select design plan B. Report findings C. Implement planned study D. Select a plan analysis

12. Which of the following would correspond to the Plan in Nursing Process? A. Select design plan B. Report findings C. Implement planned study D. Change the objectives after implementation

13. When it comes to steps in Problem Solving, which of the following would be similar in research wherein you implement the planned study? A. Theorize about facts and possible relationships B. gather, analyze relevant information C. Report findings D. Determine information needs

14. Using the Research perspective, when is the time that a nurse makes inferences? A. Define the purpose of review of literature B. Formulate a problem, define variables C. Select design sample D. Report findings

15. Which of the following is does not belong to the group?

A. Assess: Identify the problem B. Plan: Theorize C. Intervene: Gather relevant information D. Evaluate: Outcomes

16. In selecting a problem, these are the following consideration except: A. Time Factor B. Talents C. Cost D. Data availability

17. These are the purpose of Review of Related Literature except: A. Reveal investigations B. Reveal sources of data C. Reveal what is the problem D. Reveal the significant research personalities

18. As a nurse, you know the following functions of theoretical framework, except: A. Specifies relationship among the concepts B. Give a graphic view of the data C. Clarifies the concept on which the study is built D. States assumptions

19. Which of the following would not be Qualitative Research? A. Case study of Myocardial Infarction B. A Review on Corona Trial C. A Review on the Nursing Uniform D. A Review on the Performance in Related Learning Experience of student nurses

20. Using statistics in nursing research is a very vital tool in presenting the data. As a nurse, you know the definition of sampling as: A. Taking certain areas of the population dividing the areas into sections B. process of selecting a portion of the population to represent the entire population C. Using every Nth name from the list of participants D. Taking any sample as long as it comes up with the quota

21. In gathering information, as a nurse these are the reliable sources except: A. Interview B. Observation C. Grapevine D. Records

22. As a nurse educator , you want to know the reasons behind the leave of absences of student nurses. These tools can be used except? A. Interview B. Records C. Pre-Test & Post-Test D. Questionnaire

23. Upon gathering the data, which of the following can describe the most number of reasons for leave of absence? A. Median B. Mode C. Frequency D. Deviance

24. If you want to know the average age of the nursing students who has the most number of leave of absence you will need:

A. Median B. Mode C. Mean D. Deviance

25. After all the data presented, what part of descriptive statistics will you use in order to place a systematic arrangement of numerical values from lowest to highest?

A. Deviance B. Central Tendency C. Mode D. Frequency Distribution

Answers and Rationale

Related articles more from author, nclex: nursing process questions and rationale, gastrointestinal disorders nclex: nursing questions and rationale, nclex: newborn nursing questions and rationale, nclex: fundamentals of nursing questions and rationale, nclex- rn oncology & cancer practice exam questions, maternity and child nursing nclex practice exam questions.

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Review Questions

• implementation
• The client was silent during some of the admission interviews.
• There is medical history of preeclampsia with a pregnancy last year.
• The client’s family brought in some magazines and left them at the desk.
• The client states the partner will “be sorry” for their breakup.
• This is an example of the client’s inappropriate behavior.
• This is an example of secondary, objective data collection.
• This is an example of professional sharing in care planning.
• This is an example of evaluation in the nursing process.
• research/client preference/nurse competency
• nurse experience/collaboration/teamwork
• research/client safety/client preference
• nurse experience/client teaching/delegation
• The nurse remains friends with the client after discharge from care.
• The nurse considers the client a partner in care planning.
• The nurse adheres to the plan of care without change.
• The nurse avoids a directive approach at all times.
• research function
• Nurse Practice Act
• evidence-based practice guidelines
• building of a nursing database
• a model to measure expert nursing knowledge
• a model to define scope of nursing practice
• a model to regulate nursing education
• a model to measure nursing judgment and knowledge of clinical skills
• medical records
• task complexity
• time pressure
• generating solutions
• analyzing cues
• taking action
• evaluating outcomes
• the client’s recent vital signs
• the client’s cultural background
• if the doctor should be notified
• if the client has been sad recently
• safety and quality improvement
• teamwork and informatics
• safety and informatics
• evidence-based practice and person-centered care
• The client states, “I wish my mom was here.”
• The client states, “You don’t even know me.”
• The client states, “I’ll tell you about my sister.”
• The client states, “I looked up that doctor online.”
• Cues are analyzed during assessment.
• Hypotheses are formed with evaluation.
• Nurses use only secondary data.
• Unmet goals are discontinued.
• standardization of all nursing care
• elimination of future client needs
• memorization of nursing care plans
• interpretation of client care data
• They cannot use every answer option.
• They cannot test prioritization.
• They show split computer screen.
• They make up 50 percent of test items.

This book may not be used in the training of large language models or otherwise be ingested into large language models or generative AI offerings without OpenStax's permission.

Want to cite, share, or modify this book? This book uses the Creative Commons Attribution License and you must attribute OpenStax.

Access for free at https://openstax.org/books/psychiatric-mental-health/pages/1-introduction

• Authors: Rebecca Puchkors, Jeanne Saunders, David Sharp
• Publisher/website: OpenStax
• Book title: Psychiatric-Mental Health Nursing
• Publication date: Jun 12, 2024
• Location: Houston, Texas
• Book URL: https://openstax.org/books/psychiatric-mental-health/pages/1-introduction
• Section URL: https://openstax.org/books/psychiatric-mental-health/pages/28-review-questions

© May 28, 2024 OpenStax. Textbook content produced by OpenStax is licensed under a Creative Commons Attribution License . The OpenStax name, OpenStax logo, OpenStax book covers, OpenStax CNX name, and OpenStax CNX logo are not subject to the Creative Commons license and may not be reproduced without the prior and express written consent of Rice University.

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Interview Questions

50 Interview Questions About Nursing (With Answers)

Looking for your next nursing job? Here are 50 interview questions about nursing to practice.

June 10, 2024

There are countless nursing jobs available giving you plenty of opportunities to interview at great healthcare facilities. This post explores why nursing is important in the workplace and includes 50 interview questions about nursing.

Faster job search. More Offers. Use our AI Cover Letter Builder, Interview Prep and Job Search Tools to land your next job.

What is nursing?

Nursing is a multidimensional profession that goes beyond the administration of medications and treatments—it embodies the art of caring, compassion, and empathy. It involves understanding the physical, emotional, and psychological needs of patients, providing comfort during their most vulnerable moments, and advocating for their health and well-being. Nurses are critical thinkers, educators, and communicators who play a pivotal role in the healthcare system, working closely with patients and their families to ensure comprehensive care. At its core, nursing is about nurturing the human connection to promote healing and improve the quality of life for individuals and communities.

Why is nursing important in the workplace?

1. critical thinking.

Nursing is not just about following doctors' orders or procedures; it involves a significant amount of critical thinking. Nurses are often the first to notice changes in a patient's condition, requiring them to assess and make decisions quickly. This skill ensures patient care is both timely and appropriate, reducing the risk of complications and improving recovery rates.

2. Compassionate Communication

Communication is paramount in nursing, not just for conveying information but for doing so with empathy and understanding. Nurses serve as the liaison between doctors, patients, and families, often explaining complex medical information in a way that is accessible and reassuring. This skill fosters a supportive environment, essential for patient recovery and comfort during stressful times.

3. Adaptability

The healthcare environment is dynamic and unpredictable, making adaptability a crucial skill for nurses. They must be prepared to handle sudden changes in patient condition, shifts in priorities, and new technologies or procedures. This flexibility ensures that nurses can provide high-quality care under various circumstances, maintaining patient safety and contributing to the overall efficiency of the healthcare system.

Tips for Nursing-Based Interview Questions

When preparing for a nursing job interview, it's crucial to showcase your skills effectively to stand out as a competent and compassionate candidate. Skill-based interview questions in nursing are designed to assess your practical abilities, decision-making processes, and how you apply theoretical knowledge in real-life scenarios. Here are five tips for answering skill-based interview questions in nursing:

1. Reflect on Your Experiences

Before the interview, think about your past experiences in different nursing settings, such as hospitals, clinics, or community health. Identify specific situations where you demonstrated key nursing skills, including patient care, teamwork, critical thinking, and crisis management. Prepare to share these examples in a clear and concise manner, focusing on your actions and the outcomes.

2. Use the STAR Method

When structuring your answers, employ the STAR (Situation, Task, Action, Result) method. This approach helps you deliver comprehensive and engaging responses. Start by describing the Situation and the Task you were faced with. Then, detail the Actions you took to address the situation and conclude with the Result of your actions, emphasizing positive outcomes and what you learned from the experience.

3. Highlight Your Soft Skills

Nursing is not only about clinical skills but also interpersonal and emotional intelligence. When answering skill-based questions, weave in examples of how you've used communication, empathy, and teamwork to enhance patient care and collaborate effectively with colleagues. Demonstrating your soft skills is crucial in showing you can provide holistic care.

4. Stay Updated with Current Practices

Nursing is an ever-evolving field with continuous advancements in patient care techniques and technologies. Show your commitment to professional development by discussing how you stay informed about the latest practices in nursing. Mention any recent workshops, courses, or certifications you've completed and how they've improved your nursing capabilities.

5. Be Honest and Self-Reflective

If you encounter a question about a skill you're less experienced in or a challenging situation, be honest about it. It's okay to admit areas where you're seeking improvement, but also discuss the steps you're taking to enhance those skills. Employers appreciate candidates who are self-aware and committed to personal and professional growth.

1. What inspired you to pursue a career in nursing?

My inspiration to pursue a career in nursing stemmed from a combination of personal experiences and a desire to make a meaningful impact in people's lives. Growing up, I witnessed the compassionate care my grandmother received from her nurses during her battle with a chronic illness. Their dedication and empathy left a lasting impression on me. Additionally, I have always been drawn to the sciences and have a strong desire to help others. Nursing seemed like the perfect blend of these passions, allowing me to provide hands-on care while continually learning and growing in a dynamic field.

2. How do you handle the emotional stress that comes with nursing?

Handling the emotional stress that comes with nursing requires a multifaceted approach. I prioritize self-care by engaging in activities that help me unwind and recharge, such as exercise, meditation, and spending time with loved ones. At work, I make it a point to debrief with colleagues after particularly challenging cases, as sharing experiences and supporting each other can be incredibly therapeutic. I also seek professional support when needed, recognizing the importance of mental health. Maintaining a healthy work-life balance and setting boundaries is crucial to managing the emotional demands of nursing.

3. Can you share an experience where you had to deal with a difficult patient? How did you handle it?

I once cared for a patient who was extremely agitated and resistant to treatment due to severe pain and anxiety. To handle the situation, I first ensured the patient's immediate safety and then focused on building rapport. I listened attentively to their concerns, validated their feelings, and provided reassurance. By involving the patient in their care plan and explaining each step, I was able to gain their trust gradually. I also collaborated with the healthcare team to adjust pain management strategies, which significantly improved the patient's comfort and cooperation.

4. How do you stay updated with the latest nursing practices and developments?

Staying updated with the latest nursing practices and developments is essential for providing high-quality care. I regularly attend professional development workshops, conferences, and webinars to learn about new research and advancements in the field. I subscribe to reputable nursing journals and participate in online forums and discussion groups to stay informed about current trends and best practices. Additionally, I am a member of several professional nursing organizations that offer resources and networking opportunities. Continuous learning is a priority for me, as it enhances my skills and ensures I am providing the best possible care to my patients.

5. What are the most important qualities a nurse should have?

The most important qualities a nurse should have include compassion, communication skills, attention to detail, critical thinking, and resilience. Compassion is essential for providing empathetic care and building trust with patients. Effective communication skills are crucial for interacting with patients, families, and healthcare teams. Attention to detail ensures accuracy in tasks such as medication administration and patient assessment. Critical thinking allows nurses to make quick, informed decisions in complex situations. Lastly, resilience helps nurses cope with the emotional and physical demands of the profession, enabling them to provide consistent, high-quality care.

6. Describe a time when you had to work closely with doctors and other healthcare professionals. How did you ensure effective communication and collaboration?

In a previous role, I was part of a multidisciplinary team managing a patient with multiple comorbidities. Ensuring effective communication and collaboration was key to providing comprehensive care. I scheduled regular team meetings to discuss the patient's progress and treatment plan, ensuring that everyone was on the same page. I actively listened to each team member's input and shared my observations and concerns. Clear and concise documentation in the patient's electronic health record (EHR) was maintained to facilitate seamless communication. By fostering an environment of mutual respect and open dialogue, we were able to deliver coordinated and effective care.

7. How do you prioritize tasks in a fast-paced healthcare environment?

Prioritizing tasks in a fast-paced healthcare environment requires strong organizational skills and the ability to quickly assess and triage patient needs. I start by identifying the most critical tasks that require immediate attention, such as responding to acute changes in a patient's condition or administering time-sensitive medications. I use checklists and time management tools to keep track of ongoing tasks and deadlines. Effective delegation of non-critical tasks to appropriate team members also helps manage the workload. Regularly reassessing and adjusting priorities throughout the shift ensures that all patients receive timely and appropriate care.

8. What strategies do you use to maintain patient confidentiality and privacy?

Maintaining patient confidentiality and privacy is a fundamental aspect of nursing practice. I adhere to strict protocols for handling patient information, including using secure systems for electronic health records (EHRs) and ensuring physical documents are stored securely. I am mindful of my surroundings when discussing patient information, ensuring that conversations occur in private settings. I educate patients about their rights to confidentiality and obtain their consent before sharing information with others involved in their care. Regular training and staying informed about legal and ethical guidelines help me uphold the highest standards of patient privacy.

9. Can you give an example of how you have contributed to improving patient care in your previous roles?

In a previous role, I noticed that patients with chronic conditions often struggled to manage their symptoms effectively at home. To address this, I initiated a patient education program focused on self-management and prevention strategies. I developed comprehensive educational materials and conducted workshops for patients and their families, covering topics such as medication adherence, lifestyle modifications, and recognizing warning signs. By empowering patients with knowledge and skills, we saw a significant reduction in hospital readmissions and improved patient outcomes. This initiative not only enhanced patient care but also fostered a culture of proactive health management.

10. How do you deal with the physical demands of being a nurse?

Dealing with the physical demands of being a nurse involves taking proactive measures to maintain my physical well-being. I prioritize regular exercise, which helps build strength and endurance. Proper body mechanics and ergonomics are essential, so I pay close attention to techniques for lifting and moving patients to avoid injury. I also make sure to take breaks, stay hydrated, and eat nutritious meals to keep my energy levels up throughout long shifts. Wearing supportive footwear and using assistive devices when available further helps in managing the physical demands of nursing.

11. What is your approach to educating patients and their families about their health?

Educating patients and their families about their health involves clear, compassionate communication and a tailored approach. I start by assessing the patient's and family's current knowledge and understanding of their condition. I use simple, non-medical language to explain complex concepts and provide written materials or visual aids to reinforce the information. I encourage questions and take the time to address their concerns thoroughly. By involving them in the care plan and setting realistic goals, I empower patients and families to take an active role in managing their health, leading to better outcomes and compliance.

12. How do you handle situations where a patient refuses care or does not follow medical advice?

When a patient refuses care or does not follow medical advice, I first seek to understand the underlying reasons for their decision. I listen empathetically and without judgment, providing them with the information they need to make informed choices about their health. I educate them on the potential consequences of refusing care and explore alternative options that might be more acceptable to them. Involving family members or other support systems can also help in addressing their concerns. Ultimately, I respect the patient's autonomy and document their decisions and our discussions thoroughly.

13. Describe a time when you had to adapt quickly to a change in a patient's condition. What actions did you take?

I once had a patient who suddenly exhibited signs of respiratory distress. Recognizing the urgency, I immediately assessed their vital signs and oxygen saturation levels. I then administered supplemental oxygen and positioned the patient to improve breathing. Simultaneously, I alerted the physician and prepared for potential interventions. By staying calm and following protocol, I was able to stabilize the patient until further treatment could be provided. This experience highlighted the importance of quick thinking, effective communication, and teamwork in managing sudden changes in a patient's condition.

14. What is your experience with electronic health records (EHR) systems?

I have extensive experience with electronic health records (EHR) systems, having used them in various capacities throughout my nursing career. I am proficient in entering and retrieving patient data, documenting care plans, and updating progress notes. I also use EHRs to track patient outcomes, manage medication administration, and communicate with other healthcare professionals. My familiarity with EHRs has enabled me to provide more efficient and accurate care, as well as contribute to better coordination and continuity of care within the healthcare team.

15. How do you ensure that you provide culturally competent care?

Providing culturally competent care involves understanding and respecting the diverse backgrounds and beliefs of my patients. I make an effort to learn about different cultures and their health practices through continuous education and by engaging with community resources. I use interpreters and translation services when language barriers exist to ensure clear communication. I also ask open-ended questions to understand each patient's unique needs and preferences. By being aware of my own biases and practicing empathy, I strive to create a welcoming and inclusive environment for all patients.

16. What measures do you take to prevent the spread of infection?

Preventing the spread of infection is a critical aspect of nursing practice. I adhere to strict hand hygiene protocols, using hand sanitizer or washing my hands before and after patient interactions. I follow standard precautions, including the use of personal protective equipment (PPE) such as gloves, masks, and gowns when necessary. I ensure that the environment is clean by disinfecting surfaces and equipment regularly. Educating patients and visitors about infection control practices, such as proper handwashing and respiratory etiquette, is also part of my routine. By staying vigilant and following guidelines, I help maintain a safe environment for patients and staff.

17. Can you discuss a time when you had to provide end-of-life care? How did you support the patient and their family?

Providing end-of-life care is a deeply sensitive and important responsibility. I recall caring for a terminally ill patient whose family was struggling to cope with the impending loss. I focused on ensuring the patient's comfort by managing their pain and other symptoms effectively. I provided emotional support to both the patient and their family, offering a listening ear and compassionate presence. I facilitated conversations between the patient, family, and healthcare team to ensure that their wishes were honored. Additionally, I connected the family with counseling services and support groups to help them navigate their grief. This experience reinforced the importance of empathy, communication, and holistic care in end-of-life situations.

18. How do you manage your time effectively when you have multiple patients with varying needs?

Effective time management in a busy healthcare environment involves prioritizing tasks based on urgency and importance. I start my shift by reviewing each patient's condition and identifying critical tasks that need immediate attention. I use a checklist to keep track of ongoing tasks and deadlines, ensuring nothing is overlooked. I also delegate appropriate tasks to nursing assistants and other team members. Regularly reassessing and adjusting priorities throughout the shift helps me stay organized and responsive to changing patient needs. By maintaining flexibility and clear communication with the healthcare team, I can manage my time efficiently and provide quality care to all my patients.

19. What do you believe are the biggest challenges facing the nursing profession today?

One of the biggest challenges facing the nursing profession today is the increasing demand for healthcare services amid a shortage of nursing staff. This situation leads to higher workloads and burnout among nurses. Additionally, the rapidly evolving healthcare landscape, including advancements in technology and changes in healthcare policies, requires nurses to continuously update their skills and knowledge. Another challenge is providing culturally competent care to a diverse patient population, which necessitates ongoing education and awareness. Addressing these challenges involves advocating for better staffing ratios, supporting professional development, and fostering a positive work environment that prioritizes nurse well-being.

20. How do you handle feedback, whether positive or negative?

Handling feedback, whether positive or negative, is essential for personal and professional growth. I approach feedback with an open mind, viewing it as an opportunity to improve my skills and performance. When receiving positive feedback, I acknowledge it with gratitude and use it as motivation to continue my efforts. For negative feedback, I listen carefully to understand the specific areas of improvement. I ask clarifying questions if needed and reflect on how I can apply the feedback constructively. By creating an action plan to address any identified gaps, I demonstrate my commitment to continuous improvement and professional development.

21. Can you explain how you approach pain management for patients?

Effective pain management involves a holistic and individualized approach. I start by conducting a thorough assessment of the patient's pain, using standardized pain scales to gauge its intensity and impact on their daily activities. I consider the patient's medical history, current condition, and preferences when developing a pain management plan. This plan may include pharmacological interventions, such as analgesics, as well as non-pharmacological methods like relaxation techniques, physical therapy, and acupuncture. I regularly monitor the patient's response to treatment and adjust the plan as needed to ensure optimal pain relief. Educating patients about pain management options and involving them in decision-making are crucial components of my approach.

22. What is your experience with administering medication safely and accurately?

Administering medication safely and accurately is a fundamental responsibility in nursing. I adhere to the "five rights" of medication administration: the right patient, the right medication, the right dose, the right route, and the right time. I double-check prescriptions and patient records, use bar-code scanning systems, and consult with pharmacists if there are any uncertainties. I also educate patients about their medications, including potential side effects and the importance of adherence. My experience has taught me the importance of meticulous attention to detail and effective communication to prevent medication errors and ensure patient safety.

23. How do you build trust with your patients?

Building trust with patients involves demonstrating empathy, respect, and competence. I make an effort to introduce myself and explain my role in their care, creating a welcoming and approachable demeanor. Active listening is key; I ensure patients feel heard and validated by paying close attention to their concerns and responding thoughtfully. Transparency and honesty in communication help establish credibility. I follow through on commitments and provide consistent, high-quality care. By treating each patient as an individual and showing genuine concern for their well-being, I foster a trusting relationship that enhances the overall care experience.

24. Describe a situation where you had to use your critical thinking skills to solve a problem.

I once had a patient who developed unexpected symptoms post-surgery, including confusion and a sudden drop in blood pressure. Using my critical thinking skills, I quickly assessed the situation, considering various potential causes such as medication reactions, infection, or internal bleeding. I reviewed the patient's chart, consulted with the surgical team, and ordered relevant diagnostic tests. My assessment indicated a possible internal bleed, which was confirmed by imaging. I promptly communicated this to the physician, and the patient was taken back to surgery for intervention. My ability to think critically and act swiftly was crucial in preventing further complications.

25. How do you stay calm and focused in emergency situations?

Staying calm and focused in emergency situations requires a combination of training, experience, and mental resilience. I rely on my training and protocols to guide my actions, ensuring that I follow established procedures systematically. Deep breathing and mindfulness techniques help me maintain composure and clarity of thought. I prioritize tasks based on urgency and communicate clearly with the healthcare team to ensure coordinated efforts. Reflecting on past experiences and learning from each situation has strengthened my ability to remain calm under pressure. By staying focused on the immediate needs of the patient, I can provide effective care even in high-stress scenarios.

26. What are your career goals in nursing?

My career goals in nursing include advancing my clinical skills and knowledge through continuous education and specialization. I aspire to obtain advanced certifications in areas such as critical care or oncology, which align with my interests and strengths. Long-term, I aim to pursue a leadership role, such as a nurse manager or educator, where I can mentor and support other nurses while contributing to the development of best practices in patient care. Additionally, I am passionate about participating in research and quality improvement initiatives to enhance healthcare delivery and outcomes. By setting these goals, I strive to make a meaningful impact in the nursing profession.

27. How do you work effectively as part of a multidisciplinary healthcare team?

Working effectively as part of a multidisciplinary healthcare team involves clear communication, mutual respect, and collaboration. I actively participate in team meetings and rounds, sharing relevant patient information and updates. I listen to the perspectives and expertise of other team members, valuing their contributions. When coordinating care, I ensure that all team members are informed and aligned with the patient's treatment plan. Building positive relationships and fostering an environment of trust and support enhance our collective ability to provide comprehensive and coordinated care. By prioritizing teamwork, we can achieve the best possible outcomes for our patients.

28. Can you discuss your experience with patient advocacy?

Patient advocacy is a vital aspect of nursing, and I am committed to ensuring that my patients' voices are heard and their rights are respected. In my previous roles, I have advocated for patients by communicating their concerns and preferences to the healthcare team, ensuring they are included in decision-making processes. I have also assisted patients in understanding their treatment options and navigating the healthcare system. For example, I once advocated for a patient who required a specialized treatment not initially covered by insurance, successfully appealing the decision to ensure they received the necessary care. Advocacy involves being a proactive and compassionate ally for patients, promoting their best interests at all times.

29. How do you approach the care of patients with chronic conditions?

Caring for patients with chronic conditions requires a comprehensive and holistic approach. I focus on educating patients about their condition, treatment options, and self-management strategies. Collaborating with patients to set realistic goals and create individualized care plans helps them manage their symptoms and improve their quality of life. Regular follow-ups and monitoring allow me to track their progress and make necessary adjustments to the care plan. I also provide emotional support and connect patients with resources such as support groups and community programs. By empowering patients with knowledge and support, I help them take an active role in managing their chronic conditions.

30. What is your experience with wound care?

I have extensive experience with wound care, including assessing, cleaning, dressing, and monitoring various types of wounds. I am skilled in managing acute and chronic wounds, pressure ulcers, surgical incisions, and diabetic foot ulcers. My approach to wound care involves a thorough assessment of the wound's size, depth, and condition, as well as identifying any signs of infection. I use evidence-based practices to select appropriate dressings and treatment modalities. Educating patients on wound care and prevention strategies is also a key aspect of my practice. By providing meticulous and compassionate wound care, I promote optimal healing and patient comfort.

31. How do you assess and monitor patients’ vital signs accurately?

Accurately assessing and monitoring patients' vital signs is a fundamental nursing skill. I use standardized techniques and equipment to measure vital signs, including temperature, pulse, respiration rate, and blood pressure. I ensure that the equipment is calibrated correctly and follow proper procedures for each measurement. I also observe the patient's overall condition and note any changes or abnormalities. Documenting vital signs promptly and accurately in the patient's electronic health record (EHR) ensures that all healthcare team members have access to up-to-date information. Regular monitoring and reassessment help detect early signs of deterioration and guide appropriate interventions.

32. Can you share an experience where you had to provide mental health support to a patient?

I once cared for a patient who was experiencing severe anxiety and depression following a major surgery. Recognizing the importance of addressing their mental health, I took the time to listen empathetically and validate their feelings. I collaborated with the healthcare team to involve a mental health professional in their care. I provided information on coping strategies and relaxation techniques, such as deep breathing exercises and mindfulness. By creating a supportive and non-judgmental environment, I helped the patient feel more comfortable and encouraged them to actively participate in their recovery. This experience reinforced the importance of holistic care that addresses both physical and mental health needs.

33. How do you ensure you comply with healthcare laws and regulations?

Ensuring compliance with healthcare laws and regulations involves staying informed about current policies and standards. I regularly participate in mandatory training sessions and continuing education programs to keep up-to-date with legal and regulatory requirements. I adhere to institutional policies and procedures, which are designed to align with national and state regulations. I also review and understand the guidelines provided by professional nursing organizations and accreditation bodies. By maintaining a thorough knowledge of relevant laws and regulations, I ensure that my practice meets the highest standards of safety, quality, and ethical care.

34. What is your approach to dealing with family members who are anxious or upset?

Dealing with anxious or upset family members requires empathy, patience, and effective communication. I approach these situations by actively listening to their concerns and validating their emotions. Providing clear and concise information about the patient's condition and treatment plan helps alleviate their anxiety. I encourage questions and involve them in the care process, offering reassurance and support. When necessary, I connect them with additional resources, such as social workers or counselors, to address their emotional needs. By showing compassion and maintaining open communication, I help build trust and create a supportive environment for both the patient and their family.

35. How do you maintain your physical and mental well-being as a nurse?

Maintaining physical and mental well-being as a nurse requires a proactive and balanced approach. I prioritize regular exercise, healthy eating, and adequate sleep to support my physical health. Engaging in hobbies and activities that I enjoy helps me unwind and reduce stress. I practice mindfulness and relaxation techniques, such as meditation and deep breathing, to maintain mental clarity and resilience. Building a strong support network of family, friends, and colleagues provides emotional support and helps me navigate the challenges of nursing. By taking care of myself, I ensure that I can provide the best possible care to my patients.

36. Can you discuss a time when you contributed to a quality improvement project?

In a previous role, I was part of a quality improvement project aimed at reducing hospital-acquired infections (HAIs). We identified that hand hygiene compliance was a key area for improvement. I collaborated with a multidisciplinary team to develop and implement an educational campaign promoting proper hand hygiene practices. We conducted training sessions, created informational posters, and introduced hand hygiene audits. By regularly monitoring compliance and providing feedback, we saw a significant increase in adherence to hand hygiene protocols. This project not only reduced HAIs but also fostered a culture of safety and accountability within the healthcare team.

37. How do you handle situations of ethical dilemmas in patient care?

Handling ethical dilemmas in patient care involves a thoughtful and principled approach. I start by gathering all relevant information and considering the perspectives of the patient, family, and healthcare team. I refer to the nursing code of ethics and institutional policies to guide my decision-making process. Consulting with colleagues, supervisors, or an ethics committee can provide additional insights and support. I prioritize open and honest communication, ensuring that the patient's rights and best interests are respected. By carefully weighing the potential outcomes and seeking collaborative solutions, I strive to resolve ethical dilemmas in a way that upholds the highest standards of care and integrity.

38. What strategies do you employ to educate yourself about a patient's specific health condition?

Educating myself about a patient's specific health condition involves utilizing a variety of resources and strategies. I start by reviewing the patient's medical history and current health records. I consult evidence-based clinical guidelines and research articles to understand the latest best practices and treatment options. Collaborating with colleagues and specialists provides valuable insights and expertise. Attending relevant workshops, seminars, and continuing education courses helps me stay informed about advancements in healthcare. By integrating this knowledge, I can provide informed and personalized care that meets the unique needs of each patient.

39. How do you ensure effective handoff communications during shift changes?

Effective handoff communications during shift changes are crucial for ensuring continuity of care and patient safety. I follow a standardized handoff protocol that includes a comprehensive review of each patient's condition, treatment plan, and any recent changes or concerns. I use structured communication tools, such as SBAR (Situation, Background, Assessment, Recommendation), to organize and present information clearly. I also encourage questions and clarify any uncertainties to ensure the incoming nurse fully understands the patient's status. Documenting key information in the electronic health record (EHR) further supports accurate and complete handoffs. By prioritizing thorough and clear communication, I help maintain high-quality care during transitions.

40. What is your experience with pediatric or geriatric patients (depending on the role)?

In my nursing career, I have had extensive experience with geriatric patients. I have cared for elderly patients with a variety of chronic conditions, including dementia, diabetes, and cardiovascular diseases. My approach to geriatric care involves addressing the unique physical, emotional, and cognitive needs of older adults. I focus on promoting independence and quality of life, providing education on managing chronic conditions, and coordinating care with family members and other healthcare providers. I also ensure that my care is compassionate and respectful, recognizing the dignity and individuality of each patient. My experience with geriatric patients has taught me the importance of patience, empathy, and holistic care.

41. How do you approach the task of delegating responsibilities to nursing assistants or other team members?

Delegating responsibilities to nursing assistants or other team members involves clear communication, trust, and supervision. I start by assessing the skills and competencies of each team member to ensure that tasks are assigned appropriately. I provide clear instructions and expectations, including any specific requirements or precautions. I encourage open communication and make myself available for questions or assistance. Regularly checking in and providing feedback helps ensure that tasks are completed correctly and to a high standard. By fostering a collaborative and supportive environment, I enable the team to work efficiently and effectively, ultimately enhancing patient care.

42. Can you talk about a time when you had to intervene in a potentially unsafe situation to ensure patient safety?

I once noticed that a patient's intravenous (IV) line appeared to be infiltrating, with signs of swelling and redness at the insertion site. Recognizing the potential risks of IV infiltration, I immediately stopped the infusion and assessed the extent of the issue. I notified the physician and prepared to replace the IV line in a different location. I also documented the incident and the actions taken to address it. By acting quickly and decisively, I prevented further complications and ensured the patient's safety. This experience highlighted the importance of vigilance and prompt intervention in maintaining a safe care environment.

43. How do you handle the challenges of working night shifts or long hours?

Handling the challenges of working night shifts or long hours requires effective time management, self-care, and adaptability. I prioritize getting adequate rest before and after shifts, creating a sleep-friendly environment to ensure quality sleep. Maintaining a consistent sleep schedule, even on days off, helps regulate my body clock. Staying hydrated, eating balanced meals, and taking short breaks during shifts support my physical well-being. I also engage in stress-relief activities, such as exercise and mindfulness, to maintain mental resilience. Building a strong support network with colleagues and fostering a positive work environment further helps manage the demands of night shifts and long hours.

44. What methods do you use to assess a patient’s pain level?

Assessing a patient's pain level involves using both subjective and objective methods. I start by asking the patient to describe their pain using a standardized pain scale, such as the Numeric Rating Scale (0-10) or the Wong-Baker FACES Pain Rating Scale for non-verbal patients or children. I also ask about the pain's location, duration, quality, and any factors that alleviate or exacerbate it. Observing the patient's behavior, such as facial expressions, body movements, and vital signs, provides additional insights into their pain experience. By combining patient self-reports with clinical observations, I can accurately assess and manage their pain.

45. How do you contribute to creating a positive and supportive work environment?

Creating a positive and supportive work environment involves fostering open communication, collaboration, and mutual respect. I make an effort to build strong relationships with my colleagues, offering support and encouragement. Recognizing and celebrating team achievements, both big and small, helps boost morale. I promote a culture of continuous learning by sharing knowledge and resources and encouraging professional development. Addressing conflicts and challenges constructively and respectfully ensures a harmonious work environment. By leading by example and maintaining a positive attitude, I contribute to a workplace where everyone feels valued and supported.

46. Can you discuss your experience with IV therapy?

I have extensive experience with IV therapy, including inserting and managing intravenous lines, administering medications and fluids, and monitoring for complications. I am proficient in using various types of IV catheters and infusion devices. My approach to IV therapy involves ensuring proper aseptic technique to prevent infections, regularly assessing the IV site for signs of infiltration or phlebitis, and maintaining accurate documentation of all IV-related procedures. I also educate patients about the purpose of IV therapy and any potential side effects. By providing careful and competent IV care, I help ensure effective treatment and patient comfort.

47. How do you approach continuing education and professional development in nursing?

Continuing education and professional development are essential for staying current in nursing practice. I regularly attend workshops, conferences, and seminars to learn about the latest advancements in healthcare. I also take advantage of online courses and webinars to expand my knowledge and skills. Joining professional nursing organizations provides access to valuable resources and networking opportunities. I seek out certifications in specialized areas of interest, such as critical care or wound care. Additionally, I engage in reflective practice, seeking feedback from colleagues and supervisors to identify areas for improvement. By prioritizing lifelong learning, I enhance my ability to provide high-quality care.

48. What is your experience with telehealth services?

My experience with telehealth services includes conducting virtual consultations, providing remote patient monitoring, and educating patients on using telehealth technologies. I have used telehealth platforms to assess and manage patients' conditions, review medications, and offer health education. Telehealth has been particularly valuable for reaching patients in rural or underserved areas, improving access to care. I ensure that telehealth visits are as thorough and patient-centered as in-person visits by using clear communication and thorough documentation. Adapting to telehealth has enhanced my ability to provide flexible and accessible care in a rapidly evolving healthcare landscape.

49. How do you handle situations where you disagree with a colleague about patient care?

When I disagree with a colleague about patient care, I approach the situation with open-mindedness and a focus on collaboration. I seek to understand their perspective by asking questions and actively listening to their rationale. I share my own observations and concerns respectfully, providing evidence-based information to support my viewpoint. If the disagreement persists, I involve a supervisor or seek a second opinion to ensure that the patient's best interests are prioritized. Maintaining a professional and respectful demeanor helps facilitate constructive dialogue and ultimately leads to better patient outcomes.

50. Can you describe a memorable moment from your nursing career that has significantly impacted you?

A memorable moment from my nursing career that has significantly impacted me was when I cared for a terminally ill patient in their final days. The patient expressed a deep fear of dying alone, and I made it my priority to ensure they felt supported and comforted. I spent extra time at their bedside, holding their hand, and providing reassurance. I also facilitated visits from their family and coordinated with the palliative care team to manage their symptoms effectively. The gratitude and peace the patient and their family expressed profoundly moved me. This experience reinforced the importance of compassionate, patient-centered care and the impact a nurse can have on someone's life during their most vulnerable moments.

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To assess the knowledge, attitudes, and confidence of caregivers and administrators towards the oral health of nursing home residents in San Antonio, Texas

• Joseph Dumbuya 1 ,
• Rochisha S. Marwaha 1 ,
• Pankil K. Shah 2 &
• Suman Challa 1  

BMC Geriatrics volume  24 , Article number:  511 ( 2024 ) Cite this article

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Metrics details

The primary objective of this research was to use qualitative methods to assess the knowledge, attitudes, and confidence of caregivers in their ability to provide oral hygiene assistance to residents. The secondary objective was to assess the knowledge and attitude of administrators on the provision of oral hygiene assistance for residents, and their confidence in caregivers’ ability to provide oral hygiene assistance to nursing home residents in San Antonio, Texas.

A semi-structured interview guide was used to conduct face-to-face interviews with seven caregivers and twelve administrative staff from ten nursing homes in San Antonio, Texas. Employees in nursing homes who are caring for residents are referred to as caregivers and those whom they care for are referred to as nursing home residents. One survey instrument was developed for the caregiver’s knowledge, attitude, and confidence toward providing oral health care, and another to assess the administrator’s knowledge, attitude, and confidence in caregivers providing oral care for nursing home residents. The interviews were recorded, transcribed, and coded for thematic content.

The findings revealed that caregivers and administrators had adequate knowledge of the connection between oral and systemic health. The administrators were confident that caregivers were adequately trained to provide oral hygiene care for residents. Caregivers had a positive attitude toward the importance of good oral health. They regularly assessed the residents’ oral health, but due to time constraints, staffing shortages, and other competing tasks providing oral health care to the residents was challenging. Most caregivers were confident in their skills in providing oral care for the residents since 85.6% agreed. On the contrary, almost half of the administrators were confident that caregivers have the necessary skills to provide oral care for residents, while 41.7% were unsure.

Conclusions

The study gave a broader insight into the provision of oral care in nursing home residents from the perspectives of caregivers and administrative staff. Administrators must provide caregivers with adequate training and time so they can provide adequate oral health care for the residents.

Peer Review reports

Introduction

Since 2012, the older adult population aged 65 and older in the United States has experienced a rising trajectory and by the year 2050, this population was projected to be around 83.6 million, almost double the estimated 2012 population of 43.1 million [ 1 ]. As recent as 2011, about 4.1% of adults over the age of 65 years live in nursing homes, and about 15% of residents 85 years and older residing in nursing homes across the United States [ 2 ]. The city of San Antonio in Texas has a population of 243,000 inhabitants above the age of 60 years, and that population was expected to double by the year 2040 [ 3 ]. Older adults in nursing homes were more susceptible to poor oral health due to negligence, which led to unnecessary delays in responding to oral health issues, eventually affecting general health [ 4 , 5 , 6 ].

Poor oral hygiene, periodontal disease, and disease-causing bacteria in the oral cavity were associated with systemic diseases such as pneumonia, cardiovascular disease, and diabetes [ 6 ]. Pneumonia accounts for 13–48% of nursing home-related infections and had a 55% mortality rate among older adults residing in nursing homes. The aspiration of bacteria secretions from the oropharyngeal space into the lower respiratory tract was the primary pathway for bacterial pneumonia infections, particularly in patients with periodontal disease [ 2 ]. Nursing home residents with chronic diseases, degenerative nerve diseases that cause dysphagia, and those who use nasogastric or percutaneous enterogastric tubes were at a higher risk of bacteria-induced pneumonia [ 7 ]. The application of effective tooth brushing techniques, regular cleaning of dentures, and routine treatment by dentists and hygienists can decrease the rate of aspiration pneumonia in nursing home residents [ 6 ].

Most nursing home residents had poor manual dexterity and were heavily dependent on the knowledge and skills of caregivers (registered nurse (RN), licensed vocational nurse (LVN), certified nursing assistants (CNA), and medical aides) to care for their oral health. For this reason, it was essential for caregivers and administrators (social workers, Nursing home administrators, directors and assistant directors of nursing (DON) to have adequate knowledge of oral health care so they can successfully care for these residents [ 8 ]. Caregivers who were knowledgeable about caring for older adults were inclined to improve the patient’s health status, which can satisfy the expectations of the patient and their families [ 9 ]. Additionally, caregivers who had adequate knowledge, positive attitude, and skills to care for older adults in nursing homes had fewer problems in meeting the job’s daily demands and responded empathetically to the daily oral care of residents [ 10 ].

The negative attitudes of some caregivers towards oral care had affected the quality of care they provide for older adults, which can eventually lead to unfavorable oral health outcomes [ 11 ]. A cross-sectional study conducted by Lui et al. (2017) found that highly educated caregivers exhibited significant knowledge of oral health and a positive attitude toward oral hygiene care for patients [ 12 ]. Goh et al. (2016) investigated the perspectives and attitudes of caregivers toward oral care and found that caregivers had positive attitudes toward providing oral care, but about 50% lacked the confidence to provide oral care for the residents [ 13 ].

The confidence of caregivers in the delivery of oral healthcare can affect the caregiver’s ability to perform clinical tasks, quality of care, and patient’s oral health outcomes, and potentially further impact their relationships with patients and the healthcare team [ 14 ].

Studies had been performed to assess caregivers’ knowledge, attitudes, and practices regarding the oral hygiene assistance of nursing home residents internationally [ 12 , 15 , 16 ]. However, there were no reported studies regarding the assessment of the knowledge, attitudes, and confidence of caregivers in the provision of oral hygiene assistance to nursing home residents in the United States. This study aims to address the gaps in the literature regarding the beliefs and behaviors of caregivers and administrative staff in the provision of oral hygiene assistance for nursing home residents in San Antonio, Texas, and provide a new perspective for future studies. The primary objective of this research was to use qualitative methods to assess the knowledge, attitudes, and confidence of caregivers in their ability to provide oral hygiene assistance to residents. The secondary objective was to assess the knowledge and attitude of administrators in the provision of oral hygiene assistance for residents, and their confidence in caregivers’ ability to provide oral hygiene assistance to nursing home residents in San Antonio, Texas.

This research was deemed exempt (protocol number: 20210714NRR) by the Institutional Review Board (IRB) at the University of Texas Health Science Center in San Antonio. Twenty nursing homes in San Antonio that were affiliated with the University of Texas Health San Antonio School of Dentistry were randomly selected and invited to participate in the study. Out of twenty nursing homes invited to participate in the study, only 10 agreed to allow their staff to participate in the study. Nursing homes in San Antonio vary in size with 20–30 caregivers and 3–5 administrators per site. The study population included caregivers and administrators working at nursing homes or long-term care facilities in San Antonio, Texas. Registered nurses (RNs) licensed vocational nurses (LVNs), certified nursing assistants (CNAs), and medical aides are referred to as caregivers while social workers, nursing home administrators, directors, and assistant directors of nursing were referred to as administrators. Out of 250 caregivers and 40 administrators from 10 nursing homes who were eligible for the study, we were only able to recruit 7 caregivers and 12 administrators using a non-probability convenience sampling method. This study was conducted during the COVID-19 pandemic, so it was difficult to get more than 19 volunteers to participate in the study.

All caregivers and administrators who had worked at the nursing homes for at least three months, were 18 years and older, communicated in the English language, and voluntarily consented to participate in the study were eligible to participate. The participants who did not meet the inclusion criteria were excluded from the study. Also, participants provided informed consent by signing a consent form when they arrived at the interview location and before engaging in the interview. The participants were not offered any incentives for their involvement in the study.

A semi-structured interview guide developed from previous oral healthcare-related studies [ 17 , 18 , 19 , 20 ] that examined the knowledge, attitudes, practices, and confidence of various populations regarding oral healthcare was used to conduct face-to-face interviews with caregivers and administrators at nursing homes in San Antonio. Two different survey instruments were used for interviewing the caregivers and administrators. The first part of the interviews collected demographic data for the participants, such as age, gender, experience, and education. The following sections included questions to assess the knowledge of caregivers and administrators regarding oral health and their attitudes regarding the provision of oral care for nursing home residents. The final sections focus on assessing the caregiver’s confidence and administrators’ confidence in caregivers providing daily oral care for residents.

Each interview was conducted in a private space to maintain the confidentiality of the participant and lasted for 20–30 min. The interviewer obtained written informed consent before the interview, and the interviewer asked all the questions including the demographic questions. The interviews were conducted between October 2021 and January 2022 by a member of the research team and digitally recorded on an encrypted laptop, with only the research team having access to it. Data collected from study participants were stored in a safe and locked storage space at the University. The identity and confidentiality of the participants and collected data were protected throughout the study procedures.

Interviews were digitally recorded, transcribed, and hand-coded to form themes by one team member, and a qualitative data management software technology MAXQDA was used to code and generate themes by another team member using calibration among coders. The themes were compared between the two coders and a third member of the team broke the tie if the coders disagreed on t theme. The confidence-based questions were categorized on a 5-point Likert scale as it allows for a lower margin of error and provided a deeper insight. The themes gleaned from key-informant interviews were explored among team members which were followed by a discussion for quality assurance purposes.

The demographic data of caregivers ( N  = 7) and administrative staff ( N  = 12) from 10 nursing homes across San Antonio is shown in Table  1 .

Most of the study participants were female (79%), more than half of the caregivers had a high school education, and (43%) had an associate degree. All the administrators had an associate degree or higher and the participants’ mean work experience was 13.8 years.

Both the hand-coded and the MAXQDA software data analysis of the Interview data on the knowledge questions resulted in the themes, the connection between oral and systemic health, and training in oral health and oral healthcare. Interview data on attitudes resulted in the themes, the importance of good oral health, caregivers’ time constraints, and assessment of residents’ oral health.

Themes related to oral health knowledge-based questions

Theme 1: The connection between oral and systemic health : Most caregivers and staff understood the connection between oral and systemic health. They were aware that most nursing home residents had two or more morbidities some of which may lead to mortality if not treated accordingly. Their understanding of the connection between systemic and oral diseases such as diabetes, cardiovascular disease, and the side effects of certain medications on oral health has incentivized caregivers to care for the resident’s oral health to prevent the systemic spread of disease.

“At their age, if they (resident) get a tooth infection, that can travel through their bloodstream…and the resident needs to understand that. ” Caregiver.

“If you have poor oral hygiene, it can lead to infections in your system. You can get pneumonia; I think you can get it from poor oral health. It’s like a big problem: the chain of events that can lead to other things.” Administrator.

“The mouth is the gateway to your heart and the condition of your mouth will tell a lot of things about your health in general. If you are not getting good oral care, you are going to get more health issues as you progress in life, especially if you are elderly. “Administrator.

“If a resident has an infection from a tooth, it can travel throughout their body and may cause death…. I know in the past, we had problems with a patient because of tooth infection, which led to other issues with their health.” Administrator.

Theme 2: Training in oral health : Caregivers and administrators mentioned that they need more training to improve their oral health knowledge and learn new techniques to work with residents on ventilators and those with dementia who sometimes refuse or resist care. They also indicated that receiving continuing education (CE) on oral care will raise their level of awareness, increase their confidence in the delivery of oral care and hygiene, and improve health outcomes. One administrator also stressed the need to improve the curriculum of the certified nursing assistant (CNA) programs so they can get more hours of oral health education.

“More training will help a lot because sometimes we try different ways to do it, but it does not work out, so we need more information, and more training because dental care is very important.” Caregiver.

“I have been an instructor for the CNA program, and I know the training is good. If it comes from a dentist, it will probably be better regarding what the resident needs. But it is not something we can offer at this time. The training is there, but it is probably not as accepted as it should be, which needs improvement.” Administrator.

“There would be some new people coming in and may need more training on brushing teeth and doing denture care; some may be different from others. I am all up for new training and learning new things.” Caregiver.

“We need more training on the provision of oral care for residents, we need more individuals who are confident enough to train caregivers to provide oral hygiene assistance for residents. Oral care is an expertise so we need more education on that.” Administrator.

In response to the attitude-based questions, the themes that emerged were the importance of good oral health, caregivers’ time constraints, and residents’ oral health assessment.

Themes related to oral health attitude-based questions

Theme 3: The importance of good oral health : Almost all participants stressed the importance of good oral health and its impact on the residents’ overall health and well-being. They acknowledged that good oral health enables residents to consume their food adequately and absorb critical micronutrients, which were essential for the growth and function of their immune cells. Administrators believed that residents with compromised immune systems were more susceptible to chronic diseases that can be fatal. Good oral health can prevent aspiration pneumonia and other chronic diseases prevalent in nursing homes.

“Good oral health contributes to the health of the body. If you have good oral health, you tend to eat more, better, and more adequately. You will also be more likely to take your medication and be more outgoing because you feel comfortable about how you look.” Caregiver. “Residents with good oral health may have better health outcomes and be in a good mood. Good oral health makes them a whole different person, they can eat better, and their health is better.” Administrator. “In this nursing home, good oral health was essential because many patients were under ventilator and gastrostomy. Good oral health will decrease their risk of aspiration pneumonia, which was a horrible thing sometimes, we have here.” Administrator. “I think good oral health is important, especially for those who cannot do oral care because their disease process does not allow them to remember how to do it. It was also important for the caregivers to do it daily, and the family needs to see that oral care was performed and they are not going to visit their loved one and see food in their teeth… or a bad odor coming from their mouth.” Administrator.

Theme 4: Caregiver’s time constraints :. Prior to the coronavirus pandemic, some nursing homes had a proportion of 14 residents per caregiver. This situation worsened during the pandemic because nursing homes were competing with hospitals to employ caregivers. Almost all the caregivers and administrators stated that the shortage of caregivers, staff taking time off from work, absenteeism, and other competing tasks limited the time caregivers must provide oral care for the residents.

“Sometimes we have no time to care for the oral health of the residents. We have like 60 patients and 2 or 3 people to care for them, so we have no time.” Caregiver. “I don’t think they had enough time. I had always thought you had 30 patients in a hallway, and you only had two CNAs. They usually split it, and most of them require two persons’ help, limiting their time with all the chores they must do to take care of the patients.” Administrator. “I don’t think they are allowed enough time. If you have call-ins and you cannot get somebody to come in, then they are working short… they must be on that routine base, and they had to make sure they cover the shift and provide care for all the residents.” Administrator. “Making sure that caregivers had enough time to do their work is a challenge. Time management is everything but it also depends on what going on with your patients, what is going on in the hall, and how you are staffed, it depends on lots of things coming into play.” Administrator. “Our ratio of patient to caregiver is probably 1:12 and if they experience call-ins or no show then the ratio will increase from there so it is really hard to provide good oral hygiene if you are rushing from one patient to the next. Also, some of our resident’s caseloads just grow if there was a shortage of staffing and we don’t feel we had enough time as each day fluctuates. “Administrator.

Theme 5: Assessment of residents’ oral health : The state of Texas regulatory services for nursing homes requires that nursing home residents participate in an annual health screening to assess their oral health status so that nursing home administrators can plan and facilitate the provision of oral care for residents. Initial oral health assessment of newly admitted residents was also required for all nursing homes, served as a baseline, and was essential for planning and treating chronic oral diseases. Additionally, the regular assessment of the resident’s oral cavity helped caregivers determine the type of diet (soft or regular) that was suitable for the resident and subsequently enabled the nutritionist to plan the resident’s diet accordingly.

“As part of the initial assessment process, we examined the resident’s oral cavity to determine if they had total or partial dentures so we can plan for their oral care.” Caregiver. “We do initial oral health assessment for the residents upon arrival to our facility…. the nurses check their oral mucosa, gums, teeth, check for oral sores, thrush, and a partial denture or edentulous so we can carefully plan for the resident’s oral care and food type.” Administrator. “They had to assess the oral health of residents and if there were any oral issues they (caregivers) must report to the doctor, social worker, or director of nursing so they can attend to their needs.” Administrator. “We had to assess the resident’s oral cavity for missing teeth, chipped teeth, full or partial dentures… upon admission and document it. If we fail to identify any existing oral problems upon admission and something happens later then it will be our responsibility to care for that. So, it is important that we do an initial and regular assessment of the resident’s oral health.” Administrator.

Confidence of caregivers and administrators in the provision of oral health care

Confidence of caregivers relates to their confidence in the provision of oral care for residents. Administrators’ confidence in the provision of oral care relates to their confidence in their caregiver’s provision of oral health care.

The responses to the confidence-based questions for seven caregivers were based on a 5-point Likert scale (Table  2 ).

In response to questions on caregivers’ skills and denture care for residents, most caregivers agreed that they were confident in their skills to provide oral care (85.6%) and denture care (71.3%) for the residents, respectively. When asked about their confidence in providing oral care to resistive residents and discussing the harmful effects of tobacco use with the residents, most caregivers agreed that they were confident in working with combative residents (85.6%) and discussing tobacco use (57%) respectively.

The responses to the confidence-based questions for twelve administrators were also based on a 5-point Likert scale (Table  3 ).

The administrators were asked about caregivers’ confidence in providing adequate care for the residents and whether their diet contained essential nutrients for optimal oral health. Most of the administrators were confident that caregivers provided adequate care for the residents (66.7%) and that the resident’s diet contained all the nutrients to maintain optimal oral health (75%). In response to the question on caregivers’ skills to provide oral care, half of the administrators (50%were confident that their caregivers had adequate skills to provide oral care for residents, while 41.7% were unsure. Regarding training, administrators were confident that caregivers were adequately trained since 50% agreed with the statement.

To the best of our knowledge, this is the first study conducted in the United States that assessed the knowledge, attitudes, and confidence of caregivers and administrators in the provision of oral care for nursing home residents. Our findings showed that caregivers and administrators have adequate knowledge about the connection between oral and systemic health which is broadly consistent with previous studies [ 21 , 22 ]. A 2009 study to evaluate the importance of oral health in nursing homes revealed that older adults were more susceptible to chronic systemic diseases that can affect their overall health, and periodontal disease has been linked to systemic conditions through inflammatory processes [ 21 ]. In our study, caregivers and administrators were knowledgeable about the connection between oral and systemic health and that infection in the oral cavity can metastasize to other body organs through the bloodstream. They also understood that poor oral hygiene can lead to aspiration pneumonia prevalent among nursing home residents.

Another theme that emerged from the study was the need for more training for caregivers in providing oral care for the residents, which was consistent with previous studies [ 23 , 24 , 25 ]. Although caregivers and administrators were knowledgeable about oral health, a vast majority of caregivers requested continuing education (CE) to improve their knowledge and enhance their skills in providing oral healthcare for hostile and resistant patients. Additionally, almost half of the administrators felt that caregivers were adequately trainedto provide oral care for residents. Administrators who were responsible for planning and implementing CE programs for caregivers stated that they could not offer such programs due to staffing shortages, lack of time, and logistical challenges involved in implementing such programs. As a result, they are highly dependent on the oral care knowledge the Certified Nursing Assistants (CNAs) acquired from their CNA training programs which may be insufficient.

Caregivers’ time constraints emerged as a significant barrier to providing care for residents, consistent with other studies (23–24,). In this study, nearly all the administrators agreed that the caregivers lack sufficient time to provide oral care for the residents due to competing tasks, and staffing shortages leading to 1 caregiver caring for 8–10 residents at a time. Additionally, it was time-consuming to provide care for residents with dementia and combative residents. In a systematic review of studies on the knowledge, attitudes, and beliefs acting as barriers and facilitators for the provision of oral care, the authors found that it takes plenty of time to provide oral care to combative patients [ 26 ]. On the contrary, in a 2011 cross-sectional study performed in Sweden, the authors found that the nursing staff believed they had sufficient time to perform oral care practices [ 27 ].

Both caregivers and administrators understood the importance of good oral health which was consistent with previous studies [ 20 , 28 ]. Coleman (2002) found that effective oral care practice was about recognizing the importance and ensuring that daily oral hygiene care was given similar priority as bathing residents, combing their hair, administering medication, and other care practices [ 28 ]. In this study, caregivers believed that oral care was essential for nursing home residents, especially those on ventilators and gastrostomy. Residents with gastrostomy cannot be fed through the oral cavity resulting in neglect of oral care. Maeda and Akagi (2014) found that patients with limited oral intake or tube feeders need meticulous oral care to reduce poor clinical outcomes related to aspiration pneumonia [ 29 ].

Most participants revealed they must perform an initial assessment of the resident’s oral health before admission to their facility and whenever they complain of toothache. Some participants also explained that they sometimes could not adequately assess the resident’s teeth and periodontal structures due to a lack of cooperation by the residents. In a study performed in 2009, the authors stated that oral care was i not always adequately evaluated during assessments of the general health of residents due to lack of patient cooperation, time, restricted mouth opening, unpleasant nature of the task, lack of training, and knowledge [ 21 ].

Our study indicated that most of the caregivers agreed that they were confident in their skills in providing oral and denture care for the residents. However, administrators were confident in the caregiver’s ability and skills to provide oral and denture care for the residents. This is consistent with a 2014 study that reported that more caregivers felt confident in assisting residents with brushing their teeth than with flossing [ 30 ]. However, a cross-sectional study found that half of the caregivers lack confidence in providing oral care because of fear of harming the patient [ 13 ]. In our study, caregivers mentioned their challenges with providing oral care for residents on ventilators, but their experience had given them the confidence to provide adequate care.

One of the strengths of this study is that the interviews were conducted by a dentist who had no prior encounter with the participants, making it possible for participants to respond to the questions openly thereby reducing the potential for bias. Another strength of the study was that using qualitative methods provided insights into the attitudes of the respondents and why they agreed or disagreed with some of the questions and comments. Despite several strengths of this study, there were some limitations.

The study used a convenience sampling method to recruit participants, which may have led to selection bias. Most of the participants in the study were those who wanted to see positive change in the provision of oral care for residents, which may have accounted for response and social desirability bias. Participants may not have felt comfortable talking about their lack of confidence and abilities to a dentist for fear of being judged by an oral health expert, especially a dentist. They may have felt pressured to give good answers to look competent in the eyes of a dentist. Another limitation is that caregivers who volunteered to participate in the study may have been those who felt confident with their knowledge and skills, thus overestimating the caregiver’s knowledge and skills compared to the general caregiver population. Participant recruitment was a major challenge due to staffing shortages and COVID-19 restrictions in nursing homes. On several occasions, scheduled interviews with participants were canceled due to COVID-19 outbreaks and other emergencies which inadvertently prolonged the time for data collection. Although we assumed the sample is representative of nursing homes throughout Texas, the findings of this study may not be generalized to all nursing home residents in the United States due to possible differences in the regulation of oral care in nursing homes across states. Lastly, the question of whether caregivers had adequate time to perform oral hygiene care was not included in the survey instrument thereby limiting caregivers’ responses to the lack of adequate time to perform their daily tasks.

The study gave a broader insight into the provision of oral care in nursing homes from the perspectives of caregivers and administrative staff. Administrators must provide adequate training and time to caregivers so they can provide adequate oral health care for the residents. Future research must be undertaken to investigate the role of nursing home administrators in the provision of oral care for residents.

Public health recommendations

Implementation of a national policy for the provision of oral care for residents in long-term care settings, standardization of procedures coupled with an effective auditing system for compliance is indicated. In addition, nursing home authorities should be able to recruit and retain more caregivers through collaborative efforts with nursing training schools within the community to eliminate the problem of staffing shortages. We suggested that the oral care component of the curriculum of the CNA programs should be upgraded and enhanced in addition to being instructed by dental professionals. Lastly, nursing homes should consider appointing a dental champion who can coordinate continuing education and provision of oral hygiene and care for residents, especially those without dental insurance.

Data availability

The data that supports the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to acknowledge the participating nursing homes and staff who contributed their time and effort to this work. We also appreciate the support from co-resident Girish Shelke.

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Dumbuya, J., Marwaha, R.S., Shah, P.K. et al. To assess the knowledge, attitudes, and confidence of caregivers and administrators towards the oral health of nursing home residents in San Antonio, Texas. BMC Geriatr 24 , 511 (2024). https://doi.org/10.1186/s12877-024-04784-x

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