Harvey, M. and Land, L. (2017) Research methods for nurses and midwives. Los Angeles: Sage Publications. Process maps are diagrams that set out each step of what is presently happening to detect problems in the system. Solutions to the problem can be identified using driver diagrams. Beauchamp, T. and Childress, J. (2012) Principles of biomedical ethics (5 th ED) New York: Oxford University Press. Charalambous, C., Koulouri, A., Roupa, Z., Vasilopoulos, A., Kyriakou, M. and Vasiliou, M. (2019) ‘Knowledge and attitudes of nurses in a major public hospital in Cyprus towards pressure ulcer prevention’, Journal of Tissue Viability, 28(1), pp.40-45. A literature search should be conducted to generate an overview of the guidance and evidence relating to the topic, for inclusion in the writeup.

Streubert H. J., Carpenter D. R. (2011). Qualitative research in nursing: Advancing the humanistic imperative (5th ed.). Philadelphia: Wolters Kluwer. [ Google Scholar] LoBiondo-Wood G., Haber J. (2014). Nursing research, methods and critical appraisal for evidence-based practice (8th ed.). St. Louis, MI: Mosby. [ Google Scholar] Patterson B., Morin K. (2012) Methodological considerations for studying social processes. Nurse Researcher, 20, 33–38. [ PubMed] [ Google Scholar] Research methods are the ‘blueprint’ of the study, they decide how research will be conducted and how data will be gathered (Coughlan et al., 2013). They should be detailed within the methods section, including why the researcher has chosen the particular design (Gray et al., 2017). Evaluation of the studies suggested that they adopted appropriate research governance when conducting their individual researches. In-line with the World Medical Association Declaration of Helsinki (2014), the authors ensured that their studies were approved by their individual human research ethics committee. Additionally, to protect the participant’s rights and welfare, the ethical standard was upheld by the researchers as each participant was informed of the aim of the study, and both oral and written consent was also obtained from them. This was to enable the participants to make a voluntary decision either to accept or decline to participate in research (Peter, 2015). Also, confidentiality was ensured as there was a de-identification of the participants during data entry into the electronic secured database, and this is in line with the ethical principles in conducting research (Parahoo, 2014; Novak, 2014). Effective use of the research ethics is part of promoting patient’s rights, thereby observing the Helsinki’s Declaration. Beauchamp and Childress (2012) stressed that research ethics of autonomy is upheld when participants can independently decide whether to participate in a research or not. In view of the four studies, they respected the right to patient’s autonomy and ensure their safety during the research process. Carlsson and Gunningberg (2017) study elaborated more on transparency, as it provided the participants with options to voluntarily withdraw from the study at any time without explanation.To choose a topic for the QIP, trainees may consider an area of practice that impacts patient safety that they feel strongly about. Alternatively, inspiration can be taken from a patient complaint or significant event.Trainees should be able to give reasons for their choice of QIP. Barakat-Johnson, M., Lai, M., Wand, T. and White, K. (2019) ‘A qualitative study of the thoughts and experiences of hospital nurses providing pressure injury prevention and management’, Collegian, 26(1), pp.95-102. McCabe J. L., Holmes D. (2009). Reflexivity, critical qualitative research and emancipation: A Foucauldian perspective. Journal of Advanced Nursing, 65, 1518–1526. [ PubMed] [ Google Scholar] Coughlan, M., Cronin, P. and Ryan, F. (2013). Doing a Literature Review in Health and Social Care. London: Sage. The goal of the researcher is to provide an account of the “experiences, events and process that most people (researchers and participants) would agree are accurate” ( Sullivan-Bolyai et al., 2005, p. 128). The focus on producing rich description about the phenomenon from those who have the experience offers a unique opportunity to gain inside or emic knowledge and learn how they see their world.

As the four studies were conducted in different countries, the nurse’s cultures, values, beliefs about management and prevention of PUs may be different from the experience and knowledge of the nurses in the United Kingdom (UK). Therefore, one will be cautious while applying the findings to the healthcare settings in the UK as there may be differences in the PU treatment guidelines, protocols and policies. The International Council for Nurses (ICN) emphasis on the need for nurses to apply the evidence from clinical literatures which have an informed basis for their clinical decisions (ICN, 2012). Adoption of evidence-based practice (EBP) by the nurses is vital because they are directly involved in the management and treatment of PUs as part of a multidisciplinary team approach in various healthcare settings (Lehane et al., 2018). However, King Funds(2018) argues thatalthough the guidelines and research evidence are used in the management of PU’s in the UK, the quality of the treatment provided by individual nurses varies. As a result, there is a need to explore the attitude and knowledge of nurses on prevention and treatment, as well as the barriers which impact on the nurse’s management of PUs. National Institute for Health and Care Excellence (NICE, 2018) guideline emphasised on transparent treatment, quality improvement and outcome measurement. The guideline enables the nurses to improve healthcare and reduce inequalities in health treatment by effective adoption of evidence-based practice (EBP). Hence, the effective application of EBP in healthcare management is crucial in reducing avoidable PUs and promoting patient safety. This is important as research findings aids improvement of policies and practices in nursing, and research evidences help to reduce the rate and risk of PU development in patients and provides the necessary support needed for the treatment ( Lehane et al., 2018). Dowling, R., Lloyd, K. and Suchet-Pearson, S. (2017) ‘Qualitative methods III’, Progress in Human Geography, 42(5), pp.779-788.Kaiser, B., Thomas, G. and Bowers, B. (2016) ‘A Case Study of Engaging Hard-to-Reach Participants in the Research Process: Community Advisors on Research Design and Strategies (CARDS)’, Research in Nursing & Health, 40(1), pp.70-79.

This framework works well with quantitative research, for qualitative research an alternative framework SPICE is preferred, as it allows for perspectives to be incorporated (Booth et al., 2016). There are also variations of the PICO; PICOT, including time frame, PICOS, including study type and PICo. The question formulated will decide on the most applicable framework.When conducting quality improvement in healthcare, a useful framework is the Model for Improvement. This considers what the QIP is trying to achieve, how it will be known if a change resulted in an improvement, and what changes are necessary to satisfy the objective. Savin-Baden M., Howell Major C. (2013). Qualitative research: The essential guide to theory and practice. Oxon, UK: Routledge. [ Google Scholar] Essay to demonstrate an understanding of research methodologies and ethical principles underpinning research. Danby S., Farrell A. (2004). Accounting for young children’s competence in educational research: New perspectives on research ethics. The Australian Educational Researcher, 31( 3), 35–49. [ Google Scholar]

Van den Besselaar, P. and Sandström, U. (2017) ‘Vicious circles of gender bias, lower positions, and lower performance: Gender differences in scholarly productivity and impact’, PLOS ONE, 12(8), pp.234-238.Caelli K., Ray L., Mill J. (2003). “Clear as mud”: Toward greater clarity in generic qualitative research. International Journal of Qualitative Methods, 2( 2), 1–23. [ Google Scholar] There is a myriad of qualitative approaches to research. Yet, the researcher may be confronted with a question or a topic that belongs within the qualitative paradigm but does not correspond neatly with approaches that are well documented and clearly delineated. Within the literature, various terms have been used to describe research that does not fit within a traditional qualitative approach. Thorne, Kirkham, and MacDonald-Emes (1997) define “interpretive description” as a “noncategorical” qualitative research approach (p. 169). Merriam (1998) refers to this type of research as “basic or generic qualitative research” (p. 20) and Sandelowski (2000, p. 335, 2010) explores what she calls “basic or fundamental qualitative description.” Exploratory research is the umbrella term used by Brink and Wood (2001) to describe all description qualitative research and suggest it “is a Level 1 research endeavor” (p. 85), and Savin-Baden and Howell Major (2013) refer to a pragmatic qualitative approach. This interchangeable use of terms creates ambiguity and confusion in relation to qualitative description research as a methodology in its own right. Reference to “interpretive” as described by Thorne et al. (1997) can cause confusion with phenomenology, for example, and Savin-Baden and Howell Major’s (2013) use of a “pragmatic qualitative approach” might suggest that if all else fails, the researcher should adopt a pragmatic approach. How to do a Quality Improvement Project [Internet]. Royal College of General Practitioners. [cited 17 May 2021]. Available from: https://www.rcgp.org.uk/-/media/Files/GP-training-and-exams/WPBA/QIP/RCGP_How_to_do_a_QI_project.ashx?la=en