Research proposal title: How does the RUSON project at a Metropolitan Melbourne Cancer Centre improve the care provided to adult oncology patients and their families, in comparison to not having the project?
It has been recorded that 1 in 2 Australian men and women will be diagnosed with Cancer by the time they turn 85 (Cancer Council, 2019). Statistics provided by the Australian Institute of Health and Welfare also recorded that there were over 1.2 million cancer-related hospitalizations in 2016 and 2017 which accounted for approximately 1 in 9 hospitalizations in Australia (Australian Institute of Health and Welfare 2019. Cancer in Australia., 2019). Previous research conducted based upon the views of oncology patients suggests that health status, individualized care, and nursing care quality were all found to be improved when patients had more of a trusting relationship with the healthcare professionals “trust in nurses is influenced by the provision of individualized care” (Charalambous et al., 2016). Oncology patients are also highly subjected to experiencing major symptoms of fatigue, depression, and anxiety when it comes to their illness and their treatments (Kim & Na, 2017) therefore it is vital that nurses and other healthcare professionals deliver intensive care and support to oncology patients and their associated family members. The Registered Undergraduate Students of Nursing (RUSON) model is a program implemented to employ 2nd and 3rd-year students to start general nursing care activities under the direction of registered nurses. “Students are employed in a role which complements their studies and, in turn, supports the provision of more timely care whilst also relieving workload pressure for the nursing team.” (Australian Nursing and Midwifery Federation. (2018). The RUSON program could be the answer for oncology patients in metropolitan Melbourne cancer centres in regard to establishing the support needed for the oncology patients and their families to better improve their mental, physical and social wellbeing through treatment.
How does the RUSON project at a Metropolitan Melbourne Cancer Centre improve the care provided to adult oncology patients and their families, in comparison to not having the project?
To understand how the RUSON project improves patient care (if at all) to adult oncology patients and identify the aspects of care that have improved or decreased. This will enable stakeholders of the project to assess whether the project has been successful in improving patient care, and thus help identify in the future whether a RUSON project should be taken on.
The research will be conducted using the qualitative method of focus group interviews with hospital staff, patients and their families who are inpatients on the adult oncology wards. The rationale for conducting focus groups is that it helps researchers understand the perspectives and opinions of a particular group on a particular topic (Jayasekara, 2012). In this case, it will help understand how the staff, patients and their families believe the RUSON project has benefitted and improved patient care on the ward (if at all). There will be 9 focus group interviews conducted, to ensure data saturation is achieved (Guest, Namey, McKenna, 2016). The categories include hospital staff, patients, and family members. Each focus group will be run with groups of 4 participants for each category. Having separate categories will enable participants to discuss in confidence their opinions, for example, families may feel uncomfortable talking about how their burden of care has decreased in front of their loved one. The focus groups will be held two weeks after the RUSON project has begun, in order to enable participants to compare how the project has impacted care. The questions asked will be open-ended engagement questions to facilitate discussion among the group (Engard 2017), while exploration questions will be used to delve deeper into the reasons why/why not care has improved, and in what aspects (Engard 2017). The focus groups will be held on-site at the hospital to enable easy access to participants and will be audio recorded with transcripts written up afterwards. Thematic analysis will be used to identify the common themes that arose in the focus groups, which will help identify common beliefs among the population interviewed in order to answer the research question (Maguire & Delahunt, 2017). This data will then be analyzed to discover whether there was more positive or negative feedback of care provided, in order to determine whether the project improves patient care.
Informed consent must be acknowledged by the participants prior to the beginning of the research (National Health and Medical Research Committee, 2018). Consent is the process of participants of the research learning the facts and process of a research project before deciding whether to take part (Bowrey & Thompson, 2014). Non-maleficience is another ethical consideration nurses must abide by when conducting research, meaning to do no harm (National Health and Medical Research Committee, 2018). To abide by this ethical consideration, follow up care should be provided that takes into account the conduct of the research (National Health and Medical Research Committee, 2018). Due to working with people who have dealt with cancer, the research raise any difficult emotions or memories, so for this project the follow up care may involve debriefing and a follow up call with a mental health nurse. Due to the method outlining the process of an audio recording of the interviews, safe storage of this data needs to be considered due to privacy and confidentiality of the participants (National Health and Medical Research Committee, 2018). This media must be stored correctly and securely, de identified as much as possible, and only to be handled by authorized staff members (National Health and Medical Research Committee, 2018).
Benefits of a registered undergraduate student of nursing on the oncology ward can have the anticipated benefits of diminishing the fatigue and stress of the nurses. Encouraging readily available time for the nurses to focus on patient care. With the anticipated benefits of improved care provided on the wards with the addition of RUSON’s, it would be probable that undergraduate students have an increased ability to practice their hands-on skills in the hospital environment outside of short periods of placement. Studies have shown that compassion, caring, and empathy are required attributes for a nurse to learn. (Percy, Richardson & Hughes, 2015). Skills as well as building a therapeutic relationship with patients is a potential anticipated benefit to the RUSON’s as working within a hospital environment and having time to talk to the patient can create and reinforce confidence for their future practice.
The hospital’s vision statement states to strive for excellence coinciding with evidence-based clinical practice also providing a patient-centred practice. This research project has the anticipated benefits of making sure that within the nursing sector of patient care this is delivered with the RUSONS working alongside nurses to adhere to this vision of hospital used for this study. In addition, this pilot program will help other healthcare facilities have the ability to assess the research and the successes it brought, and decide whether to implement the RUSON project on their wards.
This pilot program has the research benefits of the future of nursing care towards oncology patients, that from this program it is anticipated that patients will greatly benefit with an extra pair of hands, as well as another set of ears to listen to their needs. As stated that ‘Patient of older age and that of more critical care are greatly vulnerable during hospital stays’ (Urden, Stacy and Lough, 2018). By also creating this pilot program it is also increasing student interest in the oncology sector of nursing. Lastly this pilot program with add to the body of knowledge in nursing research. Particularly on the topic of the impact of having RUSON’s on the ward- an area of knowledge that is lacking research studies to determine their effectiveness.
- Australian Institute of Health and Welfare. (2019). Australian Institute of Health and Welfare 2019. Cancer in Australia: In brief 2019. [Ebook] (p. 11). Canberra. Retrieved from https://www.aihw.gov.au/getmedia/f4f2b22f-8189-4c51-9e2a-66384cbca683/aihw-can-126.pdf.aspx?inline=true
- Australian Nursery and Midwifery Federation. (2018). Work as a nurse while you study. Retrieved from https://otr.anmfvic.asn.au/articles/work-as-a-nurse-while-you-study
- Bowrey, S., & Thompson, J. P. (2014, Jan). Nursing Research: Ethics, consent and good practice: NT. Nursing Times, 110, 20-3. Retrieved from https://search-proquest-com.ezproxy.lib.swin.edu.au/docview/1493807636/fulltext/4566D9EDC78B475BPQ/1?accountid=14205
- Cancer Council. (2019). Facts and Figures – Cancer in Australia. Retrieved from https://www.cancer.org.au/about-cancer/what-is-cancer/facts-and-figures.html
- Charalambous, A., Radwin, L., Berg, A., Sjovall, K., Patiraki, E., & Lemonidou, C., Katajisto, J., & Suhonen, R. (2016). An international study of hospitalized cancer patients’ health status, nursing care quality, perceived individuality in care and trust in nurses: A path analysis. International Journal Of Nursing Studies, 61, 176-186. doi: 10.1016/j.ijnurstu.2016.06.013
- Cranmer, P., & Nhemachena, J. (2013). Ethics for Nurses (1st ed., p. 55). Berkshire: Open University Press.
- De Kors, N. (n.d). Nurse Helping Patient Photo [Image]. Retrieved from: https://burst.shopify.com/photos/nurse-helping-patient?q=cancer+patient
- Engard, B. (2017). How to create effective focus group questions. Retrieved from: https://online.jefferson.edu/business/create-effective-focus-group-questions/
- Guest, G., Namey, E., McKenna, K. (2016). How Many Focus Groups Are Enough? Building an Evidence Base for Nonprobability Sample Sizes. Field Methods, 29(1), 3-22. doi: 10.1177/1525822X16639015
- Jayasekara, R. (2012). Focus groups in nursing research: Methodological Perspectives. Nursing Outlook, 60(6), 411-416. DOI: 10.1016/j.outlook.2012.02.001
- Kumar, R., Kumari, L., & Kumar, V. (2016). Ethical consolidations in medical practice and research. Journal of Evolution of Medical and Dental Sciences, 5(7), 343+. Retrieved from http://link.galegroup.com.ezproxy.lib.swin.edu.au/apps/doc/A469639374/AONE?u=swinburne1&sid=AONE&xid=06065f56
- Maguire, M., Delahunt, B. (2017). Doing a Thematic Analysis: A Practical, Step-by-Step Guide for Learning and Teaching Scholars. All Ireland Journal of Teaching and Learning in Higher
- National Health and Medical Research Council. (2018). National Statement on Ethical Conduct in Human Research. Canberra, Australia: Commonwealth of Australia.
- Percy, M., Richardson, C., & Hughes, J. (2015). Introducing nursing practice to student nurses: How can we promote care compassion and empathy (35th ed.). Elsevier.
- Princeton University. (2019). Research Integrity & Assurance: Best Practices for Data Analysis of Confidential Data. Retrieved from https://ria.princeton.edu/human-research-protection/data/best-practices-for-data-a
- Urden, D, L., Stacy K, M., & Lough E, M. (2018). Critical Care Nursing. (8th ed.). Retrieved from https://books.google.com.au/books?hl=en&lr=&id=VIglDgAAQBAJ&oi=fnd&pg=PP1&dq=Urden,+D.,L,+Stacy,+M.,+K,+Lough,+E.,+(2017)+Critical+Care+Nursing:+Diagnosis+and+Management&ots=jQvgPeayNf&sig=YuBlFHQdhwdjqQp5X7wmtRKcUPc#v=onepage&q=Urden%2C%20D.%2CL%2C%20Stacy%2C%20M.%2C%20K%2C%20Lough%2C%20E.%2C%20(2017)%20Critical%20Care%20Nursing%3A%20Diagnosis%20and%20Management&f=false
- VGstockstudio. (n.d). Cancer Patient on a Wheelchair [Image]. Retrieved from:https://www.shutterstock.com/image-photo/cancer-patient-on-wheelchair-woman-daughter-1180040659
Working within a group can be a difficult task, as students oftentimes balance coursework with part-time work and other assignments. Making time to meet with groups and also coordinating workload can proliferate many ancillary issues. Nonetheless, doing this research assignment as a group was a well put initiative, as it put four minds together to come up with a collaborative research proposal. Developing a good group work ethic is important within the field of nurses, as well as any workplace. Within the field of nursing research, group work is imperative, as a hospital is a smooth running bee hive incorporating a plethora of different functionalities in varying modalities.
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Group work presents as a highly effective approach to research, as multiple minds tend to generate more innovative ideas for a project. Globally, it is recognised that group work is an effective aspect of delivery for patient-centred care within a nursing environment (Babiker, A et al, 2014). More specifically, it is by employing a diverse approach to research that group work fosters effective collaboration and in this way produces more high-level delivery. On a more practical level, the quantifiable product of group work includes a wider pool of ideas, as well as a more assorted variety of ideas. In this way, group work seems to remedy human inequities with covering all the fields within a blooming landscape of ideas. Specifically within the nursing research setting, group work is beneficial in that there is the opportunity for delegation of tasks, therefore workload is evenly spread between nurses. The benefits of working within a group are clear – from enhancing the quality of individual ideas from discourse and discussion, to building confidence and collaborative skills. However, working in a group necessitates the application of skills of compromise and proactive listening. Students can find this difficult as they are programmed through tertiary education to control, dictate and direct the course of work on an individual basis. Contrastingly, group research within a nursing context requires high-level communicative skills, listening skills and empathic abilities. Overall, while group work may initially require a future nurse to switch their frame of reference from “student” to “team member”, the benefits are numerous – ranging from individual skill building, to career building. On the latter point, working within a team is a highly regarded attribute for future employers to see on one’s transcript. Of note, it has been stated in a research report that numerous employers regard group work as within the top 10 skills (Graduate Outlook Survey, 2010). Further, it seems that group work seems to help streamline processes by integrating the growth of individual characters into a mission to derive an effective and mutually decided solution.
Notwithstanding the above, working within a group on a nursing research project, or any setting, has is complications. Within some groups, there is normally a definitive leader. While this can serve benefit within a placid and hierarchical group dynamic, within a nursing sector or a research sector, this can be a deficit to a group as dominated discussion may lead to monitored and restricted ideas, as well as tension within the team. Specifically, dominated discussion may lead to members being supremely dissatisfied within the group because they feel too alienated in the decision-making process (Burke, 2011). This is an important point of contention to note within the medical field, as group work is common in the research sector, with multiple roles within one group and a multi-layered approach to decision-making. Further, the complexities of multiple personalities as well as others strengths and weaknesses can cause tension within a group. In the research area of confined labs and offices, this could backfire and result in less effective group and individual work, and restrict the functionality of the hospital holistically. Another issue that is common within group work is that group members might rely on others to sufficiently do the work for everyone, with group members not adequately doing their designated roles. (Freeman & Greenacre, 2011) This can happen within group unintendedly or intentionally, as every individual could potentially have a different goal for success or grading. Within the area of nursing research, it is forever growing and there will always be new discoveries. In conclusion, group work has many positives and negatives.
However, within nursing, adapting to collaborative environments is imperative to the functionality of hospitals. From my experience in this group assignment, I was able to effectively collaborate with my team members, and learnt how to effectively tackle points of disagreement through an open forum of communication. I was able to navigate the challenges of group work in order to see the wider positive impact of the collaborative mind. For our group, we were able to put aside our differences in order to generate more unique and innovative ideas. From this assignment, I will take away the importance of group work, and specifically how important emotional intelligence is within teams as well as the nursing industry more broadly.
- Babiker, A., El Husseini, M., Al Nemri, A., Al Frayh, A., Al Juryyan, N., Faki, M. O., … Al Zamil, F. (2014). Health care professional development: Working as a team to improve patient care. Sudanese journal of paediatrics, 14(2), 9–16.
- Burke, A., (2011) Group Work: How to Use Groups Effectively The Journal of effective teaching 11(2) 87-95 Retrieved from https://uncw.edu/jet/articles/vol11_2/burke.pdf
- Freeman, L., & Greenacre, L. (2011). An examination of socially destructive behaviors in group work. Journal of Marketing Education, 33(1) p. 5-17. Graduate Outlook Survey (2010). University of Canterbury.
- Mitchell P, Wynia M, Golden R, McNellis B, Okun S, Webb CE, et al. (2012) Core Principles and Values of Effective Team-Based Health Care Discussion Paper. Washington, DC: Institute of Medicine;
This research proposal was written by a student and is published as an example. See How to Write a Dissertation Proposal on our sister site UKDiss.com for guidance on writing your own proposal.
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