Erasing the Data Dread

When Mary Gullatte 81MSN PhD RN FAAN became corporate director for nursing innovation and research three years ago, she had a primary goal: to create a culture of clinical inquiry within Emory Healthcare (EHC) nursing, at all levels of practice and leadership.

Gullatte and her School of Nursing counterpart, Elizabeth Corwin PhD RN FAAN, associate dean for research, work side by side to boost collaboration between the two entities, now jointly known as “Emory Nursing.”

Though they’re working to create and support opportunities for collaborative research, they hope their efforts impact nursing professionals throughout Emory Nursing—active researchers or not.

“Nurses take care of patients every day,” says Gullatte. “We want them to enculturate evidence-based research, not as something extra, but as how they practice.”

Facilitating research

To foster an environment of clinical curiosity, Gullatte launched the Emory Nurse Research and Evidence-Based Practice Academy in 2015. Offered annually, this two-day, immersion program helps EHC nurses develop, refine, and begin to investigate a research question that will advance care in their specific unit or area. This year’s academy was held in July and included content on evidence-based practice.

School of Nursing faculty and EHC nurse faculty and leadership present at the academy, and Gullatte provides one-on-one guidance to try to break down one of the biggest barriers to conducting research: the data analysis itself.

“One of the reasons that nurses in practice tend to shy away from research is that it’s all about the statistics,” she says. “They’re fearful of ‘I don’t understand the statistics,’ or ‘I don’t know how to do the data analysis and how to interpret the data.’ ”

Gullatte guides and mentors the nurses through their research cycle, offering ongoing guidance and data analysis, supported by School of Nursing statistician Melinda Higgins PhD. Together, Gullatte and Higgins hope to erase the data dread.

“We want to drive out the fear of, ‘I’m going to have to do it,’ and ‘OK. Somebody else did it, but I really don’t understand the results,’ ” Gullatte says. “We make sure that nurses do understand how to interpret those results and what they all mean.”

On the School of Nursing side, Corwin has dedicated ongoing research support. Faculty researchers consult with EHC nurses on study protocol and design, and grant specialists work with EHC nurses to apply for, track, and manage grant funds.

“We assist with pre-award submissions and post-award management,” says Corwin. “We review their proposals when requested and provide the same support that we do for nursing faculty through grant reviews and manuscript assistance. Those are all win-wins—for the school, EHC, and patients and families.”

Mary Gullatte and Elizabeth Corwin

Sharing research outcomes

Doing more research is only part of the strategy. To support evidence-based practice, that evidence needs to be disseminated, so Gullatte has created more opportunities for EHC nurses to share their results.

The Emory Healthcare Nursing Research Symposium, held every two years, is a chance for EHC nurses to present their research—in either a podium or poster presentation—in a friendly peer environment.

“It really is a dry run for the national stage,” says Gullatte. “SON faculty serve as judges for the one-day event, and nurses are able to polish their presentation and Q&A skills in front of an audience of their Emory colleagues.”

“But we don’t stop there,” she adds. Nurses are encouraged to present their research externally at specialty association conferences and Magnet conferences—three abstracts from Emory nurses were accepted for the October 2018 Magnet conference alone.

Nurses can also present their research across the EHC system in monthly nursing leadership meetings, letting them share what they’ve learned beyond their own hospital or clinic.

“It does no good to do research if you’re just going to put it on the shelf,” says Gullatte. “Regardless of the outcomes, whether they were statistically significant or not, something can be learned from that. It’s important to disseminate the results.”

Seeing the results

Currently, EHC staff and School of Nursing faculty are teaming on research on “everything from molecules to mankind,” says Corwin. Teams have tackled such issues as aspirin therapy for knee pain, nausea management for chemotherapy patients, and resiliency among nurses.

And it’s the strong collaborations between EHC and SON that make it possible.

“Collaborating with EHC allows us to have access to nurses who work with patients every day and who can help us better align our research with what is important to patients,” says Corwin. “At the same time, nurses at the bedside know what’s important to patients, but they don’t always have the experience or access to the infrastructure that will allow them to translate that back into a clinical or basic research project. We facilitate that, and it’s a positive feedback loop that ultimately benefits patients and families.”

Faculty gain the flexibility to pursue research opportunities at the School of Nursing, while EHC nurses benefit from clinical experiences they might not find elsewhere. Everyone benefits from the new perspectives shared, from academic researchers and their clinical counterparts to the patients and families receiving care across the EHC system.

Some of the biggest impacts, though, are less tangible. Guided by Dean Linda McCauley 79MSN PhD FAAN FAAOHN and EHC Chief Nurse Executive Sharon Pappas PhD RN FAAN, Emory Nursing itself is gaining a new culture, through years of intentional, focused collaborations.

“What we’ve done covers more than just research,” says Corwin. “It takes the right leadership to establish a truly transformative culture where joining nursing research and practice can really happen. And that’s where we are.”

Coursera: Teaching the fundamentals of reproducible research

Melinda Higgins PhD, a statistician in the Office of Nursing Research at the School of Nursing, is fascinated by data’s “logistics infrastructure”—how to integrate all of a research project’s individual parts into one file to make workflows faster, reproducible, and virtually error-free.

“Human errors happen. Typographical mistakes happen very easily. Misplacing a decimal point can drastically change your conclusions,” says Higgins. “If we can find more ways to automate these steps, reproducible workflows can future-proof or error-proof your work.”

Her Coursera course, “Reproducible Templates for Analysis and Dissemination,” provides the basics of reproducible research and dynamic documentation. Using the open source RStudio platform, Higgins teaches how to create reusable templates to combine all of a project’s components—data, code, documents, videos, analysis, and documentation—into one seamless project, allowing for easy updating, automated processing, and painless formatting.

While fields like journalism, business, law, and basic sciences are starting to embrace reproducible research, Higgins sees a special application to nursing.

“Nurses in some ways are the front lines of the data,” she says. “They tell the most compelling stories because they understand the connection between the clinical implications and patient needs and assessment. This course provides nurses with the ability to accurately document and integrate their data and analyses so they don’t get in the way of telling their stories.”

More than 1,200 people have taken Melinda Higgins’s Coursera course since its launch in January. It is one of two Emory Coursera courses to receive a perfect five-star rating. View her course at emry.link/templates.