Standards to assure quality in nursing research

Die fokus van die artikel is kwaliteitsversekering in v e rp leeg n av o rs in g , sp es if iek die in te rn e aspek , selfevaluering. Departemente van Verpleging is verplig om m aa treë ls in te ste l om die k w a lite it van verpleegnavorsing te verseker, nie net as gevolg van bewese probleme in die onderwys van verpleegnavorsing nie, maar ook vanweë die plig om kwaliteit in alle onderwys aangeleen thede te verseker. ‘n D epartem ent van Verpleging funksioneer in ‘n goed gedefinieerde eksteme konteks. Die eksterne konteks word definieer deur spesifieke aspekte, onder andere rolspeler verwagtings en ook die huidige onderwys en professionele wetgewing. Ten einde kwaliteit te kan verseker, moet standaarde opgestel en valideer word. Standaarde is die basiese k om ponen te van ‘n k w a lite itsv e rse k e rin g s te ls e l (Booyens, 1996:305). Standaarde is rigtinggewend en moet opgestel word met inagneming van die land se kulturele, filosofiese en etiese sisteem sowel as die sosiale, ekonomiese en politieke ontwikkeling.

Die aanname van die studie is dat indien die onderrig van v e rp le e g n a v o rsin g , tew ens die to tale b e stu u r van navorsing in die departem ent, onderw erp word aan kwaliteitsbestuur, die uitkoms positief kan wees.Die navorsingsdoelwit van die studie was om standaarde te fo rm u le e r en te v a lid e e r w a a rte e n k w a lite it in verpleegnavorsing gemeet kan word.M uller se fases van stan d aard fo rm u lerin g (19 9 8 :6 9 ) is gebruik as m etodologiese basis v ird ie studie.Optimale, spesifieke standaarde is geform uleer deur gebruik te maak van 'n deduktiewe proses en die standaarde is valideer deur implementering in 'n verpleegdepartement.
The focus o f this article is quality assurance in nursing research.Due to well established problems regarding th< education o f nursing research and increasing pressure t( take responsibility for the quality of all educational activi ties, departments of nursing are obliged to initiate action; to assure quality in nursing research.A nursing depart ment functions within a well-defined external context.Th< external context comprises o f various aspects such as rol< player expectations and current educational and profes sional legislation.Standards are the basic components o any quality assurance system (Booyens, 1996:305).Stand ards give direction to the practitioner and must be com piled within the context of the country's cultural, philo sophical and ethical value systems, as well as its social economic and political development.
The premise of the study was that if the education o f nurs ing research, indeed the total management of nursing re search within the department, is subjected to quality assur ance, the outcome of the in terms o f nursing research wil be positive.The research objective addressed in the stud) was to formulate and validate standards against which qual ity in nursing research in a nursing departm ent can b( judged.M uller's phases of standard formulation were use( as the methodological basis for the study.Optimal, spe cific standards were formulated using a deductive proces; and validated by implementing the standards in a depart ment o f nursing.

Introduction
Due to well established problems regarding the education o f nursing research and increasing pressure to take respon sibility for the quality of all educational activities, depart ments of nursing are obliged to initiate actions to assure quality in nursing research (Zeelie, 2002:1-3).Standards are the basic components o f any quality assurance system (Booyens,196:305).
Standards give direction to the practitioner, and must be compiled within the context of the country's cultural, philo sophical, ethical value systems, and its social, economic and political development.Donabedian (1990:118) defined standards as a specification of good practice; and criteria as measurement scales that specify the degree of quality attained.Speller, Evans and Head (1997:218) define stand ards as agreed levels o f excellence o f performance that should be acceptable to colleagues and service users.Standards are statements of acceptable quality, but to be measurable as Donabedian indicated, criteria of quality of the standard must also be set.Criteria are defined as de scriptive measurable statements, which are used to assess the level of performance towards meeting a standard.In addition, Bowden (1995:167) stated that criteria might ad dress an educational process, an outcome, or both.There is no single correct format or way to postulate a criterion.The data that it should generate is the only guiding princi ple.
To enable the researcher to draft standards that comply with current best practices, the following points are impor tant in respect o f standards (Bowden, 1995:167):

•
Foundational to quality assurance and the essence o f the self-evaluation system The premise of he study was that if the education of nurs ing research, indeed the total m anagem ent of nursing re search within the department, is subjected to quality assur ance, the outcome of the in terms of nursing research will be positive.Quality assurance, specifically the internal aspect o f self-evaluation, has become a critical managerial responsibility in departments o f higher education in the twenty-first century.The manager of a department of nurs ing has the responsibility to assure quality in nursing re search within the context of the current educational and professional legislation.Inherent in the responsibility of the manager, is the need to fulfil the mission o f the depart ment and that of the parent institution in terms of research.
The National Plan for Higher Education o f the M inistry of Education (2001:1-4) prescribes the creation and implemen tation of a self-evaluation system in educational depart ments, but provides no blueprint for the development and validation o f such a system.This article reports on the formulation and validation of standards to assure quality in nursing research that were formulated as the basis of a self-evaluation system for quality assurance in nursing re search.

Research objective
The research objective addressed in the research study was to formulate and validate standards against which qual ity in nursing research in a nursing departm ent can be judged.

Formulation and validation of standards
M uller (1998:69) described phases of standard formulation that were employed as the methodological basis for the research study.The phases are described as the formula tion phase, the quantifying phase and the testing phase.
The formulation phase is based on an empirical and norma tive approach.
The empirical phase had a qualitative exploratory design and naïve sketches were used to elicit role player percep tions regarding the education of nursing research (Zeelie, 2002:17-55).The role player population included nurse educators, managers, clinical nurses, researchers and nurs ing students.The medical profession in an academic envi ronment, and the nursing professional organisation were also included in the population.Specific criteria for partici pation were drafted and the sample was chosen conven iently and purposively (Brink, 1996:140-1).Convenient in the sense of availability in South Africa through electronic means or the postal system and purposive due to the crite ria set for inclusion in the sample.The context encom passed institutions o f higher education and hospitals in South Africa.
The concepts deduced from the data were contextualised and recontextualised using M orse and Field's approach (1996:103-107) in combination with Tesch's data analysis approach as cited by Creswell (1994:154-156).From this basis, an extended national and international educational literature exploration was done to endorse the expectations and expand the concepts based on internationally reported best practice.
Optimal, specific standards with criteria were formulated using a deductive process and validated by implementing the standards in a nursing department (Zeelie 2002:Chapter 4).This process represents the quantifying and testing phases as prescribed by Muller.The standards and criteria are reported in full in the following section.

Standards and criteria to assure quality in nursing research
Twenty-six standards are formulated to assure quality in nursing research.Aspects that were considered are as follows: the nursing department manager's responsibilities with regards to nursing research, the research learning pro gramme, academic environment, personnel, students, de partmental policies, support systems, funding, co-ordinated research programme, quality data gathering system, facili ties/infrastructure, supervision, capacity building, feelings of competence, systematic audit process, networking, sat isfaction, relevance, productive scholarship, collectively intended, accountability, and centre of excellence.
The standards encompass the three characteristics o f struc tu re , p ro c e s s , an d o u tc o m e , b u t d u e to th e in te r connectedness o f these aspects, all aspects applicable to a specific standard are com bined in one standard.

Standard 1
Based upon the vision and mission of the parent institu tion and the vision and mission of the nursing department and managerial responsibilities, the nursing manager has the responsibility to ensure quality in the education of nursing research.
C riteria: 1.1 The jo b description of the m anager reflects the re sponsibility and accountability for the management o f the education o f nursing research.

1.2
The m anager is actively involved in the control of quality education of nursing research.

1.3
The m anager supports and is actively involved in standard setting and attaining standards with re gards to the education o f nursing research

Standard 2
The manager o f the department of nursing demonstrates appropriate abilities (knowledge, skills/competencies, at titudes, and values) required to effectively manage the edu cation of nursing research.

Criteria:
1.1 The departm ental m anager is registered with the South African Nursing Council in nursing educa tion and management.

1.2
The departmental m anager shows the ability to as semble, analyse and utilise appropriate educational statistics to optim ise the research educational out comes and goals/objectives.

1.3
The departm ental m anager maintains appropriate processes to facilitate the creation of a learning and educational environm ent that is conducive to qual ity research education.

Standard 3
The education o f nursing research is managed according to the strategic plan for the department.

C riteria:
1.1 There is a policy regarding the research program 's vision, mission, goals and objectives.

1.2
There is a written strategic plan for the department that includes the education of nursing research.

1.3
The departmental strategic plan reflects the current educational legislative requirements.

1.4
There is a written mission statem ent guiding and focussing the educational activities o f the depar tment.

5.5
Fulfilling the mission statement should enable the department to achieve the transformational objec tives of the National Plan o f the Ministry o f Educa tion.

5.6
Goals/objectives is available in written form, stating clearly what is expected o f the graduate after finish ing the research program.

5.7
There is a written educational philosophy reflecting belief statements on education, the student and the nursing educator.5.8 The short and long-term goals/objectives are de scribed including those for the education of nurs ing research.5.9 There is an operational plan for the realisation of the goals/objectives o f the education o f nursing research.5.10 A progress report on the strategic report is avail able.

5.11
There is an information technology system to facili tate educational service management.5.12 There are policies and procedures to formulate a structured design to manage research in the depart ment.

Standard 4
The research education program is planned, integrated, value-adding, building contextually on learners' existing frames of reference, experiential and outcomes based.

Criteria:
1.1 The research education program is the main vehicle to achieve the formulated goals and objectives of the department with regards to the education of nursing research.

1.2
The content o f the research education program ena bles the student to achieve the expected outcomes.

1.3
The research education program produces gradu ates with the knowledge, skills and com petencies required to participate as nursing professionals in the m odem world.1.4 There are clear indications o f the development of leadership in students 1.5 The core content is identified.1.6 The content is relevant to the profile of the institu tion's location and context and its responsiveness to regional and national priorities.1.7 The organisational structure for the program should is chosen based on specific criteria.1.8There is a system to evaluate the organisational form periodically. 1.9 The teaching strategies promote the attainm ent of the outcomes o f the research education program.1.10There is a system to review and research the teach ing strategies to ascertain their effectively, efficiency and applicability to the education o f nursing re search.

Standard 5
The department of nursing ascribes to an accepted didac tic concept in the context o f the education o f nursing re search.

C riteria:
1.1 The departm ent has decided upon a didactic con cept.

1.2
The didactic concept is consistent with the mission and objectives o f the program.

1.3
Nurse educators adhere to the departmental didac tic concept 1.4 The didactic concept of the departm ent must be rel evant and evidence-based.

1.5
The didactic concept should cause in students a life-long love of learning and critical intellectual abili ties.

Standard 6
The nursing research curriculum is designed to produce nursing practitioners who can provide appropriate care in a society with ever changing needs and an increasing tech nological environment.
C riteria: 1.1 Evidence-based nursing care is facilitated by a re search focus in all nursing programmes.1.2 The research program inculcates evidenced-based nursing care in students.

1.3
Research methodology is introduced in the first year o f the basic program.

1.4
The research program in the basic degree is experi ential and develops research knowledge and skills as well as capabilities in the students.

1.5
The basic course should prepare student for higher degrees.

1.6
The research theory and practica is correlated.1.7 The curriculum allows enough tim e for research projects.

1.8
Through all the educational activities prescribed by the curriculum , a research culture is initiated and maintained.

Standard 7
Student assessm ent is system atic, ongoing, com prehen sive, and focussed on the nursing research program's spe cific mission and goals.

Criteria:
1.1 A departmental policy is in place regarding all as sessm ents.1.2 W ritten standards regarding the criteria for the ac ceptance o f a theses or dissertation are available.

1.3
The criteria for assessment are recognised by the profession and institution.1.4 Assessment includes understanding as well as knowledge.

1.5
Objectivity is ensured in all assessments.1.6 A system exists to evaluate supervision (mentoring) of students at all levels.1.7 A system exists to gather data regarding assess ments as well as methods to present evidence and matching these against the criteria.1.8There is a system to ensure recommendations and feedback mechanisms exist regarding all assess ments regarding the education o f nursing research done in the department.

Standard 8
An academic environment, which realises through the mo tivation by management, nurse educators and students to pursue the goals of quality teaching, learning, research as well as positive advice, support and encouragement to attain quality research education outcomes C riteria: 1.1 An environment in which mentoring of colleques and students in the field of research is accomplished.

1.2
An environment exists in which the socialisation of students in the field o f nursing research occurs and in which the existence o f a community of scholars can excel.1.3 A critical mass of academics is readily available to establish and maintain an academic environment.

Standard 9
The quality of the nurse educators is such that the depart ment is capable of meeting the research related require ments set by the department and the parent institution.

Criteria :
1.1 The quality of the nurse educators influences the quality o f the program positively.

1.2
Nurse educators are knowledgeable in research methodology and are doing research.

1.3
The num ber of doctorally prepared nurse educators in the department is sufficient to realise the depart m ent's goal/objective concerning its research re quirements.

1.4
For doctoral programs, the educators is doctors/ researchers in the program area and capable of con ceiving and implementing research programs.15 The educator/student ratio is such that the optimal num ber of research students can be admitted each year.

1.6
Continuous training of nurse educators occurs.1.7 Post-doctoral research activities are maintained.1.8 A standard exists regarding the publications and presentation requirements o f nurse educators. 1.9 The prescribed num ber of published articles in ac credited refereed journals is maintained.1.10There is delivery of presentations at national and international scientific meetings.1.11 Personnel participate in committees at a national and international level.1.12 Personnel participate on the editorial board o f sci entific journals.1.13 Supervision skills are developed and nurtured.1.14 A system is in place to develop research leadership potential in nurse educators.1.15There are policies and procedures regarding publi cations, marketing of research results and how regu larly a mem ber of staff is expected to publish.1.16There are policies regarding study leave for nurse educators.1.17 Policies and procedures exist regarding the distri bution o f research and teaching loads and the de ploym ent of members of staff for teaching and re search.1.18 A policy and procedures exist for a strategy to build staff m em bers' research expertise (setting up a per sonal capacity building plan for each).1.19There is a system to ensure that all nurse educators concerned study and implem ent the policies and procedures.

Standard 10
The education o f nursing research is equipped towards addressing the research skills and competencies required of professional nursing graduates in the modern world.
C riteria: 1.1 The student's position as a novice scientist is rec ognised.

1.2
Adm ission criteria are consistent with those o f the institution and within the scope of the M inistry of Education.

1.3
Graduation rates and throughput rates are accord ing to the benchmarks o f the D epartment of Educa tion.

1.4
The research program 's dropout rate is reduced.1.5 Student should be involved in the practical aspects o f research during the programme.1.6 A system is in place to review the annual progress of doctoral students based on written com ments by all concerned including the student.1.7 A standard o f productive scholarship exists stipu lating collaboration with the educators and peers in scientific activities that result in the presentation and publication o f papers.1.8 Leadership potential is developed in research stu dents.1.9 Graduates are skilled and com petent after comple tion of the programme.1.10 The throughput rate o f post-graduate students is optimised.

1.11
Students are considered as customers of the re search program and as such are entitled to high quality education.
1.12 There are policies and procedures to ensure a roll ing plan to attract and train masters and doctoral students.1.13 Policies exist regarding the appointment o f students as research assistants.

Standard 1 1
There are written, appropriate, legally valid and updated departmental policies in place to administer and manage the education o f nursing research effectively and effi ciently.

Criteria:
1.1 The policies are in line with the parent institution.1.2 There are policies and procedures for the role and function of research related committees.1.1 Policies and procedures are dated and signed.1.2 The policies and procedures are review ed at least annually or according to predetermined review dates.1.3 The policies and procedures are appropriately in dexed, filed and retrieved to facilitate accessible by all nurse educators.

S ta n dard 1 2
Support systems are of sufficient scope to enable students to attain the skills and com petencies set as outcomes for the research program C riteria: 1.1 Support systems are facilitative in nature.

1.2
Support systems are available within the resource systems to assist student attain their goals.

1.3
There is funding available to ensure the quality of the resource systems.1.4 Resource systems are accessible.

1.5
The physical infrastructure is sufficient to accom plish the goals of the department for research, teach ing and service.

Standard 13
Financial support is available for students and educators doing research C riteria: 1.1 Nurse educators are taking a responsibility towards obtaining funding for research projects.

1.2
Research outputs are of such a nature that funding based on research outputs are readily available to the department.

1.3
Policies and procedures exist regarding applications for research funding, 1.4 Students are assisted in applying for funds.1.5 A policy for procedures to develop sources of fund ing for research -internal and external.

Standard 1 4
The existence of a co-ordinated research program versus lone-standing projects is fundamental to focussed research capacity building to purposefully empower new research ers and re-empower others.

Criteria:
1 There is a system to maximise throughput, success and graduation rates by supporting students of good academic standing who dropout but not for financial reasons.

Standard 18
Nurse educators and students are feeling com petent to perform their research-related roles

Criteria:
1.1 There is evidence of feelings o f competence, for both the nurse educator and student, to perform their respective roles in the social and professional environment.

Standard 19
A systematic audit process regarding the education of nurs ing research is operationalised C riteria: 1.1 A system exists that provides for com parison of program processes and outcomes to the standards of its parent institution and selected peer groups within the nursing profession.1.2 The system includes ongoing feedback to nurse educators and administrators to promote research education program involvement.1.

Standard 20
Networking is considered im portant and it is promoted and actively expanded C riteria: 1.1 Networking, nationally and internationally, is ac tively developed in the departm ent o f nursing 1.2 A policy exists with clear guidelines for collabora tion with external organisations and industry.

Standard 21
The satisfaction o f all role-players is considered an im portant aspect in the quality assurance of the education of nursing research C riteria: M otivation should be evaluated as part of the selfevaluation cycle.

Standard 22
Relevance is of primary importance to the research pro gram 's continued existence C riteria: 1.1 The program is currently relevant.

12
The research education program is responsive to regional and national needs.

1.3
The program is evaluated periodically in terms of its relevance.

Standard 23
Nursing scholars on all levels o f expertise are active in the production, acquisition, application, and dissemination of knowledge C riteria: 1 Scholarship o f nursing is equivalent to other pro fessional disciplines.
1.5 There are no deviations from the traditional model of academic requirements for tenure.

Standard 24
A democratic ethos and a culture of human rights condu cive to critical discourse and creative thinking, cultural tolerance, and a common commitment to a humane, non racist and non-sexist order are fostered through the re search program C riteria: 1.1 An outcome of the program is the development of graduates who are collectively intended.

S ta n dard 25
Accountability is essential and it is promoted and actively expanded

Criteria:
1.1 There is evidence o f accountability in the educa tion of nursing research.

1.2
The research program is implemented efficiently and effectively.

1.3
Strategies are in place to improve accountability.

Standard 26
Excellence is the definitive goal for the education o f nurs ing research C riteria: 1.1 Excellence is the vision for in the education o f nurs ing research.1.2 There are policies for developing the department into a centre of excellence within a given period.

1.3
The research mission statement contains guidelines that focus the department in its quest for excellence.1.4 Research goals and objectives are available in the departm ent stipulating definite actions to be taken to realise the research mission and the vision o f the department.

Conclusion
It must be emphasised the nursing research is a dynamic process and as such, the standards are part o f that dy namic process and they will have to be review ed when changes occur or they become obsolete.These standards are incapable o f themselves to assure quality in nursing research; standards must be implemented in a system to fulfil the goal they were formulated to achieve, which is assuring quality in nursing research.

Bibliography
BRINK, HI 1996: Fundamental of research methodology for health care professionals.Kelwyn: Juta.
BOOYENS, SW (ed.).1996: Introduction to health serv- Satisfaction with the performance o f the program should be measured regularly as part of the selfevaluation cycle.1.2 Satisfaction with the organisational effectiveness of the departm ent in term s o f the education o f nurs ing research should be m easured regularly as part o f the self-evaluation cycle.1.3 Community interaction is a concept must be included in the m easurem ent o f satisfaction.1.4 1.11 The outcome of the program must be of such qual ity that the mission o f the departm ent and institu tion can be fulfilled.1.12 Nursing research does not constitute an end in it self but meets real needs in the practice and educa tion o f nursing.1.13 Enquiring minds are being developed in students.1.14 Research related outcomes are form ulated for dif ferent levels of research education.1.15 Different levels o f programs build on previous knowledge and skills.1.16 Program outcomes are m easurable.