Nursing Research Study Contributions
Debbie Rhoads
Grand Canyon University
Introduction to Nursing Research
NRS 433

August 6, 2011

Nursing Research Study Contributions Fee, E., & Garofalo, M. E. (2010). Florence Nightingale and the Crimean War. American Journal of Public Health, 100(9), 1591.

Study Background
Problem
Florence Nightingale is most remembered as the pioneer of nursing as well as the first nursing researcher. During the Crimean War in 1854, Nightingale and 38 nurses traveled to the military hospital Scutari, in Turkey, to care for the wounded soldiers. The conditions they found were horrible. Soldiers were lying in filth, there was little medications and fewer supplies. There was no ventilation and an open sewer ran beneath the hospital. Morbidity and mortality rates were a staggering 43%.(Fee & Garofalo, 2010).
Significance to nursing. Nightingale's research had a great impact on the nursing profession. Her research changed the views of society as well as the military regarding the care of the soldiers. Florence focused on cleanliness, ventilation, water purity and improving sanitation, which changed the mortality rates from 43 percent to 2 percent. (Burns & Grove, 2011, p. 10-12).
Purpose of Study The morbidity and mortality rate at the military hospital was the highest among all the hospitals in the region. Nightingale's mission was to figure out why the rate was so much higher in Scutari. Her focus was also on the sanitary conditions of the hospital and how it affected the mortality rate. (Fee & Garofalo, 2010). Objectives Florence had several things she wanted to accomplish regarding the military hospital. Her first concern was sanitizing the hospital and providing soldiers with nutritional food, clean water, and appropriate medical care. Then, her focus was on a clean environment and ventilation. (Fee & Garofalo, 2010). Concepts: Nightingale believed a healthy environment was essential for the healing process. She also believed that all patients deserved respect. Everyone, including soldiers, who at that time were persecuted by the military, had the right to appropriate medical care. (Fee & Garofalo, 2010).
Methods Utilized
Quantitative/Qualitative
Florence was one of the first to use quantitative research. She kept meticulous records on the soldiers in Scutari. She was gathering the information to prove that environmental properties had an effect on mortality rates. These records would eventually be placed in tables and studied by Nightingale to change military and society views regarding healthcare. Research design. Nightingale's research design started out as statistical tables. She eventually converted these tables to a graph known as a "coxcomb". The coxcomb was a pie like graph which showed the number of deaths and their causes for a twelve month period. Florence thought this graph was easier to read and interpret. (Hegg, 2011). Sample. Florence used every soldier at the military hospital as her samples. She wanted to determine why the mortality rate at the military hospital in Scutari was greater than all the hospitals in the surrounding area. She was worried that sanitary conditions were the cause of so many deaths. (Hegg, 2011). Procedures. Florence recorded each soldier's type of illness and if they recovered or if they died. Her records also showed where they were and why they died. Florence started the recordings when she arrived in Scutari and continued after her environmental cleanup. She could then compare the results of her sanitation project to mortality rates.( Hegg, 2011).
Results of Research
Findings During Florence's first winter in Scutari, 4000 soldiers died. More alarmingly, 7 times more died of disease other than war wounds. After environmental tactics were implemented, including frequent hand washing with soap for all nurses, mortality rates dropped from a staggering 43% to 2%. This proved the importance between sanitation and mortality rates.(Hegg, 2011).
Implications for Nursing The implications for the nursing profession were tremendous. This one study changed how the military's view of soldiers and their right to have quality care, clean environment, and respect as a patient. Research was also introduced as a way to promote good patient care, with a good outcome. (Burns & Grove, 2011. P. 10-12.) Contributions of findings. Change and new concepts can be difficult to implement. Research aided Nightingale introducing the idea that environment can affect your health. She studied her patients and diseases (evidenced based practice) to prove a hypothesis. Her study also showed the importance of nurse to patient relationships, as well as the importance of nurses being involved in research. (Hegg, 2011).
Impact Florence's research had a significant impact on the soldier's health and life expectancy. Soldiers had a shorter stay in the hospital, supply use was decreased, and because of the clean environment lived healthier lives. (Hegg, 2011). Conclusion
Florence Nightingale and her team arrived in Scutari and found soldiers dying at an alarming rate, under awful conditions. Statistics proved that a healthy, clean environment had a positive effect on mortality of soldiers, mortality rates dramatically decreased. Florence inadvertently used the process of evidenced based practice in her research and this practice is continued in nursing today. She believed in direct patient care and was known as "the Lady with the Lamp". Florence was a remarkable nurse, and her legacy continues even today as nursing continues to evolve. ( Fee & Garofalo, 2010).

References
Burns, N., & Grove, S. K. (2011). Understanding Nursing Research (5th ed.). (M. Iannuzzi, Ed.). Maryland Heights, MO: Elsevier/Saunders.
Fee, E., & Garofalo, M. E. (2010). Florence Nightingale and the Crimean War. American Journal of Public Health, 100(9), 1591.
Hegge, M. (2011). The Lingering Presence of the Nightingale Legacy. Nursing Science Quarterly, 24(2), 152-162.

Week One Rubric
Article Citation - /2 points
Study Background - /3 points
Methods Utilized - /2 points
Results of Research - /2 points
Conclusion – /2 points
APA Format: /4 points * Correct format (headings, referencing in body of paper) * Reference page (at least three peer reviewed 2000 forward references – may use text. APA is not a legitimate reference) * Grammar and spelling * Paragraphs (minimum of three sentences per each paragraph) * Word count 1000-1200 (points will be deducted for overuse of quotes and/or greater than 1300 words not counting Title page and Reference page)
Total: /15 points