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 © Piranka/E+/Getty Images

THE PEDAGOGY

Introduction to Nursing Research: Incorporating Evidence-

Based Practice, Sixth Edition promotes comprehension through
diverse strategies that engage the learning essence of students
while also generating curiosity about the topic. This collaborative
tactic allows for the converging of distinct learning styles, making
this text essential reading for a grasp of strategic concepts. The
pedagogical aids present in most chapters include the following:

Chapter Objectives
Chapter objectives furnish instructors and students with a
description of the significant concepts they will cover in each
chapter. They provide specific pointers to narrow the focus of the
material for study.

Key Terms
Provided as a list at the beginning of each chapter, these terms are
essential vocabulary to better understand the concepts in the
chapter.

Think Outside the Box

Students can work on these critical thinking assignments individually
or in a group while reading through the text.

Red Flags

At the end of every chapter, these bullet points forewarn students of

areas in research that may raise concern.

Multiple-Choice Questions
Revise key concepts with these questions at the end of each chapter.

Discussion Questions

Students can use these assignments to apply the information in the

text to everyday practice.
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The authors, editor, and publisher have made every effort to provide accurate
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for the use of the products and procedures described. Treatments and side effects
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may require a dose or experience a side effect that is not described herein. Drugs
and medical devices are discussed that may have limited availability controlled by
the Food and Drug Administration (FDA) for use only in a research study or clinical
trial. Research, clinical practice, and government regulations often change the
accepted standard in this field. When consideration is being given to use of any
drug in the clinical setting, the health care provider or reader is responsible for
determining FDA status of the drug, reading the package insert, and reviewing
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Printing and Binding: LSC Communications
Library of Congress Cataloging-in-Publication Data
Names: Boswell, Carol, editor. | Cannon, Sharon, 1940- editor.
Title: Introduction to nursing research : incorporating evidence-based practice /
[edited by] Carol Boswell, Sharon Cannon.
Description: Sixth edition. | Burlington, Massachusetts : Jones & Bartlett Learning,
[2023] | Includes bibliographical references and index.
Identifiers: LCCN 2021047321 | ISBN 9781284252149 (paperback)
Subjects: LCSH: Nursing--Research--Methodology. | Evidence-based nursing.
Classification: LCC RT81.5 .I5844 2022 | DDC 610.72--dc23
LC record available at https://lccn.loc.gov/2021047321
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Printed in the United States of America
26 25 24 23 22 10 9 8 7 6 5 4 3 2 1
Dr. Boswell and Dr. Cannon wish to dedicate this edition to all the frontline nurses
who sacrificed so much during the pandemic and demonstrated to the world their
valuable contribution of caring and compassion to ensure the safety and health of
individuals.
 © Piranka/E+/Getty Images

BRIEF CONTENTS

Preface
Acknowledgments
Contributors

CHAPTER 1 Connection Between Research and Evidence-Based Practice

CHAPTER 2 Overview of Evidence

CHAPTER 3 Overview of Research

CHAPTER 4 Overview of Quality

CHAPTER 5 Ethics for Nursing Research and Evidence-Based Practice

CHAPTER 6 Asking the Right Question

CHAPTER 7 Literature Review: Searching and Writing the Evidence

CHAPTER 8 Quantitative Research Design

CHAPTER 9 Qualitative and Mixed Research Methods

CHAPTER 10 Population Management

CHAPTER 11 Data Collection

CHAPTER 12 Reliability, Validity, and Trustworthiness

CHAPTER 13 Data Analysis

CHAPTER 14 The Research Critique Process and the Evidence-Based Appraisal

Process

CHAPTER 15 Translational Research, Improvement Science, Implementation

Science, and Practical Applications

CHAPTER 16 Application of Evidence-Based Nursing Practice with Research

Glossary

Index
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 RULE III.
No one allowed to wait for signs or loaf in sign shop.
 RULE IV.
All work must be done in the order in which it is received. This
rule does not apply to window tickets.
 PEN WRITING.
The up-to-date card writer has adopted the pen to do a great deal
of his work, and, indeed, it is often used to excellent advantage. A
card written with the pen is decidedly neat and novel, and is very
effective. Perhaps it is not so bold in appearance as a card written
with a brush, but for a change (and to be up-to-date) it may serve you
to give the pen a trial.

It requires but little practice to obtain the mastery of this style of

show card writing. Buy a bottle of Sanford’s gloss black ink, and a
few of Soennecke’s round-writing pens, which may be procured from
any stationer, and see what you can accomplish. You will find it easy
and pleasant work, and soon be able to do very effective lettering.
Learn to make the simple strokes first, and then follow the style of
lettering shown you in the illustrations, as this letter lends itself
easily and gracefully to pen formation. Embellishments may be
added to the letters to suit the fancy of the artist.
 MARKING OUTFIT.
Fig. 1 is a section of a color mining stone bowl, which can be
purchased at paint goods stores. Fig. 2 is a piece of smooth marble,
eight by ten inches in size, on which to mix colors. The color mixing
knife is also shown. Fig. 3 includes a set of camel’s hair brushes,
assorted sizes. Fine brush A, is for outlines; broad ones, B and C, for
filling in. The color pots, 4, should be provided with brush supports,
D, so as to keep the brushes from the paint when not in use. A
triangle, 5, a square, 6, flat rule, 7, and a compass, 8, are also
required.
 THE USE OF STENCILS IN WINDOW
TRIMMING.
As accessories to window trimming, stencils have come to perform
a useful part in that art of decoration. Where a number of show cards
are to be lettered in the same manner, no more effective or
expeditious way of getting them out is to be found than by stenciling
the same, unless it is to have the cards printed, a much more
expensive process. Furthermore, aside from the mere lettering on the
card, the trimmer may add and reproduce any ornament or device he
choose, and there again avoid the expense of having a cut engraved.
The experienced window trimmer finds many uses for his stenciling,
and this process is especially valuable in decorating the background
of a trim, where plain white papers, colored cartridge papers, cheap
white cloth, burlaps and numerous other materials may be patterned
or lettered at very little expense and in such a manner as to add to
the attractiveness of the trim.
To begin with, the window trimmer needs but few things for
cutting and applying his stencils: a very sharp knife, any kind of extra
thick paper (this must be coated with shellac varnish or oiled to
prevent the paint from soaking into it), some paint brushes, oil and
water color paints of the desired colors, and a bottle of turpentine.
After the pattern or lettering chosen or designed is traced or drawn
upon the paper, care being taken that the design introduces cross
strips to hold all together, it is cut away. Then the varnish is applied.
When dry it is taken up and the edges of the stencil carefully cut here
and there where the varnish may have run over, as it is necessary to
keep them clear and sharp. Next the desired colors are gotten out; a
large plate will serve for a palette, though separate saucers for each
color are preferable. The colors, if oil, are mixed with a great deal of
turpentine, but water colors should be applied “stiff.” Next the stencil
is held firmly against the fabric to be lettered or decorated, and
quickly but neatly painted over, care being taken that the stencil
pattern does not slip and rub the design, and that part of the fabric
appearing through the stencil each time is thus stamped. The design
can be repeated on the fabric at will and in any arrangement the
window trimmer sees fit. On cards and thin papers it is better to use
thickly mixed water colors in place of oil colors, as these latter are
liable to spread. In the cities one can get stencils already cut, but
there is no reason why the window trimmer should not design and
cut his own, as very little practice in this art makes perfect, and one’s
own designs are, for many purposes, generally more applicable.
Stencil, alphabets of various sizes can be bought, costing all the way
from fifty cents to $1.50 a set, according to their size. These the
window trimmer will find very valuable aids in lettering his show and
price cards.

THE USE OF STENCILS IN WINDOW TRIMMING

THE STENCIL PLATE.

An exceedingly pretty effect was noticed in a down town New York

shoe dealer’s window, gotten by giving the trim for a background a
screen of light olive burlaps, upon which the monogram of the firm
was placed in stenciled pattern in metallic colors. A little ingenuity
along this line cannot fail to produce equally valuable effects. If the
spaces left by a stenciled letter are objected to, these spaces may be
easily filled in with a brush, as is shown in the letter “R” in the
illustration. By the use of stencils many pretty backgrounds may be
made. Paper the sides and back of your window with common white
print paper, and then stencil a pretty border around them, with
ornaments to suit your fancy. Stenciled ornaments may also be used
to decorate your card work. If you have a neat monogram of the
firm’s initials cut, you can use it in the corner of all your show cards.

A STENCILED BORDER.

THE STENCILED LETTER.

 CHAPTER XII.
LINEN AND HANDKERCHIEF DRAPINGS.

LINEN DISPLAYS.
The month of January is generally considered “Linen Month,” and
special pains are taken by wide awake merchants to interest buyers
by means of attractive displays of these goods. We show with this
several modes of folding napkins. Fig. 1 shows a method of wrapping
a fringed napkin or doyly closely about a stiff wire rod. This may be
used in many forms of arches and grille work.

FIG. 1.
 FIG. 2.

FIG. 3.

The regular fan-shaped fold is well known to everyone. Our

illustration shows methods of varying the simple fan by producing
the single and double circles. What is called the “bishop’s mitre” is
next illustrated, the three folds being very simple and easily
executed.

SAMPLES OF ARTISTIC TOWEL DRAPING.

We also show some samples of artistic towel draping, suitable for

both interior and window displays.
 HOW TO FOLD HANDKERCHIEFS.
The following is a description of the handkerchief folds, the
numbers corresponding with these in the illustration “A”:
No. 1:—Pleat the handkerchief from corner to corner, and pin it in
the center. This will form a double leaf.
No. 2.—Fold the handkerchief once, forming a triangle; then pleat
on the straight edge, forming a single leaf.
No. 3.—First fold the handkerchief into a small square, turn the
corner over, forming a small triangle, then pleat as in No. 2. This will
form a small leaf.
Nos. 4 and 5.—Fold each corner to the center of handkerchief, turn
the handkerchief over and fold the corners again to the center, then
pull out the corners to the outside edge, forming a puff.
No. 6.—Pleat in some pleats across the handkerchief, as indicated
in the drawing, pin about two inches from each end, and draw the
corners to the center, forming a double circle.
HANDKERCHIEF DISPLAY, SHOWING
VARIOUS FOLDS.—Morton.
 THE HANDKERCHIEF FOLDS, NUMBERED.—
A.

Nos. 7 and 13.—Fold the handkerchief twice, making a small

square; then turn the sides to the center, as shown in drawing.
No. 8.—Fold as in No. 6. Draw both the ends over, and pin so as to
form a double half circle.
No. 9.—Pleat from corner to corner, leaving one end a little short,
and pin. This will form a double leaf.
Nos. 10 and 20.—Take a small nickel rod or smooth stick the
thickness you wish, commence from the corner of the handkerchief
and roll, then pin and slide off the rod.
No. 11.—Fold the handkerchief twice, making a small square—then
turn one of the corners over, showing the complete border.
No. 12.—Pleat the handkerchief in small pleats, as shown in
drawing No. 8. Then bend in the center, which will form a small
circle.
DESIGNS IN FOLDED HANDKERCHIEFS.—B.
 DESIGNS IN FOLDED HANDKERCHIEFS.—C.

Nos. 14 and 19.—Pleat as in No. 8, and draw both ends together.

This will form a large half circle—two pinned together form No. 14.
Nos. 15, 16 and 17.—Fold the corners to the center of handkerchief,
then turn the handkerchief over and fold again, the corners to the
center. Turn it over again and fold corners to the center. Now draw
out the edges of the handkerchief. This will form a cross. No. 16
shows the back, No. 17 the front and No. 15 the center, with the
corners turned back.
No. 18.—Pleat handkerchief as in No. 8, pin in center, and open
both ends.
No. 21.—Shows two double leaves, like drawing No. 1, one laid over
the other.
The illustrations “B” and “C” will give the reader an idea of the
numerous combinations that may be made from the different folds.
With a little ingenuity you can produce designs without limit. I also
show several windows in which examples of handkerchief folding are
prominent, thus affording the reader an opportunity of selecting a
number of designs for his own use.
 DIAGRAM EXPLAINING HANDKERCHIEF
FOLDS.

If you have a big window to decorate with fancy handkerchief folds

it will be a good plan to get two or three salesgirls to assist in the
folding. Show them how to fold the designs you require and their
work will save you much valuable time. The pinning together on the
frames is quick work.
FOLDED HANDKERCHIEF DISPLAY.—Morton.
 FOLDED HANDKERCHIEF DISPLAY.—
Mohukern.

The diagram will give you a better idea of the folds than the other
pictures, which are reproductions of direct photographs from the
goods themselves.
To produce the figure of “The Greek Cross,” proceed as follows:
After the handkerchief is spread out full size turn down all four
corners exactly to the center, producing No. 1. Then turn face
downward and again fold the corners to the center, along the dotted
lines A, B, C, D. This makes No. 2, which is also turned face down
and the corners turned to the center along the lines A, B, C, D, and
secured with bent pins. The pattern is now turned with the face
upwards and the final figure is easily completed, as shown in No. 3.
Four loose laps appear, and by placing the forefinger of each hand
within these laps at point AA, and lifting the same the flaps
straighten out and form B (No. 3). When all the flaps are raised and
straightened the cross is formed and the figure completed.

Having formed this figure you may proceed to the more intricate
folds derived from this foundation. While making these first folds a
couple of sheets of stiff paper will be of assistance in keeping them in
place while turning them over. Another thing is to have the
handkerchiefs ironed smooth, and if they are stiff from starch all the
better.
 Fold A.—Starting with No. 5 as a base, turn it over, then turn
corners E, F, G, H, to center. Allow it to remain with same face
upward. Turn new corner to the center and secure it. Now turn the
handkerchief face upward and center points will turn themselves
outward. The inner points are turned back from the center, making
the complete figure as shown.

GRAND ARCH, COVERED WITH FOLDED HANDKERCHIEFS.—Morton.

 FRONTAL ARCH OF FOLDED HANDKERCHIEFS.—Shogran.

Fold B.—This is the same as the center portion of fold A. It is made

in precisely the same manner, but with the addition that the loose
outer points of A are turned to the back and secured.
Fold C.—This is an effect produced by the use of two handkerchiefs
folded one within the other. Except as regards the use of the inner
handkerchief the pattern is nearly the same as fold B, differing from
it only in the first and last folds, by which the inside handkerchief is
arranged spread outside the handkerchief as in No. 1, and placed
upon the other as shown in No. 6. Fold the outer handkerchief as in
No. 5, turn over, turn corners E, F, G, H to center and secure them;
turn face up, shake out outer points, and turn back points A, B, C, D
as shown in No. 7. Grasp points E, F, G, H, roll them under, as shown
in cut of fold C, and secure with pins.
Fold D.—Use two handkerchiefs laid evenly together corner to
corner. Make No. 2. Turn corners E, F, G, H to center; repeat and
fasten. Turn face up and turn back center points. When these points
are turned back the under one is drawn a little further out than the
upper, thus showing the borders of both. It is well to have the
borders of prettily contrasting colors.
Fold E.—Make No. 2. Turn corners E, F, G, H to center; turn over
and turn corners A, B, C, D to center and fasten. Turn face upwards.
Take the projecting points in the center and turn them outward;
draw them a little toward the corner, and the figure is complete.
 CHAPTER XIII.
ILLUSION WINDOWS.

One of the best modes of attraction for window displays is the

“illusion” centerpiece. It originated with dime museums and side
shows, but is none the less sure to arouse the curiosity of the
observer. The illusion consists of a beautiful young lady, the lower
half of whose body is invisible to the spectator, the upper portion so
resting on a pedestal as to appear to have an independent existence.
The effect of the illusion is very striking. It is produced in a very
simple manner: A pedestal of wood is arranged as shown in the
accompanying sketch, the upper portion being a hollow bowl resting
on a solid pillar or post, a sufficient portion of the bowl being cut
away to allow room for the young lady who is to take part in the
illusion to stand immediately behind the pillar and within the upper
portion of the pedestal. Extending at right angles from the pillar at
either side are mirrors imbedded in the pedestal and having the
edges A B and G H concealed by sprays of artificial flowers or other
ornament extending from top of pedestal to platform on which it
rests. Similar sprays are placed at front. The lower portion of the
mirror is concealed by the drapery which constitutes a part of the
window display or of the background. The drapery at either side of
the window corresponds to that of the background. Its reflection in
the mirrors deceives the spectator into the belief that he sees the
drapery of the background beneath and around the pedestal.
This attraction could be used to advantage for the display of
millinery, fans, parasols, etc. The best effect is obtained by having the
figure quite a distance above the spectator.
THE VANISHING LADY.

“THE VANISHING LADY.”

 An amplification of the foregoing illusion is called “The Vanishing
Lady,” and we reproduce a picture of a window in which this effect
was a recent attraction. It occupied but a small space in the center of
the display, showing the bust and head of a pretty young woman,
supported on a thin pedestal with a large bowl top. From the waist
down the young woman was invisible; at the same time one could see
all around the pedestal, which produced a startling illusion. At short
intervals this young woman would disappear right into the pedestal
(or so it would seem), and presently would reappear with new hat,
waist, gloves, etc. This would continue, showing every ten minutes or
so a complete change of hat, etc. The following diagram with
description will explain the workings. A platform 2 feet 6 inches high
is built in the window, with three frames around, 7 feet high, draped
in green plush. Erect a thin pedestal, with two large wooden meat
chopping bowls, one on top, one on bottom, neatly enameled. One-
quarter of the bowls at back are cut away, two grooves cut in pedestal
and two mirrors set in, as in diagram. The mirrors reflect the sides of
frame, which gives the appearance of seeing all around. A trap door
in the floor allows the girl to disappear down a simply constructed
elevator into the basement, where she changes her hat, neckwear,
etc., to again reappear. The elevator is balanced by two bags of sand.
When the girl gets off, a bolt is put in the beam to keep the platform
from flying up. This window was a great success. The second day the
firm using it was compelled to put up an iron rail in front of plate
glass for fear it would be broken by the crowds. The young woman
was very pretty, and every hat was becoming; and her changes were
many during the day.
 A CLEVER ILLUSION.
Fig. 1 shows an original method for a novel window attraction. It
consists in having a plush covered box on a table in the center of the
show window, and arranged in the rear as shown in Fig. 2.

The box should be about the right size to accommodate the head
and shoulders of a person. A hole is cut in the cover, through which
the person’s head projects. The entire bottom of the box is removed
and a corresponding opening is cut in the top of the table. By looking
at the arrangement from the front, the head, flags, box and table are
seen, and every one wonders where is the rest of the person. The box
is of course much too small to hold a person, and as the space
beneath the table appears perfectly clear, the mystery is increased.
This illusion is easily performed. Fig. 2 shows a side and rear view.
The whole plan is effected by means of two pieces of plate mirror,
A and B. These pieces should be high enough to reach from the floor
to the lower side of the table top, and wide enough to extend at an
angle with each, of about 45 degrees, the angle forming C, where the
sides join, and ending far enough back to cover the person. The
angular formation of the mirrors will reflect the floor in front, and if
the edges of the mirror are draped so as not to show from the front,
the appearance from the street is that the space below the table top is
open, and that the person of the individual whose head projects from
the box is in some mysterious way confined in the very limited room
which the box affords. The plate mirror is the only costly article, and
as this is not injured by use for a few weeks, it can be resold, or
perhaps rented in the beginning.