Design, setting and participants
A quasi-experimental study was conducted at the People's Hospital of Nanhai District, including one group with baseline and follow-up assessment. We used this design because it was feasible and ethical to conduct according to the authors’ real working environment.
Clinical nurses who met the criteria were recruited for this study. The inclusion criteria were registered nurses who (1) had worked for more than 1 year in the authors’ hospital, (2) had a bachelor's degree or above as their final degree and a passion for nursing innovation, and (3) filled in the recruitment form completely and clearly. The exclusion criteria were as follows: (1) registered nurses who did not work in the hospital during the investigation period (including those who went out for further study and sick leave) and (2) registered nurses who were participating in other teaching programmes or studies. According to the literature review, we found that the sample size of the workshop should be between 25 and 40 people [25, 30]. Given the specific implementation plan of this research workshop, the number of participants in the workshop was determined to be 30. Considering that there might be a 20% attrition rate during the programme, the final sample size was calculated to be 36. Ultimately, 37 participants were enrolled in the study. All of the participants completed the study.
Ethical approval of this study was granted by the Ethics Committee of the People's Hospital of Nanhai District Foshan, Guangdong. The nurses received information about the study and voluntary participation and provided informed consent before data collection. Furthermore, the participants were informed that they had the right to withdraw from the study at any time without any explanations or consequences.
Intervention
A nursing innovation workshop was administered by a research team which was composed of 10 members, including one director and one deputy director of the nursing department, one ward head nurse, one research nurse, one clinical evidence-based nursing tutor, one director of nursing education and 4 education nurses from different wards. Their responsibilities were to establish a workshop team, recruit members, conduct research on innovation, formulate training content for scientific research and innovation, and contact relevant experts to organize and implement learning on relevant topics.
According to the recruitment situation, the group was divided into 4 groups of 8-10 people. The innovation team leader was selected on the basis of the investigation of the research team and the recommendation of the innovation team members. The team leader was required to have an intermediate or above professional title, obtain one or more patents, and have solid knowledge of innovation and scientific research capabilities with a rigorous and pragmatic academic attitude and good communication skills. The responsibilities of the team leader were to lead the members to implement innovation and offer consultation to the members.
Aiming to understand the participants’ training need, we designed a questionnaire to investigate their training motivation, training methods, experience with scientific research innovation and relevant factors affecting training (Table 1) according to the literature review [31, 32]. Then, we developed a specific learning course (including the theoretical training and practical training) through the analysis of the current needs of nurses.
Theoretical training involved 12 hours of courses (once a week for two hours) that were mainly taught and guided by domestically and provincially experienced innovation experts. The content involved current innovation policies, the training of innovative thinking, patent development, application and transformation and some relevant typical innovation cases to encourage the nurses’ participation.
Practical training was accomplished with the help and support of the innovation group leaders. The main content involved conducting innovations to solve clinical problems and ultimately completing the production of product prototypes. At the end of the theoretical course, members of each group were required to brainstorm, choose their own topics, conduct a product demand survey, and conduct innovative design and resource retrieval to realize their creative ideas. The members of each group were given different roles and responsibilities to maximize the function of the team. After finishing the innovative protocol, they submitted it to the research team for discussion, optimization and amendment. Finally, there was a competition for patented products to enhance the participants’ innovative spirit after the completion of practical training.
Outcome measures
The primary outcome in this study was clinical nurses' innovation ability, assessed using the Scale of Clinical Nursing Staff Innovation Ability [4],which was divided into 4 dimensions with 41 items, including the nurses' innovation subjects (17 items), innovation process (12 items), innovation environment and pressure (7 items) and innovative products (5 items) [4]. This scale was a five-point ordinal scale (1-5) with a maximum score of 205 points; the higher the score, the higher the nurse’s innovation ability [4]. Relevant studies showed that the Cronbach's coefficient of the scale was 0.938, and the Cronbach's coefficient of each dimension was 0.825 ~ 0.876 [4, 15]. The preliminary experiment of this study showed that the Cronbach's coefficient of the scale was 0.857.
The second outcome in this study was clinical nurses' research ability, assessed using The Scale of Nursing Scientific Research Ability, which was designed by Yin-he Pan [33] from Shanxi Medical University in China. This scale has 6 dimensions and 30 items, including the ability to generate research ideas (3 items), the ability to search and review literature (5 items), the ability to design a research protocol (5 items), the ability to conduct research (6 items), the ability to analyse research data and material (5 items), and the ability to write a research report (6 items) [33]. The scale was a five-point ordinal scale (0-4) with a maximum score of 120 points; a higher score represents a higher level of research ability [33]. Relevant studies show that the scale has good reliability [34]. In our study, the Cronbach's coefficient of research ability was 0.983.
The time points for assessment were at zero (pre-intervetion) and 3 months (follow up). Participants were assessed by completing the questionnaires through an online anonymous star thematic survey questionnaire. In addition, baseline characteristics were assessed through a sociodemographic questionnaire ,including gender, age, foundational education, highest academic credential, professional title, length of service, nursing duties and department.
Data Analysis
Statistical analyses were conducted using IBM SPSS 22.0.0 statistical software, and the test level was a=0.05. The general data of clinical nurses were described by frequency, percentage, mean and standard deviation. The clinical nurses’ scores for innovation ability and scientific research ability were described by the mean and standard deviation. A paired t test was used for measurement before and after intervention.