Research Utilization in Nursing Chapter 21

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Research Utilization in NursingChapter 21

• What is research utilization?
• Why is research utilization important?
• What are the steps n the research utilization
  process?

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Research Utilization

• The use of research findings in practice to
  improve care
• Conceptual utilization- use of findings to
  cognitively restructure thinking about a
  phenomenon
• Instrumental utilization- direct application of
  knowledge to change practice

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Value of Research Utilization

• To facilitate an innovative change that leads to
  improved client outcomes
• to validate existing nursing knowledge re
  procedures or interventions

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Evidence-Based Practice

• Uses research to direct client care
• Challenges nurses to critically examine
  traditional practices, procedures, and nursing
  rituals and question those that are not
  substantiated by research or other evidence

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Value of Research Utilization

• Promotes critical thinking and reflective
  practice
• enhances professional self-concept
• ensures provision of safe and effective care
• practice is based on current, scientifically
  sound knowledge
• Self-confidence of the nurse is enhanced

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Value of Research Utilization to the Researcher

• Validates the efforts of the researcher
• Motivates scholars to continue to discover new
  knowledge
• Reinforces professional accountability
• Helps discover new clinical problems for
  investigation

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Value to the Health Care Agency

• Cost-effective nursing care
• High-quality care
• Improved client outcomes
• Retention and recruitment tools
• Professionally satisfied and stimulated nursing
  staff

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Value to the Profession

• Enhanced autonomy of practice
• Positive professional image
• Strengthen professional status
• Expand the field of nursings scientific
  knowledge base

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Steps in the Research Utilization Process

• 1. Select a relevant problem area that requires
  evidence to bring about change
• 2. Review the literature
• 3. Determine if the literature findings are
  appropriate to apply in your setting

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Steps of Research Utilization (contd)

• 4. Develop a written research-based protocol
  and/or procedure to communicate the innovation
  and ensure consistency in approach and show
  research base for it
• 5. Implementation of the planned innovation
• 6. Evaluation of the success of the innovation
• 7. Dissemination of the findings

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Barriers to Research Utilization

• Characteristics of the Nurse
• Characteristics of the Setting
• Characteristics of the Research
• Characteristics of the Innovation

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Barriers Nurse

• Knowledge
• Attitude
• Erroneous beliefs
• Lack of time

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Barriers Setting

• Ethos of openness to new ideas
• Interpersonal and information linkages
• Freedom from organizational constraints
• Supportive leadership
• Trust

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Barriers Research

• Communicate results clearly and comprehensively
• Publish widely in user-friendly journals
• Focus on problems of importance to nursing
  practice
• Increase the number of replicated studies

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Barriers Innovation

• Must offer a relative advantage over the status
  quo
• Compatibility with current practice
• Complexity of innovation is inversely related to
  success
• Trialability or pilot testing
• Observability of benefits and limitations

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CHANGE AGENT

• A person or group of people who can take an idea
  for change and carry it through all the stages of
  its implementation, and evaluate its success or
  failure

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Strategies to Facilitate Research-Based Practice

• Planned Change (unfreezing, moving, re-freezing)
  Phases (Lewin, 1951)
• Theory of Diffusion of Innovation (awareness,
  persuasion, decision, implementation,
  confirmation stages) (Rodgers, 1965,1995)

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Other Strategies

• deliberately expose one self to research
  literature and findings
• journal clubs
• conference attendance
• support research in setting
• educators can role model utilization of research
  in their teaching and engage students in
  reflective practice

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Other Strategies (contd)

• Provide critiquing assignments and regular
  research reviews to students
• Researchers can conduct rigorous studies
• Identify implications of research for practice
• Replicate previous studies
• Incorporate research findings into text books

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Exercise

• Using a theory of planned change identify the
  steps you would take to implement a research
  utilization project to deal with a problem from
  the practice setting that is of concern to you.
• 1. Identify the problem.
• 2. How would you evaluate the success of failure
  of the plan?
• 3. Why is consolidation of the innovation in
  practice important to a research utilization?

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Guidelines for evaluating implementation of
research findings

• Utility to practice
• applicability to practice
• replication
• scientific merit
• client safety
• feasibility