II. Utilization of findings

A. Barriers to using nursing research

1. Nurses' lack of knowledge

a. Unaware of nursing research studies

b. Do not read current journals that publish research

c. Lack of research knowledge base

2. Nurses' negative attitudes

a. Do not appreciate value of research for practice

b. Lack of research role models in the clinical area

3. Inadequate dissemination of research findings

a. Most nursing research studies are never published or presented at research meetings or workshops

b. Research articles are not readily available to nurses on the clinical area

c. Articles and/or presentations are not at the level of the staff nurse

d. Research is not published in popular journals with a large circulation and audience

e. Findings are not shared with laymen

4. Lack of institutional support

a. Inadequate library and computer resources

b. Inadequate people resources i.e., research experts

c. No time off to attend conferences

d. No on-the-job time to read research

e. Not enough authority to change patient care procedures

f. Insufficient time on job to implement new ideas

5. Findings not ready for use in practice

a. Need replication of studies with same population after implementing changes

b. Replication an essential component of science

c. Replicate study at least once and demonstrated to be "true" with "real patients" as well as "normal" subjects

B. Bridging the gap between research and practice

1. Steps to bridging gap

a. Identify specific clinical nursing practice problems

b. Assess the existing knowledge base on issues

c. Design a nursing practice innovation based on scientific research base

d. Implement clinical trials and evaluation of innovation

e. Adopt, revise or reject the innovation

f. Develop strategies to extend the innovation to other settings

g. Determine means of continuing the innovation over time

C. Utilization criteria - Stetler and Marram

1. Validation

a. Overall examination of strengths and weaknesses of study

b. Critique all facets of study to determine its validity

2. Comparative evaluation - feasibility

a. What variables affect decision to change practice

b. Would it be possible to implement findings

c. Legal/ethical risks examined

d. Organizational changes? Cost of change?

3. Decision-making

a. Cognitive application - use information to enhance knowledge base

b. Direct application - test out findings in practice

c. Use wisdom in applying research to practice

III. Models of research utilization in practice

A. WCHEN - 3 day workshops on change process to bring about research utilization

(Western Council on Higher Education for Nursing)

1. Goals

a. Stimulate research in clinical settings

b. use of findings in daily practice

2. Nursing innovations

a. Mutual goal setting

b. Closed Primary drainage system

c. Distress reduction through sensory prep.

d. Pain

e. IV cannula change

f. Prevention of diculutus ulcers

g. Pre-op sensory preparation to promote recovery

h. ing diarrhea in TF pts

i. Structured pre-op teaching

C. NCAST - Nursing Child Assmt Satellite Training

1. Disseminated findings of nurse-child assessment longitudinal study

2. Used two-way satellite hookup between researcher and clinical nurses

D. Agency for Health Care Policy and Research - Clinical Practice Guides

1. Pressure sores

2. Urinary incontinence

3. Pain management

4. Depression

5. Sickle Cell disease

6. Cataracts

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