RESEARCH UTILIZATION

INTRODUCTION

The purpose of research is to be of use, to change current practice, or to confirm it. Yet the process of moving new understandings and new products from research to practice usually takes years, decades, or even generations. For 20 years or more, the nursing literature has discussed the gap between the conduct of nursing research and the use of research findings to improve practice. In the interim, the quantity and quality of nursing research have grown exponentially. The research has increasingly focused on issues of clinical significance-human responses to illness, health promotion, and health protection and methods of care delivery-so more relevant, applicable research is available to guide practice. Research utilization fosters movement from innovation into practice.¹

DEFINITION

Research utilization as a “process directed toward the transfer of research-based knowledge into nursing practice.

                                                                                                                                                   (S. Rodgers (1994)

“Utilization refers to the actual systematic implementation of a scientifically sound, researchbased innovation in a health care setting with an accompanying process to access the outcome(s) of the clinical change”.

                                                                                                                                             (University of Alberta)

“The process by which scientifically produced knowledge is transferred to practice”

                                                                                                                                                          (Brown, 1999)

“A process directed toward transfer of specific research-based knowledge into practice through the systematic use of a series of activities”.

                                                                                                                                               (Logan J, Graham ID)

“It is the process of synthesizing, disseminating and using research generated knowledge to make an impact on or change in the existing practices in society”. “It refers to the use of some aspect of a study in a clinical application unrelated to the original research”.

“The emphasis is on translating empirically derived knowledge into real-world applications”.

RESEARCH UTILIZATION MODEL

The Stetler Model steps are: preparation, validation, comparative evaluation, decision making, translation/application, and evaluation.⁷

1. Preparation

Preparation involves identifying the purpose and focus of the review. The research literature might be reviewed to solve a difficult clinical, managerial, or educational problem; to provide the basis for a policy, standard or protocol; or to prepare for an in-service program or other type of professional presentation (Burns & Grove, 1997).

2. Validation

Validating the research is the second step in this model. A key factor in using the data from the research is whether the information is application is applicable and relevant.

3. Comparative Evaluation

This involves a review of findings of similar studies. 

1. Findings for population, environment and problem?

2. Feasibility of using research findings in practice focusing on the three R’s: potential risk, resources needed, a readiness of the participants.

4. Decision Making

During this decision making phase the researcher has four choices to make. There is a decision to use the findings, to consider use, to delay use of the findings or reject the findings altogether.

5. Translation/Application

This phase actually prepares for the actual implementation of the findings in practice. The main question here is “how the knowledge should be applied?”

6. Evaluation

The final phase of this utilization model involves determining the impact on the practice, policy or even perhaps the patient. This utilization model lends itself appropriate for this particular change, impaired nurses. By identifying validated research and utilizing this model, possible administrative policies could be used to address the impaired nurse practitioner.

DIFFERENCE IN RESEARCH DISSEMINATION AND UTILIZATION

Many researchers, when they begin planning for dissemination and utilization, think primarily about the “D.” Dissemination is the important item on most people’s agendas: how to get research results to intended audiences in the most effective, cost-efficient manner. But utilization is a critical element in increasing the effective reach of research outcomes. Focusing only on the “D” in D&U is like dialing nine numbers of a ten-digit telephone number: You may be 90 percent finished, but unless you dial that last digit, you’ll never make the intended connection.

STEPS IN RESEARCH UTILIZATION PROCESS

Research utilization is a multiple step process that involves; Determining the research knowledge ready for use in practice Persuading (convincing) nurses to use this knowledge Making a decision to use the knowledge in practice Implementing the knowledge to change practice Determining the outcomes from making the research based change in practice. ²

Steps of the Research Utilization process Rogers characterized the innovation—adoption process as having five stages:

 knowledge

 persuasion

 decision

 implementation

 confirmation.

During the knowledge stage, individuals or groups become aware of the innovation, During the persuasion stage, they form a positive attitude toward it.

In the decision stage, a choice is made about whether to adopt or reject the innovation. The innovation is actually put into use during the implementation stage.

During the confirmation stage, the effectiveness of the innovation is evaluated

BARRIERS OF RESEARCH UTILIZATION³

a) Factors related to nurses: The nurse’s research values, skills, and awareness

 Lack of awareness of the research

 Being isolated from knowledgeable colleagueswith whom to discuss the research

 Not feeling capable of evaluating the quality of theresearch

 Feeling the benefits of changing practice will be minimal

 Seeing little benefit for self

 Unwillingness to change/try new ideas

 Not perceiving a need to change practice

 Not seeing the value of research for practice

b) Organizational factors : Setting barriers and limitations

 Insufficient authority to change patient care procedures

 Insufficient time on the job to implement new ideas

 Physicians not cooperating with implementation

 Administration not allowing implementation

 Other staff not being supportive of implementation

 Research results not generalizable to own setting

 inadequate facilities for implementation

 insufficient time to read research

c) Factors of the innovation: Qualities of the research

 Research has not been replicated

 Uncertainty about the believability of the resultsof theresearch

 Literature reports conflicting results

 Methodology inadequacies of the research

 Research reports/articles are not published fast enough

 Conclusions drawn from the research are not justified

d) Communication factors: Presentation and accessibility of the research

 Statistical analyses are not understandable

 The relevant literature is not compiled in one place

 Implications for practice are not made clear

 Research reports/articles are not readily available

 The research is not reported clearly and readably

 The research is not relevant to the nurse’s practice

Strategies to facilitate utilization of nursing research

The most crucial factors in facilitating the research utilization are the identification of clinically relevant problems and issues. Other facilitating the factors includes environments in which individuals are committed to critical thinking and to research utilization process. Nursing administrators who provide adequate resources (e.g. – personnel, time, and money) help promote research utilization⁴ .

Barriers to research based practice are multidimensional, soothe process to implement the effective strategies to overcome these barriers will require a combined effort from nurses in education, research, administration, clinical practice.⁴

NURSE EDUCATORS

Nurse educators are crucial role models in providing a foundation for research based practice. The research based clinical practices that will solve the problems. While making work procedures more efficient and therefore less costly, are good reasons for change.To sum up educators must

• Use research findings

• Incorporate research finding in a clinical assessment

• Strive to make the research exiting so that student can be motivated to conduct research activity.

NURSE RESEARCHERS

Dissemination methods used by researchers in publications and presentations often inhibit rather than support research based practice. Clear and most useful reports are key issues for overcoming barriers to research based practice. To sum up researchers must practice some of the following measures⁵

• Focus their research activity on current clinical problems.

• Disseminate the research results as early as possible.

• Present research findings locally, regionally and nationally.

• Publish the research findings in clinical as well as scientific journals.

• Clearly delineate practice implications of results.

NURSE ADMINISTRATOR

The organization should establish the expectation of research based practice. If nurses are allowed to continually question current practices, then the expectation will exist for the present and future nurses to do so. Also structure of the health care organization should support research based practices. Establishing a department of nursing research immediately indicate the institution’s level of commitment to research.⁶ To sum up nursing administrators must follow some of the measures given below

• Establish a research friendly culture.

• Encourage the clinicians to question traditions.

• Reward risk- taking and innovation.

• Require research basis for practice changes.

• Incorporate research role in job descriptions.

• Provide research resources such as medical and nursing literature, internet access, consultants, etc.

• Encourage and support continuing education, conference participation, and publishing.

• Encourage role model research collaboration.

NURSE CLINICIANS

Nurse should be encouraged to update their research skill. This can be accomplished by seeking advanced nursing degree, or the organization can work to provide education regarding research utilization. Also provide more opportunity the nurse has to read research article, the greater the chance that research findings will be adopted. An additional way to make findings accessible is to encourage the nurses to publish their findings in professional journals. Many clinical journals are now emphasizing research based practice6 . To sum up the nurse clinicians must take initiative for the following measures:

• Question practice traditions.

• Stay update with literature.

• Commit to continuous learning, such as continuing education, joining professional organizations, and pursuing advanced degree.

• Collaborate with researchers to relay clinical issues and questions.

• Support research conduct in the clinical settings.

• Take the risk to make changes and improve practice.

CONCLUSION

When barriers to research utilization are identified, the nurse administrators, clinicians and researchers can design and implement specific strategies to overcome those obstacles. These strategies may be specific to staff members, facilities or situations. Research utilization is the vital part for the professional growth based on the situational challenges.

Conflict of Interest - None