1. Utilizing Research: Putting Research Evidence Into Nursing Practice Prepare by /Dr. AmiraYahia

2. Outlines  Introduction  RESEARCH UTILIZATION VERSUS EVIDENCEBASED PRACTICE  Utilization of Nursing Research  Research Utilization Process  Rogers characterized of the innovation  Research Utilization in Nursing Practice  Evidence-Based Practice  BARRIERS TO USING RESEARCH IN NURSING PRACTICE

3. Introduction Most nurse researchers want their findings to contribute to nursing practice, and there is growing interest among nurses in basing their practice on solid research evidence

4. RESEARCH UTILIZATION VERSUS EVIDENCEBASED PRACTICE The terms research utilization and evidence-based practice are sometimes used synonymously. Although there is overlap between the two concepts, they are, in fact, distinct. Research utilization (RU), the narrower of the two terms, is the use of the findings from a disciplined study or set of studies in a practical application that is unrelated to the original research.

5. Cont… EBP involves making clinical decisions on the basis of the best possible evidence. Usually, the best evidence comes from rigorous research

6. The Utilization of Nursing Research During the 1980s and early 1990s, research utilization became an important buzz word, and several changes in nursing education and nursing research were prompted by the desire to develop a knowledge base for nursing practice

7. Cont….. These changes, coupled with the completion of several large research utilization projects, played a role in sensitizing the nursing community to the desirability of using research as a basis for practice

8. Research utilization (RU) and evidence-based practice (EBP RU path Emergency of research finding on atopic(innovation) findings on a topic Search for best evidence to address clinical problems Evaluation/integration of other types of evidence (e.g: patient preference) Efforts to base practice on best evidence(EBP) on Efforts Evaluation/integrati on of finding :best research evidence practice (RU) (innovations) findings on a) Efforts to use n/integration Efforts to use findings in practice(RU) (innovations) findings on a topic of EBP path -->

9. Cont…. Recently studied research utilization found evidence to support three distinct types of research utilization: (1) indirect research utilization, involving changes in nurses’ thinking and therefore similar to conceptual utilization. (2) direct research utilization, involving the direct use of findings in giving patient care and therefore similar to instrumental utilization

10. (3) persuasive utilization, involving the use of findings to encourage others (typically those in decision making positions) to make changes in policies or practices relevant to nursing care.

11. Cont… These varying ways of thinking about research utilization clearly suggest that both qualitative and quantitative research can play key roles in guiding and improving nursing practice.

12. The Research Utilization Process: Rogers’ Diffusion of Innovations Theory The key elements in this process, all of which influence the rate and extent of innovation Adoption, include the following: 1. The innovation is the new idea, practice, or procedure that, if adopted, will result in changes; the nature of the innovation strongly affects decisions about adoption.

13. 2. Communication channels are the media through which information about the innovation is transmitted, and can include both mass media (e.g., journal articles, the Internet), or individual, face to- face communication

14. 3. Time is a component of the theory in that the process of knowledge diffusion occurs over time; there are varying amounts of time that elapse between the creation of the knowledge and its dissemination, and between knowledge awareness and the decision to use or reject the innovation. 4. The social system is the set of interrelated units that solve problems and seek to accomplish a common goal; diffusion occurs within social systems that vary in their norms and receptivity to innovations

15. Rogers characterized the innovation— adoption process as having five stages 1- Knowledge stage, individuals or groups become aware of the innovation 2-Persuasion stage, they form a positive attitude toward it. 3- Decision stage, a choice is made about whether to adopt or reject the innovation. 4- Implementation stage. 5- Confirmation stage, and decisions get made about continuation or discontinuation of the innovation

16. Research Utilization in Nursing Practice There is need to reduce the gap between nursing research and nursing practice. The Conduct and Utilization of Research in Nursing (CURN) Project, found major objective of the CURN project was to increase the use of research findings in the daily practice of registered nurses by disseminating current research findings, facilitating organizational changes needed to implement innovations, and encouraging collaborative clinical research

17. Evidence-Based Practice EBP, by contrast, begins with a search for information about how best to solve specific practice problems. EBP offers a solution to sustaining high health care quality in our current cost-constrained environment.

18. Six-level evidence hierarchy that also assigns grades on study quality: I. Meta-analyses of controlled studies II. Individual experimental studies III. Quasi-experimental studies IV. Nonexperimental studies V. Program evaluations, research utilization studies, quality improvement projects, case reports VI. Opinions of respected authorities and of expert committees

19. BARRIERS TO USING RESEARCH IN NURSING PRACTICE  Research-Related Barriers : For many nursing problems, the state of the art of research knowledge is fairly primitive.  Nurse-Related Barriers: Nurses’ attitudes toward research and their motivation to engage in EBP have repeatedly been identified as potential barriers

20. Cont…  Organizational Barriers : In many practice settings administrators have established procedures to reward competence in nursing practice. Organizations also may be reluctant to expend resources for RU/EBP activities or for changing organizational policy

21.  Barriers Related to the Nursing Profession: Sometimes has been difficult to encourage clinicians and researchers to interact and collaborate. They are usually in different settings, have many different professional concerns.