Research Utilization in Nursing Chapter 21 What is research utilization? Why is research utilization important? What are the steps n the research utilization process?

The use of research findings in practice to improve care 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

Value of Research Utilization To facilitate an innovative change that leads to improved client outcomes to validate existing nursing knowledge re procedures or interventions

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

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

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

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

Value to the Profession Enhanced autonomy of practice Positive professional image Strengthen professional status Expand the field of nursing’s scientific knowledge base

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

Steps of Research Utilization (cont’d) 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

Barriers to Research Utilization Characteristics of the Nurse Characteristics of the Setting Characteristics of the Research Characteristics of the Innovation

Barriers: Nurse Knowledge Attitude Erroneous beliefs Lack of time

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

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

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

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

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)

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

Other Strategies (cont’d) 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

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?

Guidelines for evaluating implementation of research findings Utility to practice applicability to practice replication scientific merit client safety feasibility