Background Many researchers have explored the barriers to research uptake in order to overcome them and identify strategies to facilitate research utilization However, the research–practice gap remains a persistent issue for the nursing profession Aims and objectives The aim of this study was to gain an understanding of perceived influences on nurses' utilization of research, and explore what differences or commonalities exist between the findings of this research and those of studies that have been conducted in various countries during the past 10 years Design Nurses were surveyed to elicit their opinions regarding barriers to, and facilitators of, research utilization The instrument comprised a 29-item validated questionnaire, titled Barriers to Research Utilisation Scale (BARRIERS Scale), an eight-item scale of facilitators, provision for respondents to record additional barriers and/or facilitators and a series of demographic questions Method The questionnaire was administered in 2001 to all nurses (n = 761) working at a major teaching hospital in Melbourne, Australia A 45% response rate was achieved Results Greatest barriers to research utilization reported included time constraints, lack of awareness of available research literature, insufficient authority to change practice, inadequate skills in critical appraisal and lack of support for implementation of research findings Greatest facilitators to research utilization reported included availability of more time to review and implement research findings, availability of more relevant research and colleague support Conclusion One of the most striking features of the findings of the present study is that perceptions of Australian nurses are remarkably consistent with reported perceptions of nurses in the US, UK and Northern Ireland during the past decade Relevance to clinical practice If the use of research evidence in practice results in better outcomes for our patients, this behoves us, as a profession, to address issues surrounding support for implementation of research findings, authority to change practice, time constraints and ability to critically appraise research with conviction and a sense of urgency

Bridging the divide: a survey of nurses' opinions regarding barriers to, and facilitators of, research utilization in the practice setting

In a keynote address to the Teacher Training Agency Annual Conference, Professor David Hargreaves suggested that teaching could become an evidence-based profession if educational researchers were made more accountable to teachers. This systematic literature review set out to explore: how teachers use research; which features of research encourage teachers to use research findings in their own practice; whether medical practitioners make greater use of research findings than teachers; and approaches to dissemination. Two key ideas emerge from this review. First, there appear to be common barriers to research use in both medicine and in education. Findings suggest that there is a need to create a culture in the public sector which supports and values research. There are, however, a number of factors, which appear to be more specific to the education field. Key differences in the way that research knowledge is constructed in the social sciences has led to researchers being challenged about their findings, pa...

The use of research to improve professional practice: a systematic review of the literature

Background.  This paper conceptualizes nursing as a health profession in transformation at the beginning of the 21st century. We frame our analysis using Michel Foucault's concept of governmentality. While extensively quoted and used in other disciplines, the work of the late French philosopher has been cited infrequently in the nursing literature. Yet a closer look at his work reveals how Foucault offers a relevant entry point for revisiting nursing theory and nursing practice.

Aim of paper.  The aim of this paper is to reflect on nursing practice as it is inscribed within the state's modus operandi. We discuss the prevalent notion that nurses are powerless and suggest they do exercise power in many ways and that they are a powerful group.

Results.  In this paper we show how nursing is a means of governmentality of individuals and of the population because its practices contribute to the management of society through a vast range of power techniques. These techniques range from disciplining individuals to promoting discourses that construct desirable subjectivities. Within this perspective, the emergence of political aspects of nursing theory and nursing practice are made explicit.

Conclusion.  We explore the limits and potentials of the concept of governmentality to the understanding of nursing as a health profession. This concept can generate a form of critical immobilism, but also promotes a more politically complex understanding of nursing practice.

Nursing as means of governmentality.

The evidence-based practice movement has highlighted the importance of translating research evidence into practice. However, the gap between research and practice points to the existence of significant barriers to research use. To identify the most commonly cited barriers to the use of research in practice, the findings arising from studies that used the Barriers to Research Utilization Scale are examined. Based on these findings, the authors discuss and make recommendations to assist nurse administrators in overcoming universally reported barriers to research use.

Beyond the BARRIERS Scale: commonly reported barriers to research use.

Different approaches to practice development are associated with different assumptions, and these need to be made explicit if practice development is to be transparent, rigorous and systematic in its intentions and approaches. A practice development methodology underpinned by critical social science is advocated because it focuses on achieving sustainable change through practitioner enlightenment, empowerment and emancipation and an associated culture, rather than focusing only on technical practice development. Implications of different worldviews about practice development for facilitation and outcome evaluation are highlighted. Emancipatory practice development underpinned by critical social science is argued as synonymous to emancipatory action research.

Practice Development Purpose, Methodology, Facilitation and Evaluation

This paper discusses a number of different levels at which the implementation of nursing research findings needs to be addressed and identifies 10 areas of potential difficulty: the complexity of the change process, the genesis of research programmes, the formulation of research questions, differences in theoretical approaches, timescales and planning cycles, information overload, credibility, applicability, response to change and the management of change. An attempt is made to shift the nature of the discourse from the personal to the organizational and from a diffusionist perspective to that of change management. It is suggested that it is simplistic to regard the apparent lack of take-up of research-based practice findings as a failure on the part of individual nurses to respond rationally to the production of new information. The integration of research and practice has to be addressed at all levels within an organization; from policy statements to procedure manuals and from managers, educators and clinicians to support workers within the framework of the management of change. The potential of action research and quality circles in this context is touched on.

Putting nursing research findings into practice: research utilization as an aspect of the management of change.

An approach to evaluating the introduction of primary nursing in an acute medical unit for the elderly--I. Principles and practice.

Assessments of quality of care using Senior Monitor in three matched wards for elderly patients were carried out on three occasions. The first assessment was carried out in June 1987 as a trial of the measurement tool. The instrument allows for a maximum score of 100. All three wards scored above 60, with two wards scoring above 70. Primary nursing was introduced in one of the wards in January 1988 and the assessment was repeated in June 1988. All ward scores were above 70, with one ward, not the primary nursing ward, scoring above 80. A third assessment was carried out in June 1989. Again, all three wards scored above 70 but this time the primary nursing ward scored 86; the highest ward score of the series. The results for the sub-sections of the assessment are explored in the paper and issues about validity, reliability and inter-rater reliability are discussed. It is argued that Senior Monitor is a useful tool for assessing changes in the quality of care delivered to patients in wards for the elderly but that its full value only becomes apparent with repetition over an extended time period. It may be less appropriate for assessing the impact of a change in the organization of care, not because of any inherent fault in the test but because the very process of using it makes staff look at their practice more critically. It is this critical re-appraisal rather than the change in organization per se which stimulates the improvement in the quality of care.

Jillian Macguire

Papers

Putting nursing research findings into practice: research utilization as an aspect of the management of change.

An approach to evaluating the introduction of primary nursing in an acute medical unit for the elderly--I. Principles and practice.

Quality of care assessed: using the Senior Monitor index in three wards for the elderly before and after a change to primary nursing.

An approach to evaluating the introduction of primary nursing in an acute medical unit for the elderly--II. Operationalizing the principles.

Nurses with degrees in the United Kingdom: careers and contributions and challenges.