Research utilisation in nursing practice : barriers and facilitators

Abstract: Research utilisation in nursing practice - barriers and facilitators To improve and develop nursing practice it is important that research findings are utilised by the nurses. The main purpose of this thesis was to explore barriers to and facilitators of research utilisation in nursing practice and to identify factors that might be of importance for that. Data were collected by means of three questionnaires; one regarding barriers to and facilitators of research use in practice (I, II, III); two work environment questionnaires (III) and by means of focus groups (IV). Study I included registered nurses in clinical practice (n = 237). Characteristics of the organisation as lack of time for reading, lack of time and resources for implementation of research findings and nurses' lack of authority together with the way the research findings are presented and its accessibility were seen as major barriers to research utilisation by the nurses. In study II the clinical nurses' perceptions (1) were compared with a group of nursing teachers' (n = 37), nursing students' (n = 166), nursing administrators' (n = 33) and physicians' (n = 127) perceptions. The teachers and the students perceived almost the same barriers as the clinical nurses did. The physicians perceived barriers to a lesser extent than the other groups did. Education to increase the nurses knowledge of research methods and to develop their skills in evaluating research findings, the allocation of resources for implementation of research findings, more staff, and research presented in a user-friendly way, were suggested as facilitators of research utilisation (I, II. In study III registered nurses' (n=833) perceptions of barriers to research utilisation were explored. These nurses reported on the whole the same barriers as mentioned in study I. Moreover multiple and logistic regression analyses were used to identify factors of importance for perceiving barriers. Unclear and unrealistic workplace goals, being dissatisfied with support from superiors for quality improvement and/or research activities and having no academic degree increased the risk of perceiving barriers. In study IV ten registered nurses participated in a researchorientated educational program with the aim of facilitating research utilisation in clinical practice. The program contained different activities to disseminate and implement research findings at the participants' wards. The nurses' experiences of disseminating and implementing research findings were explored and a qualitative content analysis was performed. Organisational and leadership issues and nurses' interest in research and the nurses reading habits were perceived as important factors for research utilisation. In consideration with the participants' new role as "change agents", support and feed back from head nurses, colleagues and physicians were perceived as important. This thesis shows that there are barriers to research utilisation and confirm that the change to a research-based nursing care is a complex issue. Support and engagement from head nurses and managers, education for head nurses as well as for clinical nurses in research subjects and the development and evaluation of models to increase the uptake of research are of utmost importance for the development of evidence based nursing care.