The dissemination and implementation of research evidence upon which clinical practice should be based, pose many well-documented problems for nurses. The study reported here set out to identify some of the common barriers to the dissemination and utilisation of research findings and went on to explore what practising nurses believed would facilitate the use of research in one important aspect of clinical care: care of the incontinent patient. A series of small scale interrelated studies were undertaken using samples which comprised nursing staff involved in caring for the elderly, and patients in a community hospital. These studies allowed the identification of specific barriers to the use of research in practice and involved nurses in the development of appropriate strategies for applying research evidence on continence care within a clinical setting. Each of the studies required specific methodologies in order to achieve their objectives. The initial study used a postal questionnaire to identify nurses' perceptions of barriers to and facilitators of research use in clinical practice. A qualitative exploratory study was then undertaken to explore these perceptions in more depth using taped semistructured interviews. The results of these interviews determined suitable strategies, specified by practising nurses for the use of research in practice. These strategies were then implemented and evaluated in two further studies using predominantly quantitative methods. The first evaluation study employed the use of a clinical handbook, this evaluation used a pre- and post-test design with an experimental and control group. This study showed that the use of the handbook, a decanted user-friendly research based resource on continence care, improved nurses' knowledge of incontinence. The final study adopted case study methodology and evaluated the use of research evidence on one aspect of continence care: bladder re-education in a single setting. This case study used a number of outcome measures, including nurses' knowledge of and attitudes to incontinence and patient severity and satisfaction with treatment. The results of this study showed improvements in each of the outcomes measured. The exploration of nurses' experiences of barriers to the use of research is not new. However, the involvement of clinicians in the development of implementation strategies is newer ground. By using this relatively novel approach, practising nurses were expected to feel enhanced ownership of strategies for implementation and as a result to be more committed to the process of change. As a result of the current health policy drive for evidence-based health care, nurses increasingly recognise the need to base care on the best available evidence. However, without education, direction, support and encouragement at user level, implementation of research evidence will continue to be a slow and uneven process. The present study attempts to identify how such education, support and encouragement can be provided and evaluated.
Permanent link to this resource: https://doi.org/10.24384/z63a-t878
Williams, Katherine S.
Supervisors: Roe, Brenda; Lindsay, Roger
Faculty of Health and Life Sciences
Year: 2000
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