Nursing students' perceptions of research: usefulness, implementation and training

AIMS: The present study explored students' perceptions of the usefulness of research for nursing practice; beliefs about difficulties in implementing research on the wards; and finally, their satisfaction with the research training received. BACKGROUND: Anecdotal reports of nursing students' dislike of research. METHOD: Recruiting preregistration students for the present study was the first obstacle, and so the sample size remained small, consisting of 12 students. Semi-structured interviews were conducted and later transcribed. RESULTS: The findings indicated that resistance, both by students and by qualified nurses, was a recurring issue. Several students disagreed with the training and expressed a need for more practical experience. CONCLUSIONS: Overall, the present study suggests that educational and organizational improvements need to be introduced to transform nursing into a research-active profession.     

Acute care nurses' perceptions of barriers to using research information in clinical decision-making

AIM: To examine the barriers that nurses feel prevent them from using research in the decisions they make. BACKGROUND: A sizeable research literature focusing on research utilization in nursing has developed over the past 20 years. However, this literature is characterized by a number of weaknesses: self-reported utilization behaviour; poor response rates and small, nonrandom sampling strategies. DESIGN: Cross-case analysis involving anonymised qualitative interviews, observation, documentary audit and Q methodological modelling of shared subjectivities amongst nurses. The case sites were three large acute hospitals in the north of England. One hundred and eight nurses were interviewed, 61 of whom were also observed for a total of 180 h, and 122 nurses were involved in the Q modelling exercise (response rate of 64%). RESULTS: Four perspectives were isolated that encompassed the characteristics associated with barriers to research use. These related to the individual, organization, nature of research information itself and environment. Nurses clustered around four main perspectives on the barriers to research use: (1) Problems in interpreting and using research products, which were seen as too complex, 'academic' and overly statistical; (2) Nurses who felt confident with research-based information perceived a lack of organizational support as a significant block; (3) Many nurses felt that researchers and research products lack clinical credibility and that they fail to offer the desired level of clinical direction; (4) Some nurses lacked the skills and, to a lesser degree, the motivation to use research themselves. These individuals liked research messages passed on to them by a third party and sought to foster others' involvement in research-based practice, rather than becoming directly involved themselves. CONCLUSIONS: Rejection of research knowledge is not a barrier to its application. Rather, the presentation and management of research knowledge in the workplace represent significant challenges for clinicians, policy-makers and the research community.     

Project 2000 diplomates' perceptions of their experiences of transition from student to staff nurse

? This paper presents findings from an exploratory study of the transition experiences of newly qualified Project 2000 diplomates. ? A qualitative approach was utilized involving in-depth interactive interviews with a sample of 10 staff nurses. ? The data indicate that some aspects of transition were initially difficult, but that all those interviewed were enjoying nursing. ? Similarities to the experiences of ‘traditionally prepared’ colleagues are highlighted by the use of phrases such as ‘in at the deep end’ and ‘cast adrift’, reflecting the practice environment once qualified. ? Paradoxically initial transition for Project 2000 diplomates is characterized by a lack of confidence, while their questioning approach to practice and a willingness to ask others when unsure (‘no bluffing’) suggests a high degree of confidence. ? Preceptorship in the context of a supportive environment is suggested as a model for easing the transition process. A re-evaluation of what an initial preparation course can and should achieve, and a re-assessment of the skills and knowledge expected of newly qualified nurses, are also indicated.     

A survey of Hong Kong nurses' perceptions of barriers to and facilitators of research utilization

A survey of 1,487 nurses was conducted to examine barriers to and facilitators of research utilization. Characteristics of the organization were the greatest barriers to research utilization; the highest ranked of these were inadequate facilities, lack of authority to change practice, lack of time, and lack of cooperation from physicians. The three highest ranked organizational facilitators were managerial support, colleague support, and education to increase nursing knowledge. Age and years of working experience were not significantly correlated with any of the subscales. To integrate the use of research evidence into the culture of various clinical settings, and with the aim of extending evidence-based practice into the private and primary health care sectors in Hong Kong, local organizational barriers and facilitators need to be addressed.     

Project 2000: perceptions of the philosophy and practice of nursing: shifting perceptions—a new practitioner?

This is the first of two papers which address aspects of the findings of a large scale study commissioned by the English National Board which set out to examine the impact of Project 2000 on perceptions of the philosophy and practice of nursing. The findings presented here suggest that there have been fundamental shifts in perceptions of the nature and discipline of nursing. Students and diplomates of the course perceive themselves as knowledgeable doers, with their practice well grounded in theory and research. They value the interpersonal skills teaching and place the patient firmly at the centre of care delivery, viewing the patient holistically and being prepared to be fierce patient advocates where necessary. It is difficult to determine the extent to which these shifts can be attributed to the Project 2000 course, although the Project 2000 approach to education appears to be an important factor.     

Implementing research findings into mental health nursing practice: exploring the clinical research fellowship approach

ABSTRACT:  The lack of research utilization within nursing practice has been extensively discussed in the literature. The Clinical Research Fellowship (CRF) program was developed to assist nurses to change practice on the basis of high-quality research evidence. This paper presents the results of a qualitative study examining the experiences of four CRF participants and three of their unit managers in completing the program and implementing changes within the clinical setting. The major themes to emerge from the data were: experience of the program, outcomes, implementation, assistance from the Centre for Psychiatric Nursing Research and Practice, Victoria, Australia, benefits and drawbacks to the program and whether it would be recommended to others. The findings indicate a positive view of the program itself although problems with the implementation stage were clearly evident. Further support following completion of the program is required to achieve maximum benefit from the program.     

A triangulation approach to the identification of acute sector nurses' training needs for formal nurse practitioner status

The current confusion surrounding the definition and role function of the nurse practitioner (NP) has created a situation in which advanced clinical practice is delivered in a variety of ways and at many levels. Not surprisingly, this has led to difficulties in regulating educational provision for NPs. This study reports a survey of the perceptions of the role definitions and training needs of all nurses working at advanced clinical levels within an acute sector Trust. Although this concept is not a novel one in advanced nursing practice, the procedure adopted differed from previous studies in two fundamental ways: firstly, a unique training needs assessment instrument was used, which because of its validity and opacity, was capable of yielding a highly reliable data-base, comprising a prioritized profile of real training needs as opposed to the standard wish-list typically elicited. Secondly, it did not rely simply on the self-reported needs of the nurse sample, but also included the perceptions of the sample's immediate medical and managerial colleagues. In this way, a triangulation paradigm was adopted. The results indicated that overall, there was high agreement between the nurses and their managers, regarding both the definition of the NP role and the essential training requirements, with somewhat different opinions being offered by the medical staff. When the raw scores were standardized to correct for response bias, the data provided an operational definition of the role of the NP and a prioritized profile of training needs for nurses who wished to train to this level.     

Approaches used to implement research findings into nursing practice: Report of a study tour to Australia and New Zealand

The focus of the study tour to several research and nursing units in Australia and New Zealand (NZ) was to investigate what has influenced the way nurses implement research into practice. The key areas examined were strategic policy influences, activities within leading academic units and responses in practice areas. The main themes to emerge were that the strategies developed by health policy makers in Australia and New Zealand have been profoundly influenced by the global clinical effectiveness and evidence-based practice movements. Nursing needs to position itself firmly in the centre of such developments and leading nursing initiatives need to be mainstreamed into the wider evidence-based movement. While activity around clinical/practice guideline development moves on, more work needs to be done to understand how best to actually implement research in practice. Issues of organizational context, ownership, practice, culture and identifying local champions are emerging as key challenges for the next stage of implementation. Much can be learnt from ongoing dialogue.     

Stakeholders' perceptions of a research capacity development project for nurses, midwives and allied health professionals

AIMS: To evaluate stakeholders perceptions of the extent to which a research facilitator post was addressing aims of: * providing academic support to enable research involvement of nurses, midwives and allied health professionals; * supporting dissemination of research into practice; * contributing to research strategy development. BACKGROUND: Barriers to research capacity development have been recognized for nurses, midwives and allied health professionals. A project established in a London NHS trust aimed to address these. METHODS: A mixed methods approach was used. RESULTS: Responses were generally very positive. The post effected improvements in the research culture and perceived increase in research-related activities. CONCLUSION: The post made substantial progress towards its aims. This approach may be useful in other healthcare locations to build research capacity. IMPLICATIONS FOR NURSING MANAGEMENT: Challenged by increasing priority accorded to research capacity and service research implementation yet recognition of barriers to achievement, this study offers insights from one means to address this.     

Tensions and contradictions in nurses' perspectives of evidence-based practice

Aim  To explore nurses' understanding and interpretation of evidence-based practice (EBP).
Background  EBP has been welcomed into the nursing lexicon without a critical examination of its interpretation by practitioners. The literature suggests that there is a great deal of confusion and contradiction over the meaning and application of EBP. Although work has been conducted on how EBP might be implemented, the general issue of how nurses understand and use EBP is largely unexplored. This paper seeks to examine in depth the understandings of EBP, to enable managers, educationalists and policy makers to implement it more effectively.
Methods  All registered nurses, midwives and health visitors in one UK National Health Service (NHS) Trust were asked to complete a questionnaire in October 2006.
Results  Despite a disappointing response rate (8.9%, 218/2438), the survey revealed interesting tensions and contradictions in nurses' understanding of EBP. National and local guidelines, practitioners' own experience and patients' preferences were the main influences on nurses' practice. Published research had relatively little impact, particularly among nurses graded E, F and G and those who had not attended a study day on EBP.
Conclusions  The hierarchies of evidence propounded in local and national guidelines are not adopted by practising nurses, who use other sources of evidence, such as reflection on their own experiences, when making clinical decisions. However, subsuming published evidence to clinical judgement does not contradict the original tenets of EBP.
Implications for Nursing Management  Unless it is incorporated into national or local guidelines, research has relatively little impact on practice. To develop nursing practice and nursing knowledge, nurse leaders need to foster the synthesis of experiential knowledge and published research, in accordance with the founding principles of the EBP movement.     

重庆市临床护理带教老师培训需求现状调查

目的调查重庆市临床护理带教老师培训需求,为制订切实可行的、高效率的培训方案提供依据。方法采用自行设计问卷,对重庆市8所三级综合医院的153名临床护理带教老师进行调查。结果培训频率为每季度1次,培训时间每次1~2h为最佳,88.9%希望采取专题讲座的形式进行教学理论培训,79.1%希望采取教学查房和教学观摩进行教学实践培训;培训内容以临床护理教学技能培训、护理实践技能培训和临床教学管理培训为主。结论加大临床护理带教老师的培训力度,科学安排培训时间,采取灵活多样的培训方式,以临床教学能力培训为主,注重人文社会学课程培训,提高培训的可持续性和有效性。     

Research utilization and attitudes towards research among psychiatric nurses in Northern Ireland

Evidence-based practice depends on a number of factors including practitioners' attitudes towards, and knowledge of, research, the availability and access to relevant research, adequate resources and managers' support. Yet little is known about these issues with regard to psychiatric nurses. The aim of this study was to survey psychiatric nurses on their attitudes to research, their perceptions of their use of research and other research-related activities. This paper reports data collected from a convenience sample of 236 nurses from the six main psychiatric hospitals and from the psychiatric wards of six general hospitals. The results show that, while they report positive attitudes towards research, their perception of their use of research in practice indicates that evidence-based practice is far from being realized. There is also some evidence to suggest that psychiatric nurses' reported extent of research utilization and frequency of reading research literature in this study are lower than those of general nurses. The implications of these and other findings are discussed.     

Project 2000. Perceptions of the philosophy and practice of nursing: preparation for practice

As part of a comprehensive study of perceptions of the philosophy and practice of nursing Project 2000 students and newly qualified diplomates were asked to reflect on their Project 2000 course as a preparation for professional practice. Data were collected from both students and diplomates through self-completion questionnaires and a small number of interviews with diplomates in two study centres, one in the north and the other in the south of England. Nurse managers and G grade practitioners were invited in focus group interviews to discuss the Project 2000 preparation and assess the diplomates 'fitness for purpose'. Findings suggest that the majority of students and diplomates acknowledged that the course had prepared them well. They acknowledged the importance of the inter-personal skills component of the course, together with the life sciences input. The diplomates particularly valued the theoretical aspect of the course, being well versed in research and keen to continue their learning. Perceived limitations of the course were the management preparation and course organization. Practical skill deficits were perceived as initial skills deficits only. Managers and practitioners were keen to employ the diplomates, whilst acknowledging their need for support and preceptorship. Three important issues for nursing and nurse education are discussed, including the balance of the Project 2000 course, preceptorship and support, and preparation for a role in the community.     

A comparison of psychiatric nurses' and general nurses' reported stress and counselling needs: a case study approach

Because of the increasing devolution of responsibility for health care, personnel management and organizational policies to the trust level, it is self-evident that staff morale and job satisfaction will depend to an ever larger extent on the quality of the individual management style and the corporate culture it fosters. This study was prompted by mounting concern within a health authority about levels of absenteeism and workforce dissaffection. To examine the extent and nature of these problems, a survey of nurses in a psychiatric Trust and a comparable general acute unit was conducted. In particular, the study investigated occupational stress levels among the two cohorts of nurses and their preparedness to use workplace counselling to manage their problems. A stratified random sample of 50  psychiatric and 50 general nurses was selected from the cognate units and a questionnaire was distributed. The results were subjected to a range of statistical analyses. Overall it was found that general nurses reported stress levels that were significantly higher than those of psychiatric nurses ( P <0·05) and that they would be more likely to use workplace counselling services ( P <0·01). These results did not accord with previous studies of this type and are explained in terms of relative organizational cultures and potential interventions designed to reduce occupational stress. The need for local surveys in identifying stress levels and understanding both its sources and solutions is emphasized.     

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

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.     

三级甲等综合医院临床护理人员培训需求现状调查

目的:了解三级甲等综合医院不同工作年限临床护理人员培训需求现状。方法:自行设计临床护理人员在职培训需求调查问卷,采用该问卷对广州市某三级甲等医院1 166名不同工作年限的临床护理人员在职培训需求现状进行调查。结果:1 166名临床护理人员在职培训需求得分为(4.35±0.49)分;不同工作年限、性别的临床护理人员在职培训需求水平差异有统计学意义(P<0.05);对于理论知识、科研知识、教学能力3个方面的培训形式,临床床理人员倾向于微课堂或网课形式的线上学习方式;对于操作技能培训,临床护理人员倾向于在教育平台观看视频学习的方式。结论:临床护理人员在职培训应根据临床护理人员需求修订培训内容,采用易于接受的培训形式进行培训,才能收到高效的培训效果。