Using the diffusion of innovation model to influence practice: a case study

There continue to be suggestions within the nursing literature that research findings are not being utilized in clinical practice The reasons for this are well documented However, less emphasis is given to ways to facilitate utilization It seemed possible that non-utilization could be due not only to lack of knowledge, but also to the method of implementing change towards research-based practice The ‘top-down’, authoritarian, approach to dissemination of information within the NHS may have been a block to research use Could staff be motivated to consider research-based change through use of a different approach? An ‘action research’ approach seemed a possible way to attempt to facilitate research-based practice Within this study one ward was used with all staff as the participants The staff identified the area to be studied (devising a protocol for preoperative information-giving) The instruments used were semi-structured interviews and informal discussions and field notes Rogers' diffusion of innovation model was used to organize data collection and to analyse results Although the results may not be generalizable, the use of this model provides a useful framework for others interested in an alternative approach to achieving research-based practice     

A quasi-experimental research to investigate the retention of basic cardiopulmonary resuscitation skills and knowledge by qualified nurses following a course in professional development

The research was undertaken with the intention of testing six null hypotheses regarding the retention of basic cardiopulmonary resuscitation (CPR) skills and knowledge of registered nurses The hypotheses were formulated from the broad aims of the research, which were to investigate conclusions reached by other researchers highlighting the speed with which retention of CPR skills and knowledge deteriorates, and to investigate the need for regular updating in CPR The research was quasi-experimental in nature The 19 nurses participating in the research were qualified staff undertaking the English National Board (ENB) 923 course in Professional Development, which included a refresher on basic CPR skills and included some discussion regarding advanced techniques The latest guidelines issued by the Resuscitation Council (1993) were used, which also aided in the design and use of the two research tools, namely an eight-point skills-testing observation tool and a 26-point knowledge-testing questionnaire While a 3-hour update in CPR skills revealed an initial improvement, the decrease in retention of skills 10 weeks later was significant ( P =0 0000) The update in CPR knowledge also revealed an initial improvement but the decrease in retention of knowledge 10 weeks later was significant ( P =0 0000) The findings of the research reflect similar results to previous research undertaken and discussed in the literature review, suggesting that retention of skills and knowledge quickly deteriorates if not used or updated regularly Therefore this research supports the importance of CPR refresher courses on a regular basis     

The changes in the role of the nurse teacher following the formation of links with higher education

A national study was conducted in England over a three-year period (1991–1994) to explore the changing role of the nurse teacher The study used multiple methods of data collection, including a modified Delphi survey and a series of telephone interviews A wide variety of respondents (nurse teachers, midwife teachers, clinical nurses, health service managers and higher education lecturers) were included in the sample This paper presents findings relating to the changes in the role of the nurse teacher following the formation of links with higher education Some of the issues discussed include the difficulties related to academic status and the relationships between nurse teachers and other lecturers in higher education, changes in teaching styles and the place of student nurses with higher education The implications for nurse teachers which stem from a closer association with higher education are explored     

Interviewing respondents who have English as a second language: challenges encountered and suggestions for other researchers

The increasing proportion of culturally diverse groups within the United Kingdom has meant that the issue of language barriers in the research situation must be addressed. The recruitment of respondents with English as a second language (ESL) to research studies is essential if their potentially unique and valid perspective is to be acknowledged. This can, however, pose several difficulties for the researcher which need to be recognized and addressed if valid data are to be collected. This paper outlines some of the challenges encountered in one study and describes strategies which were employed to meet these challenges.     

The changing pressures for cancer nurses 1986-93

Over the last decade in the United Kingdom there have been changes in the delivery of health care, technical advances in medicine, and rising public expectations for health care, all situations which effect nurses caring for cancer patients. Nursing cancer patients has frequently been described as stressful. In order to limit stress, it is necessary to monitor nurses'perceptions of its causes. This paper focuses on three studies which have identified cancer nurses'stressors between 1986 and 1993. Although no firm conclusions can be drawn from these results there is evidence to suggest sources of stress have changed. Work overload, lack of resources and staff shortages now seem to be major concerns for nurses. Conflicts with health-care workers (in particular doctors) has decreased, possibly due to improvements in pain and symptom control management. Patients'deterioration and death continues to cause nurses concern. Job satisfaction remains high, but it has declined since 1986. In order to maintain quality care for cancer patients it will be necessary to continue to provide good staff support, stress management and education in cancer care.     

Clinical supervision: a plea for 'pit head time' in cancer nursing

The concept of clinical supervision has received considerable attention in the nursing literature of late, enjoying favour not only with many practitioners and managers, but academics and policy makers alike. The following paper considers the utility of clinical supervision within the cancer nursing setting, concentrating particularly on the development of self-awareness and the facilitation of responsive, reflective, therapeutic relationships. The paper is predicated on the belief that clinical supervision not only provides a valuable means of peer review and support, for nurses both in the pre- and post- registration spheres, but that a structured process of systematic supervision sustains the necessary environment for the protection and enhancement of quality nursing interventions (Butterworth, 1992). The potential of clinical supervision, as regards the wider development of nursing as a practice discipline, is illustrated by the incorporation of an extensive literature review which explores the theoretical and practical imperatives pertaining to the notion of clinical supervision, not only in relation to the individual, but to cancer nursing and nursing per se.     

Professional supervision

This paper describes and evaluates the impact of 'professional supervision' as a method for the manager of a community hospital tofulfil the role of developing and supporting the primary nurse in becoming increasingly effective in achieving work.