The title used in this study, Nurses’ Perceptions of Research Utilization in a Corporate Health Care System, is definitely a good one. It points out the key variables (i.e. perceptions of nurses) as well as the study population-nurses working in a corporate health care system (McCloskey, 2008, p.39).
Abstract
The researcher has highlighted the major findings of the report in the abstract section. He starts by stating the purpose of the study which is to explore selected characteristics of nurses on the basis of their level of education (i.e. associate diploma/degree, baccalaureate, masters, etc), position at hospital as well as years of experience that might influence perceived accessibility of research resources, support attitude towards research as well as research use in practice. The abstract section also states that the study employed a descriptive non-experimental mailed survey design. The study methods are also captured in this section. For instance, nurses working in five health care institutions were investigated by the researcher. The Research Utilization Questionnaire (RUQ) was used to capture nurses’ perceptions on research utilization in the four aspects of perceived use of research, availability of research resources, attitude toward research as well as perceived support for research activities (McCloskey, 2008, p.39).
The findings of the study are also summarized in the abstract section. For example, the researcher used ANOVA to analyze data. Statistically significant differences [p<.001] were noticed with regard to the nurses’ perception on research utilization, mind-set about research and accessibility of research resources. The researcher found no noteworthy differences with respect to nurses’ perceptions on the basis of years of experience (McCloskey, 2008, p.39).
The conclusions of this study are also summarized in the abstract section. The investigator states that the findings of this study can have positive impact on all stakeholders currently working in health care institutions. He notes that the findings can be adopted and used by both the administrators and nurses improve health care dispensation in hospitals. The researcher has also summarized the clinical implications of this study in the abstract section. He points out that the outcomes of the present study can be positively assimilated and employed by the management and nurses in all levels to foster research utilization and evidence-based practice programs within the health care institutional structure (McCloskey, 2008, p.39).
Introduction: Statement of the Problem
The problem statement is stated in the introduction section of the report. The researcher points out that although utilization of research is an integral component for evidence-based nursing practice, there is a gap between plausible research outcomes and conversion of those outcomes into nursing practice. The researcher states that there is little interest on the demographic blend of nurses engaged in health care organizations that might influence the conversion of research into practice (McCloskey, 2008, p.39). The statement of the problem provides a persuasive argument for the current study. The researcher asserts that evidence-based research is a key component to any profession, particularly to nursing. He draws comparison with the timeless teachings of Florence Nightingale who stressed the importance of nurses using “applied scientific principles, by observing the laws of nature, and caring for the patients who required assistance in restoring their health” (Fitzpatrick, 1992, p.21). The relevance of the problem statement can be gleaned from the fact that although researchers have published numerous works on the importance of evidence-based nursing practices, most of these publications are scarcely utilized in practice (McCloskey, 2008, p.40).
Hypotheses/ Research Questions
The hypotheses/research questions are neither explicitly stated nor an explanation provided to account for their absence.
Literature Review
The literature review for this study included relevant, current studies that summarized what is known about evidence-based practice as the focal point for nursing. The sources were current and ranged in publication dates from 1986 to 2007, with the majority of the primary sources published in the last eight years.
The literature review for this study focused on the barriers encountered by nurses in research employment using the BARRIERS to Research Utilization Scale invented by Funk, Wiese, Champagne and Tornquist. The studies and articles reviewed by the researcher have revealed that the key barriers have been insufficient support for research programs as well as inadequate skills and abilities to understand or critique research outcomes. The researcher quoted Stetler (2003) who stresses the need for administrators to be conversant with the requirements of staff to enhance the conversion of nursing science by evaluating their staff capacity as well as the current initiatives. Although there is evidence to suggest that nurses are becoming more acquainted with research outcomes, the gap between publication and employment is still prominent (Karkos & Peters, 2006).
The literature review provided a sound basis for the study. For example, the researcher asserts that very few nurses can play an integral role to the science of nursing by instigating research activities. Nonetheless, nurses are better placed to assess research articles and take part in adjusting nursing practice. For this to happen; there is an urgent need to alleviate negative perceptions that affect the adoption of research findings. The researcher used several supporting evidences to provide a rationale for conducting the current study. He quotes Stetler (2003) who states that people engaged in an evidence-based organizational system must be granted access to the organizational support systems (i.e. technology, time, mentors) to be able to critique the evidence presented to them. This will help them develop a positive attitude that research is an integral component to the nursing practice.
Conceptual/Theoretical Framework
Roger’s diffusion of innovation theory was used as the theoretical framework for this study. Some of the initial steps in the diffusion of innovation process include: knowledge about the published findings; understanding their significance; and distributing the information to others (Rogers, 2003). Roger’s diffusion of innovation process entails five phases which are adequately defined. Knowledge is the first phase in which the adopter learns about the innovation. Persuasion is the second phase and entails creating either a positive or negative mind-set toward the innovation by the individuals within the organization. The innovation is considered to be in the third phase if is deemed positive and a decision is made on whether to accept or reject it. The innovation moves to the fourth (implementation) phase if a decision is made to adopt it. The fifth phase is confirmation where the implementation of the innovation is either sustained or discontinued on the basis of ongoing assessment (McCloskey, 2008, p.40).
Several factors can affect the progress of an innovation from one stage to another. These include: organizational climate; hierarchical order; and type of authority. Adopters are the most critical elements in this process because they are believed to possess varying degrees of openness to change. Rogers classifies them in five groups on a continuum of an innovativeness aspect. Adopters make a decision on whether an innovation will be embraced. Certain attributes of adopters (i.e. mind-set toward change and science, education and the rank in the organization) can influence the diffusion and utilization procedure. The rationale for using Roger’s theoretical framework was consistent with the aim of this study which was to find out whether nurses in a corporate health care system had different perceptions with respect to research utilization on the basis of selected demographic attributes such as level of education, organizational position and years of nursing experience (McCloskey, 2008, p.40).
Protection of Human Rights
The researcher enlisted licensed nurses aged above 18 years and who had previously worked either part-time or full-time for at least one year. The consent to perform the study was issued by the hospital system’s institutional review board. Respondents’ names were omitted to protect their identities. The researcher also obtained informed consents from the participants (McCloskey, 2008, p.40).
Research Design
The researcher employed a descriptive, quantitative design with survey methods for this study. This approach was the most suitable for this study because it is usually used to investigate and describe observable facts in real-life situations. What’s more, descriptive quantitative design is used to produce new knowledge in areas where limited or no research has been done (McCloskey, 2008, p.40).
Population and Sample
The population of this study is adequately described. The researcher enlisted all licensed registered nurses aged above 18 years and employed either part-time or full-time for one year or more. Besides, all of the participants (nurses) were working in a corporate health care system comprising of five hospitals in a big metropolitan region on the east coast. The investigator used interoffice mail system to mail survey packets to nurses in each health care institution. The participants were required to complete a form for demographic attributes such as age, years of employment, gender, educational level, name of the hospital currently employed, unit assigned and the current position (McCloskey, 2008, p.40). The study sample was adequate because the researcher selected a total of 270 participants. Nonetheless, sampling biases were not minimized. For example, only 5% (13 participants) were males while the rest 95% (257 participants) were females (McCloskey, 2008, p.41). Consequently, the sampling technique used in this study was inappropriate since it was gender biased.
Data Collection and Measurement
The study employed Research Utilization Questionnaire (RUQ) which was developed in 1986 by Champion. Nonetheless, items on RUQ were assessed by content experts and found to be relevant for nurses today. There are 46 items on RUQ and divided into four subscales. The participants were required to rate every item on a 5-point Likert scale. The ratings ranged from 1(strongly disagree) to 5 (strongly agree). The RUQ possesses excellent psychometric attributes. Internal uniformity for the subscales has fluctuated between 0.84 and 0.94. Reliability analysis for this study demonstrated sufficient internal uniformity for the RUQ. The four subscales utilized in this study were Availability, Support, Use and Attitude. Cronbach’s alpa for the four subscales was 0.80, 0.93, 0.93 and 0.91 respectively (McCloskey, 2008, p.41). Key variables were operationalized using the best method and there is sufficient evidence to show that the data collection method (RUQ) produced valid and reliable data.
Procedures
The researcher does not state whether respondents were assigned to intervention groups. The report also fails to mention if training was provided to research assistants prior to data collection exercise.
Results: Data Analysis
Descriptive statistics were used to describe the demographic attributed of the nurses. A mean was computed for each item on the RUQ. The significance level was set at α=0.05. The researcher used a one-way ANOVA to distinguish the scores of the subscale across selected demographic data to ascertain the impact of educational level, years of employment and position on the perceptions on each of the subscales. SPSS was used to compute all statistical procedures (McCloskey, 2008, p.41).
Findings
The findings for this study are adequately summarized. For example, out of the 2,500 survey questionnaires distributed, 270 were returned thereby giving the study an 11% response rate. 13 men and 257 women returned completed questionnaires. The mean age of participants was 43.9 while the average nursing experience was 17 years. Other major findings of the study are also summarized in tables. For example, table 1 summarizes the characteristics of the study sample such as gender, education level, years of experience and position in the organization (McCloskey, 2008, p.41).
Discussion
The target for this study was nurses employed in magnet-hospital system. The purpose was to study nursing staff in an organizational framework in an attempt to establish divergences in their perception on research utilization. The sample used was convenient since it was drawn from a big magnet-hospital system. Nonetheless, care should be taken when generalizing the findings of this study to other nursing staff in other health care institutions such as community-based health care settings without magnet status (McCloskey, 2008, p.42).
Implications
The implications of the study for clinical practice have also been discussed. For example, the researcher suggests that managers at administrative level need to grasp the different educational levels of nurses and play an active role in modeling, guiding and offering information and time to partake in resource utilization. Nurses-at the practice level- need to play an active role in converting research into practice by creating time to read and understand journal articles (McCloskey, 2008, p.43).
Global Issues
The report is well-written, organized and sufficiently detailed for critical analysis. For example, the researcher has used subheadings as well as tables and figures throughout the report to present the findings in a consistent manner. The language used is simple and the findings are easily accessible to practicing nurses. However, a CONSORT flow chart is missing to show the flow of participants in the study.
Researcher Credibility
The researcher is a distinguished scholar and a PHD holder based at National Institutes of Health, National Center for Research Resources. In addition, prior to the publication of this report, the researcher sought support from other equally distinguished scholars. Therefore, the findings and interpretations of this study are credible.
Summary
The findings of this study appear to be valid. The sample size used by the researcher and research instruments are beyond reproach. Besides, the researcher consulted widely among his peers prior to the publication of the report. The findings of this study provide meaningful evidence that can be incorporated in nursing practice. This is because the utilization of evidence-based research in nursing practice is an integral component in health care dispensation.
References
Fitzpatrick, J.J. (1992). Reflections on Nightingale’s perspective of nursing. In Notes on nursing: What it is and what it is not. Philadelphia: Lippincott.
Karkos, B., & Peters, K. (2006). A magnet community hospital: Fewer barriers to nursing research utilization. Journal of Nursing Administration, 36(7), 377–382.
McCloskey, D.J. (2008). Nurses’ Perceptions of Research Utilization in a Corporate Health Care System. Journal of Nursing Scholarship, 40(1), 39-45.
Rogers, E.M. (Eds.). (2003). Diffusion of innovation. New York: Free Press.
Stetler, C.B. (2003). Role of organization in translating research into evidence-based practice. Outcomes Management, 7(3), 97–129.