The effectiveness of three interventions to increase research utilization among practicing nurses.

Abstract

Three levels of communication about a practice innovation were tested to see which, if any, created a change in nursing practice. Level I consisted of written information, Level II added in-services, and Level III introduced administrative commitment to use the protocol. A work-related propensity to change score, a research utilization attitude score, and a perceived organizational support score were obtained from each respondent by a questionnaire which was administered before the innovation was introduced and one month after its introduction. Measurements of participation in research activities, number and type of journals read, and identified barriers and facilitators were also assessed. It was hypothesized that participation in a research study would affect some of those responses in a positive direction. The practice innovation used was the Linde-Biven (1971) finding that it is much better to assist surgical patients to cough and deep breathe prior to rather than after receiving pain medication. Nurses had only a moderate propensity to change, positive attitudes toward research utilization, and positive perceptions related to perceived organizational support. Nurses read a mean of 1.4 journals on a regular basis; the three most popular were Nursing '88, RN, and AJN. In this sample 46.5 percent of the nurses were BSN-prepared. The greatest perceived barrier to research utilization was time. Suggestions for journal clubs, newsletters, clinical specialist support, and money for research led the list of facilitating factors. The most significant finding is that all three levels of communication were associated with a significant change in nursing practice (p.0000). Nurses in Level I experienced the least change, Level II experienced a moderate change, and Level III nurses had the greatest change. There was a significant difference between Level I and Levels II and III but the difference between Level II and Level III was not statistically significant. This suggests that for this, and probably similar innovations, written communications, in-service sessions, and direct supervision can all be used to communicate research findings, leading to a significant change in nursing practice with relatively low cost to hospital administration.