Abstract
Health systems and services research by nursing personnel could inform decision-making and nursing care, providing evidence concerning quality of and patient satisfaction. Such studies are rather uncommon in Cuban research institutes, where clinical research predominates. Assess the results of a strategy implemented between 2008 and 2011 to develop nursing capacity for health systems and services research in 14 national research institutes based in Havana. The study comprised four stages: description of approaches to health systems and services research by nurses worldwide and in Cuba; analysis of current capacities for such research in Cuba; intervention design and implementation; and evaluation. Various techniques were used including: literature review, bibliometric analysis, questionnaire survey, consultation with experts, focus groups, and workshops for participant orientation and design and followup of research projects. Qualitative information reduction and quantitative information summary methods were used. Initially, 32 nursing managers participated; a further 105 nurses from the institutes were involved in research teams formed during intervention implementation. Of all published nursing research articles retrieved, 8.9% (185 of 2081) concerned health systems and services research, of which 26.5% (49 of 185) dealt with quality assessment. At baseline, 75% of Cuban nurses surveyed had poor knowledge of health systems and services research. Orientation, design and followup workshops for all institute teams developed individual and institutional capacity for health systems and services research. Post-intervention, 84.7% (27) of nurses reached good knowledge and 14.3% (5) fair; institutional research teams were formed and maintained in 9 institutes, and 13 projects designed and implemented (11 institutional, 2 addressing ministerial-level priorities) to research nursing issues at selected centers. A systematic strategy to build nursing capacity for health systems and services research can be effective in involving nurses in such research and in developing institutional support for it, fostering compliance with Cuban and international professional development priorities for nursing, as well as contributing to quality of patient services.
Highlights
Health systems and services research by nursing personnel could inform decisionmaking and nursing care, providing evidence concerning quality of and patient satisfaction
A systematic strategy to build nursing capacity for health systems and services research can be effective in involving nurses in such research and in developing institutional support for it, fostering compliance with Cuban and international professional development priorities for nursing, as well as contributing to quality of patient services
Institutional Those in which research is central to their mandate: national reference centers in their specialties; priority assigned by DNE to institute nursing research
Summary
Health systems and services research by nursing personnel could inform decisionmaking and nursing care, providing evidence concerning quality of and patient satisfaction. Public health has been defined as the science and art of preventing illness and disability, prolonging life, and promoting physical and mental health through society’s organized efforts.[1] Its primary objective is to improve the health of populations, and it does so through essential functions described by PAHO[2] as competencies required of health systems to achieve this goal. These functions are defined as the set of actions required to meet specific targets, in turn necessary to achieve the overarching population health objective. Frenk describes it as a field with two main objectives for analysis: epidemiologic study of population health conditions and study of organized social response to those conditions (in particular, how that response is structured in the health care system).[3]
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