Research Utilization Model Research Articles

Translating Best Practices in Nondrug Postoperative Pain Management

The research-to-practice gap is at the heart of the problem in the underuse of nondrug complementary methods to manage postoperative pain. To show how the six steps of the Collaborative Research Utilization (CRU) model can be used to translate research into practice, using an example of nondrug pain management protocols. The CRU model was used to translate empirically tested nondrug interventions for surgical pain management enhancement into cost-effective, easy-to-use, best-practice nursing interventions, using tailored patient teaching. The preliminary findings of the substudy in the context of the CRU model are reported. The CRU model was successful in changing patients' knowledge, attitudes, and use of nondrug interventions for pain management. Further research is needed in heterogeneous populations. Organization receptivity to research and a well-integrated computerized documentation system for cueing clinicians' pain management practices are key for effectiveness of change.

Development of an oral care guide for patients undergoing autologous stem cell transplantation

Nurses identified oral mucositis as a recurring issue in clinical practice. To meet this challenge, a group of nurses took a leadership role in developing an oral care guide. The University Health Network Nursing Research Utilization Model and the Neuman Systems Model served as conceptual frameworks. A flowchart was developed to ensure a coordinated and continuous provision of oral care. Educational presentations were conducted to familiarize nurses and members of the multidisciplinary team of the practice changes. The introduction of the oral care regimen as primary prevention, plus systematic oral assessment and monitoring had the potential to reduce the occurrence and severity of oral mucositis in patients undergoing autologous stem cell transplantation.

Clinical nurse educators as agents for change: increasing research utilization

The purpose of this study was to examine the determinants of research utilization among clinical nurse educators. The primary goal for clinical nurse educators is the facilitation of professional development of practicing nurses. Responsibilities include promoting best practice by mentoring others, acting as an information source, and assisting in the development of policies and procedures based on available research evidence. Using Rogers’ (Diffusion of Innovations, 4th edn., The Free Press, New York) diffusion of innovations theory as a theoretical foundation, we conducted a secondary analysis to test a predictive model of research utilization using linear regression. Results show that educators report significantly higher research use than staff nurses and managers. Predictors of research utilization include attitude toward research, awareness of information based on research, and involvement in research activities. Localite communication predicted conceptual research use and mass media predicted symbolic use, lending support to the idea that overall, instrumental, conceptual, and symbolic research utilization are conceptually different from one another. Our findings show that the research utilization behaviors of clinical nurse educators position them to facilitate evidence-based nursing practice in organizations. We discuss the theoretical, conceptual, and nursing role implications of our findings for nursing practice, education, and research. Suggestions for future research includes studying actual use of research findings of clinical nurse educators and designing intervention studies that assesses the effectiveness of clinical nurse educators as facilitators of research utilization in organizations.

Testing a Collaborative Research Utilization Model to Translate Best Practices in Pain Management

While millions of dollars are being spent developing the seeds of research to improve the care we give to patients, significant barriers to using empirical evidence by health care professionals and policymakers still exist. The gap between what we know from research and what we use in practice is at the heart of the translation research problem. How do we get empirical knowledge uptake and use by clinicians in the fields of practice? In addition, how do we measure if practice changes are occurring? This article describes a program of translation research in which the intervention, called the Collaborative Research Utilization model, was developed and tested in four clinical studies over 18 years.

Theory of research utilization enhancement: a model for occupational therapy.

There is a pressing need for occupational therapists to provide research-based practice, yet there is little understanding of the specific strategies and processes individual practitioners use to integrate research evidence into their clinical practice. Using grounded theory method, the self-reported research utilization strategies of a sample of 11 elite occupational therapists practicing in adult stroke rehabilitation were examined. The triangulation of the interview data, the organizational policies of their workplaces, and existing theoretical concepts and processes of research utilization resulted in the development of a theory and a practice model to guide research utilization in occupational therapy. The Theory of Research Utilization Enhancement for Occupational Therapists, and the Model of Research Utilization in Occupational Therapy are presented, and their implications for practice, policy, education and future research are discussed. Built upon the Occupational Performance Process Model, the theory and model are proposed as guides to enhance therapists' ability to maintain a client-centred approach while informing clinical practices with research evidence. The application of structured reflection, case application and peer consultation facilitate the integration of research evidence into clinical practices.

Evidence‐based practice: unravelling the rhetoric and making it real

AbstractThe present paper is based on the Winifred Raphael Memorial Lecture, presented at the Royal College of Nursing Annual Congress, 2002. It explores the rhetoric surrounding evidence‐based practice by examining different sources of evidence in the form of research evidence, professional expertise and patient preference, and by considering models of research utilization. A case study approach is then taken to describing how the principles underpinning the rhetoric were translated into evidence‐based practice initiatives in a large acute hospital. It is concluded that nursing needs to be cautious about taking its lead from medicine in moving forward the evidence‐based practice agenda. Rather, nurses need to be prepared to think beyond the traditional notions of evidence‐based medicine and direct research utilization, and to develop strategies for evidence‐based practice located in the real world of nursing practice. It is only through being creative that the rhetoric of evidence‐based practice will become real. Copyright © 2003 Whurr Publishers Ltd.

The advanced practice nurse's role regarding women's delay in seeking treatment with myocardial infarction.

To synthesize nursing literature on reasons women delay in seeking treatment for signs and symptoms of an acute myocardial infarction (AMI), to hypothesize upon the primary reason(s) for this delay, and to propose advanced practice nurse (APN) interventions to reduce this delay. Utilizing Stetler's Model of Research Utilization, all reports published in nursing journals within the last 10 years specifically examining prehospital delay related to gender factors were analyzed. Women, especially those in advanced age, delay longer before seeking treatment for signs and symptoms of AMI. Effective treatment is time dependent; mortality and morbidity rise with increased prehospital delay. The reasons identified in the literature for this delay included severity, specificity, atypical presentation of symptoms, differences in event perception according to gender roles, and the interpretation and attribution of symptoms. Identifying and teaching women at highest risk for delay, dispelling internal and external gender bias, increasing one's perception of patient vulnerability to AMI, and developing one's awareness of atypical presentations are the major factors that are likely to impact APN practice and consequently reduce prehospital delays for women at risk.

Research-based care on an acute inpatient psychiatric unit

Many studies of research-based practice in nursing highlight factors that impede the development of practice. With the aim of adding to this body of knowledge, a modified grounded theory approach was used in order to understand more about these barriers and how individual nurses utilize research in their practice. A selective sample of five staff nurses from one acute inpatient psychiatric unit took part in semi-structured interviews. Three main themes were identified, each with two sub-themes. These were (a) activities to utilize research with (i) a 'systematic' model and (ii) a 'latent' model of research utilization (b) enhancing research utilization with (i) organizational culture and (ii) individual attitude and knowledge and (c) impeding research utilization with (i) resources (ii) resistance to change. It is suggested that for these nurses research utilization occurs through their individual knowledge, skill and motivation coupled with organizational commitment. Recommendation is made that further investigation of the 'systematic' and 'latent' models should be carried out. Additionally, it is suggested that these research findings might be used to inform future training, further research-based initiatives and to raise managerial awareness of the impeding factors of research utilization.

Updating the Stetler Model of research utilization to facilitate evidence-based practice

The evidence-based practice movement raises questions about the continuing viability of research utilization models. This manuscript describes the updated, practitioner-oriented Stetler Model. First developed in 1976 with Marram, it was refined in 1994 with conceptual underpinnings and a set of assumptions. The model has been further refined on the basis of a related utilization-focused integrative review methodology, targeted evidence concepts, and continuing experience through use of the model with clinical nurse specialists. The revised model continues to focus on a series of judgmental activities about the appropriateness, desirability, feasibility, and manner of using research findings in an individual's or group's practice.Nurs Outlook 2001;49:272-9.

Issues in the application of research to practice.

In recent years calls for evidence-based practice are being made emphatically in the nursing literature worldwide. Yet, the underlying construct, which relates to use of scientifically-based knowledge and research to practice, has been with us for a long time. This analytic paper provides an overview of research utilization models developed and used in nursing and other fields, highlighting some of their features. The paper then reviews research utilization and application issues at the institutional level, highlighting the importance of organizational mechanisms for enabling optimum research use and application, rather than relying on individual nurses. It then describes ways in which research can be used at the societal level in the formation of healthy public policies, using the United States as a case study. A number of recommendations are then presented for organizations and the profession at large in a global context.

Evidence-Based Policy Making?

This article is concerned with the role of evidence, research and knowledge in the recognition, definition and framing of drugs issues in prisons and in the development, implementation and reformulation of policy. As the drugs issue in prison has become more politicized and policies have become more explicit and defined over time, research and evidence have become increasingly important dimensions within the policy process. Drawing on semistructured interviews with key policy players and an analysis of documentary materials, this article examines research utilization in the development of contemporary prison drugs policy since 1980, situating this process within its political, economic and social contexts. In order to make sense of the interplay between research and policy in this area, the analysis employs the various models of research utilization put forward by Carol Weiss (Weiss, 1986). Within the current context of increasing managerialism and new commitments to evidence-based policy making, the article concludes by suggesting that researchers should become more active agents at all stages of the policy process.

A Program of Research Evaluating the Effects of a Collaborative Research Utilization Model

Advances in research are meaningless unless they reach clinicians at the point of care. This article describes a program of research in which a collaborative research utilization (CRU) model was developed and tested in four clinical studies in the context of pain management. The overall aim of the research program was to decrease the long lag time from when research innovations are developed to when they appear in clinicians' day-to-day caregiving activities. In the model, partnerships are formed between researchers, undergraduate and graduate students, and clinicians in academic and practice settings. The developmental process, structure, and steps of the model are described as well as outcomes that have been achieved in the student, scientist, clinician, nursing practice, and most importantly, the patient.

Performance improvement through clinical research utilization: the linkage model.

Performance improvement offers tremendous opportunities for research utilization in the clinical setting. The linkage model of research utilization is characterized by a user system that accesses a resource system, adapting research findings to clinical practice. A performance improvement consultant can be the link between these systems. Research application can be instrumental in improving care delivery as demonstrated in a project concentrating on the management of individuals experiencing a cerebrovascular accident.

Surviving the era of evidence-based nursing practice: implementation of a research utilization model in practice

Ruud Uitterhoeve Oncology Clinical Nurse Specialist, University Hospital Nijmegen, PO BOX 9101, 6500 HB Nijmegen,The Netherlands Bet ty Ambaum RV, MSN, Coordinator Research, University Medical Centre Utrecht, The Netherlands Correspondence and offprint requests to: Ruud Uitterhoeve This paper describes the application and testing of the Stetler Model for Research Utilization in an out-patient clinic of a University Hospital in the Netherlands. This work was part of a wider project being undertaken jointly by EONS and EUROQUAN, the aims of which were to develop an educational framework for advanced cancer nursing practice and to formulate standards against which to audit cancer nursing practice (Knowles 1999). This paper outlines how the Stetler Model for Research Utilization was tested using Donabedian's framework of structure, process and outcome. The process involved educating clinical nurses in research methodology, selecting a topic of interest, reviewing the literature and formulating and implementing a plan of change. Evidence-based nursing practice (EBNP) is the new paradigm of nursing. It is no longer acceptable to base nursing practice on tradition. 'Because we have always done it that way' is not sufficient anymore. Nursing practice should be based on the best evidence available. When a research base exists it provides the best evidence and should be used to ensure that assessments will be true measures of clinical phenomena and that interventions will lead to intended outcomes. However, the use of available research findings is not as easy as it first appears. Different studies have shown that numerous barriers to research utilization exist. In a recent study by Rutledge et al (1998) oncology staff nurses (N-1100), randomly selected from the members of the Oncology Nursing Society, rated 28 items to the extent they perceived them as barriers to

Using a collaborative research utilization model to develop and test the effects of clinical pathways for pain management.

The article reports a study that tested a practical multidisciplinary approach to address the prevailing research-to-practice gap in pain management. By means of a collaborative research utilization model, academic scientists and students from two affiliating colleges of nursing were paired with clinicians from medicine, nursing, social work, pastoral care, and physical therapy to form three partnerships to develop and evaluate 14 pain management clinical pathways. Results showed that patients whose caregiver used the pathways had less pain across their hospital stay, less interference by pain in nearly all quality of life indicators, and greater satisfaction with caregiver responsiveness to their pain. Each of these improvements reversed after discharge, however.

Research utilization models: frameworks for implementing evidence‐based occupational therapy practice

AbstractEvidence‐based practice is an important step in the professional evolution of occupational therapy and also provides the means for state‐of‐the‐art innovative clinical service for clients. An essential step in incorporating innovations and developments into clinical practice is through research utilization. Nine models of research utilization developed in the literature are reviewed and critiqued. These are: (1) the Conduct and Utilization of Research in Nursing (CURN) Project; (2) the Stetler‐Marram Model; (3) the University of North Carolina Approach; (4) the Innovation Diffusion Process Model; (5) Killeen's Matrix of Research Activity; (6) the Iowa Model of Research In Practice; (7) the Western Interstate Commission for Higher Education In Nursing Project; (8) the Nursing Child Assessment Satellite Training Project; and (9) the Linkage Model. Research utilization models provide a framework for collaboration and the necessary conditions for research utilization activities to be successful. Copyright © 1999 Whurr Publishers Ltd.

Research utilization and the CNS: confronting the issues.

Utilization of research in nursing is still inconsistent despite nearly two decades of published models and studies on the subject, and of leaders urging that the profession must increase its use of research. In fact, several questions regarding research utilization in nursing remain unanswered. A review of selected models of research utilization is presented, as well as a review of the published studies of utilization barriers and facilitators. Three key questions for the profession as a whole and for the clinical nurse specialist (CNS) in particular are advanced, and concrete answers for the practicing CNS are offered.

Barriers to and facilitators of research utilization in perioperative nursing practice

AORN JournalVolume 65, Issue 4 p. 830-831 Department Barriers to and facilitators of research utilization in perioperative nursing practice Suzanne C. Beyea RN, CS, PhD, Suzanne C. Beyea RN, CS, PhDSearch for more papers by this authorLeslie H. Nicoll RN, MBA, PhD, Leslie H. Nicoll RN, MBA, PhDSearch for more papers by this author Suzanne C. Beyea RN, CS, PhD, Suzanne C. Beyea RN, CS, PhDSearch for more papers by this authorLeslie H. Nicoll RN, MBA, PhD, Leslie H. Nicoll RN, MBA, PhDSearch for more papers by this author First published: 01 April 1997 https://doi.org/10.1016/S0001-2092(06)63007-XCitations: 5 Editor's note: This column in the Journal highlights research issues related to perioperative nursing practice. The authors, AORN's codirectors of perioperative research, provide practical advice for reading, conducting, and using research in perioperative nursing practice. In previous articles, they have discussed other aspects of the research utilization process (eg, reading research reports, integrative research reviews, models of research utilization). This article explores barriers and facilitators to research utilization. Readers who have questions and ideas about perioperative nursing research are encouraged to call AORN's codirectors of perioperative research at (800) 755-2676 x 8277. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume65, Issue4April 1997Pages 830-831 RelatedInformation

Research utilization models help disseminate research findings and ultimately improve patient outcomes

AORN JournalVolume 65, Issue 3 p. 640-642 Department Research utilization models help disseminate research findings and ultimately improve patient outcomes Suzanne C. Beyea RN, CS, PhD, Search for more papers by this authorLeslie H. Nicoll RN, MBA, PhD, Search for more papers by this author Suzanne C. Beyea RN, CS, PhD, Search for more papers by this authorLeslie H. Nicoll RN, MBA, PhD, Search for more papers by this author First published: 01 March 1997 https://doi.org/10.1016/S0001-2092(06)63087-1Citations: 4 Editor's note: This column highlights research issues related to perioperative nursing practice. The authors, AORN's codirectors of perioperative research, provide practical advice for reading, conducting, and using research in perioperative nursing practice. Readers who have questions and ideas about perioperative nursing research are encouraged to call AORN's codirectors of perioperative research at (800) 755-2676 x 8277. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume65, Issue3March 1997Pages 640-642 RelatedInformation

Research utilization and the continuing/staff development educator.

Current health care imperatives and the continuous explosion of information and technology present new challenges for continuing/staff development educators as the nursing profession reinvents itself during the current crisis in health care. This turbulent health care environment necessitates utilization of current research findings to maintain the continued efficient and effective functioning of nursing staff. Familiarity with recent research utilization projects and models and barriers perceived to impede research utilization can assist the continuing/staff development educator to bridge the gap between knowledge generation and knowledge utilization.