Clinical nurse educators as agents for change: Increasing research utilization

University of Alberta, Faculty of Nursing, 3rd floor, Clinical Sciences Building, Edmonton, Alberta, Canada T6G 2G3.
International Journal of Nursing Studies (Impact Factor: 2.25). 12/2005; 42(8):899-914. DOI: 10.1016/j.ijnurstu.2004.11.006
Source: PubMed

ABSTRACT 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.

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    • "With increased delegation of clinical support responsibilities away from nurse managers (Advisory Committee on Health Human Resources 2002), clinical leaders are also important in influencing nurses' use of research in clinical care (Thompson et al. 2001; Redfern & Christian 2003; Milner et al. 2005). Clinical leaders such as clinical nurse specialists, nurse educators, advance practice nurses, and practice developers are ideally positioned to influence research use through their roles in mentoring, providing information, and assisting in the development of policies and procedures to support professional practice (Milner et al. 2005). Although much has been written about the importance of leadership, how to develop nursing leaders to bring about change in improved processes of care and patient outcomes is less understood (Kent & McCormack 2010). "
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    ABSTRACT: Significance: The importance of leadership to influence nurses' use of clinical guidelines has been well documented. However, little is known about how to develop and evaluate leadership interventions for guideline use. Purpose: The purpose of this study was to pilot a leadership intervention designed to influence nurses' use of guideline recommendations when caring for patients with diabetic foot ulcers in home care nursing. This paper reports on the feasibility of implementing the study protocol, the trial findings related to nursing process outcomes, and leadership behaviors. Methods: A mixed methods pilot study was conducted with a post-only cluster randomized controlled trial and descriptive qualitative interviews. Four units were randomized to control or experimental groups. Clinical and management leadership teams participated in a 12-week leadership intervention (workshop, teleconferences). Participants received summarized chart audit data, identified goals for change, and created a team leadership action. Criteria to assess feasibility of the protocol included: design, intervention, measures, and data collection procedures. For the trial, chart audits compared differences in nursing process outcomes. Primary outcome: 8-item nursing assessments score. Secondary outcome: 5-item score of nursing care based on goals for change identified by intervention participants. Qualitative interviews described leadership behaviors that influenced guideline use. Results: Conducting this pilot showed some aspects of the study protocol were feasible, while others require further development. Trial findings observed no significant difference in the primary outcome. A significant increase was observed in the 5-item score chosen by intervention participants (p= 0.02). In the experimental group more relations-oriented leadership behaviors, audit and feedback and reminders were described as leadership strategies. Conclusions: Findings suggest that a leadership intervention has the potential to influence nurses' use of guideline recommendations, but further work is required to refine the intervention and outcome measures. A taxonomy of leadership behaviors is proposed to inform future research.
    Worldviews on Evidence-Based Nursing 05/2012; 10. DOI:10.1111/j.1741-6787.2012.00254.x · 2.32 Impact Factor
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    • "ported by a joint appointment model that allows both the industry and academic sectors to have ownership of , and a vested interest in , successful research programmes . However , the skills required for this go far beyond those of research . The role of intermediaries in bridging the gap between research and clinical practice is well documented ( Milner et al . 2005 ) ."
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    ABSTRACT: This article presents a proposal for the Clinical Nurse Research Consultant, a new nursing role. Although healthcare delivery continues to evolve, nursing has lacked highly specialized clinical and research leadership that, as a primary responsibility, drives evidence-based practice change in collaboration with bedside clinicians. International literature published over the last 25 years in the databases of CINAHL, OVID, Medline Pubmed, Science Direct, Expanded Academic, ESBSCOhost, Scopus and Proquest is cited to create a case for the Clinical Nurse Research Consultant. The Clinical Nurse Research Consultant will address the research/practice gap and assist in facilitating evidence-based clinical practice. To fulfil the responsibilities of this proposed role, the Clinical Nurse Research Consultant must be a doctorally prepared recognized clinical expert, have educational expertise, and possess advanced interpersonal, teamwork and communication skills. This role will enable clinical nurses to maintain and share their clinical expertise, advance practice through research and role model the clinical/research nexus. Critically, the Clinical Nurse Research Consultant must be appointed in a clinical and academic partnership to provide for career progression and role support. The creation of the Clinical Nurse Research Consultant will advance nursing practice and the discipline of nursing.
    Journal of Advanced Nursing 05/2011; 67(10):2275-83. DOI:10.1111/j.1365-2648.2011.05687.x · 1.69 Impact Factor
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    • "Various studies (Parahoo 1998, 1999, Olade 2004, Veeramah 2004, Ofi et al. 2008) indicate that a core group ranging from almost 10–42% of nurses never or seldom use research in practice. Milner et al. (2005) found in their study that clinical nurse educators use research in all four above-mentioned forms of research utilisation more often than managers and staff nurses. For this study, 'research utilisation' was defined as the use of any kind of research. "
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    ABSTRACT: Authors:Helga E Breimaier, MScN, BScN, RN, PhD Candidate, Academic Teacher and Junior Researcher, Institute of Nursing Science, Medical University of Graz, Graz, Austria; Ruud JG Halfens, PhD, FEANS, Professor, Faculty of Health, Medicine and Life Sciences, Caphri, Department of Health Care and Nursing Science, Maastricht University, Maastricht, the Netherlands and Department of Nursing Science Witten/Herdecke University, Witten, Germany; Christa Lohrmann, PhD, MA, RN, Professor and Chair of Department, Institute of Nursing Science, Medical University of Graz, Graz, Austria
    Journal of Clinical Nursing 03/2011; 20(11-12):1744-56. DOI:10.1111/j.1365-2702.2010.03491.x · 1.23 Impact Factor
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