Research Utilization and Health Care

Research Utilization and Health Care What is Research Utilization?

Research utilization refers to the process of integrating research-based knowledge into practical applications within health care settings to enhance patient care and advance the discipline. As defined by S. Rodgers (1994), research utilization is “a process directed toward the transfer of research-based knowledge into nursing practice” with the primary goals of improving patient care and furthering the field of nursing. This process involves translating research findings into clinical practices, protocols, and guidelines that directly impact patient outcomes.

Despite being discussed for over 45 years, the actual implementation of research findings in clinical and nursing education settings remains limited. The challenge lies not only in conducting research but also in effectively translating and applying these findings in everyday health care practice.

Research Utilization Model

The concept of research utilization is supported by various models developed over the decades. These models offer frameworks for translating research into practice and are instrumental in guiding the process.

1. WCHEN Model: Developed in the 1970s, the Western Interstate Commission for Higher Education in Nursing (WCHEN) model was one of the earliest attempts to promote research utilization. This model focused on cross-organizational planning and enhancing research value. It involved training nurses from various clinical settings to identify clinical problems, review relevant research, and develop plans for implementing and evaluating practice changes. The WCHEN model also led to the establishment of the Communicating Nursing Research conferences to disseminate research findings.
2. CURN Project: The Conduct and Utilization of Research in Nursing (CURN) project was a federally funded initiative aimed at using a team approach to review research related to specific patient care issues. This model emphasized the development of clinical protocols and their testing in acute care settings. A key component was the replication of studies to ensure evidence-based practice.
3. Stetler/Marram Model: The Stetler/Marram model focused on individual-level application of research. It outlined the role of clinical specialists in facilitating the use of research findings in clinical settings. This model emphasized the need for a strong foundation in research methods and the importance of interpreting and validating research findings to effect practice changes.
4. Iowa Model: The Iowa model of research in practice is another prominent framework designed to bridge the gap between research and practice. It provides a systematic approach for implementing research findings and emphasizes the importance of organizational support, resources, and policy development to facilitate research utilization.
5. RARIN Model: The Retrieval and Application of Research in Nursing (RARIN) model, developed at Stanford University Hospital, focused on improving staff access to research through computerized databases. This model aimed to enhance the accessibility of research findings and provide nurses with the tools needed to integrate research into their practice.

Barriers and Outcome Results of Models

Despite the development of these models, research utilization in health care faces numerous barriers. Some of the common obstacles include:

1. Insufficient Skills and Knowledge: Many staff nurses report a lack of skills and knowledge about evaluating research, which hampers their ability to apply research findings in practice.
2. Lack of Awareness: Limited awareness or access to research findings prevents nurses from utilizing up-to-date evidence in their practice.
3. Perceived Lack of Value: Some nurses view research as having minimal relevance to their day-to-day practice, which affects their motivation to engage with research findings.
4. Authority and Time Constraints: Insufficient authority to make practice changes and a lack of time to read and implement research findings are significant barriers.
5. Lack of Support: A lack of cooperation and support from administration and colleagues can impede the integration of research into clinical practice.
6. Unclear Statistical Representation: Complex and unclear statistical representations of research results can make it difficult for practitioners to interpret and apply findings effectively.
7. Limited Replication Studies: Few replication studies are available to verify the evidence, which affects the confidence in changing practice based on research.
8. Access to Databases: Limited access to research databases and literature is a barrier that affects the ability of health care professionals to stay informed about the latest research.

Barriers identified by nurse administrators include isolation from research colleagues, heavy workloads, and difficulties in interpreting research findings. Addressing these barriers is crucial for effective research utilization in health care settings.

Research Utilization Process

Several facilitators can enhance the research utilization process:

1. Practice Environments: Creating practice environments that mandate research-based clinical standards can promote the integration of research into daily practice.
2. Expert Consultation: Providing expert consultation and establishing research committees can improve research skills and support the application of research findings.
3. Improved Access: Enhancing access to computerized databases and research literature is essential for keeping health care professionals informed.
4. Support for Conferences: Allocating time and funding for attending and participating in conferences can facilitate knowledge transfer and research utilization.
5. Performance Standards: Developing performance standards that include behavioral expectations related to research-based practice can drive the adoption of research findings.
6. Research Grants: Securing grants to support research projects can provide the necessary resources for conducting and utilizing research in clinical practice.

Research Utilization and the Role of Educators

Research utilization is a critical component of nursing education. However, the focus of research utilization in the literature has predominantly been on nursing practice environments, with less emphasis on how research utilization is integrated into nursing curricula.

Nursing educators play a pivotal role in promoting research utilization by:

1. Socializing Students: Introducing students at all levels to the value of research utilization and modeling the required skills is essential for preparing future practitioners.
2. Curriculum Integration: Integrating research utilization into nursing curricula, including both baccalaureate and graduate programs, is crucial. Current teaching often separates research processes from practical caregiving, limiting students’ understanding of how research can improve patient care.
3. Quality Improvement: Graduate and doctoral programs should emphasize quality improvement and outcomes evaluation methodologies to better prepare students for integrating research into practice.
4. Communication Skills: Educators should focus on teaching students how to translate research findings into clear, actionable information for clinical practice, moving beyond thesis formats to practical applications.
5. Replication Research: More attention should be given to replication research to provide generalizable and applicable results for clinical practice.

Research Utilization and Health Care

The rapidly changing health care environment demands increased attention to outcomes-based practice, evaluating patient outcomes, and demonstrating cost efficiency. Research utilization must become a fundamental aspect of professional accountability for health care practitioners and organizations.

To enhance research utilization in health care:

1. Professional Accountability: Nurses must be prepared to actively participate in and facilitate research utilization, making it a matter of professional accountability.
2. Barrier Removal: Implementing strategies to address and remove barriers identified in previous research is essential for effective utilization of research findings.
3. Technological Access: Leveraging technology to provide access to research and relevant databases is important, but timely and comprehensible reports are still needed.
4. Learning Environments: Creating learning environments where research utilization is integral to practice is crucial. This involves collaboration among students, practitioners, educators, and researchers to foster a culture of evidence-based care.
5. Common Vision: Sharing a common vision related to improving community health can drive the integration of research-based care models and ensure that all nurses are accountable for achieving optimal outcomes.

In conclusion, the utilization of research in health care is a complex and multifaceted process that involves overcoming barriers, employing effective models, and enhancing education and practice environments. By addressing these areas, the health care sector can better integrate research findings into practice, ultimately leading to improved patient outcomes and advancements in the field.