Patterns of research utilization on patient care units

Carole A Estabrooks¹ , Shannon Scott¹ , Janet E Squires¹ , Bonnie Stevens² , Linda O'Brien-Pallas³ , Judy Watt-Watson³ , Joanne Profetto-McGrath¹ , Kathy McGilton⁴ , Karen Golden-Biddle⁵ , Janice Lander¹ , Gail Donner³ , Geertje Boschma⁶ , Charles K Humphrey⁷ and Jack Williams⁸

¹Faculty of Nursing, University of Alberta, Edmonton, Canada

²Faculty of Nursing, University of Toronto and Hospital for Sick Children, Toronto, Canada

³Faculty of Nursing, University of Toronto, Toronto, Canada

⁴Toronto Rehabilitation Institute, Toronto, Canada

⁵School of Management, Boston University, Boston, USA

⁶Faculty of Nursing, University of British Columbia, Vancouver, Canada

⁷Data Library, University of Alberta, Edmonton, Canada

⁸Institute of Clinical Evaluative Sciences & Clinical Epidemiology and Health Services Research Program, Sunnybrook Health Sciences Centre, Toronto, Canada

author email corresponding author email

Implementation Science 2008, 3:31doi:10.1186/1748-5908-3-31


Published:	2 June 2008

Abstract

Background

Organizational context plays a central role in shaping the use of research by healthcare professionals. The largest group of professionals employed in healthcare organizations is nurses, putting them in a position to influence patient and system outcomes significantly. However, investigators have often limited their study on the determinants of research use to individual factors over organizational or contextual factors.

Methods

The purpose of this study was to examine the determinants of research use among nurses working in acute care hospitals, with an emphasis on identifying contextual determinants of research use. A comparative ethnographic case study design was used to examine seven patient care units (two adult and five pediatric units) in four hospitals in two Canadian provinces (Ontario and Alberta). Data were collected over a six-month period by means of quantitative and qualitative approaches using an array of instruments and extensive fieldwork. The patient care unit was the unit of analysis. Drawing on the quantitative data and using correspondence analysis, relationships between various factors were mapped using the coefficient of variation.

Results

Units with the highest mean research utilization scores clustered together on factors such as nurse critical thinking dispositions, unit culture (as measured by work creativity, work efficiency, questioning behavior, co-worker support, and the importance nurses place on access to continuing education), environmental complexity (as measured by changing patient acuity and re-sequencing of work), and nurses' attitudes towards research. Units with moderate research utilization clustered on organizational support, belief suspension, and intent to use research. Higher nursing workloads and lack of people support clustered more closely to units with the lowest research utilization scores.

Conclusion

Modifiable characteristics of organizational context at the patient care unit level influences research utilization by nurses. These findings have implications for patient care unit structures and offer beginning direction for the development of interventions to enhance research use by nurses.