Strategies to increase research-based practice: interplay with unit culture.

PURPOSE: A major focus of clinical nurse specialist nursing practice is the integration of research findings into practice. The purpose of this study was to describe strategies used to facilitate research utilization (RU) by nurses in a practice setting. DESIGN: This multiple-case study identified the strategies that clinical nurse specialists and master's degree-prepared nurse educators, working collaboratively, used to facilitate RU. SETTING/SAMPLE: The setting included 8 units in 4 sites of a university hospital with all willing nurses participating. METHODS: Open-ended focus groups and individual interviews and observational sessions were conducted using investigator-designed interview guides. Comprehensive qualitative analysis led to identification of categories and themes related to RU and the unit culture that supported it. FINDINGS: Findings demonstrated that strategies to facilitate RU by staff at the unit level included conducting original research, supporting nurses participating in research, assessing and meeting staff learning needs, promoting staff attendance at conferences, stimulating goal-setting for presentations and publications, encouraging and responding to new ideas, questioning practice and stimulating inquiry, capitalizing on expertise in research knowledge and skills, and generating information and material resources. Characteristics of unit culture were linked to varying degrees of success with these strategies. The interplay of strategies with unit culture and research-based practice is described. CONCLUSION: A wide repertoire of strategies is needed to facilitate RU, and the outcome of these strategies is influenced by the unit culture. IMPLICATIONS FOR PRACTICE: Consideration of the findings and the scope of the strategies used by nurses in the study can help clinical nurse specialist and other nursing leaders facilitate the building of practice on research.

What do nurses do when they take to the streets? An analysis of psychiatric and mental health nursing interventions in the community.

Little research can be found on nursing practice for populations needing non-traditional mental health care. A descriptive study was done with the nurses on the Community Link Service (CLS), an intensive psychiatric community follow-up program, to identify nursing interventions and the types of situations encountered. These nurses use the guiding principles of two current treatment modalities, Assertive Community Treatment and Clinical Case Management. The Nursing Interventions Classification System (NIC, McCloskey & Bulecheck, 2000) was used to code nursing interventions reported through interviews and critical incidents. The nursing interventions represented 93 interventions and included 400 different activities. The analysis showed that Case Management (79%) and Complex Relationship Building (71%) were their most common interventions followed by Medication Management (64%) and Surveillance (60%). Systems such as the NIC are useful tools, but they may not give a complete description of nursing practice in this setting.

Unit culture and research-based nursing practice in acute care.

The purpose of this multiple-case study of research utilization (RU) was to examine whether and how nursing practices in acute-care units are built on research and to identify potential explanations for the observed patterns. Open-ended data were collected from staff nurses and nursing leaders on 8 acute-care units through interviews and observation. RU varied within and across units, but unit culture emerged as the principal factor linked to patterns of RU. Unit-culture themes that formed the links were harmony of research perspective, motivation to learn, goal orientation, creativity, critical inquiry, mutual respect, and maximization of resources. The findings provide a rich description that could serve as a basis for self-assessment of unit culture in inpatient and outpatient acute-care units.