Government chief nursing officers' perceptions of barriers to using research on staffing.

BACKGROUND: Current global healthcare problems include nursing shortages contributing to low nurse staffing. Low nurse staffing is associated with poor patient and nurse outcomes, but research utilization using these findings especially at the policy level remains slow. RESEARCH OBJECTIVE: To assess high-ranking government nurses' perceptions of barriers to using research on nurse staffing. METHODS: An electronic information message about the impact of nurse staffing was presented to government chief nursing officers (CNOs) from 110 countries. The CNOs' perceptions of local barriers to utilizing these research findings were then assessed in an electronic survey. The four factors that influence the first two stages of Rogers's five-stage model of diffusion were examined. The factors, characteristics of the adopter, organization, innovation and communication, were measured using an adapted version of the BARRIERS scale. RESULTS: Barriers were present in all four characteristics. The top barrier was lack of reports and studies in one place. Other barriers were lack of cooperation within the organization and lack of awareness of the research findings. Differences according to Gross National Income were also noted. CONCLUSIONS: The CNOs and other health policy advisors can use the findings in planning for adequate nurse staffing. Development of electronic newsletters with summaries of pertinent research for CNOs and other policy advisors is needed. Future studies on nurse staffing are warranted. They should focus on other settings and how best to share research findings with policymakers.

Why an ICNP? Links among quality, information and policy.

Work has been underway for over a decade to develop and use the International Classification for Nursing Practice (ICNP). The International Council of Nurses has released ICNP Alpha and Beta versions. This article is an adaptation of the presentation given at the International Council of Nurses Congress on June 12th, 2001, in Copenhagen, Denmark. When the ICNP was originally drafted, many uses were envisioned. Key among these were that the information generated would be used by clinicians, researchers, administrators and policy makers. This article introduces examples of these uses.

Discipline-based approaches to evidence-based practice: a view from nursing.

BACKGROUND: Research carried out by nurses or by others on patient problems of concern to nurses is contributing to the development of evidence-based nursing practice. In the past few decades, there has been a dramatic increase in clinical research, in health services research, and in the content and process of informatics, all focused on nursing care. The translation of findings of this research into clinical practice and the organization of nursing is less dramatic. The opportunity to implement research-based practice is great, but requires attention, methods, and resources. Also required are a database and an information system which include terms essential to nursing practice. DIMENSIONS OF NURSES' INVOLVEMENT IN EVIDENCE-BASED PRACTICE: The importance of nurses' involvement in evidence-based practice (EBP) can be viewed from three perspectives: (1) nurses' participation in medical problems and medical interventions, (2) nursing problems and nursing interventions, and (3) development and use of a standardized language that describes the problems, interventions, and outcomes important to nursing. APPLYING EBP TO COMBINED MEDICAL AND NURSING PROBLEMS: The best outcomes for a specific patient population are achieved through a combination of the medical and nursing problems and evidence-based interventions. Examples of problems of importance to nursing practice and research include pain, dehydration, incontinence, lifestyle change, confusion, immobility, knowledge deficit, noncompliance, anxiety, skin breakdown, inappropriate use of restraints, and falls. Interventions for prevention and treatment of the individual problem or combination of problems comprise the focus of nursing research and EBP.

Toward a uniform language for nursing in the US: work of the American Nurses Association Steering Committee on databases to support clinical practice.

This paper reports on the work of the American Nurses Association Steering Committee on Databases to Support Clinical Practice, in existence since 1989. Responding to its broad charges, the Steering Committee has laid down the foundations for its work in declaring the nursing process as the framework for nursing data in database systems, and in endorsing the Nursing Minimum Data Set as the set of minimum elements for any system designed to carry health-related data that reflects nursing care. In addition, the Steering Committee has begun initiatives to: 1) promote the inclusion of nursing-related data in large health-related databases, and 2) develop a Uniform Language for nursing through a phased approach. The Steering Committee also works directly with the International Council of Nurses to promote the inclusion of nursing data in internationally used classification systems and to develop an international language that describes nursing care.

Toward an International Classification for Nursing Practice: a literature review & survey.

In 1991 the International Council of Nurses (ICN) initiated a long-term project to develop an International Classification for Nursing Practice (ICNP). To identify existing classifications and nomenclatures of nursing, a literature search and survey of national nurses' associations and individuals involved in classification across the world were conducted, in addition to a pilot search for articles describing nursing nomenclatures and classifications in countries other than the US and Canada, the latter having provided most of the examples in the original ICNP proposals. Three sources of literature were examined: international conference proceedings, Med-Line and Exerpta Medica.

Standards and holism: a reframing.

In summary, measurement of standards needs to be reframed and rearticulated. If nurses move toward using measurable standards as well as holistic standards, the goal of standards will be refocused appropriately. The standards will articulate the specifics and the whole of nursing to members of society in need of health care. Nurses will also be able to hold each other accountable not only for specific procedures but also for delivering caring, as perceived by the client. The latter is unfortunately lacking in present performance appraisals. There needs to be increasing value given to nursing's unique holistic contribution to the health care of humans, which should be evident in standards. Nurses need not be at the mercy of the quantitative paradigm; neither should they alienate themselves from it. Nurses can use this paradigm to support its value and can become courageous enough to attempt describing our holistic contribution, then to research resulting outcomes. Nurses can and should relate resource consumption, not only to established quality indicators, but also to clients' perceptions of receiving holistic nursing care. As expressed by the ANA in the 1973 standards, the main reason for standards is to hold nurses accountable to what nursing is and to communicate to our clients and other disciplines what they can expect from nurses. If nursing's voice supporting holistic quality of care is to be heard in a consumer-driven health care market, it must not be shy about giving voice to its contribution through articulation of holistic standards. The foundation provided by the ANA and the subsequent work of Paulen, Benner, AHNA, and the upcoming revisions of the ANA standards are applauded.(ABSTRACT TRUNCATED AT 250 WORDS)