RESEARCH UTILIZATION

INTRODUCTION
One of the first issues of the American Journal of Nursing describes the technique of using a mustard tub bath to reduce the temperature of a child with pneumonia.
A child’s tub is filled three fourths full with tepid water. Mustard in the proportion of one heaping table spoonful to a gallon is added. The patient is given stimulant before being placed in the tub, ice is kept on the head and constant gentle triction is applied during immersion.
Today’s nurse would not accept such advice unquestioningly. The practicing nurse would ask what is the age or size of the child this procedure is designed to treat ? How hot is tepid ? What kind of mustard is used ? What effect does the mustard have on fever control ? What is appropriate stimulant ? Why is ice placed only on the head ? What is the purpose of gentle friction ? Where is the friction applied ?
In the past, nursing procedures were based on customs or traditional practice, not on research today a mustard tub bat is not used in fever control. What became of the mustard tub bath ? Probably through the years it was found on a trial and error basis to be in effective
The above example demonstrates the need to conduct research.
NURSING RESEARCH
Nursing research is a systematic approach to examining phenomena important to nursing and nurses. Since nursing is a practice based discipline the purpose of nursing research in to create and maintain a strong scientific basis for nursing practice.
Important of Nursing Research
The future of nursing depends upon the quality and quality of nursing research for several reasons.
a.It validates nursing as a profession
b.It provides a scientific basis for nursing practices,
c.It demonstrates accountability of the profession
HISTORICAL PERSPECTIVE OF RESEARCH IN NURSING
Looking at the historical perspective of research in nursing provides for understanding nursing and its present problems and successes. Historical knowledge can provide insight into the past, thus leading to resolution of present and future issues in nursing.
1.Florence Nightingale: Nurse Researcher Florence Nightingale (1820-1910) in considered the founder of professional nursing, she is also considered the first nurse research or
Nightingale understood the importance of the scientific method and tracking. During Grimean war she kept meticulous records and statistics of mortality rates among sick and wounded British soliders. She demonstrated that as result of her nursing efforts an overall drop in the mortality rate, from 42% to 2.2% occurred within a 6 month period.
She used statistics to support her argument for reform in medical care in military and civilian hospitals.
In united states florence nightingale is system of preparing women for the profession of nursing was adopted in several American Schools but her beliefs on data collection and statistical analysis were not.
After Nightingale
1.The American nurses Association was organised in 1896 under the name of nurses. Associated Alumnae of the United states and Canada
2.Two of the earliest studies of nursing and nursing education are Nuttings (1907) The education and professional position of Nurses and Nutting by Dock’s (1907) A history of Nursing
3.After world war I the Goldmark report (1923) studied the nursing shortage and nursing education.
4.The research studies were conducted with the purpose of evaluating the nurse shortage after world war II. They were the Murdo ek report,
5.Nursing research, first published in 1952, was devoted exclusively to research in nursing.
6.An abstract for action was published in 1970. It is commonly called the ligsanght report
7.In 1976 the American Nurses association commission on Nursing research published guidelines for the academic preparation of nurses for participation in research and its utilization in preparation of nurses for participation in research
8.The 1980 saw continued increase in new journals designed for reporting nursing research and theory development and significant growth in the number of graduates schools in nursing.
9.Future directions for the 1990s are increased research priorities by specially organizations and more doctorally prepared nurses to generate new nursing knowledge.
More recently, the profession has once again embraced Nightingales ideals as evidenced by the establishment by increasing stature of the national institute of nursing research. The commitment of the ANA to standards for organized nursing services and standards of clinical nursing practice that support the use of research findings in practice and the development and dissemination of the agency for health care policy and research clinical practice guidelines.
An increasing number of clinical specialty organizations now offer grants to support the conduct and utilization of research.
BARRIERS TO UTILIZATION
I.Social system Barriers
Lack of communication
1.Social system barriers within any social system, there are forces that promote stability and oppose change as well as forces that promote change. The strength of these forces varies with the social system.
Generally, social systems that have existed over a long period of time, value tradition and have an authoritative management style with a strongly centralized power structure will be strongly resistant to change. In this type of social system, innovators are not well tolerated and opinion leaders support the institutional stance.
Some social systems take pride in being innovatives and actively encourage the utilization patterns will facilitate rapid dissemination of new ideas and support efforts to implement them. Resources needed for diffusion and implementation will be readily available knowledge. If this is so, the values and norms of nursing as a social system will need to change before innovations will be utilized. Researchers, who tend to be innovators in the nursing social system, may be in opposition to the opinion leaders, who tend to prefer stability.
Lack of communication
A frequent concern expressed in the literature is the communication gap between the university based researcher and the institutionally based practitioner. This concern is not limited to nursing to nursing; it was a major topic of discussion at the think tanks originated by the federal government
Criticism included the following
1.Researcher originated studies do not solve pressing clinical problems.
2.Findings from researcher originated studies often cannot be utilized inpractice
3.Findings are conmmunicated primarily to other researchers.
4.Findings are not expressed in terms understood by practitioners
5.Practitioners do not value research,
6.Practitioners are unwilling to read research reports
7.Practitioners have inadequate education related to the research process. There are clearly differences between doctorally prepared university based researchers and less educated practitioners
Reference groups, values and norms of the two groups are clearly different
NURSING UTILIZATION DISSEMINATION
Utilization and dissemination are closely related and integrated aspects of the research process.
Definition of utilization
Utilization is defined as the actual, systematic implementation of a scientifically sound, research based innovation in a health care setting with an accompanying process to assess the outocme(s) of the clinical change.
As a process it consists of
1.Critically analyzing the literature
2.Selecting and implementing appropriate interventions and finally evaluating the outcome
Dissemination
It refers to any systematic effort that is directed towards making the essentials of reported research available to nurse in clinical practice in a style that facilitates consideration of practice.
Dissemination efforts
Dissemination efforts may take various forms such as publications, conferences consultations, or inservice education programs as well as topic focused journals clubs.
RESEARCH UTILIZATION MODELS
1.Conduct and utilization of research in nursing (CURN) project.
2.The western Interstate commision for higher education (WICHE).
3.The nursing child assessment satellite training (NCAST) project.
4.The stefler Mawan model.
5.The pracup Breu Model
6.The quality Assurance model using research (QAMUR) model
7.The Goode Model
8.The Horn Model.
COMMITMENTS TO RESEARCH BASED PRACTICE
An increasing number of clinical speciality organizations (e.g. Association of critical care nurses, the national association of pediatric nurse associates and practitioners, and the national association of transplant co-ordinators) now offer grants to support the conduct and utilization of research.
2. Private foundations such as Robert Wood Johnson and the Pew memorial. Trust provide grant monies to practice agencies and academic centers for research and related to redesigning the delivery of nursing care.
3.The joint commission for accreditation of Health care organization (JCAHO) requires that polices, procedures, standards of patient care and standards of nursing practice be developed from current scientific knowledge
These developments and efforts testify to the professions renewed commitment to research based practice.
However, this effort, although a step in the right direction does not enable us to state unequicocally that we have significantly advanced the professions utilization and dissemination of validated research finding.
There are debates about whether nursing research is used in practice or not. There are also issues related to the utilization and dissemination of knowledge generated by nursing research. We contend that although the profession has made significant strides in recent years, the issues surrounding utilization and dissemination of research in nursing practice are still unresolved and tend themselves to further discussion.
Here we have to consider issues set forth by Horsely
1.Who is responsible for the complex set of activities involved in using research practice ?
2.The individual nurse, the organisation, or both ?
3.What factors influence the use of research in practice ?
4.What constitutes successful utilization of research in practice ?
5.Does nursing research makes a difference in practice, and if so what difference it makes ?
ARGUMENTS THAT SUPPORT THAT RESEARCH IN BEING USED IN PRACTICE
The four factors that have most contributed to the use of nursing research in practice are
1.Changes in the conceptualization of nursing and the value of research.
2.Development and testing of models for utilization of nursing research
3.Advances in the preparation of nurses to use research and
4.Minimizing barriers to research dissemination and use
1.Changes in the conceptualization of nursing and the value of research
Changes in the conceptualization of nursing an the importance of research to nursing practice have occurred primarily in the areas of professional direction, support and nurturance, as highlighted below in examples from selected professional and federal organizations.
a.American nurses association (ANA)
b.Sigma Theta Tau
c.Agency for health care poicy and research (AHEPR)
d.American Association of critical Care nurses(AACN)
2.Modes for utilization of nursing research
At present there are numerous approaches to the utilization process based on different theories of knowledge.
Examples of these models of research utilization include the curn project, Wiche, the NCAST project, the stetler Marram model, the Dracep Breu model, the QAMUR model, and Goode Model, and the Horn model. These models have been developed to facilitate the uses of scientific nursing knowledge in clinical practice settings. All of these projects have emphasized utilizing and disseminating research findings for the practicing nurse.
A.Early Utilization models
The regional program for nursing research development was an early demonstrating project designed to develop models to overcome barriers to research utilization. Another utilization program (NCAST) was actually a series of 3 training projects carried out over 10 years. One of the best known early models was the CURN project. The primary objective of this project was to develop and test a model the facilitate the use of scientific nursing knowledge in clinical settings.
B.More recent utilization models
The QAMUR model is based on the CURN model but combines the quality assurance and research utilization as well the conduct of research.
An excellent example of person and interest and commitment to research based practice is reported by Goode, Lovett, Hayes and Butcher.
The Goode model is derived from systems theory, incorporating interaction between the system and the environment. Elements of the model include input, througput, output and feedback evaluation.
Advances in the preparation of nurses to use research
The national league for nursing endorsed the position that the preparation of nurses to conduct research generally belongs at the doctoral level. There are currently six nursing education programs that offer a doctoral program in nursing. An important emphasis of these programs is the development of a strong cadre of nurse scientist.
The majority of baccalaureate nursing programs now include content related to nursing researching their curricular
Minimizing barriers to research dissemination and use
Major studies have been made in recent years to minimize barriers to the use of research in nursing practice Haller, Reynold, and Horsley Criteria to determine whether research in ready for use in practice include
1.The need for replication to provide greater confidence in the reliability and validity of findings, which usually means more than one study in a research base.
2.Examination of each study scientific merit, especially validity, reliability generalizability and statistical significance.
3.Determination of any potential risks to patients
Once these criteria have been met, the next hurdle to over come in the transmission of the information to nurses who need it and can use if in their daily practice.
Continuing education programs are an effective means to inform nurses about models of research utilization and provide an opportunity for the identification of potential areas of application of research findings.
Another mechanism for disseminating research findings for practice in the professional literature
* Relationship between research utilization and use of research in practice

CONCLUSION
In summary, there is general agreement that the conduct of clinical research and the translation and dissemination of relevant research findings into practice are important professional objectives. The degree to which these objectives are being addressed in evident in part by the amount of current literature devoted to topics related to nursing research, the strong endorsement of research by professional organizations, the number of nursing research confernces, journals and texts the increasing number of clinical nurse researchers and the amount of federal funding available for the conduct utilization and dissemination of research.
Thus, progress has been made toward an affirmative answer to the question is nursing research used in practice ? However, there is still more work to be done.
BIBLIOGRAPHY
1.McClosky, J., Grace H. (1994). Current issues in Nursing, (4th edition) St. Louis : Mosby P.P. 61-72.
2.Talbot L.A., (1995) “Principles and Practice of Nursing Research Mosby P.P. 1-22
3.Burns Nancy Grove S.K. (1995) “Understanding nursing research ” W. B. Saunders Company Pennsylvania P.P 1-19.
4.Linddery J. B., Hunter M.L., Kruszewski A. A. (1994) Introduction to nursing Iind edition Lippincott P. 65-67.