Research Utilisation in Health Care Professionals Essay

In the clinical setting, it is now expected that health care practitioners adopt evidence based practice to ensure high quality care and patient safety is maintained (Tuite & George 2010). Adopting an evidence based approach in healthcare will also help to ensure that, the care provided, is more likely to be cost effective and will result in positive patient outcomes (Jones & Bourgeouis 2007, p. 88; Bevan 2010, p. 142).

However the research and evidence provided is always changing therefore it is important for health professionals to continually stay up to date and further develop their knowledge in relation to their field of practice (Timmins & Pallen 2002, p. 100). This can be a difficult task and not all health professionals utilise research in their practice even though they know the benefits of researching (McDonnell 2004, p. 185). This essay will explore the reasons why health care professionals do not utilise research in their practice.

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It will then help identify the strategies for enhancing research utilisation by health care professionals in the clinical settings. By identifying these strategies, health professionals may be able to adopt their strategies and act as a change agent in their clinical setting. This role of a change agent will then be discussed to help other health professionals implement change within their workplace to ensure evidence based research is adopted and help to increase positive patient outcomes.

The information for this essay was gathered from UOW Library databases such as Proquest, ScienceDirect, Cochrane Collection, Academic Onefile and Informit Health Collection. Keywords such as “research”, “utilisation”, “professional”, “practice”, “barriers”, “recommendations”, “change agents”, “evidence based practice”, “strategies”, “change agents”, “health care” and “implementation” were used in the searches. The articles chosen were limited to research that was conducted within the last 15 years and were used when the abstract showed that they were relevant to this study.

It should first be noted that while evidence based research can help to increase positive health outcomes for the patient, it is not always the best option for the patients as it is based on scientific knowledge and does not consider the patients preferences which can cause harm to the patients spiritual, emotional and mental well being (McDonnell 2004, p. 187). Therefore it should be taken into consideration when implementing certain practices. It is also important to emphasise that not all research is directly usable in practice, meaning that it does not have the proper explanations and predictions available in order to be used in practice.

As research can also be indirectly usable, which only provides knowledge and insight in a particular field of research or the research can be of methodological use which involves the use of measurement scales or tools. It may not also be beneficial if the research is used inappropriately (McDonnell 2004, p. 187). As stated by McDonnell (2004), the main reasons for why health professionals do not use research, can be put into 3 categories. These are barriers related to, the accessibility of research, to the individual and to the setting

Finding evidence based research can be a difficult and time consuming task when there is limited research on a particular field of study or when the available information is not easily accessible (Wysocki & Bookbinder 2005). Difficulties include, research not being published, information being disseminated where nurses are unable to access or attend such as conferences or workshops which are during their work hours and lack of access to library facilities or electronic information (McDonnell 2004, p. 188).

Research is also published in journals which are not read by health care practitioners and when they are able to access the information, the language used is often difficult to understand or there is an overload of information which can de-motivate the health care practitioners from researching or using the information provided. (McDonnell 2004, p. 188-189; Sitzia 2002, p. 232) When it comes to barriers relating to the individual, nurses are aware of the benefits of using evidence based research with “95. % state that it has an important role to play in improving patient care” (Timmins & Pallen 2002, p. 101). However many do not read the research due to their inability to understand or use the information provided. This can also be due to a lack of confidence in themselves and the belief that they do not believe they have the authority to make a change in the policies within their workplace (McDonnell 2004, p. 189). Other barriers such as “old school beliefs” or disinterest will also prevent health practitioners from researching and updating their knowledge on their practices (Lehman, 2009).

Barriers related to the setting also include lack of time during work to research and read, especially during work hours with high work loads (Bryar et al 2003, p. 77; McDonnell 2004, p. 190) and “organisational barriers to change” such as the lack of authority to change procedures, the lack of cooperation from the managers and the difficulty to make changes in a larger organisation (McDonnell 2004, p. 190). To help enhance research utilisation, the barriers need to be broken down to help health care professionals easily access the research information that is available. (McDonnell 2004, p. 92) Strategies to help increase accessibility of research includes the increased production and promotion of clinical guidelines, systematic reviews and meta-analyses which helps to turn large amounts of studies into a simpler form and decrease the amount of time it takes for practitioners to gain the information (Bradley & Dixon 2009; McDonnell 2004, p. 192). Ensuring that the information provided is in a “user-friendly format” at a reliable and common source such at the Cochrane databases, will also make it easier for practitioners to understand and be more willing to use the information. McDonnell 2004, p. 193) Promoting the use of these databases will also show that the information is available and help to encourage the health practitioners to use the research (Pallen & Timmins 2002, p. 105) The individual can also help to decrease the barriers by attending as many educational opportunities as possible, such as seminars, training courses or in-services which help to provide the information in simpler terms with peer support and time for questions. It also reduces the amount of time needed for the individual to research the information for themselves (McDonnell 2004, p. 193).

The individual can also help by encouraging research by the organisation and other practitioners or clinicians by emphasising the need for change and this can lead to others exploring certain issues together to help gather and present information in a format which is more appealing for others to use. (Bevan 2010, p. 145) McDonnell (2004) suggests that making changes to the setting such as creating policy initiatives, using clinical leaders to promote research based practice, establishing research interest groups and creating a research culture will help to enhance research utilisation in the clinical setting by health care practitioners.

Creating a supportive researching environment by providing on the job training, educational resources and discussion groups will help to maintain the researching in clinical environments (Sitzia 2002, p. 239). The inability to access the information can also be overcome by the organisation offering information and communication technologies training which means offering education and support on how to use computers in gaining access to databases and educational resources, as many evidence based materials are only accessible through the internet and library resources and many clinicians do not use them (Gagnon et al 2009).

Breaking down the barriers to research utilisation and using these strategies to overcome them will help to increase research and promote evidence based practice. However this can not be achieved by just the individual, it requires the organisation to implement changes to facilitate research utilisation. (McDonnell 2004, p. 196; Bevan 2010, p. 143) The strategy of organisations providing education and support will be explored in detail to show how it can help to influence clinicians to utilise research into their practice.

However it should be noted that overcoming one barrier alone may not be effective in helping to enhance research utilisation as the barriers related to the information and to the individual may prevent its success. (Thomson 1998) Seminars, training courses and other forms of educational support and training provided by the organisation can be an inexpensive strategy to adopt when they are provided to large groups.

It also reduces the amount of time required to disseminate the information to large organisations and it gives staff from the whole organisation the option to attend and extend their knowledge in a particular field of study (Thompson, Moore & Estabrooks 2008; Sitzia 2002, p. 240). When health professionals attend the education seminar, their colleagues may also feel pressured or be influenced to attend the meetings which will help to create a research culture within the workplace as it helps to encourage thers to adopt practices that are evidence base (Sitzia 2002, p. 240). These strategies will not only help to break down the barriers related to the setting, but it will help to overcome the barriers related to the information that is provided. As many research studies are published using jargon and are not user-friendly which may discourage health professionals from using the information. Therefore, educational sessions will help to gather and translate the information into understandable means. (Forsetlund et al 2009).

However Thompson, Moore & Estabrooks (2008) state that educational seminars are not sufficient to be effective in promoting research and suggests that using a local opinion leader would help to facilitate the change and ensure that the educational session is effective. On a smaller scale, in-services can be provided within each ward to help provide a greater amount of support as they are able to speak to them individually compared to communicating with a larger group (Royle & Blythe 1998). Due to the difficulties in implementing change within the clinical setting, adopting change agents will help to facilitate a smooth transition.

Change agents influence the “opinions, attitudes, beliefs, motivations and behaviours of others” by acting as a role model and providing guidance (Valente & Pumpuang 2007, p. 1, Bevan 2010, p. 147). The health professional can act a change agent by supporting their peers and provide explanations as to why there is a need for change by using examples from their work environment. By demonstrating the importance of this change in helping to improve conditions within their workplace will encourage them to adopt the changes.

The relationship between the change agent and other colleagues will help increase the success of the change as they see that the change is achievable by witnessing another peer implement the changes themselves. (Bevan 2010, p. 147) For a health professional implementing research in the workplace, they can act as a change agent by influencing other health professionals implement research themselves (Crookes & Froggatt 2004, p. 215). This one on one training and support will also help to teach others how to conduct studies themselves about changes they would like to implement.

By involving other health professionals in research projects, it will help to make the task seem less daunting as there is a support network which is directly available to them and the research can be shared among others. (McDonnell 2004, p. 187) Therefore, change agents can be a useful in helping to enhance research utilisation by health professionals. In conclusion, it is evident that through this study there are many barriers to research utilisation, all of which can be categorised as barriers related to the accessibility of research, to the individual and to the setting.

By implementing strategies which are aimed at breaking down these 3 barriers, it will help to enhance research utilisation and promote evidence based practice approaches. In order to effectively facilitate health professionals into implementing research independently, they must first be trained and supported with the use of a change agent who can help to build their confidence and ensure they are able to conduct the research themselves. A change agent will also help individuals understand what is required to conduct research and facilitate change themselves leading to a culture of research utilisation.

It should also be noted that enhancing research utilisation cannot be achieve by individual health professionals but it requires change among all levels of the organisation to implement changes to help create a culture of research utilisation. REFERENCES: Bevan, H 2010, How can we build skills to transform the healthcare system? , Vol. 15, No. 2, pg. 139–148 Bradley, D & Dixon, JF 2009, Staff Nurses Creating Safe Passage with Evidence-Based Practice, Vol. 4, No. 1

Bryar, RM, Closs, SJ, Baum, G, Cooke, J, Griffiths, J, Hostick, T, Kelly, S, Knight, S, Marshall, K & Thompson, DR 2003, The Yorkshire Barriers project: diagnostic analysis of barriers to research utilisation, Vol. 40, No. 1, pg. 73-84 Crookes, PA & Froggatt, T 2004, Techniques and strategies for translating research findings into health care practices: Change Agents, in Crookes, PA & Davies, S Research into Practice: Research skills for applying research in Nursing and Healthcare, 2nd Edition, Balliere Tindall, Edinburgh, pg. 10-217 Forsetlund L, Bjorndal A, Rashidian A, Jamtvedt G, O’Brien MA, Wolf F, Davis D, Odgaard-Jensen J, Oxman AD 2009, Continuing education meetings and workshops: effects on professional practice and health care outcomes (Review), Issue 2 Gagnon, MP, Legare, F, Labrecque, M, Fremont, P, Pluye, P, Gagnon, J, Car, J, Pagliari, C, Desmartis, M, Turcot, L & Gravel K 2009, Interventions for promoting information and communication technologies adoption in healthcare professionals, Issue 2

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Thomson, MA 1998, Closing the gap between nursing research and practice, Vol. 1, pg. 7-8 Tuite, PK & George, EL 2010, The Role of the Clinical Nurse Specialist in Facilitating Evidence-Based Practice Within a University Setting, Vol. 33, No. 2, pg. 117 Valente, TW & Pumpuang, P 2007, Identifying Opinion Leaders to Promote Behavior Change, Vol. 34, No. 6, pg. 881-896 Wysocki, AB & Bookbinder, M 2005, Implementing Clinical Practice Changes: A Practical Approach, Volume 17, Number 3, 164-174

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