Introduction
Nursing knowledge was once regarded as subjective, contextually bound, and developed through experience with the context of nursing situations. That is, the knowledge used in nursing practice was not objective in that it could not be shared with other professionals (Johnson & Ratner, 1997). Afterwards, nursing practitioners have founded some special means for building up its professional knowledge. Nowadays, nursing science provides a sound basis for describing, explaining, understanding, engaging in, and changing nursing practice. To sustain quality of delivered nursing care services, modern nurses must learn how to integrate the latest discoveries of the research into their daily practice. As a team of professional practitioners who claim to be founded on a knowledge base, doing literature review critically is a very effective means for training researchers as well as frontline healthcare practitioners. It is sure that knowing the research findings has become the central element in the proper practice of nursing practitioners. The practice enables nurses to update themselves on what is being done and discovered continually. Hence, they can apply new learning materials in their own practice the best of what others are utilizing and developing (Abbott 1993). It is a pity that many modern nurses are still reluctant to utilize research findings into their daily practice. So, the following discussion will firstly illustrate why nurses do not utilize research findings to improve their practice. Corresponding recommendations for overcoming those obstacles will be made to enhance personal and professional development of nursing practitioners.
Reasons that Nurses do not Utilize Research in their Practice
Historically, Florence Nightingale did not only train her followers in the context of Victorian public hospitals. She also encouraged her student nurses to develop critical skills in delivering their nursing care services. Nursing demanded professional status from a world that should value altruistic ladies. This traditional was inherited by contemporary nursing practitioners in their strike for professional status among various healthcare professionals (Godden, 1995). Unfortunately, her followers have not inherited such a creative and informative assertion widely. There are a plethora of reasons exist that can explain why clinicians are reluctant to adopt research-based findings. Fundamentally, the issue relates to management of change and the nature of the individuals involved. Probably, large organizations are inherently difficult to change when sizes of their daily routines and operations are concerned (Robertson-Malt, Chapman, and Ingram, 2006). The reasons that nurses do not utilize research in their daily practice can be reviewed further from the following three different perspectives.
(1) Lack of Relevant Training in Integrating Research Findings into Practice
Concerning training courses conducted by previous nurse schools in Hong Kong, nearly all efforts were actually paid to generate groups of graduates who can carry out routine works effectively. The curriculum of most nursing courses conducted by the nurse schools concentrated on teaching of skills for delivering care services (Lee, Tiwari, Hui Choi, Yuen, and Wong, 2005). It is no surprise as former nurse schools were requested to produce a team of semi-skilled professional for carrying out most routine duties within the clinical areas. Even at the present days, local nurses are still expected to execute their instructions sent by the physicians and look for variations associated with patients on behalf of those physicians. Whenever there are issues relating to patients, nurses are usually not encouraged to express their professional opinions. Obviously, all training courses that enhance critical thinking skills are seldom provided for local nursing practitioners. As they do not have chance to perform duties independently, many nurses also feel that it is not necessary to acquire corresponding competences.
Moreover, local nurses usually do not possess critical thinking skills as good as their Western counterparts due to differences in their experiences gained from their learning. It is clear that critical thinking is cited as a desirable professional attribute and a highly valued educational outcome. When nurse students in Hong Kong are being measured, they usually fail to show a positive disposition toward critical thinking (Tiwari, Avery, and Lai, 2003). Without strong critical thinking skills, no one can differentiate meaning research findings from those non-relevant ones successfully. Even when a great deal of valuable nursing researches is available, one simply cannot derive any useful perspective from them. Furthermore, they cannot find out the way about integrating new insights into their daily practice without making mistakes.
(2) Lack of Local Research Findings
The development of nursing science as an academic discipline in local universities has just a very short period of time. Medical scholars carry out most local healthcare researches. Of course, their concerns are rather different from those of nursing practitioners. Certainly, successful application of any nursing model to practice requires three conditions: the model’s congruence with practice requirements, its comprehensive development in relation to practice requirements, and its specificity in relation to practice requirements (Derdiarian, 1993). Since only research findings oriented from foreign countries are available, local nurses often find that those developed models and attained insights may not be equally useful at clinical settings with different cultural and social backgrounds. If those research findings cannot be directly applied in their workplaces, it is not unreasonable that local nurses do not make use of them.
More than anything else, a small amount of local researches have been conducted and published in the recent years. They do present some important insights and advices for our colleagues. However, size and scope of those researches are still too limited. A lot of daily encountered nursing problems are still left not attempted. Even though some colleagues want to acquire new skills from the latest research findings, their efforts will only be awarded in a very limited manner.
(3) Lack of Confidence in Putting Research Findings into Force
Due to the dominant role of medical staffs in the health care team, the biomedical model was once observed strictly. In fact, the model shared the emphasis of logical empiricism on reliability and validity, value neutral observation, objectivity, experimentation, measurement and the accumulation of facts (Cull-Wilby and Pepin, 1987). Without her own body of professional knowledge, nearly all former nursing staffs were obliged to adopt the biomedical model which was developed and supported by medical staffs. Furthermore, nursing practice was once regarded as a non-professional practice because scholars of other major fields could not understand daily practice of previous practitioners. As preceding nursing practitioners did not have any nursing model for guiding their delivery of care, nursing practitioners usually were not allowed to devise their daily practice or make independent decisions.
Moreover, real-life clinical settings are lack of supportive atmosphere as expected by most student nurses. Since clinical practice is a vital component of the nursing curriculum, differences between students’ perceptions of the actual clinical learning environment and the ideal clinical learning environment they desired will discourage them to make trial there (Ip and Chan, 2005). Whenever a nurse tries to utilize certain research findings in her workplace, she will be afraid of bearing all the responsibilities associated with her choice. Lack of managerial supports implies that nursing staffs are still in a disadvantaged situation about putting research findings into practice.
Evidenced-base Recommendations for Future Nursing Practice
A life-long learning mode is a basic feature of all kinds of professionals. Among nursing staffs, evidence-based practice can enhance care services for patients and families by guiding nurses. Nursing leaders, health care administrators and policymakers are increasingly requiring that nursing practice be based on the best available evidence. Clearly, a review and synthesis of existing research is essential to identify the best available evidence. There is a need to learn skills and gain confidence. Then, they can identify the best available evidence frequently motivates staff nurses and clinicians to learn more about critical appraisal of the research literature (Laizner, 2005). Moreover, practicing an evidence-based practice can enhance patient satisfaction associated at different clinical settings (Reimanis, Cohen, and Redman, 2001). Therefore, nursing practitioners must over those obstacles that prevent them from getting their professional status. With reference to the obstacles mentioned in the previous section, some corresponding recommendations are made to enhance personal and professional development of local nursing staffs.
(1) Upgrading Academic Qualification of Nursing Staffs
Nurses need to update and upgrade their professional knowledge and skills on a continual base. In this sense, Hong Kong nurses participate actively in continuing education out of a sense of professional responsibility and personal interest (Lee et. al., 2005). In the last few years, Hong Kong Hospital Authority has urged their nursing employees to attain higher academic qualifications. At present, many local nurses have been studying in a part-time baccalaureate course in nursing science. Quite a lot of them have already attained their degrees. Anyway, they ought to integrate their newly acquired knowledge into their daily practice (Chan, Chung, Lee, Wong, Lee, Lau, Lau, Hung, Liu, and Ng, 2006). The practice can be utilized as a means for encouraging evidence-based practice among local nurses. Simply, skills for making use of research findings into daily practice cannot be thought as some kinds of basic instinct. Since most local nursing practitioners did not acquire the concerned skills and theoretical knowledge, it is not fair to blame them for their reluctance in working the scheme out. Local nurses may take advantage of their chances in continual education and equip themselves with skills to integrate research findings into their daily practice.
(2) Generating New Insights form Foreign Studies by Literature Review
As a team of professional practitioners who claim to be founded on a knowledge base, doing literature review critically is a very effective means for deriving new insights from foreign nursing studies. When local healthcare practitioners carry out the process, they may probably acquire an understanding of the research process and develop the ability to retrieve and critically access foreign research findings and literature. Furthermore, nursing practitioners can locate and summarize the findings of research on a given topic. With reference to nursing science, literature review can be applied as a research method in its own right. The method enables researchers to carry out critical analysis and summary of existing research on a particular topic of interest. After systematically identifying published materials, a coherent and logical review of the literature can then be synthesized. The above processes should result in the development of new knowledge for solving particular problems (Bell, 1998). Thus, nursing practitioners can incorporate findings of Western nursing researches into local clinical settings by this new technique.
(3) Forming Active Learning Groups
Not until nursing staffs can gain some successful experiences about generating new solutions to existing problems form research findings, they will not develop proper confidence towards their own capability. Self-assurance can be built up when evidence-based practice has become the desired aim behind organized health care. If managerial staffs can facilitate their subordinates to establish and implement an evidence-based process for the systematic review and revision of nursing clinical standards, policies, procedures and protocols, nurses can be highly motivated to modify their daily practice (Robertson-Malt, Chapman, and Ingram, 2006). Colleagues must support one another so that new insights from the latest research findings can be tried at clinical settings. When more experiences are gained, they will become more capable about making successful attempts.
Conclusion
As a member of modern healthcare professional team, nursing team must have its fellow upgraded standards of their daily practice on a continual basis. Integrating research findings into one’s practice is a very promising way to achieve relevant goals. Nonetheless, there are many barriers that may block frontline nursing practitioners to put their new learning from nursing researches into their daily operations. Considering local healthcare circumstances, most nursing staffs have not received mush training relevant to integration of research findings into their practice. Besides, there is only a small amount of local nursing researches. Also, there has not a supportive environment that enables frontline nurses to try out the practice. To meet the challenges encountered by local healthcare system, nurses must carry out evidence-based practice. First of all, nurses must attain a better academic qualification. After learning new skills, they may derive new insights from foreign studies through execution of literature review. Colleagues may also form learning groups to support one another to try out those useful research findings at their clinical wards. Hence, more nurses can achieve upgrade standards of their delivered healthcare services with the use of the latest research findings.
References:
Bell F (1998) Reviewing the literature: a student’s perspective. Journal of Child Health, 2 (3), 122-127.
Chan MF, Chung LY, LeeAS, Wong WK, Lee GS, Lau CY, Lau WZ, Hung TT, Liu ML, and Ng JW (2006) Investigating spiritual care perceptions and practice patterns in Hong Kong nurses: results of a cluster analysis. Nurse Education Today, 26(2), 139-150.
Cull-Wilby B & Pepin J (1987) Towards a co-existence of paradigms in nursing knowledge development, Journal of Advanced Nursing, 12, 515-521.
Derdiarian A K (1993) The Johnson Behavioral System Model In M. E. Parker (Ed.), Patterns of Nursing Theories in Practice. New York: National League for Nursing Press.
Godden J (1995) Victorian influences on the development of nursing. In G. G. Gray and Pratt, R. (eds) Scholarship in the Discipline of Nursing. Churchill Livingstone: Melbourne.
Ip WY and Kit Chan DS (2005) Hong Kong nursing students’ perception of the clinical environment: a questionnaire survey. International Journal of Nursing Studies, 42(6), 665-672.
Johnson JL & Ratner PA (1997) The Nature of the Knowledge Used in Nursing Practice. In.Thorne, S.E. & Hayes, V.E. Nursing Praxis: Knowledge and Action. Sage: New Delhi.
Laizner AM (2005) A research course to promote evidence-based nursing practice. Canadian Oncology Nursing Journal, 15(4), 256-257.
Lee AC, Tiwari AF, Ho Choi EW, Yuen KH, and Wong A (2005) Hong Kong nurses’ perceptions of and participation in continuing nursing education. Journal of Continuing Education in Nursing, 36 (5), 205-212.
Reimanis CL, Cohen EL, and Redman R (2001) Nurse case manager role attributes: fifteen years of evidence-based literature. Lippincotts’ Case Manager, 6(6), 230-239.
Robertson-Malt S, Chapman Y, and Ingram G (2006) Putting the evidence into practice: the King Faisal Specialist Hospital and Research Centre experience. International Journal of Nursing Practice, 12(1), 35-41.
Tiwari A, Avery A, and Lai P (2003) Critical thinking disposition of Hong Kong Chinese and Australian nursing students. Journal of Advanced Nursing, 44(3), 298-307.
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