Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
BMC Health Serv Res. 2013 Sep 14;13:351. doi: 10.1186/1472-6963-13-351.
Organizational context is recognized as an important influence on the successful implementation of research by healthcare professionals. However, there is relatively little empirical evidence to support this widely held view.
The objective of this study was to identify dimensions of organizational context and individual (nurse) characteristics that influence pediatric nurses' self-reported use of research. Data on research use, individual, and contextual variables were collected from registered nurses (N = 735) working on 32 medical, surgical and critical care units in eight Canadian pediatric hospitals using an online survey. We used Generalized Estimating Equation modeling to account for the correlated structure of the data and to identify which contextual dimensions and individual characteristics predict two kinds of self-reported research use: instrumental (direct) and conceptual (indirect).
Significant predictors of instrumental research use included: at the individual level; belief suspension-implement, research use in the past, and at the hospital unit (context) level; culture, and the proportion on nurses possessing a baccalaureate degree or higher. Significant predictors of conceptual research use included: at the individual nurse level; belief suspension-implement, problem solving ability, use of research in the past, and at the hospital unit (context) level; leadership, culture, evaluation, formal interactions, informal interactions, organizational slack-space, and unit specialty.
Hospitals, by focusing attention on modifiable elements of unit context may positively influence nurses' reported use of research. This influence of context may extend to the adoption of best practices in general and other innovative or quality interventions.
组织背景被认为是影响医疗保健专业人员成功实施研究的重要因素。然而,支持这一普遍观点的经验证据相对较少。
本研究的目的是确定影响儿科护士自我报告研究使用的组织背景维度和个体(护士)特征。使用在线调查,从加拿大 8 家儿童医院的 32 个医疗、外科和重症监护病房的注册护士(N=735)收集研究使用、个体和环境变量的数据。我们使用广义估计方程模型来解释数据的相关性结构,并确定哪些环境维度和个体特征可以预测两种自我报告的研究使用:工具(直接)和概念(间接)。
工具性研究使用的显著预测因素包括:个体层面上;信念悬置-实施、过去的研究使用以及医院层面上的文化和拥有学士学位或更高学历的护士比例。概念性研究使用的显著预测因素包括:个体护士层面上;信念悬置-实施、解决问题的能力、过去的研究使用以及医院层面上的领导、文化、评估、正式互动、非正式互动、组织松弛空间和专科单元。
医院可以通过关注单元环境中可修改的要素,积极影响护士报告的研究使用。这种环境的影响可能会扩展到普遍采用最佳实践以及其他创新或质量干预措施。