PubMed Health⌕ Search

PubMed · 8675888

Using the diffusion of innovation model to influence practice: a case study.

Abstract

There continue to be suggestions within the nursing literature that research findings are not being utilized in clinical practice. The reasons for this are well documented. However, less emphasis is given to ways to facilitate utilization. It seemed possible that non-utilization could be due not only to lack of knowledge, but also to the method of implementing change towards research-based practice. The "top-down', authoritarian, approach to dissemination of information within the NHS may have been a block to research use. Could staff be motivated to consider research-based change through use of a different approach? An "action research' approach seemed a possible way to attempt to facilitate research-based practice. Within this study one ward was used with all staff as the participants. The staff identified the area to be studied (devising a protocol for preoperative information-giving). The instruments used were semi-structured interviews and informal discussions and field notes. Rogers' diffusion of innovation model was used to organize data collection and to analyse results. Although the results may not be generalizable, the use of this model provides a useful framework for others interested in an alternative approach to achieving research-based practice.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

P Pearcey, P Draper. 1996. Using the diffusion of innovation model to influence practice: a case study.. https://doi.org/10.1111/j.1365-2648.1996.tb00042.x

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Factors influencing the development of evidence-based practice: a research tool.

AIM: The paper reports a study to develop and test a tool for assessing a range of factors influencing the development of evidence-based practice among clinical nurses. BACKGROUND: Achieving evidence-based practice is a goal in nursing frequently cited by the profession and in government health policy directives. Assessing factors influencing the achievement of this goal, however, is complex. Consideration needs to be given to a range of factors, including different types of evidence used to inform practice, barriers to achieving evidence-based practice, and the skills required by nurses to implement evidence-based care. METHODS: Measurement scales currently available to investigate the use of evidence in nursing practice focus on nurses' sources of knowledge and on barriers to the use of research evidence. A new, wider ranging Developing Evidence-Based Practice questionnaire was developed and tested for its measurement properties in two studies. In study 1, a sample of 598 nurses working at two hospitals in one strategic health authority in northern England was surveyed. In study 2, a slightly expanded version of the questionnaire was employed in a survey of 689 community nurses in 12 primary care organizations in two strategic health authorities, one in northern England and the other in southern England. FINDINGS: The measurement characteristics of the new questionnaire were shown to be acceptable. Ten significant, and readily interpretable, factors were seen to underlie nurses' relation to evidence-based practice. CONCLUSION: Strategies to promote evidence-based practice need to take account of the differing needs of nurses and focus on a range of sources of evidence. The Developing Evidence-Based Practice questionnaire can assist in assessing the specific 'evidencing' tendencies of any given group of nurses.

Clinical Nursing Research↗

Subglottic secretion viscosity and evacuation efficiency.

Ventilator-associated pneumonia (VAP) is a common nosocomial pneumonia that occurs in critically ill patients and results in mortality rates as high as 71%. Subglottic secretions (SSs) are a known risk factor. Several clinical trials have shown that continuous aspiration of subglottic secretions (CASS) reduces the risk of VAP by nearly half. Optimal suction pressure levels needed to efficiently evacuate viscous SSs are unknown. The purpose of this study was to describe SSs and the effective suction pressure (20 mmHg, 30 mmHg, 40 mmHg, and 50 mmHg) needed to maximize evacuation efficiency based on SS volume (2 ml, 4 ml, and 6 ml) and viscosity (watery, thick, and gel-like). A laboratory model was designed to replicate a human trachea. Thick secretions had the highest percentage of mean recovery representative of evacuation efficiency of SSs (mean recovery of 86%). The suction pressure of 30 mmHg had the highest overall mean of secretion recovery (83%) across all viscosity types and amounts. This study demonstrated that higher viscosity secretions were easier to evacuate than lower viscosity secretions when 30-mmHg suction pressure was applied. Management of secretion viscosity may assist in secretion removal and delay VAP development. With increased understanding of the molecular structure of SSs, there is the potential that clinicians will be able to manipulate secretion viscoelastic properties to maximize evacuation efficiency of the secretions. Further research is needed to identify safe suction pressures for optimal evacuation of SSs in human subjects.

Clinical Nursing Research↗