Syftet med denna studie var att reliabilitetstesta Alberta Context Tool (ACT) i svensk hälso- och sjukvård och beskriva ortopedsjuksköterskors skattning av kontextuella faktorer såsom ledarskap, arbetskultur, återkoppling, utvecklingsmöjligheter och forskningsanvändning, som kan påverka möjligheten att omsätta forskningsresultat i vårdarbetet. Urvalet bestod av 119 sjuksköterskor som arbetade på ortopediska vårdavdelningar på sex olika sjukhus i mellersta Sverige. ACT är ett frågeformulär framtaget utifrån de senaste årens forskning om vilka faktorer i kontexten som har betydelse för sjuksköterskors forskningsanvändning. Reliabilitetstest gjordes enligt analys med Chronbach`s Alpa och innehållsvaliditet. Resultatet visade att ACT var relevant att användas för sjuksköterskor som arbetar på ortopedisk vårdavdelning i Sverige. Reliabilitetstesten med Chronbach´s Alpa gav värden nära 0,7 för de åtta frågeområden som behandlar kontexten.Sjuksköterskorna rapporterade att det fanns brister i många av de delar av kontexten som enligt forskning visat sig ha betydelse för möjligheten att implementera evidensbaserad vård. Sjuksköterskorna trivdes med sitt arbete och kände att deras kunskaper värderades högt i vårdteamet. Resultatet visade dock att det inte fanns tillräckligt stöd från ledningen för att utveckla vården. De rapporterade att de nästan inte alls fick återkoppling i vårdarbetet. Det saknades stödfunktioner och strategier för att implementering av forskningsresultat skulle vara möjligt att implementera i vårdarbetet. Majoriteten av sjuksköterskorna såg positivt på forskningsanvändning.

Bakgrund: Snabb kunskapsutveckling, ökade krav på kvalité och kostnadseffektivitet inom hälso- och sjukvården gör det viktigt att sjuksköterskor har god förmåga att söka och använda evidensbaserad kunskap. Idag finns ett glapp mellan forskning och klinik. Sjuksköterskor upplever flera hinder till att arbeta evidensbaserat. Under hösten 2010 och våren 2011 pågick ett projekt på ett sjukhus i en stad i mellansverige. Projektet hette ”Klinisk bibliotekarie”, syftet var att höja vårdkvalitén och patientsäkerheten genom att det dagliga vårdarbetet ska bli mer evidensbaserat och att sjuksköterskorna ska känna större säkerhet i att ta fram vetenskapligt underlag för sitt arbete. Syfte: Belysa sjuksköterskornas erfarenhet av projektet ”Klinisk bibliotekarie”. Metod: Studien har en kvalitativ design. Data samlades in genom fokusgrupper och observationer. Tjugoen sjuksköterskor deltog i projektet ”Klinisk Bibliotekarie” och av dessa har nitton deltagit i föreliggande studie genom fokusgruppdiskussioner. Observationer har skett vid två tillfällen. Data analyserades med manifest och latent innehållsanalys. Resultat: Sjuksköterskorna anser att interventioner för att öka evidensbaserat arbete ska baseras på frivillighet och intresse. Vidare anser sjuksköterskorna att det ska avsättas adekvat med tid för det arbetet. En positiv effekt av projektet är, enligt sjuksköterskorna, att det etablerats en kontakt med bibliotekarien. Konklusion: För att omvårdnaden ska bli mer evidensbaserad behövs intresserade sjuksköterskor och avsatt tid. En klinisk bibliotekarie kan vara ett stöd för sjuksköterskorna. / Background: Rapid development of knowledge, increased demands on quality and cost efficiency within healthcare makes it important that nurses have the ability to seek and use evidence-based knowledge. Today there is a gap between research and clinic. Nurses are experiencing multiple barriers to work evidence based. In autumn 2010 and spring 2011 has a project been going on at a hospital in a town in central Sweden. The project was called "Clinical Librarian" and aimed to raise the quality of care and patient safety by the daily care work to become more evidence based and that nurses should feel more secure in the development of scientific basis for its work. Objective: To highlight nurses' experience of working with the project "Clinical Librarian". Method: The study has a qualitative design. Data has been collected through focus groups and observations. Twenty-one nurses participated in the project “Clinical Librarian” and of these nineteen participated in this study through focus group discussions. Observations have been made on two occasions. Data has been analyzed with manifest and latent content analysis. Results: The nurses feel that interventions to improve evidence-based nursing should be based on voluntary participation and interest. They also believe that it should be allocated adequate time for such work. A positive impact of the project, according to the nurses, is that it established a contact with the librarian. Conclusion: To become more evidens-based tce care needs interestad nurses and time for the purpose. A clinical librarian can be a support for the nurses.

Model Forests were developed to bridge the gap between the emerging policy and the practice of sustainable forest management (SFM) in the early 1990s and, as such, to facilitate uptake of research findings into practice. The purpose of this study was to explore mechanisms that may explain why some research results are used in the policy and practice of SFM and others are not. Based on interviews in three Model Forests in Canada, the most prominent factors influencing research utilization identified were (1) relevance of the research findings to users’ needs, (2) effective research design and scientific credibility, and (3) user involvement in the research process. However, it was evident that there is no one factor that influences uptake, but rather a combination dependent upon the circumstances of each situation. This study also deepens understanding of the science–practice/policy interface by exploring the notion of Model Forests as boundary organizations.

Sigrid Wangensteen has the recent years been engaged in doctoral studies at Karlstad University in combination with teaching at the bachelor program in nursing at Gjøvik Universtity College. This doctoral thesis is focused on newly graduated nurses, their perception of competence, critical thinking dispositions, research use and their experiences of being a nurse during their first year as a nurse. Qualitative and quantitative methods were used. The very first period of time was experienced as tough but when looking back the newly graduated nurses appreciated the tough time. They described the need for a supportive environment, and gaining competence through managing challenging situations. The leadership role constituted the main difference between being a student and being a nurse. In the quantitative study the nurses perceived their competence as good, rating the Helping role competence category highest and the Ensuring quality competence category lowest. With respect to critical thinking the CCTDI total scores indicated a positive disposition. As regards the CCTDI subscale scores the nurses reported highest values for intellectual curiosity (Inquisitiveness) and lowest for intellectual honesty (Truth-seeking). The nurses reported a positive attitude towards research, but only 24% were classified as research users. Supportive environment was a significant predictor for research use. Critical thinking was a prominent predictor for attitude towards research, for research use and perception of competence. Nurse leaders in clinical practice and nurse educators in nursing education and clinical practice play an important role in nurturing student nurses and newly graduated nurses with respect to critical thinking. There is a need to assess whether teaching strategies meet the requirements of critical thinking and EBP in nursing education.

Sjuksköterskors attityd till omvårdnadsforskning och forskningsanknytning i sitt omvårdnadsarbete är en del i omvårdnadens utveckling. Denna studie har för syfte att beskriva psykiatrisjuksköterskors attityd till omvårdnadsforskning och forskningsanknytning. Frågeformulär skickades till 40 slumpmässigt utvalda sjuksköterskor inom vuxenpsykiatrisk vård på ett universitetssjukhus i södra Sverige. Data har bearbetats i SPSS 11.5 och redovisas med frekvenstabeller och diagram. Resultat från 26 erhållna frågeformulär visar att psykiatrisjuksköterskorna hade en positiv attityd till forskning men att resultat från forskning inte används i någon större utsträckning. Vidare visade resultatet en begränsad forskningsmedvetenhet. Organisatoriska insatser såsom stöd och engagemang från chefer, utbildning i vetenskapliga metoder samt stöd i tillämpningen av forskningsresultat och utveckling mot evidensbaserad vård skulle främja sjuksköterskors forskningsanknytning. / Nurses` attitude to nursing research and research utilization in their field of work is a part of the nursing development. This studies aim is to describe psychiatric nurse’s attitude towards nursing research and research utilization. Questionnaires were sent to 40 randomly selected nurses within adult psychiatric care in a university hospital in the south of Sweden. Data was processed in SPSS 11.5 and described with frequency tables and diagrams. The result from 26 received questionnaire showed that psychiatric nurses have a positive attitude to research but they do not use the results of research to any large extent. Further more the results showed limited research awareness.Organizational efforts such as support from managers, education in research methods, support to bring research results into practice and development towards evidence based care would promote nurses research utilization.

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<p>The purposes of this study are to compare the differences in research utilization among rural and urban nurses working in acute care hospitals and to examine the individual and contextual factors that may be associated with the differences. A quantitative research designed was used to compare the responses of 220 nurses (109 rural and 111 urban) working in a Local Health Integrated Network in South West Ontario, Canada. Data were collected using a modified version of Estabrooks’ (1997) self-report, mail-in, Research Utilization Survey. Results from the data analysis are discussed. Rural and urban nurses reported similar conceptual, instrumental, and persuasive research utilization (RU), with conceptual RU being the most commonly used form. However, rural nurses reported using overall RU significantly less than their urban counterparts did.</p> <p>Rural nurses reported having less access to organizational champions and resources, such as library research journals and computers, than nurses in urban practice had. An analysis of the association between the individual and contextual variables and overall RU indicates that approximately 26% of variance in nurses’ overall RU scores can be predicted from the variance in scores of the following variables: (a) positive RU attitude, (b) organizational relationships supportive of RU, (c) level of competence, and (d) location of nurses. The findings support a multi-dimensional conceptualization of RU and the merits of exploring individual factors as well as organizational and environmental context in future research, theory development, and implementation of strategies to promote RU among nurses.</p> / Doctor of Philosophy (PhD)

Anestesisjuksköterskors huvudsakliga arbetsuppgift är anestesiologisk omvårdnad. De ska även verka för att den anestesiologiska vården blir evidensbaserad genom att ta initiativ till och verka för omvårdnadsforskning. Idag sker omvårdnadsforskningen i en accelererande takt och det krävs av anestesisjuksköterskan att hålla sig a´jour med vad resultaten visar. Tidigare forskning visar att det är oklart om omvårdnadsforskningsresultat idag används av anestesisjuksköterskor i den kliniska verksamheten. Syftet med studien är därför att ta reda på hur anestesisjuksköterskan upplever att ta till sig och införliva omvårdnadsforskning i det kliniska arbetet. En kvalitativ metod med en induktiv ansats har använts. Åtta intervjuer har genomförts och analyserats. Resultatet visar att anestesisjuksköterskors försök att införliva omvårdnadsforskning på arbetsplatsen styrs av begränsningar och möjligheter. Begränsningarna upplevs vara: att inte riktigt förstå innerbörden av begreppet omvårdnadsforskning, att inte ha tid till att diskutera, utvärdera eller tillämpa omvårdnadsforskningsresultat, att omvårdnadsforskning prioriteras lågt i organisationen och brist på forskningsmetodik. Möjligheterna upplevs å andra sidan vara: En vilja att hålla sig ajour, tillgång och tid till att ta till sig och införliva omvårdnadsforskning samt att ha kunskaper kring forskningsmetodik. / Program: Specialistsjuksköterskeutbildning med inriktning mot anestesisjukvård

Organizational learning through experience has been found to be associated with enhanced firm performance. Organizational experiments are a method of experiential learning that enable organizations to learn from experience and gain context-specific knowledge of how and why to implement new knowledge. Pilot projects, a type of organizational experiment, involve making intentional, systematic efforts to gather and analyze feedback in order to accurately assess the action-outcome relationships of adopting new knowledge prior to embarking on full-scale implementation. Despite the popularity of pilot projects used to test products, programs, and services as well as reports on the outcomes of such experiments, there is a dearth of research focusing on how organizational learning occurs during organizational experiments, and on the processes and structural mechanisms of organizational experiments that contribute to organizational learning. A qualitative, multiple-case study of eight pilot projects was carried out within nursing units across five acute health care organizations during Fall 2008. Interviews were conducted with 32 individuals, including pilot project leaders, nursing program managers and direct care nurses. An inductive approach to data analysis was applied and themes identified. Results were compared to 14 propositions that were developed based on the knowledge transfer, innovation diffusion, and organizational learning literature, and which were bracketed before data analysis to allow findings to emerge from the data. The findings advance existing organizational learning, innovation diffusion, and knowledge transfer models by illuminating the complexity of organizational learning processes. Several processes and structural mechanisms of organizational experiments were found to facilitate single-loop organizational learning, leading to incremental changes to meet existing goals and objectives. Although double-loop organizational learning, which may result in fundamental changes in an organization’s assumptions, norms, policies, goals and objectives was not observed, the study revealed a number of processes and structural mechanisms that have the potential to encourage this type of learning. Studies of organizational experiments are rare. Future directions for research and theory development are suggested to build on the findings of this study. Practical implications are offered to organizations in any industry interested in realizing the potential that organizational experiments have for double-loop learning and enhanced organizational performance.

Persistent lack of mathematics achievement and disparity in achievement has led to the publication of research findings related to equitable teaching practices. Although the publication of such research provides insights about approaches for potentially increasing equity in mathematics education, teachers must be able to apply what has been learned from these studies to their classroom teaching practices. Despite the widespread expectation that teachers use research-supported teaching strategies to meet the needs of their diverse classrooms, the research to practice gap persists. Little research is currently available to guide mathematics teacher educators in how to prepare future teachers to apply research to teaching practices. Inspired by advancements in social work and other health-related fields, this study departed from the standard approach of preparing teachers to utilize specific, research- based teaching strategies to preparing teachers to engage in the meta-process of applying research to practice. This meta-process has been defined by the health-related disciplines as the process of evidence-based practice (EBP). This process is explicated in a conceptual framework that is composed of the following five steps. The practitioner (1) formulates an answerable practice question, (2) searches for the best research evidence, (3) critically appraises the evidence, (4) selects the best intervention for a specific practice context, and (5) evaluates the outcome of the intervention. The purpose of this study was to examine the process of preparing preservice elementary teachers of mathematics to engage in the five-step process of EBP. Because this process, which can be conceptualized as a routine of practice, has not been identified for the field of mathematics education previously, it was examined using a design-based research (DBR) methodological approach. There were two objectives to the study: (1) to create an empirically tested teaching intervention that mathematics teacher educators can use to prepare preservice teachers to apply research to teaching practice and (2) to create a system of assessment that supports the teaching of this intervention. The study involved five iterations of the DBR process that permited the intervention to be evaluated and revised after each iteration. Although each iteration is discussed, this study focuses primarily on the process used in the fifth iteration of the DBR process. This iteration took place in the context of a mathematics methods course in a clinically-rich, undergraduate residency program for initial preparation of elementary school teachers. The twelve participants were simultaneously enrolled in the methods course and embedded in co-teaching assignments at an elementary school. The intervention to prepare teachers to engage in EBP included two workshops that were co-facilitated by an education librarian and a mathematics teacher educator and a semester-long Education Research Project. The project required participants to identify a problem of practice related to teaching or learning mathematics, find relevant research to address that problem, create an intervention to apply the research findings to classroom instruction, implement that intervention, and collect data to evaluate the effectiveness of the designed intervention. Instruments used to collect data included: (1) a self-report Information Literacy Questionnaire, (2) a self-report Familiarity with the Process of Evidence-Based Practice in Education Scale, (3) the Education Research Project report, and (4) a standardized performance assessment. The standardized performance assessment was used to assess beginning proficiency with the process of EBP. Generalizeability theory was used to evaluate the reliability of the system created for the standardized performance assessment. The system that included three raters, two tasks, and two scoring occasions was found to be fairly reliable (absolute generalizability coefficient = .81). Results from this study revealed that participants were more successful at creating implementation plans and linking those plans to research than they were at modifying their plans to meet the needs of specific students or evaluating their research implementation. This study contributes to both research and mathematics education communities' understandings about the potential of EBP as a high-leverage routine of practice and the use of generalizability theory in the creation of a reliable assessment to evaluate this routine of practice. This study documents the complexity of the process of linking research to practice and provides an empirically tested conceptual framework for preparing preservice teachers to engage in this complex practice.