Perceived Barriers to Research Utilization Among Registered Nurses in an Urban Hospital in Jamaica

Background:  Applying research-based evidence into the clinical practice reflects the gold standard of quality and cost effective patient-centered care.  Practicing without evidence-based knowledge limits nurses in providing competent care. The International Council of Nurses (ICN) has stipulated that nurses globally use research evidence in the clinical practice in order to close the existing gap between research and practice in nursing.  However despite these directives, routine practices still persist (ICN, 2012).While there are numerous clinically pertinent research-based knowledge available as well as an increase in access, the pace of adopting the evidence to provide nursing care has either been slow or lacking (Squires, Hutchinson, Boström, O'Rourke, Cobban & Estabrooks, 2011).  It has also been noted that though research is high on the agenda of hospitals, the process according to Melnyk and Fineout-Overholt (2015) is lengthy and could take years. A number of studies have highlighted various obstacles to research utilization (Buhaid, Lau & O’Connor, 2014; Chien, Bai, Wong, Wang and Lu (2013), but studies of this nature are lacking in the Caribbean of differing cultural context.

Purpose:  The purpose of this study was to examine the barriers to research utilization among Registered Nurses (RNs) in their clinical practice and the socio-demographic characteristics of the nurses that may have influenced their perception. 

Methods:  A descriptive correlational study was conducted among a randomly selected sample of 178 registered nurses at a 500-bed urban hospital.  Following ethical approval, data were collected using the BARRIERS Scale (Funk et al., 1991), a self-administered 35-item questionnaire along with a socio-demographic data form.  Twenty nine of the items were rated on a five-point likert scale. The data were analyzed using SPSS version 20.  Univariate and bivariate descriptive statistics were used to summarize the data and statistical tests; t-test and ANOVA were used to examine the relationships among key variables. The dependent variable, Barriers scores with 29 items was analyzed according to the four subscales, settings, nurse, presentation and research.

Results:  The response rate was 94.4% (168).  The mean age of respondents was 32.07 ± 6.98 years and most were 30 years old and younger (47.6%).  Of the top ten ranked barriers, 6 items were related to the ‘Setting’ subscale.  ‘A lack of authority to change patient care procedures’ was the highest ranked barrier by 83.3% of the respondents followed by ‘facilities are inadequate for implementation’ (78.3%) and ‘nurse feels results are not generalizable to own setting’ (74.6%).   Only educational level showed a significant relationship to the overall barrier scores (p = 0.02) - respondents with diploma in nursing had significantly higher scores (77.2 ± 17.3) compared to those with a bachelor’s degree (68.4 ± 14.7).

Conclusion:  Most of the barriers highlighted were in the ‘setting’ subscale.  Challenges surrounding lack of authority, support and structural resources of the work setting were obstacles that were predominantly perceived by the nurses.  In addition education at the bachelor’s level is important to minimize the barriers.  Findings from this study can provide valuable direction for administrators and educators to collaboratively develop strategic intervention programmes to increase the use of evidence thus augmenting the delivery of quality patient care.