Journal Club Article: Funk, S. G., Champagne, M. T., Wiese, R. A., & Tornquist, E. M. (1991). Barriers to using research findings in practice: The clinician’s perspective. Applied Nursing Research, 4(2), 90-95. [abstract]
In 1991, Funk and colleagues highlighted the progress made in the quantity, quality and new areas of nursing research being instigated. This paper produced the BARRIERS scale, which has been used as a validated tool to further investigate research in nursing in different settings and countries.
Aim: To determine clinicians’ perceptions of the barriers to using research findings in practice and to solicit their input as to what factors would facilitate such use.
Method: Questionnaires to 5000 selected full time working nurses based on five educational strata (those with diplomas, associate degrees, bachelor’s, master’s, and doctoral degrees). 40% completion of the questionnaire.
Nice touch part: “Each questionnaire included an individual packet of coffee and a letter inviting the recipient to take a few moments to relax and complete the questionnaire”.
BARRIERS scale: 28-item scale requires respondents to rate the extent to which they think each item is a barrier to nurses’ use of research to alter or enhance their practice. Responses are circled on a 4-point scale (I, to no extent; 2, to a little extent; 3, to a moderate
extent; and 4, to a great extent).
The scale is divided into four subscales:
- characteristics of the nurse (related to the nurse’s research values, skills, and awareness).
- characteristics of the setting (related to the barriers and limitations perceived in the work setting).
- characteristics of the research (methodological soundness and the appropriateness of conclusions drawn from the research).
- characteristics of the presentation of the research and its accessibility.
Results: “Insufficient time on the job to implement new ideas was cited most frequently, with lack of support from administration and physicians following closely behind.
The two greatest barriers were the nurse’s not feeling that she/he had “enough authority to change patient care procedures” and “insufficient time on the job to implement new ideas,” both of which are barriers of the setting.
The characteristics of the setting were rated among the top 10 barriers. They included lack of cooperation and support from physicians, administration, and other staff; inadequate facilities for implementation; and insufficient time to read research.”
The characteristics of the nurse in recognising the limits of their knowledge and skills to review and conduct research.
Summary: Nurses need to use and understand research to deliver evidence based practice. Research improves critical thinking and clinical decision making in clinicians. There are numerous barriers that hinder the use of research in the clinical setting, mainly linked to culture and traditional leadership hierarchies.
Limitation: The world and healthcare has changed since 1991, so aspects such as technology and the mass of information may lead to questions of validity for the BARRIERS scale, despite it’s historic use. Take a read of this systematic review by Kajermo et al. (2010). It may also help to understand the drivers of change, which can then be replicated in other settings to increase nurses involvement in research.
The Barriers Scale. (2018). The BARRIERS to Research Utilization Scale. UNC.edu
Kajermo, K. N., Boström, A. M., Thompson, D. S., Hutchinson, A. M., Estabrooks, C. A., & Wallin, L. (2010). The BARRIERS scale–the barriers to research utilization scale: A systematic review. Implementation Science, 5(1), 32.
Even though this study was conducted in the year 1991, I believe that the barriers that were revealed are still valid in the current times.
As any nurse would know, the barriers of time to implement changes and feeling like we lack the authority to implement changes is all too common. Therefore, the results of this study, I believe to be a true reflection of nurses in practice 27 years after this study was completed. Something needs to be done to overcome these barriers, so that we are not facing these same barriers in the next 27 years.