Barriers to and facilitators of research utilisation among nurses in Saudi Arabia

Abstract

Background: Research utilisation can be defined as the synthesis and application of research evidence to the clinical nursing care settings. Research utilisation results in Evidence-Based Practice (EBP) which is considered an important factor in improving the quality of health care as well as providing a comprehensive database of EBP for all health fields including nursing. The successful utilisation and application of research findings depend on nurses’ knowledge and understanding of EBP concepts and its application within the organisational context. Knowledgeable nurses who practise EBP not only gain patients trust but also play a role in many treatments or medical decisions which result in higher quality care. However, for decades it was perceived that research utilisation may or may not be translated into a clinical setting through material such as clinical protocol or clinical guidelines. Regardless of the importance of and nurses' acceptance of utilising research findings in nursing practice, there exist barriers and facilitators to research utilisation and the application of EBP among nurses. Aim: The aim of this study was to examine the perceived barriers to, and facilitators of, research utilisation among nurses in five hospitals in the Riyadh region of Saudi Arabia. Method: This study adopted a cross-sectional descriptive research design to investigate the barriers to, and the facilitators of research utilisation, among nurses in Saudi Arabia. It was undertaken at five hospitals within a variety of health care sectors in Saudi Arabia, including governmental and educational hospitals in Riyadh The Barrier Scale and the Facilitator Scale were both used to obtain data from participants in the study and in addition participants also completed a demographic survey. The Barrier Scale consisted of 35 items, 29 of which required nurses’ perceptions on statements based on barriers to research on a five point Likert scale. Likewise the Facilitator Scale, another five point Likert scale, was comprised of eight items which asked nurses to rate the extent to which they agreed or disagreed whether each of the items posed as a facilitator to research. Prior to the data collection, ethics approval was obtained from the College of Human Ethics Advisory Network (CHEAN) of the Royal Melbourne Institute of Technology University (BSEHAPP 38-14 JONES-ALMALKI). A convenience sample of nurses from the five selected hospitals was invited to participate in the study. The sample included clinical nurses, nurse educators, and nurse managers who had a minimum experience of two years in nursing. Results: A sample size of 1824 from a possible total of 2650 (86%) nurses participated in the study. The results indicated that the majority of the participants were females, with an average age of 20 to 40 years, with a Bachelor qualification, 6 to 10 years of experience, overwhelmingly expatriate, mainly from the Philippines, and were clinical nurses. Demographic data differed across the five hospitals. The major barriers ascertained through this study were insufficient time to implement new ideas, lack of authority, unclear practice implications and not having time to read the nursing research literature. Nurses who had Masters qualification and who were nurse educators were more likely to have a higher Barrier Score. The most common facilitators identified were advanced education, providing colleague support, conducting more clinically relevant research and employing nurses with research skills. Nurses with a Masters qualification, were nurse educators, who had more experience and who were Western educated tended to have the highest Facilitator Scores. An exploratory factor analysis of the Barrier Scale identified five factors. These were conceptualised as: lack of incentives in applying research, drawbacks in applying research, drawbacks in consuming research, inadequacies of current research and implementing research. There were also differences in what constituted facilitators to research utilisation between the five different hospitals. Nurses, who believed that there was a research culture in their hospitals, were more likely to subscribe to journals and read research articles. Hospitals differed in their strategies to apply EBP with no standardised guidelines to streamline nursing practice in hospitals in Saudi Arabia. Discussion: Much of the literature concurs with the demographics of the survey participants. The thesis results however, extend much of the literature in correlating the demographics with the barriers of and facilitators to research utilisation. There is also little in the literature in terms of a detailed analysis of the facilitators which this study with its large data set attempts to achieve. Conclusion: This study provides an evidence base for nursing education in Saudi Arabia. It identifies barriers and facilitators that impede conducting and applying research findings to nursing practice as well as the need to improve research and reading skills to facilitate interpreting research. This could be achieved through a number of strategies such as regular in-service sessions that specifically apply research evidence to practice through case studies. For nursing education, this study provides the foundation for research education that specifically develops nurses’ abilities and skills to read, understand, and interpret research. The study results also enable universities and other institutions that educate nurses to ensure that this research education is in their curricula. For further research, a more in-depth study is recommended in order to further explore nurses’ perceptions of the barriers to research utilisation and strategies they believe will assist