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Aim: To describe and study the association between registered nurses' self‐rated research utilization and their perception of their work climate. Background: Research utilization is an important part of evidence‐based nursing, and registered nurses value a work climate that supports the possibility to work evidence‐based. Method: This cross‐sectional study was conducted using the Creative Climate Questionnaire together with three questions measuring instrumental, conceptual and persuasive research utilization. The analysis was done using variable‐ and pattern‐oriented approaches. Results: An association was found between research utilization and experience of dynamism/liveliness. Women reported higher use of conceptual research utilization. Regarding work climate, younger registered nurses and registered nurses with less work experience gave higher scores for playfulness/humour and conflicts. The results showed an association between having a Bachelor's or Master's degree and higher instrumental research utilization. Discussion: Research utilization was higher in registered nurses with higher academic education. Low users of research tended to experience a lack of dynamism and liveliness, which indicates the importance of improving the work climate by creating a climate that allows opinions and initiate discussions. Conclusion: The findings support the importance of creating a work climate that encourages reflection and discussion among registered nurses, and to promote academic education for nurses plus an optimal work‐place staffing‐mix.

Aim To investigate what registered nurses (RNs) with a PhD working in clinical practice experience in terms of their role, function and work context. Background Previous studies have shown that RNs with a graduate degree contribute to better and safer care for patients. However, little is known about what further academic schooling of RNs, at PhD level, means for clinical practice. Method Qualitative design, with semi‐structured interviews and inductive content analysis. Results The main areas of responsibilities for RNs with a PhD working in clinical practice were related to practice development and implementation of research results. In their work, they experienced barriers to the full use of their competence; the expectations and prerequisites of the organisation were not clearly defined, and they often lacked a mandate to create conditions for quality improvement of nursing care. Conclusions RNs with a PhD can contribute to evidence‐based practice (EBP), clinical training, as well as the development of clinical research. Their roles and responsibilities need to be clarified, and for this, they need support from managers. Implications for Nursing Management Nurse managers have the opportunity to partner with RNs with a PhD to support the EBP process and help structure nursing practice in more efficient ways.

Rationale, aims, and objectives The risk of developing urinary incontinence (UI) is associated with older age and hip surgery. There has been limited focus on factors that promote evidence‐based UI practice in the orthopaedic context. The aim of this study was to evaluate an implementation intervention to support evidence‐based practice for UI in patients aged 65 or older undergoing hip surgery. Methods A 3‐month intervention was delivered in 2014 to facilitate the implementation of UI knowledge in orthopaedic units in 2 hospitals in Sweden. Each unit appointed a multidisciplinary team of nurses and physiotherapists or occupational therapists to facilitate the implementation. The teams were supported by external facilitators who shared knowledge about UI and implementation science. Interviews, nonparticipant observations, and audits of patient records were performed. Results Prior to the intervention, there was no use of guidelines regarding UI. The intervention raised the internal facilitators' awareness of UI risks associated with hip surgery. As internal facilitators shared this information with their peers, staff awareness of UI increased. The teams of internal facilitators described needing additional time and support from managers to implement evidence‐based UI care. A management initiative triggered by the intervention increased the documentation of UI and urinary problems in 1 unit. Conclusion To promote evidence‐based practice related to safe procedures for older people in hospital care, there is a need to better understand strategies that successfully facilitate knowledge implementation. This study suggests that a multiprofessional team approach is promising for instigating a process towards evidence‐based management of UI., Funding agencies: Vardalstiftelsen, Sweden

Aim: The aim was to explore first line nurse managers’ experiences of opportunities and obstacles to support evidence‐based nursing. Design: A qualitative study with a phenomenographical approach. Method: Data were collected through focus group interviews with 15 first line nurse managers’ in four settings. Results: The results are presented in four categories of description headed: Manage the everyday work vs. evidence‐based nursing; Uncertainties about evidence‐based nursing and nursing research; Time as a reality, as an approach; and Shaping awareness—towards an active approach to evidence‐based nursing. The overarching category of description has been formulated as follows: The internal relation—how active leadership influences evidence‐based nursing. The outcome space is presented as: The individual path—how to make vision and reality become a working entity around evidence‐based nursing.

Background: Nurses working in hospital wards, have been reported as low users of research when organizing their clinical work. Two main factors that could influence the nurses research utilization have been identified; leadership and time for reflection. Aim: The overall aim was to evaluate an intervention organi- zed with the purpose of supporting nurse leaders to facilitate research utilization among clinically working nurses. Design and methods: Based on focus group interviews with nurse leaders, an educational intervention for nurse leaders was developed. The intervention was given to approximately one third of the nurse leaders at a university hospital. It con- sists of four educational workshops with themes like practical research support, nursing theory, leading for research and literature search strategies, and was performed over a half-year period. The focus of the intervention was to provide practical paths to stimulate research utilization and to create a reflective approach among the nurse leaders. We also provided the nurse leaders with a ”mentor of sci- ence”. Before and after the intervention a survey was sent to all nurses working on the hospital wards. The survey consisted of questions about the working climate and how they use research in their daily work. Results: Preliminary results from the focus groups indicates that the nurse leaders ask for external support, and “hands on help” so the intervention was designed to provide that. The pre-intervention survey was answered by 591 nurses and will be repeated approximately one year after the intervention is completed.

Background: While urinary incontinence (UI) is a common and worrying issue among older people, promoting the use of evidence to prevent UI onset has rarely been studied. An earlier study that was conducted in nursing homes suggests that UI can be better assessed and managed, but the prevention of UI onset requires attention to the issue by staff within acute care settings. Aim: To report on the internal facilitators’ (IF) transition, identifying the 'know-do gap' between evidence and practice in UI prevention in orthopaedic care. Methods: The Onset PrevenTion of Incontinence in Orthopaedic Nursing and rehabilitation (OPTION) pilot was carried out in two Swedish orthopaedic units of different size and location. The pilot project included a programme to support nursing and rehab staff to facilitate knowledge translation (KT). Five IFs were interviewed at baseline, and one and three months after the intervention was completed, and non-participant observations were performed during the KT-intervention. Interviews and observations were triangulated, depicting when and how the IFs identified the present, local UI practice, the evidence on UI, and the know-do gap in preventing UI onset in older patients undergoing hip surgery. Results: Preliminary results indicate that before the study, neither the IFs nor their fellows at the units were aware that they could prevent UI onset. Rather, through mapping their context and matching the evidence provided by the dialogue with the experts in the KTintervention, the IFs became aware of which practice was evidence based and which evidence to implement, and how to facilitate KT and promote evidence use. Conclusion: The OPTION pilot indicates that KT can be promoted by tailored implementation strategies and tailoring evidence, supported by IFs awareness and understanding of the local know-do gap, and strategies to overcome barriers and promote use of evidence.

BACKGROUND AND AIMS: The literature implies research utilization (RU) to be a multifaceted and complex phenomenon, difficult to trace in clinical practice. A deeper understanding of the concept of RU in a nursing context is needed, in particular, for the development of instruments for measuring nurses' RU, which could facilitate the evaluation of interventions to support the implementation of evidence-based practice. In this paper, we explored nurses' demarcation of instrumental RU (IRU), conceptual RU (CRU), and persuasive RU (PRU) using an item pool proposed to measure IRU, CRU, and PRU. METHODS: The item pool (12 items) was presented to two samples: one of practicing registered nurses (n = 890) in Sweden 4 years after graduating and one of recognized content experts (n = 7). Correlation analyses and content validity index (CVI) calculations were used together with qualitative content analysis, in a mixed methods design. FINDINGS: According to the item and factor analyses, CRU and PRU could not be distinguished, whereas IRU could. Analyses also revealed problems in linking the CRU items to the external criteria. The CVIs, however, showed excellent or good results for the IRU, CRU, and PRU items as well as at the scale level. The qualitative data indicated that IRU was the least problematic for the experts to categorize, whereas CRU and PRU were harder to demarcate. CONCLUSIONS: Our findings illustrate a difficulty in explicitly demarcating between CRU and PRU in clinical nursing. We suggest this overlap is related to conceptual incoherence, indicating a need for further studies. The findings constitute new knowledge about the RU concepts in a clinical nursing context, and highlight differences in how the concepts can be understood by RNs in clinical practice and experts within the field. We suggest that the findings are useful for defining RU in nursing and further development of measures of RU.

Background. Nurses' research utilization (RU) as part of evidence-based practice is strongly emphasized in today's nursing education and clinical practice. The primary aim of RU is to provide high-quality nursing care to patients. Data on newly graduated nurses' RU are scarce, but a predominance of low use has been reported in recent studies. Factors associated with nurses' RU have previously been identified among individual and organizational/contextual factors, but there is a lack of knowledge about how these factors, including educational ones, interact with each other and with RU, particularly in nurses during the first years after graduation. The purpose of this study was therefore to identify factors that predict the probability for low RU among registered nurses two years after graduation. Methods. Data were collected as part of the LANE study (Longitudinal Analysis of Nursing Education), a Swedish national survey of nursing students and registered nurses. Data on nurses' instrumental, conceptual, and persuasive RU were collected two years after graduation (2007, n = 845), together with data on work contextual factors. Data on individual and educational factors were collected in the first year (2002) and last term of education (2004). Guided by an analytic schedule, bivariate analyses, followed by logistic regression modeling, were applied. Results. Of the variables associated with RU in the bivariate analyses, six were found to be significantly related to low RU in the final logistic regression model: work in the psychiatric setting, role ambiguity, sufficient staffing, low work challenge, being male, and low student activity. Conclusions. A number of factors associated with nurses' low extent of RU two years postgraduation were found, most of them potentially modifiable. These findings illustrate the multitude of factors related to low RU extent and take their interrelationships into account. This knowledge might serve as useful input in planning future stu

The gap between research and practice is well-known and has been addressed globally. The application of research-based knowledge in clinical practice has the potential to improve care quality and patient safety. Knowledge and abilities for critical reflection and implementation of new knowledge into practice are among the educational goals for today’s nursing education. Knowledge about newly graduated nurses’ extent of research use (RU) in clinical practice, as well as factors associated with nurses’ RU the first years postgraduation is scarce, however. The overall aim of this thesis was to study registered nurses’ self-reported instrumental, conceptual and persuasive RU (IRU, CRU and PRU) the first 3 years postgraduation, change in RU over time and associated factors. A further aim was to study nursing students’ intentions to use research in future practice and whether intention and educational factors could predict subsequent RU behavior. Methods: Data derived from the national LANE (Longitudinal Analysis of Nursing Education) survey study and its three cohorts of nursing students (subsequently registered nurses), graduating in 2002, 2004 and 2006 (the EX2002, EX2004 and EX2006 cohorts). Data were analyzed using quantitative methods. Results: In Study I, the nurses’ RU extent was studied at year 1 and 3 (Y1 and Y3) postgraduation in the EX2004 (Y1) and EX2002 (Y3) cohorts. IRU was reported as most prevalent, occurring on about half of the working shifts, followed by CRU and PRU. Using cluster analysis, seven clusters of nurses were identified at both Y1 and Y3, where each cluster represented a specific RU profile. Cluster profiles with low or very low RU across all three RU kinds predominated (45.5% at Y1, 51.6% at Y3). In Study II, the extent of RU was studied at Y2 (EX2004). Furthermore, changes in RU between Y1 and Y2 were studied in relation to changes in working conditions. No significant differences in mean values were found between the time points. The seve