Análise da produção de pesquisas de Enfermagem e estratégia para o fortalecimento de sua utilização em hospital de ensino do Triângulo Mineiro

Abstract

The use of research in practice has been encouraged by international bodies for more than 20 years. Even in view of the benefit to cost control, quality of care, and patient safety, the implementation of Evidence Based Practice has presented itself as a complex challenge to Nursing worldwide. The aim of this study was to analyze the production and use of Nursing research in a Public Teaching hospital in the Triângulo Mineiro. It is a research conducted with mixed methods and made up of four phases. In the diagnostic phase, an exploratory-descriptive study, the researches carried out by data collection in the mandatory record keeping sector of the hospital were characterized, as well as the profile of the research coordinators and the strategies of theory-to-practice translation used by them, assessed through a semi-structured interview. At the same time, competencies (Evidence-Based Practice Questionnaire) and barriers (The Barriers to research utilization Scale) were analyzed in the context of Evidence-Based Practice among Community Nurses. Subsequently, intervention was described, guided by the Theory of Diffusion of Innovation and dialectichermeneutics, to problematize this practice among nursing leaders and engage the hospital authority to legitimize the process. The integration of the results of the previous stages allowed for the elaboration of a model that conciliated the use of research in this institution. Results presented 99 research projects developed in the setting because they were linked to postgraduate (51.3%) or undergraduate programs (38.2%). Experimental or quasi-experimental research consisted of only 5.3%. Among the research coordinators (n = 36), 69.4% had superior titles, and 57.6% had been in the institution for more than 10 years. The fields of knowledge of Medical-surgical nursing (28.9%), Administration-management nursing (23.7%), and the subjects related to perception and knowledge about the health-disease process (34.5%) and description of the epidemiological profile (13.1%) were more frequent. However, the translation of the research into practice was not undertaken. Among the community of 105 nurses, teachers/researchers and students presented to be more competent for research utilization than hospital managers (p<0.001). The groups had a similar perception of barriers, which were few and moderate, ranging from the lowest to the middle point of the scale. The intervention was conducted by a team with expertise on the theme and in the organization of Workshops by focal groups. Strategic leaders participated - all nurses who were heads of the hospitalization units (n = 18). The techniques undertaken enabled them to expose the practical reality and its potential to change the reality of the hospital. Dialectical approaches allowed the decision makers to engage, legitimizing the process, resulting in an agenda of institutional commitments for the use of research in the practice of nurses. In view of the integration of the results, a model was proposed whose phases address aspects that conditioned the use of the research as a support to solve problems of this public teaching hospital. The identification of the distance between research and practice in regimental documents of the institution, the positive value of the research for Nurses and the dialectical propositions undertaken were aspects that enabled this construction. Contributing, therefore, to the increase of the national production on the subject.