BUTLER, PATRICIA WITTLE MITCHELL; PHD

                        THE UNIVERSITY OF MICHIGAN, 1986
 
                        HEALTH SCIENCES, NURSING (0569)
 

                         Funding for nursing research has increased the number of studies but no corresponding increase in
                         application of research has occurred. To have an impact on health care delivery, organizations must
                         rapidly diffuse research innovations throughout their systems to the practitioner. The purpose of this
                         study was twofold: (1) to discover Embedding-Diffusion (ED) mechanisms that facilitate the diffusion of
                         innovations through the hospital nursing department, and (2) to examine the relationship of nurses'
                         continuing learning (CL) activities to nurses' knowledge of the innovation. The ED mechanisms are the
                         structures and arrangements within the department that facilitate the dissemination, learning, skill
                         development and implementation by the practitioner. The amount of diffusion of the innovation--the
                         Guidelines for the Prevention of Catheter-Associated Urinary Tract Infections--was measured by a 26
                         item test of nurses' knowledge, the Knowledge score. Questionnaires were sent to 600 registered
                         nurses, 100 each from six hospitals. These provided data on nurses' knowledge, CL activities, and
                         background characteristics. The data for the ED mechanisms, developed into four scores, were obtained
                         from interviews with directors of nursing from the randomly selected hospitals. Three-hundred fifty-four
                         nurses returned questionnaires with a range of 35% to 70% by hospital. Multiple regression analysis
                         revealed a significant positive association between the Knowledge score (KS) and two of the ED scores,
                         External Resource, and Participation. A significant negative association was observed between the KS
                         and the Internal Resource score. The Action score was not significant. The KS and the nurses'
                         Professional CL score were positively and significantly associated. In addition, three nurse background
                         characteristics were significantly associated with higher knowledge: never married vs. sometime married,
                         employed part-time vs. full-time, and Associate degree vs. Diploma. The findings suggest that hospitals
                         having specific resources and greater nurse participation employ registered nurses who have greater
                         knowledge of the innovation.

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