Cummings et al. (2007) found that hospital characteristics
such as more responsive administration led to nurse
reports of greater unit-level autonomy, increased staffing
and support services as well as promotion of innovation. By
providing opportunities for staff development and nurseto-
nurse collaboration as well as sufficient nurse staffing
and support services, administrations positively but indirectly
influenced nurses’ RU. The participants in the study
by Nilsson Kajermo et al. (2001) reported that a heavy
workload together with a large number of patients, many
seriously ill, along with insufficient staffing, made it difficult
to find the necessary time for disseminating and implementing
research findings.
Characteristics of the Culture
Gifford et al. (2007) in their integrative review described
the leadership activities of nurse managers that influenced
nurses’ use of research evidence. The authors found that
a culture where research is valued by managers and RU
is incorporated into performance appraisals facilitated its
use. Similarly, in the integrative review by Meijers et al.
(2006), a statistically significant relationship was found
between RU and an environment where research use is
encouraged and recognised.
A particularly strong factor that emerged in the study
by Gifford et al. (2006) was the need for leaders to create
a positive milieu to support best practice. Managers
could do so by establishing practice norms and value systems,
including emphasising that implementation of the
guideline recommendations is a common goal as well as
the philosophy of the institution. The management team
in organisations where guideline use was sustained had a
reputation for trying new things and being innovative as
well as managers who lead by example and are committed
to the project.