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Future interventions aimed at increasing research utilization may be more effective if they focus on factors that contribute to a culture of busyness in nursing and address the mental time and energy required for nurses to use research in practice.

BackgroundDespite recent research supporting the use of metered dose inhalers with spacer devices (MDI/spacers) in pediatric emergency departments (PEDs) for acute exacerbations of asthma, uptake of this practice has been slow. The objectives of this study were to determine the barriers and supports to implementing MDI/spacer research and to identify factors associated with early and late adoption of MDI/spacers in Canadian PEDs.MethodsUsing a comparative case study design, we classified nine tertiary care pediatric hospital PEDs based on their stage of implementation. Data were collected using focus group interviews with physicians, registered nurses (RNs), and respiratory therapists (RTs), and individual interviews with both patient care and medical directors at each site. Initial coding was based on the Ottawa Model of Research Use (OMRU) categories of elements known to influence the uptake of innovations.ResultsOne hundred and fifty healthcare professionals from nine different healthcare institutions participated in this study. Lack of leadership in the form of a research champion, a lack of consensus about the benefits of MDI/spacers among staff, perceived resistance from patients/parents, and perceived increased cost and workload associated with MDI/spacer use were the most prevalent barriers to the adoption of the MDI/spacer. Common strategies used by early-adopting sites included the active participation of all professional groups in the adoption process in addition to a well-planned and executed educational component for staff, patients, and families. Early adopter sites were also more likely to have the MDI/spacer included in a clinical protocol/pathway.ConclusionPotential barriers and supports to implementation have been identified that will help EDs adopt MDI/spacer use. Future interventions intended to increase MDI/spacer use in PEDs will need to be sensitive to the barriers identified in this study.

Objective: To identify the beneficial attributes and mechanisms of storytelling through understanding the parental experiences of using a storybook knowledge translation intervention. Method: An exploratory descriptive design involving 23 parents of children presenting to two emergency departments for treatment of croup. Parents received a set of three storybooks, each representing a different severity level of croup (mild, moderate, and severe). Results: The storybooks were evaluated favorably. Parents were better able to understand the progression and treatment of croup by reading the stories, thus reducing uncertainty and alleviating anxiety about their child's condition. Parents consistently reported four positive outcomes associated with using the storybooks: (1) feeling reassured that they had done the right thing, (2) reduced uncertainty, (3) a normalization of the experience, and (4) feeling empowered. Conclusion: The "storybook" presentation of health information was regarded favorably by parents as a learning tool. Practice implications: The storybook format is a useful knowledge translation device.

Focus group interviews are a common approach to data collection in qualitative research projects. They are, however, a method with the potential for methodological and pragmatic difficulties, many of which stem from transcribing focus group data from an audiotape. An alternative to postinterview transcription is the use of a court reporter. Advantages found using court reporters were increased accuracy, timely receipt of transcripts, less distraction for focus group facilitators, guaranteed confidentiality, time saved reviewing transcripts, and convenience. Because court reporters do not traditionally work in health research, there might be issues with medical terminology that require diligence on the part of the researcher to ensure that jargon is appropriately identified and transcribed. Using court reporters in rural areas might be cost-prohibitive because of travel expenses. Court reporters offer a viable and worthwhile approach to data transcription, and in our experience, have provided our research team with rich and accurate data.