Bridging the Gap Between Research and Clinical Practice

Hilda, a nurse with 10 years of experience, is teaching a patient with a healing wellgranulated wound to irrigate it every day with hydrogen peroxide. Cory, a new nurse who is in the patient’s room, is listening to this conversation. She knows that what Hilda is teaching is not correct but is reluctant to say anything. A few hours later, Cory discusses the patient with Hilda and mentions that peroxide treatment is not appropriate for this patient’s wound. Hilda replies, ‘‘This is the way we always do it and I want to make sure that the wound is really clean.’’ Cory, faced with a dilemma, does not know whether she should alienate Hilda or show her the research findings that document the best practices for wound care. Do we want patients to have health care based on the latest and best knowledge or should they be treated with traditional and ritualistic methods? The best clinical practices are based on research. The primary purposes of nursing research are (1) to expand the knowledge base for nursing practice and (2) to improve the quality of patient care (Fig. 1). In addition to improving patient care, nursing research can reduce health care costs. For this to happen, relevant research needs to be incorporated into clinical practice. Research is of little value unless it is used; however, research findings are not being implemented even when there is evidence that integration of these findings would produce more effective patient outcomes and better clinical practice. Patients suffer unfortunate consequences when advances in research are not incorporated into practice. For many years it has been recognized that a gap exists between what is known (based on research) and what is done in clinical practice. At least 30% to 40% of