Promotion of Nursing Research in Clinical Situations in Japan with Support from University Faculty: Results and Issues Recognized by Hospital Nurse Managers

For clinical nurses wishing to participate in research, there are several logistical issues as high workloads, lack of time and poor research skills and knowledge that can impede research being undertaken. To address these issues, an approach was reported that a university in partnership with one of hospitals developed a clinical school with the aim of delivering postgraduate courses and undertaking collaborative clinically focused nursing research in Australia [1]. A development of a regional nursing research partnership for academic and practice collaborations as a model was demonstrated in Duke, USA [2].

In Japan, the nation-wide questionnaire which is consisted of items concerning the actual conditions of research activities, support systems, and the demands for universities was conducted to investigate the support system for research by nurses. In the survey, the directors of nursing and the chief of the research committee answered that basic knowledge and research skills, time for research, and commitment to research were insufficient. The result suggested that requirements for the construction of a research support system including continuous and individual instructions by nursing faculty who used to affiliate to a university [3]. Earlier report also described that collaborative nursing research across academic and practice settings is imperative to generate knowledge to improve patient care [3,4,5]. However models of academic/practice partnerships for nursing research in Japan are still limited.

Consequently, for university faculty members it is possible to support hospital teaching departments by providing specialist knowledge with the research methodology such as data analysis of problem-solving in the clinical field. The collaboration in research activities in nursing leads to an accumulation of new knowledge regarding nursing science.

An educational philosophy of A University in Sapporo city, Hokkaido, Japan is to contribute to the community. The university aims to serve the community through teaching, research and public service. Based on the philosophy, the university has conducted various activities to encourage hospital-university collabotation. Among them, from 2007, the university worked with seven nursing departments at hospitals, driving research activities by providing guidance for the overall research process. In this activity, nearly 30 faculty members have involved to support 120 research team. The activity is a valuable opportunity for the faculty to attend the situation and the problem of the actual clinical nursing as well as a contribution for the community by the university.

Although the university has provided nursing research support for over ten years, more clarity is needed to determine outcomes for both faculty and hospitals and the possibilities to explore in the future. In this study we aimed to clarify hospital nurse managers’ perceptions of the results of the efforts being made in the research activities of clinical nurses that were supported by university teachers and issues for further improvement.

A qualitative descriptive design was used to investigate the nurse manager’s views about the activities.

Survey period was from March to May 2017.

Our subjects for analysis were five managers from the hospitals that received the support.

According to the purpose of the research, we questioned “results obtained through research support from faculty members”, “research support issues” and “wishes for research support”. 60 min interviews of the subjects were conducted in a private room to secure privacy.

A qualitative inductive analysis was made with their remarks. The answers of the interviews were recorded with an IC recorder with the consent of the interviewees. All recorded contents were described word by word. For coding the transcript, we looked for the significant statements according to the topics addressed. Their remarks were sorted using similarities and common features and formulated into categories. All these process were throughly examined and confirmed by a panel of joint researchers.

The study was conducted after approval has been obtained from the Ethical Committee of Sapporo City University. All participants were informed of the objectives and design of the study and a written consent received from the participants for the interviews and they were free to leave the interviews if they wish.

All the subjects were female and all five interviews were analysed. From the managers’s points of view, what considered as important in the activities were as follows (Table 1-3).

 

Categories	Codes
Patient care has changed	The results of research were applied in nursing care. Researches with themes leading to elucidation of clinical phenomena were performed. The basis and essence of care became clear.
The research processes improved	The research processes improved under the guidance of the university teachers, as compared with previously when they were only under the guidance of the hospital supervisors. Research topics were identified better.
Improvements in staff motivation/morale	Making presentations at nationwide conferences motivated the entire nursing department. Nurses work with enthusiasm. Nurses quit less often. Inspired equity and objectivity in the workplace.
Improvements in supervisors’ability	The ability of hospital supervisors to guide research was improved. The educational involvement of the teachers made them role models for the supervisors of the hospitals.
Betterment of hospital administration	Having a researcher’s perspective can lead to improved day-to-day operations.
Fulfillment of continuing education	It becomes another part of continuing education The way that systematic cooperation between the hospital and the university contributed toward continuing education at the hospital.

Table 1: Results obtained through research support from faculty members.

 

Categories	Codes
Problem in accumulation	Workers at organizations like hospitals change, making it difficult to maintain research quality or knowledge accumulation.
Inconsistency between policies of both party	There were times when the hospital’s expectations and the education system lacked consistency.
Communication problem	The chances for support were not properly utilized due to lack of communication.

Table 2: Research support issues.

 

The nurse managers considered the guidance of the university teachers to be beneficial when research was successfully completed using research topics that nurses had identified during their work. It was perceived that the collation and summarization of research themes that lead to explanations for clinical phenomena has resulted in improved nursing care on a daily basis. They appreciated the fact that clinical nurses can complete research through continuous support in the process and valued expertise of the faculty members. They felt that the guidance of the university teachers was productive when it led to their being able to make presentations at national conferences.

In addition to that, the nurse managers perceived the nurses gained the ability to work with energy and vitality after completion of research work. All these changes were viewed positively by hospital nurse managers.

The study has shown that there are improved abilities of supervisors in research guidance through the attendance of teaching sessions by university professors. However there is the issue in the clinical field of nursing staff getting replaced which presents a problem with the accumulation of research skill. To accumulate the ability that has been acquired in these activities, further support towards supervisors in the future to sustain research skills was expected in the relationship with universities.

On the other hand, there was also the result that “Inconsistency between policies of both parties”. From nationwide survey in Japan, Sakashita reported that the purpose of nursing research, which is expected of the clinical nurses by the nursing department, differs to that carried out at universities and research institutions, as education is prioritized in the former [6]. Miyashiba also suggested the importance of constructing the research model and support system according to each nursing research significance to promote nursing research in clinical settings since nursing research in Japan is often perceived as an educational activities [7].

University faculty members need to have sensitivity towards the hospital’s expectations and share targets with the hospital’s nursing department.

The study has also found that there were times when guidance could not be effectively utilized due to issues such as the inability to get guidance at the desired timing. Efforts by both parties, such as both nurses and teachers checking the research time schedules or coordinating contact methods that acknowledge the difference in perspectives, are expected to produce positive collaborative results.

The study has also revealed that there are new expectations in the continuation of relationship with universities, such as support towards supervisors in the future. If the policies of the hospitals are respected, and goals are shared with the nursing departments and universities, then further favorable results can be expected.

The links between hospitals and universities have the potential to grow the research results built up through previous research support and expand it into new liaison projects and joint research. What is necessary for this event is the awareness in their respective strengths and a relationship where constructive opinions can be shared.