

































 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

The organizational context and the utilization of research evidence by nurses; a review. 

Rogers Kiprotich Chemoiwa1 

 

1Deparment of Nursing, Egerton University 
 

Corresponding author: 
Rogers Kiprotich Chemoiwa 

Deparment of Nursing, Egerton University, P.O. Box 536-20115, Egerton, Kenya 
 

ABSTRACT 

Objective: The aim of this review is to broaden the understanding of the factors which prohibit 
or promote the interplay between the context and the utilization of research evidence by 
nurses. Thematic analysis was used to review secondary data from published literature on 
utilization of research in clinical settings. Findings of this review indicate that many research 
studies attribute the poor uptake of research by nursesin their daily clinical practice to their 
individual characteristics. However the challenges in transferring research into clinical practice 
are often more due to organizational contextual factors than to individual attributes. 
 
KEY WORDS; Organizational context, research utilization 

Introduction 

At the heart of each and every health system, is the health workforce which is central to 

advancing health. They are the personification of a system’s core values – they heal and care 

for people, ease pain and suffering, prevent disease and mitigate risk. They are the human link 

that connects knowledge to health action. Each year, billions of dollars are invested in different 

ways to strengthen the health workforce pillar. One common way is through knowledge 

generation from biomedical, clinical, and health services research. But despite this, health 

service providers have failed to utilize the research evidence generated, and as a result patient 

outcomes have failed to improve, and, health systems continue to underperform. 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 130



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

 

Organizational context 

The context of a health care organization can be seen from a variety of settings, communities 

and cultures that are all influenced by (for example) economic, social, political, fiscal, historical 

and psychosocial factors(A. Kitson, Harvey, & McCormack, 1998). In this review, the term 

context is used to refer to the physical environment or setting in which people receive health 

care services, or in terms of getting research evidence into practice, ‘the environment or setting 

in which the proposed change is to be implemented’ (Kitson et al. 1998). Such an environment 

has boundaries and structures that together shape the environment for practice(G. G. 

Cummings et al., 2010; Carole A. Estabrooks, Squires, Cummings, Birdsell, & Norton, 2009; A. 

Kitson et al., 1998; McCormack et al., 2002) 

The context of an organization, has been subdivided into three core elements or dimensions: an 

understanding of the prevailing culture, the nature of human relationships as summarised 

through leadership roles, and the organization’s approach to routine monitoring of systems and 

services—that is, measurement(Carole A. Estabrooks et al., 2009; A. Kitson et al., 1998) . 

Culture is defined as "the forces at work, which give the physical environment a character and 

feel" including the prevailing beliefs and values, as well as consistency in these values and a 

receptivity to change, among members of an organizational setting. The leadership dimension 

refers to the "nature of human relationships", with effective leadership giving rise to clear roles, 

effective teamwork and organizational structures, and involvement by organizational members 

in decision making and learning.  Evaluation or measurement dimension is the feedback 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 131



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

mechanisms (both at individual level and system level), sources, and methods for evaluation (G. 

G. Cummings et al., 2010; Carole A. Estabrooks et al., 2008, 2009). 

Research utilization 

Research utilization, a specific form of knowledge translation, is a complex process in which 

research findings are transformed from one or more studies into instrumental, conceptual or 

persuasive utilization. Instrumental research utilization is the direct or concrete application of 

research findings, often identified as the application of clinical practice guidelines, procedures 

and clinical protocols.  Conceptual research utilization occurs when research serves an 

'enlightenment' function: that is, practitioners' become aware of research findings, and the 

findings inform, broaden or alter their thinking and practice in indirect ways. Persuasive or 

symbolic research utilization is when research findings are used as a tool to advocate for a 

certain procedure or practice. Generally speaking, overall research utilization can be defined as 

the use of research findings in any and all aspects of one's work .(G. G. Cummings et al., 2010; C 

A Estabrooks, 1999) 

Organizational culture and utilization of research. 

Organizational culture is defined as "the forces at work, which give the physical environment a 

character and feel", or “the invisible force behind the tangibles and observables in any 

organization, a social energy that moves people to act. It has been described as the  unifying  

theme  that  provides  meaning including the prevailing beliefs and values, as well as 

consistency in these values and a receptivity to change and, as such, it constitutes a potential 

contextual determinant of research utilization (Cahill, Narasimhan, Dhaliwal, & Heyland, 2010). 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 132



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

Scott-Findlay & Golden-Biddle, 2005, argue that organizational members draw on the 

organizational culture to understand how things operate. They also claim that organizational 

culture guides and shapes the behavior and attitudes of practitioners by providing a context 

where particular ideas, people, or events are more highly valued or deemed of worth than 

others. A culture that actively supports utilization of research evidence is significantly and 

positively related to research evidence beliefs and implementation among health service 

providers(Ellis, Howard, Larson, & Robertson, 2005; Ward et al., 2015) 

In 2001, a Canadian- wide survey was undertaken and it was found that health service 

organizations that had a positive research culture were likely to increase research utilization by 

4.81 percent (Belkhodja, Amara, Landry, & Ouimet, 2007). In another cross-sectional survey 

among 779 nurses in 32 patient care units in 8 Canadian pediatric hospitals, unit culture 

significantly predicted nurses’ instrumental research use  (i.e., direct use of research; when 

evidence is translated to a format such as a guideline or protocol and used for making decisions 

about patient care (Squires et al., 2013; Wallin, Estabrooks, Midodzi, & Cummings, 2006; 

Yamada, Squires, Estabrooks, Victor, & Stevens, 2017). Similar work by Belkhodja et al.  found 

specific aspects of unit culture, such as the unit's research culture (i.e., research as the 

preferred source of information) and the intensity of use of research sources by the unit's 

members to also be positively correlated (p < 0.05) with research utilization by healthcare 

professionals in hospital units (Belkhodja et al., 2007). 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 133



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

In a comparative ethnographic case study  in two Canadian provinces, it was found that nursing 

units with the highest mean research utilization scores clustered together on unit culture (as 

measured by work creativity, work efficiency, questioning behavior, co-worker support, and the 

importance nurses place on access to continuing education) (Carole A. Estabrooks et al., 2008). 

Similar work by (Scott & Pollock, 2008) in a pediatric unit found that a low level of research 

utilization was associated with the following elements of the unit culture: hierarchical structure 

of authority, routinized and technology-driven work at the bedside, discouragement of 

innovation, being told what to do, and no expectation of using research in practice (Scott & 

Pollock, 2008). Additionally, (NE, Suurdt, Ouelette-Kuntz, & DK, 2007) conducted semi 

structured interviews with key informants that included physicians, nurses, managers and 

dietitians and organizational culture was identified as an important factor for successful 

adherence to nutritional guideline recommendations by health service providers. 

In Malaysia where 37 primary care physicians participated in six focus group discussions (n=31) 

and six individual in-depth interviews, workplace culture was found to influence research 

utilization of the physicians (Hisham, Ng, Liew, Hamzah, & Ho, 2016). 

In a Ugandan study among midwives, respondents considered a culture that promoted on-the-

job learning from peers, good communication and cooperation among the health workers in 

the unit as one of the most important ways to acquire knowledge on best practices(Bergström, 

Peterson, Namusoko, Waiswa, & Wallin, 2012). Similarly in a Kenyan study to explore barriers 

to guideline implementation in an early phase intervention study in four district hospitals, it 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 134



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

was found that organization culture was a major barrier to encouraging correct practice, not 

just for implementing the new guidelines but also served as a motivation for acquiring new 

knowledge  (Nzinga, Mbindyo, Mbaabu, Warira, & English, 2009).  

Organizational leadership and the utilization of research 

Leadership is;  

"the process of influencing others to understand and agree about what needs to be 

done and   how to do it, and the process of facilitating individual and collective efforts to 

accomplish shared objectives"(Gifford et al., 2008).  

Leadership is an important ingredient in making changes happen in practice, particularly in 

terms of obtaining the same affective commitment to change and is necessary in 

institutionalizing utilization of research evidence in practice (Kristensen et al., 2016). Positive 

leadership is associated with more positive provider attitudes towards utilization of research 

evidence into practice. Reviews and observational studies in nursing have supported the role of 

leadership in research evidence utilization and in influencing the use of practice guidelines. 

(Aarons, Ehrhart, Farahnak, & Hurlburt, 2015) 

The key leadership behaviors that have been demonstrated when research utilization is 

institutionalized was: creating a vision and sustaining it over time, role modeling by key leaders, 

and having strong mentors (Stetler et al., 2009).  In describing the role of leadership in 

integrating utilization of research evidence, Delmonte and Oman, asserted that demonstration 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 135



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

of ongoing commitment by a core group of leaders was found to be essential (DelMonte & 

Oman, 2010) . 

A recent mixed methods study of 37 organizations in Canada, found leadership to be the only 

predictor of sustained use of clinical guideline recommendations two and three years post-

implementation, accounting for 47 percent of the variance (p < .001) (Davies, n.d.). In addition, 

using grounded theory to analyze 9 of the 37 organizations, Gifford et al. identified leadership 

behaviors as having an important impact on nurses' use of research evidence to inform practice 

and in sustaining practice change based on guideline recommendations (Gifford et al., 2008) 

Leadership behaviors associated with sustained guideline use includes providing support, role 

modelling commitment, and reinforcing organizational policies and goals for evidence-based 

care. Other effective leadership contributions are; supporting staff through adjusting 

workloads, allowing time to consider the evidence, and providing resources to free up staff 

time to support engaging in research evidence utilization in practice (Squires et al., 2013). 

Cummings and colleagues used structural equation modeling to test a theoretical model of 

relationships among features of organizational context and nurses' research utilization, they 

found that better leadership lead to reports of greater research use by nurses, which then led 

to fewer adverse patient events (G. G. Cummings et al., 2010). 

A cross sectional study that involved 32 patient care units in 8 Canadian pediatric hospitals 

showed that work environments that had strong leadership significantly moderated the effect 

of IRU among nurses (Yamada et al., 2017).  In Ugandan qualitative study among midwives 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 136



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

showed the perception on the importance of having a capable leader for knowledge translation 

was clear, whereby the leader was seen as a person that should be part of the working team 

and while also acting as a role model. Respondents in the study believed that a good leader 

should inspire and support professional development and lead in the provision of new 

knowledge (Bergström et al., 2012). Another study conducted in four district hospitals in Kenya, 

that included health service providers across cadres found out that poor leadership in the 

clinical area was the reason for lack of implementation of new clinical guidelines in hospitals 

(Nzinga et al., 2009). 

Organizational measurement/Evaluation mechanisms and utilization of research 

Evaluation relates to how the organization measures its performance, and how (or whether) 

feedback is provided to people within the organization, as well as the quality of measurement 

and feedback(Yamada et al., 2017). Measurement is a complex but necessary component of the 

environment that seeks to implement evidence into practice. Measurement is both part of the 

research process that generates evidence on which to base practice and part of the evaluation 

or feedback process that demonstrates whether or not changes to practices are 

appropriate/effective/efficient (McCormack et al., 2002). Audit coupled with a feedback 

mechanism, where data is fed back to a unit's providers in the form of some kind of report, is 

one of the most commonly applied evaluation mechanisms used in healthcare to implement 

the adoption of research-based practices (Carole A. Estabrooks et al., 2008). In low resource 

settings local communities are involved in measuring the performance of health service 

organizations at the primary care level, and this helps in shaping priorities, guide the 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 137



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

strengthening approach i.e (new guideline implementation), and creating local ownership and 

as a result health service providers are held accountable for their role in service provision 

(Peters, El-saharty, Siadat, Janovsky, & Vujicic, 2009) . 

Evaluation has been positively  correlated (at statistically significant levels) with all four types of 

research utilization:  instrumental research utilization, conceptual research utilization, 

persuasive research utilization,  and overall research utilization(Hutchinson et al., 2008). In a 

Canadian study that assessed organizational context (work environment) factors that influence 

use of best practices by care aides (nursing assistants) in nursing homes a significant predictor 

was evaluation (feedback mechanisms) (Carole A. Estabrooks et al., 2015).In another trial 

investigators reported that audit and feedback together with educational outreach and printed 

materials results in moderate improvements in nursing care, lending support to the importance 

of evaluation as a contextual predictor (Cheater et al., 2006). Additionally evaluation has been 

found to be a significant predictor of conceptual research use at the 5% level was evaluation 

(estimate: 0.353),(Squires et al., 2013) 

Supervision and audit with feedback has been found to be generally effective at changing 

practice than single component interventions. This was highlighted by evidence from a 

randomized trial which suggested that supportive supervision lead to the provision of improved 

professional practice and development (du Mortier & Arpagaus, 2005; Haines et al., 2007). If it 

is correctly done, supervision could be a mechanism for providing professional development, 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 138



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

improving health workers’ job satisfaction, and increasing motivation.(Rowe, De Savigny, 

Lanata, & Victora, 2005) 

While exploring the experiences of health workers working in primary health care facilities in 

Tanzania, participants who included nurses and doctors in focused group discussions (FGDs) 

identified positive supervision and improved feedback from referral hospitals as two achievable 

measures to improve both moral and quality of health care delivery (Manongi, Marchant, & 

Bygbjerg, 2006). 

Other contextual factors and utilization of research 

Research on organizational innovation suggests that slack resources, such as funds, staff time, 

facilities and equipment, are important determinants of successful implementation of new 

guidelines and a receptive context(Helfrich, Li, Sharp, & Sales, 2009).  Common perceived 

barriers by providers in their engagement in evidence based programs are resources, cost, and 

space (Spassiani, Harris, & Hammel, 2016). Additionally organizations that have been found to 

be most conducive to research use are those with the resources to incorporate multiple 

methods and sources of feedback into their evaluative framework(Carole A. Estabrooks et al., 

2009; Kontos & Poland, 2009). Evidence from research studies suggests that resources be 

added as the fourth important contextual component in the implementation of research 

evidence. (Carole A. Estabrooks et al., 2009). 

Organizational slack refers to  uncommitted or potential resources which allows an organization 

(unit) to adapt successfully to internal pressures for adjustments or to external pressures for 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 139



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

changes (Carole A. Estabrooks et al., 2009). More innovation is believed  to  occur  in  

organizations  with  high  levels  of  slack. Organizational slack has been found to be significantly 

correlated with instrumental and conceptual research utilization. Access to  research and 

resources has  also  been consistently identified in  nursing as  important  to the utilization of 

research (C. Estabrooks, 2003) 

In order to improve knowledge in clinical practice nurses rely on formal and informal 

interactions. Formal interactions are organizational or unit-sponsored events meant generally 

to enhance nurses’ professional skills while informal interactions Informal exchanges that occur 

between individuals working within an organization (unit) that can promote the transfer of 

knowledge. Estabrooks et al., 2005, reported that nurses rely heavily on social interactions as a 

knowledge source, using them more frequently than traditionally promoted sources, such as 

academic journals. This is because peers are not only viewed to be helpful  but also receive 

“affirmational” support, that is, validation of their feelings and ctions.(Carole A. Estabrooks et 

al., 2005) . In a research study in Canada, formal interactions, informal interactions, 

organizational slack [availability of resources (i.e., space, staff, time) which allow the unit to 

adapt successfully to internal or external pressures for change] (space), and unit specialty 

predicted conceptual research use (CRU)(Yamada et al., 2017) 

In Uganda, health workers’ commitment was a major aspect of how context influences the 

implementation of new practices. This commitment commonly referred to as ‘loss of morale’ 

was due to scarce resources, low salaries, little appreciation, a heavy workload, and the 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 140



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

presence of informal payment. Respondents in the study,  brought up ‘resources’ which 

included; human resources, equipment, drugs and supplies, space, means of transport, and 

time as an issue that influenced both the implementation of new knowledge and healthcare 

services overall (Bergström et al., 2012) 

 A study undertaken at Kenyatta National Hospital, in Kenya, reported that organizational 

support and availability of resources were significant motivators to research undertaking and 

results utilization by nurses (Kyalo, 2015).  In another study in Kenya, health workers described 

barriers at the organizational level to include staff shortages, high staff turnover, heavy 

workload, frequent staff rotations, and poor workflow structure (Nzinga et al., 2009) 

Conclusion  

Many research studies have attributed the poor uptake of research by nurses in their daily 

clinical practice to individual characteristics however this review shows that the challenges in 

transferring research into clinical practice are often more due to organizational contextual 

factors than to individual attributes. More research into this area needs to be carried out 

especially in low resource settings. 

REFERENCES 
Aarons, G. A., Ehrhart, M. G., Farahnak, L. R., & Hurlburt, M. S. (2015). Leadership and 

organizational change for implementation (LOCI): A randomized mixed method pilot study 
of a leadership and organization development intervention for evidence-based practice 
implementation. Implementation Science, 10(1), 1–12. https://doi.org/10.1186/s13012-
014-0192-y 

Belkhodja, O., Amara, N., Landry, R., & Ouimet, M. (2007). The extent and organizational 
determinants of research utilization in Canadian health services organizations. Science 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 141



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

Communication, 28(3), 377–417. https://doi.org/10.1177/1075547006298486 

Bergström, A., Peterson, S., Namusoko, S., Waiswa, P., & Wallin, L. (2012). Knowledge 
translation in Uganda: A qualitative study of Ugandan midwives’ and managers’ perceived 
relevance of the sub-elements of the context cornerstone in the PARIHS framework. 
Implementation Science, 7(1), 1–13. https://doi.org/10.1186/1748-5908-7-117 

Cahill, N. E., Narasimhan, S., Dhaliwal, R., & Heyland, D. K. (2010). Knowledge in Translation, 
685–696. 

Cheater, F. M., Baker, R., Reddish, S., Spiers, N., Wailoo, A., Gillies, C., … Cawood, C. (2006). 
Cluster randomized controlled trial of the effectiveness of audit and feedback and 
educational outreach on improving nursing practice and patient outcomes. Med Care, 
44(6), 542–551. https://doi.org/10.1097/01.mlr.0000215919.89893.8a 

Cummings, G. G., Hutchinson, A. M., Scott, S. D., Norton, P. G., & Estabrooks, C. A. (2010). The 
relationship between characteristics of contextand research utilization in a pediatric 
setting. BMC Health Services Research, 10, 168–177. Retrieved from 
http://ezproxy.net.ucf.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&
db=aph&AN=52804551&site=eds-live&scope=site 

Davies, B. (n.d.). Principal Investigator. Chsrf.Ca. Retrieved from 
http://www.chsrf.ca/migrated/pdf/researchreports/ogc/davies_final_e.pdf 

DelMonte, J., & Oman, K. (2010). Preparing and Sustaining Staff Knowledge about EBP. 
Evidence-Based Practice. Retrieved from 
https://www.google.com/books?hl=sv&lr=&id=DHoDgFV9w4YC&oi=fnd&pg=PA55&ots=1
HbEJNSTFI&sig=MXIb7NfkiFoTnCTvYElcQMNacec 

du Mortier, S., & Arpagaus, M. (2005). Quality improvement programme on the frontline: an 
International Committee of the Red Cross experience in the Democratic Republic of Congo. 
International Journal for Quality in Health Care : Journal of the International Society for 
Quality in Health Care / ISQua, 17(4), 293–300. https://doi.org/10.1093/intqhc/mzi042 

Ellis, I., Howard, P., Larson, A., & Robertson, J. (2005). From workshop to work practice: An 
exploration of context and facilitation in the development of evidence-based practice. 
Worldviews on Evidence-Based Nursing, 2(2), 84–93. https://doi.org/10.1111/j.1741-
6787.2005.04088.x 

English, M., Ntoburi, S., Wagai, J., Mbindyo, P., Opiyo, N., Ayieko, P., … Irimu, G. (2009). An 
intervention to improve paediatric and newborn care in Kenyan district hospitals: 
Understanding the context. Implementation Science, 4(1). https://doi.org/10.1186/1748-
5908-4-42 

Estabrooks, C. (2003). Translating research into practice: implications for organizations and 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 142



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

administrators. The Canadian Journal of Nursing Research = Revue Canadienne de 
Recherche En Sciences Infirmières, 35(3), 53–68. Retrieved from 
http://www.ncbi.nlm.nih.gov/pubmed/14603570 

Estabrooks, C. A. (1999). The conceptual structure of research utilization, 203–216. 
https://doi.org/10.1002/(SICI)1098-240X(199906)22:3<203::AID-NUR3>3.0.CO;2-9 

Estabrooks, C. A., Rutakumwa, W., O’Leary, K. A., Profetto-McGrath, J., Milner, M., Levers, M. J., 
& Scott-Findlay, S. (2005). Sources of practice knowledge among nurses. Qualitative Health 
Research, 15(4), 460–476. https://doi.org/10.1177/1049732304273702 

Estabrooks, C. A., Scott, S., Squires, J. E., Stevens, B., O’Brien-Pallas, L., Watt-Watson, J., … 
Williams, J. (2008). Patterns of research utilization on patient care units. Implementation 
Science, 3(1), 1–16. https://doi.org/10.1186/1748-5908-3-31 

Estabrooks, C. A., Squires, J. E., Cummings, G. G., Birdsell, J. M., & Norton, P. G. (2009). 
Development and assessment of the Alberta Context Tool. BMC Health Services Research, 
9, 1–12. https://doi.org/10.1186/1472-6963-9-234 

Estabrooks, C. A., Squires, J. E., Hayduk, L., Morgan, D., Cummings, G. G., Ginsburg, L., … Norton, 
P. G. (2015). The influence of organizational context on best practice use by care aides in 
residential long-term care settings. Journal of the American Medical Directors Association, 
16(6), 537.e1-537.e10. https://doi.org/10.1016/j.jamda.2015.03.009 

Gifford, W. A., Davies, B., Graham, I. D., Lefebre, N., Tourangeau, A., & Woodend, K. (2008). A 
mixed methods pilot study with a cluster randomized control trial to evaluate the impact of 
a leadership intervention on guideline implementation in home care nursing. 
Implementation Science, 3(1). https://doi.org/10.1186/1748-5908-3-51 

Haines, A., Sanders, D., Lehmann, U., Rowe, A. K., Lawn, J. E., Jan, S., … Bhutta, Z. (2007). 
Achieving child survival goals: potential contribution of community health workers. Lancet, 
369(9579), 2121–2131. https://doi.org/10.1016/S0140-6736(07)60325-0 

Helfrich, C. D., Damschroder, L. J., Hagedorn, H. J., Daggett, G. S., Sahay, A., Ritchie, M., … 
Stetler, C. B. (2010). A critical synthesis of literature on the promoting action on research 
implementation in health services ( PARIHS ) framework. 

Helfrich, C. D., Li, Y., Sharp, N. D., & Sales, A. E. (2009). Organizational readiness to change 
assessment ( ORCA ): Development of an instrument based on the Promoting Action on 
Research in Health Services ( PARIHS ) framework, 13, 1–13. https://doi.org/10.1186/1748-
5908-4-38 

Hisham, R., Ng, C. J., Liew, S. M., Hamzah, N., & Ho, G. J. (2016). Why is there variation in the 
practice of evidence-based medicine in primary care? A qualitative study. BMJ Open, 6(3), 
1–9. https://doi.org/10.1136/bmjopen-2015-010565 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 143



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

Hutchinson, A. M., Adachi, A., Estabrooks, C. A., Building, C. S., Barwick, M., Stinson, J., … 
Mcgrath, P. (2008). Project 2 CIHR Team in Children ’ s Pain Prepared by KUSP : Knowledge 
Utilization Studies Program. 

Kitson, A., Harvey, G., & Mccormack, B. (1998). Enabling the implementation of evidence based 
practice : a conceptual framework, 149–158. 

Kitson, A., Harvey, G., & McCormack, B. (1998). Enabling the implementation of evidence based 
practice: a conceptual framework. Quality and Safety in Health Care, 7(3), 149–158. 
https://doi.org/10.1136/qshc.7.3.149 

Kontos, P. C., & Poland, B. D. (2009). Mapping new theoretical and methodological terrain for 
knowledge translation: Contributions from critical realism and the arts. Implementation 
Science, 4(1), 1–10. https://doi.org/10.1186/1748-5908-4-1 

Kristensen, N., Nymann, C., & Konradsen, H. (2016). Implementing research results in clinical 
practice- the experiences of healthcare professionals. BMC Health Services Research, 16(1), 
1–10. https://doi.org/10.1186/s12913-016-1292-y 

Kyalo, M. A. (2015). NURSING RESEARCH AND EVIDENCE BASED PRACTICE : ASSESSMENT , 
EDUCATIONAL INTERVENTION AND ITS OUTCOME AT KENYATTA NATIONAL HOSPITAL , 
KENYA A Thesis Submitted in Fulfillment of The Requirements for the Degree of Doctor of 
Philosophy in Nursing , University. 

Kyalo Mutisya, A., KagureKarani, A., & Kigondu, C. (2015). Research Utilization among Nurses at 
a Teaching Hospital in Kenya. Journal of Caring Sciences, 4(2), 95–104. 
https://doi.org/10.15171/jcs.2015.010 

Manongi, R. N., Marchant, T. C., & Bygbjerg, I. C. (2006). Improving motivation among primary 
health care workers in Tanzania: A health worker perspective. Human Resources for Health, 
4, 1–7. https://doi.org/10.1186/1478-4491-4-6 

McCormack, B., Kitson, A., Harvey, G., Rycroft-Malone, J., Titchen, A., & Seers, K. (2002). Getting 
evidence into pratice: the meaning of “context.” Journal of Advanced Nursing, 38(1), 94–
104. 

NE, J., Suurdt, J., Ouelette-Kuntz, H., & DK, H. (2007). Implementation of the Canadian Clinical 
Practice Guidelines for nutrition support: a multiple case study of barriers and enablers. 
Nutrition in Clinical Practice, 22(4), 449–457 9p. 
https://doi.org/10.1177/0115426507022004449 

Nzinga, J., Mbindyo, P., Mbaabu, L., Warira, A., & English, M. (2009). Documenting the 
experiences of health workers expected to implement guidelines during an intervention 
study in Kenyan hospitals. Implementation Science, 4(1), 1–9. 
https://doi.org/10.1186/1748-5908-4-44 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 144



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

Peters, D. H., El-saharty, S., Siadat, B., Janovsky, K., & Vujicic, M. (2009). Improving Health 
Service Delivery in Developing Countries: From Evidence to Action. Directions in 
Development - Human Development. https://doi.org/10.1596/978-0-8213-7888-5 

Rowe, A. K., De Savigny, D., Lanata, C. F., & Victora, C. G. (2005). How can we achieve and 
maintain high-quality performance of health workers in low-resource settings? Lancet, 
366(9490), 1026–1035. https://doi.org/10.1016/S0140-6736(05)67028-6 

Rycroft-Malone, J. (2004). The PARIHS Framework—A Framework for Guiding the 
Implementation of Evidence-based Practice. Journal of Nursing Care Quality, 19(4), 297–
304. https://doi.org/10.1097/00001786-200410000-00002 

Scott-Findlay, S., & Golden-Biddle, K. (2005). Understanding how organizational culture shapes 
research use. Journal of Nursing Administration, 35(7–8), 359–65. 
https://doi.org/10.1097/00005110-200507000-00008 

Scott, S. D., & Pollock, C. (2008). The role of nursing unit culture in shaping research utilization 
behaviors. Research in Nursing and Health, 31(4), 298–309. 
https://doi.org/10.1002/nur.20264 

Spassiani, N. A., Harris, S. P., & Hammel, J. (2016). Exploring How Knowledge Translation Can 
Improve Sustainability of Community-based Health Initiatives for People with Intellectual / 
Developmental Disabilities, 433–444. 

Squires, J. E., Estabrooks, C. A., Scott, S. D., Cummings, G. G., Hayduk, L., Kang, S. H., & Stevens, 
B. (2013). The influence of organizational context on the use of research by nurses in 
Canadian pediatric hospitals. BMC Health Services Research, 13(1). 
https://doi.org/10.1186/1472-6963-13-351 

Stetler, C. B., Ritchie, J. A., Rycroft-Malone, J., Schultz, A. A., & Charns, M. P. (2009). 
Institutionalizing evidence-based practice: An organizational case study using a model of 
strategic change. Implementation Science, 4(1), 1–19. https://doi.org/10.1186/1748-5908-
4-78 

Wallin, L., Estabrooks, C. A., Midodzi, W. K., & Cummings, G. G. (2006). Development and 
validation of a derived measure of research utilization by nurses. Nursing Research, 55(3), 
149—160. https://doi.org/10.1097/00006199-200605000-00001 

Ward, S. E., Goldberg, N., Miller-mccauley, V., Mueller, C., Nolan, A., Pawlik-plank, D., … 
Murphy, B. (2015). Improving pain management at the nursing education level: evaluating 
knowledge and attitudes. BMC Health Services Research, 18(1), 1865–1871. 
https://doi.org/10.1188/15.ONF.165-173.Evidence-Based 

Yamada, J., Squires, J. E., Estabrooks, C. A., Victor, C., & Stevens, B. (2017). The role of 
organizational context in moderating the effect of research use on pain outcomes in 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 145



 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                           Rogers Kiprotich Chemoiwa * * 
https://ijojournals.com/                                                                                        Volume 08 || Issue 03 || March, 2025 || 

“The organizational context and the utilization of research evidence by nurses; a review." 

 
 

 

hospitalized children: a cross sectional study. BMC Health Services Research, 17(1), 1–11. 
https://doi.org/10.1186/s12913-017-2029-2 

Yost, J., Ganann, R., Thompson, D., Aloweni, F., Newman, K., Hazzan, A., … Ciliska, D. 

(2015). The effectiveness of knowledge translation interventions for promoting evidence-

informed decision-making among nurses in tertiary care: A systematic review and meta-

analysis. Implementation Science, 10(1), 1–15. https://doi.org/10.1186/s13012-015-0286-1 

 

IJO JOURNALS

Volume 08 | Issue 03 | March 2025 |          https://ijojournals.com/index.php/hsn/index 146


	ABSTRACT
	Organizational context
	Research utilization
	Organizational culture and utilization of research.
	Organizational leadership and the utilization of research
	Organizational measurement/Evaluation mechanisms and utilization of research
	Other contextual factors and utilization of research


	REFERENCES

