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Abstract:
A national survey of a stratified random sample (n = 240) of accredited hospitals with critical care units (CCU) was conducted in order to describe the current practice of restrictions imposed upon myocardial infarction (MI) patients. A cross-sectional correlational survey with a two-stage mailing was used. The first-stage mailing, at the institutional level, was sent to the head nurses of the CCU's. The second-stage mailing was to two randomly selected nurses plus the head nurse from each responding CCU (n = 600). Nurses were requested to give (a) importance and frequency ratings of selected coronary care nursing practices; (b) information about the use of discontinuance of two specific restrictions: ice water and rectal temperature measurement. Follow-ups by mail and/or telephone yielded response rates of about 87 percent for each stage of mailing. The conceptual framework "Diffusion of Innovations" was used to assess the diffusion of the results of studies published in clinical journals. Despite findings that cast doubt on the practices of restricting ice water and rectal temperature measurement, coronary precautions are commonly practiced. Hours spent reading and the number of journals read correlate (p less than .001) with greater levels of awareness in nurses that such restrictions are in question. Levels of awareness are not related to the importance and frequency ratings for those restrictions. Differences among nurses do not explain differences in ratings. If research is to be used, nurse researchers and managers need to actively intervene in care. Passive diffusion of research results is inadequate, unsure, and slow.