ProCare knowledge triangle

 Nursing is a scientific discipline and research has become an integral part of nurse education. Research process is essential for obtaining new knowledge to improve patient health care and for continuous development of nursing as a scientific discipline. To reach this goal, nurses need appropriate support - support in new knowledge accessibility and in pro-research system orientation.

At this point the ProCare project has come to important conclusions within WP1 and WP2. WP1 is addressing identifying various aspects of the nursing work environment. Conducted studies aimed to determine the opinions and obtain a self-evaluation of nursing respondents on the extent of working within or beyond the level of competence they gained as part of their nursing education. Despite professional competencies and activities for different categories of nursing care providers being clearly divided, clinical practice in Italy, Spain and Slovenia still shows that some profiles of healthcare providers are performing competencies not consistent with their formal education and training. The studies also aimed to determine barriers and facilitators of the nursing research. The findings were in many parts consistent with other existing data. Many studies are addressing barriers for implementation of nursing research in clinical environments. We know that the most commonly identified barriers are not knowing the research process, lack of: time and resources, access to obtain research material, knowledge to identify quality evidence and evidence interpretation, knowledge on statistics, competencies, English language competency, computer and electronic literacy etc. All listed deficits significantly affect the implementation of evidence based practice in the clinical environment. Also leadership is an important element of encouraging and providing support to nurses who would like to practice research. Management can have a negative impact on research development and implementation by not providing acceptable development strategy, bad organization, lack of designed evidence based practice implementation strategy, lack of educated managers, etc. WP2 is about linking higher education, research and hospitals to support nursing research development. So far gathered results of the studies are reflecting the need to strengthen the cooperation between hospitals and faculties. Mutual aims of HEIs and clinical environments result in quality nursing care. Cooperation reduces the gap between theory and practice. Clinical environments emphasis procedures and competencies for independent work and only these are not sufficient to develop research and evidence based nursing practice. Research and evidence based practice need to be emphasized and encouraged simultaneously – in clinical and higher education environments. This sort of partnership is beneficial for all involved, starting with students. Students have optimal conditions to successfully integrate into work environments, to maintain critical thinking and research orientation, and to use acquired knowledge autonomously. The empowerment of nurse` knowledge and competencies begins at HEIs. The educational process has the power to positively influence students` attitude towards research, their research competencies, and the perception of evidence based practice in nursing. 
As early as the early 19th century, Florence Nightingale was credited with improving patient care when she warned that poor sanitation could adversely affect the health of patients. She continued to record health statistics to determine the number of deaths in hospitals and mortality associated with illness and injury. In the 20th century, more precisely in 1972, Archie Cochrane introduced into nursing care the concept of applied randomized control trials and other experimental and non-experimental research at a lower level of research evidence. Cochrane based his work on the assumption that nursing care is limited by material resources and that only procedures that have been shown to be effective should be used. In his view, randomized controlled trials are the most reliable form of evidence, and his assertion created the foundation for the evidence-based practice doctrine. As part of the higher education study program, nursing students learn about practice and theory, both of which are closely intertwined with evidence-based practice. In recent decades, evidence-based practice became a key part of optimal patient care. Even though the application of evidence-based practice in nursing care brings excellent results that are clearly documented, it is still not used often enough. Collaboration of clinical environments and HEIs; knowledge and material resources; needs to implement research and attitudes towards research; reasons for decisions to become a nurse; management support and financial resources; formal and non-formal education; application of knowledge and understanding of research process are the key factors in promoting and at the same time hindering the development of nurses' research activity.