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Nurses learn from each other, not from current research

A new study shows that nurses use their colleagues as the most important source of up-to-date knowledge.

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Professor Mariann Fossum says there is cause for concern that nursing peers are the number one source of information for clinical nurses.

“It is worrying because it can mean that newer knowledge is not being employed, and that hospitals and health institutions in the municipalities use outdated knowledge when they practice their profession.”

That is what Mariann Fossum says. She is a professor at the University of Agder and has conducted a study on how nurses inform their clinical practice. She conducted the study together with UiA colleague Anne Opsal and Professor Anna Ehrenberg from the University of Dalarna, Sweden.

Mariann Fossum er instituttleder og professor ved Institutt for helse- og sykepleievitenskap ved UiA.

Mariann Fossum is head of department and professor at the Department of Health and Nursing Science at UiA.

A clinical nurse is the one who treats and follows up the patient in line with the requirements the health services set for health professionals.

“When nurses use nursing colleagues as primary sources, a senior nurse is often selected. That may contribute to a constant reinforcement of previous practices. Patients want new and updated treatments, but our study shows quite clearly that there’s a substantial risk that they will not get it”, Fossum says.

She refers to a similar study on clinical work in the health services. It shows that it takes 17 years before new research is put into use.

“That essentially means 17 years where nurses and other health professionals in hospitals rely on knowledge that was outdated years ago”, Fossum says.

She points out that this is not the solely the nurses’ responsibility.

“Nurses have a personal responsibility to keep up to date with their profession, but hospitals and institutions must ensure that newer information from the health authorities is readily accessible. Health institutions must give nurses time to study the information and contribute to the provision of continuing and further education for healthcare professionals”, she says.

A review of 52 studies

The new study is about clinical nurses. The goal has been to find out what sources of information nurses draw on to be able to provide up to date nursing care to patients and their families.

Fossum and her colleagues carried out a literature review of 52 research papers published in the period 2008-2022. The papers are sourced from all continents. They show that nursing colleagues are the main sources of new knowledge about clinical practice.

“It is not a problem that nurses trust each other. But it may be a problem if new and vital information from the health authorities is not getting through to the nurses”, says Mariann Fossum.

Same results in 2008

In 2008, a similar literature review was conducted. The results at that time correspond to the recent findings.

“The review from 2008 revealed that nurses more often relied on information from fellow health professionals than more up-to-date and quality-assured sources, such as systematic reviews and evidence-based guidelines for clinical practice”, Fossum says.

Increased use of internet

The new study also has positive findings. It shows some increase in nurses' use of technology. More of them increasingly search for knowledge online and access digital encyclopaedias.

“There should be a system for knowledge update in the hospitals and in the municipal health services. Nurses must have access to education and support to develop their technological skills”, Fossum says.

Overall, nursing colleagues, computers and reference materials were among the three most important sources of information for clinical nurses.

Research collaboration with the hospital

Fossum looks forward to further research in this area. She wants to continue with this topic in collaboration with the municipalities in Agder and the Hospital of Southern Norway.

“It will be important to examine which information sources are most consulted in the municipalities and at the hospital in Agder”, Fossum says.