A context of uncertainty: how context shapes nurses' research utilization behaviors.

Context has often been cited as a significant factor in shaping research utilization behavior, yet scholars have been unable to provide specific detail as to how and why it is important. From an ethnographic study of research utilization in a pediatric intensive care unit, we determined that the primary characteristic of this nursing unit was uncertainty. We identified four major sources of uncertainty: (1) the precarious status of seriously ill patients, (2) the inherent unpredictability of nurses' work, (3) the complexity of teamwork in a highly sophisticated hospital environment, and (4) a changing management. We found that uncertainty shaped nurses' behaviors such that research use was irrelevant. Reducing uncertainty is a necessary precursor to any increase in research utilization by nurses. Future knowledge translation strategies need to begin by decreasing and managing uncertainty.