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Background : the BARRIERS to research utilization scale was developed in the US almost a decade ago (Funk et al. 1991). Since then it has been used in several countries with different, relatively small groups of nurses in different settings. The work reported here is a sub-section of a larger survey of more than 2000 nurses working in acute and community settings in Yorkshire. Results for the hospital-based nurses only are presented here. Aim : the aim of the study was to produce a general picture of the main barriers to the implementation of research findings as reported by hospital nurses and to explore sub-samples in order to identify similarities and differences between them. Method : a census survey of nurses from two hospital trusts was undertaken. The BARRIERS questionnaire was sent by mail to 1984 nurses, with a response rate of 36% ( n =712). Results : the greatest area of concern focused on resources. This included time and facilities for implementation and cooperation from colleagues, in particular medical colleagues. Inadequate authority to make changes and incomprehensible statistical analyses were also major barriers. Night nurses and older nurses reported greater difficulties with the accessibility of research and had more negative views of the benefits of research for practice. Conclusions : the provision of time, facilities and peer support appeared to be needed, in keeping with other UK-based studies of hospital nurses using the BARRIERS scale. Nurses needed authority to make changes to practice. Furthermore, there was a need for training to improve nurses’ understanding of statistics, as well as statistics being presented more clearly and with greater explanation. The current drive for evidence-based practice makes the use of an instrument such as the BARRIERS scale to measure the progress of nurses with research implementation highly desirable.

Objectives the following paper addresses the etique tte of district nursing, which, it is argued, is a manifestation of the profession's non-challenging occupational culture and a barrier to clinical effectiveness. Etiquette describes courtesy rules that are applied, often unthinkingly, to facilitate smooth social interaction. Although good working relationships are essential to ‘teamwork’, there are circumstances under which patient care can suffer if politeness becomes an overriding aim. Design the data for this paper are taken from a larger ethnographic study of district nursing work. Participant observation spanned 13 days, and 50 semi-structured interviews were conducted. Setting three community trusts in North West England. Participants 37 district nurses, grades G, H and one F, were observed and interviewed. Analysis the data were analysed by constant comparative analysis until no new themes arose. Findings the findings presented here address the problem faced by the nurses of perceiving that a colleague's care was out of date, or otherwise inappropriate, and of how they dealt with this. In such circumstances, the rule of etiquette was usually that the patient's care would not be challenged, although whether the issue would be subsequently raised with the nurse concerned was attributed to a number of factors. The implications of etiquette in the workplace are addressed. Conclusions the paper concludes by suggesting that a more formal set up for clinical peer review may be a useful platform to move discussion about patient care onto a more professional footing.