Factors Affect Nurses Transfer Theoretical Knowledge Regarding Nursing Theories into Practice in Government Hospitals ( Alshaab , Khartoum North and Omdurman Teaching Hospitals ) 2015

Descriptive cross sectional hospital based study, done in period extended from October 2015 to January 2016 at government hospitals, include 120 nurses To study the factors that affect transfer of nurse’s theoretical knowledge regarding nursing theories into practice in government hospitals (Alshaab, Khartoum north and Omdurman. Teaching Hospitals). The data were collected by using Self-administered closed ended questionnaire and analyzed by using computer program (SPSS version 20). Results: The current study showed that most of study group are female (89.2%), majority of them (74%) have bachelor degree, their experience range from 1 3years. Also study showed the most common factors contributes in misapplication of theoretical knowledge regarding nursing theories into practice were environmental factors with percentage (64.2%) it include “clinical area setting, nurse patient ratio, availability of equipment’s” and documentation factors with percentage 78.3% such as (record and report based on evidence based practice, based on nursing care plan, and reality of work .


Introduction
A "nursing theory" is a description or explanation of an area of professional nursing.This description or explanation is proposed in a systematic way in order to provide the broadest and most practical information for use in nursing practice and research.[1].Nurse practice theories are constructions that deal with questions that pertain to particular and specific issues, settings and populations.They are very valuable for day-to-day experiences.However, their limitation is that they have little connection to foundational nursing theories and research.Problems are often solved with new or improvised methods.While these methods may prove effective, much time can be lost with such improvisation.Often patients in emergency situations do not have time to lose [2].There are a many factors that affect the nurses transfer their theoretical knowledge into practice in previous studies."Di-vergence in Iranian nursing organization including academic and clinical settings adversely affects knowledge transfer.Centralized and medical focused .Organizational factors affecting knowledge transfer can be grouped into two main categories or themes: (i) the dimensions of incompetent organizational content (such as work culture); and (ii) incompetent organizational structure (such as the hierarchy of authority, the expertise and the standardization).The findings showed that there was a range of competing subcultures between management and nursing.The most important basic social problem was inferred as divergence in nursing organization across academic and clinical settings " [3].Nursing theories aims to describe, predict and explain the phenomenon of nursing , help to describe criteria to measure the quality of nursing care, ideas are developed and words are defined , enhance autonomy (independence and self-governance) of nursing through defining its own independent functions and it should provide the foundations of nurs-ing practice.And there is noticed theory practice gab in nursing care [4] A theory, as a general term, is a notion or an idea that explains experience, interprets observation, describes relationships, and projects outcomes.Theories are mental patterns or constructs created to help understand and find meaning from our experience, organize and articulate our knowing, and ask questions leading to new insights.[5] Nursing models are conceptual model: These conceptual nursing models are constructed of theories or concepts from Nightingale to modern theorists, understand the purposes of describing, explaining, predicting, or prescribing & controlling of the construction theory [6] The purpose of application of nursing theory: To assess the patient condition by the various methods explained by the nursing theory , To apply the theory to solve the identified problems of the patient and To evaluate the extent to which the process was fruitful.The Purpose of Theory in a Professional Discipline: All professional disciplines have a body of knowledge consisting of theories, research, and methods of inquiry and practice.They organize knowledge, guide practice, enhance the care of patients, and guide inquiry to advance science.Nursing theories address the phenomena of interest to nursing, including the focus of nursing; the person, group, or population nursed; the nurse; the relationship of nurse and nursed; and the hoped-for goal or purposes of nursing.[7] The effects of theories on quality of care, in (1995) McKenna.

Identified three major assumptions:
1. Nursing theories lead to better quality of care; 2. Nursing theories have an uncertain effect on quality of care; 3. Nursing theories lower the quality of care.
The role of nurse managers, educators and theorists in theory application: Managers must allow nurses to question practice and take chances with new theory-based knowledge, and this must be seen as a legitimate use of staff time.Practitioners in any discipline are best able to appreciate and apply theory when they have been educated from the beginning in an environment where theory in their field is being generated, professional education in such an academic environment.Without such theoretical literacy they will have difficulty instilling the knowledge and skills of theory appreciation, awareness and application in their students , there are so many theories that it is difficult for any practitioner to make sense of them all!Yet another problem is that theorists often simply publish their work and opt out -believing that an interested practitioner will read their articles and book and implement the theory with their patients.Study area: This study will be conducted In government hospitals (Alshaab, Khartoum north and Omdurman Teaching Hospitals) (Khartoum -Sudan).

Sample size:
Total coverage of nurse's work in hospitals that included in the study.
Instrument: Self-administered closed ended questionnaire designed by researcher based on literature review to collect data that will assess the factors affect nurses transfer the theoretical knowledge regarding nursing theories into practice.

Data collection technique:
The data was collected in morning and afternoon night shifts, each participant fill questionnaire by him, each questionnaire take from 5 to 10 minutes.

Data analysis:
The collected data was analyzed by using computer program (SPSS version 20).

Discussion
The present study reveal: demographic of study group most of them female (89.2%), their age range from (20 -30 years), majority of them have bachelor degree.On the other hand near half of nurses (47.5%) their experience range from (1-3 years), the study clarify that most of nurses with percentage 70% have positive attitude of that nursing theories it useful set of frame work to guide practice, develop systematic nursing care and clearly focus on patients needs and it is a set of clear ideas about what nursing is, what values are, and what contributions to make in health care, these findings indicated that nurses more understood the meaning and benefits of nursing theories (39.2%, 47%) respectively.In addition near to half of nurses (45.8%) and above one third (37.5%) of them comment that grand and nursing practice theory are the common type of theories, regarding their knowledge about component of nursing theories.Majority of them with percentage 68.3%they explain that knowledge and skills the nurses needed to practice as a component of nursing theories, further more half of nurses with percentage 50.8%show that nursing theories in the future will be more fully integrated practice of nursing regarding nursing theories outcome.Regarding environmental factors nurse's comment, half of them with percentage 51.7%relate it to clinical area setting and near half (40%) due to nurse -patient ratio and less than quarter (12.5%) due to availability of equipment's, while they think that availability of staffing, staff training, co-operation and knowledge of staff were good indicators as staffing factors can affect application of ideal theoretical knowledge into practice (50.0%, 52.5%) respectively.

Recommendations
• The hospitals should apply nursing theories in nursing services area to guide practice.
• Establish a training program for nurses regarding nursing theories knowledge and skills.
• Motivation of nursing staff by involves them in decision-making and best leadership style and managing staff shortage.
Most of nurses have bachelor degree and their experience range from 1 -3years.The most common factors contributes in misapplication of theoretical knowledge regarding nursing theories into practice were environmental factors and documentation factors, while the less common factors is training, staffing, and discian making factors.

Nursing Theories Outcome Frequency Percent Nursing theory in the future will be more fully integrated practice of nursing
Data was presented in form of figure and tables.Approval from university Approval from Khartoum ministry of health research department.Approval from hospital.Research purposes and objectives will be explained to participants in clear simple words.Hassan EM, Makki FO, Hussein AM, Adam D (2016) Factors affect nurses transfer theoretical knowledge regarding nursing theories into practice in government hospitals (Alshaab, Khartoum north and Omdurman Teaching Hospitals) 2015.J Microbiol Genet 2016: JMGE 103 Distribution of Nurse's Knowledge about Nursing Theories Outcome (n=120).Distribution of Nurse's Knowledge about Environmental Factors: (n=120).

Table 5 :
Distribution of Nurse's Knowledge about Decision Making Factors (n=120).

Table 6 :
Distribution of Nurse's Knowledge about Training Factors (n=120).Hassan EM, Makki FO, Hussein AM, Adam D (2016) Factors affect nurses transfer theoretical knowledge regarding nursing theories into practice in government hospitals (Alshaab, Khartoum north and Omdurman Teaching Hospitals) 2015.J Microbiol Genet 2016: JMGE 103