PRODUCTION OF NURSE CLINICIANS MEDIATED BY A RESEARCH ADVISORY GROUP

This study reports on the activities developed within the Nursing Research Nucleus (NUPE) of a public school hospital and the scientific production of nurses during the period from 1999 to 2002. For this purpose, data regarding the preparation of professionals and scientific production during this period were obtained from the primary document sources of NUPE and the Human Resources Advisory Group. Nurses elaborated, alone or in collaboration with nursing students and teachers, 129 research projects, and 151 scientific studies were presented on the occasion of different events, 6 of which received a prize. Sixty-three scientific studies were submitted for publication and 36 were published. During this period, all nurses concluded a specialization course and some of them enrolled for a master’s or doctoral program. In conclusion, NUPE boosted the scientific production of the institution, with repercussions on nurses’ personal and professional development.


INTRODUCTION
In a context of constant technical-scientific innovation in different health knowledge areas, Nursing research is an important space for reflection and transformation of professional practice.
Until recently, research was mainly developed by faculty of undergraduate Nursing courses, affiliated with Brazilian universities (1) .Since the 1990's, nurse clinicians have started to take stricto sensu graduate courses and, in their search for knowledge, have also been inserted in research practice.These professionals invest in these courses because they represent resources that can grant quality, credibility and efficacy to their practice (2) .
In order to cope with deficiencies in their academic formation, as well as personal and institutional obstacles, nurses develop research, individually and/or jointly, in an attempt to get to know and apply the scientific method (3)(4) .In this respect, nurse clinicians' participation in scientific events, to disseminate research and professional experiences, deserves special attention.This attitude is directly related to the belief in the importance of research practice for personal and professional improvement ( . However, great efforts are still needed to deal with the gap between knowledge production by academic researchers and its use in Nursing care institutions (7) .Nurse researchers evidence the importance of demystifying and dethroning researchers as an essentially academic practice (7)(8) .
Therefore, it is fundamental to encourage and involve a continuously increasing number of nurse clinicians in activities that allow not only for the use, but also for the development of new studies, with a view to advancing the profession.
A recent aspect is health services, hospitals and basic health units' interest in qualifying their staff, supporting nurses to do research by forming study groups, creating research nuclei, taking e x t e n s i o n c o u r s e s , i m p l e m e n t i n g r e s e a r c h commissions and study and research centers, among other initiatives (3)(4)(9)(10)(11)(12) .
In Brazil, experiences aimed at enabling nurse clinicians to develop research activities have been going on in public and private services, called research advisory groups (12)(13)(14) . At

CONTEXT AND METHODOLOGY
The

CREATION OF THE NURSING RESEARCH NUCLEUS
professionals to expand their knowledge and can provide satisfaction at work (11) , in January 1999, the UH Nursing Administration created the Nursing Research Nucleus (NUPE).A number of limits have to be acknowledged when presenting and discussing the scientific production of nurse clinicians, due to the lack of publications about this theme and to the incipient representativeness of these professionals in the scientific nursing community (12) .In order to assess the study proposal, going beyond the strictly numerical meaning to reach what often is not manifested in the production but in the process the subjects of the action experienced, we attempted to evidence the results found beyond a quantitative comparison, discussing the importance of these activities and the rules established by the scientific community in making efforts to expand nursing knowledge.

NUPE was constituted as an
Among the information collected for analysis, the elaboration of research projects supported by NUPE is of fundamental importance, as presented in Figure 1.knowledge (12) .Thus, elaborating a research project allows nurses a moment of reflection about their c o n c e r n s a n d i n q u i r i e s a r i s i n g f r o m d a i l y professional practice, which requires that they learn and/or improve their knowledge about the scientific method, its modalities and applications.through discussions and debates that motivated involvement, creativity and the desire to learn and share knowledge (12) .
Nurse clinicians need to master knowledge about research methods.This condition must be granted to all professionals and should not remain limited to those people who can take a graduate course (7) .
In this study, nurses' scientific production revealed higher frequency levels for research than for experience reports.It should be highlighted that nurses' first contact with NUPE was often aimed at describing a professional experience.Studies presented and published by nurse clinicians in the form of experience reports do not invalidate but, instead, contribute to the understanding of professional practice (10) .We agree with other nurse researchers that these reports express daily reality in nursing and allow for knowledge construction based on a bibliographic reference framework, and also for the recording of situations, knowledge and actions in nursing practice (12) .
The nurses presented their studies at different scientific events.Most of these events were related to health or education and happened at the local, state or national level.The highest number of studies was presented in 1999 (109 or 31.41%).In the following years, the number of studies presented varied between 75 and 87 per year, totaling 347 studies presented at 72 scientific events during the period of study.
It is known that nurse clinicians have disseminated their studies more frequently at scientific events than in publications (5) .We observed the same situation in our research, which can be explained by the fact that disseminating a study during a scientific event, whether orally or as a poster presentation, is still more accessible to professionals due to their difficulties to write an article, submit it and, mainly, to obtain approval for publication in nursing and health journals.
We also found that many of the nurses supported by NUPE submitted manuscripts for publication, as shown in Figure 3.We agree that disseminating nursing research results through journal pblications facilitates access by peers, so that they can assess the contributions made by individuals and academic institutions in the knowledge area (7) .In this sense, NUPE supported and encouraged nurses with a view to the broad dissemination of knowledge and experiences, publishing them in print and on-line periodicals, journals and bulletins in the health area.

Experience Report Research
In a study carried out among nurses from public and private institutions, researchers on this theme found that professionals from private institutions publish more, possibly because they have better work conditions and because less professionals have two jobs.This certainly stimulates an increase in scientific production, together with other stimulating measures (15) .
We also found that all nurses who had not With respect to research lines, which are being organized, we observed that, in this group of nurses, there was a clear tendency towards care themes, followed by management and education.
However, there is a need for a more profound analysis of this aspect in view of the initial stage of these professionals' scientific production, so as to articulate the knowledge with research groups and lines at the institution.

Submitted Published
felt as necessary for professionals and for the profession (6)(7)16) . Ther are still many limits to research development, resulting from university training, access to graduate programs, support from employers and the professionals' interest and initiative (4,7,10,12) .
However, this is a good time to put innovative proposals into practice, which turns the permanent education process in nursing more dynamic, stimulating and promoting the development of research competencies on the basis of care practice needs.Research must be considered as a skill whose development should be encouraged, and not merely as an inherent and natural nursing activity.The attitude of encouragement and mediation by an advisory group or equivalent sector can contribute to the qualitative leap that is needed in knowledge production, dissemination and application in the area (12)(13) .
Thus, there is a need for further studies to assess ongoing proposals, involving quantitative and qualitative aspects, verifying possibilities and limits and, mainly, producing knowledge that increasingly mobilizes the achievement of a better quality of health care in our society.
Advisory Service to the Nursing Administration, coordinated by one faculty member of the Nursing Department at the UEL Health Science Center, with full-time dedication to this activity.The aims of this Research Nucleus are to: -Insert the exercise of action-reflectiontransformation into the work process of UH nurses, by using the scientific method.-Offer scientific and administrative support to these professionals for executing, presenting and publishing scientific studies.In order to comply with the nurses' expectations in a resolving way, the coordination and secretary of NUPE, with one technical-administrative employee, developed the following activities: promotion of individual and collective meetings, lectures, workshops and courses on scientific methodology; technical support to perform on-line searches for bibliographic references; typing and layout of studies; formatting and submission of articles/ abstracts to scientific events and publications; dissemination and support for presenting scientific studies at national and international events; orientation and sending of scientific studies for grammatical, bibliographical and statistical correction; orientation and elaboration of audiovisual resources (slides and posters); accompaniment of research project formalities at different levels (Nursing Administration, Graduate Coordination and Ethics Committee); promotion of Annual Scientific Encounter to disseminate research carried out by the nurses; internal dissemination of scientific studies on the Nursing Administration's notice board; organization and monitoring of research lines at the Nursing Department; survey and updating of database about the nurses' scientific production; support for research project elaboration and research development.Activities happened through a partnership between NUPE and the nurses.The Nucleus was responsible for advising them, while they committed themselves to carrying out, applying and disseminating the research they developed.On the average, nursing staff members at the UH Nursing Administration amounted to 88 nurses per year, who were active at the institution in different sectors.These professionals possessed the following characteristics: mainly women (92%); work time at the institution ranging from less than 1 year to more than 30 years, with 42 (43%) nurses who started to work at the UH from 1991 to 1995 onwards.During the four years considered in this study, 75 (82%) nurses used NUPE activities.These professionals used NUPE advice more than once during this period.

Figure 3 -
Figure 3 -Articles Submitted for Publication and Articles Published from scientific studies by nurse clinicians at the HURNP from 1999 to 2002, Londrina, 2003 taken a specialization course yet took one during the study period.Moreover, 11 professionals were taking a Master's program and two a Doctoral program.This evidenced the nurses' strong interest in their technicalscientific training, which was supported and encouraged by the institution.