Table 8.

Examples of answers of RNs, AHPs, specialists and managers to the instrumental research use item

Wording of the original English item	Definition: Using observable research-based practices when caring for residents. By this we mean practice that may be guided by guidelines, protocols, routines, care plans or procedures that are based on research.
	Question: On your LAST typical work day, how often did you use research in this way?.
German wording approved for the cognitive debriefing	Definition: Beobachtbare pflegerische Handlungen durchführen, die auf wissenschaftlichen Erkenntnissen basieren. Damit meinen wir Handlungen, für die Sie forschungsbasierte Vorgaben wie Standards, Leitlinien, Richtlinien oder Verfahrensanweisungen haben.
	Question: An Ihrem LETZTEN typischen Arbeitstag: Wie häufig haben Sie wissenschaftliche Erkenntnisse auf diese Weise angewendet?.
English back translation of the German wording	Definition: To perform observable care interventions based on evidence based findings. By this we mean interventions for which there are research based guidelines such as standards, policies and protocols, or procedure guidelines.
	Question: On your LAST typical day of work: how often did you use research in this way?.
RN example
Participant answer to questionnaire item	Almost 100% of the time.
Researcher question (general probe)	“Can you please give reasons for your answer?”.
Participant answer	“Well, I am able to do that very often. But of course the price is high. It is a matter of our personal health. I always try to comply with the guidelines 100%. That is never just 50%. Wound management, pressure ulcer prevention, challenging behaviour – all the topics you have listed here”.
Researcher question (confidence probe)	“How sure are you that your practice complies with the current state of knowledge?”.
	“Well, we have an expert for each of those topics. Wound management for example, we had a training course just yesterday. Our knowledge is always on the most current level. I am completely sure about this”.
AHP example
Researcher question (paraphrasing)	“Can you please state in your own words what the definition means to you?”.
Participant answer	“That care is being carried out properly, that no dangerous care is being provided. That is how I understand this. And that it follows the guidelines and instructions of how to care for a human being, that the person is treated and cared for accordingly.”
Specialist example
Researcher question (paraphrasing)	“Can you please try to explain in your own words how you understood the definition?”.
Participant answer	“Well, I find it is explained very good. I have got guidelines, standards, instructions anything that is written in our quality handbook. That is scientific … scientific knowledge broken down for practice and implemented into our routines. And that is exactly what I was thinking about. There is, for example, a standard for pressure ulcer prevention – and how we have implemented that one into our practice”.
Manager example
Participant answer to questionnaire item	10% or less of the time.
Researcher question (confidence probe)	“How sure are you that your answer is correct?”.
Participant answer	“I am doing all those things – pressure ulcer prevention, dealing with challenging behaviour etc. But that I use scientific knowledge for this does not happen very frequently”.