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2007, Professional Psychology: Research and Practice
Background This paper examines the hierarchy of evidence (HoE) framework and evidence-based practice (EBP) for clinical practice and nurse education. Student evaluations of a post-qualifying EBP module identified consistent tension in interpreting research papers which did not appear to "fit" into their experience of nursing practice. Community nurses identified a lack of evidence informing their practice. Design A mixed methods study facilitated a comparative analysis of HoE framework and a complimentary Familial model developed to improve student understanding. Data collection methods included a focus group of module members (n=5), a sample of n=314 respondents. Findings Identified the HoE framework fails to help nurses interpret high and low evidence, thereby reducing the potential to implement evidence into clinical practice, but it was not clear why. The 'Familial model' appeared to enable a better understanding and relevance of evidence to inform clinical action. This is a unifying principle for EBP, yet one not found within a HoE framework. Conclusion The art of nursing does not merely respond to published literature, but patient interaction and clinical implementation for community nursing requires a broader interpretation of EBP for nursing action.
British journal of nursing, 2022
BACKGROUND Nurses' ability to apply evidence effectively in practice is a critical factor in delivering high-quality patient care. Evidence-based practice (EBP) is recognised as the gold standard for the delivery of safe and effective person-centred care. However, decades following its inception, nurses continue to encounter difficulties in implementing EBP and, although models for its implementation offer stepwise approaches, factors, such as the context of care and its mechanistic nature, act as barriers to effective and consistent implementation. It is, therefore, imperative to find a solution to the way evidence is applied in practice. Evidence-informed practice (EIP) has been mooted as an alternative to EBP, prompting debate as to which approach better enables the transfer of evidence into practice. Although there are several EBP models and educational interventions, research on the concept of EIP is limited. This article seeks to clarify the concept of EIP and provide an i...
Journal of nursing management, 2008
Aim To explore nursesÕ understanding and interpretation of evidence-based practice (EBP). Background EBP has been welcomed into the nursing lexicon without a critical examination of its interpretation by practitioners. The literature suggests that there is a great deal of confusion and contradiction over the meaning and application of EBP. Although work has been conducted on how EBP might be implemented, the general issue of how nurses understand and use EBP is largely unexplored. This paper seeks to examine in depth the understandings of EBP, to enable managers, educationalists and policy makers to implement it more effectively. Methods All registered nurses, midwives and health visitors in one UK National Health Service (NHS) Trust were asked to complete a questionnaire in October 2006.
Nursing Philosophy, 2015
Nursing and Health Sciences, 2002
This paper challenges the hegemony (the mindset prevailing within education and health-care environments) that produces and maintains the problems associated with nurses using research evidence in their practise. The challenge is organized around the construct of change. The envisaged changes concern what nurses think and do in relation to nursing research. The position held in the present paper is that the use of research evidence by nurses in their practise will remain a challenge until changes occur to the ways that nurses understand, value and initiate research. It is argued that changing the ways that nurses understand, value and initiate research requires an ideological shift: a re-education from one set of beliefs, perceptions, values and practises to another. The paper concludes with some suggestions for transforming the hegemonic influences of nurse education systems and the health-care organizations in which nurses work.
Journal of clinical nursing, 2008
Aim. This paper examines the evidence-based practice movement, the hierarchy of evidence and the relationship between evidence-based practice and reflective practice.Background. Evidence-based practice is equated with effective decision making, with avoidance of habitual practice and with enhanced clinical performance. The hierarchy of evidence has promoted randomized control trials as the most valid source of evidence. However, this is problematic for practitioners as randomized control trials overlook certain types of knowledge that, through the process of reflection, provide useful information for individualized and effective practice.Method. A literature search was undertaken using CINAHL, medline and Ovid electronic databases in early 2006. The search terms used were: evidence-based practice, research evidence, evidence for practice, qualitative research, reflective practice, reflection and evidence. Other sources included handpicking of books on evidence-based practice, reflection and research. Only material written in English was included.Findings. The hierarchy of evidence that has promoted randomized control trials as the most valid form of evidence may actually impede the use of most effective treatment because of practical, political/ideological and epistemological contradictions and limitations. Furthermore, evidence-based practice appears to share very similar definitions, aims and procedures with reflective practice. Hence, it appears that the evidence-based practice movement may benefit much more from the use of reflection on practice, rather than the use of the hierarchical structure of evidence.Conclusion. Evidence-based practice is necessary for nursing, but its’ effective implementation may be hindered by the hierarchy of evidence. Furthermore, evidence-based practice and reflection are both processes that share very similar aims and procedures. Therefore, to enable the implementation of best evidence in practice, the hierarchy of evidence might need to be abandoned and reflection to become a core component of the evidence-based practice movement.Relevance to clinical practice. Provides an elaborated analysis for clinical nurses on the definition and implementation of evidence in practice.
BMC medical education, 2018
Evidence-based practice (EBP) is imperative for ensuring patient safety. Although teaching strategies to enhance EBP knowledge and skills are recommended, recent research indicates that nurses may not be well prepared to apply EBP. A three-level hierarchy for teaching and learning evidence-based medicine is suggested, including the requirement for interactive clinical activities in EBP teaching strategies. This literature review identifies the teaching strategies for EBP knowledge and skills currently used in undergraduate nursing education. We also describe students' and educators' experiences with learning outcomes and barriers. We conducted literature searches using Medline, Embase, CINAHL, ERIC and Academic Search Premier. Six qualitative studies and one mixed-method study met the inclusion criteria and were critically evaluated based on the Critical Appraisal Skills Programme. Using Braun and Clarke's six phases, the seven studies were deductively and thematically a...
Nurse Leader, 2008
W ithin the nursing profession, it is expected that new information in the form of research findings will be incorporated constantly and knowledgeably into nursing practice. The staff nurse is a critical link in bringing researchbased changes into clinical practice. Depending on the environment, a health care organization may or may not have the resources to ensure critical, succinct, reasonable evaluation and application of research findings as they relate to the point-of-care delivery. Health care organizations are beginning to create mechanisms to facilitate the process of information translation from the literature to practice.
BMC Health Services Research, 2012
Background: Health authorities in several countries have decided that the health care services should be evidence-based. Recent research indicates that evidence-based practice may be more successfully implemented if the interventions overcome identified barriers. Aims: The present study aimed to examine factors influencing the implementation of evidence-based practice among nurses in a large Norwegian university hospital. Methods: Cross-sectional data was collected from 407 nurses during the period November 8 to December 3, 2010, using the Norwegian version of Developing Evidence-based Practice questionnaire (DEBP). The DEBP included data on various sources of information used for support in practice, on potential barriers for evidence-based practice, and on self-reported skills on managing research-based evidence. The DEBP was translated into Norwegian in accordance with standardized guidelines for translation and cultural adaptation. Results: Nurses largely used experienced-based knowledge collected from their own observations, colleagues and other collaborators for support in practice. Evidence from research was seldom used. The greatest barriers were lack of time and lack of skills to find and manage research evidence. The nurse's age, the number of years of nursing practice, and the number of years since obtaining the last health professional degree influenced the use of sources of knowledge and self-reported barriers. Self-reported skills in finding, reviewing and using different sources of evidence were positively associated with the use of research evidence and inversely related to barriers in use of research evidence. Conclusion: Skills in evidence-based practice seem to reduce barriers to using research evidence and to increase use of research evidence in clinical practice.
International Journal of ADVANCED AND APPLIED SCIENCES, 2020
The nursing faculty must prepare students to meet challenges through the provision of adequate and evidence-based services amid complexities in the healthcare system. This study aims to determine the differences in demographic characteristics of the nursing students that may factor in the application of evidence-based practice. The researcher employed a quantitative comparative approach. There were 213 nursing students from the College of Nursing, the University of Hail, who served as respondents in this study. Simple random sampling was used as the sampling technique. This study used the Student Evidence-based Practice Questionnaire (S-EBPQ) for data-collection. Data were treated with the T-test to determine the difference between sex and the use of the evidence-based practice. The age and year level was tested using a one-way analysis of variance (ANOVA) tests. This study was carried out in December 2019 through February 2, 2020. There was no significant difference between the use of evidence-based practice for males (M=4.61, SD=0.90) while the female (M=4.48, SD=1.03) with t(211)=0.96. Meanwhile, there is a significant difference between age and the use of EBP by one-way ANOVA (F (2,210)=9.48, p=<0.001), and year level and the use of EBP by one-way ANOVA (F (3,209)=155.24, p=<0.001), with a partial effect size of 0.69. Demographic information of the student nurses such as sex is not significant to implementing EBP, but age and year level has been found to be determinants in implementing the EBP. Findings contribute to the development of the improvement of the program curriculum to reinforce the involvement of students in learning and practicing the evidence-based process.
Nursing times
Developing evidence-based practice among students Patient care must be based on the latest evidence-based practice. Student nurses should be introduced to the principles of this as part of pre-registration education Authors Vernel Emanuel, Karen Day and Lorraine Diegnan are senior lecturers, adult division, and Maxine Pryce-Miller is senior lecturer in Public Health; all at the School of Health and Wellbeing at the University of Wolverhampton. Abstract Emanuel V et al (2011) Developing evidence-based practice among students. Nursing Times; 107: 49/50, 21-23. In response to government initiatives and the rise in patient empowerment, nurses are increasingly being challenged to deliver high-quality care supported by evidence-based practice. This can be a challenge for nurse educators providing the foundation for pre-registration student nurses. Evidence-based practice within nursing is achieved by developing and supporting patient-centred approaches to care using the most current evide...
Critical Care Nurse, 2013
E vidence-based nursing practice involves integration of a problem-solving approach within the context of caring, considering best evidence from studies, patient care data, clinical experience and expertise, and patients' preferences and values. 1 Health care agencies, government agencies, and national professional organizations such as the American Association of Critical-Care Nurses have all been supporters of evidence-based practice (EBP) as studies continue to show improved outcomes when best evidence is used in the delivery of patient care. 2,3 Despite the awareness of the importance of practice being based on best evidence, achieving and sustaining EBP within practice Feature Evidence-based nursing practice is essential to the delivery of high-quality care that optimizes patients' outcomes. Studies continue to show improved outcomes when best evidence is used in the delivery of patient care. Despite awareness of the importance of practicing by using best evidence, achieving and sustaining evidencebased practice within practice environments can be challenging, and research suggests that integration of evidence-based practice into daily clinical practice remains inconsistent. This article addresses 4 practice issues that, first, are within the realm of nursing and if changed might improve care of patients and, second, are areas in which the tradition and the evidence do not agree and practice continues to follow tradition. The topics addressed are (1) noninvasive measurement of blood pressure in children, (2) oxygen administration for patients with chronic obstructive pulmonary disease, (3) intravenous catheter size and blood administration, and (4) infection control practices to prevent infections. The related beliefs, current evidence, and recommendations for practice related to each topic are described. (Critical Care Nurse. 2013;33[2]:28-44) This article has been designated for CNE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives:
Journal of Nursing Education, 2017
Background: Nursing students require education that integrates evidence-based practice (EBP) knowledge across classroom and clinical settings. This study was conducted to identify and examine the literature related to nursing students' use of evidence in clinical education and to identify associated research gaps. Method: A scoping review describing the extent, range, and nature of the research activity focused on students' use of evidence in clinical education. Results: Included studies ( N = 37) describe the barriers and facilitators to nursing students' EBP and describe the evaluation of strategies that support nursing students' engagement in EBP. Most commonly identified barriers include a lack of knowledge and skills for EBP; negative attitudes toward EBP in students, faculty, and nurses; and lack of support in the clinical setting. Evaluated strategies included educational sessions and EBP projects, either alone or in combination, as well as other stand-alone i...
Practice Development in Health Care, 2003
The present paper is based on the Winifred Raphael Memorial Lecture, presented at the Royal College of Nursing Annual Congress, 2002. It explores the rhetoric surrounding evidencebased practice by examining different sources of evidence in the form of research evidence, professional expertise and patient preference, and by considering models of research utilization. A case study approach is then taken to describing how the principles underpinning the rhetoric were translated into evidence-based practice initiatives in a large acute hospital. It is concluded that nursing needs to be cautious about taking its lead from medicine in moving forward the evidence-based practice agenda. Rather, nurses need to be prepared to think beyond the traditional notions of evidence-based medicine and direct research utilization, and to develop strategies for evidence-based practice located in the real world of nursing practice. It is only through being creative that the rhetoric of evidence-based practice will become real.
Journal of continuing education in nursing
To improve patient outcomes currently and in the future, it is important that an evidence-based approach to nursing care be incorporated into clinical practice settings. Nurse educators and clinical nurse educators have a mandate to model and facilitate evidence-based nursing through learning activities. Unfortunately, issues present within clinical practice settings have made this approach difficult for registered nurses to fully incorporate into practice. This article outlines issues inhibiting evidence-based nursing, such as time factors, access to information and resources, nurses' research knowledge, skills, and learning opportunities, and the current nursing culture. Strategies for change that can be used by clinical nurse educators to enhance the use of evidence-based nursing in clinical practice areas are also described.
Nursing Standard, 2008
Open Access Journal of Nursing
Introduction: Research evidence has greatly expanded over the last 30 years as numerous quality studies in nursing, medicine, and other healthcare disciplines have been conducted and disseminated. These studies are commonly communicated via conferences, journals, and the Internet. The expectations of society and the goals of healthcare systems are the delivery of quality, safe, cost-effective health care to patients, families, and communities, nationally and internationally. To ensure the delivery of quality health care, the care must be based on the current best research evidence available. Healthcare agencies are emphasizing the delivery of evidence-based health care, and nurses and physicians are focused on evidence-based practice (EBP). With the emphasis on EBP over the last 2 decades, outcomes have improved for patients, healthcare providers, and healthcare agencies.(1) Objectives & Aims: 1. To hark back to the terms of EBP and Nursing Research. 2. To comprehend the importance of EB Research in Nursing Practices. 3. To project the future of EB Research in Nursing Practices. Conclusion: Research provides the foundation for high-quality, evidence-based nursing care. However, there isn't a direct flow of knowledge from research into practice. When a question is asked to nurses where the "evidence" to guide the development of "evidence-based care" comes from? And "an interesting array of answers, from "researchers" to blank stares, as if there's no connection between the worlds of researchers and bedside nurses". If research evidence informs our nursing practice, why doesn't it come from all of us? Nurses are inquisitive, think critically about their patients' care, and want to know the best treatments for their patients-all of which makes them perfectly suited for research. Though the majority of nurses don't have the training to conduct research projects without assistance, they know how to ask questions and they know which questions need answering9. Message: Work in collaboration with other health care team members: Intra professional/disciplinary: Members of one profession work together, sharing information through the lens of their own profession. Multi/Cross disciplinary/professional: An additive process whereby members of multiple professions work in parallel alongside each other to provide input, making complementary contributions, each staying within their own professional boundaries, working separately on distinct aspects of the problem. Interdisciplinary/professional: Members Of multiple professions work together, contributing their various skills in an integrative fashion, sharing perspectives to inform decision-making. Tran disciplinary/ professional: A high level of cooperation of professionals from multiple fields who understand each other's roles and perspectives sufficiently to blur boundaries, share skills and expertise, and use them to develop new ways of viewing a problem10.
JONA The Journal of Nursing Administration
Numerous articles describe barriers to nurses conducting research and achieving evidence-based practice as well as strategies for overcoming barriers. The Research Roundtable format is one such strategy. It is an interactive means for providing novice nurse researchers and nursing students with the skill sets required to drive application of existing evidence to nursing practice and conduct outcome studies to derive new evidence. The authors discuss their Research Roundtable series that addressed a number of barriers to research, research utilization, and evidence-based practice and how the series increased nurses knowledge and skills, demystified the research process, provided role models, demonstrated managerial and collegial support, and provided library, fiscal, and other resource support to complete staff projects. The details of the Research Roundtable series will guide others in replicating the process in their own organizations and academic communities.
British Journal of Community Nursing, 2016
The aim of this paper is to discuss the impact of nurses' beliefs, knowledge and skills on the implementation of evidence-based practice (EBP) in hospital and community settings. EBP refers to the implementation of the most up-to-date robust research into clinical practice. Barriers have been well-documented and traditionally include negative beliefs of nurses as well as a lack of time, knowledge and skills. However, with degree entry nursing and a focus on community health care provision, what has changed? A comprehensive search of contemporary literature (2010-2015) was completed. The findings of this review show that the traditionally acknowledged barriers of a lack of time, knowledge and skills remained, however, nurses' beliefs towards EBP however were more positive, but positive beliefs did not affect the intentions to implement EBP or knowledge and skills of EBP. Nurses in hospital and community settings reported similar barriers and facilitators.
Factors influencing the development of evidence-based nursing practice (EBNP) were examined in Prince Edward Island, Canada. An adapted electronic questionnaire was distributed to practicing registered nurses and nurse practitioners (n=68). An analysis of variance revealed a significant difference between nurses' clinical practice setting and the EBNP scale. Significant differences were also found between age and education level when compared with the EBNP subscales where novice nurses were less likely to rely on experience and intuition, and expert nurses with a higher level of education reported being more skilful at synthesising and applying information from research findings into their nursing practice.
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