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床边、课堂与实验室:为护理实践生成循证知识的协作策略

Bedside, classroom and bench: collaborative strategies to generate evidence-based knowledge for nursing practice.

作者信息

Weaver Charlotte A, Warren Judith J, Delaney Connie

机构信息

Cerner Corporation, 2800 Rockcreek Parkway, Kansas City, MS 64117, USA.

出版信息

Int J Med Inform. 2005 Dec;74(11-12):989-99. doi: 10.1016/j.ijmedinf.2005.07.003. Epub 2005 Aug 3.

Abstract

The rise of evidence-base practice (EBP) as a standard for care delivery is rapidly emerging as a global phenomenon that is transcending political, economic and geographic boundaries. Evidence-based nursing (EBN) addresses the growing body of nursing knowledge supported by different levels of evidence for best practices in nursing care. Across all health care, including nursing, we face the challenge of how to most effectively close the gap between what is known and what is practiced. There is extensive literature on the barriers and difficulties of translating research findings into practical application. While the literature refers to this challenge as the "Bench to Bedside" lag, this paper presents three collaborative strategies that aim to minimize this gap. The Bedside strategy proposes to use the data generated from care delivery and captured in the massive data repositories of electronic health record (EHR) systems as empirical evidence that can be analysed to discover and then inform best practice. In the Classroom strategy, we present a description for how evidence-based nursing knowledge is taught in a baccalaureate nursing program. And finally, the Bench strategy describes applied informatics in converting paper-based EBN protocols into the workflow of clinical information systems. Protocols are translated into reference and executable knowledge with the goal of placing the latest scientific knowledge at the fingertips of front line clinicians. In all three strategies, information technology (IT) is presented as the underlying tool that makes this rapid translation of nursing knowledge into practice and education feasible.

摘要

循证实践(EBP)作为护理服务标准正在迅速崛起,成为一种超越政治、经济和地理界限的全球现象。循证护理(EBN)涉及越来越多由不同证据水平支持的护理知识,这些证据用于护理实践中的最佳做法。在包括护理在内的所有医疗保健领域,我们都面临着如何最有效地缩小已知与实践之间差距的挑战。关于将研究结果转化为实际应用的障碍和困难,已有大量文献。虽然文献将这一挑战称为“从实验室到病床旁”的滞后,但本文提出了三种合作策略,旨在尽量缩小这一差距。床边策略建议将护理服务中产生并存储在电子健康记录(EHR)系统海量数据库中的数据用作实证证据,对其进行分析以发现并告知最佳实践。在课堂策略中,我们描述了在护理学学士学位课程中如何教授循证护理知识。最后,实验室策略描述了应用信息学如何将纸质的循证护理协议转化为临床信息系统的工作流程。协议被转化为参考性和可执行的知识,目的是让一线临床医生能够随时获取最新的科学知识。在所有这三种策略中,信息技术(IT)被视为使护理知识迅速转化为实践和教育成为可能的基础工具。

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