Ring Nicola, Malcolm Cari, Coull Alison, Murphy-Black Tricia, Watterson Andrew
Department of Nursing & Midwifery, University of Stirling, Stirling, UK.
J Clin Nurs. 2005 Oct;14(9):1048-58. doi: 10.1111/j.1365-2702.2005.01225.x.
To explore implementation of the first five Best Practice Statements from the perspective of nurses involved in their development.
Best Practice Statements were introduced in Scotland to encourage consistent evidence-based nursing practice. As a new initiative, research was required to investigate their clinical implementation.
In this descriptive study, semi-structured interviews of a purposive sample of nurses (n = 15) were undertaken. Content analysis was used to identify themes emerging from the interview data.
Four main themes emerged from analysis of transcripts: variations in use of the Best Practice Statements; benefits to patients; benefits to practitioners; and, barriers and drivers to use. Amongst participants, personal users adopted the statements in their own practice but enablers also actively encouraged others to use the statements. Whether participants acted as enablers depended on individual, team and organizational factors. The ability of participants to act as leaders was influential in determining their ability both to facilitate local implementation and to encourage others to regard the Best Practice Statements as a priority for implementation.
This exploratory study highlighted examples of patients and practitioners benefiting from the Best Practice Statements. Such findings suggest these statements could become a useful tool in promoting evidence-based nursing practice. However, implementation of the Best Practice Statements varied between participants and their organizations. Nurses who were most effective in promoting local implementation of the Best Practice Statements adopted facilitator and leadership roles within their organizations.
By relating research findings to the literature on guideline and research utilization, this study gives further insight into the implementation of evidence-based practice by nurses. In particular, it supports the conclusion that to be truly effective, initiatives to promote evidence-based practice require nurses to act as local facilitators and leaders.
从参与制定前五项最佳实践声明的护士视角，探讨这些声明的实施情况。
苏格兰引入最佳实践声明以鼓励基于证据的一致护理实践。作为一项新举措，需要开展研究以调查其临床实施情况。
在这项描述性研究中，对一组有目的抽样的护士（n = 15）进行了半结构化访谈。采用内容分析法来识别访谈数据中出现的主题。
对访谈记录的分析产生了四个主要主题：最佳实践声明使用上的差异；对患者的益处；对从业者的益处；以及使用的障碍和驱动因素。在参与者中，个人使用者在自己的实践中采用了这些声明，但推动者也积极鼓励他人使用。参与者是否担任推动者取决于个人、团队和组织因素。参与者担任领导者的能力在决定其促进本地实施以及鼓励他人将最佳实践声明视为实施优先事项的能力方面具有影响力。
这项探索性研究突出了患者和从业者从最佳实践声明中受益的实例。这些发现表明，这些声明可能成为促进基于证据的护理实践的有用工具。然而，最佳实践声明在参与者及其组织之间的实施情况各不相同。在促进最佳实践声明本地实施方面最有效的护士在其组织中发挥了促进者和领导者的作用。
通过将研究结果与关于指南和研究应用的文献相联系，本研究进一步深入了解了护士实施基于证据的实践的情况。特别是，它支持了这样的结论，即要真正有效，促进基于证据的实践的举措要求护士担任本地促进者和领导者。
