Booth Jo, Tolson Debbie, Hotchkiss Rhona, Schofield Irene
Caledonian Nursing and Midwifery Research Centre, Glasgow Caledonian University, Glasgow, UK.
J Clin Nurs. 2007 May;16(5):945-53. doi: 10.1111/j.1365-2702.2007.01773.x.
This paper explores the development of a low-cost, involving methodology for constructing nursing-focused evidence-based national care guidance, known as Best Practice Statements, the intended users of which are gerontological nurses practising throughout Scotland.
The Best Practice Statement construction methodology forms one cycle in a five-year longitudinal action research study that aims to achieve evidence-based nursing, facilitate professional networking to support practice development and promote the principles and practice of gerontological nursing. Achieving these aims involved designing a virtual Practice Development College.
A Community of Practice comprising practising gerontological nurses, expert advisors, academic teaching and research nurses collaborated in face-to-face meetings and in the virtual Practice Development College to delineate and refine the procedural model for Best Practice Statement construction. Focus groups, telephone interviews, analysis of on-line archives and documentary outputs formed the analytic dataset.
Qualitative analysis indicated that, from the perspective of the community of practice, the emerging methodology facilitated the melding of knowledge sources reflecting the dominant evidence hierarchy with other forms of evidence valued by gerontological nurses, in the Best Practice Statement.
Current methods of care guidance construction rarely address the concerns of nurses and the evidence from which guidelines are developed is narrowly defined with regard to inclusion and acceptability. In contrast this model focuses on nursing issues, embraces a wider definition of evidence and ensures that the published Best Practice Statements are credible and achievable in gerontological practice, where they are tested and refined as an inherent aspect of the development process.
本文探讨一种低成本的方法的开发，该方法用于构建以护理为重点的基于证据的国家护理指南，即最佳实践声明，其目标用户是在苏格兰各地执业的老年护理护士。
最佳实践声明构建方法是一项为期五年的纵向行动研究中的一个循环，该研究旨在实现循证护理，促进专业网络建设以支持实践发展，并推广老年护理的原则和实践。实现这些目标涉及设计一个虚拟实践发展学院。
一个由执业老年护理护士、专家顾问、学术教学和研究护士组成的实践社区，通过面对面会议和虚拟实践发展学院进行合作，以勾勒和完善最佳实践声明构建的程序模型。焦点小组、电话访谈、在线档案分析和文献产出构成了分析数据集。
定性分析表明，从实践社区的角度来看，新兴方法有助于将反映主要证据层次的知识来源与老年护理护士重视的其他证据形式在最佳实践声明中融合。
当前的护理指南构建方法很少关注护士的担忧，并且所制定指南所依据的证据在纳入和可接受性方面定义狭窄。相比之下，该模型关注护理问题，采用更广泛的证据定义，并确保已发表的最佳实践声明在老年护理实践中可信且可实现，在实践中它们作为开发过程的一个固有方面进行测试和完善。
