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一项关于卫生专业人员利用证据为临床管理工具开发提供信息的观察性研究。

An observational study of health professionals' use of evidence to inform the development of clinical management tools.

作者信息

Hutchinson Alison M, Johnston Linda

机构信息

School of Nursing, The University of Melbourne, Victoria, Australia.

出版信息

J Clin Nurs. 2008 Aug;17(16):2203-11. doi: 10.1111/j.1365-2702.2008.02384.x.

Abstract

AIM

This observational study sought to investigate the process of evidence use by health professionals during development of evidence-based clinical management tools.

BACKGROUND

Studies conducted to explore the process of research use are scarce and knowledge of this process is essential for our understanding of the influences on research use in practice.

DESIGN

A qualitative, non-participant, observational design.

METHODS

Behaviour and actions of two separate multidisciplinary teams were observed and audio-recorded during a combined total of seven meetings for the development of clinical management tools. Semi-structured, one-to-one interviews were conducted approximately half-way through the development process and following completion of the clinical management tools.

RESULTS

Three major themes emerged from this research. First, the process of clinical management tool development and evidence use. Nurses assumed responsibility for coordination of development which focused on describing current practice. Second, the forms of evidence employed during the development process included the use of experiential knowledge, opinions and knowledge of the context, in addition to research evidence. However, reference to research evidence was limited and its incorporation into the instrument was infrequently observed. Third, the use of research evidence emerged with respect to how such evidence was employed.

CONCLUSION

This study focused on real-life discussion and decision-making that occurred between health professionals when developing evidence-based clinical management tools. Health professionals may have a tendency to rely on their professional experience and current practice in preference to seeking and applying relevant research evidence.

RELEVANCE TO CLINICAL PRACTICE

Nurses have an important role to play in the development of multidisciplinary evidence-based clinical management tools, but to actively participate in this process they need to be familiar with the relevant research evidence and have the skills and confidence to integrate the evidence into practice.

摘要

目的

本观察性研究旨在调查卫生专业人员在制定循证临床管理工具过程中使用证据的过程。

背景

探索研究应用过程的研究很少,而了解这一过程对于我们理解实践中影响研究应用的因素至关重要。

设计

定性、非参与性观察设计。

方法

在总共七次用于制定临床管理工具的会议期间,观察并录音了两个不同多学科团队的行为和行动。在开发过程大约进行到一半时以及临床管理工具完成后,进行了半结构化的一对一访谈。

结果

本研究出现了三个主要主题。第一,临床管理工具开发和证据使用的过程。护士承担了开发协调的责任,开发重点是描述当前实践。第二,开发过程中使用的证据形式包括经验知识、意见和情境知识,此外还有研究证据。然而,对研究证据的引用有限,将其纳入工具的情况也很少见。第三,研究证据的使用体现在如何运用此类证据方面。

结论

本研究关注卫生专业人员在制定循证临床管理工具时进行的现实生活中的讨论和决策。卫生专业人员可能倾向于依赖他们的专业经验和当前实践,而不是寻求和应用相关研究证据。

与临床实践的相关性

护士在多学科循证临床管理工具的开发中可发挥重要作用,但要积极参与这一过程,他们需要熟悉相关研究证据,并具备将证据整合到实践中的技能和信心。

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