Brown Caroline E, Wickline Mary A, Ecoff Laurie, Glaser Dale
UCSD Medical Center, University of California, San Diego, USA.
J Adv Nurs. 2009 Feb;65(2):371-81. doi: 10.1111/j.1365-2648.2008.04878.x. Epub 2008 Nov 27.
This paper is a report of a study to describe nurses' practices, knowledge, and attitudes related to evidence-based nursing, and the relation of perceived barriers to and facilitators of evidence-based practice.
Evidence-based practice has been recognized by the healthcare community as the gold standard for the provision of safe and compassionate healthcare. Barriers and facilitators for the adoption of evidence-based practice in nursing have been identified by researchers. Healthcare organizations have been challenged to foster an environment conducive to providing care based on evidence and not steeped in ritualized practice.
A descriptive, cross-sectional research study was conducted in 2006-2007 with a convenience sample of 458 nurses at an academic medical center in California (response rate 44.68%). Two reliable and valid questionnaires were electronically formatted and administered using a secured website. Relationships between responses to the two instruments were examined and results compared with previously published data.
Organizational barriers (lack of time and lack of nursing autonomy) were the top perceived barriers. Facilitators were learning opportunities, culture building, and availability and simplicity of resources. Statistically significant correlations were found between barriers and practice, knowledge and attitudes related to evidence-based practice.
Similar barriers to the adoption of evidence-based practice have been identified internationally. Educators must work with managers to address organizational barriers and proactively support evidence-based practice.
本文报告一项研究，旨在描述护士与循证护理相关的实践、知识和态度，以及循证实践中感知到的障碍与促进因素之间的关系。
循证实践已被医疗界公认为提供安全且富有关爱之心的医疗服务的黄金标准。研究人员已确定了护理中采用循证实践的障碍与促进因素。医疗保健机构面临着营造一种有利于提供基于证据而非拘泥于常规做法的护理环境的挑战。
2006 - 2007年进行了一项描述性横断面研究，对加利福尼亚州一家学术医疗中心的458名护士进行便利抽样（应答率44.68%）。两份可靠且有效的问卷采用电子格式，并通过安全网站进行发放。对两份问卷的回答之间的关系进行了检验，并将结果与先前发表的数据进行了比较。
组织障碍（时间不足和缺乏护理自主权）是最常被感知到的障碍。促进因素包括学习机会、文化建设以及资源的可获取性和简易性。在障碍与实践、与循证实践相关的知识和态度之间发现了具有统计学意义的相关性。
国际上已确定了采用循证实践的类似障碍。教育工作者必须与管理人员合作，以解决组织障碍，并积极支持循证实践。
