EBP Nursing Service, Phoenix VA Health Care System, Phoenix, AZ, USA.
Worldviews Evid Based Nurs. 2009;6(4):200-9. doi: 10.1111/j.1741-6787.2009.00161.x. Epub 2009 Aug 17.
BACKGROUND/RATIONALE: Health care professionals are expected to provide patient care based on best evidence. The context of the acute care setting presents a challenging environment for registered nurses (RNs) to utilize research and implement best evidence in practice. No organizational infrastructure has been identified that offers acute care RNs the support needed for evidence-based practice (EBP). The value of "learning organizations" has long been understood by corporate leaders. Potentially, the dimensions of a "learning organization" may offer a supportive EBP infrastructure for acute care RNs.
(1) What is the relationship of the characteristics of the learning organization to registered nurses' beliefs regarding EBP? (2) Is there an impact of EBP beliefs on RNs' implementation of EBP?
A descriptive, survey design study was conducted. Three established questionnaires were distributed to 1,750 RNs employed within six acute care hospitals.
RESULTS/FINDINGS: There were 594 questionnaires returned for a response rate of 34%. RNs rated their organizations in the mid-range on the dimensions of learning organization. Perceptions of the learning organization were found to be significant, although relatively small, predictors explaining 6% of knowledge beliefs, 11% of value beliefs, and 14% of resource beliefs. EBP beliefs explained 23% of EBP implementation reported by RNs.
The study results indicate relationships between RNs' reported perception of a learning organization and EBP beliefs, and between EBP beliefs and implementation. However, findings were mixed. Overall, nurses rated their organizations the lowest in the dimensions of "promote inquiry and dialogue" and "empower people toward a collective vision." Leaders have an opportunity to offer a more supportive infrastructure through improving their organization in these two areas. RN beliefs explained 23% of EBP implementation in this study with a residual 77% yet to be identified.
Acute care hospitals were perceived mid-range on learning organization dimensions by RNs, indicating an opportune area for leaders to strengthen their organizational infrastructure.
背景/基本原理：医疗保健专业人员应根据最佳证据提供患者护理。在急性护理环境中，这对注册护士（RN）提出了挑战，他们需要利用研究并将最佳证据付诸实践。目前尚未确定任何组织架构能够为急性护理 RN 提供实施循证实践（EBP）所需的支持。企业领导者早就认识到“学习型组织”的价值。从理论上讲，“学习型组织”的维度可能为急性护理 RN 提供支持 EBP 的基础设施。
（1）学习型组织的特征与注册护士对 EBP 的信念之间存在什么关系？（2）EBP 信念是否会对 RN 实施 EBP 产生影响？
本研究采用描述性调查设计。向六所急性护理医院的 1750 名 RN 发放了三份已确立的问卷。
结果/发现：共收回 594 份问卷，回应率为 34%。RN 对学习型组织的维度评价其组织处于中等水平。学习型组织的认知被认为是解释知识信念的 6%、价值信念的 11%和资源信念的 14%的重要但相对较小的预测指标。EBP 信念解释了 RN 报告的 EBP 实施的 23%。
研究结果表明，RN 对学习型组织的感知与 EBP 信念之间以及 EBP 信念与实施之间存在关系。然而，研究结果喜忧参半。总体而言，护士对组织在“促进探究和对话”以及“使人们对共同愿景充满信心”这两个维度的评价最低。领导者有机会通过改善这两个方面的组织来提供更有力的支持基础设施。在这项研究中，RN 信念解释了 EBP 实施的 23%，还有 77%的剩余部分有待确定。
急性护理医院的 RN 对学习型组织维度的评价处于中等水平，这表明领导者有机会加强其组织基础设施。
