Melnyk Bernadette Mazurek, Fineout-Overholt Ellen, Giggleman Martha, Cruz Ron
Arizona State University, College of Nursing & Health Innovation, Phoenix, AZ 85004, USA.
Nurs Outlook. 2010 Nov-Dec;58(6):301-8. doi: 10.1016/j.outlook.2010.06.002.
Evidence from research and outcomes management projects strongly supports the use of evidence-based practice (EBP) in improving quality of health care and patient outcomes as well as reducing hospital costs. In addition, published anecdotal reports have indicated that clinicians who use an evidence-based approach to care and practice in cultures that support EBP feel more empowered and satisfied in their roles. However, research is lacking that has specifically examined the relationships among beliefs about and implementation of EBP by hospital staff, organizational culture for EBP, group cohesion and job satisfaction. Therefore, the purpose of this descriptive correlational study was to examine the relationships among these variables in 58 health professionals, prior to their participation in a 12-month EBP mentorship program as part of implementing the Advancing Research and Clinical practice through close Collaboration (ARCC) Model in a community hospital system. Findings indicated that participants' EBP beliefs were significantly correlated with perceived organizational culture for EBP, the extent to which they implemented EBP, group cohesion, and job satisfaction. Organizational culture for EBP was significantly and positively related to EBP beliefs and EBP implementation. Findings support the need for hospitals to establish cultures that support EBP and to implement strategies to strengthen individuals' cognitive beliefs about the value of EBP and their ability to implement it for the ultimate purpose of improving quality of care and enhancing job satisfaction.
来自研究和成果管理项目的证据有力地支持了循证实践（EBP）在改善医疗保健质量、患者预后以及降低医院成本方面的应用。此外，已发表的轶事报告表明，在支持循证实践的文化环境中采用循证护理和实践方法的临床医生在其工作中会感到更有自主权和满足感。然而，缺乏专门研究医院工作人员对循证实践的信念与实施情况、循证实践的组织文化、团队凝聚力和工作满意度之间关系的研究。因此，这项描述性相关性研究的目的是在58名卫生专业人员参与为期12个月的循证实践指导计划之前，研究这些变量之间的关系，该计划是在一个社区医院系统中实施通过紧密合作推进研究与临床实践（ARCC）模式的一部分。研究结果表明，参与者的循证实践信念与他们所感知的循证实践组织文化、他们实施循证实践的程度、团队凝聚力和工作满意度显著相关。循证实践的组织文化与循证实践信念和循证实践实施显著正相关。研究结果支持医院需要建立支持循证实践的文化，并实施策略来强化个人对循证实践价值的认知信念及其实施能力，最终目的是提高护理质量和增强工作满意度。
