Fairbrother Greg, Cashin Andrew, Conway Rae, Symes Annette, Graham Iain
Collegian. 2016;23(1):29-37. doi: 10.1016/j.colegn.2014.09.011.
To establish self-reported skill levels, behaviours and barriers in relation to evidence-based practice (EBP) among a representative sample of regional Australian nurses and midwives in senior roles.
It has been widely established that nurses and midwives continue to face challenges in relation to putting evidence into practice on the clinical floor. Prior to conducting an EBP capacity building activity in a regional Australian Local Health District, a survey assessing needs and skill and barrier areas was conducted.
A quantitative descriptive survey which utilised the 'Developing Evidence Based Practice Questionnaire' (DEBPQ) was conducted in early 2012 among senior nurses and midwives of a regional New South Wales Local Health District (LHD). The survey results were contrasted with reported DEBPQ results from a sample of UK metropolitan nurses and a sample of Australian general practice nurses (GPNs).
One hundred and sixty nine nurses completed the survey (response rate 42%). Survey respondents' reliance on accepted evidentiary knowledge sources was found to be low. Research literature-related knowledge sources were ranked outside of the top 10 sources, compared with numerous personalised and subjective sources, which ranked within the top 10. Access to and understanding of research material was a primary barrier to reviewing evidence in the study sample. Time-related barriers to changing practice on the basis of evidence figured prominently in the study sample and the UK and Australian GPN samples. The study sample rated their EBP skill levels significantly higher than both their UK counterparts and the Australian GPN sample (P < 0.0001).
Capacity building interventions are needed among senior nurses and midwives in Australian regional LHDs, as the most prominent knowledge sources reported are non-evidentiary in nature and barriers to finding and reviewing evidence, along with barriers to making practice change, remain significant.
在澳大利亚地区担任高级职务的护士和助产士代表性样本中,确立与循证实践(EBP)相关的自我报告技能水平、行为及障碍。
护士和助产士在临床实践中运用证据方面持续面临挑战,这一点已得到广泛证实。在澳大利亚一个地区性地方卫生区开展循证实践能力建设活动之前,进行了一项评估需求、技能和障碍领域的调查。
2012年初,在新南威尔士州一个地区性地方卫生区(LHD)的高级护士和助产士中开展了一项定量描述性调查,该调查使用了“循证实践发展调查问卷”(DEBPQ)。将调查结果与英国大都市护士样本和澳大利亚全科护士(GPN)样本报告的DEBPQ结果进行对比。
169名护士完成了调查(回复率42%)。研究发现,调查对象对公认的证据性知识来源的依赖程度较低。与众多排在前10位的个性化和主观来源相比,与研究文献相关的知识来源排在前10位之外。获取和理解研究资料是研究样本中审查证据的主要障碍。在研究样本以及英国和澳大利亚全科护士样本中,基于证据改变实践的时间相关障碍都很突出。研究样本对其循证实践技能水平的评分显著高于英国同行和澳大利亚全科护士样本(P<0.0001)。
澳大利亚地区性地方卫生区的高级护士和助产士需要进行能力建设干预,因为报告的最主要知识来源本质上是非证据性的,寻找和审查证据的障碍以及实践改变的障碍仍然很大。