Carter Eileen J, Rivera Reynaldo R, Gallagher Kelly A, Cato Kenrick D
Author Affiliations: Clinical Nurse Scientist (Dr Carter), Director of Research and Innovation (Dr Rivera), and Clinical Nurse Scientist (Dr Cato), New York-Presbyterian Hospital; and Assistant Professor of Nursing at CUMC (Dr Carter) and Assistant Professor (Dr Cato), Columbia University School of Nursing, New York; and Director (Ms Gallagher), Nurse Residency Program, Penn Medicine, Philadelphia, Pennsylvania.
J Nurs Adm. 2018 Jan;48(1):18-24. doi: 10.1097/NNA.0000000000000565.
The aim of this study is to assist nurse leaders in developing innovative structures to foster a culture of inquiry among professional nurses.
Critical to nurse's engagement in evidence-based practice (EBP) is a culture of inquiry, in which nurses critically evaluate patient care activities and actively review existing evidence to address identified clinical issues. A bundle of structural interventions was implemented across a large, multisite hospital to advance a culture of inquiry. We measured the impact of these interventions on nurses' library use and on nurses' knowledge, attitudes, and practices towards EBP.
Structural interventions included: 1) EBP and Research Committee meetings, in which nurses were educated on how to formulate a clinical question and critically appraise a research article; 2) Academic Partners Program, in which nurse academicians provided scholarly mentorship and guidance during monthly committee meetings; 3) hiring of clinical nurse scientists who provided 1-on-1 education and mentorship to clinical nurses in EBP and research; and 4) a Nurse Residency Program partnership, in which newly graduated nurses were required to complete an EBP project. We examined the impact of these structural interventions on nurses' use of library resources and nurses' knowledge, attitudes, and practices toward EBP.
The implementation of structural interventions to support nurses' engagement in EBP was associated with a significant increase in the number of nurse-generated library consultative requests over time. Results showed high levels of nurse knowledge, attitudes, and practices in EBP.
Nurse leaders may advance a culture of inquiry by providing the infrastructure to support EBP activities and by empowering nurses to question and seek answer to identified practice questions. Infrastructures should include access to scientific articles and partnerships with schools of nursing. Additional research is needed to validate nurse library use as a measure of nurse engagement in EBP.
本研究旨在协助护理领导者构建创新架构，以培育专业护士的探究文化。
探究文化对于护士参与循证实践（EBP）至关重要，在这种文化中，护士批判性地评估患者护理活动，并积极审视现有证据以解决已识别的临床问题。在一家大型多院区医院实施了一系列结构性干预措施，以推动探究文化。我们测量了这些干预措施对护士图书馆使用情况以及护士对循证实践的知识、态度和实践的影响。
结构性干预措施包括：1）循证实践与研究委员会会议，会上对护士进行如何制定临床问题以及批判性评价研究文章的培训；2）学术伙伴计划，护士学者在每月的委员会会议期间提供学术指导；3）聘请临床护理科学家，为临床护士提供循证实践和研究方面的一对一教育与指导；4）护士住院医师计划合作伙伴关系，要求新毕业护士完成一个循证实践项目。我们考察了这些结构性干预措施对护士图书馆资源使用情况以及护士对循证实践的知识、态度和实践的影响。
随着时间推移，实施支持护士参与循证实践的结构性干预措施与护士发起的图书馆咨询请求数量显著增加相关。结果显示护士在循证实践方面的知识、态度和实践水平较高。
护理领导者可以通过提供支持循证实践活动的基础设施，并赋予护士质疑和寻求已识别实践问题答案的权力，来推动探究文化。基础设施应包括获取科学文章的途径以及与护理学院的合作伙伴关系。需要进一步研究以验证将护士图书馆使用情况作为衡量护士参与循证实践的指标。
