The Research Unit of Orthopaedic Nursing, Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark.
Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark.
J Clin Nurs. 2021 Feb;30(3-4):488-498. doi: 10.1111/jocn.15563. Epub 2020 Nov 28.
To explore nurses' constructions of the concept of evidence-based practice through their understandings of and experiences with evidence-based practice in a clinical care setting.
The primary purpose of evidence-based practice is high-quality patient outcomes. However, the adoption of evidence-based practice is described as a complex process, and research shows that evidence-based practice is not translated into practice. Research often explores facilitators and barriers of implementing and adopting evidence-based practice. Yet there is limited knowledge on how nurses construct the concept in practice.
This study has a constructivist approach and follows COREQ guidelines.
Ten semi-structured interviews with 26 nurses were conducted in 2019. Data were analysed with an emic and inductive approach.
Three key constructions emerged. Understandings of evidence-based practice were based on the original concept of evidence-based medicine. This included the hierarchy of evidence which was perceived as an inflexible concept not encompassing the nursing care. However, while not using the term evidence-based practice, the nurses were doing evidence-based practice portrayed through outcomes from management-supported nursing-based projects and incorporated reflections and discussions into weekly meetings. A discrepancy between a theoretical understanding and a practical doing of evidence-based practice appeared and was especially evident when the nurses' primary evidence sources consisted of the immediate options, for example asking colleagues or following accessible guidelines. Searching for evidence was central in their theoretical understanding but not an incorporated part of their daily work tasks.
The nurses' constructions of evidence-based practice indicate a discrepancy between the theoretical understanding of evidence-based practice and the practical doing of evidence-based practice, which hinders the basis of working according to the concept.
Theoretical discussions of evidence-based practice within the nursing field remain academic, as nurses in practice construct the concept on standards from evidence-based medicine.
通过了解和体验临床护理环境中的循证实践，探索护士对循证实践概念的构建。
循证实践的主要目的是提高患者的治疗效果。然而，循证实践的采用被描述为一个复杂的过程，研究表明循证实践并没有转化为实践。研究通常探讨实施和采用循证实践的促进因素和障碍。然而，对于护士如何在实践中构建这一概念，我们知之甚少。
本研究采用建构主义方法，并遵循 COREQ 指南。
2019 年进行了 10 次半结构化访谈，共涉及 26 名护士。采用emic 和归纳方法对数据进行分析。
出现了三个关键的构建。对循证实践的理解基于循证医学的原始概念。这包括证据等级，被认为是一个僵化的概念，不包括护理。然而，虽然没有使用循证实践这个术语，但护士们通过管理支持的基于护理的项目所产生的结果以及将反思和讨论纳入每周会议来进行循证实践。理论理解和实践循证实践之间出现了差异，当护士的主要证据来源是即时选择，例如询问同事或遵循可获得的指南时，这种差异尤为明显。寻找证据在他们的理论理解中是核心，但不是他们日常工作任务的组成部分。
护士对循证实践的构建表明，循证实践的理论理解与实践循证实践之间存在差异，这阻碍了依据该概念开展工作的基础。
护理领域内对循证实践的理论讨论仍然停留在学术层面，因为实践中的护士根据循证医学的标准构建这一概念。
