TriService Nursing Research, Uniformed Services University of the Health Sciences, 4301, Bethesda, MD 20814, USA.
Science and Technology, USAF, 59th Medical Wing, Office of the Chief Scientist, Joint Base, San Antonio, TX 78150, USA.
Mil Med. 2023 Nov 10;189(Suppl 1):5-13. doi: 10.1093/milmed/usad343.
Evidence-based practice (EBP) is an innovative systematic problem-solving methodology that incorporates the best research evidence into clinical practice to improve patient outcomes, job satisfaction, and reduced healthcare costs. Although there are significant advances to implement EBP into military healthcare and operational settings, many barriers and challenges still exist. Civilian healthcare organizations have examined barriers and solutions to integrate EBP into clinical practice, but limited data exists to identify barriers and solutions to integrate EBP into military healthcare settings. Advancing the implementation of EBPs within military healthcare settings has the power to transform the administrative processes of healthcare management and most importantly, the delivery of healthcare for service members and beneficiaries. The purpose of this article is to present findings from a qualitative descriptive research study which analyzed data obtained during an EBP military summit.
A qualitative descriptive research study was used to examine EBP barriers and solutions to implement EBP in military healthcare settings. Participants attended a virtual 1-day military EBP summit (n = 182). As part of the summit, participants were invited to voluntarily participate in focus groups. Focus groups were conducted to gain an understanding of EBP barriers and solutions from military and civilian nurses and medics with interest and experience conducting EBP within military healthcare settings (n = 42). Focus group discussions were transcribed and analyzed by the study team.
The study analysis identified six themes: leadership, command culture, EBP barriers (specific to MTF/operational environments), communication, infrastructure support, and outcome measures. Sub-themes identified additional dimensions military-specific barriers and solutions within the six identified themes.
The results of this research study identify actionable tasks and recommendations to advance EBP within the military healthcare system. EBP is currently underutilized in the military healthcare system, and supportive implementation of EBP can be accomplished through enhanced leadership engagement, changing command culture, addressing EBP barriers, infrastructure, communication planning, and integration of existing national clinical and financial outcome measures. Given the critical need to further transition of military healthcare to evidence-based data driven decisions, the knowledge gained from this study can optimize readiness and advance healthcare delivered to service members and beneficiaries within the military healthcare system.
循证实践（EBP）是一种创新的系统问题解决方法，它将最佳研究证据纳入临床实践，以改善患者结局、提高工作满意度并降低医疗保健成本。尽管在将 EBP 引入军事医疗保健和作战环境方面取得了重大进展，但仍存在许多障碍和挑战。民用医疗保健组织已经研究了将 EBP 纳入临床实践的障碍和解决方案，但将 EBP 纳入军事医疗保健环境的障碍和解决方案的数据有限。在军事医疗保健环境中推进 EBP 的实施，具有改变医疗保健管理行政流程的力量，最重要的是，为军人和受益人提供医疗保健服务。本文的目的是介绍一项定性描述性研究的研究结果，该研究分析了在 EBP 军事峰会上获得的数据。
采用定性描述性研究方法，研究在军事医疗保健环境中实施 EBP 的障碍和解决方案。参与者参加了为期 1 天的虚拟军事 EBP 峰会（n=182）。作为峰会的一部分，邀请参与者自愿参加焦点小组。进行焦点小组讨论，以了解对在军事医疗保健环境中进行 EBP 有兴趣和经验的军人和医务人员的 EBP 障碍和解决方案（n=42）。研究小组对焦点小组讨论进行了转录和分析。
研究分析确定了六个主题：领导力、指挥文化、EBP 障碍（特定于 MTF/作战环境）、沟通、基础设施支持和结果衡量标准。确定的六个主题中的子主题进一步确定了军事特有的障碍和解决方案。
这项研究的结果确定了在军事医疗保健系统中推进 EBP 的可操作任务和建议。EBP 在军事医疗保健系统中的利用率较低，通过增强领导力参与、改变指挥文化、解决 EBP 障碍、基础设施、沟通规划以及整合现有的国家临床和财务结果衡量标准，可以支持 EBP 的实施。鉴于进一步将军事医疗保健过渡到基于证据的、数据驱动的决策的迫切需要，从这项研究中获得的知识可以优化准备工作，并推进为军事医疗保健系统中的军人和受益人提供的医疗保健服务。
