Nursing Research Foundation, Helsinki, Finland.
The Finnish Centre for Evidence-Based Health Care - A JBI Centre of Excellence, Helsinki, Finland.
Worldviews Evid Based Nurs. 2024 Apr;21(2):137-147. doi: 10.1111/wvn.12701. Epub 2024 Feb 17.
Basing practice on evidence is a widely acknowledged requirement for nursing, but shortcomings still exist. An increased understanding of the actualization of evidence-based nursing (EBN) across different nursing contexts is needed to develop better support for EBN and promote uniform high-quality nursing.
The aim of this study was to compare the actualization of EBN in different organizational contexts in Finland.
Data for this survey were collected in 2021. The actualization of EBN in primary, specialized, and social care organizations was evaluated with the Actualization of Evidence-Based Nursing instrument, nurses' version, which focuses on individual and organizational-level EBN support structures. Differences between (1) specialized and primary healthcare, and (2) different nursing practice settings were tested with Welch's two sample t-test, the Kruskal-Wallis rank sum test, and the Wilcoxon rank sum test.
Based on nurse (n = 1020) evaluations, those working in specialized healthcare hold more positive attitudes toward EBN (p = .021) and evaluated their organization's methods for monitoring and evaluating nursing practices (p = .004) more positively than those working in primary healthcare. Regarding different nursing practice settings (n = 1241), the most positive results were observed within preventive healthcare where nurses evaluated their attitudes toward EBN, EBN competence, and personal evidence-based practices more positively compared to other nursing practice settings. The results were parallel regarding several organizational structures for EBN. Positive results were also observed within somatic units at university hospitals, and most negative results were within institutional care settings, health centers, and home care settings.
There is a need for targeted support to strengthen EBN across different organizational contexts, with special attention to those contexts where nursing professionals with lower education levels work. Future research needs to focus on further analyzing the organizational differences and what can be learned, especially from preventive healthcare but also somatic units at university hospitals.
以证据为基础进行实践是护理工作的广泛共识要求，但仍存在不足之处。为了更好地支持循证护理（EBN）并促进统一的高质量护理，需要加深对不同护理背景下 EBN 实现情况的理解。
本研究旨在比较芬兰不同组织背景下 EBN 的实现情况。
本调查数据于 2021 年收集。采用《证据为本护理实现度量表》（护士版）评估初级保健、专科保健和社会保健组织中的 EBN 实现情况，该量表侧重于个体和组织层面的 EBN 支持结构。采用 Welch 两样本 t 检验、Kruskal-Wallis 秩和检验和 Wilcoxon 秩和检验比较（1）专科保健和初级保健之间的差异，以及（2）不同护理实践环境之间的差异。
根据护士（n=1020）的评估，在专科保健机构工作的护士对 EBN 的态度更为积极（p=0.021），对组织监测和评估护理实践的方法评价更为积极（p=0.004），而在初级保健机构工作的护士则不然。在不同护理实践环境中（n=1241），在预防保健中观察到最积极的结果，护士在预防保健中对 EBN 的态度、EBN 能力和个人循证实践的评价更为积极，与其他护理实践环境相比。几个 EBN 组织结构的结果也相似。在大学附属医院的躯体科室中也观察到积极的结果，而在机构护理环境、健康中心和家庭护理环境中则观察到最消极的结果。
需要有针对性地支持不同组织背景下的 EBN，特别关注那些教育程度较低的护理专业人员工作的环境。未来的研究需要进一步分析组织差异以及可以从中学习到的内容，特别是从预防保健以及大学附属医院的躯体科室中。
