Content area
Full Text
Growing interest in the Magnet Recognition Program(TM) has fostered increased awareness and use of evidence-based nursing care practices (American Nurses Credentialing Center, 2005). Increasingly, nurse administrators expect nursing practice to be evidence- based within their organizations. Achieving that expectation requires strategies that simultaneously educate, stimulate, and support all nursing staff in identifying clinical nursing questions and searching for evidence-based nursing interventions to address these questions. The purpose of this study was to implement and evaluate the effects of such strategies at a rural community hospital.
Background
Nursing and evidence-based practice (EBP). Evidence-based nursing (EBN) is "an integration of the best evidence available, nursing expertise and the values and preferences of the individuals, families and communities served" (Sigma Theta Tau International, 2005, paragraph 1). Research utilization, a component of EBN, involves using research findings (evidence) as a basis for nursing practice; it also requires a process of planned change to implement and evaluate the adapted innovations (Jones, 2000).
Only a few nursing interventions rely solely on research that is translated to direct practice (Rycroft-Malone et al., 2002). Instead, nursing clinical decisionmaking is a combination of research, clinical experience, and patient preferences. Clinical practice guidelines are a prominent source of EBP. However, Woolf (2000b) observed that these guidelines often do not change practitioner behavior. Various practitioner and external barriers limit the use of clinical practice guidelines (Cabana et al., 1999). Woolf's framework (2000a) explains the use of clinical practice guidelines by physicians, and characterizes barriers and facilitators. Key influences on the use of EBP guidelines are practitioner knowledge and attitudes about EBP, and organizational support for EBP implementation.
Knowledge and skill. Nursing organizations have articulated the competencies related to research (and EBP). The nurse prepared with an associate's degree (AD) is expected to help identify clinical nursing problems, assist in data collection, and with support, appropriately use research findings in clinical practice (American Nurses Association, 1994). Nurses with baccalaureate degrees (BS) are expected to understand basic research process and to review and use research findings in their own daily practice, while nurses with graduate degrees (MS) are expected to critique research and implement changes in practice based on research data (American Association of Colleges of Nursing, 1999).
In their research utilization study of 122 acute care nurses,...