Journal of Community Nursing - page 98

98 JCN
2013,Vol 27, No 4
IMPROVING PRACTICE
D
espite the importance of
nursing practice being based
on robust evidence, nurses
encounter considerable challenges to
achieving evidence-based practice at an
individual and an organisational level
(Bryar et al, 2003; Gerrish et al, 2008).
One study examining barriers to using
research evidence in clinical decision-
making (McCaughan et al, 2002)
identified that hospital nurses may:
Be willing to use research but lack
the skills to do so
Encounter problems with
interpreting research publications,
which are seen to be too complex
Perceive that research publications
lack clinical credibility and fail to
provide sufficient clinical direction
Prefer to access research-based
information through a third party
rather than seek it out
for themselves
Factors influencing evidence-based
practice among community nurses
Experience a lack of organisational
support and/or unsupportive
colleagues.
Nurses working in the community
may encounter similar problems.
They can lack the knowledge and
skills to use research findings to
inform their decision-making, have
insufficient time to access, interpret
and apply research and, therefore,
need research information to be
presented in a format that is easily
accessible with the implications for
practice made clear (Thompson et al,
2005). Nurses can also find it hard to
use research evidence to influence
changes in primary care (McKenna et
al, 2004).
While research findings are an
important source of evidence, expert
clinical opinion, organisational
information and patient preferences
are additional forms of ‘evidence’ that
nurses use in practice (Bucknall and
Rycroft-Malone, 2010, Gerrish, 2010).
Most studies to date have focused
on nurses’use of research, however,
there is a need to understand how
nurses use other sources of evidence.
Hospital nurses tend to rely
heavily on informal, interactive
sources of evidence (Spenceley et
al, 2008), but little is known about
community nurses’use of different
sources of evidence. The survey
reported in this article seeks to
address this gap in knowledge.
AIM
The aim of this survey was to identify
factors influencing evidence-based
practice among community nurses.
METHODS
A postal survey was sent to
community nurses across six
primary care trusts (PCTs) in South
Yorkshire. The questionnaire was
a validated instrument (Gerrish et
al, 2007), which sought to identify
factors influencing the development
of evidence-based practice. These
factors included:
Sources of knowledge that
nurses use to inform their
practice
Perceived barriers to finding
and reviewing research and
organisational information
Perceived barriers to changing
practice based on‘best’ evidence
Perceived factors that facilitate
nurses to provide evidence-
based practice
Self-assessment of nurses’ skills
in finding, reviewing and using
different sources of evidence.
The sample included district
nurses, community nurses, practice
nurses, health visitors and school
nurses. Questionnaires were
distributed to a random sample from
each group in each PCT. Responses
were coded for computer analysis
and statistical testing was performed
using SPSS (Statistical Package for
the Social Sciences).
Kate Gerrish, Professor of Nursing Research,
University of Sheffield/Sheffield Teaching Hospitals
NHS Foundation Trust, School of Nursing and
Midwifery; Jo Cooke, Programme Manager
NIHR Collaborations and Leadership in Applied
Health Research and Care for SouthYorkshire
(CLAHRC SY), Sheffield Teaching Hospitals NHS
Foundation Trust
Nurses working in the community may have insufficient time to access,
interpret and apply research, and, therefore, need information to be
presented in a format that is easily accessible. As community nurses
rise to the challenges outlined in recent health policy, it is increasingly
important that they maximise their potential to deliver evidence-based
practice. This article looks at a survey that aimed to identify factors
influencing evidence-based practice among community nurses. The
findings indicate that in order to make progress it is important to adopt
a multifaceted approach, taking into account the real world in which
nurses currently practice. While it is important to develop nurses’ skills
in accessing and reviewing research information, constraints on time
mean that it will be difficult to achieve a nursing workforce where all
nurses are active in reviewing research evidence.
KEYWORDS:
Evidence-based practice
Research
Practice development
Kate Gerrish, Jo Cooke
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