Journal of Community Nursing - page 99

JCN
2013,Vol 27, No 4
99
IMPROVING PRACTICE
FINDINGS
Of the 766 questionnaires distributed,
337 were returned giving an overall
response rate of 44%. Respondents
were evenly distributed across the
nursing groups (
Table 1
). The sample
comprised 331 (98.2%) women
and 6 (1.8%) men, of which 48.1%
(162) worked full time, and 51.6%
(175) part time. The average age of
respondents was 44.3 years (range
23–66 years).
SOURCES OF KNOWLEDGE
Nurses were asked to identify the
extent to which they used 22 different
sources of knowledge to inform their
practice by rating them on a five-point
scale, ranging from‘never’(score 1) to
‘always’(score 5). The frequency with
which nurses used various sources of
knowledge is reflected in the mean
(average) scores for each item. These
scores, ordered from most to least
frequent use, are shown in
Table 2
.
Nurses drew most frequently on
experiential sources of knowledge
gained through interactions with
patients (ranked 1 and 5). Workplace
sources of knowledge such as
protocols and guidelines (ranked 2
and 3) and training and conferences
(ranked 4) were also often used.
Knowledge gained from
colleagues, including senior nurses
(ranked 6), fellow practitioners
(ranked 7), and doctors (ranked 9) also
featured prominently. Less frequently
used sources of knowledge included
journal articles, textbooks, the internet
and pharmaceutical literature.
BARRIERS TO REVIEWING
RESEARCH AND INFORMATION
This section of the questionnaire asked
nurses to rate the extent to which 10
items concerned with finding and
reviewing research and organisational
information were perceived to be
barriers to evidence-based practice.
Each item was scored on a five-point
scale against the statement, ranging
from‘strongly agree’(score 1) to
‘strongly disagree’(score 5). The extent
to which nurses perceived different
items to be a barrier is reflected in the
mean scores. These scores, ordered
from the greatest to the least barrier,
are shown in
Table 3
.
The greatest barriers to nurses
accessing and reviewing evidence-
based information relate to time and
their skills in judging the quality of
information. Nurses were generally
more confident about where to
locate protocols and organisational
information. Research information
appeared to be more difficult to find.
Identifying implications for
practice was less of a barrier for nurses
in both research and organisational
information. These observations
highlight the need for strategies
that ensure that evidence-based
information is readily available to
nurses in a format that is easy to
understand and which includes
an indication of the quality of
the research.
BARRIERS TO CHANGING
PRACTICE
Nurses were asked to rate the extent
to which they encountered barriers
in using evidence to change practice.
Items were scored on a scale of 1
(‘strongly agree’) to 5 (‘strongly
disagree’). The mean scores, ordered
Table 1:
Respondents by nursing group
Nursing group
Number of responses
% of sample
Response rate
District nurses
68
20.2%
47.5
Community nurses
77
22.8%
46.9
Health visitors
72
21.4%
44.7
Practice nurses
67
19.9%
37.6
School nurses
53
15.7%
42.0
Total
337
100%
Table 2:
Sources of knowledge used to inform practice
Rank order Source of knowledge
Mean score
1
Information that I learn about each patient/client as an individual
4.41
2
Information I get from local policy and protocols
4.25
3
Information I get from national policy initiatives/guidelines
4.13
4
Information I get from attending in-service training/conferences
4.09
5
My personal experience of caring for patients/clients over time
4.03
6
Information senior clinical nurses share, e.g. clinical nurse specialists,
nurse practitioners
3.88
7
Information my fellow practitioners share
3.71
8
Information I learned in my training
3.53
9
What doctors discuss with me
3.5
10
Articles published in nursing journals
3.46
11
Information I get from local audit reports
3.38
12
New treatments and medications that I learn about when doctors
prescribe them for patients
3.27
13
My intuitions about what seems to be‘right’for the patient/client
3.19
14
Information in textbooks
3.13
15
Articles published in research journals
3.06
16
Articles published in medical journals
3.04
17
Information I get from the internet
3.02
18
Information I get from pharmaceutical or equipment literature
3.01
19
What has worked for me for years
2.9
20
Medications and treatments I gain about/from pharmaceutical or
equipment company representatives
2.61
21
The ways that I have always done it
2.43
22
Information I get from the media (e.g. popular magazines, television)
2.13
1...,89,90,91,92,93,94,95,96,97,98 100,101,102,103,104,105,106,107,108,109,...116