A Case Study on the Meaning of Evidence-Based Practice among Bedside Staff Nurses Working in the Intensive Care Unit.

摘要

This study explored the meaning of evidence-based practice (EBP) among critical care staff nurses working at the bedside in a 5-hospital healthcare system in South Texas. EBP has been well established and there is abundance of studies on the dissemination, facilitation, and utilization of EBP. However, although there has been an increase in the momentum on the recognition of EBP as the gold standard for quality and safe care, there is still disagreement and inconsistency in the use of EBP. In spite of the growing emphasis on the use of EBP, there is scarce evidence of nurses' readiness to integrate EBP principles. The purpose of this qualitative case study was to explore how nurses perceive the implementation of EBP including the (a) identification, evaluation, and application of research, (b) use of best evidence, (c) problem-solving and decision-making, (d) clinical professional expertise, and (e) patient preferences and values. Using the case study method, this inquiry focused on the exploration of the meaning of the ways nurses implement EBP. The responses from the participants reflected the barriers and enablers on the utilization of EBP cited in the current literature, including the lack of time and lack of accessibility to EBP resources. The barriers and enablers to EBP implementation occurred at the individual such as the lack of experience of the nurses and organizational levels including administrative support and resources. The findings from the semi-structured interviews and the triangulation of the interview data with the secondary sources of data revealed two concepts - clinical expertise and patient values and preferences -- that are deemed to be discrepant with the contemporary definition of evidence-based practice. Recommendations to promote effective implementation of EBP among staff nurses are offered.