Health care organisations need to consider multiple strategies to facilitate and promote evidence-based practice. Managerial support, facilitation, and a culture that is receptive to change are essential.
Evidence-based care has become the new mantra within the NHS, despite the fact that the concept of applying research to practice has been promoted for several decades. However, literature on the subject suggests that formidable obstacles remain to the integration of research into care delivery. This article describes a study which used Funk et al's (1991a,b) Barriers Scale with a population of nurses in a large teaching hospital in the UK. This scale was specifically developed to identify barriers to the introduction of research into practice, and modified for a UK context. The results suggest that a complex array of barriers exist but that foremost among these is the nature of the organizations within which nurses work. Comparisons are made with data from the USA, and the need to create time for nurses to implement change, and to empower them to do so, is stressed.
Improving clinical effectiveness is a major challenge facing nurses working in the United Kingdom and requires a coordinated approach in order to ensure that the information about which interventions work is made available to those in a position to use it. This means that policy makers, administrators, and nurses need to base decision making on the best available evidence. In this article we explore the background to the drive for evidence-based practice and discuss how a group of nurse researchers have begun working with nurse administrators and practitioners in a large acute hospital to help change the rhetoric of evidence-based practice in nursing into reality.
This paper describes one part of a feasibility study carried out in England which examined the costs, quality and effectiveness of continence services in areas with different approaches to provision. It involved the design of instruments to collect the views and perceptions of patients and an investigation of ways to develop a methodology to implement comparative studies. It is the design and piloting of the questionnaires and the way patients responded that forms the focus of this paper. The main sample group recruited for the study were women who had recently sought formal help with urinary incontinence and were likely to receive conservative treatment or management in the community. They were interviewed and asked to complete four questionnaires at two points in time. A smaller sub-group of disabled women, interviewed only once, were included to compare cost profiles for different client groups. The questionnaires which were developed address the impact of urinary incontinence (using a standard scale), the effectiveness of service provision in terms of patients' clinical history, expectations and hoped-for outcomes, service receipt and its cost, and patients' satisfaction with several aspects of service provision. In total 118 women were interviewed, including 28 disabled women. The study generated a set of survey instruments which might be used for a variety of purposes including audit and future research and which could inform purchaser and provider decisions by using patients' perspectives of quality of life outcomes to enhance service development.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.