Evidence‐based practice integration in hospital wards—The complexities and challenges in achieving evidence‐based practice in clinical nursing

Abstract

Aim Exploring the processes involved in two different strategies to integrate evidence‐based practice into nursing practice. Design Classical grounded theory methodology was used. Methods Data were collected through 90 hr of observation and 4 focus groups among clinical nurses in two different hospital wards. Results We identified a multidimensional evidence‐based practice integration framework that illuminates the complexities involved in the integration process. The dimensions were approaches to evidence‐based practice, positions of evidence‐based practice and levels of evidence‐based practice. The interactions between the dimensions gave five combinations; an explicit evidence‐based practice performed as a parallel to daily work at the systems level, an implicit evidence‐based practice integrated into daily work at the systems level, an explicit evidence‐based practice integrated into daily work at the individual level, an explicit evidence‐based practice integrated into daily work at the systems level and an implicit evidence‐based practice integrated into daily work at the individual level.

Readiness and leadership in evidence-based practice and knowledge management: A cross-sectional survey of nurses’ perceptions

“…5,17,36 Managers need to understand the importance of their role and to work actively to remove barriers to EBP. 18 As in previous studies, the nurses considered their managers' roles in arranging resources, solving problems and encouraging discussion about EBP as weak areas. 1,10,37 This indicates that nurses need more concrete support from their managers in reviewing practices and implementing EBP.…”

“…1,10,37 This indicates that nurses need more concrete support from their managers in reviewing practices and implementing EBP. Organizations should promote strategies for acquiring research knowledge, improve the availability of 18,33 According to Caramanica and Spiva, 15 training improves managers' readiness to support nurses' EBP and promote a supportive work environment. However, based on the results of this study, it appears that nurse manager education needs to be reformed.…”

“…16 Both EBP and KM have the same underlying principles for enhancing competencies: learning to apply new knowledge and innovation within organizations collaboratively. 16 The challenges to KM 17,18 are similar to those affecting EBP implementation, including a lack of allocated time and human resources, and a lack of support for KM and EBP by management and at an organizational level. Knowledge management includes organizing the acquisition and sharing of knowledge, and generating new knowledge and putting it into use effectively.…”

The Importance of Context and Organization Culture in the Understanding of Nurses’ Barriers Against Research Utilization: A Systematic Review

“…A definitively greater focus on research utilization in clinical practice, constituting the development and usage of empirical research knowledge in practice (Estabrooks, 1999), has been applied in the past 50 years to move closer to evidence‐based practice (Mackey & Bassendowski, 2017). Daily care in nursing, however, is still based on routines and personal experience, despite the availability of more effective interventions (Renolen, Hjälmhult, Høye, Danbolt, & Kirkevold, 2019). Therefore, it is important to develop, evaluate, and implement research in a clinical nursing practice.…”

Evidence Into Practice: Starting in Your Own Backyard

“…Nurse managers (NMs) are in a key role to use EBP to address questions from clinical practice, affecting the culture and climate of the unit. [1][2][3][4] The NM is often the first to hear about frontline questions, challenges, or opportunities to improve care processes through EBP, making them critical to cultivating a climate of inquiry. Yet, NMs may not feel competent in this role.…”