Integration of evidence-based practice by acute care nurse practitioner
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Evidenced based practice (EBP) is a concept that has been widely enveloped by the heath care industry. The benefits of EBP include cost savings, improved patient outcomes, and the translation ofresearch findings to the bedside. In spite of the industry's acceptance of EBP, the literature is devoid of studies exploring the ways in which EBP is integrated into daily practice. This study is the fjrst to document the real world experience of daily EBP use by a particular group of providers, namely the Acute Care Nurse Practitioners (ACNPs). The ACNPs use ofEBP was studied using a qualitative phenomenological approach guided by the philosophical tenets of Merleau-Ponty' s Phenomenology of Perception (1962). Ten practicing ACNPs from 2 large teaching and 1 community hospitals were interviewed in a major, southern city in the United States. The transcripts were reviewed -and thematic descriptors were identified. The ACNPs were overwhelmingly supportive of the use of EBP within imposed limits and the overarching theme was identified EBP- an important factor of care. EBP, while the preferred method of delivering care was not regarded as a blanket prescription . A wide range of mitigating factors were identified mandating careful consideration prior to applying EBP V recommendations. Four themes emerged from the mitigating factors and included: 1. beyond the barriers- balancing influencing factors, 2. to trust or not to trust, 3. balancing clinical knowledge and evidence and 4. the patient is always right. This study's findings document the need for further study, improved instrument development, and educational initiatives that focus on the real world practice of integrating EBP among ACNPs and all health care providers.