Evidence-based emergency nursing practice: State of the science and recommendations for the profession
Over the past two decades, there has been a shift in healthcare towards practice that embraces evidence over tradition. This shift has started a discourse in nursing for the need to develop initiatives to create and sustain nursing practice that is based on high quality evidence. Information about how U.S. emergency nurses find and use evidence to inform practice has not been reported. The purpose of this study was to identify sources of knowledge, skills, barriers, and facilitators to the implementation of evidence-based practice in the emergency care setting. Rogers Diffusion of Innovation theory guided this descriptive correlation study. The diffusion of evidence-based practice involves both individual and organizational factors. Factors influencing adoption of evidence-based practice include (a) characteristics of the adopter (nurse), (b) characteristics of the organization, (c) communication channels, and (d) the innovation (evidence-based practice). The Developing Evidence-Based Practice questionnaire was used to survey randomly selected registered nurse members of the Emergency Nurses Association. The questionnaire explored sources of knowledge used to infuse practice, barriers and facilitators to finding and using evidence to change practice, and self-reported skills in finding, reviewing, and using evidence. A total of 280 questionnaires, 28% of the total mailed, were returned within the study timeframe. Findings suggest that emergency nurses use experiential sources of knowledge more frequently than literature sources. Information from policies, procedures, and guidelines were easier to find and use than research reports. Barriers to developing evidence-based practice include time constraints, lack of resources, lack of authority to change practice, and difficulty in understanding identifying implications of research. Skill in finding and using organizational information was greater than finding and using research information. Interpreting statistics and conclusions in research articles were problematic for many. Nurses with higher education levels have greater self-reported skills in finding, reviewing, and using evidence.