of 2
7/28/2019 Ritual Over Best Practice Evidence
1/2
Do rituals still rule overresearch evidence?
Copyright of Full Text rests with the originalcopyright owner and, except as permitted underCopyright Act 1968, copyingthis copyright rnatenalis prohibited without the permission of the o ~ e r orits exclusive licensee or agent or by way ofa licencefrom Copyright Agency Limited. For informationabout such licences contactCopyrightAgencyLimitedon (02) 93947600 (ph) or (02) 93947601(fax)
,- - l ~ U I I ~ I rtmn87055751
Nursing tssues
Despite the recent burst of activity in the field of evidence based practice (EBP) _including the expansion of the Joanna Briggs Institute for Evidence Based Nursingand Midwifery from its South Australian base into NSW, New Zealand and Hong Kong- many nurses still work in environments where ritual and tradition rule over researchevidence. RN and La Trobe University PhD student Julie O'Caliaghan asks whethernurses are merely paying lip service to evidence based practice.
Evidence based practice ...must become an expected,valued and rewarded activity.
barriers to implementing EBP - andillustrated the quantifiable benefitsmanagement would have to improvepatient outcomes and provide costeffective care.The objectives of the EBP proposalaligned directly with the missionstatement of the organisation and yetthe resources were denied with thesuggestion that enthusiasm aloneshould be enough to ensure success ofthe project.Research into the barr iers to nursesfostering a posit ive research cultureindicates that in order for EBP tobe successfully implemented, it mustbecome an expected, valued andrewarded activity:Issues of utilisation occur at all levelsof the organisat ion from missionstatements through to pol ic ies andprocedures -as well as on an individuallevel."
It seems despite the agendas of healthorganisations to remain competitivethrough the provision of EBP in theory,the baniers of time, access, resources,and lack of managerial recognitioncontinue to perpetuate the gap betweennursing theory and practice.Overcoming a negative research culturemay indeed be the greatest challengeto improving the implementation ofEBpS-IO
evidence of value for money fors takeholders in heal thcare , and canmeasure outcomes of the effectivenessof care delivered.However, despite all the enthusiastictalk about EBP there is still a gapbetween the theory of EBP and whatactually happens in nursing practice, asituation that persists because of anegative research culture in the nursingenvironment.A study into nurses' a tt it udes toresearch and research activity revealed:'nurses in Victorian hospit als he ldfavourable attitudes towards nursingresearch'."However, despite the readiness ofnurses to embrace EBP and deliver thehighest level of patient care, theycontinue to feel inadequately preparedor supported.In one Victorian hospital, for example,a group of nurses eager to embraceEBP p roposed that managementapprove Internet access to a computerlying idle in the staff room. Theproposal was rejected on the basis thatthe nurses would use the service for'other purposes'.Eager to foster a positive researchculture and improve patient outcomes,the nurses presented a professionalbusiness plan which out lined thecos ts and benefi ts of the In te rnet The future directive of nursing pract icedictates that nurses can il l affordproposal. to ignore the economical, ethical,The p roposal clearly out lined the- 'humanit ari an and legal implicationsbenefits that access, familiarity, time, which command adherence to theand recogni tion from management principals of evidence based nursingwould have in overcoming the practice.
By now nurses should all know theimportance of evidence based practice- practice which is enhanced byutilising the findings of qualityscienti fic research. Its purpose hasbeen drummed into nurses' heads sinceFlorence Nightingale first donned hercap and became the patron icon ofnursing research. University lecturersreligiously chant the mantra of EBPand preach its virtues; its ability toquantify the value ofwhat nurses do; itscapacity to have nursing recognisedas a profession comparat ive to o therprofessions.EBP has also become imperative in thedevelopment of hospital policies andguidelines, which dictate the standardsof care to which practising nurses areheld accountable.'Increasingly, standards of prac ti ceand Australian Nursing Councilcompetencies reflect the emergence ofEBP as centra l to the basis of modernnursing practice, and advanced rolessuch as clinical nurse consultant andnurse practitioner define standards ofpractice which demand interventionsare based upon the best availableevidence.Nursing organisations such as the ANFand Victorian Nursing Council reiteratethe importance of EBP as a means ofdelivering the safest and most effectivenursing care.To keep pace with the growing needsof the health industry, organisationsare under increased pressure toprovide evidence of value for moneyfor the health dollar. EBP provides
MB'Ch200, - volume eight nmoer eq'u Australll)') N ~ , , ~ r l f 1 , Jou, :"i -
7/28/2019 Ritual Over Best Practice Evidence
2/2
Nursing IssuesWith the consumerist trend in healthcare gaining momentum, as patientsdemand evidence of cost effective andquality health care, nurses must beequipped with the resources to meetthis challenge. Jl13
The public already assumesthat they are receivinghealth care based uponsound scientifically provenevidence.The public already assumes that theyare receiving health care based uponsOW1d scientifically proven evidence. 16Yet in reality, health care decisionsar e of ten principally based upontraitition,opuuon,resources,conunonsense and intuition, with littleattention paid to systematic appraisalof the best available evidence. EBP isat risk of becoming a fashionableconcept to which nurses merely paylip service. 16.
I f th e gap between the theory an dpractice of EBP is to be overcome,health care authorities must provideth e resources to empower nurses topu t into action what those authoritiesembrace so readily in theory.No matter how eager nurses are tosoar, i f they jump off the cliff withoutwings they will surely fall. Nurses nowknow that time, access, resources andmanagerial recognition are the wingsthey need to fly.References
Upton, D.J. How can we achieve evidencebased practice if we have a theory practicegap in nursing today? Journal of AdvancedNursing, 29:4, 1999, p.55l.
2 Sellick, K. et al. Victorian hospital nurses'research ouuudee and activity, AustralianJournal ofAdvanced Nursing, 13:4,1996,p.14.3 Cavanagh, S.J. and Tross , G. Utilisingresearch findings in nursing; Policy andpractice considerations, Journal ofAdvanced Nursing, 24:5, 1996, p.l084.4 Closs, S.J. and Cheater, F.M. Utilisation of
nursing research: Culture interest andsupport, Journal ofAdvanced Nursing,19:4,1994, p.762.
5 Colyer, R.I. and Kamath, P.Evidencebasedpractice. A philosophical and polit ical
analysis: Some matters for considerationby professional practitioners, Journal ofAdvanced Nursing, 29:1, 1999,p.193.
6 Thison,D.Practice innovation: A methodicalmaze, Journal of Advanced Nursing, 1999,30:2,p.389.7 Upton, op.cit. p.549.8 Capel, S. Nurses' access to library andi1iformation services, Nursing Standard,
12:25, 1998, p.46.9 Cavanagh, op.cit. p.l085.10O'Correll, D. and McMahon, A &searchand development coordinating centre,
Nursing Standard, 1998, 12:38, p. 32.11Closs, op.ctt, p. ll.12Muir-Gray, JA Evidence based health care,In Evidence based hea lt h care: How tomake health policy and managementdecisions, New York, Churchill Livingstone,1997, p.6.
13Shorten, A and Wallace, M. Evidence basedpractice: The future is clear, AustralianNursingJournal, 4:6, 1997, p.24.14ibid. p.22.15Upton, D. Attitudes towards, andknowledge oj, clinical effectiveness innurses midwives, pract ice nurses and
health visitors, Journal of AdvancedNursing, 29:4, p.885.
16 French, P. The development of evidencebased practice, Journal of AdvancedNursing, 1999, 29:1, pp.72-77.
17 Muir-Gray, op.cit, p.l.
The Middle East is calling you!Short-term contracts available now.ChoiceOneMeditemp can now offer you 3 month locumpositions in varied locations throughout the Middle East. NICUI SCBU ICUICCU Paediatrics Midwives VIP Clinic Oncology ER Surgical ORThis isyour chance to have a taste of the fabulous culture,shopping and lifestyle! Our experienced consultants havefirst-hand knowledge of the region and can answer yourquestions on long or short-term contracts.Call Kathleen O'Connor on 1300 655 060Email [email protected] St Georges TerraceAustralia 6000Fax+61892153885www.choiceone.com.au
2001
AUSTRALIAN REMOTE & RURAL NURSINGSCHOLARSHIP SCHEME
Contact Margo Wright on phone: 02 6283 3425 oremail: [email protected] for an applicationpackage for undertaking educational programs orattending a conference relevant to your practice.Applications can also be downioaded from theCollege website at www.rcna.org.au.
Royal College of Nursing, Australia invitesRegistered and Enrolled nurses who currently liveand practice in remoteand rural areas to apply for ascholarship to assist in undertaking professionaldevelopmentactivities.
,. ; ~ 7 ~ ) ~ . : : - ' - Y ; " j 0 , 9 ~ : ~ , ~ . ; ' ~ . F , : ~ ; , , , ; , ~ ~ ~ : 7 ? ~ . '. ! , p p l l . ~ a t i o n s . c l o s e , T h ~ r s d l ! Y . : 3 ~ M a y 2 9 0 1 : ~ b ' "'. _ ~ < : : " ' ; ' " . > " ~ . : ' " " +,-:',._' .. ~ . ' . - . .1. ,\ ,';,.;- , " . , ~ . ".,-._. :', ."Funded '6y:the,' c o m m o r i ~ e a i t ~ ' D e p a r t ~ e A t b F . ~ ~ : - : ~ ~ : . ? " \ : t;, .0: '" . , ; ~ , - ; ~ ~ j t h and A g e d , c ~ ~ r , : ~ . > : . : . , : ; f . P - : " ' ~ " - : ~ ~ ; ' ! . \ , : ' < '
