This is my very first Blog! Similar to Roberta, I am excited to have this opportunity to use this platform to discuss with nurses from around the world. I find it rather mind boggling that there are no boundaries to sharing and discussing our knowledge. My research interests lie in how to transfer best available evidence into nursing practice. Blogging is one format for sharing best practices that allows us to participate and to share our knowledge with nurses from diverse cultures, clinical settings, and nursing roles.
There are several types of knowledge that are relevant to our practice: information or facts that are systematically obtained in a manner that is replicable, observable, credible, verifiable, or basically supportable (i.e., research findings; Rycroft-Malone, & Stetler, 2004). Research findings are often translated into best practice guidelines. However, there is strong evidence in the literature indicating inadequate use of well-known best practice guidelines (Registered Nurses Association of Ontario, 2012). Researchers have estimated that 30% to 45% of patients do not receive care according to scientific evidence and 20% to 25% of the care provided is not needed or is potentially harmful (Grol, 2001; McGlynn, 2003). Research knowledge is not the only type of knowledge that informs our practice. Knowledge that will inform our care decisions also includes clinical experience, professional craft knowledge (tacit “how to” knowledge), care recipient’s preferences and experiences, and local information that enables collaborative care (Kitson et al., 2008).
Often it isn’t easy to access, assess, adapt, and apply the evidence for a variety of reasons. Time is probably the most important factor, but others such as not knowing where to access the information, not understanding the language in the research article, and not knowing how the reported findings will affect a particular patient. What can we do to promote the use of best available evidence? Strategies that have worked for me include consulting with a ‘knowledge broker’ or colleague who has expertise in the area, searching online for credible sources of information, and going to reputable websites. I also find that patients, especially those with chronic conditions often are very knowledgeable about how to manage their particular condition.
I am very interested in hearing about how you incorporate best available evidence into your practice. What factors within your health care setting facilitate your access to best available evidence and the co-creation of new knowledge between yourself and your patient? I look forward to receiving your responses!
Grol, R. (2001). Successes and failures in the implementation of evidence-based guidelines for clinical practice. Medical Care, 39, 1146-1154.
Kitson, A., Rycroft-Malone, J., Harvey, G., McCormack, B., Seers, K., & Titchen, A. (2008). Evaluating the successful implementation of evidence into practice using the PARIHS framework: Theoretical and practical challenges. Implementation Science, 3(1), 1-12.
McGlynn, E., Asch, S.M., Adams, J., Keesey, J., Hicks, J., DeCristofaro, A., Kerr, E.A. (2003). The quality of health care delivered to adults in the United States. New England Journal of Medicine, 348, 2635-2645.
Registered Nurses Association of Ontario (RNAO). (2012). Toolkit: Implementation of best practice guidelines (2nd ed.). Retrieved from http://rnao.ca/sites/rnao-ca/files/RNAO_ToolKit_2012_2ed.pdf
Rycroft-Malone, J., & Stetler, C.B. (2004). Commentary on evidence, research, knowledge: A call for conceptual clarity. Worldviews on Evidence-Based Nursing, 1(2), 98-101.
Dorothy Forbes