Rob McSherry

Evidence-based nursing: clarifying the concepts for nurses in practice.

AIM To provide a critical analysis of key concepts associated with evidence-based nursing (EBN) to substantiate an operational definition for nurses to use in practice. BACKGROUND Despite the plethora of literature surrounding what evidence-based nursing is and is not and how it differs from its cousins, evidence-based medicine and evidence-based practice, nurses still struggle to get evidence into practice. Several reasons for this have been reported, for example, a lack of understanding about what evidence-based nursing means or time to engage with and apply the evidence into practice. DESIGN An in-depth critical review and synthesis of literature was undertaken. METHOD Using the key words; evidence-based nursing, evidence-based medicine and evidence-based practice 496 articles were yielded. These articles were limited to 83. Using Burns and Groves (2001) phased approach to reviewing the literature the articles were critically reviewed and categorised into key concepts and themes. RESULTS The in-depth critical review and synthesis of the literature demonstrated that evidence-based nursing could be defined as a distinct concept. The review clearly shows that for evidence-based nursing to occur, nurses need to be aware of what evidence-based nursing means, what constitutes evidence, how evidence-based nursing differs from evidence-based medicine and evidence-based practice and what the process is to engage with and apply the evidence. CONCLUSION The in-depth critical review and synthesis of the evidence-based nursing literature reinforces the need to consolidate a position for nursing in the evidence-based field. The review confirms that evidence-based nursing can be defined and conceptualised; however, for nurses to engage and apply with the evidence-based processes they need to be informed of what these are and how to engage with them in practice. RELEVANCE TO CLINICAL PRACTICE This paper examines the concept of evidence-based nursing and its application to clinical practice.

Embracing external scrutiny to build bridges and genuine partnerships between education and clinical practice

Despite having made significant changes and improvements since 2007, publication of The Mid-Staffordshire National Health Service Foundation Trust Public Inquiry (2013) refocused attention on the poor care standards that had taken place. Recommendations include far reaching national transformational changes not only for the National Health Service but also for professional regulatory bodies and other agencies linked to health and social care. This paper describes how external scrutiny was embraced to move staff from initial loss of confidence, feelings of anger and defensiveness to embracing opportunities to increase transparency, build bridges and genuine partnerships between universities and healthcare providers. Following an Extraordinary Review by the Nursing and Midwifery Council an action plan was collaboratively formulated between Staffordshire University and Mid-Staffordshire National Health Service Foundation Trust. This resulted in the implementation of a Practice Learning Improvement Project which monitored the action plan, ensured sharing of all learning and production of evidence for external scrutiny. Key lessons learnt included the need to: move beyond mere compliance with regulatory performance indicators; engage senior staff in all aspects of student learning; develop candid sharing of soft and hard intelligence, clearly delineate placement support roles and ensure engagement of academics in practice has transparent outcomes for the student, practice and education.

The Importance of Information Technology: A Regional Guide to the Development, Implementation and Evaluation of Integrated Care Pathways. Part 2

The first article in this series1 briefly outlined the background to this project, the role and responsibilities of the project team and reference group, how the clinical teams were recruited, and why sharing and disseminating information gathered by the production of a CD-ROM was important. This second article builds on the previous by detailing the key processes and outcomes of the project offering practical advice and guidance on developing, implementing and evaluating integrated care pathways (ICPs). The intention is to share and disseminate information gathered, so that our experiences and those of our colleagues can assist other professional teams in developing ICPs as a vehicle to promote evidence-based practice within the context of clinical governance. To ease the process of sharing and dissemination, the information is available on CD-ROM.