Using research findings in nursing practice
- Correspondence to Alison Twycross
Reader in Children's Nursing, Faculty of Health and Social Care Science, Kingston University- St George's University of London, London SW17 0RE, UK;
Welcome to the July edition of Evidence-Based Nursing (EBN). In this edition, there are two new features which we hope will enable readers to use evidence in practice more effectively. The first of these is the Research Made Simple series. This will provide a one-page overview about key areas of research with the aim of increasing readers' understanding of the research process. The first article in the series, written by Jane Clarke, one of the associate editors for the journal, identifies the key features of a systematic review. Other articles in the series will explore other areas of research including ‘what is a randomised controlled trial?’ and ‘qualitative data analysis’.
The other new item in this edition is the Resource Page. This page will be included in each edition of the journal and will bring together new and updated sources of information about current evidence for nursing practice. Information has been collated from the Cochrane Nursing Network, the Drug and Therapeutics Bulletin, the Scottish Intercollegiate Guidelines Network, RCN Learning and BMJ Learning. We hope that this information will enable you to access information about current best practice to inform how you care for your patients. The information from the webpages and associated hyperlinks will also be included on the EBN webpage (http://ebn.bmj.com/).
If you are an individual subscriber to the journal, you can access the EBN webpages for free. Doing so currently provides you with access to the Nursing Standard archive. If you have not done so already, register now via the following link: https://secure.rcnpublishing.co.uk/index.asp?jid=2&mode=challenge. You can also sign up for e-alerts to receive an email as new content is made available on the EBN website as online first. Alongside this, you can follow the journal on Twitter or via Facebook. To do so, just go to http://ebn.bmj.com/ and click on the links on the right hand side of the webpage.
The two new features in this edition of the journal aim to help nurses use evidence more effectively in practice. This made me think about the extent to which nurses use research evidence in practice. A recent systematic review by Squires et al1 reports that nurses have described moderately high use of research in their practice since the early 2000s. However, many of the included studies used self-report measures and, therefore, may portray an overly optimistic view of the use of research findings in practice. This conjuncture is supported by other studies which suggest that nurses do not always use theoretical knowledge in practice.2 3 Another key finding of Squires et al's1 systematic review is a lack of research examining whether increasing the use of evidence in practice improves nursing care. There is an assumption that it does make a difference, but research is needed to ensure that this is the case. Watch out for a commentary on the Squires et al1 article in a future edition of EBN.
Across the world, nurses are currently dealing with financial cutbacks because of the global economic crisis, and it is timely to reflect on ways of limiting the impact of this on nursing care. One of the first areas where cuts are often made is in education for registered nurses. One of the studies included in this edition of EBN illustrates how training can improve patient care; a communication skills training programme for oncology nurses was found to improve patient-centred communication, enhance empathy and increase discussion about patients' psychosocial needs.4 There is, of course, no guarantee that what is taught will be used in practice, but, if nurses have limited or no access to on-going education, it is likely to have an impact on patient care now and in the long term.
Organisational culture also appears to have an impact on the quality of care provided. This is illustrated in another study featured in this edition of the journal.5 The study was carried out in care homes for people with dementia and found that organisational culture impacted on the quality of care provided. Homes with a ‘clan culture’ (characterised by shared values and goals and a sense of ‘we-ness’) were found to provide the best quality of care. Other studies have also found differences in the care provided which relate to organisational culture. One example is Lauzon Clabo's6 ethnographic study on two wards in one hospital in the USA. Participants described a clear but different pattern of pain assessment on each ward. The social (organisational) context of the ward appeared to influence nurses' practices. In these times of economic uncertainty, it is important that we do not lose sight of the importance of organisational factors in ensuring that we provide the best possible care to patients and their families.