Developing organisational systems and culture to support evidence-based practice: the experience of the Evidence-Based Ward Project
- 1Research Centre for Transcultural Studies in Healthcare Middlesex University and Barnet & Chase Farm Hospitals NHS Trust, UK
- 2Research Centre for Transcultural Studies in Healthcare Middlesex University, UK
- 3Barnet & Chase Farm Hospitals NHS Trust, UK
The advancement of research based practice has been a goal in nursing for many years. Evidence-based practice (EBP) provides a framework and process for the systematic incorporation of research evidence and patient preference into clinical decision making at the level of the individual practitioner and the healthcare organisation. Few well designed studies have tested the effectiveness of organisational strategies for encouraging the systematic use of research in nursing practice,1 and more research is needed into the reality and consequences of adopting EBP.2
In 1996, an acute National Health Service (NHS) hospital trust and a university department in London, UK began a joint project to increase the systematic use of research by nurses in clinical practice. EBP was selected as the approach, and the hospital-wide project began in late 1996. The project was facilitated by a senior lecturer appointed jointly by the 2 organisations, with half of his time allocated for this role. A diagnostic assessment done early in the project identified the need for the development of organisational and individual capacity to support and use EBP.3 The Evidence-Based Ward Project used action research to explore ways in which the organisation and culture of practice in a busy acute ward could be developed to make EBP part of the “normal” approach to practice. The project ran for 10 months and was coordinated by the new ward manager and the senior lecturer.
When the project began, the hospital was a fairly typical UK NHS district general hospital, with approximately 520 beds. During the project, the hospital merged with a neighbouring NHS trust of similar size. The hospital had a history of providing nurse training but had only recently become a clinical placement site for medical students. The ward was selected as typical of other wards in the hospital, with …