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Barriers to evidence-based practice in primary care nursing - why viewing decision-making as a context is helpful

Thompson, C., McCaughan, D., Cullum, N., Sheldon, T. and Raynor, P. (2005) Barriers to evidence-based practice in primary care nursing - why viewing decision-making as a context is helpful. Journal of Advanced Nursing, 52 (4). pp. 432-444. ISSN 0309-2402

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Aim: This paper reports a study examining the barriers associated with research knowledge transfer amongst primary care nurses in the context of clinical decision-making.

Background: The research literature on barriers to nurses' use of research knowledge is characterized by studies that rely primarily on self-report data, making them prone to reporting biases. Studies of the barriers to evidence-based practice often fail to examine information use and behaviour in the context of clinical decision-making.

Methods: A multi-site, mixed method, case study was carried out in 2001. Data were collected in three primary care organizations by means of interviews with 82 primary care nurses, 270 hours of non-participant observation and 122 Q-sorts. Nurses were selected using a published theoretical sampling frame. Between-methods triangulation was employed and data analysed according to the principles of constant comparison. Multiple linear regression was used to explore relationships between a number of independent demographic variables (such as length of clinical experience) and the dependent variable of nurses' perspectives on the barriers to their use of research knowledge.

Results: Three perspectives on barriers to research information use emerged: the need to bridge the skills and knowledge gap for successful knowledge transfer; information formats need to maximize limited opportunities for consumption; and limited access in the context of limited time for decision-making and information consumption. Demographic variables largely failed to predict allegiance to any of the perspectives identified.

Conclusions: Researchers should consider using decision-making as a contextual backdrop for exploring information use and behaviour, avoid relying solely on self-reported behaviour as data, and use a variety of research methods to provide a richer picture of information-related behaviour. Practice developers need to recognize that understanding the decisions to which research knowledge is to be applied should be a characteristic of any strategy to increase research uptake by nurses.

Item Type: Article
Institution: The University of York
Academic Units: The University of York > Health Sciences (York)
Depositing User: York RAE Import
Date Deposited: 04 Aug 2009 17:52
Last Modified: 04 Aug 2009 17:52
Published Version: http://dx.doi.org/10.1111/j.1365-2648.2005.03609.x
Status: Published
Publisher: Blackwell Publishing
Identification Number: 10.1111/j.1365-2648.2005.03609.x
URI: http://eprints.whiterose.ac.uk/id/eprint/6390

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