Paper
Wednesday, July 11, 2007
Evidence-based practice in surgery; reality or utopia?
Anouk M. Knops, MSc1, Hester Vermeulen, PhD2, and Dirk T. Ubbink, MD, PhD1. (1) Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center to the University of Amsterdam, Amsterdam, Netherlands, (2) Amsterdam Center for Evidence Based Practice, Academic Medical Center to the University of Amsterdam, Amsterdam, Netherlands
| Learning Objective #1: The learner will be able to define two barriers and facilitators to research utilization specific for nurses and for doctors. |
| Learning Objective #2: The learner will apprehend that an encouraging and stimulating organisational environment is essential for implementing transdisciplinary evidence-based practice. |
Aim: to perform a transdisciplinary measurement of, firstly, the present attitudes, awareness, knowledge and use of evidence-based practice (EBP), and secondly, the barriers and facilitators in order to tailor our efforts to further implement and improve EBP among professionals of a surgical department in a tertiary teaching hospital.
Method: a questionnaire was composed consisting of the BARRIERS Scale and the McColl et al. questionnaire. All nurses (without formal EBP training in their curriculum) and doctors (after up to 7 years of postgraduate EBP training) of the surgical department were asked to contribute.
Results: The questionnaire was completed by 60% of the nurses and 67% of the doctors.
Attitudes of both disciplines towards EBP were positive, although staff nurses’ attitudes were more positive than other qualified nurses (p=0.012). EBP terminology and sources were rather unknown to nurses, who also tended to give socially desirable answers. This was in contrast with the results among doctors; knowledge of 6 out of 8 EBP terms appeared present. Barriers to using research in practice for nurses were; ‘unawareness of EBP’ (67%) and ‘unclearly reported research’ (59%) and for doctors; ‘conflicting results’ (79%) and ‘methodological inadequacies’ (73%) of research reports. Constant involvement was the most cited condition to facilitate the use of research according to nurses as well as doctors.
Conclusion: EBP is increasingly welcomed by nurses and doctors. However, implementation still needs further improvement. For this purpose, nurses should be taught basic skills of EBP in terms of a more critical attitude during and regarding daily practice, as appeared effective in doctors. Moreover, in both disciplines a better communication about the existence of surgical evidence as well as a pursuit to obtain consensus as to the best available evidence may improve research utilisation. This has to be guided by an encouraging and stimulating organisational environment.