Practice Theory and Evidence-Based Practice

Tuesday, 14 July 2009

Lee A. Schmidt, RN, PhD
Mary K. Walker, PhD, RN, FAAN
Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL

Learning Objective 1: Describe the relationship between practice theory and evidence-based practice.

Learning Objective 2: Identify advantages to using practice theory as a strategy to optimize conditions for evidence-based practice.

Purpose: The purpose of this presentation is to suggest practice theory as a mechanism to optimize conditions for realizing the fullest benefits of evidence-based practice.The emphasis on evidence-based practice (EBP), research utilization (RU) and knowledge translation (KT) in nursing has been fueled by several sources, most notably and recently, the quality and safety movement.  Fundamentally, the use of the best available evidence, including research evidence, is central to the social contract between nursing and society.  The availability of EBP, RU, and KT models suggests an adequate supply of tools to facilitate the translation and incorporation of research findings into practice.  Yet, barriers continue to work as inhibitors toward patients realizing the full, beneficial effects from EBP.  These barriers have stimulated newer and revised models to guide the use of research evidence in practice and transformations of the institutional infrastructure to better support EBP.

Methods: Literature review; critical reflection and dialogue.

Results: N/A.

Conclusion: The position is taken that resource intensive efforts toward transforming institutional infrastructures are premature until a fundamental issue is confronted: the overwhelming volume of research literature available to nursing care providers is not in an efficient form.  Even the most competent clinician could become overwhelmed with the vast amount of research evidence for a clinical situation.  The position that situation producing practice theory is the missing element in bridging the gap between research and practice is presented. Situation producing practice theory produces a more generalizable and useful mechanism for using research evidence to guide nursing practice. Practice theory may also significantly reduce or even eliminate some of the barriers associated with EBP.