David Sackett (2000) identifies failure to gain "coal-face" commitment as one reason why randomized controlled trials "fail" front-line patient care. Our institution faces a similar problem: how to gain commitment to evidence-based practice from bedside nurses, most with no formal research education. Our Nursing Research Council (NRC), primarily comprised of staff nurses and supported by a full-time hospital-based doctorally prepared nurse, uses disciplined clinical inquiry (DCI)(Sanares & Heliker, 2002) as an overall framework for helping themselves and their peers become aware of, increasingly knowledgeable about, and eventually committed to evidence-based practice. The development and use of traveling posters will be described as one example of how DCI is operationalized. This example might be considered a 'nested' strategy in which direct-care nurses are primary stakeholders in communication, collaboration, and reflection with NRC members as coaches at one level, and NRC members--themselves staff nurse representatives--are stakeholders in reflection, inquiry, and synthesis with the doctorally prepared nurse as coach at the second level. The traveling poster serves as a focus and means for communication and feedback between these two levels. Posters include a statement of the problem, proposed intervention, and specific population; the search strategy used to find relevant literature; a brief description of the literature; a statement of whether and what recommendations for practice can be made; and, suggested 'next steps'. A specific clinical example will be used to demonstrate how traveling posters provide a means for keeping evidence-based practice relevant to nurses at the "coal-face" of patient care.
Sackett, D.L. (2000). Why randomized controlled trials fail but needn't: 1. Failure to gain "coal-face" commitment and to use the uncertainty principle. Canadian Medical Association Journal, 162(9), 1311-1314.
Sanares, D. & Heliker, D. (2002). Implementation of an evidence-based nursing practice model: disciplined clinical inquiry. Journal for Nurses in Staff Development, 18(5), 233-238.
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Sigma Theta Tau International
9 July 2003