: The purpose of this exploratory study is to understand how nursing unit culture affects the emergence and maintenance of evidence-based nursing practice in the hospital setting. Evidence-based practice (EBP) has been identified as a cornerstone of safe and effective healthcare and has been related to recent improvements in several critical outcomes, including ventilator-associated pneumonia [1-2], central-line associated infections [3], and surgical site infections [4]. Yet, recent studies have shown that a large number of nurses and physicians do not practice within an evidence-based framework [5-9]. Efforts to understand and apply interventions at the level of the individual nurse to induce EBP have been inadequate. Recently, there has been an acknowledgement that the successful implementation of EBP requires evaluating the environment (context) where care is provided [10-16]. With increasing focus on professional practice environments, and in particular, """"""""magnet"""""""" environments that support excellence in nursing practice, there is an emerging opportunity to understand the role of environmental characteristics on EBP and to expand the scope of interventions that enable EBP in hospitals. The goal of this research is to explore the impact of the nursing unit environment upon individual nurse's EBP utilization. The ultimate aim of this research is to expand the scope of interventions that optimize EBP in the acute setting. This study theorizes a new multi-level framework (individual and cultural) to demonstrate the theoretical interplay between the magnet culture and individual behavior. Qualitative methods will be used to integrate these observations with Ajzen's theory of planned behavior (individual) and Schein's organizational culture conceptual framework. In-depth interviews of staff nurses on medical-surgical and critical care units at two hospitals will be conducted to gather perceptions, thoughts, and experiences of individual nurses at various stages on the magnet journey (in-process and designated) to identify individual and cultural characteristics that impact successful implementation of EBP.
Specific aims of the study are to (1) identify how staff nurses define EBP, (2) describe staff nurse perceptions of how they integrate EBP in daily patient care, (3) describe nurses'perceptions of the EBP implementation process, and (4) describe nurses'perceptions of the role of unit culture on their ability to engage in EBP. The ultimate aim of this research will be to guide the future development of targeted interventions to facilitate and optimize EBP implementation and improve the safety and quality of care. Patients admitted to the hospital are entitled to safe, effective, quality care that is based on an evidence-based decision-making process that incorporates the best evidence, patient preferences, and clinical expertise. Hospitals have yet to consistently implement EBP and therefore care is not always safe, effective, or of good quality. This study will begin to identify how the magnet culture affects the emergence and maintenance of EBP by identifying theoretically based cultural and individual interventions that will optimize EBP implementation that will improve the quality, safety, and effectiveness of care provided.
Patients admitted to the hospital are entitled to safe, effective, quality care that is based on an evidence-based decision-making process that incorporates the best evidence, patient preferences, and clinical expertise. Hospitals have yet to consistently implement EBP and therefore care is not always safe, effective, or of good quality. This study will begin to identify how the magnet culture affects the emergence and maintenance of EBP by identifying theoretically based cultural and individual interventions that will optimize EBP implementation that will improve the quality, safety, and effectiveness of care provided.
