Evidence‐based practice – an incomplete model of the relationship between theory and professional work

Journal of Evaluation in Clinical Practice - Tập 10 Số 2 - Trang 187-196 - 2004
Helen Hancock1, Patrick Easen2
1School of Health, Community and Education Studies, Northumbria University, Newcastle-upon-Tyne, UK
2Associate Dean, School of Health Community and Education Studies, Northumbria University, Newcastle-upon-Tyne, UK

Tóm tắt

AbstractRationale, aims and objectives  Current day realities of diminishing resources, reductions in spending and organizational change within health care systems have resulted in an increased emphasis on a multidisciplinary team approach to quality patient care. The movement of nursing towards more autonomous practice combined with the current trend towards ‘evidence‐based practice’ in health care demands increased accountability in clinical decision making. This paper focuses on one aspect of nurses’ clinical decision making within the demands of evidence‐based practice and cardiac surgery. In this field recent advances, combined with increasing demands on health care institutions, have promoted early extubation of post‐operative cardiac patients. While this remains a medical role in many institutions, an increasing number of intensive care units now consider it as a nursing role.Method  This paper explores the realities of nurses’ clinical decision making through a discussion of current practice in the extubation of patients following cardiac surgery. In addition, it considers the implications of current practice for both nurse education and the continued development of clinical nursing practice.Conclusion  The findings indicate that evidence‐based practice appears to be an incomplete model of the relationship between theory and professional work.

Từ khóa


Tài liệu tham khảo

Argyris C., 1978, Theory in Practice: Increasing Professional Effectiveness

10.1111/j.1547-5069.1989.tb00100.x

10.1097/00000446-198412000-00027

10.2307/3470396

Blickensderfer I., 1996, Nurses and physicians: creating a collaborative environment, Journal of Intravenous Nursing, 19, 127

10.1111/j.1365-2648.1977.tb03313.x

10.1097/00006216-198500930-00012

10.1016/0266-612X(91)90047-U

10.1046/j.1365-2648.1997.1997025229.x

Del Bueno D.J., 1986, Organisational culture: how important is it?, Journal of Nursing Administration, 16, 15

Burnard P., 1988, Professional and Ethical Issues in Nursing

10.1518/001872096779048066

10.1046/j.1365-2648.1997.1997025386.x

Carslile D., 1992, Scope for extensions, Nursing Times, 88, 26

Cerveo R.M., 1985, Continuing professional education and behavioural change: a model for research and evaluation, Journal of Continuing Education in Nursing, 16, 85, 10.3928/0022-0124-19850501-05

Chapman R., 1992, Post‐registration education on three fields of clinical practice, Nursing Times, 88, 53

10.1016/S1053-0770(05)80105-3

10.1016/S0022-5223(96)70062-4

Cheng D., 1996, Early extubation after CABG surgery reduces costs and improves resource use, Journal of Thoracic and Cardiovascular Anaesthesia, 9, 460

10.1046/j.1365-2648.1993.18071033.x

10.1016/S0964-3397(97)80152-8

Dowie J., 1988, Professional Judgement: Introductory Texts 1–4, 111

10.1136/bmj.306.6892.1593

Dreyfus H., 1979, What Computers Can’t Do: the Limits of Artificial Intelligence

Dreyfus H., 1986, Mind Over Machine: The Power of Human Intuition and Expertise in the Era of the Computer.

10.1046/j.1365-2648.1996.02413.x

10.1097/00003465-199607000-00002

Eisner E., 1993, Educational Research – Current Issues, 49

Eraut M., 1994, Developing Professional Knowledge and Competence

Furnham A., 1997, The Psychology of Behaviour At Work

10.1097/00006199-197603000-00007

Guenther C.R., 1995, Early extubation after cardiac surgery does not decrease intensive care unit stay and cost, Journal of Thoracic and Cardiovascular Surgery, 9, 465

Hammond P., 1964, In use of a decision tree to improve accuracy of diagnosis, Nursing Research, 28, 182

10.1111/j.1365-2648.1991.tb03429.x

10.1097/00002727-199511000-00006

Hickey R.F., 1995, Timing of tracheal extubation in adult cardiac surgical patients, Journal of Cardiovascular Surgery, 10, 340

10.1046/j.1365-2648.1993.18091461.x

Itano J.K., 1989, A comparison of the clinical judgement process in experienced registered nurses and student nurses, Journal of Nursing Education, 28, 120, 10.3928/0148-4834-19890301-07

Jesurum J.T., 1996, Fast track recovery after aortocoronary bypass surgery: early extubation and intensive care unit transfer, Seminars in Perioperative Nursing, 5, 12

Joseph S.H., 1988, Actual decision‐making factors that determine practices in clinical settings, Canadian Journal of Nursing Research, 20, 19

10.1016/0001-6918(88)90042-X

Karski J.M., 1995, Practical aspects of early extubation in cardiac surgery, Journal of Cardiothoracic and Vascular Anaesthesia, 9, 30

10.1097/00003465-199607000-00004

Kim H.S., 1983, Advances in Nursing Theory Development, 271

Lippincott R.C., 1979, Psychological stress factors in decision‐making, Heart and Lung, 8, 1093

Lynes‐Hayes P., 1987, Nursing caste: who keeps you there?, Senior Nurse, 7, 23

10.1016/S0147-9563(96)80014-8

Moloney M., 1986, Professionalism of Nursing

Moore W., 1970, The Professions.

10.1111/j.1365-2648.1995.tb02740.x

Orme L., 1992, Continuing Professional Education in the Context of Health Care: A Report for the English National Board for Nursing, Midwifery and Health Visiting Project.

10.1016/0260-6917(93)90052-4

10.12968/bjon.1993.2.14.730

Papadakos P.J., 1995, Physician and nurse considerations for receiving a fast track patient into the ICU, Journal of Cardiothoracic and Vascular Anaesthesia, 9, 21

Polanyi M., 1958, Personal Knowledge

Robinson J.A., 1990, Coping with ICU work related stressors: a study, Critical Care Nurse, 10, 80, 10.4037/ccn1990.10.5.80

Salvage J., 1992, Policy Issues in Nursing, 9

Schein E.H., 1985, Organisational Culture and Leadership.

10.1016/1053-0770(93)90204-X

10.1378/chest.113.6.1481

10.1016/1053-0770(92)90020-8

10.1006/obhd.1996.0026

10.1046/j.1365-2648.1997.1997025186.x

Tanner C., 1983, Review of Research in Nursing Education, 2

10.1016/S0964-3397(98)80085-2

10.1006/obhd.1996.0025

Turner P., 1991, Benefits and certificates of continuing education: an analytical survey, Journal of Continuing Education in Nursing, 22, 104, 10.3928/0022-0124-19910501-07

Walshe K., 1997, Who's Acting on Evidence?, Health Service Journal, 107, 22

10.1016/0020-7489(92)90033-D

Williams S., 1991, Evaluating a continuing education programme, Australian Journal of Advanced Nursing, 9, 21

Wolf Z.R., 1988, Nurse's work. The Sacred and the Profane

Thông tin
Thông tin xuất bản

Journal of Evaluation in Clinical Practice

Tập 10 Số 2

187-196

Thông tin tác giả