Date of Award

2020

Degree Type

Thesis

Degree Name

Doctor of Philosophy

School

Discipline of Nursing, Murdoch University & School of Nursing and Midwifery, Edith Cowan University

First Advisor

Professor Anne Williams

Second Advisor

Dr Elisabeth Jacob

Third Advisor

Professor Lisa Whitehead

Abstract

Evidence based practice (EBP) in nursing is an important part of care provision, both in Australia and globally. The experience of applying evidence in practice presents many challenges for nurses. This study focused on the application of EBP in the acute care hospital setting. Grounded Theory methodology was used and 21 semi-structured recorded interviews with Registered Nurses from two acute care hospitals were conducted. Data were analysed using the constant comparative method.

A substantive theory was developed, Traversing the EBP Conundrum, as the process used to manage the core issue: The Challenge of Applying EBP. Time Constraints, Nurses’ Inherent Traits, and The Organisation Talking the Talk but not Walking the Walk, were conditions affecting the nurses’ daily practice. These conditions resulted in a discrepancy between the ideal mandated by the nursing profession and organisations, and the reality of working in a context of Consideration for Quality and Safety. In applying the process, nurses were found to Survive the Conundrum: Navigating Alternative Pathways; by Getting Lost in the Bush: Going Their Own Way; by Scaling New Heights Working Over and Above to Optimise Outcomes.

This study raises questions regarding the quality and safety of patient care, as well as the wellbeing of nurses, and the ideal of EBP which is mandated by professional bodies. The findings lead to recommendations including: further research into the reality of EBP for nurses and its impact upon patient outcomes, safety, nurses job satisfaction and nurse retention; consideration by the professional body as to how realistic professional and organisational expectations of EBP are in nursing; and a review of decision making by leaders in relationship to EBP, therefore quality and safety.

Available for download on Tuesday, January 03, 2023

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