Implementation of Evidence-Based Practice in Nursing Using Action Research: A Review

Authors

  • Guus Munten RGN, MSc,

    1. Guus Munten, Senior Lecturer, Member of the Knowledge Centre ‘Implementation and Evaluation of Evidence Based Practice in Nursing’ of Fontys University of Applied Science Eindhoven, Tranzo, Tilburg University;Joop van den Bogaard, Research Coordinator, Tranzo, Tilburg University, Faculty of Behavioural and Social Sciences, GGZ Breburg Group;Karen Cox, Clinical Chair of the Knowledge Centre ‘Implementation and Evaluation of Evidence Based Practice in Nursing’ of Fontys University of Applied Science, Eindhoven;Henk Garretsen, Professor, Chairman of Tranzo University Tilburg, Faculty of Behavioural and Social Sciences;Inge Bongers, Manager Knowledge Development, Tranzo, Tilburg University, Faculty of Behavioural and Social Sciences, GGzE; all authors are in the Netherlands.
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  • Joop Van Den Bogaard PhD,

    1. Guus Munten, Senior Lecturer, Member of the Knowledge Centre ‘Implementation and Evaluation of Evidence Based Practice in Nursing’ of Fontys University of Applied Science Eindhoven, Tranzo, Tilburg University;Joop van den Bogaard, Research Coordinator, Tranzo, Tilburg University, Faculty of Behavioural and Social Sciences, GGZ Breburg Group;Karen Cox, Clinical Chair of the Knowledge Centre ‘Implementation and Evaluation of Evidence Based Practice in Nursing’ of Fontys University of Applied Science, Eindhoven;Henk Garretsen, Professor, Chairman of Tranzo University Tilburg, Faculty of Behavioural and Social Sciences;Inge Bongers, Manager Knowledge Development, Tranzo, Tilburg University, Faculty of Behavioural and Social Sciences, GGzE; all authors are in the Netherlands.
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  • Karen Cox PhD,

    1. Guus Munten, Senior Lecturer, Member of the Knowledge Centre ‘Implementation and Evaluation of Evidence Based Practice in Nursing’ of Fontys University of Applied Science Eindhoven, Tranzo, Tilburg University;Joop van den Bogaard, Research Coordinator, Tranzo, Tilburg University, Faculty of Behavioural and Social Sciences, GGZ Breburg Group;Karen Cox, Clinical Chair of the Knowledge Centre ‘Implementation and Evaluation of Evidence Based Practice in Nursing’ of Fontys University of Applied Science, Eindhoven;Henk Garretsen, Professor, Chairman of Tranzo University Tilburg, Faculty of Behavioural and Social Sciences;Inge Bongers, Manager Knowledge Development, Tranzo, Tilburg University, Faculty of Behavioural and Social Sciences, GGzE; all authors are in the Netherlands.
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  • Henk Garretsen PhD,

    1. Guus Munten, Senior Lecturer, Member of the Knowledge Centre ‘Implementation and Evaluation of Evidence Based Practice in Nursing’ of Fontys University of Applied Science Eindhoven, Tranzo, Tilburg University;Joop van den Bogaard, Research Coordinator, Tranzo, Tilburg University, Faculty of Behavioural and Social Sciences, GGZ Breburg Group;Karen Cox, Clinical Chair of the Knowledge Centre ‘Implementation and Evaluation of Evidence Based Practice in Nursing’ of Fontys University of Applied Science, Eindhoven;Henk Garretsen, Professor, Chairman of Tranzo University Tilburg, Faculty of Behavioural and Social Sciences;Inge Bongers, Manager Knowledge Development, Tranzo, Tilburg University, Faculty of Behavioural and Social Sciences, GGzE; all authors are in the Netherlands.
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  • Inge Bongers PhD

    1. Guus Munten, Senior Lecturer, Member of the Knowledge Centre ‘Implementation and Evaluation of Evidence Based Practice in Nursing’ of Fontys University of Applied Science Eindhoven, Tranzo, Tilburg University;Joop van den Bogaard, Research Coordinator, Tranzo, Tilburg University, Faculty of Behavioural and Social Sciences, GGZ Breburg Group;Karen Cox, Clinical Chair of the Knowledge Centre ‘Implementation and Evaluation of Evidence Based Practice in Nursing’ of Fontys University of Applied Science, Eindhoven;Henk Garretsen, Professor, Chairman of Tranzo University Tilburg, Faculty of Behavioural and Social Sciences;Inge Bongers, Manager Knowledge Development, Tranzo, Tilburg University, Faculty of Behavioural and Social Sciences, GGzE; all authors are in the Netherlands.
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  • The authors thank Shaun Cardiff and Angie Titchen, PhD, for their language support in writing the earlier version of this article and anonymous reviewers whose comments helped improve the content of this article considerably.

Address correspondence to Guus Munten, Fontys University of Applied Science, Postbus 347, 5600 AH Eindhoven, the Netherlands; a.munten@fontys.nl

ABSTRACT

Background: As is often reported in the literature exploring the research–practice gap, applying the principles of evidence-based practice is easier said than done. Action research is a methodology with an explicit intent of linking the worlds of research and practice. This review attempts to answer the question: What is known about implementing evidence-based practice in nursing through action research?

Approach: A total of 21 action research studies have been used to answer this question. To prevent possible confusion over terminology, we used a conceptual framework that distinguishes various influencing factors in terms of four target groups (ranging from the individual end user to society as a whole) at whom the strategy is aimed and various strategies (ranging from individual feedback to contracting care providers) related to the same four target groups.

Findings: Studies often failed to name the implementation strategies applied, necessitating deduction from the text by the reader. In most of the studies the implementation strategy was directed at a combination of target groups. Many of the projects reviewed reported positive contextual outcomes, “knowledge improvement” among nurses, and to a lesser degree, improved “performance.” Patient outcomes were the least reported outcome measure.

Conclusion: With an element of caution, this review concludes that the implementation of evidence-based practice using action research is a promising approach. Caution is needed because of the lack of detailed descriptions of implementation strategies, and their intensity and frequency prevents us from drawing firm conclusions. These are important considerations for any action researcher intending to implement EBP using this approach.

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