Practice makes perfect-research makes perfect practice

Nursing culture: An enemy of evidence-based practice? A focus group exploration

Evidence-based practice (EBP) is challenging for most nurses due to the time constraints of caring for patients and the emerging pressures of a changing health service. To explore these challenges, and thus to establish possible means of overcoming them, three focus groups (n = 17) with children's nurses were conducted. Participants were asked how they would define EBP, what the barriers to EBP were, what skills they needed to help access evidence and how they could integrate evidence into everyday practice. Data were analysed thematically and the anticipated themes of definitions of EBP, barriers, education and nursing culture were determined. Important subthemes were personal and employer disengagement, passivity and lack of resource utilisation. Passive use of evidence readily available in patient folders and on the wards was common. It seemed that little consideration was given to how often this evidence was updated. Nurses define their access to evidence as primarily passive in nature. This is reinforced by a lack of ready access to ongoing education and a perceived lack of investment at institutional level in their continued engagement with evidence. Promoting EBP needs to engage more with those ritual and traditional aspects of nursing culture to challenge these perceptions.