The Magnet journey: Understanding the role of unit culture in evidence-based practice adoption
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Purpose: The purpose of this exploratory study was to identify salient cognitive beliefs and cultural assumptions that affect the emergence and maintenance of evidence-based practice (EBP) in the hospital setting.
Scope: The use of EBP does not consistently occur in the nation’s hospitals and this leads to substandard patient/family outcomes. EBP is a decision-making process that integrates the use of best evidence or research, patient/family preferences, and clinical expertise. This definition parallels the IOM’s calls for transformation of the healthcare system to one that is evidence-based and patient/family centered. Understanding individual and cultural attributes that influence nurses’ behavior is vital to achieving this goal.
Methods: This exploratory study utilized a qualitative approach, consisting of in-depth interviews of 35 Registered Nurses on adult medical-surgical or critical care units in a Magnet journey or Magnet designated hospital in a large metropolitan area in the Southeastern US. Data were analyzed using the principles of analytic ethnography.
Results: The multilevel theoretical model framing this study was extended and refined based on the data resulting in the creation of a new multilevel model. Extensions to the model included the identification of two antecedent variables: hospital-level basic assumptions and unit leader characteristics. Refinements to the model included specification of the unit-level culture and individual cognitive beliefs. New relationships among all variables were identified.
Significance: The new EBP implementation and sustainability model provides a more complete description of how nurses implement and maintain EBP in the acute care setting. Further study of the hospital-level culture and unit-level nurse leader characteristics is needed to develop effective interventions to accelerate the use of EBP in the hospital staff nurses.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3541598; ProQuest document ID: 1084803440. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
| Type | Dissertation |
| Acquisition | Proxy-submission |
| Review Type | None: Degree-based Submission |
| Format | Text-based Document |
| Evidence Level | Ethnography |
| Research Approach | Pilot/Exploratory Study |
| Keywords | Evidence-Based Practice Model; Research Utilization; Leadership; Empowerment |
| Grantor | Emory University |
| Advisor | Lamp, Gerri; Hepburn, Kenneth |
| Level | PhD |
| Year | 2012 |
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