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Developing best practice in critical care nursing: knowledge, evidence and practice.

Paul Fulbrook1

  • 1Institute of Health & Community Studies, Bournemouth University, Royal London House, Bournemouth. fulbrook@bournemouth.ac.uk

Nursing in Critical Care
|July 16, 2003
PubMed
Summary

Evidence-based critical care nursing faces challenges as qualitative nursing knowledge is undervalued. A pragmatic approach is needed, valuing all evidence types equally within their context for stronger nursing practice.

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Area of Science:

  • Nursing
  • Evidence-based practice
  • Qualitative research

Background:

  • Current evidence-based critical care nursing prioritizes positivist paradigms, devaluing qualitative research and personal knowing.
  • This hierarchy creates a 'Catch 22' where nursing's practical knowledge, often 'soft science,' is deemed weak evidence.
  • Nurses utilize various forms of knowledge, some difficult to articulate, complicating evidence appraisal.

Purpose of the Study:

  • To address the disparity in evidence valuation within critical care nursing.
  • To propose a framework for integrating diverse nursing knowledge forms.
  • To advocate for a pragmatic approach to evidence appraisal in nursing.

Main Methods:

  • The paper argues for a paradigm shift in evidence evaluation.

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  • It proposes a pragmatic approach considering context-specific value of all knowledge forms.
  • It suggests practice development as a catalyst for change.

    • Main Results:

    • The current evidence hierarchy disadvantages crucial nursing knowledge.
    • A pragmatic approach can elevate the status of all nursing evidence.
    • Integrating diverse knowledge forms strengthens the evidence base for nursing practice.

    Conclusions:

    • A pragmatic approach is essential to recognize the full spectrum of nursing knowledge.
    • Valuing all evidence types contextually enhances critical care nursing practice.
    • Practice development should be the primary driver for evidence integration in nursing.