Implementing evidence-based nursing practice: a tale of two intrapartum nursing units

Area of Science:

• Nursing
• Sociology of Health
• Healthcare Management

Background:

• Evidence-based practice (EBP) adoption in nursing is debated, with concerns about it becoming performative.
• Scientific knowledge is not the sole driver of practice in dynamic healthcare settings.
• Contextual factors are as crucial as individual practitioners in implementing healthcare innovations.

Purpose of the Study:

• To explore the influence of socio-cultural contexts on the implementation of evidence-based intrapartum nursing practices.
• To analyze the complexities encountered during the adoption of EBP innovations in nursing.

Main Methods:

• Focused ethnography conducted following a trial on a marketing strategy for EBP adoption.
• Utilized Bourdieu's concepts of habitus, capital, and social field for analysis.
• Examined nursing leadership, interprofessional dynamics, community characteristics, and physical environment.

Main Results:

• Nursing leadership, interprofessional struggles with physicians, community characteristics, and the physical environment were key issues.
• Socio-historical context and site-specific experiences highlighted implementation complexities.
• Contextual factors significantly impacted the outcomes of evidence-based practice implementation.

Conclusions:

• Healthcare innovation implementation is deeply influenced by social and contextual factors.
• Understanding the socio-cultural field is essential for successful EBP adoption in nursing.
• Effective implementation requires addressing systemic and environmental influences beyond individual practitioner knowledge.