Evidence-based practice integration in hospital wards-The complexities and challenges in achieving evidence-based...

Exploring the processes involved in two different strategies to integrate evidence-based practice into nursing practice.

Classical grounded theory methodology was used.

Data were collected through 90 hr of observation and 4 focus groups among clinical nurses in two different hospital wards.

We identified a multidimensional evidence-based practice integration framework that illuminates the complexities involved in the integration process. The dimensions were approaches to evidence-based practice, positions of evidence-based practice and levels of evidence-based practice. The interactions between the dimensions gave five combinations; an explicit evidence-based practice performed as a parallel to daily work at the systems level, an implicit evidence-based practice integrated into daily work at the systems level, an explicit evidence-based practice integrated into daily work at the individual level, an explicit evidence-based practice integrated into daily work at the systems level and an implicit evidence-based practice integrated into daily work at the individual level.