Implementing Evidence-Based Practice in Critical Care Nursing: An Ethnographic Case Study of Knowledge Use

Area of Science:

• Nursing Research
• Critical Care Medicine
• Evidence-Based Practice

Background:

• Critical care nursing involves complex knowledge application under pressure.
• Understanding how nurses access and use knowledge is crucial for improving practice.

Purpose of the Study:

• To explore how critical care nurses access, negotiate, and apply knowledge.
• To identify organizational, cultural, and leadership factors influencing evidence-based practice (EBP) implementation.

Main Methods:

• Focused ethnographic collective case study in two English critical care units.
• Data collection via non-participant observation, semi-structured interviews, and document review.
• Analysis guided by Spradley's Developmental Research Sequence over eight months.

Main Results:

• Key themes: knowledge sources, institutional influences, experiential knowledge, EBP challenges, and integration strategies.
• Enablers of EBP included leadership, mentorship, and digital resources.
• Barriers comprised workload, inconsistent guidelines, and hierarchical cultures.

Conclusions:

• Knowledge use in critical care is a dynamic, relational process.
• Visible leadership, peer learning, and valuing experiential knowledge are vital for EBP.
• Strengthening systems and nurse development are key to enhancing evidence-based critical care.