Contextual Factors Affecting Evidence-Based Practice in Orthopaedic Nursing and Rehabilitation: A Mixed Methods...

Area of Science:

• Healthcare Management
• Nursing Research
• Orthopaedic Surgery

Background:

• Evidence-based practice (EBP) is crucial for quality healthcare.
• Understanding contextual factors is key to successful EBP implementation.
• Orthopaedic care presents unique challenges for EBP.

Purpose of the Study:

• To investigate factors enabling evidence-based practice (EBP) in general.
• To examine EBP in relation to bladder-monitoring guideline implementation in orthopaedics.
• To identify barriers and facilitators for EBP in orthopaedic care.

Main Methods:

• Convergent parallel mixed-method design.
• Data collected via interviews, patient surveys, and staff surveys across 17 Swedish orthopaedic sites (2021-2023).
• Analysis involved deductive content analysis, descriptive statistics, and mixed-methods integration.

Main Results:

• Staff collaboration, multiprofessional engagement, positive attitudes, leadership, and adequate staffing supported EBP.
• Orthopaedic fast-track procedures limited patient involvement, positioning them as passive recipients.
• Shortage in evaluation and high staff turnover hindered EBP implementation.

Conclusions:

• Orthopaedic care has enabling factors for EBP, but patient-centredness and mutual information exchange require more focus.
• Audit and feedback mechanisms were lacking, hindering improvements.
• Slimmed care processes necessitate attention to patient participation in EBP.