Developing evidence-based practice: experiences of senior and junior clinical nurses

Aim: To compare factors influencing the development of evidence-based practice identified by junior and senior nurses. Background: Assessing factors influencing the achievement of evidence-based practice is complex. Consideration needs to be given to a range of factors including different types of evidence, the skills nurses require to achieve evidence-based practice together with barriers and facilitators. To date, little is known about the relative skills of junior and senior clinical nurses in relation to evidence-based practice. Method: A cross sectional survey was undertaken at two hospitals in England, using the Developing Evidence-Based Practice questionnaire administered to qualified nurses (n=1411). A useable sample of 598 (response rate 42%) was achieved. Data were collected during 2003 and analysed collectively with comparisons undertaken between junior nurses and senior nurses. Findings: Nurses relied heavily on personal experience and communication with colleagues rather than formal sources of knowledge. All nurses demonstrated confidence in accessing and using evidence for practice. Senior nurses were more confident in accessing all sources evidence including published sources and the internet, and felt able to initiate change. Junior nurses perceived more barriers to implementing change, and were less confident in accessing organizational evidence. Junior nurses saw lack of time and resources as significant barriers, whereas senior nurses felt empowered to overcome these constraints. Conclusion: Senior nurses are developing skills in evidence-based practice. However, the nursing culture seems to disempower junior nurses so that they are unable to develop autonomy in implementing evidence-based practice.