大型医院临床护士实施循证护理的认知状况

The status quo of clinical nurses＇ cognition towards the implementation of the evi-dence-based nursing at large hospitals

目的 了解护士对实施循证护理的认知状况. 主要包括护士对实施循证护理的看法;护士对实施循证护理存在的主要障碍和困难的认知;护士对循证护理基本术语的理解程度以及她们获取临床知识的主要渠道的认知. 方法 在2014年3-5月期间,采用自制的调查表对北京一大型医院的临床护士进行调查,399名应答者完成了问卷调查. 结果 有73. 4%的护士知道循证护理,然而,熟悉和比较熟悉循证护理的仅有9. 1%;73. 6%的护士认为在护理工作中有必要开展循证护理;67. 2%的护士在护理工作中有过尝试循证护理的想法,但在临床实践中尝试过循证护理的仅有7. 6%. 为一半护士所认知的实施循证护理的障碍是工作太忙,没有时间、缺乏检索和理解研究资料和报告方面的知识以及学习和培训的机会太少. 只有少数人能够理解循证护理术语并且可以解释给他人. 护士获取临床知识主要渠道是教科书、网络和学术会议. 结论 尽管临床护士对实施循证护理持积极态度,然而,循证护理认知和实施循证护理实践的水平较低,阻止循证护理实施的主要认知障碍是缺乏时间,缺乏检索和理解研究资料和报告方面的知识以及学习和培训机会少. 此外,临床护士循证护理基础知识十分欠缺. 结果提示医院管理者需要构建和采取综合性的策略措施,通过合理安排时间以及适当的教育培训来增强临床护士循证护理的认知和知识技能.

Objective The purpose of this study was to understand nurses＇ cognition towards the implementa-tion of the evidence-based nursing （ EBN） , which includes nurses＇ opinion and perceived major barriers regarding the implementation of EBN, nurses＇ understanding of technical terms used in EBN and the major sources of their acquisition for the clinical knowledge. Methods A self-designed questionnaire was used to investigate the clinical nurses at a large hospital in Beijing during the period of March 2013 to May 2013 , and a total of 399 respondents completed and returned the questionnaire. Results Among the respondents, 73. 4% were aware of EBN, whereas, only 9. 1% were familiar with it;73. 6% respondents considered it is necessary to implement EBN; 67. 2% of the nurses had a desire to try EBN, however, only 7. 6% of the nurses had ever tried it in clinical practice. Perceived barriers to implement EBN by half of the nurses were busy work, limited time, lack of knowledge related to the difficulty in searching and understand-ing research reports and data, and lack of opportunities for learning and training. Only a small fraction of nurses could understand research terms used in EBN and could explain them to others. In addition, the major sources of acquiring clinical knowledge for nurses were textbook, internet and academic conference. Conclusion Although nurses showed a positive attitude towards EBN, the perception and practical implementation of EBN remained at a very low level. The perceived barriers for implementing EBN were mainly limited time, lack of knowledge regarding searching and under-standing the research reports and data and limited opportunities for education and training. And the base knowledges on EBN for nurses were in great demand. It is, therefore, desirable that hospital managers should develop comprehensive strategy for improving EBN competencies through reasonable scheduled time and proper learning and training.