Evidence-based practice
Why do we need supporting structures for evidence-based practice?
The need for evidence-based practice (EBP) is emphasized in health care, but many barriers relating to EBP are identified. Among them are limited resources in health care and health professionals’ skills for searching evidence (e.g. Shafaghat et al. 2021). In addition, there exists a misunderstanding concerning the process of utilizing evidence. Nurses may think, as was previously taught in evidence-based courses, that it is their duty to define the clinical problem and search for the research literature by themselves, appraise its methodological quality, interpret the results and make conclusions before applying the evidence into practice. These kinds of expectations are not realistic and they hold up the barriers to EBP due to an ever-increasing workload and simultaneous shortage of staff. Instead, nurses need to know where to find reliable synthesized evidence and how to implement it into practice. (e.g. Warren et al. 2016).
Two models, the Action Model of Expertise (FinAME™) and Model for Developing Evidence-Based Practices (OMEBP), were developed to support evidence implementation and EBP in nursing.
References:
Shafaghat T, Nasab MHI, Bahrami MA, Kavosi Z, Montazer MRA, Zarchi MKR, Bastani P. 2021. A mapping of facilitators and barriers to evidence-based management in health systems: a scoping review study. Systematic Reviews 10:24.
Warren JI, Lothschuetz Montgomery K, Friedmann E. 2016. Three-year pre-post analysis of EBP integration in a Magnet-Designated community hospital. Worldviews on Evidence-Based Nursing 13:1, 50-58.
The titles, roles and tasks of different type of nursing experts in healthcare are inconsistent both nationally (Finland) and globally. The inconsistency creates barriers to utilization of their expertise in evidence-based healthcare (EBHC). FinAME – the Action Model of Expertise™ describes the roles and activities of different nursing experts in promoting evidence-based nursing.
The FinAME-model has been developed since 2008. Previously, the model (known as AME-model) described the role of different types of clinical nurses in evidence-based nursing. In the FinAME-model, their roles have been updated, and the roles of nursing managers, nursing information management specialists, nurse educators and researchers in evidence-based nursing have also been described. The updated FinAME-model has been developed using the JBI Evidence-Based Healthcare (EBHC) -model (Jordan et al. 2019) as a guiding framework.
The first draft of the model (formerly known as AME) was developed in Oulu University Hospital in Finland. The FinAME was further developed in a Steering Group for Development of Nursing Care set up by the Ministry of Social Affairs and Health (Finland) and published in the Action Plan ‘Increasing the effectiveness and attraction of nursing care by means of management’ by the Ministry of Social Affairs and Health (2009). In recent years, the Nursing Research Foundation (NRF) has further developed AME which is nowadays known as FinAME™.
In cooperation with the University of Oulu and an expert group coordinated by the Finnish Nurses Association (Suomen Sairaanhoitajat ry) the model has been expanded to describe also the core competencies of nursing educators, managers and clinical researchers in EBHC based on the JBI model of EBHC (including global health, evidence generation, evidence synthesis, evidence transfer, evidence implementation; publication of the updated model in process).
