Constructing a new approach to developing evidence-based practice with nurses and older people.
OBJECTIVE
Providing evidence-based nursing care to older people is central to the international development agenda. This paper is a report on the first 5 years (2000-2005) of a participatory research project, the purpose of which was to collaborate with practitioners and older people to develop approaches to promote the attainment of evidence-based nursing care across Scotland.


METHODS
Many theoretical influences shaped the design of this action research study including realistic evaluation, participatory social learning theory, and descriptions of communities of practice. Multiple methods of data collection were used during four action cycles. The inaugural community of practice comprised 30 nurses, a second group of 30 nurses joined midway, followed by a third group of 15 nurses, and finally, an older person-carer community of 21 members was established.


RESULTS
Project outputs included the construction of an internet-based, practice-development college. A procedural model for developing and demonstrating care guidance drawn from a diversity of evidence and reflective of an agreed set of principles was piloted and endorsed by the national standard setting agency. A preliminary version of a promising approach to practice development, "the Caledonian Model," was delineated for future testing and refinement.


CONCLUSIONS
This work indicates the merits of using participatory research to find solutions to the challenge of promoting evidence-based practice. Evaluation data suggest that in combination, the approaches developed in this project empower nurses to work with older people to champion developments even in seemingly unfavorable conditions.
Tolson
Debbie
D
Gerontological Nursing, Midwifery and Community Health, Glasgow Caledonian University, Glasgow, UK. D.tolson@gcal.ac.uk
Irene
Schofield
S
Booth
Jo
J
Kelly
Timothy B
TB
James
Louise
L
D000368:Aged; D018672:Community Health Planning / Q000379:methods*; D003256:Community Participation; D003625:Data Collection / Q000379:methods; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D005851:Geriatric Nursing / Q000379:methods*; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D017146:Models, Organizational; D016730:Program Development; D012606:Scotland