Evidence-informed practice: from individual to context.
OBJECTIVE
This commentary considers the shift in evidence-informed practice away from the individual practitioner to an acknowledgement that context is also important.


BACKGROUND
The view of practitioner as 'rational agent' capable of searching, appraising and translating research evidence into individual practice has dominated the literature. However, a growing body of research leads us to question whether evidence use is indeed an individual activity.


RESULTS
Key research studies were purposively selected to build the case for the arguments made.


RESULTS
Apart from attitude, there is little to indicate that any potential individual determinants influence research use. Views of what constitutes evidence for evidence-based practice have become more inclusive and sophisticated. Evidence tends to be contextually bound and individually interpreted and particularized within that context. As such, evidence use is beginning to be recognized more widely as a contingent process, which varies across setting and time. A number of contextual factors have been found to be potentially influential including culture and leadership. CONCLUSION(S) AND IMPLICATIONS FOR NURSING MANAGEMENT: It cannot be assumed that evidence-based resources such as clinical guidelines will be accepted at face value by practitioners. Developing the skills of individuals to critically appraise research will not automatically lead to greater evidence use. Reviewing organizations' capacity for evidence-informed practice as a system property and cultural factor may lead to insights about the barriers and facilitators to evidence use. Investing in the capability of key individuals at multiple levels of the organization as leaders of evidence-based practice activities may be one promising organizational strategy.
Rycroft-Malone
Jo
J
Health Services Research, Centre for Health-Related Research, School of Healthcare Sciences, College of Health & Behavioural Sciences, University of Wales, Bangor, UK. j.rycroft-malone@bangor.ac.uk
D015400:Clinical Nursing Research; D019317:Evidence-Based Medicine; D006801:Humans; D009718:Nurse Administrators; D024802:Nurse's Role; D009726:Nurses