School Nurse's Implementation of Evidence-based Practice: A Mixed Method Study

School Nurse's Implementation of Evidence-based Practice: A Mixed Method Study

Author: 
Michelle Baxley
Program of study: 
Ph.D./NUR
Abstract: 
Evidence-based practice (EBP) ensures excellent nursing care; however, limited literature exists for implementing EBP within schools. This mixed method study, using the Promoting Action on Research Implementation in Health Services (PARIHS) framework, explained EBP implementation within three school districts. Quantitative results identified the level of implementation and nursing characteristics predictive of EBP implementation. The mean EBP Implementation score (n = 64) was 8.36 (SD 9.75), indicating a low level of EBP implementation. EBP Belief scores was the only nursing characteristic that explained 34% of the variance. Qualitative results explained survey results, using a multiple case study design with interviews with six school nurses with high or low EBP Implementation scores. Analysis included pattern matching to propositional statements derived from PARIHS evidence, context, and facilitation concepts. Individual case stories varied and demonstrated both positive and negative patterns. Data synthesis examining propositions and themes indicated all cases supported four evidence propositions. No cases supported the evidence proposition about collecting and using routine student data. Three cases (n =3) with high EBP Implementation scores supported six evidence and context propositions. Three cases (n = 3) with low EBP Implementation scores supported thirteen propositions for the evidence, contest, and facilitation concepts. Common themes across cases were using evidence, cultural influences, structural supports, and impeding implementation. When integrating findings only three EBP Implementation scale items indicated routine implementation of evidence, which matched with evidence propositions supported across cases and the theme using evidence. Context and facilitation propositions and themes primarily explained low EBP Implementation items.