Utilising the PARIHS Framework to Assess and Enhance the Implementation of Evidence-Based Nursing Practice in Intensive Care Units-A Mixed Method Study.

INTRODUCTION

Evidence-based practice (EBP) plays an indispensable role in ensuring the safety and quality of nursing interventions, especially in labor-intensive and technology-dependent clinical environments such as intensive care units (ICUs). However, implementing EBP continues to be challenging due to perennial structural, organisational, and workforce issues. Concepts of implementation science can provide a framework with which to assess and facilitate the integration of factors that drive EBP implementation within ICUs.

AIM: To assess the level of EBP implementation within ICUs and examine the barriers and facilitators that drive EBP implementation using the PARIHS framework.

METHODS

A concurrent mixed method design was utilised. The study was performed in the ICUs of two tertiary hospitals and involved nurses who completed survey questionnaires and participated in focus group discussions and semi-structured interviews. Ethics approval was obtained from relevant research ethics committees.

RESULTS

EBP implementation was low. EBP skills and training need significantly predicted levels of EBP implementation. Factors comprising context and facilitation affected nurses' experiences of implementing EBP, grouped into three themes of Identity, Power Ownership, and Dynamism. Meta-inferences showed that evidence, context, and facilitation can be characterised as a continuum, providing a three-dimensional perspective of implementing EBP.

CONCLUSION

The PARIHS framework has provided an alternative perspective with which to approach EBP implementation, foregrounding the role of context and facilitation in promoting the uptake of evidence into clinical practice.

PATIENT AND PUBLIC INVOLVEMENT: Critical care nurses have contributed to the development of the research design and data collection plan.