Iranian nurses perceptions of evidence-based practice: A qualitative study

During the past two decades, evidence based practice has been increasingly proved as a higher level of standard and quality of health care. Nurses who base their practices on scientific evidences bring their clients and organizations to a better and more cost-effective level of care. However, little is known about Iranian nurse's perception of evidence based practice so the present study was conducted to evaluate their understandings and experiences on evidence based practice. A qualitative study was carried out on 21 participants from different groups of nurses including 9 practicing nurses, 6 head nurses, 3 metrons and supervisor nurses, and 3 nursing school teachers at Kashan University of Medical Sciences. Semi-structured interviews and participant observation methods were used for data gathering. Content analysis was used to analyze the data according to the Cheevakumjorn's method. Two main categories of "nature of evidence" and "the concept of evidence based nursing" emerged from the data. The participants used the term standard care as synonymous with evidence based practice. According to them, evidence based practice cares the clients based on the nurses professional knowledge as well as the patient's needs. The data related to the nature of evidence were categorized in five groups of "knowledge of patient", "environmental knowledge", learned knowledge", "practical knowledge", and "research based knowledge". However they mentioned that at present the nursing practice is not based on scientific evidences. Our nursing care is not based on evidence based practice and the research has little application in our current nursing practice. Evidence based nursing practice requires the access and appraisal of research evidences and their integration with clinical expertise and patient's values. Therefore, it is the responsibility of the managers and educators to identify the barriers and facilitate the process of evidence based practice and its application for the nursing staff.