Progressing evidence-based practice: an effective nursing model?

Aims. This paper presents findings from telephone interviews completed with link nurses 2 years into the project to explore how participation progressed achievement of evidence-based practice where the link nurses worked. Background. In 2001, an innovative practice development initiative was launched in Scotland. A national network of experienced nurses from across the country was recruited to form the inaugural Community of Practice. This involved describing gerontological nursing, pioneering a nurse-sensitive methodology to craft care guidance that reflects the agreed practice model, and constructing a virtual college based on a situated learning model. Methods. A volunteer sample of link nurses took part in telephone interviews exploring experiences of using the virtual college and the extent to which the description of gerontological nursing and the first best practice statement on nutrition had influenced practice. Findings. Five components (themes) were identified as facilitating the attainment of evidence-based practice. These focussed on confidence-building and the positive benefits of achieving vision and clarity for gerontological nursing. Membership of a national Community of Practice afforded status and strengthened sense of professional identity. The inclusive knowledge synthesis methodology used to prepare, pilot and support implementation of the best practice statement was highly valued. Progress towards evidence-based practice in all affiliated areas was reported. Major challenges for nurses in participating in the virtual college included the absence of a learning-at-work culture, lack of time and doubts about the legitimacy of internet-based learning. Conclusion. The evaluation indicates the potential merits of e-practice development, particularly for nurses who feel geographically and professionally isolated or disenchanted with available continuing professional development opportunities. Participation in the virtual college appeared to enrich practice and foster a culture of change.