Interpreting research to inform practice : the hierarchy of evidence framework

Ball, E; Regan, P

Abstract

Background: This paper examines the hierarchy of evidence (HoE) framework and evidence-based practice (EBP) for clinical practice and nurse education. Student evaluations of a post-qualifying EBP module identified consistent tension in interpreting research papers which did not appear to “fit” into their experience of nursing practice. Community nurses identified a lack of evidence informing their practice.
Design: A mixed methods study facilitated a comparative analysis of HoE framework and a complimentary Familial model developed to improve student understanding. Data collection methods included a focus group of module members (n=5), a sample of n=314 respondents.
Findings: Identified the HoE framework fails to help nurses interpret high and low evidence, thereby reducing the potential to implement evidence into clinical practice, but it was not clear why. The ‘Familial model’ appeared to enable a better understanding and relevance of evidence to inform clinical action. This is a unifying principle for EBP, yet one not found within a HoE framework.
Conclusion: The art of nursing does not merely respond to published literature, but patient interaction and clinical implementation for community nursing requires a broader interpretation of EBP for nursing action.



Keywords: Evidence-based practice, hierarchy of evidence, Familial model

• Journal Article Type: Article
• Acceptance Date: Dec 13, 2018
• Online Publication Date: Jan 22, 2019
• Publication Date: Jan 22, 2019
• Deposit Date: Dec 17, 2018
• Publicly Available Date: Jul 22, 2019
• Journal: Journal of Health Visiting
• Print ISSN: 2050-8719
• Electronic ISSN: 2052-2908
• Publisher: MA Healthcare
• Volume: 7
• Issue: 1
• Pages: 32-38
• DOI: https://doi.org/10.12968/johv.2019.7.1.32
• Publisher URL: https://doi.org/10.12968/johv.2019.7.1.32
• Related Public URLs: http://www.journalofhealthvisiting.com/