12 New Era of Evidence-Based Nursing Hatlevik, 2012; Titler, 2004 neomodern nursing philosophy 2010 Whall Sinclair Parahoo 2006 adequate infrastructur

Size: px

Start display at page:

Download "12 New Era of Evidence-Based Nursing Hatlevik, 2012; Titler, 2004 neomodern nursing philosophy 2010 Whall Sinclair Parahoo 2006 adequate infrastructur"

副别
5 years ago
Views:

1 11 實證護理的新時代全面啟動發展護理科學蔣立琦 1 林佳慧 2 王桂芸 3* 1 國防醫學院護理學系教授暨中國醫藥大學護理學系兼任教授 2 三軍總醫院附設基隆民眾診療服務處護理科主任暨國防醫學院醫學科學研究所博士候選人 3 臺北榮民總醫院護理部主任暨國防醫學院護理學系合聘教授摘要 : 科學的演化是必然發生的過程, 科學哲學家孔恩指出, 當科學處在革命階段, 代表該學門即將產生典範轉移並邁向另一新的里程以人為中心的跨專業團隊健康照護之普世價值下, 實證健康照護促使近代護理科學的發展面臨必要的典範轉移, 此意味著實證護理時代的來臨, 將全面啟動發展護理科學本文透過文獻的整合, 介紹實證護理知識的建構檢視國際重要的實證護理推動模式再提出具體推動實證護理的策略, 期望藉由本文能達到拋磚引玉之效, 提升臨床實證護理的應用, 及啟動護理科學在教育研究服務之全面性發展關鍵詞 : 實證護理護理科學護理 Balas Boren World Health Organization, WHO 2005 knowledge translation synthesis exchange application person-centered care Bayne, Neukrug, Hays, & Britton, in press 2013 nursing scientist * kywang@vghtpe.gov.tw doi: /jn

2 12 New Era of Evidence-Based Nursing Hatlevik, 2012; Titler, 2004 neomodern nursing philosophy 2010 Whall Sinclair Parahoo 2006 adequate infrastructure Whall et al., 2006 problemsolving approach; Fineout-Overholt, Melnyk, & Schultz, 2005evidence-based nursing, EBN Fineout-Overholt et al., 2005 Oxford Center for Evidence Based Medicine, CEBM CEBM, 2013 Mulrow 1994 power bias systemic error Titler, 2004 Iowa model of evidence-based practiceadvancing research and clinical practice through close collaboration model, ARCC model Academic Center for Evidence-Based Practice star model, ACE star model Iowa model Titler et al., 2001 ARCC model

3 13 Iowa model ARCC model ACE star model primary research systematic review metaanalysis meta-synthesis Cochrane Handbook package clinical practice guideline, CPGs CPGs CPGs CPGs ARCC = advancing research and clinical practice through close collaboration ACE = Academic Center for Evidence-Based Practice

4 14 New Era of Evidence-Based Nursing EBP champion role definitionuse of resources creating a culture that fosters EBP practical strategies for implementing EBP; Fineout-Overholt, Levin, & Melnyk, 2004; Fineout-Overholt et al., 2005 ACE star model 2012 Academic Center for Evidence-Based Practice, ACE discovery research evidence summary translation to guidelines practice integrationprocess, outcome evaluation; Stevens, 2004 collection interpretation integration valid important applicable empowerment Olade, 2004 Cummings, Estabrooks, Midodzi, Wallin, & Hayduk, 2007; Fink, Thompson, & Bonnes, 2005; Olade, 2004 Taylor & Allen, 2007 Olade, 2004 Fineout-Overholt et al., 2005; Olade, 2004 Taylor & Allen, 2007 Cummings et al., 2007

5 15 mentorship Fineout- Overholt et al., 2005 Cummings et al., 2007 Fink et al., 2005 Olade 2004 Fineout-Overholt et al., 2005 Taylor & Allen, 2007 Titler, 2004 Olade 2004 Salmond, 2007 Titler, [Lin, C. H., Chen, Y. J., & Chiang, L. C. (2013). Trans-disciplinary EBP model to increase health quality and safety. VGH Nursing, 30(2), ] doi: /jn [Hung, H. M., Wang, H. L., Chang, Y. H., & Chen, C. H. (2010). Nursing knowledge:

6 16 New Era of Evidence-Based Nursing The evolution of scientific philosophies and paradigm trends. The Journal of Nursing, 57(1), ] Balas, E. A., & Boren, S. A. (2000). Managing clinical knowledge for healthcare improvements. In V. Schattauer (Ed.), Yearbook for medical informatics (pp ). New York, NY: Stuttgart. Bayne, H., Neukrug, E., Hays, D., & Britton, B. (in press). A comprehensive model for optimizing empathy in person-centered care. Patient Education and Counseling. doi: /j.pec Centre for Evidence Based Medicine. (July 1, 2013). Oxford centre for evidence-based medicine- Levels of evidence. Retrieved from Cummings, G. G., Estabrooks, C. A., Midodzi, W. K., Wallin, L., & Hayduk, L. (2007). Influence of organizational characteristics and context on research utilization. Nursing Research, 56(4, Suppl.), S24 S39. doi: /01. nnr Fineout-Overholt, E., Levin, R. F., & Melnyk, B. M. (2004). Strategies for advancing evidence-based practice in clinical settings. The Journal of the New York State Nurses Association, 35(2), Fineout-Overholt, E., Melnyk, B. M., & Schultz, A. (2005). Transforming health care from the inside out: Advancing evidence-based practice in the 21st century. Journal of Professional Nursing, 21(6), doi: / j.profnurs Fink, R., Thompson, C. J., & Bonnes, D. (2005). Overcoming barriers and promoting the use of research in practice. The Journal of Nursing Administration, 35(3), doi: / Hatlevik, I. K. R. (2012). The theory-practice relationship: Reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education. Journal of Advanced Nursing, 68(4), doi: /j x Mulrow, C. D. (1994). Systematic reviews: Rationale for systematic reviews. British Medical Journal, 309(6954), doi: /bmj Olade, R. A. (2004). Strategic collaborative model for evidence-based nursing practice. Worldviews on Evidence Based Nursing, 1(1), doi: / j x Salmond, S. W. (2007). Advancing evidence-based practice: A primer. Orthopaedic Nursing, 26(2), doi: /01.nor a Stevens, K. R. (2004). ACE star model of EBP: Knowledge transformation. Academic center for evidence-based practice. Retrieved from Taylor, S., & Allen, D. (2007). Visions of evidence-based nursing practice. Nurse Researcher, 15(1), doi: /nr c6057 Titler, M. G. (2004). Methods in translation science. Worldviews on Evidence Based Nursing, 1(1), doi: / j x Titler, M. G., Kleiber, C., Steelman, V. J., Rakel, B. A., Budreau, G., Everett, L. Q.,... Goode, C. J. (2001). The Iowa model of evidence-based practice to promote quality care. Critical Care Nursing Clinics of North America, 13(4), Whall, A. L., Sinclair, M., & Parahoo, K. (2006). A philosophic analysis of evidence-based nursing: Recurrent themes, metanarratives, and exemplar cases. Nursing Outlook, 54(1), doi: /j.outlook World Health Organization. (2005). Bridging the Know Do gap: Meeting on knowledge translation in global health. Retrieved from g%20report,%20oct 05.pdf

7 17 The New Era of Evidence-Based Nursing: Comprehensive Mobilization and Development of the Nursing Sciences Li-Chi Chiang 1 Chia-Huei Lin 2 Kwua-Yun Wang 3 * 1 PhD, RN, Professor, School of Nursing, National Defense Medical Center and Adjunct Professor, School of Nursing, China Medical University; 2 MSN, RN, Director, Department of Nursing, Tri-Service General Hospital, Keelung Civilian Administration Division and Doctoral Candidate, Graduate Institute of Medical Science, National Defense Medical Center; 3 PhD, RN, Director, Department of Nursing, Taipei Veterans General Hospital and Professor, School of Nursing, National Defense Medical Center. Abstract: Science is subject to inevitable evolutionary change. Philosopher of science Thomas Kuhn defined a scientific revolution as a period in time during which a particular field of scientific knowledge is set to transition to a new paradigm that will propel it toward a new milestone. Because person-centered care embraces the universal values of trans-disciplinary healthcare teams, evidence-based healthcare represents a paradigm shift toward evidence-based nursing. The rapid development of evidence-based practice is an evolutionary process of revolutionary importance to science. The resulting era of evidencebased nursing will help fully realize the development potential of the nursing sciences. This article introduces the process of knowledge construction in evidence-based nursing, reviews the literature to identify the general model used to promote evidence-based nursing internationally, and proposes practical strategies to promote evidence-based nursing in Taiwan. We hope this article will help further promote the clinical application of evidence-based nursing and the development of nursing science. Key Words: evidence-based nursing, nursing sciences, nursing. Accepted for publication: August 26, 2013 *Address correspondence to: Kwua-Yun Wang, No. 201, Shipai Rd. Sec. 2, Beitou District, Taipei City 11217, Taiwan, ROC. Tel: +886 (2) ext ; kywang@vghtpe.gov.tw

7_6論文.indd

7_6論文.indd 一黃春滿董道興 * 師慧娟 ** 中文摘要本篇個案報告是探討一術後病的, 期間為 94 年 4 月 28 日至 5 月 13 日筆藉由 Gordon 十一項健康功能評估為工具, 運用身體評估觀察及會談的方式收集資料, 在期間發現個案出現體溫過高焦慮疼痛