Flooded with evidence: using a 'spillway' model to improve research implementation in nursing practice

Abstract

Objective: To identify barriers to implementing evidence-based practice initiatives in small to medium sub-acute facilities in Queensland.

Design: The study uses a qualitative methodology in which field observations and convergent interviews were employed to generate data.

Setting: Four south-east Queensland sub-acute care facilities participated in the study. Observational and interview data were collected.

Subjects: Field observations were recorded across the sites. Five research fellows collected observational data on evidencebased practice implementation across a period of six months. Nine clinicians participated in in-depth, convergent interviews at the end of the period of observation.

Main outcome measures: The authors analysed observational and interview data using qualitative thematic analysis.

Results: Three themes emerged which described the needs of clinicians when evidence-based practice initiatives were being implemented: (1) valuing evidence; (2) risk prioritisation; and (3) controlling the flow of evidence. A ‘Spillway Model’ is proposed as a mechanism for targeting clinical priorities using integrated risk management.

Conclusion: This study supports the use of integrated risk management as part of a Spillway Model to guide the introduction of evidence-based practice initiatives in the clinical setting.