如何在醫院中推行實證護理實務

Strategy for Promoting Evidence-Based Nursing Practice in Hospital

實證實務為臨床決策及健康照護的趨勢，更是國內外臨床照護的核心能力及醫療教育的評鑑指標之一，研究顯示實證實務能提升照護品質與滿意度，及降低醫療照護成本，也因而成為促使實證概念融滲於學校及繼續教育重要的方針。為推廣實證實務概念，醫療院所及專業學會都積極舉辦實證相關訓練及競賽活動，但臨床實務的推動卻進行緩慢，文獻指出，缺乏推動實證實務的策略及模式是其因素之一。本文中介紹影響實證實務推行的阻礙因素及促成因素，以及如何推動的模式與策略，再以實例分享醫院推動的經驗，以提供國內推動實證護理實務的參考。

Evidence-based practice has been demonstrated to improve quality of care, increase patients’ satisfaction, and reduce the costs of medical care. Therefore, evidence-based practice is now central to the clinical decision-making process and to achieving better quality of care. Today, it is one of the important indicators of core competences for healthcare providers and accreditation for healthcare and educational systems. Further, evidence-based practice encourages in-school and continuous education programs to integrate evidence-based elements and concepts into curricula. Healthcare facilities and professional organizations proactively host campaigns and encourage healthcare providers to participate in evidence-based related training courses. However, the clinical evidence-based practice progress is slow. The general lack of a model for organizational follow-up may be a key factor associated with the slow adoption phenomenon. The authors provide a brief introduction to the evidence-based practice model, then described how it may be successfully translated through a staged process into the evidence-based practices of organizational cultures. This article may be used as a reference by healthcare facilities to promote evidence-based nursing practice.