Irish psychiatric nurses' self-reported sources of knowledge for practice.

Evidence-based practice (EBP) is an approach to health care in which health professionals use the best evidence available to guide their clinical decisions and practice. Evidence is drawn from a range of sources, including published research, educational content and practical experience. This paper reports the findings of a study that investigated the sources of knowledge or evidence for practice used by psychiatric nurses in Ireland. The paper is part of a larger study, which also investigated barriers, facilitators and level of skills in achieving EBP among Irish psychiatric nurses. Data were collected in a postal survey of a random sample of Irish psychiatric nurses using the Development of Evidence-Based Practice Questionnaire. The findings revealed that the majority of survey respondents based their practice on information which was derived from interactions with patients, from their personal experience and from information shared by colleagues and members of the multidisciplinary team, in preference to published sources of empirically derived evidence. These findings are consistent with those of the previous similar studies among general nurses and suggest that Irish psychiatric nurses face similar challenges to their general nursing counterparts in attaining of EBP.

Irish psychiatric nurses' self-reported barriers, facilitators and skills for developing evidence-based practice.

Evidence-based practice places an emphasis on integration of clinical expertise with available best evidence, patient's clinical information and preferences, and with local health resources. This paper reports the findings of a study that investigated the barriers, facilitators and skills in developing evidence-based practice among psychiatric nurses in Ireland. A postal survey was conducted among a random sample of Irish psychiatric nurses and survey data were collected using the Development of Evidence-Based Practice Questionnaire. Respondents reported that insufficient time to find and read research reports and insufficient resources to change practice were the greatest barriers to the development of evidence-based practice. Practice development coordinators were perceived as the most supportive resource for changing practice. Using the Internet to search for information was the highest-rated skill and using research evidence to change practice was the lowest-rated skill for developing evidence-based practice. Nurses' precursor skills for developing evidence-based practice, such as database searching and information retrieval, may be insufficient in themselves for promoting evidence-based practice if they cannot find evidence relating to their particular field of practice or if they do not have the time, resources and supports to develop their practice in response to evidence.

The theory-practice relationship in nursing: an exploration of contemporary discourse.

The nature of nursing practice, the nature and origins of nursing theory and the issue of the relationship between theory and practice are matters which have and continue to generate extensive philosophical discourse within nursing. Despite the abundance of literature on these matters, to date there have been few attempts to bring together, to summarise and to characterise the various ways in which the theory-practice relationship is understood within nursing. This paper offers a description of the principal ways in which the theory-practice relationship is commonly understood within contemporary philosophical discourse. An exploration of contemporary, scholarly discourse within the nursing literature, using Carr's typology of theories of theory and practice, as a framework for analysis, points to evidence that the theory-practice relationship is understood in a number of different ways. Foremost among these is the tendency to think of nursing as an applied-science and there is a tendency to think of theory and practice as separate endeavours. The content of the discourse also points to a tendency to view the relationship as one in which the basis for practice lies in the collective 'common-sense' understandings of practitioners engaged in practice. The relationship is also understood in terms of nursing being an 'ethical' activity in which practical wisdom, deliberation, judgements and choices are required for the conduct of practice. There is, in more recent discourse, evidence of views which attempt to contextualise nursing within its social reality and thus to conceive of the theory-practice relationship in ways congruent with the recognition that nursing practice is a human and a social enterprise that is inherently 'problematic'. These contemporary conceptualizations of the theory-practice relationship would appear to have evolved through a process in which each new conception has been accommodated with and assimilated into the already existing understandings. Ways of viewing the theory-practice relationship are expressed either explicitly or, in many instances, are implicit in and recoverable from expressions of views, beliefs and assumptions. It would appear that the current state of thinking with respect to the theory-practice relationship is one of eclecticism and pluralism and there is a general openness to the contribution of different paradigms of knowing to epistemological development.

The theory-practice relationship in nursing: the practitioners' perspective.

Within contemporary scholarly discourse, there are a number of distinctive approaches to understanding the theory-practice relationship. Carr identifies four principal approaches, each of which is sustained within explicit views about the nature of theory. Carr terms these approaches the 'common-sense' approach, the 'applied-science' approach, the 'practical' approach and the 'critical' approach. Each approach is recoverable from the explicit and implicit content of scholarly literature. The study reported here sought to uncover the ways in which practising nurses understand the relationship between theory and practice and to establish the extent to which their explicit and implicit understandings accord with Carr's typology. The study involved in-depth interviews with six practising nurses. The purpose of the interviews was to prompt each study participant to enter into a reflective mode in a way that would generate narrative information, which would illustrate the various ways in which each theorized with respect to the theory-practice relationship. In this reflective theorizing, the study participants indicated that they understood the theory-practice relationship in ways that accorded with elements of Carr's typology. A brief discussion considers the limitations of the study and the implications for further research into the theory-practice relationship.

Professional caring: the moral dimension.

The concept of caring, its intentions, actions and its achievements, as it relates to nursing is a concept on which many nurses' minds have been focused. The concern and at times a major preoccupation with the need to explore and explain caring among the nursing body is a concern which is rooted in socio-political and cultural phenomena related to the evolution of nursing. The need to explore and explain caring through philosophical discourse is a necessary and an ongoing part of this evolutionary process. This paper represents an attempt to partake in such discourse. More precisely, the paper undertakes an analysis of the concept of caring as it happens in both nonprofessional and in professional caring contexts and represents an attempt to characterize professional caring. In an effort to do this the author considers the moral-ethical dimension of caring in the light of important theoretical positions on social morality. When considered against these theories of social morality and against the professionally derived imperatives which guide caring actions, professional caring may be construed as a distinct mode of caring.