At the February 2018 Australian Council of Australian Governments (COAG) meeting, state and territory leaders met to discuss future national public hospital funding and healthcare reform. Key strategic areas were focussed upon including the need to drive best practice and performance in healthcare using data and research.
It is widely recognised that safe, effective, affordable, appropriate, and efficient healthcare should be underpinned by rigorous research evidence and high-quality data.
Likewise, assumptions of benefit within each of these domains should be tested carefully both prior to entering ‘real world’ settings, and then on an ongoing basis as they are evaluated for continued suitability and sustainability.
Research supports continuing advancements in healthcare and in the way that healthcare professionals, including nurses and midwives, carry out their work and are educated and trained.
As pervasive as it’s impact is in healthcare practice, research can sometimes appear to occur in a world separate to everyday clinical work and be conducted by a select few.
Indeed, historically, medical doctors have dominated healthcare research and notwithstanding the significant developments and benefits this has brought healthcare, has meant that nursing and midwifery research can be further from one’s mind when thinking about the research evidence.
Nurses and midwives account for the greatest proportion of Australia’s healthcare workforce, and while nurses and midwives use the results of research evidence every day, comparatively few are directly involved in its conduct and reporting.
For some, engagement with research work may have been most evident during education and again when encountering training opportunities, but otherwise may not be embedded in professional life. Nurses have been involved in research for much longer than many might assume, with Florence Nightingale (1820-1910) pioneering early developments in the framework of evidence-based healthcare (McDonald, 2001).
The contribution that nursing and midwifery research has made, and continues to make, is considerable and must continue to grow.
Nurses’ and midwives’ contemporary clinical application, coupled with tertiary knowledge and expertise provides a foundation to foster nurse and/or midwifery led research.
Due to the nature of nurses’ and midwives’ work, they have strong engagement with healthcare consumers, family members, and other healthcare professionals; often as the coordinators of care.
This means they are optimally placed to make important contributions to the growth and translation of research evidence in Australia. Nurses and midwives can rapidly and accurately recognise issues in the delivery of care and have a wealth of insight and practical knowledge regarding possible approaches and practical strategies for improving clinical practice and health consumer outcomes.
Evidence-based healthcare itself is a process of problem-solving, where nurses and midwives can reflect upon their knowledge of research evidence to inform decisions they make when providing care for their patients. This process is also influenced by knowledge of what the patient or their support person find appropriate or suitable to meet their needs, as well as the nurse or midwife’s own expertise and experience and knowledge of the context within which they are delivering care (Sackett and Haynes, 1998). Getting evidence into practice through implementation science is a field where nurses and midwives can advance care delivery and outcomes considerably (Van Achterberg, Schoonhoven, and Grol, 2008).
There are known barriers to engaging with research (Koehn and Lehman, 2008). However, it takes considerable time to sift through vast quantities of research, and knowledge and skills are required to be able to confidently assess the quality and reliability of research evidence and to skilfully synthesise this with one’s own ingrained understanding of the local context and situation, and the consumer’s wishes.
Australia’s healthcare sector and nursing and midwifery professional practice must be supported by the collection, sharing, linkage, analysis, implementation, and evaluation of high quality data and evidence from research as well as expert and consumer sources. Nurses and midwives can and should have a key role in these processes. Over the coming months, a series of short papers will be published in the ANMJ addressing some of the challenges that nurses and midwives face in engaging with research evidence and enabling the research to be applied effectively in everyday practice. The intention of these papers will be to stimulate readers’ interest in engaging with research and evidence – both in terms of potentially carrying out research – or implementation work themselves, strategies to progress research, or in reading and critically reflecting upon the outputs of research and applying them effectively in practice.
Koehn, M.L. & Lehman, K. 2008 Nurses’ perception of evidence-based nursing practice. Journal of Advanced Nursing. 62(2), 209-215.
McDonald, L. 2001. Florence Nightingale and the early origins of evidence-based nursing. Evidence Based Nursing, 4(3):68-69.
Sackett, D. & Haynes RB. 1995. On the need for evidence-based medicine. Evidence Based Medicine. 1(1):5-6.
Van Achterberg, T. Schoonhoven, L. & Grol, R. 2008. Nursing implementation science: how evidence-based nursing requires evidence-based implementation. Journal of Nursing Scholarship. 40(4): 302-310.
Dr Micah D J Peters is the ANMF National Policy Research Adviser (Federal Office) based in the Rosemary Bryant AO Research Centre, School of Nursing and Midwifery, University of South Australia