Constructing a New Approach to Developing Evidence-Based Practice with Nurses and Older People

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Abstract
Providing evidence-based nursing care to older people is central to the international development agenda. This paper is a report on the first 5 years (2000-2005) of a participatory research project, the purpose of which was to collaborate with practitioners and older people to develop approaches to promote the attainment of evidence-based nursing care across Scotland. Many theoretical influences shaped the design of this action research study including realistic evaluation, participatory social learning theory, and descriptions of communities of practice. Multiple methods of data collection were used during four action cycles. The inaugural community of practice comprised 30 nurses, a second group of 30 nurses joined midway, followed by a third group of 15 nurses, and finally, an older person-carer community of 21 members was established. Project outputs included the construction of an internet-based, practice-development college. A procedural model for developing and demonstrating care guidance drawn from a diversity of evidence and reflective of an agreed set of principles was piloted and endorsed by the national standard setting agency. A preliminary version of a promising approach to practice development, "the Caledonian Model," was delineated for future testing and refinement. This work indicates the merits of using participatory research to find solutions to the challenge of promoting evidence-based practice. Evaluation data suggest that in combination, the approaches developed in this project empower nurses to work with older people to champion developments even in seemingly unfavorable conditions.