Revealing the contribution of bioscience*-based nursing knowledge to clinically effective patient care

Abstract

Objectives: To discuss how bioscience-based nursing knowledge contributes to clinically effective patient care and demonstrate the value of evidence derived from qualitative research and clinical expertise with reference to the ‘evidence-based’ hierarchy. We also present a second argument that an ‘evidence-based’ focus on outcomes may not be sufficiently sensitive to reveal and evaluate those aspects of process, including nursing knowledge and expertise, which influence nursing interventions and affect patient outcomes.Design: The paper draws on qualitative data generated in a study examining the influence of nurse’s bioscience knowledge on the achievement of patient outcomes in post-anaesthesia practice.Setting: Two UK regional centres comprising in patient and day care post-anaesthesia practice in a number of surgical specialist areas.Participants: Thirty-two experienced post-anaesthesia nurses.Analysis: Hermeneutic text interpretation. An interpretative method which reflects the convergence of researcher’s and participants’ perspectives in order to understand the meaning of written descriptions of experiences.Findings: Nursing activities comprise a number of segmental outcomes. These segmental outcomes influence overall patient outcomes. Nurses used bioscience based knowledge as one source of best available evidence to influence achievement of intended patient outcomes.Conclusion: In order to demonstrate how nursing knowledge constitutes a valid source of evidence, segmental outcomes of care need to be defined and evaluated. In this way, the fine details of the process are more apparent and questions about the evidence underpinning nursing interventions are easier to answer. Although the setting is a specialist area of practice, the findings have wider applications because segments of care can be considered for any nursing interventions.