Fostering collaborative evidence-based decision-making: The public health nurse's role.

Abstract

The Canadian Nursing Association promotes the use of evidence-based decision-making (EBDM) as a component of quality nursing care. A shift to a population health approach encourages public participation in health-related decision-making. Public health nurses (PHNs) participate in joint health-related decision-making with community partners. The purpose of this exploratory and descriptive study was to gain an in-depth understanding of EBDM from the perspective of the PHN. The meaning of EBDM, the perceived barriers and facilitators of using evidence, and the role of the PHN in bringing evidence to the joint decision-making process that they share with community partners was explored. A qualitative methodology known as ethnography was used and data were collected from two sources: observations at team meetings and semi-structured interviews with PHNs. Analysis of the data led to the identification of three sub-themes: holistically knowing the community, bridging 'evidence' to context, and actively managing information. All three sub-themes contribute to the main theme: the PHNs' role in fostering collaborative 'evidence-based' decision-making in the community. The PHNs' holistic view of evidence, which includes hard and soft data, contextual data and professional experience, is discussed. Basic steps in a shared EBDM process are described and dimensions of the context in which PHNs practice are explored. Implications for education, practice, research, and policy are discussed.