Date of Paper/Work

5-2014

Type of Paper/Work

Systems Change Project

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Roberta J. Hunt

Abstract

Evidence-based care in public health nursing is meant to guide practice through the integration of research evidence, clinical expertise, and client preference. Minimal study has explored clinical expertise, including what it means to be an expert, how practice wisdom informs decision-making, and whether experiential knowledge can be transformed to the benefit of others. Eight public health nurses, all of whom were highly experienced in providing home visiting services to high risk, pregnant and parenting families, participated in this qualitative inquiry. Interviews were conducted with the goal of exploring, describing, and understanding practice expertise from the perspective of those who know it best. The intended outcome of this research was to establish a source of practical knowledge that could be used in the recruitment and orientation of newly hired nursing staff. Data analysis was guided by a series of sequenced processes described by Colaizzi (1978). Five themes emerged from the data including: 1) public health nursing practice is derived from academic and experiential learning, 2) the knowledge of clinical experts contributes to the practice of others, 3) public health nursing expertise can be described through a collection of certain characteristics, 4) evidence-based nursing isn’t well understood in community health settings, nor are processes fully incorporated into practice; and 5) critical steps of evidence-based care may not fully translate to public health nursing practice. Evidence-based public health nursing practice is a relatively young and as such, there is a need for expanded research, knowledge development, and the creation of meaningful and applicable methods of adapting processes to better reflect the realities of practice.

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