Contextual Factors Affecting Evidence-Based Practice in Orthopaedic Nursing and Rehabilitation: A Mixed Methods Study.
Madeleine Winberg, Erika Fjordkvist, Eva Joelsson-Alm and 3 others
PMID 40682329WHAT IT FOUND
Orthopaedic hip surgery teams described teamwork and supportive leadership, but fast-track care, heavy workload and weekend staffing shortages limited patient communication.
Bladder care was frequent yet poorly explained.
Key findings
01Staff questionnaire scores classified leadership, culture, evaluation, social capital, staffing, space and extra time as enabling evidence-based practice, while formal interaction, informal interaction and structural/electronic resources were classified as barriers.
02Patients described bladder care as common and frequent, but poorly communicated, and staff did not explain why bladder care mattered.
03Staff questionnaire scores treated staffing, space and extra time as enabling, while staff interviews described these resources as barriers.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The questionnaire response rate was 26% to 35%, so the staff sample may not represent all orthopaedic staff. Only consenting staff answered the questionnaire, so the study could not check whether non-respondents had different views of the context. Staff were not specifically asked in the questionnaire to judge conditions for bladder guideline implementation, although interviews explored this. Some questionnaire scores were close to the cutoff values, so their classification as enabling or barrier may be unstable. The results reported here are context scores, interviews and free-text experiences; they are not patient outcome results. Patients took part as interviewees and survey respondents, but not as representatives shaping the study design.
Declared interests
The authors declared no conflicts of interest. Funding came from the Swedish Research Council for Health, Working Life and Welfare (FORTE), Nyckelfonden Research Foundation and Region Örebro County.
The easy way to misread this
Do not read the enabling questionnaire scores as proof that guidelines were followed or bladder care was explained. The study measured context perceptions and experiences, not clinical outcomes.