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The Nature of evidence to inform critical care nursing practice.

By P. Fulbrook


This thesis presents a body of publications, in the area of critical care nursing, for consideration for the award of Doctor of Philosophy by Publication. The thesis is presented in three chapters: Introduction; Body of Work;\ud and Research, Knowledge, Evidence and Practice. In the first chapter the emergence of evidence-based practice is described, in general. Initially, an overview of the origins and trends of nursing research methodology is\ud provided; the purpose of which is to set in context the body of work. Utilising a narrative approach (Boje, 2001; McCance et aL, 2001; Sandelowski, 199 1; Vezeau, 1994) as a 'personal journal of discovery' I then reflexively describe my own development as a nurse researcher practitioner, drawing on my own publications to illustrate my progress, the development of my thinking, my research practice and the development of my understanding of pragmatice pistemology. The second chapter is comprised of my publications relevant to critical care nursing. Spanning a period of eleven years, they represent my contribution to critical care nursing knowledge. In the concluding chapter I have summarised initially my own contribution to critical care nursing knowledge, before moving on to a more detailed critique of evidence-based practice. Finally I have made\ud recommendations for the way forward. In addition to presenting my body of work, the aim of this PhD is to\ud challenget he current concept of evidence-based practice,\ud arguing that its definition is too narrow to encompass the rage of different types of knowledge that nurses use when caring for critically ill patients. I have utilised my own publications, to demonstrate how a variety of approaches are necessary to provide the best evidence for developing\ud practice. I have positioned my argument within a theoretical\ud understanding of pragmatic epistemology. In this way, I am working towards the development of a science of practice. Simultaneously I am also, to some extent, challenging conventional concepts of what constitutes doctoral level knowledge and how a PhD looks. My conclusion is that critical care nursing knowledge is drawn from many sources, and should be applied in an integrated way that enables\ud practitioners to make a positive difference to the life of patients.Knowledge that is not or cannot be applied to practice is therefore of no value. The valuing of practice knowledge brings with it the requirement that all forms of knowledge (and their relevant methodologies) are\ud considered as equal,in terms of their potential to impact on practice and that nothing should be rejected on paradigmatic grounds. In contemporary healthcare evidence is hierarchically valued and this raises many questions of equity. Where the value of knowledge becomes unequal is when its application to practice is limited. The corollary of a pragmatice pistemology is that it requires a pragmatic process to make it work. For me, at this point in time, the best available is practice development. In summary,this thesis represents a construction of work that makes an\ud original contribution to knowledge. The product of my thesis is a theory of pragmatic epistemology as the basis for a science of practice.\u

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  2. (2000). Evidence-based practice in nursing - the current state of play in Britain. doi
  3. (1984). From Novice to Expert: Excellence and Power in Clinical Nursin Practice. Menlo Park, doi
  4. (1978). Fundamental patterns of knowing in nursing. doi
  5. (2002). Getting evidence into practice: the role and function of facilitation. doi
  6. (2003). Hierarchy of evidence: a framework for ranking evidence evaluating healthcare interventions. doi
  7. (2000). Introducing evidence-based policy and practice in public services. In: HTO Davies, S Nutley, PC Smith (Eds). What Works? Evidence Based Poligy and Practice in Public Servi-ces. doi
  8. (1985). Knowledge creation and use in professional contexts. doi
  9. (1988). Leaming by Doing: A Guide to Teaching and Leaming -Methods.
  10. (2000). Non-formal learning and tacit knowledge in professional work. doi
  11. (2000). On Dialogue. In: On Dialogue, doi
  12. (2003). Praiseworthy pragmatism? Validity and action research. doi
  13. (2001). Seeking a clarification of meaning: a phenomenological interpretation of the craft of mental health nursing. doi
  14. (2003). Survivorship as craft and conviction: rcflections on rcscarch in progress.
  15. (1996). The Parctitioner-Researcher: Developing Theoly from Practice. San Francisco,
  16. (1996). Using reflection to develop clinical expertise. doi
  17. (2002). When do we know what we know? Considering the truth of research findings and the craft of qualitative research. doi

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