Midwives' use of best available evidence in practice: An integrative review

Abstract

Aims and objectives To synthesise international research that relates to midwives' use of best available evidence in practice settings and identify key issues relating to the translation of latest evidence into everyday maternity care. Background Midwifery is a research‐informed profession. However, a gap persists in the translation of best available evidence into practice settings, compromising gold standard maternity care and delaying the translation of new knowledge into everyday practice. Design A five‐step integrative review approach, based on a series of articles published by the Joanna Briggs Institute (JBI) for conducting systematic reviews, was used to facilitate development of a search strategy, selection criteria and quality appraisal process, and the extraction and synthesis of data to inform an integrative review. Methods The databases CINAHL, MEDLINE, Web of Science, Implementation Science Journal and Scopus were searched for relevant articles. The screening and quality appraisal process complied with the PRISMA 2009 checklist. Narrative analysis was used to develop sub‐categories and dimensions from the data, which were then synthesised to form two major categories that together answer the review question. Results The six articles reviewed report on midwives' use of best available evidence in Australia, the UK and Asia. Two major categories emerged that confirm that although midwifery values evidence‐based practice (EBP), evidence‐informed maternity care is not always employed in clinical settings. Additionally, closure of the evidence‐to‐practice gap in maternity care requires a multidimensional approach. Conclusion Collaborative partnerships between midwives and researchers are necessary to initiate strategies that support midwives' efforts to facilitate the timely movement of best available evidence into practice. Relevance to clinical practice Understanding midwives' use of best available evidence in practice will direct future efforts towards the development of mechanisms that facilitate the timely uptake of latest evidence by all maternity care providers working in clinical settings.

Women’s experience of the decision-making process for home-based postnatal midwifery care when discharged early from hospital: A Swedish interview study

“…Since the interviews were of a relatively long length and data were content-rich these issues did not appear to have negatively influenced the findings. In-depth interviews can be considered appropriate when wanting to improve or implement patient- or women-informed evidence-based maternity care 30 . To be noted, the sample size only represents women having an uncomplicated childbirth and mainly including multiparous women.…”

Knowledge, attitudes and use of evidence-based practice among midwives in Belgium: A cross-sectional survey

“…Additional research would be interesting to deepen this relation, and the other factors we identified in relation to the implementation of EBP, so we know how to reach every midwife (irrespective of the demographic background) to implement EBP guidelines. Understanding midwives’ use of best available evidence in practice will direct efforts towards developing mechanisms that facilitate the timely uptake of the latest evidence by all maternity care providers working in clinical settings 28 .…”

Midwifery Qualification in Selected Countries: A Rapid Review

“…Evidence-based practice (EBP), ”the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients” [ 112 ] (p.71) positively impacts patient outcomes in nursing and midwifery, reduces healthcare costs and empowers nurses and midwives, resulting in the WHO Regional Office in Europe urging its Member States to encourage and develop EBP culture in nursing and midwifery [ 113 ]. An integrative review found that although EBP in midwifery is valued, implementation is still lacking [ 114 ]. Similarly, Lai et al [ 115 ] found that nursing and allied health practitioners in several Malaysian hospitals reported less favourable attitudes towards EBP, which could possibly be due to the low confidence attributed to their diploma qualification level.…”