Editorial
Science for action-based nursing
A recent Lancet editorial by Clark et al. (2012) highlighted
the gap in nursing between evidence and practice. In this
editorial, we explore one of the reasons why this gap may
exist in parts of Europe. According to our experience, espe-
cially in countries where English is not the first language,
we confirm the findings reported by Milner et al. (2005)
that nurses’ use of research-based evidence tends to decrease
with the increase of their working seniority. The main rea-
sons for this are that senior nurses very often have difficulty
understanding English-language publications, they lack con-
fidence in assessing the quality of research due to the differ-
ent type of education they received, and they prefer to use
self-experienced knowledge because of their many years of
practice. According to Dalheim et al. (2012), evidence-
based practice could be successfully implemented if barriers,
such as the ones reported above, are identified and
removed.
European sources (Commission of the European Com-
munities 2008, OECD/European Union 2012) report a
rapid increase in nurses’ average retiring age and there-
fore in the average age of nursing professionals. In 2007,
the mean retirement age of nurses in Italy was
59Á9 years, whereas in 2012, they retired at the mean age
of 60Á7 years (men at the age of 61 years, and women at
the age of 60Á6 years). In Europe, approximately half of
the nurses in at least five Member States have an average
age of over 45 years (OECD/European Union 2012). This
phenomenon, for the reasons mentioned above, has a sig-
nificant impact on the gap between evidence and practice
in nursing, underlining the urgent need to adopt specific
educational strategies capable of removing barriers and
enhancing the use of evidence-based practice. Educational
strategies specifically designed for senior nurses should be
provided, mainly involving lifelong learning programmes
that focus on how to translate evidence into practice by
asking them to find solutions for a set of real-life
complex problems that stimulate critical thinking, deci-
sion-making, and clinical judgement on the basis of
evidence.
According to the Commission of the European Commu-
nities (2008, p. 6–7), the ‘key to maintaining a sufficient
workforce, in the face of the impending retirement of the
‘baby boom’ generation, is to educate, recruit and retain
young practitioners while reinvesting in the mature work-
force’. Some of the influencing factors and possible areas
for action suggested by the Commission of the European
Communities include: (i) ensuring better working condi-
tions for health workers; (ii) increasing staff motivation
and morale; (iii) taking advantage of the growth in the
proportion of over-55s in the workplace and those who
no longer have family commitments; (iv) organizing
chronic disease management practices and long-term care
provision; and (v) considering ‘return to practice’ cam-
paigns to attract back those who have left the health
workforce.
Therefore, in the light of this context, especially non-
English speaking senior nurses who have many years of
experience urgently need specific lifelong learning courses
that systematically focus on how to translate evidence into
practice. In addition, there should be a system that mea-
sures the impact of these courses on the quality of health
care and patient safety. The use of valid and reliable obser-
vation scales that measure the nurses’ cognitive skills across
their professional life will be able to produce standardized
data related to the impact of these skills on the patients’
health outcomes, especially if the patients’ conditions are
complex, due to their ageing and multiple diseases (Persoon
et al. 2012). To conclude, we feel that, at least across
Europe, common continued professional development
programmes focusing on a wide and interdisciplinary range
of opportunities aimed at translating evidence into practice
would need to be designed and implemented.
Loredana Sasso
1
, Giuseppe Aleo
2
&
Annamaria Bagnasco
3
1
Loredana Sasso MA MSc PN
Associate Professor of Nursing
Health Sciences Department, University of Genoa,
Genoa, Italy
© 2013 John Wiley & Sons Ltd 2373
JAN
JOURNAL OF ADVANCED NURSING