Conectar
To explore the lived experiences of nurses and patients co-producing evidence-based care for long-term conditions, and to understand how they make sense of this process within relational, emotional and organisational contexts.
A qualitative study using the Interpretative Phenomenological Approach.
Semistructured interviews were conducted with 20 participants, comprising 11 registered nurses and 9 adult patients living with at least one Long-Term Condition. Participants were recruited from primary and secondary care settings across the Midlands, England. Data were collected between February and August 2023 and analysed using Interpretative Phenomenological Approach's iterative and inductive framework.
Five experiential themes were identified: (1) weaving together different knowledges, (2) the relational foundations of co-production, (3) organisational pressures and misalignments, (4) shifting identities and power dynamics and (5) emotional and ethical complexity in co-producing care. Participants described co-production as a deeply relational and negotiated process, shaped by trust, vulnerability and shared decision-making.
Co-producing evidence-based care in Long-Term Condition management involves more than implementing guidelines. It is a relational, emotional and contextual practice that requires shared interpretation of evidence, deep listening and responsiveness to individual lives. Findings suggest a need to reframe evidence-based practice as a co-creative process grounded in relational ethics and contextual awareness.
Findings emphasise the centrality of relational competence and organisational flexibility in enabling co-produced care. Findings call for educational and policy reforms that value emotional labour, professional humility and patient knowledge as essential to evidence-based nursing. Internationally, this work provides a grounded model for integrating person-centred approaches into chronic care delivery and policy.
The study offers a relational model of evidence-based practice that moves beyond protocol-driven care to one shaped through dialogue, empathy and contextual negotiation, offering practical insights for transforming professional roles and health systems globally.
Patient representatives contributed to study design, development of interview guides and interpretation of findings to ensure alignment with lived experiences.
This study follows the SRQR guideline.
To explore how critical care nurses access, negotiate and apply knowledge in high-pressure clinical environments, focusing on organisational, cultural and leadership factors influencing evidence-based practice implementation in acute hospital settings.
A focused ethnographic collective case study was conducted across two contrasting critical care units in England.
Methods included non-participant observation (56 sessions), semi-structured interviews (36 participants) and document review. Spradley's Developmental Research Sequence guided data generation and analysis. Data were collected over an eight-month period (February to September 2022).
Five major themes were identified: sources of knowledge and acquisition strategies; institutional and hierarchical influences on knowledge use; role of experiential knowledge and clinical intuition; challenges to evidence-based practice implementation; and strategies for integrating knowledge into practice. Organisational structures, leadership engagement, mentorship and access to updated digital resources were key enablers of evidence-based practice. Barriers included workload pressures, inconsistent guideline dissemination and hierarchical cultures. Adaptive blending of formal evidence, clinical experience and intuition characterised effective knowledge negotiation at the bedside.
Knowledge use in critical care nursing is a dynamic, relational process shaped by leadership, organisational culture and systemic pressures. The availability of evidence alone is insufficient; visible leadership, peer learning, protected educational time and valuing of experiential knowledge are critical to embedding evidence-based practice into routine practice.
Strengthening organisational systems, investing in nurse manager development, expanding simulation-based learning and legitimising experiential knowledge are vital strategies to enhance evidence-based critical care.
This study provides actionable insights for healthcare leaders, educators and policymakers seeking to optimise evidence-based practice adoption in high-acuity clinical environments and improve patient outcomes.
The Consolidated Criteria for Reporting Qualitative Research checklist guided reporting.
Patients and the public were not involved in the design, conduct, reporting or dissemination of this research.
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