Newly graduated nurses' use of knowledge sources: a meta-ethnography

Abstract

Aim: To advance evidence on newly graduated nurses' use of knowledge sources.

Background: Clinical decisions need to be evidence-based and understanding the knowledge sources that newly graduated nurses use will inform both education and practice. Qualitative studies on newly graduated nurses' use of knowledge sources are increasing though generated from scattered healthcare contexts. Therefore, a metasynthesis of qualitative research on what knowledge sources new graduates use in decision-making was conducted.

Design: Meta-ethnography.

Data sources: Nineteen reports, representing 17 studies, published from 2000-2014 were identified from iterative searches in relevant databases from May 2013-May 2014.

Review methods: Included reports were appraised for quality and Noblit and Hare's meta-ethnography guided the interpretation and synthesis of data.

Results: Newly graduated nurses' use of knowledge sources during their first 2-year postgraduation were interpreted in the main theme 'self and others as knowledge sources,' with two subthemes 'doing and following' and 'knowing and doing,' each with several elucidating categories. The metasynthesis revealed a line of argument among the report findings underscoring progression in knowledge use and perception of competence and confidence among newly graduated nurses.

Conclusion: The transition phase, feeling of confidence and ability to use critical thinking and reflection, has a great impact on knowledge sources incorporated in clinical decisions. The synthesis accentuates that for use of newly graduated nurses' qualifications and skills in evidence-based practice, clinical practice needs to provide a supportive environment which nurtures critical thinking and questions and articulates use of multiple knowledge sources.

Keywords: clinical decision-making; critical thinking; evidence-based practice; knowledge sources; literature review; meta-ethnography; new graduate nurses; nursing knowledge; transition phase.