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Poiroux L, Bruyneel A, Larcin L, Fossat G, Kamel T, Labro G, Goursaud S, Rouze A, Heming N, Hermann B. Barriers to research findings utilization amongst critical care nurses and allied health professionals: An international survey. Intensive Crit Care Nurs 2024; 81:103610. [PMID: 38171952 DOI: 10.1016/j.iccn.2023.103610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 11/16/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES To determine the perceived barriers to the implementation of research findings in clinical practice among critical care nurses and allied health professionals. METHODS A cross-sectional study was conducted using an online questionnaire sent to critical care nurses and allied health professionals in French-speaking countries. The primary objective was the identification and grading of perceived barriers to implementation of research findings into clinical practice, using a previously validated tool (French version of the BARRIERS scale). The scale is divided into 4 dimensions, each containing 6 to 7 questions to be answered using a 4-point Likert scale (1: no barrier, 4: great barrier). Descriptive statistics were performed and weighted score per dimensions were compared. Univariate and multivariate linear regressions were performed to identify factors associated with the total score by dimension. RESULTS A total of 994 nurses and allied health professionals (85.1 % of ICU nurses) from 5 countries (71.8 % from France) responded to the survey. Main reported barriers to research findings utilization were "Statistical analyses are not understandable" (54.5 %), "Research articles are not readily available" (54.3 %), and "Implications for practice are not made clear" (54.2 %). Weighted scores differed between dimensions, with the "communication" and "organization" dimensions being the greatest barriers (median [IQR]: 2.3 [1.8-2.7] and 2.0 [1.6-2.4], while the "adopter" and "innovation" dimensions having lower scores (1.5 [1.2-1.8] and 1.5 [1.0-1.8] (all pairwise comparisons p-value < 0.0001, except for the adopter vs. innovation comparison, p > 0.05). CONCLUSIONS Accessibility and understanding of research results seem to be the main barriers to research utilization in practice by respondents. A large number of the reported barriers could be overcome through education and organizational change. IMPLICATIONS FOR PRACTICE Promoting a research culture among nurses and allied health professionals is an issue that needs investment. This should include training in critical reading of scientific articles and statistics.
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Affiliation(s)
- Laurent Poiroux
- Medical intensive care unit, University Hospital of Angers, France; Nursing Department Health Faculty of the University of Angers - Inserm UMR 1085 - Equipe d'épidémiologie en santé au travail et ergonomie (ESTER), France
| | - Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium.
| | - Lionel Larcin
- Research Centre for Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles, Belgium
| | - Guillaume Fossat
- Medical Intensive Care Unit, Regional Hospital Centre, Orléans, France; UR 20201, Equipe de Recherché Paramédicale sur le Handicap Neuromoteur (ERPHAN), université Versailles Saint-Quentin en Yvelines, France
| | - Toufik Kamel
- Medical Intensive Care Unit, Regional Hospital Centre, Orléans, France
| | - Guylaine Labro
- Medical Intensive Care Unit, Groupement Hospitalier Régional Mulhouse Et Sud Alsace, Hôpital Emile Muller, Mulhouse, France
| | | | - Anahita Rouze
- University Lille, Inserm U1285, CHU Lille, Medical Intensive Care Unit, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, F-59000 Lille, France
| | - Nicholas Heming
- Department of Intensive Care, Hôpital Raymond Poincaré, APHP University Versailles Saint Quentin-University Paris Saclay, 92380 Garches, France; Laboratory of Infection & Inflammation-U1173, School of Medicine Simone Veil, University Versailles Saint Quentin-University Paris Saclay, INSERM, 92380 Garches, France; FHU SEPSIS (Saclay and Paris Seine Nord Endeavour to PerSonalize Interventions for Sepsis), 92380 Garches, France
| | - Bertrand Hermann
- Medical Intensive Care Unit, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris Cité (APHP.Centre-Université Paris Cité), Paris, France; INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP), Université Paris Cité, Paris, France
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Macedo APMDC, Padilha KG, Püschel VADA. Professional practices of education/training of nurses in an intensive care unit. Rev Bras Enferm 2019; 72:321-328. [PMID: 31017192 DOI: 10.1590/0034-7167-2017-0793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 08/05/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To understand the education/training of nurses working in an intensive care unit. METHOD Case study with qualitative approach, with an intentional sample. Data collection and analysis used different research techniques, mainly document analysis, interview and field observation. RESULTS The data highlights feelings of well-being, satisfaction and motivation as important for education and training in a work context. Some organizational practices seem to promote interpersonal relationships and, consequently, increase the willingness of these professionals to adopt a reward perspective regarding continuing education and training, establishing a close relationship between the formal, the non-formal and the informal. FINAL CONSIDERATION The attractiveness of this organization is related to the valorization and recognition that it can offer to the professionals. There is a reciprocity between a hospital that endorses up-to-date care and professionals who seek scientific evidence.
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Grant A, Coyer F. Contextual factors to registered nurse research utilisation in an Australian adult metropolitan tertiary intensive care unit: A descriptive study. Aust Crit Care 2019; 33:71-79. [PMID: 30910478 DOI: 10.1016/j.aucc.2019.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 12/22/2018] [Accepted: 01/07/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Organisational and unit-level context can have a significant impact on implementation of evidence in practice, the latter being particularly important in the complex intensive care context. Evaluating the context may allow modifiable characteristics to be identified and addressed. OBJECTIVES The objective was to examine the relationship between dimensions of the context and research utilisation in one intensive care unit. METHODS This study used a quantitative cross-sectional survey. All registered nurses working in one Australian quaternary referral hospital intensive care unit were surveyed using the Alberta Context Tool and research utilisation instrument. Descriptive statistics were used, and bivariate analysis was undertaken to determine associations among demographic data, dimensions of context, and research utilisation. RESULTS The survey response rate was 33% (67/205). Most respondents were women with a mean of 8 years of intensive care nursing experience. The dimensions of culture, evaluation, informal interactions, structural/electronic resources, and organisational slack (time and space) were positively correlated with research utilisation. CONCLUSIONS Research utilisation was associated with numerous context dimensions, emphasising their effect on knowledge translation in this setting. Intensive care nurses are in a unique position to impact care delivery and provide evidence-based care to ensure optimal outcomes to patients at high risk of morbidity and mortality. Identified dimensions may be targeted and developed in future strategies to optimise the context for translating evidence into this complex practice environment.
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Affiliation(s)
- Anna Grant
- Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; Level 3, Ned Hanlon Building, Royal Brisbane and Women's Hospital, Butterfield St, Herston, 4029, Brisbane, QLD, Australia.
| | - Fiona Coyer
- Level 3, Ned Hanlon Building, Royal Brisbane and Women's Hospital, Butterfield St, Herston, 4029, Brisbane, QLD, Australia; Joint Appointment Intensive Care Services, Royal Brisbane and Women's Hospital and School of Nursing, Queensland University of Technology, Australia.
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Andrade BRPD, Barros FDM, Lúcio HFÂD, Campos JF, Silva RCD. EXPERIENCE OF NURSES IN THE MANAGEMENT OF CONTINUOUS HEMODIALYSIS AND ITS INFLUENCES ON PATIENT SAFETY. TEXTO & CONTEXTO ENFERMAGEM 2019. [DOI: 10.1590/1980-265x-tce-2018-0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to analyze the professional experience of intensive care nurses and its influence on their work activities in the continuous hemodialysis process and patient safety in the intensive care unit within the scope of the collaborative model. Method: qualitative and exploratory research, based on the systemic paradigm of patient safety, developed at the Intensive Care Unit of a private institution in the city of Rio de Janeiro, Brazil. There were 23 nurse participants who had been working for more than three months in study scenery and in direct contact with continuous hemodialysis. The data were produced from June to October of 2016 by means of observation, analyzed using thick description as well as semi-structured interviews, and then submitted to the content analysis technique. Results: were organized in two categories: the first one portrays the influence of the professional working experience on the safety of nurses' performance, which verified that in relation to continuous hemodialysis, inexperienced nurses follow guidelines and manuals, without a complete evaluation of this care situation and face difficulties in the performance of everyday care. The second category demonstrates the impact of the nurse´s inexperience on the occurrence of active errors, evidencing actions that result in the occurrence of adverse events. Conclusion: the insertion of inexperienced nurses is a latent condition in the investigated system that results in the occurrence of incidents in the continuous hemodialysis process, requiring the improvement of the collaborative model through the systematic monitoring of the performance of these professionals, such as the proposal of a safety barrier.
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Hill MC, Salmon D, Aitken LM. What are the beliefs and perceptions of practice nurses’ influence about the uptake of the measles, mumps, and rubella vaccine?: An integrative literature review. J Adv Nurs 2018; 75:266-276. [DOI: 10.1111/jan.13827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 07/03/2018] [Accepted: 07/14/2018] [Indexed: 10/28/2022]
Affiliation(s)
| | - Debra Salmon
- School of Health Sciences; City, University of London; London UK
| | - Leanne M. Aitken
- School of Health Sciences; City, University of London; London UK
- Menzies Health Institute Queensland; Griffith University; Nathan Qld Australia
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Describing knowledge encounters in healthcare: a mixed studies systematic review and development of a classification. Implement Sci 2017; 12:35. [PMID: 28292307 PMCID: PMC5351057 DOI: 10.1186/s13012-017-0564-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 03/01/2017] [Indexed: 11/18/2022] Open
Abstract
Background Implementation science seeks to promote the uptake of research and other evidence-based findings into practice, but for healthcare professionals, this is complex as practice draws on, in addition to scientific principles, rules of thumb and a store of practical wisdom acquired from a range of informational and experiential sources. The aims of this review were to identify sources of information and professional experiences encountered by healthcare workers and from this to build a classification system, for use in future observational studies, that describes influences on how healthcare professionals acquire and use information in their clinical practice. Methods This was a mixed studies systematic review of observational studies. DATA SOURCES: OVID MEDLINE and Embase and Google Scholar were searched using terms around information, knowledge or evidence and sharing, searching and utilisation combined with terms relating to healthcare groups. ELIGIBILITY: Studies were eligible if one of the intentions was to identify information or experiential encounters by healthcare workers. DATA EXTRACTION: Data was extracted by one author after piloting with another. STUDY APPRAISAL: Studies were assessed using the Mixed Methods Appraisal Tool (MMAT). PRIMARY OUTCOME: The primary outcome extracted was the information source or professional experience encounter. ANALYSIS: Similar encounters were grouped together as single constructs. Our synthesis involved a mixed approach using the top-down logic of the Bliss Bibliographic Classification System (BC2) to generate classification categories and a bottom-up approach to develop descriptive codes (or “facets”) for each category, from the data. The generic terms of BC2 were customised by an iterative process of thematic content analysis. Facets were developed by using available theory and keeping in mind the pragmatic end use of the classification. Results Eighty studies were included from which 178 discreet knowledge encounters were extracted. Six classification categories were developed: what information or experience was encountered; how was the information or experience encountered; what was the mode of encounter; from whom did the information originate or with whom was the experience; how many participants were there; and where did the encounter take place. For each of these categories, relevant descriptive facets were identified. Conclusions We have sought to identify and classify all knowledge encounters, and we have developed a faceted description of key categories which will support richer descriptions and interrogations of knowledge encounters in healthcare research. Electronic supplementary material The online version of this article (doi:10.1186/s13012-017-0564-1) contains supplementary material, which is available to authorized users.
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Rolls K, Hansen M, Jackson D, Elliott D. Why We Belong - Exploring Membership of Healthcare Professionals in an Intensive Care Virtual Community Via Online Focus Groups: Rationale and Protocol. JMIR Res Protoc 2016; 5:e99. [PMID: 27296929 PMCID: PMC4923593 DOI: 10.2196/resprot.5323] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 02/06/2016] [Accepted: 03/24/2016] [Indexed: 11/13/2022] Open
Abstract
Background Many current challenges of evidence-based practice are related to ineffective social networks among health care professionals. Opportunities exist for multidisciplinary virtual communities to transcend professional and organizational boundaries and facilitate important knowledge transfer. Although health care professionals have been using the Internet to form virtual communities for many years, little is known regarding “why” they join, as most research has focused on the perspective of “posters,” who form a minority of members. Objective Our aim was to develop a comprehensive understanding of why health care professionals belong to a virtual community (VC). Methods A qualitative approach will be used to explore why health care professionals belong to an intensive care practice-based VC, established since 2003. Three asynchronous online focus groups will be convened using a closed secure discussion forum. Participants will be recruited directly by sending emails to the VC and a Google form used to collect consent and participant demographics. Participants will be stratified by their online posting behaviors between September 1, 2012, and August 31, 2014: (1) more than 5 posts, (2) 1-5 posts, or (3) no posts. A question guide will be used to guide participant discussion. A moderation approach based on the principles of focus group method and e-moderation has been developed. The main source of data will be discussion threads, supported by a research diary and field notes. Data analysis will be undertaken using a thematic approach and framed by the Diffusion of Innovation theory. NVivo software will be used to support analyses. Results At the time of writing, 29 participants agreed to participate (Focus Group 1: n=4; Focus Group 2: n=16; Focus Group 3: n=9) and data collection was complete. Conclusions This study will contribute to a growing body of research on the use of social media in professional health care settings. Specifically, we hope results will demonstrate an enhancement of health care professionals’ social networks and how VCs may improve knowledge distribution and patient care outcomes. Additionally, the study will contribute to research methods development in this area by detailing approaches to understand the effectiveness of online focus groups as a data collection method for qualitative research methods.
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Affiliation(s)
- Kaye Rolls
- Agency for Clinical Innovation, Intensive Care Coordination and Monitoring Unit, Chatswood, Australia.
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Early rehabilitation in the intensive care unit: An integrative literature review. Aust Crit Care 2015; 28:216-25. [DOI: 10.1016/j.aucc.2015.05.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 04/19/2015] [Accepted: 05/11/2015] [Indexed: 11/21/2022] Open
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Kvande M, Delmar C, Lykkeslet E, Storli SL. Foresight and awareness of incipient changes in a patient' clinical conditions--Perspectives of intensive care nurses. Intensive Crit Care Nurs 2015; 31:261-8. [PMID: 26188385 DOI: 10.1016/j.iccn.2015.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/02/2015] [Accepted: 06/12/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this study was to explore the phenomenon of becoming aware of incipient changes in patient condition from the perspectives and experiences of intensive care nurses. RESEARCH METHODOLOGY This study involved close observations of and in-depth interviews with 11 experienced intensive care nurses. The text was analysed using a hermeneutic phenomenological method that was inspired by van Manen. SETTING This study was undertaken at two different high-technology intensive care units (ICUs) in Norwegian university hospitals. FINDINGS Nurses formed images of individual patients composed of signs (of changes in a patient's condition) that were sensory, measurable, and manifested as the mood of the nurse. The signs may be viewed as separate from and opposed to one another, but they are tightly interwoven and interact with one another. Care situations are powerful stimuli for the patient, and it is of great importance for nurses to become aware of signs in these situations. Nurses also ascribe that following the patient over time is important for becoming aware of signs. CONCLUSION An awareness of incipient changes in patient clinical condition requires understanding the ever-changing dynamics of patient condition and dialogic images composed of signs. Care situations and the following of patients through shifts are essential in enabling nurses to detect these signs.
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Affiliation(s)
- Monica Kvande
- Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, N-9037 Tromsø, Norway.
| | - Charlotte Delmar
- Section for Nursing, Department of Public Health, Health Faculty Aarhus University, DK & Faculty of Health Science, Aalborg University, DK & University College Diakonova, Oslo, Norway.
| | - Else Lykkeslet
- Faculty of Health and Social Care, Molde University College, Molde, Norway.
| | - Sissel Lisa Storli
- Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, N-9037 Tromsø, Norway.
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