Evidence-Based Nursing Practice: The PEACE Framework

Implementation lead nurses to lead EBP quality improvement project using the PEACE framework

Implementing evidence-based practice (EBP) in clinical practice is an ongoing challenge for nurses. EQUIP-Evidence-based QUality Improvement Project- is a multiphase project aimed at equipping nurses with the essential skills to implement EBP and advanced nursing practice. EQUIP embraces the assumption that implementation science models and partnership models can facilitate the implementation process of EBP, leading to successful and sustainable change. The current study is one of the EQUIP feasibility investigations in which the perspective of 12 implementation lead nurses (IL nurses) who attended a 1-day PEACE-based workshop was explored. Thematic analysis identified 2 overarching themes, 6 themes, and 18 subthemes. The first overarching theme showed that the PEACE-based workshop has successfully achieved its intended training implications, and the second overarching theme gave insight into factors that may influence the role of IL nurses. IL nurses reported general satisfaction and willingness to use the PEACE model at work; however, some IL nurses found Step 3 difficult to apply. The study's findings provide evidence of the perceived usefulness of adopting the PEACE model as an augmented approach in the EQUIP and the interest and enthusiasm of IL nurses in receiving more training on the implementation process of EBP.

The Application Effect of Evidence-Based Care in Gastrointestinal Surgical Pipeline Nursing

With the improvement of the higher nursing education system, the overall quality and work ability of clinical nurses have also been significantly improved. Most nursing staff have a positive attitude towards evidence-based nursing medicine but lacking of the knowledge and skills about evidence-based nursing. Clinical nurses are still short of the ability to evaluate relevant research data, which is one of the cause of interference for the clinical nurses to use the latest research results reasonably and effectively at present. The purpose of this paper is to explore the application effect of evidence-based nursing in gastrointestinal surgical pipeline nursing and to clarify the impact of evaluation ability on nurses in clinical practice, investigate, and discuss the application effect of evidence-based nursing in gastrointestinal surgical pipeline nursing. This paper selects the clinical nurses of the three top three hospitals in a province as the research object, using the ways of general data questionnaire, the general individual performance sensitivity scale, the evidence-based nursing application behavior questionnaire, the evidence-based nursing application behavior willingness questionnaire, and the evaluation ability training needs questionnaire to collect data for 100 cases of gastrointestinal surgery clinical nurses. Analyze nurses’ awareness level of evidence-based nursing, the willingness of evidence-based nursing behavior, and the relevance of evidence-based nursing behaviors. Use multiple regression analysis methods to explore its influencing factors, and use data statistics to analyze the role and effect of evidence-based nursing in the gastrointestinal surgery pipeline. The research results show that the evaluation ability has a significant promotion effect on clinical nursing application, and it is one of the important factors for clinical nurses to use evidence-based nursing. Clinical nurses have a higher demand for evaluation ability training, and basically here, the application effect of evidence-based nursing in the gastrointestinal surgical pipeline nursing is relatively good.

Leading through the ‘new normality’ of health care

Health care institutions are witnessing a ‘new normality’, which profoundly reshapes the strategic and management challenges faced by health professionals in their attempt to achieve excellence in the design and delivery of care. This ‘new normality’ triggers a transformation of conventional managing models and leadership styles, which have proved to be unfit with the changed attributes of the external and internal contexts of health care organizations. The ‘new normal’ leadership style relies on the ability of leaders to make sense out of the new challenges that are faced by health care organizations and on their capability to act managerially, sticking to an empowering approach which enables followers. However, the transformation of conventional leadership style is impossible if a rethinking of training activities and learning experiences delivered to health professionals is missing. The article provides an overview of the issues that health leaders and managers encounter in the ‘new normality’ of health care, identifying several unanswered questions which should be addressed to thrive in the changed landscape of health services’ delivery.

Teaching evidence-based practice piece by PEACE

Teaching evidence-based practice (EBP) to nurse practitioner (NP) students creates a challenge. Practicing NPs are frequently called upon to develop EBP protocols and therefore, must be proficient in defining clinical problems, retrieving and appraising evidence, implementing protocols to change practice based on evidence, and evaluating the practice changes. A new faculty team integrated the constructivist approach using the PEACE framework to rebuild the EBP course. Course modules corresponded to each letter of the PEACE framework: problem identification, evidence retrieval, appraisal of evidence, changing practice or conducting more research, and evaluation. Students collaborated with a non-nursing professional as part of the college's commitment to interprofessional learning. Following the PEACE framework, students created an evidence-based poster of a proposed clinical practice change. Feedback from faculty and students was positive. Areas for improvement included eliminating redundancy in module content, standardizing all grading rubrics, and adding more virtual sessions for student/faculty interaction.

Targeted Interventions to Advance a Culture of Inquiry at a Large, Multicampus Hospital Among Nurses

OBJECTIVES

The aim of this study is to assist nurse leaders in developing innovative structures to foster a culture of inquiry among professional nurses.

BACKGROUND

Critical to nurse's engagement in evidence-based practice (EBP) is a culture of inquiry, in which nurses critically evaluate patient care activities and actively review existing evidence to address identified clinical issues. A bundle of structural interventions was implemented across a large, multisite hospital to advance a culture of inquiry. We measured the impact of these interventions on nurses' library use and on nurses' knowledge, attitudes, and practices towards EBP.

METHODS

Structural interventions included: 1) EBP and Research Committee meetings, in which nurses were educated on how to formulate a clinical question and critically appraise a research article; 2) Academic Partners Program, in which nurse academicians provided scholarly mentorship and guidance during monthly committee meetings; 3) hiring of clinical nurse scientists who provided 1-on-1 education and mentorship to clinical nurses in EBP and research; and 4) a Nurse Residency Program partnership, in which newly graduated nurses were required to complete an EBP project. We examined the impact of these structural interventions on nurses' use of library resources and nurses' knowledge, attitudes, and practices toward EBP.

RESULTS

The implementation of structural interventions to support nurses' engagement in EBP was associated with a significant increase in the number of nurse-generated library consultative requests over time. Results showed high levels of nurse knowledge, attitudes, and practices in EBP.

CONCLUSIONS

Nurse leaders may advance a culture of inquiry by providing the infrastructure to support EBP activities and by empowering nurses to question and seek answer to identified practice questions. Infrastructures should include access to scientific articles and partnerships with schools of nursing. Additional research is needed to validate nurse library use as a measure of nurse engagement in EBP.