Factors affecting nurse practitioners' integration of evidence into practice

Barriers and facilitators of the nurse providing evidence-based preoperative visit-care for transcatheter aortic valve replacement: a mixed-methods study based on an evidence application setting

BACKGROUND

Preoperative visit-care for transcatheter aortic valve replacement (TAVR) plays a crucial role in improving the quality of care and patient safety. However, preoperative care for TAVR patients is still in its early stages in China, with the care often being experience-based. The application of relevant evidence in nursing practice is necessary. Little is known regarding the facilitators and barriers to apply and compliance to the evidences about preoperative visit-care for TAVR in nursing.

METHODS

The Nurse's Compliance Checklist was used to investigate the evidence-based compliance of nurses (n = 21) who worked in the TAVR team in the evidence-based implementation setting. Meanwhile, an Evidence-Based Practice Beliefs Scale, and Influencing Factors Checklist were used to investigate all nurses (n = 66) who work in the same setting. Stakeholders (Middle and senior-level nursing administrators, frontline clinical nurses, and patients) interview was carried out to further disclose the barriers and facilitators in the process of evidence-based practice.

RESULTS

The results of this study showed that only 1 evidence implemented fully (100%) by nurses, 3 evidences with 0% implementation rate, and implementation rate of the other evidences were 9.5∼71.4%. The overall score of nurses' evidence-based nursing belief level was (3.52 ± 0.82). Three domains of barriers were identified: the Context Domain included lack of nursing procedures, inadequate health education materials, insufficient training; the Practitioner Domain included insufficient attention, lack of relevant knowledge, high work pressure and uncertainty of expected results, and Patient Domain included lack of relational knowledge. Facilitating factors included leadership support, nurse' high evidence-based nursing belief, high executive ability and enthusiasm for learning.

CONCLUSION

The study indicated that the nurses' compliance of evidence-based practice in preoperative visit-care for TAVR was in lower level. There were some factors influencing the application of the evidences. The study revealed potential modifiable barriers to the successful implementation of evidence-based preoperative visit-care, including a lack of preoperative visit- care routine, related knowledge and training. Leadership support and nurse training should be considered to improve nurses' compliance with evidence-based practice.

Advanced practice nurses' evidence-based healthcare competence and associated factors: A systematic review

BACKGROUND

Evidence-based healthcare (EBHC) enables consistent and effective healthcare that prioritises patient safety. The competencies of advanced practice nurses (APNs) are essential for implementing EBHC because their professional duties include promoting EBHC.

AIM

To identify, critically appraise, and synthesise the best available evidence concerning the EBHC competence of APNs and associated factors.

DESIGN

A systematic review.

DATA SOURCES

CINAHL, PubMed, Scopus, Medic, ProQuest, and MedNar.

METHODS

Databases were searched for studies (until 19 September 2023) that examined the EBHC competence and associated factors of APNs were included. Quantitative studies published in English, Swedish and Finnish were included. We followed the JBI methodology for systematic review and performed a narrative synthesis.

RESULTS

The review included 12 quantitative studies, using 15 different instruments, and involved 3163 participants. The quality of the studies was fair. The APNs' EBHC competence areas were categorised into five segments according to the JBI EBHC model. The strongest areas of competencies were in global health as a goal, transferring and implementing evidence, while the weakest were generating and synthesising evidence. Evidence on factors influencing APNs' EBHC competencies was contradictory, but higher levels of education and the presence of an organisational research council may be positively associated with APNs' EBHC competencies.

CONCLUSION

The development of EBHC competencies for APNs should prioritise evidence generation and synthesis. Elevating the education level of APNs and establishing a Research Council within the organisation can potentially enhance the EBHC competence of APNs.

IMPLICATIONS FOR THE PROFESSION

We should consider weaknesses in EBHC competence when developing education and practical exercises for APNs. This approach will promote the development of APNs' EBHC competence and EBHC implementation in nursing practice.

REGISTRATION, AND REPORTING CHECKLIST

The review was registered in PROSPERO (CRD42021226578), and reporting followed the PRISMA checklist.

PATIENT/PUBLIC CONTRIBUTION

None.

An Integrative Review of Response Rates in Nursing Research Utilizing Online Surveys

BACKGROUND

Online surveys in nursing research have both advantages and disadvantages. Reaching a sample and attaining an appropriate response rate is an ongoing challenge and necessitates careful consideration when designing a nursing research study using an online survey approach.

OBJECTIVE

In this study, we aimed to explore response rates and survey characteristics of studies by nurse researchers that used online methodologies to survey nurses, nursing students, and nursing faculty.

METHODS

We conducted an integrative review of research studies that used online surveys for data collection published from 2011 to 2021. We examined response rates and survey characteristics such as recruitment method, use of incentives, question type, length of survey, time to complete the survey, and use of reminders.

RESULTS

Our review included 51 studies published by nurses with target samples of nurses, nursing students, or nursing faculty. Study sample sizes ranged from 48 to 29,283, the number of respondents ranged from 29 to 3,607, and the response rates ranged from 3.4% to 98%, with an average of 42.46%. Few patterns emerged regarding recruitment or other factors to enhance response rates; only five studies used incentives.

CONCLUSION

Response rates to online surveys are unlikely to reach the rates seen in older mailed surveys. Researchers need to design online survey studies to be easily accessible, concise, and appealing to participants.

NP Use of Practice Guidelines Is Helped by Easy Access and Support from Leadership

Barriers to implementing guidelines include patient comorbidities, time constraints.