Stroke unit Nurse Managers' views of individual and organizational factors liable to influence evidence-based practice: A survey

Frontline nurse leaders' competences in evidence-based healthcare: A scoping review

AIM

To identify evidence on frontline nurse leaders' competences in evidence-based healthcare (EBHC) and the instruments measuring these competences.

DESIGN

A scoping review.

DATA SOURCES

The search was conducted in June 2021 and complemented in June 2022. The CINAHL, ProQuest, Medline (Ovid), Scopus, Web of Science databases and MedNar along with the Finnish database Medic were searched.

REVIEW METHOD

The scoping review was conducted in accordance with the Joanna Briggs institute methodology for scoping reviews. Titles, abstracts and full-text versions were screened independently by two reviewers according to the inclusion criteria. Deductive-inductive content analysis was used to synthesize data.

RESULTS

A total of 3211 articles published between 1997 and 2022 were screened, which resulted in the inclusion of 16 articles. Although frontline nurse leaders had a positive attitude towards EBHC, they had a lack of implementing EBHC competence into practice. Part of the instruments were used in the studies, and only one focused especially on leaders. None of instruments systematically covered all segments of EBHC.

CONCLUSION

There is a limited understanding of frontline nurse leaders' competence in EBHC. It is important to understand the importance of EBHC in healthcare and invest in the development of its competence at all levels of leaders. Frontline nurse leaders' support is essential for direct care nurses to use EBHC to ensure the quality of care and benefits to patients. Leaders must enhance their own EBHC competence to become role models for direct care nurses. It is also essential to develop valid and reliable instruments to measure leaders' competence covering all EBHC segments. The results can be utilized in the assessment and development of frontline nurse leaders' EBHC competence by planning and producing education and other competence development methods.

The evidence-based practice teaching competence of clinical preceptors at different stages of innovation-decision process: A cross-sectional survey in traditional Chinese medicine hospitals

BACKGROUND

Traditional Chinese Medicine Nursing Clinical Preceptors (TCMN-CPs) are crucial to cultivate undergraduates' evidence-based practice (EBP) competence during clinical practicum in traditional Chinese Medicine (TCM) hospitals. However, the TCMN-CPs' EBP teaching competence is unclear. Underpinned by Rogers' innovation-decision process, our study aimed to investigate TCMN-CPs' EBP teaching competence and the related characteristic factors at five stages of knowledge, persuasion, decision, implementation and confirmation.

METHODS

An online survey was conducted by using a modified evidence-based practice teaching competence questionnaire (EBPT-COQ) encompassing attitude, knowledge/skill and practice of EBP teaching in four TCM teaching hospitals in Beijing, China.

RESULTS

A total of 654 TCMN-CPs were included, with a response rate of 91.47 %. Most TCMN-CPs were in knowledge stage (339, 51.83 %), followed by the persuasion stage (166, 25.38 %), decision stage (123, 18.81 %), implementation stage (23, 3.52 %) and confirmation stage (3, 0.46 %). The total and dimension scores of EBPT-COQ increased as the diffusion stage developing, the confirmation stage was the highest (5.48 ± 0.80). Twenty-three items' mean scores were higher than 4 points (95.83 %), except for "Research skills" (3.58 ± 1.38). The related characteristic factors were 1) age (Z = -4.177), working experience (H = 11.087), clinical teaching experience (H = 12.602), management position (Z = 2.565), research experience (Z = -2.867) and EBP training (Z = 3.146) at Knowledge stage; 2) research experience (ZPersuasion = -2.617; ZDecision = -3.510), EBP training (ZPersuasion = 2.528; ZDecision = 3.433) at Persuasion and Decision stage (all P<0.05). And the first three stages TCMN-CPs' EBPT-COQ scores were positively correlated with TCMN-CPs' attitude toward clinical teaching (r = 0.244-0.331, P<0.001).

CONCLUSIONS

Most of the TCMN-CPs' EBP teaching status are in the first three diffusion stages. Though their attitude, knowledge/skills and practice to EBP teaching competence have gradually improved with the deepening of the diffusion stage, much efforts should be made to keep progressing. TCMN-CPs' qualifications of EBP teaching could include rich clinical work and teaching experience, enjoying teaching. Nursing managers, with higher EBP teaching competence, might play a crucial role in promoting the diffusion of EBP teaching. All TCMN-CPs showed an inadequacy of research skills of EBP teaching. Therefore, it is warranted to explore the minimum research skill requirements for EBP teaching and to establish academic-practice partnerships.

Leadership as a Facilitator of Evidence Implementation by Nurse Managers: A Metasynthesis

Evidence-based practice is often not implemented in nursing for reasons relating to leadership. This article aims to cast light on the factors that facilitate nursing evidence implementation perceived by nurse managers in their practical experiences of this implementation. It is a qualitative, narrative metasynthesis of primary studies on nurse managers' leadership-related facilitation experiences, following the Joanna Briggs Institute meta-aggregative approach and the Promoting Action on Research Implementation in Health Services (PARiHS) model. Eleven primary studies were included and three general categories were identified as leadership-related factors facilitating evidence implementation: teamwork (communication between managers and staff nurses), organizational structures (strategic governance), and transformational leadership (influence on evidence application and readiness for change among leaders). Nurse managers act as facilitators of evidence-based practices by transforming contexts to motivate their staff and move toward a shared vision of change. Always providing support as managers and colleagues, sharing their experience in the clinic environment.

Attitude, source of knowledge, and supporting factors on evidence-based nursing among cardiovascular nurses: A cross-sectional descriptive study in Turkey

RATIONALE, AIMS, AND OBJECTIVES

Cardiovascular nursing has been a rapidly growing specialty since the 1960s. Assessing cardiovascular nurses' EBN (evidence-based nursing) attitudes and beliefs and the factors supporting EBN is important to assist the training programmes in fostering EBN practice in a clinical environment. Few investigations have been conducted on EBN knowledge, attitudes, beliefs, and implementation among cardiovascular nurses. The present study aims to investigate cardiovascular nurses' attitudes towards EBN, sources of knowledge, and the factors supporting EBN in Turkey.

METHODS

A cross-sectional survey with a descriptive and comparative design was conducted with 62 cardiovascular nurses working at two hospitals in Turkey. Data were collected by using the Evidence-Based Nursing Attitude Questionnaire, a sociodemographic questionnaire concerning demographic information and including questions about nurses' sources of knowledge, supporting factors to implement EBN, research experience, use of clinical guidelines, and barriers to applying EBN. Data were analysed with descriptive and inferential statistics.

RESULTS

The research revealed that cardiovascular nurses have positive attitudes, feelings, beliefs, and intention of conduct towards EBN. Cardiac surgery nurses reported significantly higher positive feelings, beliefs, intention of conduct, and attitude towards EBN than cardiology nurses. Nursing experience and information acquired through nursing school were the most frequently used sources of knowledge rather than research results (35.5%) in their clinical practice. Half of the respondents (47%) were familiar with EBN. Cardiovascular nurses who had graduate degrees, reviewed nursing research and were familiar with EBN had significant positive attitudes towards EBN. Nurses needed enough time and resources, a background in clinical practice, and support from the hospital administration to implement EBN.

CONCLUSIONS

An education intervention should be provided about EBN knowledge and skills for cardiovascular nurses. Mentor nurses should be trained and assigned in cardiovascular clinics to implement EBN.