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Morquin D, Ologeanu‐Taddei R, Paré G, Wagner G. A method for resolving organisation‐enterprise system misfits: An action research study in a pluralistic organisation. INFORMATION SYSTEMS JOURNAL 2023. [DOI: 10.1111/isj.12433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Affiliation(s)
| | | | - Guy Paré
- HEC Montréal Montreal Quebec Canada
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Jabonete FGV, Roxas REO. Barriers to Research Utilization in Nursing: A Systematic Review (2002–2021). SAGE Open Nurs 2022; 8:23779608221091073. [PMID: 35600005 PMCID: PMC9118897 DOI: 10.1177/23779608221091073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/24/2022] [Accepted: 03/11/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction There is an existing gap between what people learned from theory and what they clinically practiced, as revealed in research studies in nursing. This gap is primarily due to identified barriers in utilizing the research findings in actual nursing practice. Objective To present a scientific mapping of the Scopus-indexed literature published from 2002 to 2021, which studied barriers to research utilization in nursing using the BARRIER scale. Methods This systematic review utilized bibliometric analysis. One hundred seventy-nine extracted literature from Scopus was manually reviewed, and the study included 53 documents for further analysis. Results Remarkably, almost three-fourths of the documents identified setting-related factors as the most common barrier to research utilization in nursing (n = 39, 73.58%). This is followed by presentation-related factors (n = 16.98%) and nurse-related factors (n = 5, 9.43%), respectively. Findings revealed that insufficient time at work in implementing new ideas was perceived as the top barrier in research utilization in nursing. Conclusion It is crucial to determine the hindrances to the utilization of research findings. The results of this study establish the connection between research and evidence-based practice which stimulates in meeting the gap in the current nursing practice. Future studies must include research utilization studies that apply tools other than the BARRIER scale.
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Almalki MS, Kimpton A, Jones LK, Da Costa C. Nurses’ Perceived Facilitators of Research Utilisation in a Multicultural Setting in Saudi Arabia: Observational Study. NURSING REPORTS 2022; 12:164-174. [PMID: 35324563 PMCID: PMC8951267 DOI: 10.3390/nursrep12010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/11/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Facilitators of research utilisation are important in the implementation of evidence-based practice. Numerous facilitators for nursing practice have been identified, but knowledge of the impact of demographic characteristics on these enablers of research utilisation is limited. The study’s aim was to determine nurses’ perceptions of the facilitators of research utilisation and assess differences in the facilitator of research utilisation score based on nurses’ demographic characteristics. A total of 2650 registered nurses from five hospitals in Riyadh, Saudi Arabia, were recruited for participation. A facilitator scale and self-designed demographic survey were used for data collection. The number of completed questionnaires was 1824 (69%). The results showed that many of the participants were female, aged between 20 to 40 years, and were expatriates mainly from the Philippines. Most respondents were clinical nurses with 6 to 10 years of experience. Many of the nurses had a bachelor’s degree and a qualification from the Asian region. The mean total facilitator score was 26.1, with strong facilitators of research, including advanced education, providing colleague support, more clinically focused research and employing nurses with research skills. Recommendations for the facilitation of research utilisation include a strengthening of the research curriculum in nursing education programs as well as through continuing professional education.
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Affiliation(s)
| | - Amanda Kimpton
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, P.O. Box 71, Bundoora, VIC 3083, Australia; (A.K.); (C.D.C.)
| | - Linda Katherine Jones
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, P.O. Box 71, Bundoora, VIC 3083, Australia; (A.K.); (C.D.C.)
- Correspondence: ; Tel.: +61-411-209-169
| | - Cliff Da Costa
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, P.O. Box 71, Bundoora, VIC 3083, Australia; (A.K.); (C.D.C.)
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Da'seh A, Rababa M. Military nurses' perspectives towards research utilization barriers. Heliyon 2021; 7:e08181. [PMID: 34703932 PMCID: PMC8526769 DOI: 10.1016/j.heliyon.2021.e08181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/03/2021] [Accepted: 10/11/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Research utilization in nursing practice includes integrating research findings into clinical practice to guide nursing practice towards safe and effective clinical decision-making. However, nursing leaders are faced with barriers which hinder research utilization and hence create a gap between research and clinical practice. This study aimed to identify the barriers to research utilization as perceived by Jordanian Royal Medical Services nurses. METHODS A descriptive cross-sectional design was employed. A convenience sample of 365 nurses working with the Jordanian Royal Medical Services was recruited from three hospitals. The BARRIERS scale and a self-designed questionnaire were used for data collection, and descriptive statistics, t-tests, one way ANOVA, and Pearson's correlation were used to analyze the data. RESULTS The mean age of the participants was 30 years. The majority of the participating nurses were female (62.5%), and 91.8% held a bachelor's degree. Overall, the greatest barrier to research utilization was related to the setting factor (mean = 3.01), followed by the presentation of research factor (mean = 2.86). Further, lack of time to read research identified as a top-ranked barrier among the individual items (m = 3.3). In addition, there were significant differences in the participants' mean BARRIERS scale scores based on age and hospital (p value = .002 and <.0001, respectively). CONCLUSION The study findings highlighted the need for organizational support, recognition, and encouragement of research utilization. Continuous education for nurses that focuses on research skills, knowledge, and awareness is also crucial.
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Affiliation(s)
- Ayat Da'seh
- Applied Science Department, Al-Balqa Applied University, Aqaba, Jordan
| | - Mohammad Rababa
- Department of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, 22110, Jordan
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Gasteiger N, van der Veer SN, Wilson P, Dowding D. Upskilling health and care workers with augmented and virtual reality: protocol for a realist review to develop an evidence-informed programme theory. BMJ Open 2021; 11:e050033. [PMID: 34226234 PMCID: PMC8258595 DOI: 10.1136/bmjopen-2021-050033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/10/2021] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Augmented reality (AR) and virtual reality (VR) are increasingly used to upskill health and care providers, including in surgical, nursing and acute care settings. Many studies have used AR/VR to deliver training, providing mixed evidence on their effectiveness and limited evidence regarding contextual factors that influence effectiveness and implementation. This review will develop, test and refine an evidence-informed programme theory on what facilitates or constrains the implementation of AR or VR programmes in health and care settings and understand how, for whom and to what extent they 'work'. METHODS AND ANALYSIS This realist review adheres to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) standards and will be conducted in three steps: theory elicitation, theory testing and theory refinement. First, a search will identify practitioner, academic and learning and technology adoption theories from databases (MEDLINE, Scopus, CINAHL, Embase, Education Resources Information Center, PsycINFO and Web of Science), practitioner journals, snowballing and grey literature. Information regarding contexts, mechanisms and outcomes will be extracted. A narrative synthesis will determine overlapping configurations and form an initial theory. Second, the theory will be tested using empirical evidence located from the above databases and identified from the first search. Quality will be assessed using the Mixed Methods Appraisal Tool (MMAT), and relevant information will be extracted into a coding sheet. Third, the extracted information will be compared with the initial programme theory, with differences helping to make refinements. Findings will be presented as a narrative summary, and the MMAT will determine our confidence in each configuration. ETHICS AND DISSEMINATION Ethics approval is not required. This review will develop an evidence-informed programme theory. The results will inform and support AR/VR interventions from clinical educators, healthcare providers and software developers. Upskilling through AR/VR learning interventions may improve quality of care and promote evidence-based practice and continued learning. Findings will be disseminated through conference presentations and peer-reviewed journal articles.
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Affiliation(s)
- Norina Gasteiger
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Division of Informatics, Imaging and Data Sciences, Centre for Health Informatics, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Sabine N van der Veer
- Division of Informatics, Imaging and Data Sciences, Centre for Health Informatics, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Paul Wilson
- Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Dawn Dowding
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Heinemann AW, Nitsch KP, Gracz K, Ehrlich-Jones L, Engel E, Wilson M, Zale C, Graham ID. Implementing Patient-Reported Outcome Measures in Inpatient Rehabilitation: Challenges and Solutions. Arch Phys Med Rehabil 2021; 103:S67-S77. [PMID: 34144004 DOI: 10.1016/j.apmr.2021.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 05/10/2021] [Accepted: 05/17/2021] [Indexed: 11/02/2022]
Abstract
A project with the goal of implementing electronic health record (EHR) - based patient-reported outcome measures (PROMs) into a large inpatient spinal cord injury (SCI) rehabilitation program took twice as long as expected. This report details the lessons learned from the barriers, successes, and unexpected issues that arose during this prolonged, but now successful project. The goals of this implementation project were to (1) identify barriers and supports to the use of PROMs; (2) develop an implementation strategy to incorporate the use of PROMs into inpatient rehabilitation; and (3) implement the strategy and evaluate its effects on team communication. In brief, we conducted an initial pilot phase outside of the EHR and used our findings to guide procedural and EHR incorporation during a demonstration phase. We encountered multiple barriers. Procedural issues were significant: even though grant funding covered the cost of writing the code for integration of the PROMs into the EHR, our institution's competing priorities slowed progress. Institutional inertia was reflected in the reluctance of some clinical staff members to assume new duties that would take away from direct patient care responsibilities. Therefore, we needed to obtain additional staffing. Detailed planning upfront, guided by changes when necessary, cooperation and interaction with our institution's Information Systems department, and identification of key players and implementation champions proved essential to our success. We now have an up-and-running system and are sharing our experience, observations, and recommendations to assist other healthcare organizations incorporate PROMs into their EHRs.
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Affiliation(s)
- Allen W Heinemann
- Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine and Director, Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab.
| | - Kristian P Nitsch
- Department of Psychology, Shepherd Pathways, Shepherd Center, Atlanta, GA
| | | | - Linda Ehrlich-Jones
- Research Associate Professor, Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, and Associate Director, Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab
| | - Edeth Engel
- Project Coordinator, Shirley Ryan AbilityLab
| | - Meghan Wilson
- Clinical Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Arkansas for Medical Sciences College of Medicine
| | - Colleen Zale
- Occupational/Physical Therapist, Shirley Ryan AbilityLab
| | - Ian D Graham
- FRSC Professor, School of Epidemiology and Public Health, University of Ottawa, and Senior Scientist, Clinical Epidemiology Program, Ottawa Hospital Research Institute
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Voldbjerg SL, Wiechula R, Sørensen EE, Grønkjaer M. Newly graduated nurses' socialisation resulting in limiting inquiry and one-sided use of knowledge sources-An ethnographic study. J Clin Nurs 2020; 30:701-711. [PMID: 33290615 DOI: 10.1111/jocn.15592] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 11/17/2020] [Accepted: 11/21/2020] [Indexed: 11/30/2022]
Abstract
AIM To explore how the socialisation into the clinical setting and interaction between newly graduated nurses and experienced nurses influences the new graduates' use of knowledge sources. BACKGROUND Newly graduated nurses' use of knowledge sources in decision-making has been subject to an increased interest in relation to evidence-based practice. Despite interventions to strengthen nurses' competencies required for making reflective clinical decisions within an evidence-based practice, studies highlight that new graduates only draw on knowledge from research, patients and other components within evidence-based practice to a limited extent. Research exploring new graduates' use of knowledge sources calls attention to the experienced nurses' decisive role as a valued knowledge source. The new graduates' process of socialisation and their interaction with the experienced nurse raises further questions. METHODS Ethnography using participant-observation and individual semi-structured interviews of nine newly graduated nurses from a University Hospital in Denmark. Data were collected in 2014. The study adheres to COREQ. RESULTS Two main structures were found: "Striving for acknowledgment" and "Unintentionally suppressed inquiry." CONCLUSIONS New graduates are socialised into limiting their inquiry on clinical practice and unintentionally being restricted to using the experienced nurse as predominant knowledge source. Depending on how the experienced nurse responds to the role as predominant knowledge source, they could either limit or nurture the new graduates' inquiry into practice and thus the variety of knowledge sources used in clinical decision-making. Limited inquiry into the complexity of nursing practice indirectly excludes the use of a variety of knowledge sources, which are fundamental to an evidence-based practice. RELEVANCE If clinical practice wishes to benefit from the newly graduated nurses' inquiring approach and skills within evidence-based practice, clinical practice will have to greet the nurses with a supportive culture where questioning practice is seen as a strength rather than a sign of insecurity and incompetence.
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Affiliation(s)
- Siri Lygum Voldbjerg
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,School of Nursing, University College of Northern Denmark, Aalborg, Denmark.,Adelaide Nursing School, Adelaide Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Rick Wiechula
- Adelaide Nursing School, Adelaide Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.,Centre for Evidence-based Practice South Australia, A Joanna Briggs Institute Centre of Excellence, Adelaide, South Australia, Australia.,School of Master in Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Erik Elgaard Sørensen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg Øst, Denmark
| | - Mette Grønkjaer
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg Øst, Denmark
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8
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Orton ML, Nilsen P, Nelson Follin N, Dannapfel P. Is It Possible for Registered Nurses and Physicians to Combine Research and Clinical Work to Facilitate Evidence-Based Practice? Worldviews Evid Based Nurs 2020; 18:15-22. [PMID: 33290642 DOI: 10.1111/wvn.12481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Evidence-based patient care requires clinicians to make decisions based on the best available evidence and researchers to provide new scientific knowledge. Clinician-scientists (i.e., registered nurses [RNs] and physicians with a PhD) make important contributions to health care; yet, their roles are not fully understood, supported, or recognized by healthcare leaders. Only a few studies have addressed the factors that enable RNs and physicians to simultaneously pursue both clinical work and research after earning a PhD. AIM To explore what factors have a bearing on the ability of RNs and physicians to pursue research and clinical work simultaneously after earning a PhD. METHODS The study used a qualitative design based on open-ended, in-depth interviews. Data were analyzed using conventional content analysis. RESULTS Analysis of the data yielded a broad range of factors that RNs and physicians perceived to either facilitate or hinder continued research while simultaneously undertaking clinical work. Most of the perceived barriers were due to factors external to the individual. Several factors applied to both professions yet differed in impact. Factors mentioned as fundamental to continued research were financial support and allocated time for research. Maintenance of a good relationship with academia and support from management were also considered to be important. In addition, personal factors, such as motivation to pursue a research career after obtaining a PhD, were influential. LINKING EVIDENCE TO ACTION A supportive infrastructure is important for enabling clinician-scientists to pursue research after earning a PhD. Creating favorable conditions for RNs and physicians to combine research with clinical work can facilitate evidence-based practice. This information can be used for interventions aimed at improving the conditions for clinician-scientists.
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Affiliation(s)
- Marie-Louise Orton
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.,Karolinska University Hospital, Stockholm, Sweden
| | - Per Nilsen
- Department of Health and Society, Division of Social Medicine and Public Health Science, Linköping University, Linköping, Sweden
| | - Nina Nelson Follin
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.,Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical and Experimental Medicine, Division of Children's and Women's Health, Linköping University, Linköping, Sweden.,National Specialized Medical Care, Region Stockholm, Stockholm, Sweden
| | - Petra Dannapfel
- Karolinska University Hospital, Stockholm, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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9
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Eilayyan O, Visca R, Zidarov D, Ware P, Bussières A, Ahmed S. Developing theory-informed knowledge translation strategies to facilitate the use of patient-reported outcome measures in interdisciplinary low back pain clinical practices in Quebec: mixed methods study. BMC Health Serv Res 2020; 20:789. [PMID: 32843032 PMCID: PMC7445906 DOI: 10.1186/s12913-020-05616-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 08/02/2020] [Indexed: 01/23/2023] Open
Abstract
Background There is a growing interest among healthcare providers (HCPs) to use Patient Reported Outcome Measures (PROMs) in clinical care. PROMs can help improve patient-care provider communication and may be used to inform the need for interdisciplinary care for Low Back Pain (LBP). However, PROM implementation to support clinical decision-making is complex and requires knowledge translation (KT) interventions that will overcome barriers to using PROMs in interdisciplinary clinical settings. Objectives to 1) identify potential barriers and enablers to using PROMs in primary care LBP clinical practice from the perspective of healthcare team members, and 2) develop a theory-based tailored KT intervention to facilitate the use of PROMs in interdisciplinary clinical practice. Methods We invited 25 HCPs working in an interdisciplinary team to complete a self-administered survey designed based on the Theoretical Domain Framework (TDF) to identify the barriers and enablers to using PROM scores in LBP clinical practice. The questionnaire consisted of 30 questions rated on a 5-point Likert scale (quantitative) and included open-ended questions (qualitative). Quantitative and qualitative data were analysed to estimate the frequency of barriers and enablers. Findings were then reviewed by a panel of four KT experts who mapped behaviour change techniques to barriers identified that informed the design of a KT intervention. Results Eighteen HCPs responded to the survey. Factors identified as likely to restrict the use of PROM scores included knowledge, skills, social/professional role and identity, goals, decision processes, beliefs about consequences, environmental context and resources, behavioural regulation, and social influence. A multi-component evidence-based KT intervention was proposed by the panel of experts to address these barriers: a training workshop; educational materials; and use of PROM score reports to HCPs that were all delivered by an opinion leader. Conclusion The routine use of PROMs in clinical practice may optimize the quality of LBP care and improve patients’ outcomes. The proposed multi-component KT intervention is expected to be an effective strategy to increase HCPs’ ability to integrate PROMs into clinical decision-making and to engage patients in their care.
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Affiliation(s)
- Owis Eilayyan
- School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,College of Applied Medical Sciences, Physical Therapy and Rehabilitation Department, Jouf University, Sakaka, Jouf, Saudi Arabia.,Center for outcome research and evaluation, Clinical Epidemiology, McGill University Health Center, McGill University, Montréal, QC, Canada.,Centre de recherche interdisciplinaire en réadaptation (CRIR), Constance Lethbridge Rehabilitation Center, Montréal, QC, Canada
| | - Regina Visca
- RUISSS McGill Centre of Expertise in Chronic Pain, Montréal, QC, Canada.,Family Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - Diana Zidarov
- Faculté de Médecine, École de réadaptation, Université de Montréal, Montréal, QC, Canada.,Institut universitaire sur la réadaptation en déficience physique de Montréal, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada.,Centre de recherche interdisciplinaire en réadaptation (CRIR), Institut de réadaptation Gingras-Lindsay-de-Montréal, Montréal, QC, Canada
| | - Patrick Ware
- Centre for Global eHealth InnovationCentre for Global eHealth Innovation, University Health Network, Toronto, ON, Canada
| | - André Bussières
- School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,Centre de recherche interdisciplinaire en réadaptation (CRIR), Constance Lethbridge Rehabilitation Center, Montréal, QC, Canada.,Département chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Sara Ahmed
- School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada. .,Center for outcome research and evaluation, Clinical Epidemiology, McGill University Health Center, McGill University, Montréal, QC, Canada. .,Centre de recherche interdisciplinaire en réadaptation (CRIR), Constance Lethbridge Rehabilitation Center, Montréal, QC, Canada. .,Centre de recherche interdisciplinaire en réadaptation (CRIR), Institut de réadaptation Gingras-Lindsay-de-Montréal, Montréal, QC, Canada.
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10
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Belita E, Squires JE, Yost J, Ganann R, Burnett T, Dobbins M. Measures of evidence-informed decision-making competence attributes: a psychometric systematic review. BMC Nurs 2020; 19:44. [PMID: 32514242 PMCID: PMC7254762 DOI: 10.1186/s12912-020-00436-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 05/19/2020] [Indexed: 11/10/2022] Open
Abstract
Background The current state of evidence regarding measures that assess evidence-informed decision-making (EIDM) competence attributes (i.e., knowledge, skills, attitudes/beliefs, behaviours) among nurses is unknown. This systematic review provides a narrative synthesis of the psychometric properties and general characteristics of EIDM competence attribute measures in nursing. Methods The search strategy included online databases, hand searches, grey literature, and content experts. To align with the Cochrane Handbook of Systematic Reviews, psychometric outcome data (i.e., acceptability, reliability, validity) were extracted in duplicate, while all remaining data (i.e., study and measure characteristics) were extracted by one team member and checked by a second member for accuracy. Acceptability data was defined as measure completion time and overall rate of missing data. The Standards for Educational and Psychological Testing was used as the guiding framework to define reliability, and validity evidence, identified as a unified concept comprised of four validity sources: content, response process, internal structure and relationships to other variables. A narrative synthesis of measure and study characteristics, and psychometric outcomes is presented across measures and settings. Results A total of 5883 citations were screened with 103 studies and 35 unique measures included in the review. Measures were used or tested in acute care (n = 31 measures), public health (n = 4 measures), home health (n = 4 measures), and long-term care (n = 1 measure). Half of the measures assessed a single competence attribute (n = 19; 54.3%). Three measures (9%) assessed four competence attributes of knowledge, skills, attitudes/beliefs and behaviours. Regarding acceptability, overall missing data ranged from 1.6–25.6% across 11 measures and completion times ranged from 5 to 25 min (n = 4 measures). Internal consistency reliability was commonly reported (21 measures), with Cronbach’s alphas ranging from 0.45–0.98. Two measures reported four sources of validity evidence, and over half (n = 19; 54%) reported one source of validity evidence. Conclusions This review highlights a gap in the testing and use of competence attribute measures related to evidence-informed decision making in community-based and long-term care settings. Further development of measures is needed conceptually and psychometrically, as most measures assess only a single competence attribute, and lack assessment and evidence of reliability and sources of established validity evidence. Registration PROSPERO #CRD42018088754.
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Affiliation(s)
- Emily Belita
- McMaster University, School of Nursing, McMaster Innovation Park (MIP), 175 Longwood Road South, Suite 210a, Hamilton, ON L8P 0A1 Canada
| | - Janet E Squires
- University of Ottawa/Université d'Ottawa, School of Nursing/École des sciences infirmières, Room RGN 3038, Guindon Hall, 451 Smyth Road, Ottawa, ON Canada
| | - Jennifer Yost
- Villanova University, M. Louise Fitzpatrick College of Nursing, Driscoll Hall, Room 330, 800 Lancaster Avenue, Villanova, PA 19085 USA
| | - Rebecca Ganann
- McMaster University, School of Nursing, 1280 Main St. W., HSC 3N25F, Hamilton, ON Canada
| | - Trish Burnett
- McMaster University, School of Nursing, McMaster Innovation Park (MIP), 175 Longwood Road South, Suite 210a, Hamilton, ON L8P 0A1 Canada
| | - Maureen Dobbins
- McMaster University, School of Nursing, McMaster Innovation Park (MIP), 175 Longwood Road South, Suite 210a, Hamilton, ON L8P 0A1 Canada
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11
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Auty SG, Stein MD, Walley AY, Drainoni ML. Buprenorphine waiver uptake among nurse practitioners and physician assistants: The role of existing waivered prescriber supply. J Subst Abuse Treat 2020; 115:108032. [PMID: 32600629 DOI: 10.1016/j.jsat.2020.108032] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 04/27/2020] [Accepted: 05/09/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Buprenorphine is an effective pharmacotherapy for the treatment of opioid use disorder (OUD), but recent increases in the rate of OUD in the U.S. have outpaced the supply of clinicians waivered to prescribe buprenorphine. To increase the supply of buprenorphine prescribers, the Comprehensive Addiction and Recovery Act expanded buprenorphine prescribing waiver eligibility beyond physicians to nurse practitioners (NP) and physician assistants (PA) in 2017. Little is known about patterns of waiver uptake among NPs and PAs. This study examined associations between the existing supply of waivered prescribers and waiver uptake among NPs and PAs in U.S. states. METHODS NP and PA waiver uptake was evaluated as the number of NPs or PAs obtaining an initial buprenorphine prescribing waiver per 10,000 state residents from January 2017 to December 2018 using data from the Buprenorphine Waiver Notification System. NP and PA waiver uptake was estimated as a function of existing waivered prescriber supply, OUD treatment capacity, and other state characteristics using generalized least squares (GLS) regression. RESULTS 28,010 NPs and PAs have become waivered to prescribe buprenorphine since January 2017. GLS regressions indicated that waivered prescriber supply was significantly, positively associated with both NP (b = 0.101 p < 0.001) and PA (b = 0.030, p < 0.001) waiver uptake. Results suggest an addition of ten waivered prescribers to existing supply was associated with an increase of one waivered NP, and an addition of thirty-three waivered prescribers to existing supply was associated with an increase of one waivered PA. CONCLUSIONS NP and PA waiver uptake is strongly associated with the existing supply of waivered prescribers in a state, suggesting NPs and PAs may be more likely to acquire waivers in states with a high existing supply of buprenorphine prescribers. Additional policy solutions are needed to scale up the supply of buprenorphine prescribers in underserved states.
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Affiliation(s)
- Samantha G Auty
- Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA.
| | - Michael D Stein
- Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA.
| | - Alexander Y Walley
- Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, 1 Medical Center Place, Boston, MA, 02118, USA.
| | - Mari-Lynn Drainoni
- Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA; Department of Infectious Disease, Boston University School of Medicine, 801 Massachusetts Ave Crosstown Center, Boston, MA, 02118, USA.
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12
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Iqbal J, Ahmad RB, Khan M, Fazal-e-Amin, Alyahya S, Nizam Nasir MH, Akhunzada A, Shoaib M. Requirements engineering issues causing software development outsourcing failure. PLoS One 2020; 15:e0229785. [PMID: 32271783 PMCID: PMC7144980 DOI: 10.1371/journal.pone.0229785] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 02/13/2020] [Indexed: 11/19/2022] Open
Abstract
Software development outsourcing is becoming more and more famous because of the advantages like cost abatement, process enhancement, and coping with the scarcity of needed resources. Studies confirm that unfortunately a large proportion of the software development outsourcing projects fails to realize anticipated benefits. Investigations into the failures of such projects divulge that in several cases software development outsourcing projects are failed because of the issues that are associated with requirements engineering process. The objective of this study is the identification and the ranking of the commonly occurring issues of the requirements engineering process in the case of software development outsourcing. For this purpose, contemporary literature has been assessed rigorously, issues faced by practitioners have been identified and three questionnaire surveys have been organized by involving experienced software development outsourcing practitioners. The Delphi technique, cut-off value method and 50% rule have also been employed. The study explores 150 issues (129 issues from literature and 21 from industry) of requirements engineering process for software development outsourcing, groups the 150 issues into 7 identified categories and then extricates 43 customarily or commonly arising issues from the 150 issues. Founded on 'frequency of occurrence' the 43 customarily arising issues have been ranked with respect to respective categories (category-wise ranking) and with respect to all the categories (overall ranking). Categories of the customarily arising issues have also been ranked. The issues' identification and ranking contribute to design proactive software project management plan for dealing with software development outsourcing failures and attaining conjectured benefits of the software development outsourcing.
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Affiliation(s)
- Javed Iqbal
- Department of Computer Science, COMSATS University, Islamabad, Pakistan
| | - Rodina B. Ahmad
- Faculty of Computer Science and Information Technology, University of Malaya, Kuala Lumpur, Malaysia
| | - Muzafar Khan
- Department of Engineering, National University of Modern Languages, Islamabad, Pakistan
| | - Fazal-e-Amin
- College of Computer and Information Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sultan Alyahya
- College of Computer and Information Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mohd Hairul Nizam Nasir
- Faculty of Computer Science and Information Technology, University of Malaya, Kuala Lumpur, Malaysia
| | - Adnan Akhunzada
- Department of Computer Science, COMSATS University, Islamabad, Pakistan
| | - Muhammad Shoaib
- College of Computer and Information Sciences, King Saud University, Riyadh, Saudi Arabia
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13
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Al Zoubi FM, French SD, Patey AM, Mayo NE, Bussières AE. Professional barriers and facilitators to using stratified care approaches for managing non-specific low back pain: a qualitative study with Canadian physiotherapists and chiropractors. Chiropr Man Therap 2019; 27:68. [PMID: 31857892 PMCID: PMC6909494 DOI: 10.1186/s12998-019-0286-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/01/2019] [Indexed: 12/28/2022] Open
Abstract
Background Recent clinical practice guidelines for the management of non-specific low back pain (LBP) recommend using stratified care approaches. To date, no study has assessed barriers and facilitators for health professionals in using stratified care approaches for managing non-specific LBP in the Canadian primary care setting. This study aimed to identify and contrast barriers and facilitators to using the stratified care approaches for non-specific LBP among Canadian physiotherapists and chiropractors. Methods Individual telephone interviews, underpinned by the Theoretical Domains Framework (TDF), explored beliefs and attitudes about, and identified barriers and facilitators to the use of stratified care approaches for managing non-specific LBP in a purposive sample of 13 chiropractors and 14 physiotherapists between September 2015 and June 2016. Interviews were digitally recorded, transcribed verbatim and analysed by two independent assessors using directed content analysis. Results Three and seven TDF domains were identified as likely relevant for physiotherapists and chiropractors, respectively. Shared key beliefs (and relevant domains of the TDF) for both physiotherapists and chiropractors included: lack of time, cost, and expertise (Environmental Context and Resources); and consulting more experienced colleagues and chronic patients with important psychological overlay (Social Influences). Unique key domains were identified among physiotherapists: incompatibility with achieving other objectives (Goals), and chiropractors: confidence in using stratified care approaches (Beliefs about Capabilities); intention to use stratified care approaches (Intentions); awareness and agreement with stratified care approaches (Knowledge); assessment of readiness for change and intentional planning behaviour (Behavioural Regulation); and improving the management of non-specific LBP patients and the uptake of evidence-based practice (Beliefs about Consequences). Conclusions Several shared and unique barriers and facilitators to using the stratified care approaches for non-specific LBP among Canadian physiotherapists and chiropractors were identified. Findings may help inform the design of tailored theory-based knowledge translation interventions to increase the uptake of stratified care approaches in clinical practice.
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Affiliation(s)
- Fadi M Al Zoubi
- 1School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, 3630 Promenade Sir-William-Osler, H3G 1Y5, Montreal, QC Canada.,2Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, QC Canada
| | - Simon D French
- 3Department of Chiropractic, Macquarie University, Sydney, NSW Australia.,4School of Rehabilitation Therapy, Queen's University, Kingston, ON Canada
| | - Andrea M Patey
- 5Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Nancy E Mayo
- 1School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, 3630 Promenade Sir-William-Osler, H3G 1Y5, Montreal, QC Canada.,2Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, QC Canada
| | - André E Bussières
- 1School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, 3630 Promenade Sir-William-Osler, H3G 1Y5, Montreal, QC Canada.,2Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, QC Canada.,6Département chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, QC Canada
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14
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Misoprostol, Magnesium Sulphate and Anti-shock garment: A knowledge, availability and utilization study at the Primary Health Care Level in Western Nigeria. PLoS One 2019; 14:e0213491. [PMID: 30897096 PMCID: PMC6460555 DOI: 10.1371/journal.pone.0213491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 02/22/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction Nigeria has one of the highest maternal mortality ratios in the world. The
nurses and midwives being the first point of contact play a central role in
addressing these problems. This study was conducted to assess the knowledge
and utilization of the technologies (misoprostol, anti-shock garment and
magnesium sulphate) in the reduction of maternal mortality amongst the
Primary Health Care (PHC) nurses and midwives in Lagos State, Nigeria. In
addition, the availability of the technologies in the flagship Primary
Health Centres (PHCs) was assessed. Methods This was a cross-sectional study among all the nurses and midwives at the
flagship PHCs in Lagos state and a total of 230 were eventually studied.
Data was collected using a self-administered, structured questionnaire and a
checklist. Descriptive and inferential statistics were applied. Level of
significance was set at 5% (p<0.05). Results All the respondents were aware of the technologies but most (73.9%) had poor
knowledge of them. Majority (74.8%) of the respondents had good knowledge of
maternal mortality and its major causes. Most, 81.3% of the respondents have
administered misoprostol, 37.0% magnesium sulphate while 52.2% have
administered anti shock garment. Out of the 57 flagship PHCs, 27 (47.4%) had
magnesium sulphate, 42 (73.7%) had misoprostol and 52 (91.2%) had anti-shock
garments in their facilities. Respondents who were double qualified
(nurse/midwife) had significantly better knowledge of maternal mortality and
its major causes (p = 0.009) than the other cadres. Longer years of
experience (p = 0.019), training in the use of misoprostol (p = 0.020) and
training in the use of magnesium sulphate (p = 0.001) significantly improved
knowledge of the technologies. Conclusion Respondents had good knowledge of maternal mortality and its major causes and
poor knowledge of the technologies for maternal mortality reduction, despite
the trainings attended. Of the three technologies considered, misoprostol
was the most commonly used. Periodic refresher courses for the training and
retraining of PHC nurses and midwives on the technologies for maternal
mortality reduction is recommended.
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Heinemann AW, Nitsch KP, Ehrlich-Jones L, Malamut L, Semik P, Srdanovic N, Kocherginsky M, Hobbs S. Effects of an Implementation Intervention to Promote Use of Patient-Reported Outcome Measures on Clinicians' Perceptions of Evidence-Based Practice, Implementation Leadership, and Team Functioning. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2019; 39:103-111. [PMID: 31021968 DOI: 10.1097/ceh.0000000000000249] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Patient-reported outcome measures (PROMs) are administered rarely during rehabilitation hospitalizations because clinicians are unfamiliar with their use and the technology to integrate PROMs into electronic medical records is nascent. This study evaluated an implementation intervention that targeted teams' perceptions of evidence-based practice (EBP), implementation leadership, and team functioning that might facilitate PROM use. METHODS We compared clinicians' perceptions on three inpatient rehabilitation units, with sequential implementation across units. Clinicians completed the EBP Attitudes Scale, Implementation Leadership Scale, and the Team Functioning Survey before, shortly after, and 1 month after training. RESULTS Forty-seven clinicians participated, including nurses (27.7%), occupational (21.3%) and physical therapists (21.3%), and two physicians. They worked on spinal cord injury (46.8%), neurologic (40.4%), or pediatric (12.8%) units. EBP Attitude Scale scores improved from preintervention to postintervention and remained above baseline levels at follow-up. The interaction between time and unit was statistically significant for the Divergence subscale such that Pediatric Unit scores increased from preintervention to postintervention and follow-up, while on the spinal cord injury, unit scores increased from preintervention to postintervention, and on the Neurologic Unit scores declined from preintervention to postintervention and follow-up. The EBP Attitudes Requirements score increased at postintervention and follow-up. The Implementation Leadership Scale Proactive score and team functioning survey scores decreased slightly. DISCUSSION Implementing PROMs had varied effects on EBP attitudes and perceptions of leadership and team functioning. Perceptions across units were distinctive on the Evidence-Based Practice Attitudes Scale Divergence subscale. Introduction of PROMs should consider clinician attitudes regarding EBP as well as implementation leadership and team functioning.
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Affiliation(s)
- Allen W Heinemann
- Mr. Heinemann: professor, Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, and Director Shirley Ryan AbilityLab, Center for Rehabilitation Outcomes Research, Chicago, Illinois. Mr. Nitsch: postdoctoral fellow, Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland. Ms. Ehrlich-Jones: Research associate professor, Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, and assistant director, Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois. Ms. Malamut: project coordinator, Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois. Mr. Semik: data analyst, Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois. Ms. Srdanovic: Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine. Dr. Kocherginsky: Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Ms. Hobbs: therapy manager, Spinal Cord Innovation Center, Shirley Ryan Ability Lab, Chicago, Illinois
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Carlsson ÕU, Wadensten B. Professional practice-related training and organizational readiness for change facilitate implementation of projects on the national core value system in care of older people. Nurs Open 2018; 5:593-600. [PMID: 30338105 PMCID: PMC6177551 DOI: 10.1002/nop2.185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 05/21/2018] [Indexed: 11/06/2022] Open
Abstract
AIM To explore whether professional training contributed to implementation of the national core value system in practice in care of older people and to identify course participants' perceptions about factors that facilitated or obstructed them in implementing their projects. To identify participants' perceptions concerning factors that facilitate or obstruct implementation. DESIGN Descriptive and cross-sectional. METHODS Data were retrieved from 451 participants who had completed the course "Understanding and providing leadership based on the national core value system for older people" at Uppsala University during spring semester and autumn semester of 2018. Quantitative and qualitative data were obtained using a web-based questionnaire. RESULTS The results showed that the majority (73%) of project plans were initiated, although not always completed and sometimes interrupted. Organizational readiness in terms of management supporting and prioritizing these plans were two principle facilitators chosen by half of the respondents and consequently the absence of these factors was an obstacle. In addition, successful implementation required dedicated co-workers and certain resources, such as time and funds. Surprisingly, factors related to the project leader were reported to be of limited importance.
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Affiliation(s)
- Õie Umb Carlsson
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
| | - Barbro Wadensten
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
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17
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Knight M, Bolton P, Kopeski L. Providing Physical Care to Persons With Serious Mental Illness: Attitudes, Confidence, Barriers and Psychological Empowerment. Arch Psychiatr Nurs 2017; 31:447-453. [PMID: 28927507 DOI: 10.1016/j.apnu.2017.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/21/2017] [Accepted: 07/07/2017] [Indexed: 10/19/2022]
Abstract
The prevalence of metabolic syndrome (MetS) in people with serious mental illness (SMI) has been well documented in the mental health literature. Despite the adoption of various guidelines for monitoring risk factors for diabetes and cardiovascular risk in this population, limited translation has occurred in actual practice (Hermes, Sernyak, & Rosenheck, 2013). The Institute of Medicine (IoM) (2009) has noted a lag time in the application of knowledge within clinical settings. Evidence-based practice was deemed as a means of improving healthcare outcomes through the use of science supported standards of care. Evidence-based practice (EBP) is a process to guide clinical decision making that involves the clinician's experience, well documented research findings, and the patient's values and choices (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996). The IoM has established that by the year 2020, 90% of clinical decisions should be based upon current and scientifically based information (IoM, 2009). Psychiatric-mental health nurses are challenged to utilize EBP for clients with MetS in assessing their health status and discussing the findings, educating them about their current risk and life style modifications to mitigate risk, and finally, partnering with them to maximize health and quality of life.
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Affiliation(s)
- Margaret Knight
- School of Nursing, University of Massachusetts Lowell, Lowell, MA, United States.
| | - Paula Bolton
- Psychiatric Neurotherapeutics Program, McLean Hospital, Belmont, MA, United States
| | - Lynne Kopeski
- Behavioral Health Partial Hospital Program, McLean Hospital, Belmont, MA, United States
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Hamaideh SH. Sources of Knowledge and Barriers of Implementing Evidence-Based Practice Among Mental Health Nurses in Saudi Arabia. Perspect Psychiatr Care 2017; 53:190-198. [PMID: 28681446 DOI: 10.1111/ppc.12156] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 12/16/2015] [Accepted: 01/27/2016] [Indexed: 11/27/2022] Open
Abstract
PURPOSES The purposes of this study were to identify the sources of knowledge for nursing practices and to identify the barriers of using "evidence-based practice" (EBP). DESIGN AND METHODS Descriptive cross-sectional design was used to collect data from 164 Saudi mental health nurses by completing the Development of Evidence-Based Practice Questionnaire. FINDINGS The most frequently used sources of knowledge were relied on social interactions and the nurses' own experiences, while the least frequently used sources were external sources of knowledge and research evidences. Insufficient time to find research reports, difficulty in understanding research reports, and insufficient resources for evidences were the barriers of using EBP. PRACTICE IMPLICATIONS The organizations should encourage using EBP by providing adequate time, resources, knowledge, and skills for mental health nurses through conducting workshops and mentoring.
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Affiliation(s)
- Shaher H Hamaideh
- Shaher H. Hamaideh, PhD, RN, is Associate Professor of Mental Health Nursing, Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Bressan V, Bagnasco A, Bianchi M, Rossi S, Moschetti F, Barisone M, Pellegrini R, Aleo G, Timmins F, Sasso L. Barriers to research awareness among nurses in Italy. J Nurs Manag 2017; 25:243-245. [DOI: 10.1111/jonm.12494] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Valentina Bressan
- Department of Otolaryngology/Head & Neck Surgery; University Hospital Santa Maria della Misericordia; Azienda Sanitaria Universitaria Integrata di Udine; Udine Italy
| | | | - Monica Bianchi
- Department of Business Economics, Health and Social care; University of Applied Science and Arts of Southern Switzerland; Manno Switzerland
| | - Silvia Rossi
- Department of Health Sciences; University of Genoa; Genoa Italy
| | | | | | | | - Giuseppe Aleo
- Department of Health Sciences; University of Genoa; Genoa Italy
| | - Fiona Timmins
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
| | - Loredana Sasso
- Department of Health Sciences; University of Genoa; Genoa Italy
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Voldbjerg SL, Grønkjaer M, Wiechula R, Sørensen EE. Newly graduated nurses’ use of knowledge sources in clinical decision-making: an ethnographic study. J Clin Nurs 2017; 26:1313-1327. [DOI: 10.1111/jocn.13628] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Siri Lygum Voldbjerg
- Department of Nursing; University College of Northern Denmark; Aalborg Denmark
- Clinical Nursing Research Unit; Aalborg University Hospital; Aalborg Denmark
| | - Mette Grønkjaer
- Clinical Nursing Research Unit; Aalborg University Hospital; Aalborg Denmark
| | - Rick Wiechula
- Centre for Evidence-based Practice South Australia; School of Nursing; University of Adelaide; Adelaide SA Australia
| | - Erik Elgaard Sørensen
- Clinical Nursing Research Unit; Aalborg University Hospital; Aalborg Denmark
- Department of Clinical Medicine; Aalborg University; Aalborg Denmark
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Gamble J, Toohill J, Slavin V, Creedy DK, Fenwick J. Identifying Barriers and Enablers as a First Step in the Implementation of a Midwife-Led Psychoeducation Counseling Framework for Women Fearful of Birth. INTERNATIONAL JOURNAL OF CHILDBIRTH 2017. [DOI: 10.1891/2156-5287.7.3.152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND:Around 20% of women report high levels of childbirth fear. An evidence-based psychoeducation intervention delivered by midwives reduced maternal childbirth fear and increased confidence for birth. Implementation of the intervention into practice is now required. Translating evidence into practice, however, remains challenging.AIM:This study aimed to explore organizational factors, including barriers and possible solutions that may impact on the successful application of the midwife psychoeducation intervention in practice.METHODS:Mixed methods data collection included a self-administered survey (n= 62), clinician-led focus groups (n= 28), and interviews with key stakeholders (n= 5). Simple descriptive statistics were used to analyze the quantitative data. Latent content analysis was used to analyze the qualitative data.RESULTS:Midwives were perceived to be best placed to deliver psychoeducation to women fearful of birth. Support for normal birth was high. There was, however, disparity between positive attitudes toward evidence-based practice in theory and its clinical application. Similarly, although the workplace learning culture was generally assessed as positive, many participants believed changing practice was difficult and reported a low sense of agency for challenging or facilitating change. Participants reported that barriers to implementing the evidence included time constraints and heavy workloads. There was a lack of awareness and confidence to implement evidence-based practice (EBP) with participants identifying that resistance to change was often the result of clinician fear and self-interest. The way services were routinely structured was considered problematic as fragmentation actively worked against midwives forming meaningful relationships with women. Enablers included organizational support, education, local champions, and continuity of midwifery care.CONCLUSION:The study identified the clinicians’ readiness, barriers, and possible solutions to the widespread implementation of an evidence-based psychoeducation intervention delivered by midwives for women fearful of birth at one maternity facility in South East Queensland, Australia. Many of the identified barriers were commensurate with the international literature on translating evidence into practice.
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Saunders H, Vehviläinen-Julkunen K. Nurses’ Evidence-Based Practice Beliefs and the Role of Evidence-Based Practice Mentors at University Hospitals in Finland. Worldviews Evid Based Nurs 2016; 14:35-45. [DOI: 10.1111/wvn.12189] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Hannele Saunders
- Early Stage Researcher and Doctoral Candidate, Department of Nursing Science, Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
| | - Katri Vehviläinen-Julkunen
- Professor, Department of Nursing Science, Faculty of Health Sciences; University of Eastern Finland and Kuopio University Hospital; Kuopio Finland
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Bennett S, Allen S, Caldwell E, Whitehead M, Turpin M, Fleming J, Cox R. Organisational support for evidence-based practice: occupational therapists perceptions. Aust Occup Ther J 2016; 63:9-18. [PMID: 26856800 DOI: 10.1111/1440-1630.12260] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Barriers to the use of evidence-based practice extend beyond the individual clinician and often include organisational barriers. Adoption of systematic organisational support for evidence-based practice in health care is integral to its use. This study aimed to explore the perceptions of occupational therapy staff regarding the influence of organisational initiatives to support evidence-based practice on workplace culture and clinical practice. METHODS This study used semi-structured interviews with 30 occupational therapists working in a major metropolitan hospital in Brisbane, Australia regarding their perceptions of organisational initiatives designed to support evidence-based practice. RESULTS Four themes emerged from the data: (i) firmly embedding a culture valuing research and EBP, (ii) aligning professional identity with the Research and Evidence in Practice model, (iii) experiences of change: pride, confidence and pressure and (iv) making evidence-based changes to clinical practices. CONCLUSION Organisational initiatives for evidence-based practice were perceived as influencing the culture of the workplace, therapists' sense of identity as clinicians, and as contributing to changes in clinical practice. It is therefore important to consider organisational factors when attempting to increase the use of evidence in practice.
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Affiliation(s)
- Sally Bennett
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Shelley Allen
- 4 Degrees Qualitative Research Consultancy, Queensland, Australia
| | | | - Mary Whitehead
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Merrill Turpin
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Ruth Cox
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
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Ho LP, Ho SSM, Leung DYP, So WKW, Chan CWH. A feasibility and efficacy randomised controlled trial of swaddling for controlling procedural pain in preterm infants. J Clin Nurs 2016; 25:472-82. [PMID: 26818372 DOI: 10.1111/jocn.13075] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2015] [Indexed: 01/29/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to investigate the feasibility and efficacy of swaddling to control procedural pain among preterm infants. BACKGROUND Swaddling has been recommended for controlling neonatal pain. However, the feasibility for use is uncertain and insufficient evidence is available among preterm infants. DESIGN A two-arm randomised controlled trial with repeated measures. METHOD The study was conducted in a 21-bed neonatal intensive care unit of a regional hospital in Hong Kong. Preterm infants who required heelstick procedure were eligible. Fifty-four preterm infants between 30-37 gestational weeks were randomly assigned to swaddling (n = 27) and control (standard care, n = 27) groups. Pain assessment was performed pre, during, immediate, two, four, six and eight minutes after heelstick procedure using the Premature Infant Pain Profile. RESULTS The mean Premature Infant Pain Profile scores were significantly reduced in the intervention group compared to the control group during, immediate, two, four, and six minutes after the heelstick procedure. The mean changes of heart rate and oxygen saturation in the intervention group were significantly lower than that of the control group at all measured time points. Notably, the swaddled infants quickly resumed to the baseline level at two minutes whereas the control group reached the stable state at an extended period of six minutes. CONCLUSION The findings show that swaddling is feasible and efficacious in controlling pain for heelstick procedure among preterm infants. No adverse effects were observed. RELEVANCE TO CLINICAL PRACTICE This article presents the feasibility and efficacy of swaddling as a non-pharmacological and non-invasive intervention to relieve pain during the heelstick procedures among preterm infants. Swaddling can contribute to control minor procedural pain in neonates as one of the simple, safe, cost effective, humanistic and natural analgesia alternatives.
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Affiliation(s)
- Lai Ping Ho
- Neonatal Unit, Prince of Wales Hospital, Hong Kong SAR, China
| | - Simone S M Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Doris Y P Leung
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Winnie K W So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
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Abstract
A correlation study design was used to examine the interrelatedness of power, attitudes regarding intermittent fetal monitoring, and perceived barriers to research utilization with a labor and delivery nurse’s attitude toward patient advocacy using the conceptual framework of the science of unitary human beings. The linear combination of the three independent variables was significantly correlated to attitude toward patient advocacy and power as knowing participation in change had the greatest impact on patient advocacy.
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Abstract
How home healthcare aides (HHAs) adapt their classroom training to their workplaces is central to their own safety and that of their care recipients. A qualitative approach was adopted for this inquiry, where new workers were interviewed in-depth following their classroom training. Findings suggest a perceived lack of supervisor support for classroom training and lack of follow-up in the workplace. Moreover, the need for more peer support was contended, and more comprehensive written materials in clients' homes may also assist workers' learning and enacting safe manual handling techniques in the workplace. The article concludes with recommendations for supporting HHAs' learning, and includes suggestions for future research.
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Nguyen TNM, Wilson A. Hospital readiness for undertaking evidence-based practice: A survey. Nurs Health Sci 2016; 18:465-472. [PMID: 27345522 DOI: 10.1111/nhs.12293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 04/25/2016] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
Abstract
Despite the fact that evidence-based practice has increasing emphasis in health care, organizations are not always prepared for its implementation. Identifying organizational preparedness for implementing evidence-based practice is desirable prior to application. A cross-sectional survey was developed to explore nurses' perception of organizational support for evidence-based practice and was implemented via a self-enumerated survey completed by 234 nurses. Data were analyzed with descriptive and inferential statistics. Nurses reported that implementation of evidence-based practice is complex and fraught with challenges because of a lack of organizational support. A conceptual framework comprising three key factors: information resources, nursing leadership, and organizational infrastructure was proposed to assist health authorities in the implementation of evidence-based practice. Suggestions of how organizations can be more supportive of research utilization in practice include establishing a library, journal clubs/mentoring programs, nurses' involvement in decision-making at unit level, and a local nursing association.
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Affiliation(s)
- Thi Ngoc Minh Nguyen
- Nursing Faculty, Danang University of Medical Technologies and Pharmacy, Danang City, Vietnam
| | - Anne Wilson
- School of Medicine, Flinders University, Adelaide, South Australia, Australia.,School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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Fairbrother G, Cashin A, Conway R, Symes A, Graham I. Evidence based nursing and midwifery practice in a regional Australian healthcare setting: Behaviours, skills and barriers. Collegian 2016; 23:29-37. [PMID: 27188037 DOI: 10.1016/j.colegn.2014.09.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To establish self-reported skill levels, behaviours and barriers in relation to evidence-based practice (EBP) among a representative sample of regional Australian nurses and midwives in senior roles. BACKGROUND It has been widely established that nurses and midwives continue to face challenges in relation to putting evidence into practice on the clinical floor. Prior to conducting an EBP capacity building activity in a regional Australian Local Health District, a survey assessing needs and skill and barrier areas was conducted. METHODS A quantitative descriptive survey which utilised the 'Developing Evidence Based Practice Questionnaire' (DEBPQ) was conducted in early 2012 among senior nurses and midwives of a regional New South Wales Local Health District (LHD). The survey results were contrasted with reported DEBPQ results from a sample of UK metropolitan nurses and a sample of Australian general practice nurses (GPNs). RESULTS One hundred and sixty nine nurses completed the survey (response rate 42%). Survey respondents' reliance on accepted evidentiary knowledge sources was found to be low. Research literature-related knowledge sources were ranked outside of the top 10 sources, compared with numerous personalised and subjective sources, which ranked within the top 10. Access to and understanding of research material was a primary barrier to reviewing evidence in the study sample. Time-related barriers to changing practice on the basis of evidence figured prominently in the study sample and the UK and Australian GPN samples. The study sample rated their EBP skill levels significantly higher than both their UK counterparts and the Australian GPN sample (P < 0.0001). CONCLUSION Capacity building interventions are needed among senior nurses and midwives in Australian regional LHDs, as the most prominent knowledge sources reported are non-evidentiary in nature and barriers to finding and reviewing evidence, along with barriers to making practice change, remain significant.
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Flores R, Naranjo C, Hein A. Use of Evidence in the Implementation of Social Programs: A Qualitative Study from Chile. ACTA ACUST UNITED AC 2016; 13:562-575. [PMID: 27266890 DOI: 10.1080/23761407.2015.1086716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Through this qualitative, empirical study the authors aim to explore and describe the sources of knowledge that are used to guide intervention practice by social workers in Chile. Particular attention was paid to factors that may facilitate or hinder the use of research-based evidence to guide social interventions design, implementation, and outcome evaluation. In order to explore these issues, 25 semi-structured interviews with social workers from Chilean social service non-profit organizations were conducted. The main findings suggest that social workers do not use research-based evidence to support their social interventions due to various personal organizational constraints (e.g., lack of time, lack of access to resources for disseminating evidence, lack of English command). In addition, no evaluation processes of social programs which will support evidence-based effectiveness could be found. One key barrier to support use of evidence and evidence production may be related to the fact that most non-governmental organizations maintain a hierarchical and vertical relationship with state agencies (program design, oversight, and funding) for social program development.
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Affiliation(s)
- Rodrigo Flores
- a Pontificia Universidad Católica de Chile, Faculty of Social Sciences , Santiago , Chile
| | | | - Andreas Hein
- c Pontificia Universidad Católica de Chile, Social Work , Santiago , Chile
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Saunders H, Stevens KR, Vehviläinen-Julkunen K. Nurses' readiness for evidence-based practice at Finnish university hospitals: a national survey. J Adv Nurs 2016; 72:1863-74. [DOI: 10.1111/jan.12963] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Hannele Saunders
- Department of Nursing Science; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
| | - Kathleen R. Stevens
- Improvement Science Research Network; University of Texas Health Science Center; San Antonio Texas USA
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science; Faculty of Health Sciences; University of Eastern Finland and Kuopio University Hospital; Finland
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31
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Wehrlen L, Krumlauf M, Ness E, Maloof D, Bevans M. Systematic collection of patient reported outcome research data: A checklist for clinical research professionals. Contemp Clin Trials 2016; 48:21-9. [PMID: 27002223 DOI: 10.1016/j.cct.2016.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 03/10/2016] [Accepted: 03/14/2016] [Indexed: 12/30/2022]
Abstract
Understanding the human experience is no longer an outcome explored strictly by social and behavioral researchers. Increasingly, biomedical researchers are also including patient reported outcomes (PROs) in their clinical research studies not only due to calls for increased patient engagement in research but also healthcare. Collecting PROs in clinical research studies offers a lens into the patient's unique perspective providing important information to industry sponsors and the FDA. Approximately 30% of trials include PROs as primary or secondary endpoints and a quarter of FDA new drug, device and biologic applications include PRO data to support labeling claims. In this paper PRO, represents any information obtained directly from the patient or their proxy, without interpretation by another individual to ascertain their health, evaluate symptoms or conditions and extends the reference of PRO, as defined by the FDA, to include other sources such as patient diaries. Consumers and clinicians consistently report that PRO data are valued, and can aide when deciding between treatment options; therefore an integral part of clinical research. However, little guidance exists for clinical research professionals (CRPs) responsible for collecting PRO data on the best practices to ensure quality data collection so that an accurate assessment of the patient's view is collected. Therefore the purpose of this work was to develop and validate a checklist to guide quality collection of PRO data. The checklist synthesizes best practices from published literature and expert opinions addressing practical and methodological challenges CRPs often encounter when collecting PRO data in research settings.
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Affiliation(s)
- Leslie Wehrlen
- Nursing Department, National Institutes of Health Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA.
| | - Mike Krumlauf
- Nursing Department, National Institutes of Health Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA.
| | - Elizabeth Ness
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, 20892, USA.
| | | | - Margaret Bevans
- Nursing Department, National Institutes of Health Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA.
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Bressan V, Tolotti A, Barisone M, Bagnasco A, Sasso L, Aleo G, Timmins F. Perceived barriers to the professional development of modern nursing in Italy – A discussion paper. Nurse Educ Pract 2016; 17:52-7. [DOI: 10.1016/j.nepr.2016.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/02/2016] [Accepted: 02/03/2016] [Indexed: 11/17/2022]
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Veeramah V. The use of evidenced-based information by nurses and midwives to inform practice. J Clin Nurs 2016; 25:340-50. [DOI: 10.1111/jocn.13054] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Ven Veeramah
- Faculty of Education and Health; University of Greenwich; London UK
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Dadich A, Abbott P, Hosseinzadeh H. Strategies to promote practice nurse capacity to deliver evidence-based care. J Health Organ Manag 2015; 29:988-1010. [DOI: 10.1108/jhom-05-2013-0089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose
– Evidence-based practice is pivotal to effective patient care. However, its translation into practice remains limited. Given the central role of primary care in many healthcare systems, it is important to identify strategies that bolster clinician-capacity to promote evidence-based care. The purpose of this paper is to identify strategies to increase Practice Nurse capacity to promote evidence-based sexual healthcare within general practice.
Design/methodology/approach
– A survey of 217 Practice Nurses in an Australian state and ten respondent-interviews regarding two resources to promote evidence-based sexual healthcare – namely, a clinical aide and online training.
Findings
– The perceived impact of both resources was determined by views on relevance and design – particularly for the clinical aide. Resource-use was influenced by role and responsibilities within the workplace, accessibility, and support from patients and colleagues.
Research limitations/implications
– This is the first Australian study to reveal strategies to promote evidence-based sexual healthcare among Practice Nurses. The findings provide a platform for future research on knowledge translation processes, particularly among clinicians who might be disengaged from sexual healthcare.
Practical implications
– Given the benefits of evidence-based practices, it is important that managers recognize their role, and the role of their services, in promoting these. Without explicit support for evidence-based care and recognition of the Practice Nurse role in such care, knowledge translation is likely to be limited.
Originality/value
– Knowledge translation among Practice Nurses can be facilitated by: resources-deemed informative, relevant, and user-friendly, as well as support from patients, colleagues, and their workplace.
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Fearing G, Barwick M, Kimber M. Clinical transformation: Manager's perspectives on implementation of evidence-based practice. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2015; 41:455-68. [PMID: 23494388 DOI: 10.1007/s10488-013-0481-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Implementation of evidence-based practices (EBPs) is highly encouraged within mental health services. This single case study examines the process of an EBP implementation effort, guided by the National Implementation Research Network (NIRN) implementation model, from the perspective of behavioural healthcare managers in a child and youth mental health provider organization. Qualitative methods identified process themes emerging over 3 years of an organizational change process that support and refine the NIRN model. Dedicated management oversight and implementation teams are essential for EBP implementation; practice leads and practice coaches are useful implementation innovations; and organizations seeking to implement several EBPs simultaneously must guard against organizational absorptive capacity. These findings can guide EBP implementation in child and youth behavioural healthcare.
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Affiliation(s)
- Gwendolyn Fearing
- Lynwood Charlton Centre, 526 Upper Paradise Road, Hamilton, ON, L9C 5E3, Canada,
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36
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The assessment and management of pain in an orthopaedic out-patient setting: A case study. Int J Orthop Trauma Nurs 2015; 22:24-8. [PMID: 26711709 DOI: 10.1016/j.ijotn.2015.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 09/30/2015] [Accepted: 10/01/2015] [Indexed: 11/22/2022]
Abstract
The management of pain is an important aspect of an orthopaedic nurse's role. The aim of this paper is to use an individual case study to demonstrate the role of an out-patient orthopaedic nurse in the identification, assessment and management of pain. This paper describes how pain was identified and managed for a patient in the orthopaedic outpatient department, highlighting that pain and its management are not isolated to the in-patient setting. The case study illustrates the importance of recognising pain and taking into account the numerous factors that can influence pain perception. The assessment of an individual patient's pain led to obtaining help from the Acute Pain Team which led to improvement in the patient's pain management and quality of life. The nursing team reflected and discussed the issues identified by this case study which led to changes in practice being introduced. This has resulted in an increased knowledge of and confidence in pain management within the nursing team and development and improvement of pain management practice within the orthopaedic out-patient department.
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Blackman IR, Giles T. Psychometric Evaluation of a Self-Report Evidence-Based Practice Tool Using Rasch Analysis. Worldviews Evid Based Nurs 2015; 12:253-64. [DOI: 10.1111/wvn.12105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Ian R. Blackman
- School of Nursing & Midwifery; Flinders University; Adelaide South Australia Australia
| | - Tracey Giles
- School of Nursing & Midwifery; Flinders University; Adelaide South Australia Australia
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38
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kahouei M, Alaei S, Shariat Panahi SSG, Zadeh JM. Strategy of health information seeking among physicians, medical residents, and students after introducing digital library and information technology in teaching hospitals of Iran. J Evid Based Med 2015; 8:91-7. [PMID: 25955257 DOI: 10.1111/jebm.12154] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 01/25/2015] [Indexed: 01/11/2023]
Abstract
OBJECTIVES It is important for physicians, medical students and health care organizations of developing countries to use reliable clinical information in order to deliver the best practice. Therefore, health sector of Iran endeavored to encourage physicians and medical students to integrate research findings into practice since 2005. Several educational interventions in the areas of information technology and databases were performed. Digital library was introduced in the teaching hospitals. The purpose of this study was to investigate whether these interventions increased the use of evidence-based health information resources among physicians, medical residents and students. METHODS This descriptive study involved 315 physicians, assistants and medical students in affiliated hospitals of Semnan University of medical sciences in 2013. RESULTS A total 52.9% of physicians and 79.5% of medical residents and students always used patient data. 81.3% of physicians and 67.1% of medical residents and students reported using their own experiences, 26.5% of physicians and 16.9% of medical residents and students always used databases such as PubMed and MEDLINE for patient care. CONCLUSION Our results revealed that in spite of providing educational and technical infrastructures for accomplishment of research utilization in medical education, the study subjects often identified and used what they regarded as reliable and relevant information from sources that do not truly represent the best evidence that is available.
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Affiliation(s)
- Mehdi kahouei
- Research Center for Social Determinants of Health, Health Information Management Department, Nursing and Allied Health Faculty, Semnan University of Medical Sciences, Semnan, Iran
| | - Safollah Alaei
- Surgery and Anesthesia Department, Nursing and Allied Health Faculty, Semnan University of Medical sciences, Semnan, Iran
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Kahouei M, Alaei S, Panahi SSGS, Zadeh JM. Evaluation of Organizational Readiness in Clinical Settings for Social Supporting Evidence-Based Information Seeking Behavior after Introducing IT in a Developing Country. ACTA ACUST UNITED AC 2015; 12:500-8. [DOI: 10.1080/15433714.2014.921587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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40
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Sandström B, Willman A, Svensson B, Borglin G. Perceptions of national guidelines and their (non) implementation in mental healthcare: a deductive and inductive content analysis. Implement Sci 2015; 10:43. [PMID: 25888854 DOI: 10.1186/s13012-0150234-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 03/13/2015] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND National guidelines are being produced at an increasing rate, and politicians and managers are expected to promote these guidelines and their implementation in clinical work. However, research seldom deals with how decision-makers can perceive these guidelines or their challenges in a cultural context. Therefore, the aim of this study was twofold: to investigate how well Promoting Action on Research Implementation in Health Services (PARIHS) reflected the empirical reality of mental healthcare and to gain an extended understanding of the perceptions of decision-makers operating within this context, in regard to the implementation of evidence-based guidelines. METHODS The study took place in the southeast of Sweden and employed a qualitative design. The data were collected through 23 interviews with politicians and managers working either in the county council or in the municipalities. The transcribed text was analysed iteratively and in two distinct phases, first deductively and second inductively by means of qualitative content analysis. RESULTS Our deductive analysis showed that the text strongly reflected two out of three categorisation matrices, i.e. evidence and context representing the PARIHS framework. However, the key element of facilitation was poorly mirrored in the text. Results from the inductive analysis can be seen in light of the main category sitting on the fence; thus, the informants' perceptions reflected ambivalence and contradiction. This was illustrated by conflicting views and differences in culture and ideology, a feeling of security in tradition, a certain amount of resistance to change and a lack of role clarity and clear directions. Together, our two analyses provide a rich description of an organisational culture that is highly unlikely to facilitate the implementation of the national guidelines, together with a distrust of the source behind such guidelines, which stands in stark contrast to the high confidence in the knowledge of experienced people in authority within the organisational context. CONCLUSIONS Our findings have highlighted that, regardless of by whom guidelines are released, they are not likely to be utilised or implemented if those who are responsible for implementing them do not trust the source. This aspect (i.e. contextual trust) is not covered by PARIHS.
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Affiliation(s)
- Boel Sandström
- Department of Health, Blekinge Institute of Technology, SE-371 79, Karlskrona, Sweden.
- Department of Health Sciences, University of Lund, SE-221 00, Lund, Sweden.
- Blekinge Center of Competence, SE-371 81, Karlskrona, Sweden.
| | - Ania Willman
- Department of Health, Blekinge Institute of Technology, SE-371 79, Karlskrona, Sweden.
- Department of Care Science, Malmö University, SE-205 06, Malmö, Sweden.
| | - Bengt Svensson
- Department of Health Sciences, University of Lund, SE-221 00, Lund, Sweden.
| | - Gunilla Borglin
- Department of Health, Blekinge Institute of Technology, SE-371 79, Karlskrona, Sweden.
- Department of Care Science, Malmö University, SE-205 06, Malmö, Sweden.
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Wynaden D, Tohotoa J, Al Omari O, Happell B, Heslop K, Barr L, Sourinathan V. Administering intramuscular injections: how does research translate into practice over time in the mental health setting? NURSE EDUCATION TODAY 2015; 35:620-624. [PMID: 25596035 DOI: 10.1016/j.nedt.2014.12.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/09/2014] [Accepted: 12/16/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Increasingly, mental health nurses are expected to base their clinical practice on evidence based knowledge and many of the practice traditions that have passed between generations of nurses must now be examined within this scientific context. Since 2000, there has been an increasing debate on what is best practice for the administration of intramuscular injections particularly in relation to site selection, needle size and technique. Weight gain associated with second generation long acting antipsychotics influences the site and needle size for effective medication delivery. AIM To determine intramuscular injecting practice choices made by nurses working in the mental health setting in 2006 compared to those made by a similar group of nurses in 2012. METHODS A descriptive cross sectional study conducted across two time points: 2006 (93 participants) and 2012 (245 participants) utilising the same questionnaire designed to measure nurses' intramuscular injecting practice choices. RESULTS Data were analysed using SPSS version 20 package. Six statistically significant practice changes were recorded related to needle size, site selection and the use of the Z-tracking technique. A continued higher usage of the dorsogluteal site was also reported in 2012 contrary to the recommendations in the current research for the ventrogluteal site. CONCLUSION Whilst some practice changes occurred, translation of research into evidenced based practice is challenging and definitive best practice in the administration of intramuscular injections remains unclear. Education and randomised controlled trials are needed to provide the evidence to ensure the delivery of safe and effective intramuscular injecting practice.
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Affiliation(s)
- Dianne Wynaden
- School of Nursing and Midwifery, Curtin University, GPO Box U 1987, Perth, Western Australia 6945, Australia.
| | - Jenny Tohotoa
- School of Nursing and Midwifery, Curtin University, GPO Box U 1987, Perth, Western Australia 6945, Australia.
| | - Omar Al Omari
- School of Nursing and Midwifery, Jerash University, Amman, Irbid International Street, 26150 Jerash, Jordan.
| | - Brenda Happell
- Central Queensland University, Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation, School of Nursing and Midwifery, Bruce Highway, Rockhampton, Queensland 4702, Australia.
| | - Karen Heslop
- School of Nursing and Midwifery, Curtin University, GPO Box U 1987, Perth, Western Australia 6945, Australia.
| | - Lesley Barr
- State Forensic Mental Health Services, Brockway Rd, Claremont, Western Australia 6010, Australia.
| | - Vijay Sourinathan
- State Forensic Mental Health Services, Brockway Rd, Claremont, Western Australia 6010, Australia.
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Sandström B, Willman A, Svensson B, Borglin G. Perceptions of national guidelines and their (non) implementation in mental healthcare: a deductive and inductive content analysis. Implement Sci 2015; 10:43. [PMID: 25888854 PMCID: PMC4392750 DOI: 10.1186/s13012-015-0234-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 03/13/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND National guidelines are being produced at an increasing rate, and politicians and managers are expected to promote these guidelines and their implementation in clinical work. However, research seldom deals with how decision-makers can perceive these guidelines or their challenges in a cultural context. Therefore, the aim of this study was twofold: to investigate how well Promoting Action on Research Implementation in Health Services (PARIHS) reflected the empirical reality of mental healthcare and to gain an extended understanding of the perceptions of decision-makers operating within this context, in regard to the implementation of evidence-based guidelines. METHODS The study took place in the southeast of Sweden and employed a qualitative design. The data were collected through 23 interviews with politicians and managers working either in the county council or in the municipalities. The transcribed text was analysed iteratively and in two distinct phases, first deductively and second inductively by means of qualitative content analysis. RESULTS Our deductive analysis showed that the text strongly reflected two out of three categorisation matrices, i.e. evidence and context representing the PARIHS framework. However, the key element of facilitation was poorly mirrored in the text. Results from the inductive analysis can be seen in light of the main category sitting on the fence; thus, the informants' perceptions reflected ambivalence and contradiction. This was illustrated by conflicting views and differences in culture and ideology, a feeling of security in tradition, a certain amount of resistance to change and a lack of role clarity and clear directions. Together, our two analyses provide a rich description of an organisational culture that is highly unlikely to facilitate the implementation of the national guidelines, together with a distrust of the source behind such guidelines, which stands in stark contrast to the high confidence in the knowledge of experienced people in authority within the organisational context. CONCLUSIONS Our findings have highlighted that, regardless of by whom guidelines are released, they are not likely to be utilised or implemented if those who are responsible for implementing them do not trust the source. This aspect (i.e. contextual trust) is not covered by PARIHS.
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Affiliation(s)
- Boel Sandström
- Department of Health, Blekinge Institute of Technology, SE-371 79, Karlskrona, Sweden. .,Department of Health Sciences, University of Lund, SE-221 00, Lund, Sweden. .,Blekinge Center of Competence, SE-371 81, Karlskrona, Sweden.
| | - Ania Willman
- Department of Health, Blekinge Institute of Technology, SE-371 79, Karlskrona, Sweden. .,Department of Care Science, Malmö University, SE-205 06, Malmö, Sweden.
| | - Bengt Svensson
- Department of Health Sciences, University of Lund, SE-221 00, Lund, Sweden.
| | - Gunilla Borglin
- Department of Health, Blekinge Institute of Technology, SE-371 79, Karlskrona, Sweden. .,Department of Care Science, Malmö University, SE-205 06, Malmö, Sweden.
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Bussières AE, Al Zoubi F, Quon JA, Ahmed S, Thomas A, Stuber K, Sajko S, French S. Fast tracking the design of theory-based KT interventions through a consensus process. Implement Sci 2015; 10:18. [PMID: 25880218 PMCID: PMC4330935 DOI: 10.1186/s13012-015-0213-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 01/24/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite available evidence for optimal management of spinal pain, poor adherence to guidelines and wide variations in healthcare services persist. One of the objectives of the Canadian Chiropractic Guideline Initiative is to develop and evaluate targeted theory- and evidence-informed interventions to improve the management of non-specific neck pain by chiropractors. In order to systematically develop a knowledge translation (KT) intervention underpinned by the Theoretical Domains Framework (TDF), we explored the factors perceived to influence the use of multimodal care to manage non-specific neck pain, and mapped behaviour change techniques to key theoretical domains. METHODS Individual telephone interviews exploring beliefs about managing neck pain were conducted with a purposive sample of 13 chiropractors. The interview guide was based upon the TDF. Interviews were digitally recorded, transcribed verbatim and analysed by two independent assessors using thematic content analysis. A 15-member expert panel formally met to design a KT intervention. RESULTS Nine TDF domains were identified as likely relevant. Key beliefs (and relevant domains of the TDF) included the following: influence of formal training, colleagues and patients on clinicians (Social Influences); availability of educational material (Environmental Context and Resources); and better clinical outcomes reinforcing the use of multimodal care (Reinforcement). Facilitating factors considered important included better communication (Skills); audits of patients' treatment-related outcomes (Behavioural Regulation); awareness and agreement with guidelines (Knowledge); and tailoring of multimodal care (Memory, Attention and Decision Processes). Clinicians conveyed conflicting beliefs about perceived threats to professional autonomy (Social/Professional Role and Identity) and speed of recovery from either applying or ignoring the practice recommendations (Beliefs about Consequences). The expert panel mapped behaviour change techniques to key theoretical domains and identified relevant KT strategies and modes of delivery to increase the use of multimodal care among chiropractors. CONCLUSIONS A multifaceted KT educational intervention targeting chiropractors' management of neck pain was developed. The KT intervention consisted of an online education webinar series, clinical vignettes and a video underpinned by the Brief Action Planning model. The intervention was designed to reflect key theoretical domains, behaviour change techniques and intervention components. The effectiveness of the proposed intervention remains to be tested.
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Affiliation(s)
- André E Bussières
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, 3630 Promenade Sir-William-Osler, H3G 1Y5, Montreal, QC, Canada.
- Département chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.
- Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, QC, Canada.
| | - Fadi Al Zoubi
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, 3630 Promenade Sir-William-Osler, H3G 1Y5, Montreal, QC, Canada.
| | - Jeffrey A Quon
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
- International Collaboration on Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
- Spine Program, Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Sara Ahmed
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, 3630 Promenade Sir-William-Osler, H3G 1Y5, Montreal, QC, Canada.
- Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, QC, Canada.
- Clinical Epidemiology, McGill University Health Center, Montréal, QC, Canada.
| | - Aliki Thomas
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, 3630 Promenade Sir-William-Osler, H3G 1Y5, Montreal, QC, Canada.
- Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, QC, Canada.
- Center for Medical Education, Faculty of Medicine, McGill University, Montréal, QC, Canada.
| | - Kent Stuber
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
| | | | - Simon French
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
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Williams B, Perillo S, Brown T. What are the factors of organisational culture in health care settings that act as barriers to the implementation of evidence-based practice? A scoping review. NURSE EDUCATION TODAY 2015; 35:e34-e41. [PMID: 25482849 DOI: 10.1016/j.nedt.2014.11.012] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 10/31/2014] [Accepted: 11/12/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND The responsibility to implement evidence-based practice (EBP) in a health care workplace does not fall solely on the individual health care professional. Organisational barriers relate to the workplace setting, administrational support, infrastructure, and facilities available for the retrieval, critique, summation, utilisation, and integration of research findings in health care practices and settings. OBJECTIVE Using a scoping review approach, the organisational barriers to the implementation of EBP in health care settings were sought. METHOD This scoping review used the first five of the six stage methodology developed by Levac et al. (2010). The five stages used are: 1) Identify the research question; 2) identify relevant studies; 3) study selection; 4) charting the data; and 5) collating, summarising and reporting the results. The following databases were searched from January 2004 until February 2014: Medline, EMBASE, EBM Reviews, Google Scholar, The Cochrane Library and CINAHL. RESULTS Of the 49 articles included in this study, there were 29 cross-sectional surveys, six descriptions of specific interventions, seven literature reviews, four narrative reviews, nine qualitative studies, one ethnographic study and one systematic review. The articles were analysed and five broad organisational barriers were identified. CONCLUSIONS This scoping review sought to map the breadth of information available on the organisational barriers to the use of EBP in health care settings. Even for a health care professional who is motivated and competent in the use of EBP; all of these barriers will impact on their ability to increase and maintain their use of EBP in the workplace.
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Affiliation(s)
- Brett Williams
- Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia.
| | - Samuel Perillo
- Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia
| | - Ted Brown
- Department of Occupational Therapy, Monash University, Victoria, Australia
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Fairbrother G, Chiarella M, Braithwaite J. Models of care choices in today’s nursing workplace: where does team nursing sit? AUST HEALTH REV 2015; 39:489-493. [DOI: 10.1071/ah14091] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 03/23/2015] [Indexed: 11/23/2022]
Abstract
This paper provides an overview of the developmental history of models of care (MOC) in nursing since Florence Nightingale introduced nurse training programs in a drive to make nursing a discipline-based career option. The four principal choices of models of nursing care delivery (primary nursing, individual patient allocation, team nursing and functional nursing) are outlined and discussed, and recent MOC literature reviewed. The paper suggests that, given the ways work is being rapidly reconfigured in healthcare services and the pressures on the nursing workforce projected into the future, team nursing seems to offer the best solutions.
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Malik G, McKenna L, Plummer V. Perceived knowledge, skills, attitude and contextual factors affecting evidence-based practice among nurse educators, clinical coaches and nurse specialists. Int J Nurs Pract 2014; 21 Suppl 2:46-57. [PMID: 25355492 DOI: 10.1111/ijn.12366] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Evidence-based practice (EBP) in the clinical setting is recognized as an approach that leads to improved patient outcomes. Nurse educators (NEs), clinical coaches (CCs) and nurse specialists are in key positions to promote and facilitate EBP within clinical settings and have opportunities to advance practice. Therefore, it is important to understand their perceptions of factors promoting EBP and perceived barriers in facilitating EBP in clinical settings, before developing educational programmes. This paper reports findings from a study that aimed to explore NEs' , CCs' and nurse specialists' knowledge, skills and attitudes associated with EBP. This study used a questionnaire containing quantitative and a small number of qualitative questions to capture data collected from NEs, CCs and nurse specialists working at a tertiary health-care facility in Victoria, Australia. The questionnaire was distributed to a total of 435 people, of whom 135 responded (31%). Findings revealed that the three senior nurse groups relied heavily on personal experience, organizational policies and protocols as formal sources of knowledge. Furthermore, they had positive attitudes towards EBP. However, participants demonstrated lack of knowledge and skills in appraising and utilizing evidence into practice. They indicated a desire to seek educational opportunities to upskill themselves in the process of EBP.
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Affiliation(s)
- Gulzar Malik
- Faculty of Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Lisa McKenna
- Faculty of Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Virginia Plummer
- Faculty of Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Peninsula, Victoria, Australia
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Neher M, Ståhl C, Ellström PE, Nilsen P. Knowledge sources for evidence-based practice in rheumatology nursing. Clin Nurs Res 2014; 24:661-79. [PMID: 25059719 DOI: 10.1177/1054773814543355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
As rheumatology nursing develops and extends, knowledge about current use of knowledge in rheumatology nursing practice may guide discussions about future knowledge needs. To explore what perceptions rheumatology nurses have about their knowledge sources and about what knowledge they use in their practice, 12 nurses working in specialist rheumatology were interviewed using a semi-structured interview guide. The data were analyzed using conventional qualitative content analysis. The analysis yielded four types of knowledge sources in clinical practice: interaction with others in the workplace, contacts outside the workplace, written materials, and previous knowledge and experience. Colleagues, and physicians in particular, were important for informal learning in daily rheumatology practice. Evidence from the medical arena was accessed through medical specialists, while nursing research was used less. Facilitating informal learning and continuing formal education is proposed as a way toward a more evidence-based practice in extended roles.
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Pryse Y, McDaniel A, Schafer J. Psychometric Analysis of Two New Scales: The Evidence-Based Practice Nursing Leadership and Work Environment Scales. Worldviews Evid Based Nurs 2014; 11:240-7. [DOI: 10.1111/wvn.12045] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Yvette Pryse
- Assistant Professor, Associate Director of BSN Program, College of Nursing; University of Cincinnati; Cincinnati Ohio
| | - Anna McDaniel
- Dean, College of Nursing; University of Florida; Gainesville Florida
| | - John Schafer
- John Schafer, Associate Professor, College of Nursing; University of Cincinnati; Cincinnati Ohio
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Al Wahaibi A, Adawi SA, Shehhi WA, Rizvi SGA, Al-Kemyani N, Al-Amrani K, Al-Khabori M. Knowledge and Attitudes of Oman Medical Specialty Board Residents towards Evidence-Based Medicine. Oman Med J 2014; 29:178-84. [PMID: 24936266 DOI: 10.5001/omj.2014.45] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 04/09/2014] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE This study aims to evaluate the knowledge and attitudes of Oman Medical Specialty Board (OMSB) residents towards Evidence-Based Medicine (EBM). METHODS This cross sectional study was conducted on all OMSB residents through a self-administered online questionnaire between October 2012 and March 2013. An electronic survey was designed to identify and determine residents' knowledge and attitudes toward the use of EBM. RESULTS The survey was completed by 93 (21%) OMSB residents, 76 (82%) of whom took part in continuing education courses and 50 (54%) belonged to professional practice-oriented organizations. On average, the residents were reportedly involved in patient care for approximately 70% (Standard Deviation [SD] 17%) of their time, while 14% (SD 12%) participated in research activities. The results showed that 53 respondents (57%) were competent users of medical search engines compared to 23 residents (25%) who rated their skills as neutral. Sixteen percent of the respondents strongly agreed and 46% only agreed that the facility supports the use of current research in practice. Fourteen percent strongly agreed and fifty-three percent only agreed that the foundation of EBM is part of OMSB academic preparation. On the other hand, 17% of the respondents thought that insufficient time is always a barrier against EBM, while another 27% perceived insufficient time as a usual barrier. The lack of information resources was reported to always be a barrier in 11% of the respondents while 32% thought that it usually acts as a barrier. CONCLUSION Time constraints and skills in EBM were found to be the two major obstacles. This study was, however, limited by the low response rate of the survey; thus larger studies with a previously validated questionnaire should be conducted in the future.
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Affiliation(s)
- Aiman Al Wahaibi
- Department of Medicine, Oman Medical Specialty Board, Muscat, Sultanate of Oman
| | - Saada Al Adawi
- Department of Medicine, Oman Medical Specialty Board, Muscat, Sultanate of Oman
| | - Wafa Al Shehhi
- Department of Medicine, Oman Medical Specialty Board, Muscat, Sultanate of Oman
| | - Syed Gauhar A Rizvi
- Department of Epidemiology and Medical Statistics, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Nasser Al-Kemyani
- Department of Anesthesia, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
| | - Khalfan Al-Amrani
- Emergency Department, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
| | - Murtadha Al-Khabori
- Departments of Hematology, Sultan Qaboos University Hospital, P.O Box: 35, PC: 123, AL-Koudh, Muscat, Sultanate of Oman
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Leung K, Trevena L, Waters D. Systematic review of instruments for measuring nurses' knowledge, skills and attitudes for evidence-based practice. J Adv Nurs 2014; 70:2181-95. [DOI: 10.1111/jan.12454] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Kat Leung
- Sydney Medical School; The University of Sydney; Camperdown New South Wales Australia
| | - Lyndal Trevena
- Sydney Medical School; The University of Sydney; Camperdown New South Wales Australia
| | - Donna Waters
- Sydney Nursing School; The University of Sydney; Camperdown New South Wales Australia
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