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Otts JA, Pittman J, Riley B, Mestas L, Hall H. Academic-Practice Partnership to Prevent and Manage Pressure Injuries: An Evidence-Based Quality Improvement Initiative. J Wound Ostomy Continence Nurs 2023; 50:463-473. [PMID: 37698422 DOI: 10.1097/won.0000000000001019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
PURPOSE This evidence-based quality improvement (EBQI) initiative examined the effect of an academic-practice (A-P) partnership on improvement in quality measures in an acute care setting, specifically hospital-acquired pressure injury (HAPI) prevention and management. DESIGN A pre-/postdescriptive design was conducted using the practice-informed active learning program to guide the project. PARTICIPANTS AND SETTING The EBQI initiative was conducted at a Southern Gulf-Coast university college of nursing and clinical nursing practice leaders at its affiliated 406-bed academic health center/level I trauma center, regional burn center, and comprehensive stroke center. Both institutions are located in the Southeastern United States (Mobile, Alabama). METHODS The A-P council used a participatory action research approach and developed a practice-informed active learning program incorporating Melnyk's evidence-based practice (EBP) steps, the Donabedian Model and the Patient-Centered Outcomes Research Institute (PCORI) Stakeholder Engagement in Question Development and Prioritization (SEED). METHOD Hospital-acquired pressure injuries were selected as the quality outcome to address. To identify HAPI prevention/management evidenced-based practices, the A-P council conducted an integrative literature review and developed a concept map and the Pressure Injury Prevention Gap Analysis Instrument. The gap analysis identified significant gaps between EBP and current pressure injury prevention practices, with priority ranking of gaps for action by key stakeholders. OUTCOME Following the practice-informed active learning program objectives, the A-P council identified 79 HAPI best EBPs organized by Donabedian domains of structure, process, and outcome and prioritized 3 gaps for action. Actions to address the HAPI gaps included: restructuring the hospital HAPI program, incorporating appropriate leadership to guide the HAPI program, modifying the HAPI reporting process, hiring specialized experts (WOC nurses) with emphasis on pressure injury prevention, establishing a standardized HAPI prevalence survey, improving electronic documentation, increasing transparency of HAPI reporting, improving HAPI accountability at the unit level, and exploring technology to enhance skin assessment. While HAPIs increased by 6.3% from 2019 (n = 104) to 2021 (n = 111), HAPI severity (Stages 3 and 4) decreased by 9.9% from 2019 (n = 14, or 13.46%) to 2021 (n = 4, or 3.6%). IMPLICATIONS FOR PRACTICE Our experience with this quality improvement initiative indicates that an A-P partnership can provide a model to address complex clinical problems, quality indicators, and quality improvement while advancing a culture of inquiry and scholarship and building nursing capacity.
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Affiliation(s)
- Jo Ann Otts
- Jo Ann Otts, DNP, RN, NEA-BC, CENP, College of Nursing, University of South Alabama, Mobile
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile
- Bettina Riley, PhD, RN, College of Nursing, University of South Alabama, Mobile
- Lisa Mestas, MSN, RN, BAS, USA Health University Hospital, Mobile, Alabama
- Heather Hall, PhD, RN, NNP-BC, College of Nursing, University of South Alabama, Mobile
| | - Joyce Pittman
- Jo Ann Otts, DNP, RN, NEA-BC, CENP, College of Nursing, University of South Alabama, Mobile
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile
- Bettina Riley, PhD, RN, College of Nursing, University of South Alabama, Mobile
- Lisa Mestas, MSN, RN, BAS, USA Health University Hospital, Mobile, Alabama
- Heather Hall, PhD, RN, NNP-BC, College of Nursing, University of South Alabama, Mobile
| | - Bettina Riley
- Jo Ann Otts, DNP, RN, NEA-BC, CENP, College of Nursing, University of South Alabama, Mobile
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile
- Bettina Riley, PhD, RN, College of Nursing, University of South Alabama, Mobile
- Lisa Mestas, MSN, RN, BAS, USA Health University Hospital, Mobile, Alabama
- Heather Hall, PhD, RN, NNP-BC, College of Nursing, University of South Alabama, Mobile
| | - Lisa Mestas
- Jo Ann Otts, DNP, RN, NEA-BC, CENP, College of Nursing, University of South Alabama, Mobile
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile
- Bettina Riley, PhD, RN, College of Nursing, University of South Alabama, Mobile
- Lisa Mestas, MSN, RN, BAS, USA Health University Hospital, Mobile, Alabama
- Heather Hall, PhD, RN, NNP-BC, College of Nursing, University of South Alabama, Mobile
| | - Heather Hall
- Jo Ann Otts, DNP, RN, NEA-BC, CENP, College of Nursing, University of South Alabama, Mobile
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile
- Bettina Riley, PhD, RN, College of Nursing, University of South Alabama, Mobile
- Lisa Mestas, MSN, RN, BAS, USA Health University Hospital, Mobile, Alabama
- Heather Hall, PhD, RN, NNP-BC, College of Nursing, University of South Alabama, Mobile
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Tanenbaum GJ, Holden LR. A Review of Patient Experiences and Provider Education to Improve Transgender Health Inequities in the USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6949. [PMID: 37887687 PMCID: PMC10606079 DOI: 10.3390/ijerph20206949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/28/2023]
Abstract
Transgender individuals are an underserved, vulnerable population. They face many inequities including barriers in both accessing and receiving adequate healthcare. These inequities are proposed here to be rooted in a lack of education about transgender people and their experiences. We begin by exploring the existing transgender healthcare research carried out in the USA, examining client experiences, provider education and attitudes, and the barriers transgender people face to obtaining proper healthcare. Secondly, we look at the previous research on educational interventions implemented with medical students and practitioners in the USA to enhance knowledge about transgender people, and increase sensitivity and awareness, while also increasing the level of comfort in working with these clients. The limitations in these fields of study are discussed in order to understand how to better serve transgender clients in the USA. We will do this through a narrative review to determine evidence-based best practices for educational intervention, uncovering gaps in the literature and highlighting where to focus in future work for researchers and practitioners.
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Affiliation(s)
- Gabriel J. Tanenbaum
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL 61820, USA;
| | - LaTasha R. Holden
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL 61820, USA;
- Beckman Institute, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
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Yao J, Yuan H, Zhu M, Wang J, Wang Q, Chen Z, Chen Y, Zhang X. Nursing student learning of evidence-based nursing through case-based learning and flipped learning: A mixed study. Nurs Open 2023; 10:6551-6558. [PMID: 37394713 PMCID: PMC10416045 DOI: 10.1002/nop2.1910] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 05/02/2023] [Accepted: 06/05/2023] [Indexed: 07/04/2023] Open
Abstract
AIM To evaluate a teaching experience in evidence-based nursing learning through case-based learning (CBL) and flipped learning (FL). DESIGN Embedded mixed methods study. METHODS In the first phase, a questionnaire on utility, satisfaction and perceived competency development is used to collect quantitative data, and the open question instrument is used to collect qualitative data. After the first phase, an in-depth semi-structured interview is used. RESULTS Five themes are identified: the enhancement of learning content, knowledge integration and transfer, the development of teamwork competency, the didactic support of FL and the difficulties and challenges faced by students. Regarding utility, 'combine theory and practice' and 'select the best evidence from what is found in the search' have the highest values. The most developed skills are communication and critical thinking ability. Finally, most participants are satisfied. CONCLUSIONS The combination of CBL and FL is an innovative strategy for learning evidence-based nursing courses. No Patient or Public Contribution.
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Affiliation(s)
- Jiannan Yao
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
- The First Affiliated Hospital of the China Medical UniversityShenyangChina
| | - Hua Yuan
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
| | - Mingyue Zhu
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
| | - Jia Wang
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
| | - Qiuchen Wang
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
| | - Zhiming Chen
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
| | - Yahong Chen
- China‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Xiuying Zhang
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
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Ezeruigbo CFS. Evidence-Based Practice Among Psychiatric Nurses: Knowledge, Attitudes, Organizational Readiness, Levels of Implementation, and Barriers and Facilitators. J Psychosoc Nurs Ment Health Serv 2023; 61:47-55. [PMID: 37527520 DOI: 10.3928/02793695-20230726-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
The current study examined psychiatric nurses' views, knowledge, attitudes, organizational readiness, levels of evidence-based practice (EBP), as well as barriers and facilitators to EBP in a Nigerian tertiary neuropsychiatric hospital. This study used a cross-sectional descriptive research approach. Structured questionnaires were administered to all psychiatric nurses (N = 131) at the hospital. Results showed that psychiatric nurses had an acceptable degree of EBP knowledge and a positive attitude toward EBP. Levels of EBP implementation were below average, and organizational culture and preparation for EBP were moderate. Participants reported a moderate degree of barriers to EBP adoption (mean = 40.08, SD = 9.63), and a high level of assertion to positive facilitators of EBP (mean = 19.88, SD = 4.16). Findings show that although most psychiatric nurses had adequate knowledge and good attitudes toward EBP, certain barriers prevented its application. Thus, there is a need for a policy framework to mitigate existing barriers and improve EBP facilitators in psychiatric nursing practices in Nigeria to improve productivity measures. [Journal of Psychosocial Nursing and Mental Health Services, 61(9), 47-55.].
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Hwang JHA, Fraser EE, Downing MG, Ponsford JL. A qualitative study on the attitudes and approaches of Australian clinicians in addressing sexuality after acquired brain injury. Disabil Rehabil 2022; 44:8294-8302. [PMID: 34951561 DOI: 10.1080/09638288.2021.2012605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE Studies indicate that up to 50% of survivors of acquired brain injury (ABI) experience persistent changes in sexuality. However, research on clinicians' perspectives in addressing sexuality issues post-ABI is limited. This study explored the attitudes and approaches, barriers and facilitators, and training preferences of Australian clinicians in addressing sexuality in individuals post-ABI. METHOD Purposive sampling was used to recruit 20 Australian multi-disciplinary clinicians from a related survey study. Semi-structured interviews were conducted and qualitatively analysed using thematic analysis. RESULTS Three broad themes were identified: ABI results in multi-faceted changes in sexuality; there is a fundamental discomfort in talking about sexuality; and, strategies proposed by clinicians may help to improve sexuality support. Participants also provided suggestions for sexuality training, which they believed should start at university. CONCLUSION Most clinicians are aware of sexuality issues post-ABI but fail to adequately address sexuality in individuals post-ABI due to personal levels of discomfort, perpetuated by institutional factors. Therefore, participants believe that changes made at individual and institutional levels may increase sexuality support for individuals with ABI. However, further research on the causes and treatment of sexual problems and patient perspectives is required to provide the evidence-based guidelines and training programs that clinicians require.Implications for rehabilitationUp to half of individuals experience changes in sexuality after ABI that restrict quality of life and relationships.The consequences of ABI and their impacts on sexuality are understood by Australian clinicians but remain largely unaddressed due to individual discomfort, perpetuated by institutional factors.This study suggests that professional training targeted towards understanding, assessing and treating sexuality issues post-ABI may help to reduce the discomfort.Adjustments should also be made at individual, policy and procedural levels to ensure that sexuality is addressed within rehabilitation post-ABI.
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Affiliation(s)
- Jill H A Hwang
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Elinor E Fraser
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Marina G Downing
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Jennie L Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
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Portela Dos Santos O, Melly P, Hilfiker R, Giacomino K, Perruchoud E, Verloo H, Pereira F. Effectiveness of Educational Interventions to Increase Skills in Evidence-Based Practice among Nurses: The EDITcare Systematic Review. Healthcare (Basel) 2022; 10:2204. [PMID: 36360544 PMCID: PMC9691114 DOI: 10.3390/healthcare10112204] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 09/08/2024] Open
Abstract
BACKGROUND Using evidence-based practice (EBP) improves the implementation of safe, high-quality healthcare for patients, reduces avoidable costs, and plays a crucial role in bridging knowledge-action gaps and reducing health inequities. EBP combines the best available evidence in the relevant literature with patient preferences and values and healthcare professionals' (HCPs) expertise. METHODS Systematic searches of ten bibliographic databases, unpublished works, and the Grey Literature Report sought studies published up to 30 September 2022. RESULTS The 15 studies retained involved 2712 nurses. Three types of effective educational interventions were identified: (1) multifaceted educational strategies incorporating mentoring and tutoring; (2) single educational strategies, often delivered online; and (3) multifaceted educational strategies using the five steps of EBP. Eleven primary outcomes (EBP beliefs, EBP self-efficacy, perceived EBP implementation, EBP competencies, EBP knowledge, EBP skills, EBP attitudes, EBP behaviors, EBP desire, EBP practice, and perceptions of organizational culture and readiness) were assessed using 13 qualitative and quantitative instruments. CONCLUSIONS Ensuring the successful implementation of EBP requires effective educational strategies. Computer-based learning seems the most cost-effective and efficient strategy, when considering caregivers' characteristics, the clinical field, and educational interventions across the pre-, peri-, and post-implementation processes.
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Affiliation(s)
- Omar Portela Dos Santos
- Department of Nursing Sciences, School of Health Sciences, HES-SO Valais/Wallis, University of Applied Sciences and Arts Western Switzerland, Chemin de l’Agasse 5, CH-1950 Sion, Switzerland
- Institute of Health Sciences, Universidade Católica Portuguesa, Rua de Diogo Botelho 1327, 4169-005 Porto, Portugal
| | - Pauline Melly
- Department of Nursing Sciences, School of Health Sciences, HES-SO Valais/Wallis, University of Applied Sciences and Arts Western Switzerland, Chemin de l’Agasse 5, CH-1950 Sion, Switzerland
| | - Roger Hilfiker
- Department of Physiotherapy, School of Health Sciences, HES-SO Valais/Wallis, University of Applied Sciences and Arts Western Switzerland, Rathausstrasse 8, CH-3954 Leukerbad, Switzerland
| | - Katia Giacomino
- Department of Physiotherapy, School of Health Sciences, HES-SO Valais/Wallis, University of Applied Sciences and Arts Western Switzerland, Rathausstrasse 8, CH-3954 Leukerbad, Switzerland
| | - Elodie Perruchoud
- Department of Nursing Sciences, School of Health Sciences, HES-SO Valais/Wallis, University of Applied Sciences and Arts Western Switzerland, Chemin de l’Agasse 5, CH-1950 Sion, Switzerland
| | - Henk Verloo
- Department of Nursing Sciences, School of Health Sciences, HES-SO Valais/Wallis, University of Applied Sciences and Arts Western Switzerland, Chemin de l’Agasse 5, CH-1950 Sion, Switzerland
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Route de Cery 60, CH-1008 Lausanne, Switzerland
| | - Filipa Pereira
- Department of Nursing Sciences, School of Health Sciences, HES-SO Valais/Wallis, University of Applied Sciences and Arts Western Switzerland, Chemin de l’Agasse 5, CH-1950 Sion, Switzerland
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McNett M, Tucker S, Zadvinskis I, Tolles D, Thomas B, Gorsuch P, Gallagher-Ford L. A Qualitative Force Field Analysis of Facilitators and Barriers to Evidence-Based Practice in Healthcare Using an Implementation Framework. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2022; 2:195-208. [PMID: 35974880 PMCID: PMC9373890 DOI: 10.1007/s43477-022-00051-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/20/2022] [Indexed: 11/01/2022]
Abstract
Research has identified facilitators and barriers to implementation of evidence-based practices (EBPs). Few studies have evaluated which factors persist among healthcare clinicians with extensive education and training on EBP implementation. Therefore, the purpose of this study was to examine facilitators and barriers to EBP implementation across a national sample of specialty-prepared EBP mentors in healthcare settings. Healthcare clinicians participating in an immersive 5-day EBP knowledge and skill building program were invited to complete a follow-up survey 12 months later to report on implementation experiences. The Consolidated Framework for Implementation Research (CFIR) guided content analysis of responses. A force field analysis using Lewin’s change theory was used to assign numerical ‘weights’ to factors. Eighty-four individuals reported facilitators and barriers to implementation. The majority occurred within the inner setting of the CFIR model. Facilitators were strong leadership engagement (n = 15), positive EBP culture (n = 9), and resources (n = 4). Barriers included lack of resources (n = 21), poor leadership engagement (n = 19), implementation climate (n = 17), lack of relative priority (n = 12), and organizational characteristics (n = 9). Respondents also identified simultaneous facilitators and barriers within the process domain of the CFIR model. The construct of stakeholder engagement was a barrier when absent from the implementation process (n = 23), yet was a strong facilitator when present (n = 23). Implementation in healthcare settings appears most effective when conducted by an interprofessional team with strong leadership, resources, stakeholder engagement, and positive EBP culture. When these same factors are absent, they remain persistent barriers to implementation, even among specialty-trained healthcare clinicians.
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Nursing educators' and undergraduate nursing students' beliefs and perceptions on evidence-based practice, evidence implementation, organizational readiness and culture: An exploratory cross-sectional study. Nurse Educ Pract 2021; 54:103122. [PMID: 34174719 DOI: 10.1016/j.nepr.2021.103122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/18/2021] [Accepted: 06/15/2021] [Indexed: 01/21/2023]
Abstract
AIMS To describe the undergraduate nursing students' and nursing educators' evidence-based practice beliefs, their extent of evidence-based practice implementation and their perspectives regarding organizational culture for evidence-based practice. To identify any relationship between the mentioned variables. BACKGROUND The integration of evidence-based practice in nursing curricula is crucial to educate nursing students to incorporate evidence-based practice in their future clinical practice. Therefore, to promote its integration within nursing education, it is important to deeply understand how prepared academic institutions are for teaching about and supporting evidence-based practice integration. DESIGN Cross-sectional study. METHODS Nursing educators and undergraduate nursing students from nine Portuguese nursing schools were invited to participate in this study through an electronic survey comprising socio-demographic questions and the scales. RESULTS Sixty-eight nursing educators replied to the survey. Most were female, have PhD and have evidence-based practice training. They showed mean scores of 88.92 ± 8.18 for evidence-based practice beliefs, 40.20 ± 18.93 for evidence-based practice implementation and 80.59 ± 17.52 for evidence-based practice organizational culture and readiness. Concerning nursing educator sample, there were moderate and statistically significant relationship between: evidence-based practice beliefs and implementation; and evidence-based practice beliefs and organizational culture and readiness for school-wide integration of evidence-based practice. Between evidence-based practice implementation and organizational culture and readiness for school-wide integration of evidence-based practice, there was a small relationship. One hundred and sixty-seven undergraduate nursing students answered the survey. Mostly, they were female and were in third or fourth year of their nursing degree. Similarly, to educators, students showed mean scores of 58.69 ± 6.92 for evidence-based practice beliefs, 32.37 ± 16.97 for evidence-based practice implementation and 84.20 ± 23.48 for evidence-based practice organizational culture and readiness. Regarding undergraduate nursing student sample, there were moderate and statistically significant relationship between the different variables. CONCLUSIONS Both nursing educators and undergraduate nursing students had strong evidence-based practice beliefs, but low levels of evidence-based practice implementation. In nursing educators' and undergraduate nursing students' perspectives, there were opportunities in their schools for the development of an evidence-based practice culture. Based on results, support for development and testing of interventions, specifically tailored for promoting evidence-based practice implementation in nursing educational contexts, is recommended.
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Ginex PK, Dickman E, Thomas B, Tucker S, Guo J, Gallagher-Ford L. Evidence-Based Practice in Oncology Nursing: Oncology Nursing Society Survey Results. Clin J Oncol Nurs 2021; 25:282-289. [PMID: 34019024 DOI: 10.1188/21.cjon.282-289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Evidence-based practice (EBP) is a clinical decision-making approach that improves quality and outcomes in health care but is not yet standard in clinical settings. OBJECTIVES The purpose of this study was to determine EBP beliefs, knowledge, implementation strategy self-efficacy, and competencies among a national sample of oncology nurses. METHODS Oncology nurses completed an online survey of EBP attributes and open-ended questions. Analyses were conducted on data collected from 893 participants from a range of healthcare organizations across a diverse geographic sample of the United States. FINDINGS Respondents rated themselves competent to question clinical practice to improve quality care. Oncology nurses reported competency to question clinical practice but deficits in EBP knowledge and skills.
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Schuler E, Mott S, Forbes PW, Schmid A, Atkinson C, DeGrazia M. Evaluation of an evidence-based practice mentorship programme in a paediatric quaternary care setting. J Res Nurs 2021; 26:149-165. [PMID: 35251236 DOI: 10.1177/1744987121991417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Evidence-based practice (EBP) is essential for clinical decision-making, improving care, reducing costs and achieving optimal patient outcomes. The Evidence-based Practice Mentorship Program (EBPMP) is a flexible, self-directed programme whereby participants carry out EBP projects guided by expert mentors. AIMS To evaluate EBPMP effectiveness and participant experience. METHODS To evaluate effectiveness, as measured by changes in EBP value, knowledge and implementation, participants completed pre- and post-EBPMP Quick-EBP-Value, Implementation and Knowledge (VIK) surveys. To understand participants' experiences individual and group interviews were conducted at the end of the programme and analysed using qualitative content analysis. RESULTS Most participants were over 50 years old, Caucasian, inpatient staff nurses, baccalaureate prepared, with over 11 years' experience. Statistically significant improvements were observed in the post Quick-EBP-VIK knowledge and implementation domains. Individual and group participant interviews revealed four categories of importance to the experience: 1. perceived benefits of EBP, 2. time as a barrier to EBP, 3. desire for more cohort interaction and 4. positive mentee-mentor experience. CONCLUSIONS EBPMP can improve participants' knowledge and implementation of EBP in an environment that values EBP; however, opportunities exist to implement programme modifications that address barriers identified by participants including project time and increased participant interactions.
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Affiliation(s)
- Ethan Schuler
- Pediatric Nurse Practitioner II, Cardiovascular and Critical Care Nursing Patient Services, Boston Children's Hospital, USA
| | - Sandra Mott
- Nurse Scientist, Cardiovascular and Critical Care Nursing Patient Services, Boston Children's Hospital, USA
| | - Peter W Forbes
- Senior Biostatistician, Clinical Research Program, Boston Children's Hospital, USA
| | - Alexis Schmid
- Staff Nurse, Emergency Department, Boston Children's Hospital, USA
| | - Carole Atkinson
- Nurse Practice Specialist II, Neuroscience Programs, Boston Children's Hospital, USA
| | - Michele DeGrazia
- Director of Nursing Research for the Neonatal Intensive Care Unit, Cardiovascular and Critical Care Nursing Patient Services, Boston Children's Hospital, USA. Harvard Medical School, USA
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Kerwien-Jacquier E, Verloo H, Pereira F, Peter KA. Adaptation and validation of the evidence-based practice beliefs and implementation scales into German. Nurs Open 2020; 7:1997-2008. [PMID: 33072385 PMCID: PMC7544869 DOI: 10.1002/nop2.593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/15/2020] [Accepted: 07/23/2020] [Indexed: 01/10/2023] Open
Abstract
Aims To culturally adapt and translate the Evidence-Based Practice Belief Scale (EBP-B) and the Evidence-Based Practice Implementation Scale (EBP-I), explore the psychometric properties of their validated German versions and compare results with those of the original scales. Design Cross-sectional descriptive study. Method The study was conducted on a sample of 131 Registered Nurses in a Swiss German hospital. Internal consistency was rated using Cronbach's alpha. Principal component analysis using varimax rotation was used to determine construct validity. The study was undertaken in accordance with the STROBE-checklist in Appendix S1. Results German versions of the EBP-B and EBP-I showed good reliability. Their Cronbach alphas showed lower values than those of the original scales. Principal component analysis showed medium-to-high factor loading. Principal component analyses using varimax rotations of the EBP-B's 16 items and the EBP-I's 17 items resulted in four-factor and five-factor solutions, respectively.
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Affiliation(s)
- Emmanuelle Kerwien-Jacquier
- School of Health Sciences HES-SO Valais/Wallis University of Applied Sciences and Arts of Western Switzerland Visp Switzerland
| | - Henk Verloo
- School of Health Sciences HES-SO Valais/Wallis University of Applied Sciences and Arts of Western Switzerland Visp Switzerland
| | - Filipa Pereira
- School of Health Sciences HES-SO Valais/Wallis University of Applied Sciences and Arts of Western Switzerland Visp Switzerland
| | - Karin Anne Peter
- Division of Applied Research & Development in Nursing Bern University of Applied Sciences Bern Switzerland
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Spanakis M, Patelarou AE, Patelarou E. Nursing Personnel in the Era of Personalized Healthcare in Clinical Practice. J Pers Med 2020; 10:E56. [PMID: 32610469 PMCID: PMC7565499 DOI: 10.3390/jpm10030056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 12/27/2022] Open
Abstract
Personalized, stratified, or precision medicine (PM) introduces a new era in healthcare that tries to identify and predict optimum treatment outcomes for a patient or a cohort. It also introduces new scientific terminologies regarding therapeutic approaches and the need of their adoption from healthcare providers. Till today, evidence-based practice (EBP) was focusing on population averages and their variances among cohorts for clinical values that are essential for optimizing healthcare outcome. It can be stated that EBP and PM are complementary approaches for a modern healthcare system. Healthcare providers through EBP often see the forest (population averages) but miss the trees (individual patients), whereas utilization of PM may not see the forest for the trees. Nursing personnel (NP) play an important role in modern healthcare since they are consulting, educating, and providing care to patients whose needs often needs to be individualized (personalized nursing care, PNC). Based on the clinical issues earlier addressed from clinical pharmacology, EBP, and now encompassed in PM, this review tries to describe the challenges that NP have to face in order to meet the requisites of the new era in healthcare. It presents the demands that should be met for upgrading the provided education and expertise of NP toward an updated role in a modern healthcare system.
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Affiliation(s)
- Marios Spanakis
- Computational BioMedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology—Hellas (FORTH), Heraklion, GR-70013 Crete, Greece
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, Heraklion, GR-71004 Crete, Greece; (A.E.P.); (E.P.)
| | - Athina E. Patelarou
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, Heraklion, GR-71004 Crete, Greece; (A.E.P.); (E.P.)
| | - Evridiki Patelarou
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, Heraklion, GR-71004 Crete, Greece; (A.E.P.); (E.P.)
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Cultivating evidence-based practice through mentorship. Appl Nurs Res 2020; 55:151295. [PMID: 32499077 DOI: 10.1016/j.apnr.2020.151295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 03/06/2020] [Accepted: 05/07/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Nurses' use of evidence-based practice (EBP) improves patient outcomes through provision of optimal patient care. AIM The Evidence-Based Practice Mentorship Program (EBPMP) is a self-directed, year-long immersion program implemented for staff nurses to experience the EBP process with close mentor support. The aim of this program is to bolster a culture of EBP at a single large pediatric quaternary care hospital in the Northeast. RESULTS A total of 81 nurses across 4 cohorts participated in this organization wide program from 2016 to 2019. To date the program has produced 46 internally and externally disseminated EBP projects. Of the graduates, 7-nurse mentees have become formal EBPMP mentor's, 3 have applied and been accepted into the organizational based Nursing Science Fellowship to carry out clinical inquiry projects to fill important literary gaps, and 6 have received promotions or career advancements. Most importantly, graduates have anecdotally reported that program participation inspired deeper critical reflection of patient care. SUMMARY Utilizing mentorship to facilitate EBP was a key educational strategy for the busy mentors and mentees, as many of the nurse participants were direct care providers. This self-directed program resulted in a high project completion rate leading to continued organizational support for the program, which is now in its fourth year.
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Oh EG, Yoo JY. Experiences of evidence-based practice mentors: a phenomenological study. Contemp Nurse 2020; 56:331-343. [PMID: 32270744 DOI: 10.1080/10376178.2020.1736593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: The importance of the role of clinical nursing leaders as Evidence-based Practice (EBP) mentors has increased; however, information regarding their experiences is limited. Aims: This study aimed to explore EBP mentors' lived experiences. Design: This qualitative study used a phenomenological framework suggested by Colaizzi. Methods: The participants were seven EBP mentors working as unit managers in Korea. Data were collected via in-depth, semi-structured interviews. Findings: The experiences of EBP mentors were identified to three categories: 'challenges in taking on the new role of EBP mentor', 'forming intimate EBP mentor-staff nurse relations' and 'becoming independent as a facilitator'. The EBP mentors experienced role ambiguity, stress, and burden during the initial phase of EBP mentorship; however, they adjusted and reported positive experiences during the adjustment process. Conclusion: Before implementation an EBP initiative, systematic and educational programs that target the EBP mentors should be offered. A systematic approach to creating an institutional culture of EBP are also needed.
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Affiliation(s)
- Eui Geum Oh
- College of Nursing, Yonsei University, Seoul, South Korea.,Yonsei Evidence Based Nursing Centre of Korea, A Joanna Briggs Institute Centre of Excellence, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea
| | - Jae Yong Yoo
- Department of Nursing, College of Medicine, Chosun University, 309 Pilmundae-ro, Dong-gu, Gwangju 61452, South Korea
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Bartos S, Kris AE. Transformation of Organizational Culture Through the Use of a Nursing Research Facilitator. Worldviews Evid Based Nurs 2020; 17:168-169. [DOI: 10.1111/wvn.12406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Susan Bartos
- Marion Peckham Egan School of Nursing and Health Studies Fairfield University Fairfield CT USA
| | - Alison E. Kris
- Marion Peckham Egan School of Nursing and Health Studies Fairfield University Fairfield CT USA
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Ayoubian A, Nasiripour AA, Tabibi SJ, Bahadori M. Evaluation of Facilitators and Barriers to Implementing Evidence-Based Practice in the Health Services: A Systematic Review. Galen Med J 2020; 9:e1645. [PMID: 34466560 PMCID: PMC8343503 DOI: 10.31661/gmj.v9i0.1645] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/26/2019] [Accepted: 09/02/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Evidence-based practice (EBP) is an ambition for health service administrators. We aimed to systematically review the major relevant articles in case of barriers and facilitators to implementing evidence-based practice in health services. MATERIALS AND METHODS The type of study was a systematic review. We searched the libraries and online sources such as PubMed, MEDLINE, Wiley, EMBASE, ISI Web of Knowledge, Scopus, Science Direct, Cochrane Library, and Google scholar. We used keywords included "Evidence-Based Practice", "Evidence-Based Management", "Healthcare", "Care Management, Evidence-Based Healthcare Management", "Health Care", Health", "Barrier", "Facilitator", policy and "Evidence-Based Healthcare". RESULTS In total, 12 studies were included. Several barriers and facilitators were recognized through the included papers, the factors such as organization support and a helpful education system improved skills, knowledge, and confidence to EBP. The outcomes of studies were identified as the employ of the internet as a highest-rated skill for increasing EBP quality. CONCLUSION Generally, the results showed health service administrators should first identify barriers of EBP then transferred them to facilitators to the implementation of proper and efficient EBP.
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Affiliation(s)
- Ali Ayoubian
- Department of Health Services Management, Faculty of Medical Sciences and Technologies, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Amir Ashkan Nasiripour
- Department of Health Services Management, Faculty of Medical Sciences and Technologies, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Seyed Jamaledin Tabibi
- Department of Health Services Management, Faculty of Medical Sciences and Technologies, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mohammadkarim Bahadori
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Gallagher‐Ford L, Koshy Thomas B, Connor L, Sinnott LT, Melnyk BM. The Effects of an Intensive Evidence‐Based Practice Educational and Skills Building Program on EBP Competency and Attributes. Worldviews Evid Based Nurs 2020; 17:71-81. [DOI: 10.1111/wvn.12397] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Lynn Gallagher‐Ford
- Helene Fuld Health Trust National Institute for EBP in Nursing & Healthcare Columbus OH USA
- Helene Fuld Health Trust National Institute for EBP in Nursing & Healthcare, College of Nursing The Ohio State University Columbus OH USA
| | - Bindu Koshy Thomas
- Helene Fuld Health Trust National Institute for EBP in Nursing & Healthcare, College of Nursing The Ohio State University Columbus OH USA
| | - Linda Connor
- Helene Fuld Health Trust National Institute for EBP in Nursing & Healthcare, College of Nursing The Ohio State University Columbus OH USA
- College of Nursing The Ohio State University Columbus OH USA
| | | | - Bernadette Mazurek Melnyk
- Helene Fuld Health Trust National Institute for EBP in Nursing & Healthcare Columbus OH USA
- College of Nursing The Ohio State University Columbus OH USA
- College of Medicine The Ohio State UniversityColumbus OH USA
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Campbell C, Nowell A, Karagheusian K, Giroux J, Kiteley C, Martelli L, McQuestion M, Quinn M, Rowe Samadhin YP, Touw M, Moody L. Practical innovation: Advanced practice nurses in cancer care. Can Oncol Nurs J 2020; 30:9-15. [PMID: 33119001 DOI: 10.5737/23688076301915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objectives The objectives of this study were to gather emerging practice evidence, through consultation with Advance Practice Nurses (APN), to fill the evidence gaps in the published guidelines, Effective Use of Advanced Practice Nurses in the Delivery of Adult Cancer Services in Ontario, and to provide a set of expert panel recommendations to build a research agenda to promote the collection and publication of Level 1 and 2 evidence. Method A three-step RAND/UCLA Appropriateness Methodology (RAM) modified Delphi process was used to solicit expert opinion on the use of APNs in adult cancer care in Ontario. Results Thirty-four (34) case examples of APN use were gathered. The modified Delphi process concluded with the endorsement of 30 APN role statements that were used to develop nine (9) additional recommendations regarding the use of APNs in the delivery of adult cancer care. Conclusion The recommendations from this study provide direction for future research to close the current evidence gap regarding the role of APNs in cancer care delivery in Canada.
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Affiliation(s)
- Colleen Campbell
- Nurse Practitioner, Stronach Regional Cancer Centre, 596 Davis Dr., Newmarket, ON L3Y 2P9,
| | - Allyson Nowell
- Advanced Practice Nurse, Palliative Care Consult Service, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, H337, Toronto, ON, M4N 3M5,
| | - Karen Karagheusian
- Senior Specialist, Cancer Care Ontario, 620 University Ave., Toronto, ON M5G 2L7,
| | - Janet Giroux
- de Souza APN, Nurse Practitioner-Adult, Gynecology Oncology, Oncology Sexual Health Clinic-NP, Kingston Health Sciences Centre, Kingston General Hospital, Cancer Centre of Southeastern Ontario,
| | | | - Lorraine Martelli
- Provincial Head of Cancer-Nursing, Ontario, Cancer Care Ontario, 620 University Ave., Toronto, ON M5G 2L7,
| | - Maurene McQuestion
- Clinical Nurse Specialist/Advanced Practice Nurse, Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network,
| | - Maureen Quinn
- Nurse Practitioner-Adult, London Health Sciences Centre, 800 Commissioners Road East, PO Box 5010, Stn B,
| | - Yvonne P Rowe Samadhin
- Nurse Practitioner-Hospice Palliative Care Team, Waterloo Wellington Local Health Integration Network, 73 Water Street North, Cambridge, ON N1R 7L6,
| | - Melissa Touw
- Clinical Nurse Specialist - Palliative Care, Kingston Health Sciences Centre - KGH site,
| | - Lesley Moody
- Director, Person-Centred Care, 620 University Ave., Toronto, ON M5G 2L7,
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Campbell C, Nowell A, Karagheusian K, Giroux J, Kiteley C, Martelli L, McQuestion M, Quinn M, Rowe Samadhin YP, Touw M, Moody L. Innovation pratique : infirmières en pratique avancée et soins du cancer. Can Oncol Nurs J 2020; 30:16-22. [PMID: 33118993 DOI: 10.5737/236880763011622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objectifs La présente étude avait pour but de recueillir, en consultation avec les infirmières en pratique avancée (IPA), des données probantes sur les pratiques émergentes afin de combler les lacunes à cet égard dans les lignes directrices sur le recours judicieux aux infirmières en pratique avancée dans la prestation des services aux adultes atteints de cancer en Ontario (Effective Use of Advanced Practice Nurses in the Delivery of Adult Cancer Services in Ontario), ainsi que de proposer un ensemble de recommandations, formulées par un groupe d'experts, pour créer un programme de recherche qui permettra de recueillir et de publier des données probantes de niveau 1 et de niveau 2. Méthodologie Une enquête Delphi modifiée à trois tours faisant appel à la méthodologie mise au point par RAND et UCLA (aussi appelée ≪ Appropriateness Methodology ≫) a été utilisée pour solliciter l'avis des spécialistes sur le recours aux IPA pour le soin des adultes atteints de cancer en Ontario. Résultats Trente-quatre (34) cas de recours aux IPA ont été recensés. L'enquête Delphi modifiée a permis de définir 30 énoncés de rôle à partir desquels ont été formulées neuf (9) recommandations supplémentaires sur l'intervention des IPA dans la prestation des soins aux adultes atteints de cancer. Conclusion Les recommandations de la présente étude orienteront les recherches à venir pour combler les lacunes au chapitre des données probantes quant au rôle des IPA dans la prestation des soins du cancer au Canada.
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Affiliation(s)
- Colleen Campbell
- Infirmière praticienne, Centre régional de cancérologie Stronach, 596 Davis Dr, Newmarket, ON L3Y 2P9,
| | - Allyson Nowell
- Infirmière en pratique avancée, consultation en soins palliatifs, Centre des sciences de la santé Sunnybrook, 2075 Bayview Avenue, H337, Toronto, ON M4N 3M5,
| | - Karen Karagheusian
- Spécialiste principale, Action Cancer Ontario, 620 University Ave., Toronto, ON M5G 2L7,
| | - Janet Giroux
- IPA de Souza, Infirmière praticienne-Adulte, oncologie gynécologique, infirmière praticienne en clinique de santé sexuelle et d'oncologie, Centre des sciences de la santé de Kingston, Hôpital général de Kingston, Centre de cancérologie du Sud-Est de l'Ontario,
| | | | - Lorraine Martelli
- Directrice du programme provincial de soins infirmiers oncologiques de l'Ontario, Action Cancer Ontario, 620 University Ave., Toronto, ON M5G 2L7,
| | - Maurene McQuestion
- Infirmière clinicienne spécialisée / Infirmière en pratique avancée, programme de médecine des rayonnements, Centre de cancérologie Princess Margaret, Réseau universitaire de santé,
| | - Maureen Quinn
- Infirmière praticienne-Adulte, Centre des sciences de la santé de London, 800 Commissioners Road East, C.P. 5010, Stn B,
| | - Yvonne P Rowe Samadhin
- Infirmière praticienne - équipe de soins palliatifs, Réseau local d'intégration des services de santé de Waterloo Wellington, 73 Water Street North, Cambridge, ON N1R 7L6,
| | - Melissa Touw
- Infirmière clinicienne spécialisée - Soins palliatifs, Centre des sciences de la santé de Kingston - Hôpital général de Kingston,
| | - Lesley Moody
- Directrice, Soins centrés sur la personne, 620 University Ave., Toronto, ON M5G 2L7,
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20
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Yoo JY, Kim JH, Kim JS, Kim HL, Ki JS. Clinical nurses' beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PLoS One 2019; 14:e0226742. [PMID: 31877147 PMCID: PMC6932768 DOI: 10.1371/journal.pone.0226742] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 12/03/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This study aimed to identify clinical nurses' evidence-based practice (EBP) knowledge, beliefs, organizational readiness, and EBP implementation levels, and to determine the factors that affect EBP implementation in order to successfully establish EBP. This study was conducted at a university-affiliated tertiary hospital located in a provincial area in Korea. The research design was based on Melnyk and Fineout-Overholt's Advancing Research & Clinical Practice through Close Collaboration model as the first step. METHODS A descriptive and cross-sectional design was conducted and a convenience sample of 521 full-time registered nurses from an 849-bed tertiary hospital were included. Structured questionnaires were used to assess EBP knowledge, EBP beliefs, organizational culture & readiness and EBP implementation. Data were analyzed using SPSS V 25.0 by using descriptive and inferential statistics and hierarchical multiple regression was performed to determine the factors affecting the implementation of EBP. RESULTS Our findings showed that the clinical nurses had a positive level of EBP beliefs, but the level of EBP knowledge, organizational readiness and EBP implementation were insufficient. EBP knowledge, beliefs, and organizational readiness were significantly positively correlated with EBP implementation. In the final model, EBP knowledge and organizational readiness were significant predictors of EBP implementation; the model predicted 22.2% of the variance in implementation. CONCLUSIONS Based on these results, the main focus of the study was the importance of individual nurses' efforts in carrying out EBP, but above all efforts to create an organizational culture to prepare and support EBP at the nursing organization level. In the initial process of introducing and establishing EBP, nurse administrators will need to minimize expected barriers, enhance facilitators, and strive to build an infrastructure based on vision, policy-making, budgeting, excellent personnel and facilities within the organization.
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Affiliation(s)
- Jae Yong Yoo
- Department of Nursing, College of Medicine, Chosun University, Gwangju, South Korea
| | - Jin Hee Kim
- Department of Nursing, College of Medicine, Chosun University, Gwangju, South Korea
| | - Jin Sun Kim
- Department of Nursing, College of Medicine, Chosun University, Gwangju, South Korea
| | - Hyun Lye Kim
- Department of Nursing, College of Medicine, Chosun University, Gwangju, South Korea
| | - Jung Suk Ki
- Department of Nursing, Chosun University Hospital, Gwangju, South Korea
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Ramis MA, Chang A, Conway A, Lim D, Munday J, Nissen L. Theory-based strategies for teaching evidence-based practice to undergraduate health students: a systematic review. BMC MEDICAL EDUCATION 2019; 19:267. [PMID: 31319892 PMCID: PMC6637485 DOI: 10.1186/s12909-019-1698-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 07/08/2019] [Indexed: 06/02/2023]
Abstract
BACKGROUND Undergraduate students across health professions are required to be capable users of evidence in their clinical practice after graduation. Gaining the essential knowledge and clinical behaviors for evidence-based practice can be enhanced by theory-based strategies. Limited evidence exists on the effect of underpinning undergraduate EBP curricula with a theoretical framework to support EBP competence. A systematic review was conducted to determine the effectiveness of EBP teaching strategies for undergraduate students, with specific focus on efficacy of theory-based strategies. METHODS This review critically appraised and synthesized evidence on the effectiveness of EBP theory-based teaching strategies specifically for undergraduate health students on long or short-term change in multiple outcomes, including but not limited to, EBP knowledge and attitudes. PubMed, CINAHL, Scopus, ProQuest Health, ERIC, The Campbell Collaboration, PsycINFO were searched for published studies and The New York Academy of Medicine, ProQuest Dissertations and Mednar were searched for unpublished studies. Two independent reviewers assessed studies using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. RESULTS Twenty-eight studies reporting EBP teaching strategies were initially selected for review with methodological quality ranging from low to high. Studies varied in course duration, timing of delivery, population and course content. Only five included papers reported alignment with, and detail of, one or more theoretical frameworks. Theories reported included Social Cognitive Theory (one study), Roger's Diffusion of Innovation Theory (two studies) and Cognitive Apprenticeship Theory (one study). Cognitive Flexibility Theory and Cognitive Load Theory were discussed in two separate papers by the same authors. All but one study measured EBP knowledge. Mixed results were reported on EBP knowledge, attitudes and skills across the five studies. CONCLUSIONS EBP programs for undergraduate health students require consideration of multiple domains, including clinical behaviors, attitudes and cognitive learning processes; Interventions grounded in theory were found to have a small but positive effect on EBP attitudes. The most effective theory for developing and supporting EBP capability is not able to be determined by this review therefore additional rigorous research is required.
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Affiliation(s)
- Mary-Anne Ramis
- Mater Health, Evidence in Practice Unit & Queensland Centre for Evidence Based Nursing and Midwifery, A Joanna Briggs Institute Centre of Excellence, South Brisbane, QLD 4101 Australia
- Queensland University of Technology, School of Nursing, Victoria Park Road, Kelvin Grove, Brisbane, Queensland 4059 Australia
| | - Anne Chang
- Queensland University of Technology, School of Nursing, Kelvin Grove Campus, Victoria Park Road, Brisbane, 4059 Australia
| | - Aaron Conway
- Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5G 2N2 Canada
| | - David Lim
- School of Science and Health, Western Sydney University, Sydney, 2751 Australia
| | - Judy Munday
- Queensland University of Technology, School of Nursing, Kelvin Grove Campus, Victoria Park Road, Brisbane, 4059 Australia
- Faculty of Health and Sports Sciences, University of Agder, Grimstad, Norway
| | - Lisa Nissen
- Queensland University of Technology, School of Clinical Sciences, Gardens Point Campus, QLD, Brisbane, 4000 Australia
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Pittman J, Cohee A, Storey S, LaMothe J, Gilbert J, Bakoyannis G, Ofner S, Newhouse R. A Multisite Health System Survey to Assess Organizational Context to Support Evidence-Based Practice. Worldviews Evid Based Nurs 2019; 16:271-280. [PMID: 31231947 DOI: 10.1111/wvn.12375] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Implementation and sustainability of a culture of evidence-based practice (EBP) require a systematic approach. A baseline assessment of the organizational context can inform implementation efforts. AIMS To examine organizational hospital context and provider characteristics associated with EBP readiness and to describe EBP context across hospitals. METHODS A nonexperimental descriptive correlational design was used to conduct a web-based survey of direct-care registered nurses (N = 701) and nurse managers (N = 94) across a large Midwestern multisite healthcare system using the Alberta Context Tool (ACT). RESULTS Many significant relationships existed among nurse characteristics and ACT domains, including age (lower age had higher Leadership, Evaluation, and Formal Interactions), education (graduate education had lower Social Capital than a bachelor's or associate degree), role (direct-care nurses had lower Culture than managers and lower Social Capital), and work status (full-time employees had lower Evaluation and Social Capital). EBP context across type of hospitals is similar, with marginal differences in Social Capital and Organizational Slack (higher in critical access hospitals). LINKING EVIDENCE TO ACTION Assessing organizational context to support EBP is the first step in developing and enhancing a sustainable culture of inquiry. The ACT has been tested across countries, settings, and healthcare disciplines to measure perception of readiness of the practice environment toward EBP. Optimal organizational context is essential to support EBP and sustain the use of evidence in professional nursing practice. Nursing leaders can use baseline assessment information to identify strengths and opportunities to enhance EBP implementation. Enhancing organizational context across nurse characteristics (e.g., age, role, and work status) to acknowledge nurses' contributions, balance nurses' personal and work life, enhance connectedness, and support work culture is beneficial. Fostering development of Social Capital in nurses is needed to influence EBP readiness. A systematic and standardized approach to foster EBP across health systems is key to successful implementation.
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Affiliation(s)
- Joyce Pittman
- Ostomy,Continence Program, Indiana University Health, Indianapolis, IN, USA.,Indiana University School of Nursing, Indianapolis, IN, USA
| | - Andrea Cohee
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Susan Storey
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Julie LaMothe
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Jason Gilbert
- Indiana University Health Adult Academic Health Center, Indianapolis, IN, USA
| | - Giorgos Bakoyannis
- Fairbanks School of Public Health and School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Susan Ofner
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robin Newhouse
- Indiana University School of Nursing, Indianapolis, IN, USA.,Indiana University, Indianapolis, IN, USA
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Cardoso D, Santos E, Cardoso ML, Oliveira CR, Rodrigues MA, Apóstolo J. Instruments for measuring undergraduate nursing students' knowledge, attitudes and skills in evidence-based practice: a systematic review protocol. ACTA ACUST UNITED AC 2018; 15:1979-1986. [PMID: 28800044 DOI: 10.11124/jbisrir-2016-003218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION/OBJECTIVE The objective of this systematic review is to identify and assess the properties of instruments for measuring undergraduate nursing students' knowledge, attitudes and skills in evidence-based practice (EBP).More specifically, the review questions are as follows.
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Affiliation(s)
- Daniela Cardoso
- 1Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal 2Nursing School of Coimbra, Coimbra, Portugal 3Portugal Centre for Evidence-Based Practice: a Joanna Briggs Institute Centre of Excellence, Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal 4Faculty of Medicine, University of Coimbra, Coimbra, Portugal 5Emergency Department: Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal 6Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
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Green A, Jeffs DA, Boateng BA, Lowe GR, Walden M. Evaluating Evidence-Based Practice Knowledge and Beliefs Through the e-Learning EBP Academy. J Contin Educ Nurs 2017; 48:304-311. [PMID: 28658498 DOI: 10.3928/00220124-20170616-07] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 02/01/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND This research examined evidence-based practice (EBP) knowledge and beliefs before and after a 3-month e-learning program was implemented to build EBP capacity at a large children's hospital. METHOD Ten clinicians completed the development, implementation, and evaluation of the e-learning education, comprising phase one. Revision and participation by 41 clinicians followed in phase two. Participants in both phases completed the EBP Beliefs and Implementation Scales preintervention, postintervention, and 6 months after postintervention. RESULTS EBP beliefs and implementation increased immediately and 6 months after postintervention, with statistically significant increases in both phases. Participants in both phases applied knowledge by completing mentor-supported EBP projects. CONCLUSION Although EBP beliefs and implementation scores increased and e-learning provided flexibility for clinician participation, challenges arose, resulting in lower-than-expected completion. Subsequent revisions resulted in hybrid education, integrating classroom and e-learning with project mentoring. This funded e-learning research contributes knowledge to the growing specialty of professional development. J Contin Educ Nurs. 2017;48(7):304-311.
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Kim SC, Ecoff L, Brown CE, Gallo AM, Stichler JF, Davidson JE. Benefits of a Regional Evidence-Based Practice Fellowship Program: A Test of the ARCC Model. Worldviews Evid Based Nurs 2017; 14:90-98. [DOI: 10.1111/wvn.12199] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Son Chae Kim
- Professor, St. David's School of Nursing; Texas State University; Round Rock TX USA
| | - Laurie Ecoff
- Director of Research, Education, and Professional Practice; Sharp Memorial Hospital; San Diego CA USA
| | | | - Ana-Maria Gallo
- Director of Nursing Education, Research, and Professional Practice; Sharp Grossmont Hospital; La Mesa CA USA
| | - Jaynelle F. Stichler
- Professor Emerita, San Diego State University and Consultant, Research and Professional Development; Sharp Memorial Hospital and Sharp Mary Birch Hospital for Women & Newborns; San Diego CA USA
| | - Judy E. Davidson
- EBP/Research Nurse Liaison; University of California San Diego Health System; San Diego CA USA
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26
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Friesen MA, Brady JM, Milligan R, Christensen P. Findings From a Pilot Study: Bringing Evidence-Based Practice to the Bedside. Worldviews Evid Based Nurs 2017; 14:22-34. [DOI: 10.1111/wvn.12195] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Mary Ann Friesen
- Nursing Research and Evidence Based Practice Coordinator; Inova Health System; Falls Church Virginia USA
| | - Joni M. Brady
- Director of Perioperative Innovation; North American Partners in Anesthesia; Melville New York USA
| | - Renee Milligan
- Professor, George Mason University School of Nursing; Fairfax Virginia USA
| | - Patricia Christensen
- Formerly Director Nursing Excellence and Innovation; Inova Health System; Falls Church Virginia USA
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27
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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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Melnyk BM, Fineout-Overholt E, Giggleman M, Choy K. A Test of the ARCC© Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes. Worldviews Evid Based Nurs 2016; 14:5-9. [DOI: 10.1111/wvn.12188] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Bernadette Mazurek Melnyk
- Associate Vice President for Health Promotion; University Chief Wellness Officer
- Dean and Professor, College of Nursing; Professor of Pediatrics & Psychiatry
- College of Medicine; The Ohio State University; Columbus Ohio
| | - Ellen Fineout-Overholt
- Mary Coulter Dowdy Distinguished Professor of Nursing; College of Nursing & Health Sciences University of Texas at Tyler; Tyler Texas
| | | | - Katie Choy
- Senior Director, Nursing Practice and Education; Washington Hospital Healthcare System; Fremont California
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Kim SC, Stichler JF, Ecoff L, Brown CE, Gallo AM, Davidson JE. Predictors of Evidence-Based Practice Implementation, Job Satisfaction, and Group Cohesion Among Regional Fellowship Program Participants. Worldviews Evid Based Nurs 2016; 13:340-348. [DOI: 10.1111/wvn.12171] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Son Chae Kim
- Professor, St. David's School of Nursing; Texas State University; Round Rock TX
| | - Jaynelle F. Stichler
- Professor Emerita, San Diego State University; Consultant, Research and Professional Development; Sharp Memorial Hospital and Sharp Mary Birch Hospital for Women & Infants; San Diego CA
| | - Laurie Ecoff
- Director of Research, Education, and Professional Practice; Sharp Memorial Hospital; San Diego CA
| | | | - Ana-Maria Gallo
- Director of Nursing Education; Research and Professional Practice; La Mesa CA
| | - Judy E. Davidson
- EBP/Research Nurse Liaison; University of California San Diego Health System; San Diego CA
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Malik G, McKenna L, Plummer V. Facilitators and barriers to evidence-based practice: perceptions of nurse educators, clinical coaches and nurse specialists from a descriptive study. Contemp Nurse 2016; 52:544-554. [PMID: 27160348 DOI: 10.1080/10376178.2016.1188017] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Implementation of evidence-based practice (EBP) is a major initiative within health care settings to ensure clinical and policy decisions incorporate best available evidence. AIMS This paper reports findings from a descriptive study exploring nurse educators', clinical coaches' and nurse specialists' perceptions of factors associated with using EBP. METHODS Data was collected from a senior group of nurses working in a tertiary health care network in Victoria, Australia by employing a questionnaire that was distributed to a total of 435 people, of whom 135 responded. DATA ANALYSIS Descriptive statistics for each questionnaire item were determined using SPSS (Statistical Package for Social Sciences version 17). Thematic analysis was performed for the qualitative part of the questionnaire. Results Findings revealed that organisational support, sufficient resources, and access to continuing education were perceived as factors promoting acceptance of EBP. Barriers to such acceptance in health care settings were identified as lack of knowledge and skills, poor time allowance, limited support, and insufficient resources. CONCLUSION The reported findings create evidence-based information for organisational strategic planning. Organisations need to develop educational programs to promote EBP and employ strategies to overcome barriers to implementation.
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Affiliation(s)
- Gulzar Malik
- a School of Nursing and Midwifery, Faculty of Medicine, Nursing & Health Sciences , Monash University , 35 Rainforest Walk, Wellington Road, Clayton , VIC 3800 , Australia
| | - Lisa McKenna
- b School of Nursing and Midwifery, Faculty of Medicine, Nursing & Health Sciences , Monash University , 10 Chancellors Walk, Wellington Road, Clayton , VIC 3800 , Australia
| | - Virginia Plummer
- c School of Nursing and Midwifery, Faculty of Medicine, Nursing & Health Sciences , Monash University and Peninsula Health , Building E, McMahons Road, , PO Box 527, Frankston 3199 , Australia
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Melnyk BM, Gallagher-Ford L, Thomas BK, Troseth M, Wyngarden K, Szalacha L. A Study of Chief Nurse Executives Indicates Low Prioritization of Evidence-Based Practice and Shortcomings in Hospital Performance Metrics Across the United States. Worldviews Evid Based Nurs 2016; 13:6-14. [DOI: 10.1111/wvn.12133] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Bernadette Mazurek Melnyk
- Associate Vice President for Health Promotion, University Chief Wellness Officer, Dean and Professor, College of Nursing, Professor of Pediatrics and Psychiatry, College of Medicine; The Ohio State University; Columbus OH USA
| | - Lynn Gallagher-Ford
- Director, Center for Transdisciplinary Evidence-Based Practice, Clinical Associate Professor, The Ohio State University; College of Nursing; Columbus OH USA
| | - Bindu Koshy Thomas
- Technology Coordinator, Center for Transdisciplinary Evidence-Based Practice, The Ohio State University; College of Nursing; Columbus OH USA
| | - Michelle Troseth
- Chief Professional Practice Officer; Elsevier Clinical Solutions; Grand Rapids MI USA
| | - Kathy Wyngarden
- Manager, Elsevier CPM Consortium; Elsevier Clinical Solutions; Grand Rapids MI USA
| | - Laura Szalacha
- Director of Research Methods and Statistics; University of Arizona College of Nursing; Tucson AZ USA
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Harvey G, McInnes E. Disinvesting in Ineffective and Inappropriate Practice: The Neglected Side of Evidence-Based Health Care? Worldviews Evid Based Nurs 2015; 12:309-12. [DOI: 10.1111/wvn.12137] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 10/28/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Gill Harvey
- Professorial Research Fellow, School of Nursing, University of Adelaide, Australia, Professor of Health Management, Alliance Manchester Business School; University of Manchester; UK
| | - Elizabeth McInnes
- Deputy Director, Nursing Research Institute, St Vincent's Health Australia (Sydney) and Australian Catholic University; School of Nursing, Midwifery and Paramedicine; North Sydney Australia
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Gullick JG, West SH. Building research capacity and productivity among advanced practice nurses: an evaluation of the Community of Practice model. J Adv Nurs 2015; 72:605-19. [DOI: 10.1111/jan.12850] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2015] [Indexed: 02/04/2023]
Affiliation(s)
- Janice G. Gullick
- Sydney Nursing School; University of Sydney; New South Wales Australia
| | - Sandra H. West
- Sydney Nursing School; University of Sydney; New South Wales Australia
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The state of readiness for evidence-based practice among nurses: An integrative review. Int J Nurs Stud 2015; 56:128-40. [PMID: 26603729 DOI: 10.1016/j.ijnurstu.2015.10.018] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/23/2015] [Accepted: 10/23/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To review factors related to nurses' individual readiness for evidence-based practice and to determine the current state of nurses' evidence-based practice competencies. DESIGN An integrative review study. DATA SOURCES Thirty-seven (37) primary research studies on nurses' readiness for evidence-based practice, of which 30 were descriptive cross-sectional surveys, 5 were pretest-posttest studies, and one study each was an experimental pilot study and a descriptive qualitative study. Included studies were published from the beginning of 2004 through end of January 2015. REVIEW METHODS The integrative review study used thematic synthesis, in which the quantitative studies were analyzed deductively and the qualitative studies inductively. Outcomes related to nurses' readiness for evidence-based practice were grouped according to the four main themes that emerged from the thematic synthesis: (1) nurses' familiarity with evidence-based practice (EBP); (2) nurses' attitudes toward and beliefs about evidence-based practice; (3) nurses' evidence-based practice knowledge and skills; and (4) nurses' use of research in practice. Methodological quality of the included studies was evaluated with Joanna Briggs Institute critical appraisal tools. RESULTS Although nurses were familiar with, had positive attitudes toward, and believed in the value of EBP in improving care quality and patient outcomes, they perceived their own evidence-based practice knowledge and skills insufficient for employing evidence-based practice, and did not use best evidence in practice. The vast majority (81%) of included studies were descriptive cross-sectional surveys, 84% used a non-probability sampling method, sample sizes were small, and response rates low. Most included studies were of modest quality. CONCLUSIONS More robust, theoretically-based and psychometrically sound nursing research studies are needed to test and evaluate the effectiveness of interventions designed to advance nurses' evidence-based practice competencies, especially teaching them how to integrate evidence-based practice into clinical decision-making. All efforts should be focused on systematically using knowledge transformation strategies shown to be effective in rigorous studies, to translate best evidence into practice-friendly, readily usable forms that are easily accessible to nurses to integrate into their clinical practice.
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Spurlock D, Wonder AH. Validity and Reliability Evidence for a New Measure: The Evidence-Based Practice Knowledge Assessment in Nursing. J Nurs Educ 2015; 54:605-13. [DOI: 10.3928/01484834-20151016-01] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 07/08/2015] [Indexed: 11/20/2022]
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Underhill M, Roper K, Siefert ML, Boucher J, Berry D. Evidence-Based Practice Beliefs and Implementation Before and After an Initiative to Promote Evidence-Based Nursing in an Ambulatory Oncology Setting. Worldviews Evid Based Nurs 2015; 12:70-8. [DOI: 10.1111/wvn.12080] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Meghan Underhill
- Nurse Scientist and Instructor, Phyllis F. Cantor Center for Research in Nursing & Patient Care Services; Dana-Farber Cancer Institute; Boston MA USA
- Instructor, Harvard Medical School; Boston MA USA
| | - Kristin Roper
- Clinical Inquiry Specialist, Phyllis F. Cantor Center for Research in Nursing & Patient Care Services; Dana-Farber Cancer Institute; Boston MA USA
| | - Mary Lou Siefert
- Nurse Specialist, Center for Clinical and Professional Development; Phyllis F. Cantor Center for Research in Nursing & Patient Care Services; Dana-Farber Cancer Institute; Boston MA USA
| | - Jean Boucher
- Clinical Inquiry Specialist, Phyllis F. Cantor Center for Research in Nursing & Patient Care Services; Dana-Farber Cancer Institute; Boston MA USA
- Assistant Professor of Nursing and Medicine, University of Massachusetts Worcester; Graduate School of Nursing; Worchester MA USA
| | - Donna Berry
- Director, Phyllis F. Cantor Center for Research in Nursing & Patient Care Services; Dana-Farber Cancer Institute; Boston MA USA
- Associate Professor; Harvard Medical School; Boston MA USA
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Melnyk BM. Important information about clinical practice guidelines: key tools for improving quality of care and patient outcomes. Worldviews Evid Based Nurs 2015; 12:1-2. [PMID: 25583239 DOI: 10.1111/wvn.12079] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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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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Zeleníková R, Beach M, Ren D, Wolff E, Sherwood P. Faculty perception of the effectiveness of EBP courses for graduate nursing students. Worldviews Evid Based Nurs 2014; 11:401-13. [PMID: 25270089 DOI: 10.1111/wvn.12068] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Effective teaching is key in preparing students to become successful evidence-based healthcare professionals. The effectiveness of graduate evidence-based practice (EBP) pedagogy is not often a subject of research studies. PURPOSE The purpose of this study was to determine how faculty from the 50 top graduate nursing schools in the United States perceived the effectiveness of EBP courses for graduate nursing students. METHODS A descriptive cross-sectional design was used to explore faculty perception of the effectiveness of EBP courses. A web-based survey was used for data collection. A total of 45 questionnaires were subjected to statistical analysis. RESULTS The mean perception of the effectiveness of EBP courses for the whole sample, on a scale from 1 to 7, was 5.58 (min. 4.29; max. 6.73), a higher score signifying higher perceived effectiveness. The highest rated item concerned a school's access to different databases. The strongest correlations were found between the total score and the scores for items describing students' opportunities to strengthen and apply their EBP skills (rs = .66). The internal consistency of the Perception of Effectiveness of EBP Courses scale, based on standardized Cronbach's alpha, was .84, which signifies strong internal consistency. Faculty perceived themselves as most competent at the following EBP skills: (a) "Asking questions regarding patients' care" (6.56), (b) "Considering patient preferences when implementing EBP" (6.40), and (c) "Critically appraising the relevant body of evidence to address clinical questions" (6.40). DISCUSSION To strengthen the effectiveness of EBP courses, students should have more opportunities to implement their EBP knowledge and skills after completing EBP courses. LINKING EVIDENCE TO ACTION Evaluation of faculty perceptions of the effectiveness of EBP courses can help to guide the development of nursing school curricula that better integrate EBP. Further evaluation of the psychometric properties of the instrument used to measure perception of the effectiveness of EBP courses is required along with objective measures of faculty knowledge and skills in teaching EBP.
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Affiliation(s)
- Renáta Zeleníková
- Assistant Professor, Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Czech Republic
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Gallagher-Ford L. Implementing and Sustaining EBP in Real World Healthcare Settings: Transformational Evidence-Based Leadership: Redesigning Traditional Roles to Promote and Sustain a Culture of EBP. Worldviews Evid Based Nurs 2014; 11:140-2. [DOI: 10.1111/wvn.12033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Melnyk BM. Building Cultures and Environments That Facilitate Clinician Behavior Change to Evidence-based Practice: What Works? Worldviews Evid Based Nurs 2014; 11:79-80. [DOI: 10.1111/wvn.12032] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Green A, Jeffs D, Huett A, Jones LR, Schmid B, Scott AR, Walker L. Increasing Capacity for Evidence-Based Practice Through the Evidence-Based Practice Academy. J Contin Educ Nurs 2014; 45:83-90. [DOI: 10.3928/00220124-20140124-20] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Gallagher-Ford L. Implementing and Sustaining EBP in Real World Healthcare Settings: A Leader's Role in Creating a Strong Context for EBP. Worldviews Evid Based Nurs 2014; 11:72-4. [DOI: 10.1111/wvn.12022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2013] [Indexed: 11/29/2022]
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Melnyk BM, Gallagher-Ford L, Long LE, Fineout-Overholt E. The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews Evid Based Nurs 2014; 11:5-15. [PMID: 24447399 DOI: 10.1111/wvn.12021] [Citation(s) in RCA: 338] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although it is widely known that evidence-based practice (EBP) improves healthcare quality, reliability, and patient outcomes as well as reduces variations in care and costs, it is still not the standard of care delivered by practicing clinicians across the globe. Adoption of specific EBP competencies for nurses and advanced practice nurses (APNs) who practice in real-world healthcare settings can assist institutions in achieving high-value, low-cost evidence-based health care. AIM The aim of this study was to develop a set of clear EBP competencies for both practicing registered nurses and APNs in clinical settings that can be used by healthcare institutions in their quest to achieve high performing systems that consistently implement and sustain EBP. METHODS Seven national EBP leaders developed an initial set of competencies for practicing registered nurses and APNs through a consensus building process. Next, a Delphi survey was conducted with 80 EBP mentors across the United States to determine consensus and clarity around the competencies. FINDINGS Two rounds of the Delphi survey resulted in total consensus by the EBP mentors, resulting in a final set of 13 competencies for practicing registered nurses and 11 additional competencies for APNs. LINKING EVIDENCE TO ACTION Incorporation of these competencies into healthcare system expectations, orientations, job descriptions, performance appraisals, and clinical ladder promotion processes could drive higher quality, reliability, and consistency of healthcare as well as reduce costs. Research is now needed to develop valid and reliable tools for assessing these competencies as well as linking them to clinician and patient outcomes.
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Affiliation(s)
- Bernadette Mazurek Melnyk
- Associate Vice President for Health Promotion, University Chief Wellness Officer, Dean and Professor, College of Nursing, Professor of Pediatrics and Psychiatry, College of Medicine, The Ohio State University, Columbus, OH
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Melnyk BM. Educational Programming in Undergraduate and Graduate Academic Curricula: Friend or Foe to Accelerating Evidence-Based Practice? Worldviews Evid Based Nurs 2013; 10:185-6. [DOI: 10.1111/wvn.12020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Malloch K, Melnyk BM. Developing high-level change and innovation agents: competencies and challenges for executive leadership. Nurs Adm Q 2013; 37:60-66. [PMID: 23222755 DOI: 10.1097/naq.0b013e318275174a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The work of health care reform and revolution requires leadership competencies that integrate the digital realities of time, space, and media. Leadership skills and behaviors of command, control, and directing from predigital times are no longer effective, given the impacts of the digital changes. Developing leadership competence in evidence-driven processes, facilitation, collaborative teamwork, and instilling a sense of urgency is the work of today's executive leaders. Ten competencies necessary for contemporary executive leadership are presented in this article.
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Melnyk BM. Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of evidence-based practice. Nurs Adm Q 2012; 36:127-135. [PMID: 22407205 DOI: 10.1097/naq.0b013e318249fb6a] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
High-reliability health care organizations are those that provide care that is safe and one that minimizes errors while achieving exceptional performance in quality and safety. This article presents major concepts and characteristics of a patient safety culture and a high-reliability health care organization and explains how building a culture of evidence-based practice can assist organizations in achieving high reliability. The ARCC (Advancing Research and Clinical practice through close Collaboration) model for systemwide implementation and sustainability of evidence-based practice is highlighted as a key strategy in achieving high reliability in health care organizations.
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