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Bourgault AM, Davis JW, LaManna J, Conner NE, Turnage D. Trends in publication impact of evidence-based healthcare terminology (2013-2022). J Adv Nurs 2024; 80:3600-3615. [PMID: 38504441 DOI: 10.1111/jan.16128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/07/2024] [Accepted: 02/15/2024] [Indexed: 03/21/2024]
Abstract
AIMS This article explored the publication impact of evidence-based healthcare terminology to determine usage and discuss options for low usage terms. BACKGROUND A plethora of terms describe the scholarship of evidence-based healthcare. Several terms are synonyms, creating redundancy and confusion. The abundance and overlap of terms may impede the discovery of evidence. DESIGN This discursive article explored and discussed publication impact of evidence-based healthcare terms. METHODS Evidence-based healthcare terms were identified, and their 10-year (2013-2022) publication impact was assessed in the CINAHL and Medline databases. A card sort method was also used to identify terms with low usage. RESULTS A total of 18/32 terms were included in the review. The terms evidence-based practice, quality improvement, research and translational research were the most highly published terms. Publication data were presented yearly over a 10-year period. Most terms increased in publication use over time, except for three terms whose use decreased. Several terms related to translational research have multiple synonyms. It remains unknown whether these terms are interchangeable and possibly redundant, or if there are nuanced differences between terms. CONCLUSION We suggest a follow-up review in 3-5 years to identify publication trends to assess context and terms with continued low publication usage. Terms with persistent low usage should be considered for retirement in the reporting of scholarly activities. Additionally, terms with increasing publication trends should be treated as emerging terms that contribute to evidence-based healthcare terminology. IMPLICATIONS FOR NURSING Confusion about the use of appropriate terminology may hinder progress in the scholarship of evidence-based healthcare. We encourage scholars to be aware of publication impact as it relates to the use of specific terminology and be purposeful in the selection of terms used in scholarly projects and publications.
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Affiliation(s)
| | - Jean W Davis
- College of Nursing, University of Central Florida, Orlando, Florida, USA
| | - Jacqueline LaManna
- College of Nursing, University of Central Florida, Orlando, Florida, USA
| | - Norma E Conner
- College of Nursing, University of Central Florida, Orlando, Florida, USA
| | - Dawn Turnage
- College of Nursing, University of Central Florida, Orlando, Florida, USA
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Elsheikh R, Le Quang L, Nguyen NQT, Van PT, Hung DT, Makram AM, Huy NT. The role of nursing leadership in promoting evidence-based nursing practice. J Prof Nurs 2023; 48:93-98. [PMID: 37775247 DOI: 10.1016/j.profnurs.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 10/01/2023]
Abstract
Although the undermining of the nursing profession, time constraints, and the lack of inclusive teaching of evidence-based nursing (EBN) in the nursing school's curriculum have long been identified as being some of the main barriers to the adoption of evidence-based practice (EBP) by nurses, the specific role of nurse leaders in directly influencing and supporting evidence-based nursing is not well demonstrated. This opinion piece discusses potential factors that influence the implementation of EBP into clinical routine practice, as well as how nursing leadership styles can contribute to its promotion in contemporary healthcare settings.
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Affiliation(s)
- Randa Elsheikh
- Deanery of Biomedical Sciences at Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom; Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan.
| | - Loc Le Quang
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Ngoc Quynh Tram Nguyen
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Phu Tran Van
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Tra Vinh University, Tra Vinh City, Viet Nam
| | - Dang The Hung
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Abdelrahman M Makram
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Public Health, Imperial College London, London, United Kingdom.
| | - Nguyen Tien Huy
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.
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Kernan LM, Dryden EM, Nearing K, Kennedy MA, Hung W, Moo L, Pimentel CB. Integrating CFIR-ERIC and e-Delphi Methods to Increase Telegeriatrics Uptake. THE GERONTOLOGIST 2023; 63:545-557. [PMID: 35902211 DOI: 10.1093/geront/gnac107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Participatory implementation methods are needed in geriatric health care to improve care and services for a growing population of older adults. We describe an efficient participatory approach to improve uptake of Geriatric Research Education and Clinical Center (GRECC) Connect, a national geriatrics outpatient consultation service using telehealth technology to connect geriatric specialists to rural, older veterans though community-based clinics. RESEARCH DESIGN AND METHODS We designed a three-phase participatory method to identify high-priority implementation strategies to support the uptake of GRECC Connect. We used the Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change (CFIR-ERIC) Strategy Matching Tool to derive expert-recommended implementation strategies informed by qualitative interviews with both GRECC Connect staff and clinicians at community-based clinics. We engaged expert panelists in a participatory two-step modified e-Delphi process using confidential surveys and discussion to prioritize strategies nationally. RESULTS Qualitative interviews revealed barriers, facilitators, and recommendations for program uptake. Many strategies recommended by CFIR-ERIC addressed multiple barriers but needed to be tailored to our specific context. In our two-step e-Delphi process, expert panelists shared previous experience with the strategies presented, views on the importance and feasibility of each, and arrived at a consensus about which strategies to prioritize nationally. DISCUSSION AND IMPLICATIONS We demonstrate the feasibility and benefits of engaging subject matter experts to identify strategies to be tested on a national level. Future considerations include weighting of survey responses, accounting for regional differences, and sensitivity of Likert scales used in the e-Delphi process.
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Affiliation(s)
- Laura M Kernan
- Center for Healthcare Organization and Implementation Research, Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts, USA
- Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Eileen M Dryden
- Center for Healthcare Organization and Implementation Research, Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts, USA
| | - Kathryn Nearing
- Eastern Colorado Geriatric Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus , Aurora, Colorado, USA
| | - Meaghan A Kennedy
- New England Geriatric Research Education and Clinical Center, VA Bedford Healthcare System, Bedford, Massachusetts, USA
- Department of Family Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Will Hung
- Bronx Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine, Mount Sinai, New York, New York, USA
| | - Lauren Moo
- New England Geriatric Research Education and Clinical Center, VA Bedford Healthcare System, Bedford, Massachusetts, USA
- Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Camilla B Pimentel
- Center for Healthcare Organization and Implementation Research, Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts, USA
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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Rumsey M, Stowers P, Sam H, Neill A, Rodrigues N, Brooks F, Daly J. Development of PARcific Approach: Participatory Action Research Methodology for Collectivist Health Research. QUALITATIVE HEALTH RESEARCH 2022; 32:1297-1314. [PMID: 35638562 DOI: 10.1177/10497323221092350] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This article explores the evolution of a novel approach designed to advance qualitative methods in cross-cultural health research. This methodology was developed by synthesising several research methods and involved in-depth stakeholder consultation with participants of a Pacific-based nursing and midwifery health leadership program. Many of these participants played a crucial role in creating, exploring and evaluating several research methods and implementing and evaluating this co-designed research methodology. Starting with a Participatory Action Research framework, the research methodology evolved as it was informed by the local Pacific methodologies (in particular Talanoa and Kakala frameworks), where researchers, co-researchers and participants alike, working from within their own collectivist/individualist paradigms, negotiated cultural differences. Finally, a methodological framework of 'best practice' for future health research methods was developed for use with capacity building research. The new methodology could provide a foundation for future co-designed cross-cultural research in collectivist cultures.
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Affiliation(s)
- Michele Rumsey
- WHO Collaborating Centre Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Pelenatete Stowers
- WHO Collaborating Centre Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- National University of Samoa, Toomatagi, Apia, Samoa
| | - Harriet Sam
- Directive of Hospital and Curative Services, Ministry of Health, Port Vila, Vanuatu
| | - Amanda Neill
- WHO Collaborating Centre Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Nathalia Rodrigues
- WHO Collaborating Centre Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Fiona Brooks
- University of Technology Sydney, Sydney, NSW, Australia
| | - John Daly
- WHO Collaborating Centre Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Ward L, Walter R. Participatory Action Research (PAR) - to better understand the experiences of nurse academics working in a team. Contemp Nurse 2021; 57:269-279. [PMID: 34709982 DOI: 10.1080/10376178.2021.1999835] [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: 10/20/2022]
Abstract
BACKGROUND There is considerable literature outlining the high levels of occupational stress nurse academics experience, and the potential effect of workplace pressure on mental health and wellbeing. OBJECTIVES/AIMS/HYPOTHESES To support the notion that to succeed in an academic environment, academics are more successful when working in a team, two academics conducted a Participation Action Research study. DESIGN The PAR study was developed in line with a Clinical Skill Project to better understand the experiences of nurse academics working in a team. The Clinical Skills Project involved the write up of 40 nursing skills for publication. Twenty-seven academics were recruited into the project and allocated skills to write, in teams of 2-3, according to clinical expertise and interest. The Participatory Action Research (PAR) approach formed the framework for the project, as well as, provided an opportunity for the nurse academics to 'come together' at fortnightly team meetings to discuss the project and talk about their experience working in a team. METHODS Using the PAR cyclical process of observing, reflecting, planning, and acting there was ongoing opportunity for the academic nurses to discuss, question and share knowledge about academic practices. These Interactive reflections were recorded in a team reflective diary during the meetings. Participants were also asked to reflect on their individual experience of working in the team, before, during and after the project. At the completion of the project all reflective comments were transcribed to form a combined narrative. RESULTS Thematic and content analysis was then undertaken to identify any similarities and or differences in academic staff experience. CONCLUSIONS The analysis revealed the following key themes. Working in a team creates better staff relationships, Working in a team can change workplace culture and Working in a team can Improve staff health and well-being.
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Affiliation(s)
- Louise Ward
- School of Nursing and Midwifery, College of Science Health and Engineering, La Trobe University, George Singer Building Room 3/327, Melbourne, Victoria 3086, Australia
| | - Ruby Walter
- School of Nursing and Midwifery, College of Science Health and Engineering, La Trobe University, George Singer Building Room 3/327, Melbourne, Victoria 3086, Australia
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Hu J, Gifford W, Ruan H, Harrison D, Li Q, Ehrhart MG, Harrison M, Barrowman N, Aarons GA. Validating the Implementation Leadership Scale in Chinese nursing context: A cross-sectional study. Nurs Open 2021; 8:3420-3429. [PMID: 33960677 PMCID: PMC8510775 DOI: 10.1002/nop2.888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/14/2021] [Accepted: 03/29/2021] [Indexed: 11/11/2022] Open
Abstract
AIM This study aimed to evaluate the validity, reliability and acceptability of the Implementation Leadership Scale in the Chinese nursing context. DESIGN This study utilized a cross-sectional design. METHODS This study was conducted in one general tertiary hospital with 234 nurses (85.3% response rate) from 35 clinical units in China. Content validity, structural validity, convergent validity, reliability (internal consistency), agreement indices and acceptability were evaluated. The data collection was from December 1st, 2017 to June 30th, 2018. RESULTS Confirmatory factor analysis demonstrated a good model fit to the four-factor implementation leadership model. The psychometric testing also indicated good convergent validity, high internal consistency and acceptable aggregation. Most participants completed the scale in two minutes or less and agreed or strongly agreed that the questions were relevant to implementation leadership, clear and easy to answer. CONCLUSIONS This study demonstrated that the Chinese Implementation Leadership Scale is a valid, reliable and pragmatic tool for measuring strategic leadership for implementing evidence-based practices.
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Affiliation(s)
- Jiale Hu
- Department of Nurse AnesthesiaVirginia Commonwealth UniversityRichmondVAUSA
- School of NursingUniversity of OttawaOttawaONCanada
| | - Wendy Gifford
- School of NursingUniversity of OttawaOttawaONCanada
- Center for Research on Health and NursingUniversity of OttawaOttawaONCanada
| | - Hong Ruan
- Integrated Administration DepartmentShanghai Ninth People’s HospitalShanghaiChina
- Shanghai Nursing AssociationShanghaiChina
| | - Denise Harrison
- School of NursingUniversity of OttawaOttawaONCanada
- Department of NursingFaculty of MedicineDentistry and Health SciencesThe University of MelbourneMelbourneVIC.Australia
| | - Qingge Li
- Nursing DepartmentWomen’s Hospital affiliated to School of Medicine Zhejiang UniversityHangzhou CityZhejiang ProvinceChina
| | - Mark G. Ehrhart
- Department of PsychologyUniversity of Central FloridaOrlandoFLUSA
| | - Mary‐Ann Harrison
- Research Institute, Children's Hospital of Eastern OntarioOttawaONCanada
| | - Nick Barrowman
- Research Institute, Children's Hospital of Eastern OntarioOttawaONCanada
| | - Gregory A. Aarons
- Department of PsychiatryUniversity of CaliforniaLa JollaCAUSA
- Child and Adolescent Services Research CenterUniversity of CaliforniaSan DiegoCAUSA
- UC San Diego Dissemination and Implementation Science CenterLa JollaCAUSA
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Manietta C, Quasdorf T, Rommerskirch-Manietta M, Braunwarth JI, Purwins D, Roes M. Protocol for conducting scoping reviews to map implementation strategies in different care settings: focusing on evidence-based interventions for preselected phenomena in people with dementia. BMJ Open 2021; 11:e051611. [PMID: 34493523 PMCID: PMC8424849 DOI: 10.1136/bmjopen-2021-051611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Various evidence-based interventions are available to improve the care of people with dementia in different care settings, many of which are not or are only partially implemented in routine care. Different implementation strategies have been developed to support the implementation of interventions in routine care; however, the implementation of complex interventions remains challenging. The aim of our reviews is to identify promising strategies for, significant facilitators of and barriers to the implementation of evidence-based interventions for very common dementia care phenomena: (A) behaviour that challenges supporting a person with dementia in long-term care, (B) delirium in acute care and (C) the postacute care needs of people with dementia. METHODS AND ANALYSIS We will conduct one scoping review for each preselected dementia care phenomenon (A, B and C). For this, three literature searches will be carried out in the following electronic databases: MEDLINE (via PubMed), CINAHL (via EBSCO) and PsycINFO (via EBSCO). Additionally, we will perform backward and forward citation tracking via reference lists and Google Scholar. Identified records will be independently screened by two reviewers (title/abstract and full text) using the defined inclusion criteria. We will include all study designs and publications in the German or English language. For the data analyses, we will conduct a deductive content analysis using two different analytical approaches: Expert Recommendations for Implementation Change and the Consolidated Framework for Implementation Research. ETHICS AND DISSEMINATION Due to the nature of a review, ethical clearing is not required. We will disseminate our results in peer-reviewed journals, workshops with stakeholders, and (inter)national conferences.
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Affiliation(s)
- Christina Manietta
- German Centre for Neurodegenerative Diseases Witten, Witten, Nordrhein-Westfalen, Germany
- Department of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Tina Quasdorf
- German Centre for Neurodegenerative Diseases Witten, Witten, Nordrhein-Westfalen, Germany
- Department of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Mike Rommerskirch-Manietta
- German Centre for Neurodegenerative Diseases Witten, Witten, Nordrhein-Westfalen, Germany
- Department of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Jana Isabelle Braunwarth
- German Centre for Neurodegenerative Diseases Witten, Witten, Nordrhein-Westfalen, Germany
- Department of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Daniel Purwins
- German Centre for Neurodegenerative Diseases Witten, Witten, Nordrhein-Westfalen, Germany
- Department of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Martina Roes
- German Centre for Neurodegenerative Diseases Witten, Witten, Nordrhein-Westfalen, Germany
- Department of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
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Use of a Symptom Diary on Oncology Wards: Effect on Symptom Management and Recommendations for Implementation. Cancer Nurs 2021; 44:E209-E220. [PMID: 31990694 DOI: 10.1097/ncc.0000000000000792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Management of symptoms is essential in reducing the symptom burden of cancer patients. The effect of symptom diaries on symptom management to date has been evaluated only in ambulatory settings. OBJECTIVE The aims of this study were to identify the key facilitators for successful implementation of symptom diaries on oncology wards from patients' and professionals' perspectives and to evaluate implementation outcomes. METHODS In 2 cycles of action research, the Utrecht Symptom Diary (USD) was implemented on 3 oncology wards and a daycare unit. Key facilitators for implementation were identified by thematic coding of interviews. The effect of the implementation was evaluated in cycle II in a pretest-posttest design. We performed statistical tests (Mann-Whitney/t test/χ2) on Symptom Management Performance items in questionnaires and medical records. RESULTS We interviewed 25 patients, 8 doctors, and 25 nurses. Seven key facilitators for implementation emerged. After implementation of the USD in cycle II, Symptom Management Performance was significantly (P < .05) improved for patients (3/12 items, n = 33 pretest/26 posttest) and professionals (6/12 items, n = 21 pretest/19 posttest). Significantly more symptoms (P = .00), working hypotheses (P = .023), treatment plans (P = .00), and interventions (P = .00) were reported (n = 47 pretest/47 posttest). CONCLUSIONS Implementation of the USD significantly improved symptom management in oncology wards. We recommend (1) using a diagnosis-specific diary; (2) making clear, individualized working-arrangements; (3) training professionals; (4) using the plan-do-check-act cycle; (5) acting multidisciplinary; (6) providing guidelines and training; and (7) assuring adequate information communications technology (ICT). IMPLICATIONS Symptom diaries are increasingly used, but implementation is challenging. This study provides knowledge on their benefits and an evidence-based strategy for implementation with positive outcomes achieved in patient care.
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Roberts K, Casey M, Coghlan D, Cornall C, Hudson C, Stokes D, Carroll A. A scoping review protocol to map the evidence on the use of action research methodology by healthcare professionals and in healthcare team settings. HRB Open Res 2021; 4:68. [PMID: 38800821 PMCID: PMC11116937 DOI: 10.12688/hrbopenres.13275.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 05/29/2024] Open
Abstract
Background: Action research (AR) starts with an existing practical situation with which there is a concern or potential for improvement. It seeks transformative change through the simultaneous process of doing research and undertaking actions, both of which are linked together by a critical reflective process. It simultaneously allows one to systematically investigate a given social situation while promoting democratic change and collaborative participation. AR approaches have been used for many years in business management and education. More recently, AR has become an increasingly popular method of inquiry in healthcare, particularly in nursing, to investigate professional practice while simultaneously; introducing innovations; planning and undertaking action; and evaluating new ideas. The overall goal is to augment collaboration whilst improving the patient experience and outcomes. Methods: The Arksey and O'Malley methodology framework will be used to guide this scoping review process: stage 1 will identify the research questions; the eligibility criteria and search strategy will be defined in stage 2; studies will then be selected in stage 3; data will be extracted and charted from these included studies in stage 4; stage 5 involves aggregating and summarising these results along with criteria relevant for health professionals and policy-makers. An optional consultation (stage 6) exercise may potentially be included. Conclusion: This scoping review will comprehensively map the evidence on the use of AR methodology by healthcare professionals and in healthcare team settings. It is predicted that the findings will inform researchers in carrying out future AR and highlight gaps in the literature. An article reporting the results of the completed scoping review will be submitted for publication to a scientific journal and presented at relevant national and international conferences.
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Affiliation(s)
- Kinley Roberts
- National Rehabilitation Hospital, Dun Laoghaire, Dublin, A96 E2H2, Ireland
- School of Medicine and Medical Science, University College Dublin, Dublin, D04 C7X2, Ireland
| | - Mary Casey
- School of Nursing Midwifery & Health Systems, University College Dublin, Dublin, D04 C7X2, Ireland
| | - David Coghlan
- Trinity Business School, Trinity College Dublin, Dublin, D02 F6N2, Ireland
| | - Catherine Cornall
- National Rehabilitation Hospital, Dun Laoghaire, Dublin, A96 E2H2, Ireland
| | - Clare Hudson
- National Rehabilitation Hospital, Dun Laoghaire, Dublin, A96 E2H2, Ireland
| | - Diarmuid Stokes
- UCD Library, University College Dublin, Dublin, D04 C7X2, Ireland
| | - Aine Carroll
- National Rehabilitation Hospital, Dun Laoghaire, Dublin, A96 E2H2, Ireland
- School of Medicine and Medical Science, University College Dublin, Dublin, D04 C7X2, Ireland
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Owolabi OO, Jordan PJ, Williams M, Ten Ham-Baloyi W. Strategies for the implementation of best practice guidelines in operating theatres: An integrative literature review. Health SA 2021; 26:1488. [PMID: 34230856 PMCID: PMC8252143 DOI: 10.4102/hsag.v26i0.1488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/04/2021] [Indexed: 11/05/2022] Open
Abstract
Best practice guidelines (BPGs) exist for operating theatre (OT), but strategies to implement them are lacking. To address the gap, an integrative review was undertaken to identify strategies which can be used to implement BPGs in OT. This article aimed to summarise the best existing literature in order to identify and describe strategies for the implementation of BPGs in OT. An extensive search was undertaken to include relevant literature from February 2005 to March 2020 using the following databases: CINAHL, Medline, Biomed Central, Academic Search Complete and Health Source: Nursing/Academic Edition (EBSCOhost) and the Cochrane library. This integrative literature review followed the methodology proposed by Whittemore and Knafl, namely: (1) identification of the research problem, (2) search of the literature, (3) evaluation of the data, (4) analysis of the data and (5) presentation of the results. On completion of the critical appraisal, 15 (n = 15) articles met the inclusion criteria and relevant data were synthesised. The review identified six strategies facilitating implementation of BPGs in OT, namely, communication, education materials and mass media, academic detailing, opinion leaders, audit and feedback, and teamwork and collaboration. The review validated strategies for the implementation of BPGs in OT. Implementation of BPGs is essential to both provide and improve patient care and to benefit health outcomes. This review is expected to contribute to the provision of strategies to implement BPGs in OT.
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Affiliation(s)
- Olukemi O Owolabi
- Department of Nursing, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
| | - Portia J Jordan
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Margaret Williams
- Department of Nursing, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Wilma Ten Ham-Baloyi
- Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
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Cerulus M, Bossuyt I, Vanderhaeghen B. An integrative literature review of the implementation of advance care planning in hospital settings. J Clin Nurs 2021; 30:3099-3110. [PMID: 34010482 DOI: 10.1111/jocn.15835] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/09/2021] [Accepted: 04/14/2021] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To identify and synthesise existing literature about action research in the implementation of advance care planning in a hospital setting. BACKGROUND Despite the proven added value of advance care planning, there is a lack of wide integration of this concept. There are several obstacles known for the implementation but it remains unclear how these can be overcome. Action research is described in the literature as a plausible way to overcome obstacles to the implementation of quality enhancing projects. DESIGN An integrative literature review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and reported in accordance with the PRISMA statement. METHODS We searched databases MEDLINE, EMBASE, CINAHL and Web of Science to identify executed action research for the implementation of advance care planning programs within a hospital setting, from January 2005 until November 2019. Studies were assessed for comprehensiveness and were supplemented by studies in reference lists of included articles. A quality appraisal and a thematic synthesis were performed on all included studies. RESULTS Five studies met inclusion criteria. Interventions focused on both nurses, physicians and hospitalised patients. Interventions targeted three different themes: identifying at-risk patients, adapting documentation to the local context and using communication improvement tools. CONCLUSIONS A Supportive and Palliative Care Indicators Tool is proposed to identify patients in need of advance care planning to work more efficiently. Furthermore, adapting documentation and instruments to a specific care context are shown to make advance care planning more effective. Communication challenges can be addressed by promoting communication skills and increase stakeholder self-confidence.
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Bjurling-Sjöberg P, Pöder U, Jansson I, Wadensten B, Nordgren L. Action research improved general prerequisites for evidence-based practice. Heliyon 2021; 7:e06814. [PMID: 33981884 PMCID: PMC8085704 DOI: 10.1016/j.heliyon.2021.e06814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/03/2021] [Accepted: 04/12/2021] [Indexed: 11/23/2022] Open
Abstract
The present study was part of an action research project that was performed to implement a clinical pathway for patients on mechanical ventilation and simultaneously explore the implementation process in a Swedish intensive care unit. The aim of this questionnaire study was to evaluate whether an action research methodology could affect the general prerequisites for evidence-based practice (EBP). Informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework, the study included registered nurses, assistant nurses and anesthesiologists in the unit at start of the project (n = 50) and at follow-up (n = 44). Data was collected with the Evaluation Before Implementation Questionnaire and the Attitudes towards Guidelines Scale. The results revealed that the general prerequisites for EBP in the setting improved. Compared to baseline measurements, the staff at follow-up conversed significantly more about the importance of the patients’ experiences, research utilization, context and facilitation, while changes with respect to clinical experiences were not significant. The attitudes towards guidelines were perceived as positive at baseline as well as at follow-up and did not significantly change. Longer professional experience was associated with a slightly lower probability of perceiving that the importance of research utilization was discussed and reflected upon, while belonging to a profession with longer education was associated with a higher probability of this perception. Compared to registered nurses and assistant nurses, the anesthesiologists perceived, to a greater extent, that the importance of clinical experience was discussed and reflected upon in the setting, while there was no significant association with the length of professional experience and/or specific professions regarding the other components. In conclusion, using action research to implement a clinical pathway methodology seems to set in motion various mechanisms that improve some but not all prerequisites that, according to the PARIHS framework, are advantageous for EBP.
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Affiliation(s)
- Petronella Bjurling-Sjöberg
- Department of Public Health and Caring Sciences, Caring Science, Uppsala University, Sweden.,Centre for Clinical Research Sörmland/Uppsala University, Sweden.,Department of Patient Safety, Region Sörmland, Sweden
| | - Ulrika Pöder
- Department of Public Health and Caring Sciences, Caring Science, Uppsala University, Sweden
| | - Inger Jansson
- Institute of Health and Caring Sciences, University of Gothenburg, Sweden
| | - Barbro Wadensten
- Department of Public Health and Caring Sciences, Caring Science, Uppsala University, Sweden
| | - Lena Nordgren
- Department of Public Health and Caring Sciences, Caring Science, Uppsala University, Sweden.,Centre for Clinical Research Sörmland/Uppsala University, Sweden
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Martínez-Gimeno ML, Fernández-Martínez N, Escobar-Aguilar G, Moreno-Casbas MT, Brito-Brito PR, Caperos JM. SUMAMOS EXCELENCIA ® Project: Results of the Implementation of Best Practice in a Spanish National Health System (NHS). Healthcare (Basel) 2021; 9:374. [PMID: 33800670 PMCID: PMC8066682 DOI: 10.3390/healthcare9040374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 11/16/2022] Open
Abstract
The use of certain strategies for the implementation of a specific recommendation yields better results in clinical practice. The aim of this study was to assess the effectiveness of an evidence-based model using clinical audits (GRIP model), for the implementation of recommendations in pain and urinary incontinence management as well as fall prevention, in the Spanish National Health System during the period 2015-2018. A quasi-experimental study has been conducted. The subjects were patients treated in hospitals, primary care units and nursing home centers. There were measures related to pain, fall prevention and urinary incontinence. Measurements were taken at baseline and at months 3, 6, 9, and 12. The sample consisted of 22,114 patients. The frequency of pain assessment increased from 59.9% in the first cycle to a mean of 71.6% in the last cycle, assessments of risk of falling increased from 56.8% to 87.8% in the last cycle; and finally, the frequency of assessments of urinary incontinence increased from a 43.4% in the first cycles to a mean of 62.2% in the last cycles. The implementation of specific evidence-based recommendations on pain, fall prevention, and urinary incontinence using a model based on clinical audits improved the frequency of assessments and their documentation.
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Affiliation(s)
- María-Lara Martínez-Gimeno
- San Juan de Dios Foundation, San Rafael-Nebrija Health Sciences Center, Nebrija University, 28036 Madrid, Spain;
- SALBIS Research Group, Faculty of Health Sciences, University of Leon, 24401 Ponferrada, Spain
| | - Nélida Fernández-Martínez
- Department of Biomedical Sciences, Faculty of Veterinary Medicine, University of León, 24071 Leon, Spain;
| | - Gema Escobar-Aguilar
- San Juan de Dios Foundation, San Rafael-Nebrija Health Sciences Center, Nebrija University, 28036 Madrid, Spain;
| | - María-Teresa Moreno-Casbas
- Nursing and Healthcare Research Unit (Investen-isciii), Carlos III Health Institute, 28029 Madrid, Spain;
| | - Pedro-Ruyman Brito-Brito
- Training and Research in Care, Primary Care Management of Tenerife, The Canary Islands Health Service, 38204 Santa Cruz de Tenerife, Spain;
- Department of Nursing, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain
| | - Jose-Manuel Caperos
- UNINPSI, Department of Psychology, Universidad Pontificia Comillas, 28015 Madrid, Spain;
- Fundación San Juan de Dios, 28036 Madrid, Spain
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Moreno-Poyato AR, Rodríguez-Nogueira Ó, Casanova-Garrigos G, El Abidi K, Roldán-Merino JF. The impact of a participatory intervention on the therapeutic relationship in mental health nurses: A multicentre study. J Adv Nurs 2021; 77:3104-3115. [PMID: 33748977 DOI: 10.1111/jan.14835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/25/2021] [Accepted: 03/05/2021] [Indexed: 12/01/2022]
Abstract
AIMS To evaluate the effects of an intervention aimed at improving the therapeutic relationship, using the participatory-action research method, in terms of improving the quality of the nurse-patient therapeutic relationship. DESIGN A single-group pre-post research design. METHODS Quantitative data were collected between January 2018 and June 2019 using an online form completed by nurses from 18 mental health units (N = 95). Data were collected before and after the intervention, which consisted of the design, implementation and evaluation of strategies to improve the therapeutic relationship through participatory-action research involving nurses. The Working Alliance Inventory-Short, Interpersonal Reactivity Index, Evidence-Based Practice Questionnaire and Practice Environment Scale of the Nursing Work Index were used. The Wilcoxon rank-sum test was used together with the Spearman's correlation coefficient. Two multiple linear regressions models were constructed. RESULTS Overall, the intervention improved the nurse-patient therapeutic relationship. In addition, the results revealed that, above all, the improvement in evidence-based practice along with a decrease in nurses' personal distress were the factors associated with the improvement of the nurse-patient therapeutic relationship. CONCLUSION In mental health units, the therapeutic nurse-patient relationship can be improved through participatory interventions that include the implementation of evidence-based practices. IMPACT This research examined the effects of an intervention aimed at improving the therapeutic relationship among nurses working at mental health units using participatory action research. The results show that the therapeutic relationship can be improved through participatory methods where evidence-based practice is implemented and enhanced among nurses, since a better therapeutic relationship along with reduced staff discomfort are determining factors that influence the quality of the therapeutic relationship. Institutional managers should promote participatory group interventions to enable nurses to develop evidence-based aspects of the therapeutic relationship together with expanding personal aspects and self-knowledge.
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Affiliation(s)
- Antonio R Moreno-Poyato
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L´Hospitalet de Llobregat, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Óscar Rodríguez-Nogueira
- SALBIS Research Group, Department of Nursing and Physiotherapy, Universidad de León, Ponferrada, Spain
| | | | - Khadija El Abidi
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Juan F Roldán-Merino
- Campus Docent Sant Joan de Déu Fundació Privada, School of Nursing, University of Barcelona, Esplugues de llobregat, Spain
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Kindblom K, Edvardsson D, Boström AM, Vikström S. A learning process towards person-centred care: A second-year follow-up of guideline implementation. Int J Older People Nurs 2021; 16:e12373. [PMID: 33739623 DOI: 10.1111/opn.12373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 11/24/2020] [Accepted: 02/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Research claims that 'learning by doing' creates new thinking, often leading to new practice. OBJECTIVES The aim was to explore and describe the staff learning process from the first to the second year when adopting person-centred care into clinical practice in a nursing home for persons with dementia. METHOD The data consisted of poster texts from staff and written notes by researchers obtained from the group discussions. The study involved 24 care units (200 staff). Content analysis was chosen as method to explore the learning process. RESULT The staff described the actions that they took during year 1 and year 2, in which five categories emerged, activities, environment, information, priorities and staff routines. With researchers' analysis the categories together created the learning process and formed a sub-theme. They further formed an overarching theme from simplicity to complexity and consensus. Staff changes year 1 pertained more to planning and doing, while year 2 changes constituted a larger complexity of person-centred care with reflection, collaborative learning and a mind-set change. CONCLUSION Staff chose the development area, and the learning process was illuminated by the researchers. This underscores the value to visualise and verbalise the steps of change as well as include these steps in the design of an implementation process. The concept of person-centred care could be viewed on different levels. The findings may contribute to a more comprehensive understanding of staff learning process when implementation of person-centred care. IMPLICATIONS FOR PRACTICE Making staff's learning process visible can be a guide for improvement and change from a generic care towards person-centred care. The Regional Board of Research Ethics approved the study (Reg no. 2010/1234-31/5).
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Affiliation(s)
- Kristina Kindblom
- Division of Physiotherapy, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - David Edvardsson
- Division of Nursing, The Medical Faculty, Umeå University, Umeå, Sweden
| | - Anne-Marie Boström
- Division of Nursing, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Sofia Vikström
- Division of Occupational Therapy, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Allchin B, Goodyear M, O'Hanlon B, Weimand BM. Leadership perspectives on key elements influencing implementing a family-focused intervention in mental health services. J Psychiatr Ment Health Nurs 2020; 27:616-627. [PMID: 32037644 DOI: 10.1111/jpm.12615] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/22/2020] [Accepted: 02/07/2020] [Indexed: 01/09/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Family-focused interventions in Adult Mental Health Services (AMHS) address the needs of families where a parent is diagnosed with a mental illness. One of these interventions is the "Let's Talk about Children" programme (Let's Talk) (Solantaus & Toikka, 2006 International Journal of Mental Health Promotion, 8(3), 37). There is limited implementation knowledge on family-focused interventions. A body of research to better understand the transfer of evidence-based interventions into everyday practice has identified multiple influencing elements. The Consolidated Framework for Implementation Research (CFIR) has combined these known elements from research into five domains of influence. Elements that influence the implementation of evidence-based practice are inter-related and need to be understood in combination. Understanding different stakeholder perspectives on implementation in real-world settings helps to understand uptake, challenges and opportunities. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: As the first study to document leadership's perspectives of implementing Let's Talk, this paper contributes to the evidence base on their role in implementing family-focused practice models in mental health. There are specific roles of leadership that need to be addressed to support implementing Let's Talk in changing environments. Leadership's knowledge of Let's Talk and approach to change influences implementation. Questions are raised about the role the readiness of the parent and the impact that the dynamic process between the practitioner and parent has on implementing Let's Talk. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Engaging leadership needs to address the influence of their different organizational roles in shaping implementation for Let's Talk. Further research is needed to understand the dynamic process between parent and practitioner that influences readiness for trialling Let's Talk. ABSTRACT: Introduction Different stakeholder's perspectives are needed to understand challenges and opportunities in implementing and sustaining evidence-based practices (EBP) in real-world settings. Aim/Question To identify leadership perspectives on key elements influencing the process of implementation of Let's Talk about Children (Let's Talk), a family-focused practice for practitioners working with parents diagnosed with a mental illness. Method Semi-structured interviews were conducted with 16 service managers and implementation leads, to establish their views on key elements influencing implementation of Let's Talk during a randomized controlled trial. A thematic analysis applied both inductive and deductive approaches, using the Consolidated Framework for Implementation Research (CFIR). Results Impacts to effective translation to practice were grouped into three broad themes with eight subthemes: inner and outer setting impacting organization, leadership affecting readiness and parent and practitioner readiness. Discussion The findings suggest that specific roles for leadership are vital to implementation within an environment of constant change, and more attention is needed to understand the dynamics of parent and practitioner readiness for delivering Let's Talk. Implications for practice Different leadership roles need to be engaged to sustain Let's Talk in changing real-world environments. The dynamic processes between parent and practitioner are suggested to influence readiness and need further research.
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Affiliation(s)
- Becca Allchin
- Faculty of Medicine, Nursing and Health Sciences, School of Rural Health, Monash University, Clayton, Vic., Australia.,Eastern Health Mental Health Program, Melbourne, Vic., Australia
| | - Melinda Goodyear
- Faculty of Medicine, Nursing and Health Sciences, School of Rural Health, Monash University, Clayton, Vic., Australia.,Emerging Minds, Hilton, SA, Australia
| | - Brendan O'Hanlon
- The Bouverie Centre, La Trobe University, Melbourne, Vic., Australia
| | - Bente M Weimand
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Division Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,School of Nursing and Midwifery, Queens University Belfast, Belfast, Northern Ireland
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17
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Ramos-Morcillo AJ, Harillo-Acevedo D, Armero-Barranco D, Leal-Costa C, Moral-García JE, Ruzafa-Martínez M. Barriers Perceived by Managers and Clinical Professionals Related to the Implementation of Clinical Practice Guidelines for Breastfeeding through the Best Practice Spotlight Organization Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6248. [PMID: 32867353 PMCID: PMC7504213 DOI: 10.3390/ijerph17176248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/15/2022]
Abstract
International institutions facilitate the contact of health professionals to evidence-based recommendations for promoting exclusive breast feeding (BF). However, the achievement of good rates of exclusive BF is still far from the optimum. The intention of the present work is to determine the barriers identified by managers and health professionals involved in the implementation and sustainability of Clinical Practice Guidelines (CPG) for breastfeeding under the auspices of the Best Practice Spotlight Organization program. A qualitative research study was carried out. The participants were managers, healthcare assistants, nurses, midwives, pediatricians and gynecologists. Semi-structured interviews were conducted which were transcribed and analyzed using the six steps of thematic analysis. Twenty interviews were conducted, which defined four major themes: (1) Lack of resources and their adaptation; (2) Where, Who and How; (3) Dissemination and reach of the project to the professionals; and (4) The mother and her surroundings. This research identifies the barriers perceived by the health professionals involved in the implementation, with the addition of the managers as well. Novel barriers appeared such as the ambivalent role of the midwives and the fact that this CPG is about promoting health. The efforts for promoting the implementation program should be continuous, and the services should be extended to primary care.
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Affiliation(s)
| | | | - David Armero-Barranco
- Faculty of Nursing, University of Murcia, 30100 Murcia, Spain; (A.J.R.-M.); (M.R.-M.)
| | - César Leal-Costa
- Faculty of Nursing, University of Murcia, 30100 Murcia, Spain; (A.J.R.-M.); (M.R.-M.)
| | - José Enrique Moral-García
- Physical Activity and Sports Sciences, Faculty of Education, Pontifical University of Salamanca, 37007 Salamanca, Spain;
| | - María Ruzafa-Martínez
- Faculty of Nursing, University of Murcia, 30100 Murcia, Spain; (A.J.R.-M.); (M.R.-M.)
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18
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Abayneh S, Lempp H, Hanlon C. Participatory action research to pilot a model of mental health service user involvement in an Ethiopian rural primary healthcare setting: study protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:2. [PMID: 31934350 PMCID: PMC6951014 DOI: 10.1186/s40900-019-0175-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/19/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Involvement of service-users at all levels of the mental health system is a policy imperative in many countries internationally. However, putting policy into practice seems complex; little is known about how best to involve service users and efforts are often criticized for being tokenistic. In low-and-middle income countries, less attention has been given to the roles of service users within mental health systems. The proposed study is part of a larger project intended to develop service-user involvement in mental health system strengthening in Ethiopia. A Theory of Change (ToC) model has already been developed through a participatory approach. This study protocol aims to describe the theoretical background and methods to pilot this model using participatory action research (PAR) and explore participants' experience of involvement. METHODS The proposed study will apply a PAR approach situated in critical social theory and conduct a phenomenological case study to find out participants' experience of involvement. This will be conducted in three stages. The focus of Stage 1 will be to(i) establish a Research Advisory Group (RAG), and Research Participant Group (RPG) at district and primary healthcare facility levels, respectively, and (ii) identify and prioritize potential areas of concern for involvement in the domains of advocacy, service planning and development, monitoring and improving service quality. In Stage 2, we will work with the RPG to develop a plan of action for the selected area. Stage 3 will aim to assist the RPG to implement and evaluate the plan of action. Process indicators and observation will be combined with in-depth interviews with participants to elicit their experiences of involvement. Thematic content analysis will be used. DISCUSSION The participatory approach to mental health service user involvement in health system strengthening employed by this study will support the implementation of solutions through locally relevant and contextualized actions. Findings from this study will contribute to the body of knowledge towards understanding the complexity of implementation of service user involvement and refine the ToC model for transferability to similar settings.
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Affiliation(s)
- Sisay Abayneh
- College of Health Sciences, School of Medicine, Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, Addis Ababa University, Addis Ababa, Ethiopia
| | - Heidi Lempp
- King’s College London, Centre for Rheumatic Diseases, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, Weston Education Centre, 10, Cutcombe Rd, London, SE5 9RJ UK
| | - Charlotte Hanlon
- College of Health Sciences, School of Medicine, Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, Addis Ababa University, Addis Ababa, Ethiopia
- King’s College London, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF UK
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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19
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Li S, Cao M, Zhu X. Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine (Baltimore) 2019; 98:e17209. [PMID: 31574830 PMCID: PMC6775415 DOI: 10.1097/md.0000000000017209] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This study is to summarize the status of knowledge, attitudes, implementation, facilitators, and barriers of evidence-based practice (EBP) in community nurses (CNs). EBP has been widely adopted but the knowledge, attitudes, and implementation of EBP among CNs, and the facilitators and barriers they perceived have not been clearly confirmed. METHODS A literature search was conducted using combined keywords in 3 English databases and 3 Chinese databases of peer-reviewed publications covering the dates of publication from 1996 to July, 2018. Twenty articles were included. The information of the knowledge, attitudes, implementation, and the perceived facilitators and barriers of EBP in CNs was extracted and summarized. RESULTS CNs had positive attitudes toward EBP, but insufficient knowledge and unprepared implementation. The most cited facilitators were academic training, management functions, and younger age. Inadequate time and resources were recognized as main barriers hindering the transforming from knowledge and attitudes to implementation. Developed interventions mainly focused on knowledge facilitation rather than the elimination of objective barriers. CONCLUSIONS Findings demonstrate a compelling need for improvement in knowledge and implementation of EBP in CNs, compared with the better attitudes. Except education, knowledge translating into implementation needs more coordination with authorities to magnify the facilitators and overcome the barriers. Further studies need to concentrate on deficient knowledge and implementation of EBP among CNs. Policy makers can use the facilitators and barriers found by this review to modify nursing education, current scientific resources supplement, practice supports for care improving.
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20
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Poon AWC, Harvey C, Fuzzard S, O'Hanlon B. Implementing a family-inclusive practice model in youth mental health services in Australia. Early Interv Psychiatry 2019; 13:461-468. [PMID: 29052957 DOI: 10.1111/eip.12505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 06/25/2017] [Accepted: 08/20/2017] [Indexed: 11/28/2022]
Abstract
AIM A brief family-inclusive practice model, single session family consultation (SSFC), was introduced at 4 youth mental health service sites to determine the extent to which the model could be implemented in this context and its acceptability as a means of engaging families of young people. METHODS Within an action research paradigm, both quantitative and qualitative measures were used for this implementation project with the former reported here. There were 2 components: (1) evaluation of the experiences of young people and their families and (2) evaluation of the extent of implementation of SSFC. Quantitative data were analysed descriptively (item scores, range and any changes over time). RESULTS Twenty practitioners who were trained and supported in the use of SSFC participated in the 6-month implementation evaluation. In 6 months, 131 SSFC sessions were conducted across the 4 sites and the young people and their families were very satisfied with sessions (overall mean = 5.2, range = 0-6). Six months post-training, there were statistically significant improvements in the practitioners' confidence in providing family interventions (mean improvement = -0.47 (95% confidence interval (CI) = -0.91, -0.04), P = .035) and familiarity with approaches to working with families (mean improvement = -0.61 (95% CI = -1.13, -0.10, P = .023). Practitioners perceived significant improvement in organizational support for working with families. CONCLUSIONS SSFC was acceptable to clients and their families, was adopted by practitioners and was successfully implemented in the participating sites. This suggests that SSFC, when appropriately implemented, is useful to engage families in the treatment of young people facing mental health issues.
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Affiliation(s)
- Abner Weng Cheong Poon
- School of Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Carol Harvey
- Psychosocial Research Centre, Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia.,NorthWestern Mental Health, Coburg, Victoria, Australia
| | - Suzanne Fuzzard
- headspace Murray Bridge, Murray Bridge, South Australia, Australia
| | - Brendan O'Hanlon
- The Bouverie Centre, La Trobe University, Melbourne, Victoria, Australia
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21
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Hamzeh J, Pluye P, Bush PL, Ruchon C, Vedel I, Hudon C. Towards an assessment for organizational participatory research health partnerships: A systematic mixed studies review with framework synthesis. EVALUATION AND PROGRAM PLANNING 2019; 73:116-128. [PMID: 30583063 DOI: 10.1016/j.evalprogplan.2018.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 11/27/2018] [Accepted: 12/06/2018] [Indexed: 05/19/2023]
Abstract
Within the health sciences, organizational participatory research (OPR) is defined as a blend of research and action, in which academic researchers partner with health organization members. OPR is based on a sound partnership between all stakeholders to improve organizational practices. However, little research on the evaluation of OPR health partnership exists. This systematic mixed studies review sought to produce a new theoretical model that structures the evaluation of the OPR processes and related outcomes of OPR health partnerships. Six bibliographic databases were searched together with grey literature sources for OPR health partnership evaluation questionnaires. Six questionnaires were included, from which a pool of 95 OPR health partnership evaluation items were derived. The included questionnaires were appraised for the quality of their origin, development and measurement properties. A framework synthesis was performed using an existing OPR framework by organizing questionnaire items in a matrix using a hybrid thematic analysis. This led to our proposed Organizational Participatory Research Evaluation Model (OPREM) that includes three axes, Trust, Collective Learning and Sustainability (with specific dimensions) and 95 items. This model provides information to help stakeholders comprehensively structure the evaluation of their partnerships and subsequent improvement; thus, potentially helping to improve health organization practices.
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Affiliation(s)
- J Hamzeh
- Method Development, Quebec SPOR Support Unit, 5858 Côte-des-Neiges, 3rd Floor, Suite 300, Montréal, QC, H3S 1Z1, Canada.
| | - P Pluye
- Method Development, Quebec SPOR Support Unit, 5858 Côte-des-Neiges, 3rd Floor, Suite 300, Montréal, QC, H3S 1Z1, Canada; Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, 3rd Floor, Suite 300, Montréal, QC, H3S 1Z1, Canada.
| | - P L Bush
- Method Development, Quebec SPOR Support Unit, 5858 Côte-des-Neiges, 3rd Floor, Suite 300, Montréal, QC, H3S 1Z1, Canada.
| | - C Ruchon
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, 3rd Floor, Suite 300, Montréal, QC, H3S 1Z1, Canada.
| | - I Vedel
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, 3rd Floor, Suite 300, Montréal, QC, H3S 1Z1, Canada.
| | - C Hudon
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, 3001, 12e avenue Nord Sherbrooke, QC, J1H 5N4, Canada.
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22
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Moreno‐Poyato AR, Delgado‐Hito P, Leyva‐Moral JM, Casanova‐Garrigós G, Montesó‐Curto P. Implementing evidence‐based practices on the therapeutic relationship in inpatient psychiatric care: A participatory action research. J Clin Nurs 2019; 28:1614-1622. [DOI: 10.1111/jocn.14759] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/31/2018] [Accepted: 12/05/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Antonio R. Moreno‐Poyato
- Escola Superior d’Infermeria del Mar Barcelona Spain
- IMIM (Hospital del Mar Medical Research Institute) Barcelona Spain
| | - Pilar Delgado‐Hito
- School of Nursing, L'Hospitalet del Llobregat University of Barcelona Barcelona Spain
| | - Juan M. Leyva‐Moral
- Department of Nursing, Faculty of Medicine Universitat Autònoma de Barcelona Cerdanyola del Vallès, Barcelona Spain
| | - Georgina Casanova‐Garrigós
- Fundació Pere Mata Terres de l'Ebre Amposta, Tarragona Spain
- School of Nursing Universitat Rovira i Virgili Tarragona Catalunya Spain
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Bush PL, Pluye P, Loignon C, Granikov V, Wright MT, Repchinsky C, Haggerty J, Bartlett G, Parry S, Pelletier JF, Macaulay AC. A systematic mixed studies review on Organizational Participatory Research: towards operational guidance. BMC Health Serv Res 2018; 18:992. [PMID: 30577859 PMCID: PMC6421946 DOI: 10.1186/s12913-018-3775-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 11/28/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Organizational Participatory Research (OPR) seeks organizational learning and/or practice improvement. Previous systematic literature reviews described some OPR processes and outcomes, but the link between these processes and outcomes is unknown. We sought to identify and sequence the key processes of OPR taking place with and within healthcare organizations and the main outcomes to which they contribute, and to define ideal-types of OPR. METHODS This article reports a participatory systematic mixed studies review with qualitative synthesis A specialized health librarian searched MEDLINE, CINAHL, Embase Classic + Embase, PsycINFO, the Cochrane Library, Social Work Abstracts and Business Source Complete, together with grey literature data bases were searched from inception to November 29, 2012. This search was updated using forward citation tracking up to June 2014. Reporting quality was appraised and unclear articles were excluded. Included studies clearly reported OPR where the main research related decisions were co-constructed among the academic and healthcare organization partners. Included studies were distilled into summaries of their OPR processes and outcomes, which were subsequently analysed using deductive and inductive thematic analysis. All summaries were analysed; that is, data analysis continued beyond saturation. RESULTS Eighty-three studies were included from the 8873 records retrieved. Eight key OPR processes were identified. Four follow the phases of research: 1) form a work group and hold meetings, 2) collectively determine research objectives, 3) collectively analyse data, and 4) collectively interpret results and decide how to use them. Four are present throughout OPR: 1) communication, 2) relationships; 3) commitment; 4) collective reflection. These processes contribute to extra benefits at the individual and organizational levels. Four ideal-types of OPR were defined. Basic OPR consists of OPR processes leading to achieving the study objectives. This ideal-type and may be combined with any of the following three ideal-types: OPR resulting in random additional benefits for the individuals or organization involved, OPR spreading to other sectors of the organization and beyond, or OPR leading to subsequent initiatives. These results are illustrated with a novel conceptual model. CONCLUSION The model provides operational guidance to help OPR stakeholders collaboratively address organizational issues and achieve desired outcomes and more. REVIEW REGISTRATION As per PROSPERO inclusion criteria, this review is not registered.
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Affiliation(s)
- Paula Louise Bush
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, Quebec, H3S 1Z1 Canada
| | - Pierre Pluye
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, Quebec, H3S 1Z1 Canada
| | - Christine Loignon
- Department of Family Medicine, Sherbrooke University, 150 Place Charles Lemoyne suite 200, Longueuil, Quebec, J4K 0A8 Canada
| | - Vera Granikov
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, Quebec, H3S 1Z1 Canada
| | - Michael T. Wright
- Institute for Social Health, Catholic University of Applied Sciences Berlin, Köpenicker Allee 39-57, 10318 Berlin, Germany
| | - Carol Repchinsky
- Special projects, Canadian Pharmacists Association, 1785 Alta Vista Drive, Ottawa, ON K1G 3Y6 Canada
| | - Jeannie Haggerty
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, Quebec, H3S 1Z1 Canada
| | - Gillian Bartlett
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, Quebec, H3S 1Z1 Canada
| | - Sharon Parry
- West Island YMCA, 230 Brunswick Blvd, Pointe-Claire, Quebec, H9R 5N5 Canada
| | | | - Ann C. Macaulay
- CIET/Participatory Research at McGill (PRAM), 5858 Cote de Neiges, 3rd floor, Montreal, Montreal, QC H3S 1Z1 Canada
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Pluye P, Loignon C, Lagarde F, Doray G, El Sherif R, Granikov V, Gonzalez Reyes A, Bujold M, Grad R, Bartlett G, Barwick M, Schuster T, Turcotte E, Bouthillier F. Assessing and Improving the Use of Online Information About Child Development, Education, Health, and Well-Being in Low-Education, Low-Income Parents: Protocol for a Mixed-Methods Multiphase Study. JMIR Res Protoc 2018; 7:e186. [PMID: 30459143 PMCID: PMC6280034 DOI: 10.2196/resprot.9996] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/24/2018] [Accepted: 08/14/2018] [Indexed: 11/16/2022] Open
Abstract
Background This study is born from a partnership between Web editors of Naître et grandir (N&G) and AboutKidsHealth (AKH) and researchers who developed and validated the Information Assessment Method (IAM). N&G and AKH are popular Canadian websites with high-quality comprehensive information about child development, education, health, and well-being. IAM allows parents to assess online information and provide feedback to Web editors. High-quality online consumer health information improves knowledge, self-efficacy, and health. However, low-socioeconomic status (SES) parents underuse N&G and IAM, despite these parents being more likely to report decreased worries and increased confidence as outcomes from N&G information. Objective The study is aimed to improve low-SES parents’ use of online child information and interaction with Web editors and explore subsequent health outcomes for parents and children. Methods Multiphase mixed-methods design. Our general approach is centered on organizational participatory research. In phase 1, we will conduct a qualitative interpretive study to identify barriers and facilitators to using N&G information and to interacting with N&G editors via IAM; interview more than 10 low-SES parents about their experience with N&G and IAM and more than 10 nonusers of N&G and IAM; and use thematic analysis to identify main barriers and facilitators. In phase 2, we will integrate parents’ views (phase 1 findings) in N&G and IAM and implement a new version: IAM+N&G+. In phase 3, we will conduct a quantitative prospective longitudinal study (pre-/postimplementation monitoring of knowledge use and outcomes). We will compare the use of original (IAM and N&G) and new (IAM+ and N&G+) versions using Google Analytics variables, IAM variables, a material and social deprivation index, and demographics. We anticipate increased use post implementation (linear mixed modeling). In phase 4, we will conduct a qualitative descriptive study on outcomes of information use. We will interview more than 30 low-SES parents who receive and rate the N&G+ newsletter using IAM+ and analyze data in the form of life histories to describe how parents and children experience perceived outcomes. Results The project was funded in 2017 by the Canadian Institutes of Health Research and received an ethics approval by the McGill University’s institutional review board. Data collection for phase 1 was completed in 2018. Phases 2 to 4 will be conducted until 2020. Findings from this study will also be used to develop a free toolkit, useful to all Web editors, with recommendations for improving health information for low-SES persons and interactions with them using IAM. Conclusions The results of this study will provide a deep understanding of how low-SES parents use online child information and interact with Web editors. Following the implementation of IAM+N&G+, results will also elucidate subsequent health outcomes for low-SES parents and children after interaction with Web editors has been optimized. International Registered Report Identifier (IRRID) PRR1-10.2196/9996
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Affiliation(s)
- Pierre Pluye
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Christine Loignon
- Département de médecine de famille, Université de Sherbrooke, Longueuil, QC, Canada
| | | | - Geneviève Doray
- Naître et grandir, Fondation Lucie et André Chagnon, Montréal, QC, Canada
| | - Reem El Sherif
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Vera Granikov
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | | | - Mathieu Bujold
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Roland Grad
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Gillian Bartlett
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Melanie Barwick
- The Hospital for Sick Children, Research Institute, Toronto, ON, Canada
| | - Tibor Schuster
- Department of Family Medicine, McGill University, Montréal, QC, Canada
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Ghanbari A, Rahmatpour P, Jafaraghaee F, Kazemnejad E, Khalili M. Quality assessment of diabetic foot ulcer clinical practice guidelines. J Evid Based Med 2018; 11:200-207. [PMID: 29882311 DOI: 10.1111/jebm.12304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 05/17/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Nurses play an effective role in diabetic foot care and they should know the best evidence. In this way, implementations according evidence-based clinical practice guidelines have positive effects on nurses' practice and patient outcomes. The objective of this study was quality assessment of diabetic foot ulcer clinical practice guidelines. METHODS Evidence about nursing care in diabetic foot ulcer in last 5 years was searched and categorized based on nursing diagnosis (ND) and evidence levels and was finally designed as a guideline. Quality appraisal of guideline was evaluated with AGREEII tool by an expert panel. AGREEII consists of 23 items, grouped in six domains: scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence. Applicability of the guideline in clinical was assessed with a checklist by the nursing group. Data analysis was carried out with SPSS v.18 (descriptive statistics and binomial test). RESULTS Of the 114 studies, evidence of 19 studies was selected. The guidelines had three parts: introduction, nursing recommendation, and appendix. Evidence was categorized according to 8 NDs. According to AGREEII, the guideline had the highest score in the "scope and purpose" (92.7%) and the lowest in "applicability" (76.2%) domains. Also, nurses reported the positive effect of implementation of guideline recommendations and lack of needed equipment for its implementation. CONCLUSIONS Guidelines received acceptable scores in all the domains of AGREEII. Based on nurses' opinion, recommendations of guidelines will play an effective role in prevention, treatment, reduction of complication among diabetic foot patients. Therefore, adaptation, implementation, and evaluation of the guidelines were recommended.
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Affiliation(s)
- Atefeh Ghanbari
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Pardis Rahmatpour
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Fateme Jafaraghaee
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Kazemnejad
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Malahat Khalili
- School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
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Cusack C, Cohen B, Mignone J, Chartier MJ, Lutfiyya Z. Participatory action as a research method with public health nurses. J Adv Nurs 2018; 74:1544-1553. [DOI: 10.1111/jan.13555] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Cheryl Cusack
- Faculty of Health Sciences; College of Nursing; University of Manitoba; Winnipeg MB Canada
| | - Benita Cohen
- Faculty of Health Sciences; College of Nursing; University of Manitoba; Winnipeg MB Canada
| | - Javier Mignone
- Department of Community Health Sciences; College of Medicine; Faculty of Health Sciences; University of Manitoba; Winnipeg MB Canada
| | - Mariette J. Chartier
- Manitoba Centre for Health Policy; Winnipeg MB Canada
- Department of Community Health Sciences; College of Medicine; Faculty of Health Sciences; University of Manitoba Bannatyne Campus; Winnipeg MB Canada
| | - Zana Lutfiyya
- Educational Administration, Foundations & Psychology; University of Manitoba; Winnipeg MB Canada
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Moreno-Poyato AR, Delgado-Hito P, Suárez-Pérez R, Lluch-Canut T, Roldán-Merino JF, Montesó-Curto P. Improving the therapeutic relationship in inpatient psychiatric care: Assessment of the therapeutic alliance and empathy after implementing evidence-based practices resulting from participatory action research. Perspect Psychiatr Care 2018; 54:300-308. [PMID: 28901552 DOI: 10.1111/ppc.12238] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 07/07/2017] [Accepted: 08/06/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To examine how evidence about the therapeutic alliance gleaned from participatory action project affected the level of this alliance and the degree of empathy of psychiatric nurses. DESIGN AND METHODS Quasi-experimental study in two psychiatric units. In one group, evidence-based practices that affected the therapeutic alliance were implemented; in the comparison group, there was no such intervention. FINDINGS The nurses from the intervention group improved their degree of empathy and factors such as agreement on objectives and tasks with the patient. PRACTICE IMPLICATIONS The results confirm the possibility of measuring and improving the therapeutic relationship in psychiatric care.
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Affiliation(s)
- Antonio R Moreno-Poyato
- Escola Superior d'Infermeria del Mar, Parc de Salut Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Pilar Delgado-Hito
- School of Nursing, University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Raquel Suárez-Pérez
- Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain
| | - Teresa Lluch-Canut
- School of Nursing, University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Juan F Roldán-Merino
- Campus Docent Fundació Privada Sant Joan de Déu. School of Nursing, University of Barcelona, Esplugues de Llobregat, Barcelona, Spain
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Bujold M, Pluye P, Légaré F, Haggerty J, Gore GC, Sherif RE, Poitras MÈ, Beaulieu MC, Beaulieu MD, Bush PL, Couturier Y, Débarges B, Gagnon J, Giguère A, Grad R, Granikov V, Goulet S, Hudon C, Kremer B, Kröger E, Kudrina I, Lebouché B, Loignon C, Lussier MT, Martello C, Nguyen Q, Pratt R, Rihoux B, Rosenberg E, Samson I, Senn N, Li Tang D, Tsujimoto M, Vedel I, Ventelou B, Wensing M. Decisional needs assessment of patients with complex care needs in primary care: a participatory systematic mixed studies review protocol. BMJ Open 2017; 7:e016400. [PMID: 29133314 PMCID: PMC5695438 DOI: 10.1136/bmjopen-2017-016400] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 07/28/2017] [Accepted: 08/23/2017] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options in a cascade of interrelated decisions involving different stakeholders (themselves, their families, their caregivers, their healthcare practitioners). Gaps in knowledge, values clarification and social support in situations where options need to be deliberated hamper effective decision support interventions. This review aims to (1) assess decisional needs of PCCNs from the perspective of stakeholders, (2) build a taxonomy of these decisional needs and (3) prioritise decisional needs with knowledge users (clinicians, patients and managers). METHODS AND ANALYSIS This review will be based on the interprofessional shared decision making (IP-SDM) model and the Ottawa Decision Support Framework. Applying a participatory research approach, we will identify potentially relevant studies through a comprehensive literature search; select relevant ones using eligibility criteria inspired from our previous scoping review on PCCNs; appraise quality using the Mixed Methods Appraisal Tool; conduct a three-step synthesis (sequential exploratory mixed methods design) to build taxonomy of key decisional needs; and integrate these results with those of a parallel PCCNs' qualitative decisional need assessment (semistructured interviews and focus group with stakeholders). ETHICS AND DISSEMINATION This systematic review, together with the qualitative study (approved by the Centre Intégré Universitaire de Santé et Service Sociaux du Saguenay-Lac-Saint-Jean ethical committee), will produce a working taxonomy of key decisional needs (ontological contribution), to inform the subsequent user-centred design of a support tool for addressing PCCNs' decisional needs (practical contribution). We will adapt the IP-SDM model, normally dealing with a single decision, for PCCNs who experience cascade of decisions involving different stakeholders (theoretical contribution). Knowledge users will facilitate dissemination of the results in the Canadian primary care network. PROSPERO REGISTRATION NUMBER CRD42015020558.
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Affiliation(s)
- Mathieu Bujold
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Pierre Pluye
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - France Légaré
- Department of Family Medicine and Emergency Medicine, Université Laval, Montréal, Québec, Canada
| | - Jeannie Haggerty
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | | | - Reem El Sherif
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Marie-Ève Poitras
- Department of Family Medicine and Emergency Medicine, Université Laval, Montréal, Québec, Canada
| | | | | | - Paula L Bush
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Yves Couturier
- École de travail social, Université de Sherbrooke, Canada
| | | | - Justin Gagnon
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Anik Giguère
- Department of Family Medicine and Emergency Medicine, Université Laval, Montréal, Québec, Canada
| | - Roland Grad
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Vera Granikov
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Serge Goulet
- Department of Family Medicine, Université de Sherbrooke, Canada
| | - Catherine Hudon
- Department of Family Medicine, Université de Sherbrooke, Canada
| | | | | | - Irina Kudrina
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Bertrand Lebouché
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | | | | | - Cristiano Martello
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Quynh Nguyen
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Rebekah Pratt
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, United States
| | - Benoit Rihoux
- Centre de Science Politique et de Politique Comparée, Université catholique de Louvain, Belgium
| | - Ellen Rosenberg
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Isabelle Samson
- Department of Family Medicine and Emergency Medicine, Université Laval, Montréal, Québec, Canada
| | | | - David Li Tang
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | | | - Isabelle Vedel
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
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Bush PL, Pluye P, Loignon C, Granikov V, Wright MT, Pelletier JF, Bartlett-Esquilant G, Macaulay AC, Haggerty J, Parry S, Repchinsky C. Organizational participatory research: a systematic mixed studies review exposing its extra benefits and the key factors associated with them. Implement Sci 2017; 12:119. [PMID: 29017557 PMCID: PMC5634842 DOI: 10.1186/s13012-017-0648-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 09/25/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND In health, organizational participatory research (OPR) refers to health organization members participating in research decisions, with university researchers, throughout a study. This non-academic partner contribution to the research may take the form of consultation or co-construction. A drawback of OPR is that it requires more time from all those involved, compared to non-participatory research approaches; thus, understanding the added value of OPR, if any, is important. Thus, we sought to assess whether the OPR approach leads to benefits beyond what could be achieved through traditional research. METHODS We identified, selected, and appraised OPR health literature, and at each stage, two team members independently reviewed and coded the literature. We used quantitative content analysis to transform textual data into reliable numerical codes and conducted a logistic regression to test the hypothesis that a co-construction type OPR study yields extra benefits with a greater likelihood than consultation-type OPR studies. RESULTS From 8873 abstracts and 992 full text papers, we distilled a sample of 107 OPR studies. We found no difference between the type of organization members' participation and the likelihood of exhibiting an extra benefit. However, the likelihood of an OPR study exhibiting at least one extra benefit is quadrupled when the impetus for the study comes from the organization, rather than the university researcher(s), or the organization and the university researcher(s) together (OR = 4.11, CI = 1.12-14.01). We also defined five types of extra benefits. CONCLUSIONS This review describes the types of extra benefits OPR can yield and suggests these benefits may occur if the organization initiates the OPR. Further, this review exposes a need for OPR authors to more clearly describe the type of non-academic partner participation in key research decisions throughout the study. Detailed descriptions will benefit others conducting OPR and allow for a re-examination of the relationship between participation and extra benefits in future reviews.
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Affiliation(s)
- Paula L. Bush
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, Quebec H3S 1Z1 Canada
| | - Pierre Pluye
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, Quebec H3S 1Z1 Canada
| | - Christine Loignon
- Department of Family Medicine, Sherbrooke University, 150 Place Charles Lemoyne suite 200, Longueuil, Quebec J4K 0A8 Canada
| | - Vera Granikov
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, Quebec H3S 1Z1 Canada
| | - Michael T. Wright
- Catholic University of Applied Sciences Berlin | Institute for Social Health, Köpenicker Allee, 39-57 10318 Berlin, Germany
| | | | - Gillian Bartlett-Esquilant
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, Quebec H3S 1Z1 Canada
| | - Ann C. Macaulay
- CIET/Participatory Research at McGill (PRAM), 5858 Cote de Neiges, 3rd floor, Montreal, QC H3S 1Z1 Canada
| | - Jeannie Haggerty
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, Quebec H3S 1Z1 Canada
| | - Sharon Parry
- West Island YMCA, |230 Brunswick Blvd, Pointe-Claire, Quebec H9R 5N5 Canada
| | - Carol Repchinsky
- Special Projects, Canadian Pharmacists Association, 1785 Alta Vista Drive, Ottawa, ON K1G 3Y6 Canada
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Charniot C, Berchouchi F, Marchand C, Gagnayre R, Sebbane G, Pamoukdjian F. [Training and action research in a short-stay geriatric oncology unit]. SOINS. GÉRONTOLOGIE 2017; 22:26-30. [PMID: 28687130 DOI: 10.1016/j.sger.2017.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A participative action research project was undertaken in a geriatric oncology hospital unit. It resulted in the training of paramedical staff regarding the specific care to be provided to elderly people with cancer.
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Affiliation(s)
- Christine Charniot
- Instituts de formation en soins infirmiers et aides-soignants (Ifsi/Ifas), Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, 21 avenue de la République, 94205 Ivry sur Seine, France
| | - Florence Berchouchi
- Institut de formation en soins infirmiers (Ifsi) Séraphine de Senlis, Centre Hospitalier Les Murets, 17 rue du Général Leclerc, 94510 La Queue-en-Brie, France
| | - Claire Marchand
- Laboratoire Éducations et Pratiques de Santé-LEPS (EA3412), Université Paris 13 Sorbonne Paris-Cité, 74 rue Marcel Cachin, 93017 Bobigny cedex, France
| | - Rémi Gagnayre
- Laboratoire Éducations et Pratiques de Santé-LEPS (EA3412), Université Paris 13 Sorbonne Paris-Cité, 74 rue Marcel Cachin, 93017 Bobigny cedex, France
| | - Georges Sebbane
- Laboratoire Éducations et Pratiques de Santé-LEPS (EA3412), Université Paris 13 Sorbonne Paris-Cité, 74 rue Marcel Cachin, 93017 Bobigny cedex, France; Service de médecine gériatrique, Hôpital Avicenne, Hôpitaux Universitaires de Paris Seine-Saint-Denis (HUPSSD), 93000 Bobigny, France; Unité de coordination en oncogériatrie (UCOG93), Hôpital Avicenne, Hôpitaux Universitaires de Paris Seine-Saint-Denis (HUPSSD), 93000 Bobigny, France
| | - Frédéric Pamoukdjian
- Laboratoire Éducations et Pratiques de Santé-LEPS (EA3412), Université Paris 13 Sorbonne Paris-Cité, 74 rue Marcel Cachin, 93017 Bobigny cedex, France; Service de médecine gériatrique, Hôpital Avicenne, Hôpitaux Universitaires de Paris Seine-Saint-Denis (HUPSSD), 93000 Bobigny, France; Unité de coordination en oncogériatrie (UCOG93), Hôpital Avicenne, Hôpitaux Universitaires de Paris Seine-Saint-Denis (HUPSSD), 93000 Bobigny, France.
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Mekki TE, Øye C, Kristensen B, Dahl H, Haaland A, Nordin KA, Strandos M, Terum TM, Ydstebø AE, McCormack B. The inter-play between facilitation and context in the promoting action on research implementation in health services framework: A qualitative exploratory implementation study embedded in a cluster randomized controlled trial to reduce restraint in nursing homes. J Adv Nurs 2017; 73:2622-2632. [PMID: 28513876 DOI: 10.1111/jan.13340] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2017] [Indexed: 11/29/2022]
Abstract
AIM To explore the inter-play between external facilitation and nursing home contexts relative to intervention outcomes. BACKGROUND The Promoting Action on Research Implementation in Health Services framework is frequently used to theoretically inform implementation and research in nursing and recent reviews indicate high face validity for health services. However, the inter-play and relationship between framework sub-elements of evidence, context and facilitation and the prospective utility in non-English speaking contexts warrant further illumination. DESIGN In an overarching single-blind cluster-randomized controlled trial, we applied participatory action research and ethnography from August 2011-June 2015 to evaluate a standardized education intervention to reduce restraint and agitation in nursing home residents living with dementia. The trial results are published elsewhere. METHODS Prospectively informed by the PARIHS framework, a research team and eight facilitators participating in dual roles as action researchers designed, implemented, and evaluated the intervention. How contextual factors influenced the facilitation processes were explored in focus group interviews (1), reflection notes (84) written by the facilitators' after each education session, ethnographic field studies (6 homes), and co-analysis workshops (5). Directed content analysis was used to analyse data. RESULTS Clinical leaders taking roles of internal facilitator influenced the success of implementation, while complex and fluctuating context elements determined whether restraint use was reduced- or not. The PARIHS framework was found to be relevant in a non-English nursing home setting, albeit some elements merit further conceptualization. CONCLUSIONS Our findings confirm the prospective utility of the PARIHS framework for implementation in a non-English context, particularly the notion of implementation processes as dynamic and multifaceted.
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Affiliation(s)
- Tone Elin Mekki
- Center for Care Research, Western Norway University of Applied Sciences, Bergen, Norway
| | - Christine Øye
- Center for Care Research, Western Norway University of Applied Sciences, Bergen, Norway
| | - Bodil Kristensen
- Center for institutional and home care services, Hordaland, Norway
| | - Helen Dahl
- Center for Care Research, Western Norway University of Applied Sciences, Bergen, Norway
| | - Astrid Haaland
- Center for institutional and home care services, Haugesund, Norway
| | - Kristin Aas Nordin
- SESAM, Regional centre for geriatric medicine and collaboration, Helse Stavanger HF, Norway
| | - Marta Strandos
- Center for institutional and home care services, Sogn og Fjordane, Norway
| | - Toril Marie Terum
- Center for Care Research, Western Norway University of Applied Sciences, Bergen, Norway
| | - Arnt Egil Ydstebø
- Developing Center for institutional and Home Care Services, Rogaland, Norway
| | - Brendan McCormack
- Department of Nursing, Queen Margaret University, Edinburgh, UK.,Drammen, University College of Southeast Norway, Norway
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Padilha JM, Sousa PAF, Pereira FMS. Nursing clinical practice changes to improve self-management in chronic obstructive pulmonary disease. Int Nurs Rev 2017; 65:122-130. [PMID: 28294320 DOI: 10.1111/inr.12366] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To propose nursing clinical practice changes to improve the development of patient self-management. BACKGROUND Chronic obstructive pulmonary disease is one of the main causes of chronic morbidity, loss of quality of life and high mortality rates. INTRODUCTION Control of the disease's progression, the preservation of autonomy in self-care and maintenance of quality of life are extremely challenging for patients to execute in their daily living. However, there is still little evidence to support nursing clinical practice changes to improve the development of self-management. METHODS A participatory action research study was performed in a medicine inpatient department and the outpatient unit of a Portuguese hospital. The sample comprised 52 nurses and 99 patients. For data collection, we used interviews, participant observation and content analysis. RESULTS The main elements of nursing clinical practice that were identified as a focus for improvement measures were the healthcare model, the organization of healthcare and the documentation of a support decision-making process. The specific guidelines, the provision of material to support decision-making and the optimization of information sharing between professionals positively influenced the change process. This change improved the development of self-management skills related to the awareness of the need for 'change', hope, involvement, knowledge and abilities. DISCUSSION The implemented changes have improved health-related behaviours and clinical outcomes. CONCLUSION To support self-management development skills, an effective nursing clinical practice change is needed. This study has demonstrated the relevance of a portfolio of techniques and tools to help patients adopt healthy behaviours. IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY The involvement and participation of nurses and patients in the conceptualization, implementation and evaluation of policy change are fundamental issues to improve the quality of nursing care and clinical outcomes.
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Affiliation(s)
- J M Padilha
- Nursing School of Porto, CINTESIS, Porto, Portugal
| | - P A F Sousa
- Nursing School of Porto, CINTESIS, Porto, Portugal
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Moch SD, Vandenbark RT, Pehler SR, Stombaugh A. Use of Action Research in Nursing Education. Nurs Res Pract 2016; 2016:8749167. [PMID: 28078138 PMCID: PMC5203904 DOI: 10.1155/2016/8749167] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 11/07/2016] [Indexed: 11/29/2022] Open
Abstract
Purpose. The purpose of this article is to describe action research in nursing education and to propose a definition of action research for providing guidelines for research proposals and criteria for assessing potential publications for nursing higher education. Methods. The first part of this project involved a search of the literature on action research in nursing higher education from 1994 to 2013. Searches were conducted in the CINAHL and MEDLINE databases. Applying the criteria identified, 80 publications were reviewed. The second part of the project involved a literature review of action research methodology from several disciplines to assist in assessing articles in this review. Results. This article summarizes the nursing higher education literature reviewed and provides processes and content related to four topic areas in nursing higher education. The descriptions assist researchers in learning more about the complexity of both the action research process and the varied outcomes. The literature review of action research in many disciplines along with the review of action research in higher education provided a framework for developing a nursing-education-centric definition of action research. Conclusions. Although guidelines for developing action research and criteria for publication are suggested, continued development of methods for synthesizing action research is recommended.
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Affiliation(s)
- Susan D. Moch
- Department of Nursing, College of Nursing and Health Sciences, University of Wisconsin-Eau Claire, 105 Garfield Avenue, P.O. Box 4004, Eau Claire, WI 54702-4004, USA
| | - R. Todd Vandenbark
- Vogel Library, Wartburg College, No. 225, 100 Wartburg Blvd, P.O. Box 1003, Waverly, IA 50677, USA
| | - Shelley-Rae Pehler
- Department of Nursing, College of Nursing and Health Sciences, No. 219 Nursing Building, University of Wisconsin-Eau Claire, 105 Garfield Ave, P.O. Box 4004, Eau Claire, WI 54702, USA
| | - Angela Stombaugh
- Department of Nursing, College of Nursing and Health Sciences, University of Wisconsin-Eau Claire, 105 Garfield Avenue, P.O. Box 4004, Eau Claire, WI 54702-4004, USA
- Center for Excellence in Teaching and Learning, University of WI-Eau Claire, Eau Claire, WI, USA
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Kwong EW, Hung MS, Woo K. Improvement of pressure ulcer prevention care in private for-profit residential care homes: an action research study. BMC Geriatr 2016; 16:192. [PMID: 27884131 PMCID: PMC5123273 DOI: 10.1186/s12877-016-0361-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 11/10/2016] [Indexed: 12/05/2022] Open
Abstract
Background A need exits to develop a protocol for preventing pressure ulcers (PUs) in private for-profit nursing homes in Hong Kong, where the incidence of PUs is relatively high and which have high proportion of non-professional care staff. The implementation of such protocol would involve changes in the practice of care, likely evoking feelings of fear and uncertainty that may become a barrier to staff adherence. We thus adopted the Systems Model of Action Research in this study to manage the process of change for improving PU prevention care and to develop a pressure ulcer prevention protocol for private for-profit nursing homes. Methods A total of 474 residents and care staff who were health workers, personal care workers, and/or nurses from four private, for-profit nursing homes in Hong Kong participated in this study. Three cyclic stages and steps, namely, unfreezing (planning), changing (action), and refreezing (results) were carried out. During each cycle, focus group interviews, field observations of the care staff’s practices and inspections of the skin of the residents for pressure ulcers were conducted to evaluate the implementation of the protocol. Qualitative content analysis was adopted to analyse the data. The data and methodological triangulation used in this study increased the credibility and validity of the results. Results The following nine themes emerged from this study: prevention practices after the occurrence of PUs, the improper use of pressure ulcer prevention materials, non-compliance with several prevention practices, improper prevention practices, the perception that the preventive care was being performed correctly, inadequate readiness to use the risk assessment tool, an undesirable environment, the supplying of unfavorable resources, and various management styles in the homes with or without nurses. At the end of the third cycle, the changes that were identified included improved compliance with the revised risk assessment method, the timely and appropriate use of PU prevention materials, the empowering of staff to improve the quality of PU care, and improved home management. Conclusion Through the action research approach, the care staff were empowered and their PU prevention care practices had improved, which contributed to the decreased incidence of pressure ulcers. A PU prevention protocol that was accepted by the staff was finally developed as the standard of care for such homes. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0361-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Enid Wy Kwong
- School of Nursing, Tung Wah College, Wylies Road, Kowloon, Hong Kong, China.
| | - Maria Sy Hung
- School of Nursing, Tung Wah College, Wylies Road, Kowloon, Hong Kong, China
| | - Kevin Woo
- School of Nursing, Tung Wah College, Wylies Road, Kowloon, Hong Kong, China
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Cordeiro L, Soares CB. Implementation of evidence-based health care using action research: An emancipatory approach. Int J Nurs Pract 2016; 22:333-8. [DOI: 10.1111/ijn.12467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 06/15/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Luciana Cordeiro
- Speech Therapy and Occupational Therapy, Faculty of Medicine; University of Sao Paulo; SP Brazil
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Cheng L, Feng S, Hu Y. Evidence-based nursing implementation in Mainland China: A scoping review. Nurs Outlook 2016; 65:27-35. [PMID: 27665492 DOI: 10.1016/j.outlook.2016.07.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/12/2016] [Accepted: 07/30/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND It is crucial to identify the challenges of evidence-based nursing implementation faced by countries in transitional stage. PURPOSE The purpose of this study was to identify the state of evidence on implementation in Chinese nursing contexts and to determine gaps that need to be pursued. METHODS We performed a scoping review on existing literature on implementation studies conducted in nursing context in Mainland China. After systematically searching eight (four Chinese and four English) databases, we extracted and analyzed data from the included studies. RESULTS Ninety-five articles met inclusion criteria. Publications were on the rise, with most funding from academic institutions. Most studies were quantitative, with patient outcomes as primary indicators. Eighteen studies used a theoretical framework. Frequently used strategies and barriers to evidence-based nursing implementation were mainly from the organizational level. CONCLUSIONS This scoping review indicates an urgent requirement of Chinese evidence-based nursing resources, more funding and support from clinical managerial level, cooperation between academic and clinical institutes, and a call for more rigorous studies of implementation science under a Chinese nursing context.
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Affiliation(s)
- Lei Cheng
- School of Nursing, Fudan University, Shanghai, China
| | - Sheng Feng
- Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, China.
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Häggman-Laitila A, Mattila LR, Melender HL. Educational interventions on evidence-based nursing in clinical practice: A systematic review with qualitative analysis. NURSE EDUCATION TODAY 2016; 43:50-9. [PMID: 27286945 DOI: 10.1016/j.nedt.2016.04.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 04/18/2016] [Accepted: 04/27/2016] [Indexed: 05/06/2023]
Abstract
AIMS To gather, assess and synthesise the currently available evidence of educational interventions on evidence-based nursing (EBN). BACKGROUND Previous systematic reviews have focused on the items used in reporting educational interventions for facilitating evidence-based practices in medicine and health care or teaching research literacy in nursing as well as on the outcomes of these interventions. DESIGN A systematic review based on a procedure of the Centre for Reviews and Disseminations for conducting a systematic review of health interventions. DATA SOURCES AND METHODS Texts from 2008 to 2015 were sought from the Cochrane, CINAHL and PubMed Medline databases. Eight studies were selected for the final data and reviewed for quality. Data were analysed with narrative synthesis including qualitative content analysis. RESULTS Four main categories and sixteen subcategories were identified. The learning contents included principles of EBN and research, the process of EBN, and planning a change in practice. The most popular teaching/learning methods were lectures/didactic presentations and group work. The interventions encouraged learners to critically examine and evaluate their practice. The interventions also improved participants' capacity to identify the need for research evidence in clinical practice. CONCLUSION The educational interventions were fairly similar and had promising results. However, as the level of evidence was modest in the studies, there are several development needs for interventions and further research challenges. Interventions should provide participants with sufficient competences for implementing every step of EBN, with special focus on the implementation of evidence in patient care. The assessment of the outcomes of interventions should cover all learning categories of EBN with focus on medium to long-term effectiveness. The influence of different teaching/learning methods and learning contexts and settings should be investigated further.
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Affiliation(s)
- Arja Häggman-Laitila
- Department of Nursing Science, University of Eastern Finland, P.O. BOX 1627, FI-70211 Kuopio, Finland.
| | | | - Hanna-Leena Melender
- Department of Social and Health Care, VAMK University of Applied Sciences, Raastuvankatu 31-33, 65100 Vaasa, Finland.
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Bostwick L, Linden L. Evaluation Criteria for Nursing Student Application of Evidence-Based Practice: A Delphi Study. J Nurs Educ 2016; 55:336-41. [PMID: 27224462 DOI: 10.3928/01484834-20160516-06] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 03/16/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Core clinical evaluation criteria do not exist for measuring prelicensure baccalaureate nursing students' application of evidence-based practice (EBP) during direct care assignments. The study objective was to achieve consensus among EBP nursing experts to create clinical criteria for faculty to use in evaluating students' application of EBP principles. METHOD A three-round Delphi method was used. Experts were invited to participate in Web-based surveys. Data were analyzed using qualitative coding and categorizing. Quantitative analyses were descriptive calculations for rating and ranking. RESULTS Expert consensus occurred in the Delphi rounds. The study provides a set of 10 core clinical evaluation criteria for faculty evaluating students' progression toward competency in their application of EBP. CONCLUSION A baccalaureate program curriculum requiring the use of Bostwick's EBP Core Clinical Evaluation Criteria will provide a clear definition for understanding basic core EBP competence as expected for the assessment of student learning. [J Nurs Educ. 2016;55(5):336-341.].
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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: 112] [Impact Index Per Article: 12.4] [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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Correa-de-Araujo R. Evidence-Based Practice in the United States: Challenges, Progress, and Future Directions. Health Care Women Int 2015; 37:2-22. [PMID: 26473771 PMCID: PMC4804828 DOI: 10.1080/07399332.2015.1102269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Scientific literature demonstrates that advances in evidence-based nursing have improved systems of care and women's health outcomes. Experts agree that nurses worldwide can play a key role in building such evidence and working with interdisciplinary health care teams and systems to accelerate its implementation.
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Cordeiro L, Rittenmeyer L, Soares CB. Action research methodology in the health care field: a scoping review protocol. ACTA ACUST UNITED AC 2015. [DOI: 10.11124/01938924-201513080-00008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Friesen-Storms JHHM, Moser A, van der Loo S, Beurskens AJHM, Bours GJJW. Systematic implementation of evidence-based practice in a clinical nursing setting: a participatory action research project. J Clin Nurs 2014; 24:57-68. [PMID: 25258116 DOI: 10.1111/jocn.12697] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2014] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To describe the process of implementing evidence-based practice in a clinical nursing setting. BACKGROUND Evidence-based practice has become a major issue in nursing, it is insufficiently integrated into daily practice and its implementation is complex. DESIGN Participatory action research. METHODS The main participants were nurses working in a lung unit of a rural hospital. A multi-method process of data collection was used during the observing, reflecting, planning and acting phases. Data were continuously gathered during a 24-month period from 2010 to 2012, and analysed using an interpretive constant comparative approach. Patients were consulted to incorporate their perspective. RESULTS A best-practice mode of working was prevalent on the ward. The main barriers to the implementation of evidence-based practice were that nurses had little knowledge of evidence-based practice and a rather negative attitude towards it, and that their English reading proficiency was poor. The main facilitators were that nurses wanted to deliver high-quality care and were enthusiastic and open to innovation. Implementation strategies included a tailored interactive outreach training and the development and implementation of an evidence-based discharge protocol. The academic model of evidence-based practice was adapted. Nurses worked according to the evidence-based practice discharge protocol but barely recorded their activities. Nurses favourably evaluated the participatory action research process. CONCLUSIONS Action research provides an opportunity to empower nurses and to tailor evidence-based practice to the practice context. Applying and implementing evidence-based practice is difficult for front-line nurses with limited evidence-based practice competencies. RELEVANCE TO CLINICAL PRACTICE Adaptation of the academic model of evidence-based practice to a more pragmatic approach seems necessary to introduce evidence-based practice into clinical practice. The use of scientific evidence can be facilitated by using pre-appraised evidence. For clinical practice, it seems relevant to integrate scientific evidence with clinical expertise and patient values in nurses' clinical decision-making at the individual patient level.
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Affiliation(s)
- Jolanda H H M Friesen-Storms
- Research Centre Autonomy and Participation of Persons with a Chronic Illness, Nursing Department, Zuyd Health, Zuyd University of Applied Science, Heerlen, Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
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Sanders C, Bray L. Examining professionals' and parents' views of using transanal irrigation with children: Understanding their experiences to develop a shared health resource for education and practise. J Child Health Care 2014; 18:145-55. [PMID: 23423999 DOI: 10.1177/1367493512474866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Irrigation as a bowel management approach has been reportedly used with children for more than 20 years. Parents managing their child's chronic bowel problem have previously been shown to have increased emotional stress. The aim of this study was to explore professionals' (n = 24) understanding and parents' (n = 18) experiences of using transanal irrigation with children at home as a mid to longer term bowel management approach. This study was underpinned by action research methodology and used mixed methods determined by an action research group of parents, professionals, researchers, a voluntary sector worker, commercial representative and independent observer. Data informed the study outcome which was the development and evaluation of a shared health resource to support professionals in their holistic approach when prescribing transanal irrigation and guide parents in the areas of education, management, problem solving, support and goal setting. The resource includes constructed case studies from parents of their experiences to inform choice and decision-making between parents and professionals. The shared health resource provides an approach to initiating and evaluating transanal irrigation and is available in a paper format from key Internet sites across hospital, community and voluntary services.
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Affiliation(s)
| | - Lucy Bray
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
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Langlois S, Goudreau J, Lalonde L. Scientific rigour and innovations in participatory action research investigating workplace learning in continuing interprofessional education. J Interprof Care 2014; 28:226-31. [PMID: 24559150 DOI: 10.3109/13561820.2014.885003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The persistent theory-practice gap shows how challenging it can be for healthcare professionals to keep updating their practices. The continuing education challenges are partly explained by the tremendous stream of new discoveries in health and the epidemic of multi-morbid conditions. Participatory action research (PAR) is used in healthcare as a research approach that capitalizes on people's resources to better understand and enhance their professional practices. PAR thus can consolidate our knowledge on workplace learning in continuing interprofessional education while directly improving quality of care. However, PAR lacks clear scientific criteria to ensure the consistency between the investigators' methodology and philosophy, which jeopardize its credibility. This paper outlines the principles of rigour in PAR and describes the additions of a preliminary planning phase to Kemmis and McTaggart's PAR description as well as the use of the professional co-development group, an action-oriented data collection method. We believe that this will help PAR co-participants achieve improved scientific rigour and encourage more investigators to collaborate through this research approach contributing to the advancement of knowledge on workplace learning in continuing interprofessional education.
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Jeffs L, Sidani S, Rose D, Espin S, Smith O, Martin K, Byer C, Fu K, Ferris E. Using theory and evidence to drive measurement of patient, nurse and organizational outcomes of professional nursing practice. Int J Nurs Pract 2013; 19:141-8. [PMID: 23577971 DOI: 10.1111/ijn.12048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
An evolving body of literature suggests that the implementation of evidence based clinical and professional guidelines and strategies can improve patient care. However, gaps exist in our understanding of the effect of implementation of guidelines on outcomes, particularly patient outcomes. To address this gap, a measurement framework was developed to assess the impact of an organization-wide implementation of two nursing-centric best-practice guidelines on patient, nurse and organizational level outcomes. From an implementation standpoint, we anticipate that our data will show improvements in the following: (i) patient satisfaction scores and safety outcomes; (ii) nurses ability to value and engage in evidence based practice; and (iii) organizational support for evidence-informed nursing care that results in quality patient outcomes. Our measurement framework and multifaceted methodological approach outlined in this paper might serve as a blueprint for other organizations in their efforts to evaluate the impacts associated with implementation of clinical and professional guidelines and best practices.
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Affiliation(s)
- Lianne Jeffs
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's, Canada.
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Shifaza F, Evans D, Bradley H, Ullrich S. Developing evidence-based practice champions in the Maldives. Int J Nurs Pract 2013; 19:596-602. [PMID: 24330210 DOI: 10.1111/ijn.12106] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Evidence-based practice (EBP) is an approach that has gained recognition for facilitating the transfer of evidence into clinical practice. EBP champions is a strategy that can be adopted to encourage the uptake of EBP. This paper describes an action research project that was undertaken in Maldives. EBP champion model has been introduced in the Maldives early 2012 and aims to produce clinical leaders from variety of backgrounds who could implement EBP. This paper provides an extended discussion of the process that was undertaken to prepare EBP champions and their roles in implementing EBP.
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Affiliation(s)
- Fathimath Shifaza
- School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia
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Blackford J, Street A. Tracking the route to sustainability: a service evaluation tool for an advance care planning model developed for community palliative care services. J Clin Nurs 2012; 21:2136-48. [PMID: 22788555 DOI: 10.1111/j.1365-2702.2012.04179.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIMS AND OBJECTIVES The study aim was to develop a service evaluation tool for an advance care planning model implemented in community palliative care. BACKGROUND Internationally, advance care planning programmes usually measure success by completion rate of advance directives or plans. This outcome measure provides little information to assist nurse managers to embed advance care planning into usual care and measure their performance and quality over time. An evaluation tool was developed to address this need in Australian community palliative care services. DESIGN Multisite action research approach. METHODS Three community palliative care services located in Victoria, Australia, participated. Qualitative and quantitative data collection strategies were used to develop the Advance Care Planning-Service Evaluation Tool. RESULTS The Advance Care Planning-Service Evaluation Tool identified advance care planning progress over time across three stages of Establishment, Consolidation and Sustainability within previously established Model domains of governance, documentation, practice, education, quality improvement and community engagement. The tool was used by nurses either as a peer-assessment or self-assessment tool that assisted services to track their implementation progress as well as plan further change strategies. CONCLUSION The Advance Care Planning-Service Evaluation Tool was useful to nurse managers in community palliative care. It provided a clear outline of service progress, level of achievement and provided clear direction for planning future changes. RELEVANCE TO CLINICAL PRACTICE The Advance Care Planning-Service Evaluation Tool enables nurses in community palliative care to monitor, evaluate and plan quality improvement of their advance care planning model to improve end-of-life care. As the tool describes generic healthcare processes, there is potential transferability of the tool to other types of services.
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Affiliation(s)
- Jeanine Blackford
- School of Nursing & Midwifery, La Trobe University, Bundoora, Vic., Australia.
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Abad-Corpa E, Cabrero-García J, Delgado-Hito P, Carrillo-Alcaraz A, Meseguer-Liza C, Martínez-Corbalán JT. Effectiveness of participatory-action-research to put in practice evidence at a nursing onco-hematology unit. Rev Lat Am Enfermagem 2012; 20:59-67. [PMID: 22481722 DOI: 10.1590/s0104-11692012000100009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 01/06/2012] [Indexed: 11/22/2022] Open
Abstract
The aim was to evaluate the effectiveness of evidence implementation through participatory-action research (PAR). A prospective quasi-experimental design with two non-equivalent and non-concurrent groups (2006 and 2008) was adopted. The research was conducted at the bone marrow transplant unit of a tertiary-level Spanish hospital. To put the evidence in practice, PAR was adopted as an "intervention studied". The dependent variables were: professional performance and patient outcomes (psycho-emotional area and adverse effects). In total, 125 patients were recruited (1(st) period=56; 2(nd) period=69). The results in the second period show significant improvements in professional performance in terms of the quality of the registers of signs and symptoms. In the psycho-emotional area, the psycho-social adjustment improved significantly; without caregiver burden or satisfaction showing any clear tendencies. Among the adverse effects, catheter-related thrombosis and catheter-related infection improved significantly; there were no significant differences in the level of pain or mucositis. Through the PAR, evidence could be put in practice and the outcomes under analysis could be improved.
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Affiliation(s)
- Eva Abad-Corpa
- Technical Training and Research, Consejería de Sanidad, Murcia, Spain.
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Pastor-Montero SM, Romero-Sánchez JM, Paramio-Cuevas JC, Hueso-Montoro C, Paloma-Castro O, Lillo-Crespo M, Castro-Yuste C, Toledano-Losa AC, Carnicer-Fuentes C, Ortegón-Gallego JA, Frandsen AJ. Tackling perinatal loss, a participatory action research approach: research protocol. J Adv Nurs 2012; 68:2578-85. [DOI: 10.1111/j.1365-2648.2012.06015.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Reducing staff isolation and developing evidence-informed practice in the aged care environment through an action research approach to falls prevention. ANS Adv Nurs Sci 2012; 35:3-13. [PMID: 22228387 DOI: 10.1097/ans.0b013e3182433b27] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study aimed to examine whether an action research approach was effective in reducing the isolation of staff in 2 residential aged care facilities, within the context of an evidence-informed falls prevention program. A Falls Action Research Group comprising 12 nursing/nonnursing staff across 2 residential aged care facilities was established and engaged in critical dialogue and action over 12 months to improve their fall prevention activities. Through the group members' engagement, a research community was established that diminished staff isolation by engaging members in a sustained process of collaboration around falls prevention, which worked to disrupt occupational silos and challenge traditional staff hierarchies.
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