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Eslami J, Saeedi AA, Najafi Kalyani M. Assessing Evidence-Based Practice in Operating Room Nursing Students: A Cross-Sectional Study in the Southwest of Iran. ScientificWorldJournal 2024; 2024:5552711. [PMID: 38756479 PMCID: PMC11098602 DOI: 10.1155/2024/5552711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/10/2024] [Accepted: 04/24/2024] [Indexed: 05/18/2024] Open
Abstract
Evidence-based practice (EBP) is a clinical decision-making process that is grounded in the utilization of the most reliable and up-to-date evidence. It involves utilizing resources and evidence to enhance patient management. The application of evidence-based decisions in patient care and education is of utmost importance in the performance of health sciences students. However, the emphasis on this concept among operating room nursing students has been lacking. Hence, the objective of this research is to assess the implementation of evidence-based practice among operating room nursing students studying in the operating room department at the Shiraz University of Medical Sciences in Iran. The study follows a descriptive, cross-sectional design, with a sample of 148 operating room nursing students selected through census sampling based on the student list. After obtaining informed consent, participants completed a demographic information form and the Rubin-Parrish evidence-based practice questionnaire. The data that were gathered underwent analysis through the utilization of SPSS version 22 software, employing descriptive statistics, T-tests, and Pearson correlation coefficient tests. The results revealed that the overall average score of evidence-based practice among the students exceeded the standard scores (172.66 ± 14.74). There was a significant association between the evidence-based practice score and prior familiarity with evidence-based practice, interest in the field of study, research experience, intention to participate in the Master's exam, and the participants' grade point average (GPA) (p < 0.05). These findings indicate that operating room nursing students displayed an average level of evidence-based practice, emphasizing the need for effective plans and strategies to improve their performance. Addressing the identified factors from this study becomes crucial in this regard.
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Affiliation(s)
- Jamshid Eslami
- Department of Anesthesia, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Arsalan Saeedi
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Najafi Kalyani
- Department of Medical Emergencies, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Hulbert‐Lemmel S, Madhuvu A, Team V. Acute care nurses' experience in providing evidence-based care for patients with laparotomy wounds: A scoping review. Int Wound J 2024; 21:e14591. [PMID: 38151989 PMCID: PMC10961882 DOI: 10.1111/iwj.14591] [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: 10/31/2023] [Accepted: 12/08/2023] [Indexed: 12/29/2023] Open
Abstract
To systematically search and synthesise available literature on barriers and enablers to evidence-based care for patients with laparotomy wounds reported by acute care nurses. Specifically, we focused on wound assessment, infection control techniques, wound products used, escalation of care, dressing application, documentation and holistic care. The Preferred Reporting Items for Systematic review and Meta-Analyses extension for Scoping Reviews Checklist and explanation documents directed the review. The methodology framework created by Arksey and O'Malley, updated by Levac et al., and the Joanna Briggs Institute were utilised to assist the scoping review process. Data synthesis was guided by the Theoretical Domains Framework. Six qualitative and mixed methods studies were selected for the review. Most reported barriers and enablers were mapped to knowledge, skills, beliefs about consequences, environmental context and resources and beliefs about capability domains. The main barriers were limited access to and utilisation of wound assessment tools and clinical practice guidelines for wound management and suboptimal time management skills. Inconsistent management of laparotomy wounds was related to ward culture and nurses' lack of knowledge and skills in surgical wound assessment and aseptic technique during wound encounters. The reported enablers were knowledge of multi-factorial risk factors for surgical wound recovery, valuing education and reflective practice and believing that protocols should be utilised alongside comprehensive wound assessments. Holistic wound care included patient education on the role of mobilisation and nutrition in wound healing. Acute care nurses do not routinely incorporate comprehensive, evidence-based care recommendations for laparotomy wound management. Further research on evidence-based care behaviours in managing laparotomy wounds is required. The results indicate a need for standardising the practice of laparotomy wound management while acknowledging the current challenges faced in the ward environment.
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Affiliation(s)
- Sarah Hulbert‐Lemmel
- Monash University, Nursing and Midwifery, Peninsula CampusFrankstonVictoriaAustralia
| | - Auxillia Madhuvu
- Monash University, Nursing and Midwifery, Peninsula CampusFrankstonVictoriaAustralia
| | - Victoria Team
- Monash University, Nursing and Midwifery Clayton CampusClaytonVictoriaAustralia
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Tomotaki A, Sakai I, Fukahori H, Tsuda Y, Okumura-Hiroshige A. Factors affecting the critical appraisal of research articles in Evidence-Based practices by advanced practice nurses: A descriptive qualitative study. Nurs Open 2023; 10:3719-3727. [PMID: 36698246 PMCID: PMC10170922 DOI: 10.1002/nop2.1628] [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: 09/16/2022] [Revised: 12/17/2022] [Accepted: 01/13/2023] [Indexed: 01/27/2023] Open
Abstract
AIM To describe factors affecting critical appraisal of research articles in evidence-based practice by certified nurse specialists who were advanced practice nurses in Japan. DESIGN A descriptive qualitative study. METHODS Fourteen certified nurse specialists with master's degree were included by a snowball sampling to maximize the variety of specialty fields for advanced practice nurses in Japan. Individual semi-structured interviews were conducted between November 2016 and March 2017. Interview guides included the experience of evidence-based practice and learning about critical appraisal. RESULTS The following four aspects were identified as factors affecting the critical appraisal of research articles in evidence-based practices-individual beliefs and attitude, learning status, organizational readiness and availability of research evidence. Each factor included both positive and negative aspects for critical appraisal in evidence-based practice. PATIENT OR PUBLIC CONTRIBUTION If advanced practice nurses acquire knowledge/skills of critical appraisal, they would be able to select more appropriate care. This will increase to improve the health-related outcome for patients or populations.
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Affiliation(s)
- Ai Tomotaki
- Faculty of Nursing, School of Medicine, Tokai University, Isehara-shi, Kanagawa, Japan
| | - Ikuko Sakai
- Department of Nursing Systems Management, Graduate School of Nursing, Chiba University, Chiba-shi, Chiba, Japan
| | - Hiroki Fukahori
- Faculty of Nursing and Medical Care, Keio University, Fujisawa-shi, Kanagawa, Japan
| | - Yasunobu Tsuda
- St. Marianna University Hospital, Kawasaki-shi, Kanagawa, Japan
| | - Akemi Okumura-Hiroshige
- Department of Nursing Science, Faculty of Health Sciences, Tokyo Metropolitan University, Arakawa-ku, Tokyo, Japan
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Swedish Registered Nurse Anesthetists’ Understanding of Difficult Airway Algorithms. J Perianesth Nurs 2022; 37:706-711. [DOI: 10.1016/j.jopan.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/19/2021] [Accepted: 12/09/2021] [Indexed: 11/22/2022]
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Effect of Hierarchical Nursing Management in Patients with Hypertension Complicated with Cardiovascular and Cerebrovascular Risk Factors. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:1246566. [PMID: 34880928 PMCID: PMC8648470 DOI: 10.1155/2021/1246566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/06/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022]
Abstract
Hierarchical management is an essential component of nurse post management and an unavoidable tendency in nursing education. According to their existing condition, various hospitals around the country have actively tested the hierarchical usage and management model of clinical nurses, with some success. The application impact of hierarchical nursing care in patients with hypertension complicated by cardiovascular and cerebrovascular risk factors is the focus of this research. In a hospital, 300 patients with hypertension complicated by cardiovascular and cerebrovascular risk factors were chosen. All patients were split into two groups using the coin-throwing random method: the observation group received hierarchical nurse management and the control group received regular nursing management, with 150 cases in each group. The two groups' blood pressure, blood lipids, blood glucose, poor habits, rehospitalization rate, and cardiovascular and cerebrovascular problems were also examined. At the same time, the patients' poor mood and quality of life were assessed before and after the intervention. In the control group followed up for 1 year, the blood pressure compliance rate was 44.88%, the blood lipid compliance rate was 28.65%, the blood glucose compliance rate was 45.00%, the smokers with bad lifestyle habits were 26.57%, the overweight and obese were 23.5%, the high sodium was 31.67%, the rehospitalization rate was 15.48%, and the incidence of cardiovascular and cerebrovascular complications was 43.00%. The observation group's blood pressure, blood lipids, and blood sugar compliance rates rose substantially (P = 0.05) as compared to the control group. The occurrence of poor luck living habits, the rate of rehospitalization, and the incidence of cardiovascular and cerebrovascular complications were significantly reduced (P < 0.05). Before nursing intervention, there was no significant difference in the bad mood scores SAS, SDS, and quality of life between the two groups of patients (P > 0.05); after nursing intervention, compared with the control group, the observation group's bad mood scores were significantly reduced, physical factors, psychological factors, and total scores all increased significantly, and the difference was statistically significant (P < 0.05).
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Jangland E, Gunningberg L, Nyholm L. A mentoring programme to meet newly graduated nurses' needs and give senior nurses a new career opportunity: A multiple-case study. Nurse Educ Pract 2021; 57:103233. [PMID: 34678635 DOI: 10.1016/j.nepr.2021.103233] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022]
Abstract
AIM To evaluate the implementation of a multifaceted mentoring programme in a large university hospital and describe its value from the perspectives of newly graduated nurses, experienced nurses and the hospital organisation. BACKGROUND Healthcare organisations need long-term competence-planning strategies to retain nurses, prevent their premature departure from the profession and use their competencies. This paper reports a mentoring programme focused on supporting newly graduated nurse' transition to practice and senior nurses' professional development as supervisors. DESIGN A multiple-case study. METHODS We performed 35 interviews with nurses, supervisors and nurse managers in the five units that implemented the programme, mapped the programme at the hospital level and extracted the nurses' working hours. The interviews were analysed thematically using the theoretical lens of the head-heart-hand model to interpret the results. RESULTS Of 46 units in the hospital, 14 had implemented one or several of the components in the mentoring programme. The programme corresponded to the newly graduated nurses' needs, gave senior nurses a new career opportunity and contributed to an attractive workplace. The main theme, Giving new nurses confidence, experienced nurses a positive challenge and the organisation an opportunity to learn, reflects the value of the programme's supervisory model to new and experienced nurses and to the organisation as a whole. CONCLUSION The mentoring programme appeared to be a promising way to smooth the transition for newly graduated nurses. The experienced supervising nurses were key to the success of this complex programme, supporting the new nurses at the bedside and being available to respond to their questions and reflections. Embedding the supervisors in the units' daily practice was necessary to the success of the different parts of the programme. Despite the strategic and well-designed implementation of this mentoring programme aimed to solve the everyday challenge of nurse shortages in the hospital, it was a challenge to implement it fully in all the units studied.
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Affiliation(s)
- Eva Jangland
- Department of Surgical Sciences, Uppsala University, Uppsala University Hospital, Entrance 15, SE-751 85 Uppsala, Sweden.
| | - Lena Gunningberg
- Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, SE-751 85 Uppsala, Sweden.
| | - Lena Nyholm
- Department of Neuroscience/Neurosurgery, Uppsala University, Uppsala University Hospital, Entrance 85, SE-751 85 Uppsala, Sweden.
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Halberg N, Assafi L, Nørholm V. Understandings of and experiences with evidence-based practice in practice among nurses in a surgical department: A constructivist approach. J Clin Nurs 2020; 30:488-498. [PMID: 33174256 DOI: 10.1111/jocn.15563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/05/2020] [Accepted: 10/31/2020] [Indexed: 11/26/2022]
Abstract
AIM AND OBJECTIVES To explore nurses' constructions of the concept of evidence-based practice through their understandings of and experiences with evidence-based practice in a clinical care setting. BACKGROUND The primary purpose of evidence-based practice is high-quality patient outcomes. However, the adoption of evidence-based practice is described as a complex process, and research shows that evidence-based practice is not translated into practice. Research often explores facilitators and barriers of implementing and adopting evidence-based practice. Yet there is limited knowledge on how nurses construct the concept in practice. DESIGN This study has a constructivist approach and follows COREQ guidelines. METHOD Ten semi-structured interviews with 26 nurses were conducted in 2019. Data were analysed with an emic and inductive approach. RESULTS Three key constructions emerged. Understandings of evidence-based practice were based on the original concept of evidence-based medicine. This included the hierarchy of evidence which was perceived as an inflexible concept not encompassing the nursing care. However, while not using the term evidence-based practice, the nurses were doing evidence-based practice portrayed through outcomes from management-supported nursing-based projects and incorporated reflections and discussions into weekly meetings. A discrepancy between a theoretical understanding and a practical doing of evidence-based practice appeared and was especially evident when the nurses' primary evidence sources consisted of the immediate options, for example asking colleagues or following accessible guidelines. Searching for evidence was central in their theoretical understanding but not an incorporated part of their daily work tasks. CONCLUSION The nurses' constructions of evidence-based practice indicate a discrepancy between the theoretical understanding of evidence-based practice and the practical doing of evidence-based practice, which hinders the basis of working according to the concept. RELEVANCE TO CLINICAL PRACTICE Theoretical discussions of evidence-based practice within the nursing field remain academic, as nurses in practice construct the concept on standards from evidence-based medicine.
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Affiliation(s)
- Nina Halberg
- The Research Unit of Orthopaedic Nursing, Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark
| | - Lone Assafi
- The Research Unit of Orthopaedic Nursing, Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark
| | - Vibeke Nørholm
- Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark
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Tegelberg A, Muntlin Å, Juhlin C, Jangland E. Engagement under difficult conditions: Caring for patients with acute abdominal pain across the acute-care chain: A qualitative study. Int Emerg Nurs 2020; 52:100910. [PMID: 32827935 DOI: 10.1016/j.ienj.2020.100910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/08/2020] [Accepted: 08/05/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Studies report that patients with acute abdominal pain do not always receive optimal care and can experience poor pain management, safety failures, and emotional harm. Deeper understanding of how health professionals experience care delivery is needed to improve care to patients with acute abdominal pain. AIM To explore, from the perspective of registered nurses and physicians, how care is provided for patients with acute abdominal pain in the acute care chain, and to identify barriers that they describe in the delivery of care. METHOD Registered nurses and physicians (n = 19) working in ambulance services, emergency departments, and surgical departments at five hospitals in Sweden were interviewed. A content analysis was performed. RESULTS Five categories were identified; interaction: a decisive moment, competence and resources: not always available, guidelines: limited use, medical care: a main focus, and feedback and collaboration: limited across acute care chain. CONCLUSION This study adds new insights relating to how health professionals reflect on patient needs and obstacles to satisfying them. To deliver high quality care and meet patients' fundamental needs, there is a need of general guidelines and close collaboration in the acute care chain.
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Affiliation(s)
- Alexander Tegelberg
- Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Sweden.
| | - Åsa Muntlin
- Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Sweden; Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala, Sweden; Department of Medical Sciences/Clinical Epidemiology, Uppsala University, Uppsala, Sweden; Adelaide Nursing School, University of Adelaide, Adelaide, Australia.
| | - Claes Juhlin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Eva Jangland
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
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Avallin T, Muntlin Athlin Å, Björck M, Jangland E. Using communication to manage missed care: A case study applying the Fundamentals of Care framework. J Nurs Manag 2020; 28:2091-2102. [PMID: 31985109 DOI: 10.1111/jonm.12963] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 01/21/2020] [Indexed: 12/22/2022]
Abstract
AIM To explore, through the patient's perspective, how patient-provider communication is linked to missed nursing care vs. meeting patients' fundamental care needs. BACKGROUND Missed nursing care causes severe consequences for patients. Person-centred fundamental care, in which communication is central, provides an approach to manage this challenge. However, the specific patient-provider communications linked to care outcomes are unknown. METHODS Case study using secondary analysis of observations and interviews. A purposeful sample of 20 patients with acute abdominal pain collected using ethnographic methodology at one emergency department and two surgical wards. The Fundamentals of Care framework guided the analysis. RESULTS Communications that included the patient as an equal member of the care team were observed to make a difference between adequate and missed nursing care. Four categories were identified: interpersonal respect, humanized context of care, available and accessible communication channels, and mutual holistic understanding of the care needs and care plan. CONCLUSION Communication can be an essential tool to avoid missed nursing care and address the critical need for nursing managers to restore the fundamentals of care. IMPLICATIONS FOR NURSING MANAGEMENT Nursing managers can use this new knowledge of communication to facilitate person-centred fundamental care and thereby avoid missed nursing care.
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Affiliation(s)
- Therese Avallin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Åsa Muntlin Athlin
- Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala, Sweden.,Department of Medical Sciences/Clinical Epidemiology, Uppsala University, Uppsala, Sweden.,Department of Public Health and Caring Sciences/Health Services Research, Uppsala University, Uppsala, Sweden.,Adelaide Nursing School, University of Adelaide, Adelaide, Australia
| | - Martin Björck
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Eva Jangland
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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