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Elhabashy S, Moriyama M, Mahmoud EIED, Eysa B. Effect of evidence-based nursing practices training programme on the competency of nurses caring for mechanically ventilated patients: a randomised controlled trial. BMC Nurs 2024; 23:225. [PMID: 38566049 PMCID: PMC10986015 DOI: 10.1186/s12912-024-01869-1] [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: 04/19/2023] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Evidence-Based Practice (EBP) has been recognised worldwide as a standardised approach for enhancing the quality of healthcare and patient outcomes. Nurses play a significant role in integrating EBP, especially in Intensive Care Unit (ICU). Consequently, this study aims to examine the effect of an adapted evidence-based nursing practices training programme on the competency level of nurses caring for mechanically ventilated patients. METHODS A prospective open-label parallel 1:1 randomised controlled trial was conducted on 80 nurses caring for ICU patients at the National Hepatology and Tropical Medicine Research Institute, Egypt. The trial was carried out between November 2022 and February 2023 under the registration number NCT05721664. The enrolled nurses were randomly divided into intervention and control groups. The intervention group received the evidence-based nursing practice training programme (EBNPTP) in accordance with the Johns Hopkins EBP conceptional model, whereas the control group received traditional in-service education. Four assessments (one pre- and three post-assessments) were conducted to evaluate nurses' competency level over time using the adapted evidence-based nursing competency assessment checklist. The primary endpoint was an increase the competency levels among nurses caring for mechanically ventilated patients. RESULTS The current study results revealed statistically significant differences between intervention and control groups in relation to their level of competency across the three post-assessments, with (p <.001). The study also demonstrated that the nurses' competency level continued to decline significantly over time, with (p <.001). Additionally, a significant correlation was found between the nurses' pre-assessment and educational level, acting as independent variables (predictors), and the third endpoint assessment (p <.01), indicated by multiple linear regression. CONCLUSION The EBP training programme demonstrated a significant increase in the nurses' level of competency compared with traditional in-service education. This suggests that by training the nurses in various settings with the essential skills and knowledge for EBP, their competency level can be enhanced, leading to the delivery of effective care and improving patient outcomes. However, the long-term sustainability of the EBP adoptions was insufficient; further studies are needed to investigate the factors that affect the durability of EBP adoption. TRIAL REGISTRATION The study was registered with Clinical Trials.gov (Registration # NCT05721664) on 10/02/2023.
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Affiliation(s)
| | - Michiko Moriyama
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 734-8551, Kasumi, Hiroshima, Japan
| | | | - Basem Eysa
- National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
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Walsh S, Ryan C, McCreary L, Ocho ON, Potisopha W, Jeremiah RD. 'Capacity building skills in the implementation of evidence-based practice for community health nurses: an exploratory descriptive cohort study'. Contemp Nurse 2024:1-12. [PMID: 38489482 DOI: 10.1080/10376178.2024.2322982] [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: 10/11/2023] [Accepted: 02/20/2024] [Indexed: 03/17/2024]
Abstract
Background: While nurses are strategically placed to support the achievement of universal health, their practice may not always be informed by evidence, especially in a context where research evidence is not commonly used to inform practice.Objective/Aim/Hypothesis: Improve management of clients with CNCDs in Caribbean community through evidence-based practice (EBP) capacity building workshops.Design/Methods: A descriptive, quantitative design was used for this study. Participants included Community Based Nurses who attended an initial and recall workshop on EBP in a Caribbean island. All participants were included as the sample. Data were collected as a Pre-Test and Post Test before the initial workshop and at the recall workshop. Analysis was done quantitatively. Since the sample was small, only descriptive statistics were used.Results: Data showed 64% of participants had no experience with EBP, 55% needed more essential resources to participate in EBP and 55% recognized a need to include EBP to change their clinical practice effectively.Conclusions: The nurses and district supervisors observed a high level of interest and commitment to initiating and completing EBP projects. However, the reality of significant workplace demands, and limitations in consistent logistical and supervisory support impacted long-term sustainability.
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Affiliation(s)
- Susan Walsh
- PAHO/WHO Collaborating Centre for International Nursing Development in Primary Health Care, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Catherine Ryan
- PAHO/WHO Collaborating Centre for International Nursing Development in Primary Health Care, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Linda McCreary
- PAHO/WHO Collaborating Centre for International Nursing Development in Primary Health Care, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Oscar Noel Ocho
- PAHO/WHO Collaborating Centre in Nursing Policies and Leadership, School of Nursing, University of the West Indies St. Augustine, St. Augustine, Trinidad and Tobago
| | | | - Rohan D Jeremiah
- PAHO/WHO Collaborating Centre for International Nursing Development in Primary Health Care, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
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Kim S, Jeong HW. Developing and evaluating an evidence-based practice research competency enhancement program for clinical nurses in Korea: a pilot study. BMC Nurs 2024; 23:111. [PMID: 38431603 PMCID: PMC10909249 DOI: 10.1186/s12912-024-01749-8] [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: 07/10/2023] [Accepted: 01/21/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Evidence-based practice (EBP) is crucial for delivering high-quality healthcare and effective self-care. Enhancing clinical nurses' research competencies through structured mentorship is key to the widespread application of EBP. This study evaluated a newly developed Research Competency Enhancement Program (RCEP), aimed at bolstering EBP among experienced nurses. METHODS Conducted in a tertiary university hospital in Korea, this single-group study employed a pretest-post-test design and a mixed-methods approach. The RCEP involved 11 experienced clinical nurses in an 8-week intervention, featuring mentor-led workshops, interactive sessions, and resource-driven activities. Data were collected using the Evidence-Based Practice Beliefs Scale (EBPB), the Evidence-Based Practice Attitude Scale (EBPA), and the Research Practice Ability (RPA) tool, alongside qualitative feedback. These measures assessed the program's feasibility, acceptability, and preliminary effectiveness. RESULTS The quantitative analysis indicated significant improvements in research competency post-intervention. Mean scores on the EBPB and RPA scales increased (Z = -2.53, p = .011; Z = -2.66, p = .008). Participants described the RCEP as inspirational and challenging, creating an environment conducive to research. Facilitators included mentor support and innovative learning tools, while barriers were internet connectivity and scheduling conflicts. Suggestions for improvement included more hands-on sessions, small team collaborations, and integration with academic institutions. CONCLUSION The RCEP, facilitated by EBP mentors, significantly improved the research competencies and attitudes of clinical nurses towards EBP. The study underscores the importance of continual RCEP refinement, integrating structured, interactive, and collaborative elements to further empower nurses in evidence-based practice. The program shows promise in enhancing research competencies and fostering a commitment to EBP in clinical settings.
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Affiliation(s)
- Suhyun Kim
- Department of Nursing, Mokpo National University, 1666 Yeongsan-ro, Cheonggye-myeon, Muan-gun, Jeollanam-do, 58645, Republic of Korea
| | - Hye Won Jeong
- Department of Nursing, Nursing Education Team, Chonnam National University Hospital and College of Nursing, Chonnam National University, 42 Jebong-Ro, Dong-Gu, Gwangju, 61469, Republic of Korea.
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Zhang X, Peng M, He M, Du M, Jiang M, Cui M, Cai Y, Yan Q, Wang Y. Climates and associated factors for evidence-based practice implementation among nurses: a cross-sectional study. BMC Nurs 2024; 23:62. [PMID: 38254125 PMCID: PMC10801976 DOI: 10.1186/s12912-023-01694-y] [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: 07/13/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The organizational climate that fosters and supports the implementation of evidence is a key factor influencing the effective implementation of evidence-based practice (EBP). Nurses, being the largest group of medical staff, play a crucial role in EBP implementation. The perception of the climate for EBP implementation among nurses in their organizations is unknown, especially among Chinese nurses. AIMS To clarify the implementation climate of EBP among Chinese nurses and identify the factors associated with the implementation and development of evidence-based nursing practices. METHODS This study employed a descriptive cross-sectional study design. From March 2023 to April 2023, a sample of nurses (n = 1260) from two Tertiary care hospitals in central China were selected and surveyed by self-designed social-demographic questionnaire and Implementation Climate Scale. Multiple linear stepwise regression analysis was conducted to determine the predictors of implementation climate. RESULTS The nurses achieved a mean ICS score of 59.10 ± 11.22, with mean scores exceeding 3 points for each sub-dimension and item. In the results of multiple linear regression, income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during working life, and specific training or courses in evidence-based nursing practice were predictors of ICS. Of these, income satisfaction was the most significant predictor. These factors could explain 17.5% of the total variance in implementation climate. CONCLUSION The climate for implementing EBP in Chinese nursing organizations was relatively strong. Nursing managers can enhance the climate for implementing EBP in their organizations by actively improving salary and enhancing EBP-related trainings and practices. RELEVANCE TO CLINICAL PRACTICE Understanding nurses' perceptions of the EBP implementation climate in their organizations can help to identify specific barriers and facilitators to the development of EBP and facilitate its successful implementation. PATIENT OR PUBLIC CONTRIBUTION Clinical nurses were involved in data collection and completed the questionnaires on EBP implementation climate.
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Affiliation(s)
- Xinyue Zhang
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China
| | - Mengting Peng
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China
| | - Mei He
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China
| | - Meijie Du
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China
| | - Mengyao Jiang
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China
| | - Mengying Cui
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China
| | - Yue Cai
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China
| | - Qi Yan
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China
| | - Ying Wang
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China.
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Furtado L, Coelho F, Mendonça N, Soares H, Gomes L, Sousa JP, Duarte H, Costeira C, Santos C, Araújo B. Exploring Professional Practice Environments and Organisational Context Factors Affecting Nurses' Adoption of Evidence-Based Practice: A Scoping Review. Healthcare (Basel) 2024; 12:245. [PMID: 38255132 PMCID: PMC10815808 DOI: 10.3390/healthcare12020245] [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: 12/11/2023] [Revised: 01/07/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
This scoping review, conducted within the Joanna Briggs Institute (JBI) framework, analysed the recent literature (January 2018 to March 2023) addressing factors inherent to professional practice environments and organisational contexts influencing nurses' adoption of evidence-based practice (EBP). This review included studies involving nurses regardless of sector, practice setting, and scope of practice. A systematic search was undertaken across the PubMed, Web of Science, CINAHL, and MEDLINE databases, as well as the EThOS, OATD, and RCAAP platforms. The extracted textual elements underwent a content analysis, resulting in a coding structure established through an inductive approach that categorised information into main categories and subcategories linked by similarity and thematic affinity. Forty-one studies were included, revealing four main categories of factors impacting EBP adoption by nurses: (1) organisational dynamics, (2) management and leadership, (3) teamwork and communication, and (4) resources and infrastructure. The study's limitations acknowledge the subjective nature of categorisation, recognising potential variations based on individual perspectives despite adopting procedures to minimise the risk of bias. The results provide a substantial foundation for developing interventions to cultivate environments conducive to EBP adoption by nurses, thereby enhancing the integration of evidence into nurses' professional practice contexts. This review was prospectively registered on the Open Science Framework (registration no. osf.io/e86qz).
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Affiliation(s)
- Luís Furtado
- Department of Nursing, Mental Health and Gerontology, School of Health, University of the Azores, 9700-042 Angra do Heroísmo, Portugal
- Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal
| | - Fábio Coelho
- Department of Nursing, Mental Health and Gerontology, School of Health, University of the Azores, 9700-042 Angra do Heroísmo, Portugal
| | | | - Hélia Soares
- Department of Nursing, Mental Health and Gerontology, School of Health, University of the Azores, 9700-042 Angra do Heroísmo, Portugal
| | - Luís Gomes
- Department of Nursing, Mental Health and Gerontology, School of Health, University of the Azores, 9700-042 Angra do Heroísmo, Portugal
| | - Joana Pereira Sousa
- Center for Innovative Care and Health Technology—ciTechCare, School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal
| | - Hugo Duarte
- Center for Innovative Care and Health Technology—ciTechCare, School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal
| | - Cristina Costeira
- Center for Innovative Care and Health Technology—ciTechCare, School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal
| | - Cátia Santos
- Center for Innovative Care and Health Technology—ciTechCare, School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal
| | - Beatriz Araújo
- Center for Interdisciplinary Research in Health, Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, 4169-005 Porto, Portugal
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O'Grady K, Flores G. Are Working Nurses Enrolled in Graduate School Aware of Medical Librarians at Their Workplace? A Survey to Close the Research-to-Bedside Gap. Med Ref Serv Q 2024; 43:1-14. [PMID: 38237021 DOI: 10.1080/02763869.2024.2289334] [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] [Indexed: 01/23/2024]
Abstract
This article reports the results from an anonymous survey sent to working graduate nursing students. The survey asked about nurses' awareness of medical librarians at the healthcare institutions where they work. Less than half of the survey respondents were aware that medical librarians were available to them at work. Less than half of the survey respondents claimed they consulted with a medical librarian at work or witnessed another nurse consulting with a medical librarian. The disconnect between academia and patient care is part of the 15-year research-to-bedside gap that exists in nursing. Medical librarians can help to close the gap.
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Hu A, Whitney RL. Evaluating the Impact of an Evidence-Based Practice Education Program in a Nurse Residency Program on Evidence-Based Practice Beliefs, Implementation, and Competency. J Nurses Prof Dev 2024; 40:35-40. [PMID: 37812125 DOI: 10.1097/nnd.0000000000000968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
This quality improvement project examined implementation of the John Hopkins Nursing evidence-based practice (EBP) model, a standardized EBP education curriculum, in a hospital-based nurse residency program. We found that EBP education increased nurse residents' EBP beliefs, implementation frequency, and competencies. Our findings suggest that adopting existing EBP curricula is a convenient and effective approach to EBP education. Staff development professionals should continue to support and advocate for the adoption of EBP education within their organizations.
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Turner K, McNett M, Potter C, Cramer E, Al Taweel M, Shorr RI, Mion LC. Alarm with care-a de-implementation strategy to reduce fall prevention alarm use in US hospitals: a study protocol for a hybrid 2 effectiveness-implementation trial. Implement Sci 2023; 18:70. [PMID: 38053114 PMCID: PMC10696656 DOI: 10.1186/s13012-023-01325-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/22/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Fall prevention alarms are commonly used among US hospitals as a fall prevention strategy despite limited evidence of effectiveness. Further, fall prevention alarms are harmful to healthcare staff (e.g., alarm fatigue) and patients (e.g., sleep disturbance, mobility restriction). There is a need for research to develop and test strategies for reducing use of fall prevention alarms in US hospitals. METHODS To address this gap, we propose testing the effectiveness and implementation of Alarm with Care, a de-implementation strategy to reduce fall prevention alarm use using a stepped-wedge randomized controlled trial among 30 adult medical or medical surgical units from nonfederal US acute care hospitals. Guided by the Choosing Wisely De-Implementation Framework, we will (1) identify barriers to fall prevention alarm de-implementation and develop tailored de-implementation strategies for each unit and (2) compare the implementation and effectiveness of high- versus low-intensity coaching to support site-specific de-implementation of fall prevention alarms. We will evaluate effectiveness and implementation outcomes and examine the effect of multi-level (e.g., hospital, unit, and patient) factors on effectiveness and implementation. Rate of fall prevention alarm use is the primary outcome. Balancing measures will include fall rates and fall-related injuries. Implementation outcomes will include feasibility, acceptability, appropriateness, and fidelity. DISCUSSION Findings from this line of research could be used to support scale-up of fall prevention alarm de-implementation in other healthcare settings. Further, research generated from this proposal will advance the field of de-implementation science by determining the extent to which low-intensity coaching is an effective and feasible de-implementation strategy. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT06089239 . Date of registration: October 17, 2023.
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Affiliation(s)
- Kea Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
- Department of Oncological Sciences, University of South Florida Morsani College of Medicine, MFC-EDU, 12902 USF Magnolia Drive, Tampa, FL, 33612-9416, USA.
| | - Molly McNett
- Helene Fuld Health Trust National Institute for Evidence-Based Practice, The Ohio State University, 760 Kinnear Road, Columbus, OH, 43212, USA
| | - Catima Potter
- Press Ganey Associates, 1173 Ignition Dr, South Bend, IN, 46601, USA
| | - Emily Cramer
- Department of Health Outcomes and Health Services Research, Children's Mercy Hospital and Clinics, 2401 Gilham Road, Kansas City, MO, 64108, USA
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO, 64108, USA
| | - Mona Al Taweel
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH, 43210, USA
| | - Ronald I Shorr
- Geriatric Research Education and Clinical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Road, Gainesville, FL, 32608, USA
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, 1225 Center Drive, Gainesville, FL, 32611, USA
| | - Lorraine C Mion
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH, 43210, USA
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Otts JA, Pittman J, Riley B, Mestas L, Hall H. Academic-Practice Partnership to Prevent and Manage Pressure Injuries: An Evidence-Based Quality Improvement Initiative. J Wound Ostomy Continence Nurs 2023; 50:463-473. [PMID: 37698422 DOI: 10.1097/won.0000000000001019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
PURPOSE This evidence-based quality improvement (EBQI) initiative examined the effect of an academic-practice (A-P) partnership on improvement in quality measures in an acute care setting, specifically hospital-acquired pressure injury (HAPI) prevention and management. DESIGN A pre-/postdescriptive design was conducted using the practice-informed active learning program to guide the project. PARTICIPANTS AND SETTING The EBQI initiative was conducted at a Southern Gulf-Coast university college of nursing and clinical nursing practice leaders at its affiliated 406-bed academic health center/level I trauma center, regional burn center, and comprehensive stroke center. Both institutions are located in the Southeastern United States (Mobile, Alabama). METHODS The A-P council used a participatory action research approach and developed a practice-informed active learning program incorporating Melnyk's evidence-based practice (EBP) steps, the Donabedian Model and the Patient-Centered Outcomes Research Institute (PCORI) Stakeholder Engagement in Question Development and Prioritization (SEED). METHOD Hospital-acquired pressure injuries were selected as the quality outcome to address. To identify HAPI prevention/management evidenced-based practices, the A-P council conducted an integrative literature review and developed a concept map and the Pressure Injury Prevention Gap Analysis Instrument. The gap analysis identified significant gaps between EBP and current pressure injury prevention practices, with priority ranking of gaps for action by key stakeholders. OUTCOME Following the practice-informed active learning program objectives, the A-P council identified 79 HAPI best EBPs organized by Donabedian domains of structure, process, and outcome and prioritized 3 gaps for action. Actions to address the HAPI gaps included: restructuring the hospital HAPI program, incorporating appropriate leadership to guide the HAPI program, modifying the HAPI reporting process, hiring specialized experts (WOC nurses) with emphasis on pressure injury prevention, establishing a standardized HAPI prevalence survey, improving electronic documentation, increasing transparency of HAPI reporting, improving HAPI accountability at the unit level, and exploring technology to enhance skin assessment. While HAPIs increased by 6.3% from 2019 (n = 104) to 2021 (n = 111), HAPI severity (Stages 3 and 4) decreased by 9.9% from 2019 (n = 14, or 13.46%) to 2021 (n = 4, or 3.6%). IMPLICATIONS FOR PRACTICE Our experience with this quality improvement initiative indicates that an A-P partnership can provide a model to address complex clinical problems, quality indicators, and quality improvement while advancing a culture of inquiry and scholarship and building nursing capacity.
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Affiliation(s)
- Jo Ann Otts
- Jo Ann Otts, DNP, RN, NEA-BC, CENP, College of Nursing, University of South Alabama, Mobile
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile
- Bettina Riley, PhD, RN, College of Nursing, University of South Alabama, Mobile
- Lisa Mestas, MSN, RN, BAS, USA Health University Hospital, Mobile, Alabama
- Heather Hall, PhD, RN, NNP-BC, College of Nursing, University of South Alabama, Mobile
| | - Joyce Pittman
- Jo Ann Otts, DNP, RN, NEA-BC, CENP, College of Nursing, University of South Alabama, Mobile
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile
- Bettina Riley, PhD, RN, College of Nursing, University of South Alabama, Mobile
- Lisa Mestas, MSN, RN, BAS, USA Health University Hospital, Mobile, Alabama
- Heather Hall, PhD, RN, NNP-BC, College of Nursing, University of South Alabama, Mobile
| | - Bettina Riley
- Jo Ann Otts, DNP, RN, NEA-BC, CENP, College of Nursing, University of South Alabama, Mobile
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile
- Bettina Riley, PhD, RN, College of Nursing, University of South Alabama, Mobile
- Lisa Mestas, MSN, RN, BAS, USA Health University Hospital, Mobile, Alabama
- Heather Hall, PhD, RN, NNP-BC, College of Nursing, University of South Alabama, Mobile
| | - Lisa Mestas
- Jo Ann Otts, DNP, RN, NEA-BC, CENP, College of Nursing, University of South Alabama, Mobile
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile
- Bettina Riley, PhD, RN, College of Nursing, University of South Alabama, Mobile
- Lisa Mestas, MSN, RN, BAS, USA Health University Hospital, Mobile, Alabama
- Heather Hall, PhD, RN, NNP-BC, College of Nursing, University of South Alabama, Mobile
| | - Heather Hall
- Jo Ann Otts, DNP, RN, NEA-BC, CENP, College of Nursing, University of South Alabama, Mobile
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile
- Bettina Riley, PhD, RN, College of Nursing, University of South Alabama, Mobile
- Lisa Mestas, MSN, RN, BAS, USA Health University Hospital, Mobile, Alabama
- Heather Hall, PhD, RN, NNP-BC, College of Nursing, University of South Alabama, Mobile
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Almarwani AM, Alzahrani NS. Factors affecting the development of clinical nurses' competency: A systematic review. Nurse Educ Pract 2023; 73:103826. [PMID: 37951064 DOI: 10.1016/j.nepr.2023.103826] [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: 07/29/2023] [Revised: 10/22/2023] [Accepted: 10/30/2023] [Indexed: 11/13/2023]
Abstract
AIM To synthesize and analyze the literature on nursing clinical competence to assess the factors affecting nursing clinical competency. BACKGROUND Nursing competence affects not only patients but also nurses themselves. Competent nurses contribute to patient safety. Prioritizing clinical competency enables nurses to deliver high-quality care. Clinical nursing competency is influenced by various factors including education and training, experience, professional development, clinical judgment, decision-making skills and communication. DESIGN This was a systematic review. METHODS This study utilized an extensive literature search of online databases, including SCOPUS, Web of Science and PubMed. This review followed the guidelines provided by the Effective Practice and Organization of Care (EPOC) Cochrane Group and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS This systematic review provided 20 valuable articles, with a total of 6273 participants across the 20 studies, including 18 cross-sectional studies and two descriptive-correlational studies, predominantly using quantitative research methods. The analysis revealed several key factors that significantly affect nurses' clinical competency. These factors included years of experience, workplace environment, theoretical knowledge and educational level, marital status, clinical training, job satisfaction, turnover intention, job stress and critical thinking. CONCLUSIONS Understanding and addressing these factors are crucial for enhancing nurses' clinical competence and ultimately improving patient outcomes. Further research and interventions should be directed towards promoting supportive work environments, continuous education and the development of critical thinking skills among nurses to optimize their clinical competencies.
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Affiliation(s)
- Abdulaziz Mofdy Almarwani
- Department of Psychiatric Nursing, College of Nursing, Taibah University, Medina 42353, Saudi Arabia.
| | - Naif S Alzahrani
- Department of Medical-Surgical Nursing, College of Nursing, Taibah University, Medina 42353, Saudi Arabia
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Schetaki S, Patelarou E, Giakoumidakis K, Kleisiaris C, Patelarou A. Evidence-Based Practice Competency of Registered Nurses in the Greek National Health Service. NURSING REPORTS 2023; 13:1225-1235. [PMID: 37755348 PMCID: PMC10536009 DOI: 10.3390/nursrep13030105] [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: 07/31/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023] Open
Abstract
Nurses' competency toward evidence-based practice (EBP) has been extensively investigated by several studies worldwide. However, factors affecting the competence of Greek nurses working in the NHS have not been fully investigated in terms of EBP. Thus, this study aimed to explore the impact of the individual qualifications of nurses on their competence toward EBP. Data from 473 registered nurses working in 10 hospitals in the Greek National Health Service (NHS) were collected between October and December 2020 using a convenience sampling method in a cross-section design. The Greek version of the 35-item (five-point Likert scale) Evidence-Based Practice Competency Questionnaire for Professional Registered Nurses (EBP-COQ Prof) was used to assess the competence level of nurses, focusing on attitudes, skills, and knowledge, as well as the utilization of EBP in clinical practice. One-way ANOVA and Pearson coefficient tests were applied to compare the possible differences among variables (two or more groups) as appropriate. A multi-factorial regression model was applied to explore participants' qualifications, including demographics (MSc degree, gender, English language knowledge, etc.) as independent variables, and to control for potential confounding effects toward EBP competency. The p-values < 0.05 were considered statistically significant. The mean age of the 473 participants (402 women and 71 men) was 44.7 ± 9.2 years old. The mean value of competence subscales was found as follows: attitudes 3.9 ± 0.6, knowledge 3.7 ± 0.6, skills 3.1 ± 0.8, and utilization 3.4 ± 0.7. A multivariate regression analysis revealed that associates of "Master's degree" (t = 3.039, p = 0.003), "Writing an academic article" (3.409, p = 0.001), "Working in a University clinic" (2.203, p = 0.028), and "Computer Skills" (2.404, p = 0.017) positively affected "Attitudes", "Knowledge", "Skills", and "Utilization", respectively. The research data suggest that nurses working in the Greek NHS were limited in competence regarding EBP in comparison with other European countries. Therefore, vocational, educational, and training programs tailored to EBP enhancement are crucially important. This study was not registered.
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Affiliation(s)
| | | | | | | | - Athina Patelarou
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece; (S.S.); (E.P.); (K.G.); (C.K.)
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Furuki H, Sonoda N, Morimoto A. Factors related to the knowledge and skills of evidence-based practice among nurses worldwide: A scoping review. Worldviews Evid Based Nurs 2023; 20:16-26. [PMID: 36571237 DOI: 10.1111/wvn.12623] [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: 05/26/2022] [Revised: 09/17/2022] [Accepted: 09/22/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Promoting evidence-based practice (EBP) among nurses may be a valuable component of improving health care. However, a comprehensive analysis of the factors associated with the knowledge and skill EBP in nurses has not been performed to date. This is essential for facilitating the acquisition of relevant knowledge and skills to effectively implement EBP. AIMS The aim of the study was to determine the factors related to the knowledge and skills of EBP among nurses. METHODS We searched various literature databases up to October 25, 2021, for relevant studies that investigated the factors associated with the knowledge and skills of EBP in nurses. The authors, year of study, country, study design, study subject information, instruments used for the assessment EBP knowledge and skills, use of multivariable analysis, and factors significantly associated with the knowledge and skills of EBP among nurses were extracted from each eligible study and collated to identify commonly reported factors. RESULTS We identified 47 eligible studies conducted in a wide range of countries. Nine articles applied multivariable analyses, and 38 articles did not perform any multivariable analyses. The factors related to the knowledge and skill levels of EBP among nurses were classified into two categories: personal and work-environment factors. In the nine articles that conducted multivariable analysis, personal factors, which included educational level, participation in EBP education, and experience conducting research, and work-environment factors, such as resources and organizational support for EBP, were related to the knowledge and skills of EBP among nurses. LINKING EVIDENCE TO ACTION Our review highlighted educational level, participation in EBP education, experience conducting research, and resources and organizational support for EBP as important factors that are associated with the knowledge and skills of EBP in nurses worldwide. Focusing on these factors may help improve nurses' understanding of EBP and facilitate the implementation of EBP.
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Affiliation(s)
- Hideaki Furuki
- Graduate School of Nursing, Osaka Metropolitan University, Osaka, Japan
| | - Nao Sonoda
- Graduate School of Nursing, Osaka Metropolitan University, Osaka, Japan
| | - Akiko Morimoto
- Graduate School of Nursing, Osaka Metropolitan University, Osaka, Japan
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Cleary-Holdforth J, Leufer T, Baghdadi NA, Almegewly W. Organizational culture and readiness for evidence-based practice in the Kingdom of Saudi Arabia: A pre-experimental study. J Nurs Manag 2022; 30:4560-4568. [PMID: 36200560 PMCID: PMC10091796 DOI: 10.1111/jonm.13856] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/22/2022] [Accepted: 10/02/2022] [Indexed: 12/30/2022]
Abstract
AIM This study aims to establish postgraduate students' perceptions of the organizational culture and readiness for evidence-based practice of their workplaces in the Kingdom of Saudi Arabia. BACKGROUND Nurse shortages and a reliance on a transient nurse workforce have long been a challenge in the Kingdom of Saudi Arabia. Developing a home-grown nurse workforce, a key objective of the Government of Saudi Arabia, can help to address this. Evidence-based practice offers a mechanism to address this. Evidence-based practice implementation is heavily reliant on the prevailing organizational culture. Establishing the organizational culture and readiness for evidence-based practice is crucial for sustainable evidence-based practice implementation. METHODS A pre-experimental pilot study collected data from the same participants at three different points. As part of this, a questionnaire measuring organizational culture and readiness for evidence-based practice was administered twice. Descriptive, inferential and correlational statistics were employed to analyse the data. RESULTS Results demonstrated improved participant perceptions of the organizational culture and readiness for evidence-based practice of their workplaces between the first (M = 76.58, SD = 19.2) and second (M = 92.10, SD = 23.68) data collection points, indicating moderate movement towards a culture of evidence-based practice. Strengths, challenges and opportunities for improvement were identified. CONCLUSION This study established participants' perceptions of the organizational culture and readiness for evidence-based practice of their workplaces, affording insight into context-specific strategies to embed evidence-based practice in health care organizations. IMPLICATIONS FOR NURSING MANAGEMENT Assessing an organization's culture and readiness for evidence-based practice (EBP) can afford insight on the strengths, challenges and opportunities that exist to equip nurse managers to advance evidence-based practice at individual, professional and organizational levels. This study demonstrated the importance of promoting an environment conducive to EBP and putting in place the necessary resources to support evidence-based practice implementation. Nurse managers can play a central role in this.
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Affiliation(s)
- Joanne Cleary-Holdforth
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Therese Leufer
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Nadiah A Baghdadi
- Nursing Management and Education Department, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Wafa Almegewly
- Community Health Nursing Department, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Thompson L. Using mixed-methods in evidence-based nursing: a scoping review guided by a socio-ecological perspective. J Res Nurs 2022; 27:639-652. [PMID: 36405803 PMCID: PMC9669941 DOI: 10.1177/17449871221113740] [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: 11/03/2023] Open
Abstract
Background Increased pressure for evidence-based practice in nursing necessitates that researchers use effective approaches. Mixed-methods research (MMR) has potential to improve the knowledge and implementation of evidence-based nursing (EBN) by generating outcome-based and contextually-focused evidence. Aims To identify methodological trends in how MMR is used in EBN research. Methods Searches were completed in PubMed, CINAHL, and Google Scholar using the terms "nursing", "mixed-methods", and "evidence-based". Seventy-two articles using MMR to address EBN and published 2000-2021 were reviewed across content themes and methodological domains of the Socio-Ecological Framework for MMR. Results Mixed-methods research has been used to study how EBN strategies are perceived, developed and assessed, and implemented or evaluated. A few studies provided an MMR definition reflecting the methods perspective, and the dominant MMR rationale was gaining a comprehensive understanding of the issue. The leading design was concurrent, and half of studies intersected MMR with evaluation, action/participatory, and/or case-study approaches. Research quality was primarily assessed using criteria specific to quantitative and qualitative approaches. Conclusions Mixed-methods research has great potential to enhance EBN research by generating more clinically useful findings and helping nurses understand how to identify and implement the best available research evidence in practice.
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Affiliation(s)
- Lieu Thompson
- PhD Candidate, Health Services Administration, The University of Alabama at
Birmingham, Birmingham, AL, USA
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Saul T, Rangel T, Sperry MV, Doyle C, Roney JK, Mendelson S. Influence of a Formal Mentor on Hospital-Based Nurse Research Resources and Outcomes. J Nurs Adm 2022; 52:549-553. [PMID: 36166632 DOI: 10.1097/nna.0000000000001197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Magnet® hospitals must conduct nursing research to maintain designation. Relationships between hospital research infrastructure, activities, and a designated nurse research mentor were explored in a large health system using survey methodology. Hospitals with a formal mentor reported more research resources (n = 23, m = 2.5) compared with those without (n = 16, m = 1.8, P < 0.001). Hospitals aspiring for Magnet may benefit from a doctorally prepared research mentor.
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Affiliation(s)
- Trisha Saul
- Author Affiliations: Associate Nurse Scientist (Dr Saul), Providence Southern California Region, Irvine; Nurse Scholar (Dr Rangel), Providence Health Care, Spokane, Washington; Clinical Nurse (Dr Sperry), Cedars-Sinai Tarzana Medical Center, Tarzana, California; Chief Nursing Officer (Dr Doyle), Providence Alaska Medical Center, Anchorage; Nursing Professional Development Specialist (Dr Roney), Covenant Health, Lubbock, Texas; and Nurse Scientist (Dr Mendelson), Providence Holy Cross Medical Center, Mission Hills, California
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Tucker S, McNett M, O'Leary C, Rosselet R, Mu J, Thomas B, Gallagher‐Ford L, Melnyk BM. EBP education and skills building for leaders: An RCT to promote EBP infrastructure, process and implementation in a comprehensive cancer center. Worldviews Evid Based Nurs 2022; 19:359-371. [PMID: 35923135 PMCID: PMC9804542 DOI: 10.1111/wvn.12600] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/22/2022] [Accepted: 05/25/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Implementation of evidence-based practice (EBP) in healthcare remains challenging. The influence of leadership has been recognized. However, few randomized trials have tested effects of an educational and skills building intervention for leaders in clinical settings. AIMS Test effects of an EBP leadership immersion intervention on EBP attributes over time among two cohorts of leaders at a national comprehensive cancer center. METHODS A stratified, randomized, wait-list group, controlled design was conducted. Participants received the evidence-based intervention one year apart (2020, n = 36; 2021, n = 30) with EBP knowledge, beliefs, competencies, implementation self-efficacy, implementation behaviors, and organizational readiness measured at pre- and post-intervention, and one- and two-year follow-ups. Participants applied learnings to a specific clinical or organization priority topic. RESULTS Baseline outcomes variables and demographics did not differ between cohorts except for age and years of experience. Both cohorts demonstrated significant changes in EBP attributes (except organizational readiness) post-intervention. Mixed linear modeling revealed group by time effects at 3-months for all EBP attributes except implementation behaviors and organizational readiness after the first intervention, favoring cohort 2020, with retained effects for EBP beliefs and competencies at one year. Following Cohort 2021 intervention, at 12-weeks post-intervention, implementation behaviors were significantly higher for cohort 2021. LINKING EVIDENCE TO ACTION An intensive EBP intervention can increase healthcare leaders' EBP knowledge and competencies. Aligning EBP projects with organizational priorities is strategic. Follow-up with participants to retain motivation, knowledge and competencies is essential. Future research must demonstrate effects on clinical outcomes.
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Affiliation(s)
- Sharon Tucker
- Helene Fuld Health Trust National Institute for EBPColumbusOhioUSA
| | - Molly McNett
- Implementation/Translation Science Core, Helene Fuld Health Trust National Institute for EBPColumbusOhioUSA
| | - Colleen O'Leary
- Evidence‐Based Practice James Cancer Hospital Department of Research and Evidence‐Based PracticeColumbusOhioUSA
| | | | - Jinjian Mu
- The Ohio State UniversityColumbusOhioUSA
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Sabin LL, Mesic A, Le BN, Halim N, Cao CTH, Bonawitz R, Nguyen HV, Larson A, Nguyen TTT, Le AN, Gill CJ. Costs and Cost-Effectiveness of mCME Version 2.0: An SMS-Based Continuing Medical Education Program for HIV Clinicians in Vietnam. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-22-00008. [PMID: 36041848 PMCID: PMC9426988 DOI: 10.9745/ghsp-d-22-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/24/2022] [Indexed: 11/15/2022]
Abstract
This cost analysis found that a mobile phone-based continuing medical education (mCME) intervention, involving daily text messages with links to relevant materials, for HIV clinicians in northern Vietnam was relatively low-cost and cost-effective, particularly for future nationwide models. Such mobile approaches to CME are worthy of attention in resource-constrained settings. Background: The Mobile Continuing Medical Education (mCME) 2.0 project was a randomized controlled trial that found that a 6-month text message-based CME intervention improved both the use of online medical training resources and medical knowledge among a cadre of HIV clinicians in Vietnam. This companion study analyzed intervention costs and cost-effectiveness. Methods: We conducted (1) a financial analysis based on costs incurred during the trial’s planning and implementation; (2) an economic analysis to consider resource utilization; and (3) cost-effectiveness analyses to estimate cost inputs relative to impact: increase in self-study (measured by visits to online courses) and increase in knowledge (measured by exam score improvement) (in 2016 US$). Finally, we estimated the economic cost of a 9-month national program and a 10-year scaled-up model (in 2021 US$). Results: The total financial cost of the intervention was US$49,552; the main cost drivers were personnel time (71.4%) and technology inputs (14.9%). The total economic cost was estimated at US$92,212, with the same key cost inputs (representing 77.7% and 8.0%, respectively, of total costs). The financial cost per 10% increase in accessing online courses was US$923, while the cost of improving knowledge, measured by a 10% improvement in mean exam score across the study population, was US$32,057 (US$605 per intervention clinician). The comparable total economic cost of each improvement, respectively, was US$1,770 and US$61,452 (US$1,159 per intervention clinician). A future 9-month national program was estimated to cost US$37,403, while the full 10-year scaled-up program was estimated at US$196,446. Conclusions: This analysis indicates that leveraging mobile technology could be a feasible way to provide distance learning to health professions across Vietnam at a relatively low cost. Given the need for practical ways to expand CME in resource-constrained regions of the world, this approach warrants further study and possible adoption.
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Affiliation(s)
- Lora L Sabin
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA.
| | - Aldina Mesic
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Bao Ngoc Le
- Consulting Research for Community Development, Hanoi, Vietnam
| | - Nafisa Halim
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Chi Thi Hue Cao
- Vietnam Administration for AIDS Control, Ministry of Health, Hanoi, Vietnam
| | - Rachael Bonawitz
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Ha Viet Nguyen
- Center for Population Research Information and Databases, General Office for Population and Family Planning, Ministry of Health, Hanoi, Vietnam
| | - Anna Larson
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Tam Thi Thanh Nguyen
- Center for Population Research Information and Databases, General Office for Population and Family Planning, Ministry of Health, Hanoi, Vietnam
| | | | - Christopher J Gill
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
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McNett M, Tucker S, Zadvinskis I, Tolles D, Thomas B, Gorsuch P, Gallagher-Ford L. A Qualitative Force Field Analysis of Facilitators and Barriers to Evidence-Based Practice in Healthcare Using an Implementation Framework. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2022; 2:195-208. [PMID: 35974880 PMCID: PMC9373890 DOI: 10.1007/s43477-022-00051-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/20/2022] [Indexed: 11/01/2022]
Abstract
Research has identified facilitators and barriers to implementation of evidence-based practices (EBPs). Few studies have evaluated which factors persist among healthcare clinicians with extensive education and training on EBP implementation. Therefore, the purpose of this study was to examine facilitators and barriers to EBP implementation across a national sample of specialty-prepared EBP mentors in healthcare settings. Healthcare clinicians participating in an immersive 5-day EBP knowledge and skill building program were invited to complete a follow-up survey 12 months later to report on implementation experiences. The Consolidated Framework for Implementation Research (CFIR) guided content analysis of responses. A force field analysis using Lewin’s change theory was used to assign numerical ‘weights’ to factors. Eighty-four individuals reported facilitators and barriers to implementation. The majority occurred within the inner setting of the CFIR model. Facilitators were strong leadership engagement (n = 15), positive EBP culture (n = 9), and resources (n = 4). Barriers included lack of resources (n = 21), poor leadership engagement (n = 19), implementation climate (n = 17), lack of relative priority (n = 12), and organizational characteristics (n = 9). Respondents also identified simultaneous facilitators and barriers within the process domain of the CFIR model. The construct of stakeholder engagement was a barrier when absent from the implementation process (n = 23), yet was a strong facilitator when present (n = 23). Implementation in healthcare settings appears most effective when conducted by an interprofessional team with strong leadership, resources, stakeholder engagement, and positive EBP culture. When these same factors are absent, they remain persistent barriers to implementation, even among specialty-trained healthcare clinicians.
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Hines S, Ramsbotham J, Coyer F. The Experiences and Perceptions of Nurses Interacting With Research Literature: A Qualitative Systematic Review to Guide Evidence-Based Practice. Worldviews Evid Based Nurs 2021; 18:371-378. [PMID: 34729898 DOI: 10.1111/wvn.12542] [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] [Accepted: 05/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is an evidence that some nurses struggle with reading and using research. This struggle becomes a barrier to engaging in evidence-based practice (EBP). Personal beliefs, attitudes about research, and difficulties with research language and statistics have been reported as important variables in quantitative studies. AIMS The aim of this review was to explore nurses' experiences and perceptions of interacting with research literature for work or educational purposes. METHODS Studies eligible for inclusion were qualitative, published in English from years 2009-2020, and included registered nurses engaged in interaction with research literature for any work or educational purpose. The Joanna Briggs Institute's qualitative systematic review methods were used. RESULTS We included 11 qualitative studies with 186 participants. Most studies used focus groups or semi-structured interviews to collect data. Overall, study quality was moderate. We extracted 29 findings, which were synthesized into five categories, and meta-aggregated into one synthesis. Research is a complex field of engagement for nurses, who simultaneously value its contribution to their profession and feel the burden of unsupported expectations. Nurses perceive a double standard in their workplaces where expectations of using evidence in practice are often discussed, but EBP education and access to literature can be hard to access. LINKING EVIDENCE TO ACTION Educators conducting research education should consider the complex emotional reactions this activity may engender in participants who may feel unprepared by their previous experience or education. Clinicians and workplace leaders trying to encourage the use of evidence in practice should consider the source of any reluctance to engage. An observed lack of engagement in their staff may be related to issues with understanding the materials.
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Affiliation(s)
- Sonia Hines
- Centre for Remote Health: a JBI Affiliated Group, Flinders University, Alice Springs, NT, Australia.,School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Joanne Ramsbotham
- School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Fiona Coyer
- School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia.,Royal Brisbane and Women's Hospital, Herston, QLD, Australia
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Rana R, Caron MP, Kanters S. Nurse mentored, student research in undergraduate nursing education to support evidence-based practice: A pilot study. Nurs Forum 2021; 57:225-233. [PMID: 34713907 DOI: 10.1111/nuf.12667] [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: 08/04/2021] [Revised: 10/01/2021] [Accepted: 10/22/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim was to investigate if an extracurricular research skills development program builds the knowledge, attitudes, and skills (KAS) to support evidence-based practice (EBP). METHODS Twenty nursing students and six mentors in four teams completed small, student-led research projects over 1 year. Using a mixed-methods design, the knowledge, attitudes, and practice (KAP) survey was administered at three-time points, followed by qualitative interviews. A linear mixed-effects regression model was used to analyze survey data and thematic analysis for qualitative data. RESULTS The change from the KAP survey from the first to the third time point showed a statistically significant difference following engagement in the program. Qualitative data indicated benefits and challenges to participation for both students and mentors. Mentorship provided students with improved relationships, collaboration, and leadership skills. Students believed the program enhanced their understanding of research and reported increased confidence in using EBP. CONCLUSION Offering students innovative first-hand experiences with research develops research KAS to support EBP.
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Affiliation(s)
- Ruhina Rana
- Bachelor of Science in Nursing Program, Douglas College, Coquitlam, British Columbia, Canada
| | - Marie-Pier Caron
- Bachelor of Science in Nursing Program, Douglas College, Coquitlam, British Columbia, Canada
| | - Steve Kanters
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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A pre-experimental pilot study exploring EBP Beliefs and EBP Implementation among post-graduate student nurses in Saudi Arabia. Nurse Educ Pract 2021; 57:103215. [PMID: 34700260 DOI: 10.1016/j.nepr.2021.103215] [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: 12/18/2020] [Revised: 09/07/2021] [Accepted: 09/20/2021] [Indexed: 11/21/2022]
Abstract
AIM This study aimed to measure the impact of a dedicated EBP module on the knowledge, skills and capability for EBP of students undertaking the inaugural MSc in Nursing: Advanced Practice programme in the KSA. BACKGROUND Evidence-based practice (EBP) yields multiple benefits for all key stakeholders of healthcare. Key to this are healthcare professionals armed with necessary EBP knowledge and skills. Nurses, the largest professional group in healthcare, can be instrumental in effecting sustained EBP implementation. In the Kingdom of Saudi Arabia (KSA) achieving this is hindered by a chronic shortage of nurses and a heavy reliance on expatriate nurses who are often a transient workforce, resulting in a high turnover. The Government of Saudi Arabia 2030 Vision aspires to address the indigenous nurse shortage and the quality of healthcare. In 2017 the inaugural MSc in Nursing: Advanced Practice programme was established in the KSA to prepare Saudi nurses for emerging advanced practice roles. A dedicated EBP module was a core component of the programme. METHODS A pre-experimental pilot study conducted over 18-months collected data from the same participants at three different points. Two validated EBP questionnaires measuring EBP Beliefs and EBP Implementation were administered to post-graduate students undertaking the MSc in Nursing: Advanced Practice programme in one Higher Education Institution in the KSA. Descriptive, inferential and correlational statistics were employed to analyse the demographic data, group mean scores and distribution on the EBP scales, as well the correlation between EBP Beliefs and EBP Implementation. FINDINGS Findings demonstrated that the educational intervention did improve participants' EBP beliefs and implementation. Participants reported positive beliefs about EBP at all 3 data collection points (M = 57.4 SD = 7.0; M = 62.54 SD = 7.21; M = 55.31 SD = 15.81, respectively). EBP implementation was low prior to undertaking the module but improved thereafter as illustrated across the 3 data collection points (M = 15.14 SD = 11.9; M = 27.64 SD = 14.35; M = 25.9 SD = 20.43). On both measures, higher scores indicate higher EBP beliefs and implementation. CONCLUSION This study established the EBP Beliefs and EBP Implementation of a sample of postgraduate nursing students in the KSA. Findings revealed a substantial improvement in both EBP Beliefs and EBP Implementation following the EBP module. Findings support the use of a dedicated module to prepare nurses to use EBP and to practice at an advanced level while simultaneously preparing them for leadership roles in healthcare in KSA. In so doing, this will help to advance the healthcare goals of the KSA 2030 vision.
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Melnyk BM, Tan A, Hsieh AP, Gallagher-Ford L. Evidence-Based Practice Culture and Mentorship Predict EBP Implementation, Nurse Job Satisfaction, and Intent to Stay: Support for the ARCC © Model. Worldviews Evid Based Nurs 2021; 18:272-281. [PMID: 34309169 DOI: 10.1111/wvn.12524] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Advancing Research and Clinical practice through close Collaboration (ARCC© ) Model is a system-wide framework for implementing and sustaining evidence-based practice (EBP) in hospitals and healthcare systems. The model involves assessing organizational culture and readiness for EBP in addition to the development of a critical mass of EBP mentors who work with point-of-care clinicians to facilitate the implementation of evidence-based care. Determining how the various components of the ARCC© Model relate to one another is important for understanding how EBP culture and mentorship impact EBP implementation, nurses' job satisfaction, and intent to stay. AIMS The current study aimed to test a model that could explain the relationships and direct pathways among eight key variables in the ARCC© Model: (1) EBP culture, (2) mentorship, (3) knowledge, (4) beliefs, (5) competency, (6) implementation, (7) nurses' job satisfaction, and (8) intent to stay. METHODS Structural equation modeling was used to test relationships among the variables in the ARCC© Model with data obtained from an earlier cross-sectional descriptive study with 2,344 nurses from 19 hospitals and healthcare systems across the United States. RESULTS The final structural equation model found that EBP culture and mentorship were key variables that positively impacted EBP knowledge, beliefs, competency, implementation, job satisfaction, and intent to stay among nurses. LINKING EVIDENCE TO ACTION As described in the ARCC© Model, establishing a strong sustainable EBP culture along with a critical mass of EBP mentors is crucial for the development of EBP competency and consistent implementation of evidence-based care by nurses. A strong EBP culture along with EBP mentorship also can result in higher job satisfaction and intent to stay. Implementation of the ARCC© Model is a key strategy in assisting systems to reach health care's Quadruple Aim.
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Affiliation(s)
- Bernadette Mazurek Melnyk
- The Ohio State University, Columbus, Ohio, 43210, USA.,College of Nursing, The Ohio State University, Columbus, Ohio, USA.,The Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare, College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Alai Tan
- Center of Research and Health Analytics, College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | | | - Lynn Gallagher-Ford
- The Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare, College of Nursing, The Ohio State University, Columbus, Ohio, USA
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Melnyk BM, Hsieh AP, Gallagher-Ford L, Thomas B, Guo J, Tan A, Buck J. Psychometric Properties of the Short Versions of the EBP Beliefs Scale, the EBP Implementation Scale, and the EBP Organizational Culture and Readiness Scale. Worldviews Evid Based Nurs 2021; 18:243-250. [PMID: 34288388 DOI: 10.1111/wvn.12525] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Evidence-based practice (EBP) is a problem-solving approach to clinical decision making that leads to a higher quality and safety of health care. Three valid and reliable scales that measure EBP attributes, including the EBP Beliefs Scale, the EBP Implementation Scale, and the Organizational Culture and Readiness Scale for System-Wide Integration of EBP, are widely used but require approximately 5 min each to complete. Shorter valid and reliable versions of these scales could offer the benefit of less time for completion, thereby decreasing participant burden. AIM The aim of this study was to determine the psychometric properties of the three shortened EBP scales, adapted from the longer versions. METHODS This study used a descriptive survey design with 498 nurses who completed the three original EBP scales along with a shortened version of each scale. Exploratory factor analysis was conducted with principal components extracted to examine the factor structure of each EBP measure for the three shortened EBP scales. Item intercorrelations and the Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO) were used to confirm the validity of using factor analysis. Reliability of each scale using Cronbach's α was examined. Convergent validity of the three shortened EBP scales was assessed by correlating each shortened scale with its longer scale. RESULTS Factor analysis supported the construct validity of each of the three shortened scales, as all item intercorrelations were greater than 0.40, and KMO values were 0.62 to 0.74. The shortened scales Cronbach alphas were 0.81 for the EBP Beliefs Scale, 0.89 for the EBP Implementation Scale, and 0.87 for the EBP Culture and Readiness Scale. The three shortened EBP scales had acceptable convergent validity (r = 0.42-.072) for the correlations between the shortened and longer scales. LINKING EVIDENCE TO ACTION The three shortened EBP scales, which are valid and reliable, can be used as an alternative to the longer three scales to decrease participant burden when conducting program evaluations, research, or organizational assessments.
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Affiliation(s)
| | | | - Lynn Gallagher-Ford
- The Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare, College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Bindu Thomas
- The Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare, College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Jinhong Guo
- Center of Research and Health Analytics, College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Alai Tan
- Center of Research and Health Analytics, College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Jacalyn Buck
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
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Tucker S, McNett M, Mazurek Melnyk B, Hanrahan K, Hunter SC, Kim B, Cullen L, Kitson A. Implementation Science: Application of Evidence-Based Practice Models to Improve Healthcare Quality. Worldviews Evid Based Nurs 2021; 18:76-84. [PMID: 33779042 DOI: 10.1111/wvn.12495] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Translating research into practice is complex for clinicians, yet essential for high quality patient care. The field of implementation science evolved to address this gap by developing theoretical approaches to guide adoption and sustained implementation of practice changes. Clinicians commonly lack knowledge, time, and resources of how evidence-based practice (EBP) models can guide implementation, contributing to the knowledge-to-practice gap. AIM This paper aimed to equip clinicians and other healthcare professionals with implementation science knowledge, confidence, and models to facilitate EBP change in their local setting and ultimately improve healthcare quality, safety, and population health outcomes. METHODS The field of implementation science is introduced, followed by application of three select models. Models are applied to a clinical scenario to emphasize contextual factors, process, implementation strategies, and outcome evaluation. Key attributes, strengths, opportunities, and utilities of each model are presented, along with general resources for selecting and using published criteria to best fit clinical needs. Partnerships between implementation scientists and clinicians are highlighted to facilitate the uptake of evidence into practice. LINKING EVIDENCE TO ACTION Knowledge of implementation science can help clinicians adopt high-quality evidence into their practices. Application-oriented approaches can guide clinicians through the EBP processes. Clinicians can partner with researchers in advancing implementation science to continue to accelerate the adoption of evidence and reduce the knowledge-to-action gap.
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Affiliation(s)
- Sharon Tucker
- Implementation Science Core, Helene Fuld Health Trust National Institute for EBP, College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Molly McNett
- Implementation Science, Helene Fuld Health Trust National Institute for EBP, College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Bernadette Mazurek Melnyk
- Implementation Science Core, Helene Fuld Health Trust National Institute for EBP, College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Kirsten Hanrahan
- Department of Nursing Services and Patient Care, University of Iowa Health Care, Iowa City, IA, USA
| | - Sarah C Hunter
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Bo Kim
- HSR&D Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Laura Cullen
- Department of Nursing Services and Patient Care, University of Iowa Health Care, Iowa City, IA, USA
| | - Alison Kitson
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
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Rawas H. The theory of evidence-based practice among clinical teaching assistants at a college of nursing in Jeddah, Saudi Arabia. SAUDI JOURNAL FOR HEALTH SCIENCES 2021. [DOI: 10.4103/sjhs.sjhs_35_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Melnyk BM, Zellefrow C, Tan A, Hsieh AP. Differences Between Magnet and Non-Magnet-Designated Hospitals in Nurses' Evidence-Based Practice Knowledge, Competencies, Mentoring, and Culture. Worldviews Evid Based Nurs 2020; 17:337-347. [PMID: 33022875 DOI: 10.1111/wvn.12467] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Obtaining Magnet recognition is important to hospitals as it has been linked to positive nursing and patient outcomes. Evidence-based practice (EBP) also has been shown to positively impact these same outcomes. However, the effect that Magnet designation has on different facets of EBP when compared to non-designated institutions is less understood. AIMS To determine the differences between Magnet-designated versus non-Magnet-designated hospitals on nurses' EBP knowledge, competency, mentoring, and culture. METHODS A secondary analysis was performed on data obtained from the Melnyk et al. (2018) national study of U.S. nurses' EBP competencies. RESULTS 2,344 nurses completed the survey (n = 1,622 Magnet and n = 638 non-Magnet). Magnet-designated hospital nurses had higher scores in EBP knowledge (mean ± SD: 19.9 ± 6.8 vs. 19.1 ± 7.0, Cohen's d = 0.12), mentoring (22.6 ± 11.1 vs. 18.6 ± 10.1, d = 0.38), and culture (82.9 ± 21.8 vs. 74.1 ± 21.3, d = 0.41). There was no difference between the two groups in EBP competency scores (53.8 ± 16.2 vs. 53.0 ± 15.9, d = 0.05), and average scores for the 24 EBP competency items were less than competent in both groups. LINKING EVIDENCE TO PRACTICE Despite having higher knowledge, stronger perceived EBP cultures, and greater EBP mentoring than non-Magnet-designated nurses, Magnet nurses did not meet the EBP competencies. A tremendous need exists to provide nurses with the knowledge and skills to achieve the EBP competencies in both Magnet and non-Magnet-designated hospitals. A critical mass of EBP mentors who also meet the EBP competencies is needed to work with point-of-care nurses to ensure that EBP competency is achieved in order to ultimately ensure healthcare quality and safety. Rigorous studies are needed to determine which interventions at the academic and clinical education level result in improved EBP competency.
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Affiliation(s)
- Bernadette Mazurek Melnyk
- Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, The Ohio State University, Columbus, OH, USA
| | - Cindy Zellefrow
- Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, The Ohio State University, Columbus, OH, USA
| | - Alai Tan
- Center of Research of Health Analytics, College of Nursing, The Ohio State University, Columbus, OH, USA
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