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Wang Z, Wen N, Ren Y, Liang W, Ding Y, Ji M, Xu M, Chen C, Song Y, Chen X. Mediating Role of Evidence-Based Nursing Competence Between Specialist Nurses' Information Literacy and Innovative Behaviour: A Multicentre Cross-Sectional Study. J Adv Nurs 2024. [PMID: 39206870 DOI: 10.1111/jan.16433] [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: 05/12/2024] [Revised: 07/19/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024]
Abstract
AIM To investigate the levels of information literacy, evidence-based nursing competence and innovative behaviour in specialist nurses, determine the impact of information literacy and evidence-based nursing competence on the innovative behaviour of specialist nurses and to analyse the mediating role of evidence-based nursing competence between information literacy and innovative behaviour among specialist nurses. DESIGN A multicenter cross-sectional design. METHODS In March 2024, a survey was conducted on 313 specialist nurses in four tertiary Grade A comprehensive hospitals in China. Data collection involved the utilization of general demographic questionnaire, the Information Literacy Questionnaire, the Evidence-Based Nursing Competence Scale and the Nurse Innovation Behaviour Scale. The data were analysed using IBM SPSS26 and Amos28 software. RESULTS Specialist nurses scored above average in information literacy, evidence-based nursing competence and innovative behaviour. Information literacy significantly positively correlated with innovative behaviour. Evidence-based nursing competence also positively affected innovative behaviour and partially mediated the relationship between information literacy and innovative behaviour. CONCLUSION This research indicated that specialist nurses exhibited above-average levels of evidence-based nursing competence, information literacy and innovative behaviour. Both information literacy and evidence-based nursing competence positively impacted innovative behaviour, with evidence-based nursing competence playing a significant mediating role between information literacy and innovative behaviour. IMPACT The findings suggest that nursing managers should focus on enhancing information literacy and evidence-based nursing competence in specialist nurses. Improving these abilities will support the implementation of innovative practices and advance the nursing field. REPORTING METHOD The research findings were presented in strict accordance with the STROBE statement. PATIENT OR PUBLIC CONTRIBUTION Not applicable. CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY It provides reference guidance and theoretical basis for global nursing managers to formulate targeted interventions, so as to effectively enhance the innovative behaviour of specialist nurses.
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Affiliation(s)
- Zeen Wang
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Na Wen
- Department of Nursing, Huai'an 82 Hospital, Huai'an, Jiangsu, China
| | - Yuanpeng Ren
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wei Liang
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yaping Ding
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Minghui Ji
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Min Xu
- Department of Nursing, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Chunyan Chen
- Department of Nursing, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yan Song
- Department of Nursing, The Second Hospital of Nanjing, Nanjing, Jiangsu, China
| | - Xian Chen
- Department of Outpatient, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
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Gundo R, Mulaudzi MF. Collaborative design of a health research training programme for nurses and midwives in Tshwane district, South Africa: a study protocol. BMJ Open 2024; 14:e076959. [PMID: 38569696 PMCID: PMC11146391 DOI: 10.1136/bmjopen-2023-076959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 03/14/2024] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Nurses are essential for implementing evidence-based practices to improve patient outcomes. Unfortunately, nurses lack knowledge about research and do not always understand research terminology. This study aims to develop an in-service training programme for health research for nurses and midwives in the Tshwane district of South Africa. METHODS AND ANALYSIS This protocol outlines a codesign study guided by the five stages of design thinking proposed by the Hasso-Plattner Institute of Design at Stanford University. The participants will include nurses and midwives at two hospitals in the Tshwane district, Gauteng Province. The five stages will be implemented in three phases: Phase 1: Stage 1-empathise and Stage 2-define. Exploratory sequential mixed methods including focus group discussions with nurses and midwives (n=40), face-to-face interviews (n=6), and surveys (n=330), will be used in this phase. Phase 2: Stage 3-ideate and Stage 4-prototype. A team of research experts (n=5), nurses and midwives (n=20) will develop the training programme based on the identified learning needs. Phase 3: Stage 5-test. The programme will be delivered to clinical nurses and midwives (n=41). The training programme will be evaluated through pretraining and post-training surveys and face-to-face interviews (n=4) following training. SPSS V.29 will be used for quantitative analysis, and content analysis will be used to analyse qualitative data. ETHICS AND DISSEMINATION The protocol was approved by the Faculty of Health Sciences Research Ethics Committee of the University of Pretoria (reference number 123/2023). The protocol is also registered with the National Health Research Database in South Africa (reference number GP_202305_032). The study findings will be disseminated through conference presentations and publications in peer-reviewed journals.
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Affiliation(s)
- Rodwell Gundo
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
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Castiglione SA, Lavoie-Tremblay M, Kilpatrick K, Gifford W, Semenic SE. Exploring Shared Implementation Leadership of Point of Care Nursing Leadership Teams on Inpatient Hospital Units: Protocol for a Collective Case Study. JMIR Res Protoc 2024; 13:e54681. [PMID: 38373024 PMCID: PMC10912983 DOI: 10.2196/54681] [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: 12/01/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Nursing leadership teams at the point of care (POC), consisting of both formal and informal leaders, are regularly called upon to support the implementation of evidence-based practices (EBPs) in hospital units. However, current conceptualizations of effective leadership for successful implementation typically focus on the behaviors of individual leaders in managerial roles. Little is known about how multiple nursing leaders in formal and informal roles share implementation leadership (IL), representing an important knowledge gap. OBJECTIVE This study aims to explore shared IL among formal and informal nursing leaders in inpatient hospital units. The central research question is as follows: How is IL shared among members of POC nursing leadership teams on inpatient hospital units? The subquestions are as follows: (1) What IL behaviors are enacted and shared by formal and informal leaders? (2) What social processes enable shared IL by formal and informal leaders? and (3) What factors influence shared IL in nursing leadership teams? METHODS We will use a collective case study approach to describe and generate an in-depth understanding of shared IL in nursing. We will select nursing leadership teams on 2 inpatient hospital units that have successfully implemented an EBP as instrumental cases. We will construct data through focus groups and individual interviews with key informants (leaders, unit staff, and senior nurse leaders), review of organizational documents, and researcher-generated field notes. We have developed a conceptual framework of shared IL to guide data analysis, which describes effective IL behaviors, formal and informal nursing leaders' roles at the POC, and social processes generating shared leadership and influencing contextual factors. We will use the Framework Method to systematically generate data matrices from deductive and inductive thematic analysis of each case. We will then generate assertions about shared IL following a cross-case analysis. RESULTS The study protocol received research ethics approval (2022-8408) on February 24, 2022. Data collection began in June 2022, and we have recruited 2 inpatient hospital units and 25 participants. Data collection was completed in December 2023, and data analysis is ongoing. We anticipate findings to be published in a peer-reviewed journal by late 2024. CONCLUSIONS The anticipated results will shed light on how multiple and diverse members of the POC nursing leadership team enact and share IL. This study addresses calls to advance knowledge in promoting effective implementation of EBPs to ensure high-quality health care delivery by further developing the concept of shared IL in a nursing context. We will identify strategies to strengthen shared IL in nursing leadership teams at the POC, informing future intervention studies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54681.
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Affiliation(s)
| | | | | | - Wendy Gifford
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
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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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Chironda G, Jarvis MA, Brysiewicz P. Family-Focused Nursing Research in WHO Afro-Region Member States: A Scoping Review. JOURNAL OF FAMILY NURSING 2023; 29:136-154. [PMID: 36433834 PMCID: PMC10160405 DOI: 10.1177/10748407221132018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Although family nursing research has become an important focus for over the past 20 years, the evolution and extent of family nursing research in the World Health Organization (WHO) Afro-regions is less explored. The purpose of this scoping review was to map the evidence of family-focused nursing research using the Joanna Briggs Institute Scoping Review methodology. A systematic electronic search of articles was carried out for the period January 1, 2000 to December 31, 2020. The review process culminated in 85 articles, evidencing an increase in publications particularly in 2019 (n = 12). Eighteen countries were involved, with the Southern African region contributing 52% of the studies. Family members were predominantly described as parents, siblings, and children, with the most focused area of study being family experiences (n = 52). The majority of studies (n = 59) used qualitative methodologies. Despite the recent increase in family-focused nursing research in the WHO Afro-regions, further qualitative research, including more complex methodologies and interventions are still required to build contextualized evidence-based family-focused nursing.
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Implementation Science for the Practice-Oriented Nurse Leader. Nurs Adm Q 2023; 47:107-117. [PMID: 36862564 DOI: 10.1097/naq.0000000000000572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Senior nurse leaders are accountable for improving patient outcomes efficiently and cost-effectively. Nurse leaders often find heterogeneous patient outcomes across comparable nursing units in the same enterprise, presenting a challenge for nurse leaders tasked with making system-wide quality improvements. Implementation science (IS) offers a promising new approach to guide nurse leaders in understanding why certain implementation efforts meet with success or failure and the barriers faced in making practice changes. Knowledge of IS builds upon evidenced-based practice and quality improvement knowledge, adding to the armamentarium of tools at nurse leaders' disposal for improving nursing and patient outcomes. In this article, we demystify IS, differentiate it from evidence-based practice and quality improvement, describe IS concepts every nurse leader should be familiar with, and outline nurse leaders' role in building IS in their organizations.
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Shuman CJ, Ehrhart MG, Veliz PT, Titler MG. Perceptual differences in nursing implementation leadership and climate: a cross-sectional study. Implement Sci Commun 2023; 4:9. [PMID: 36670493 PMCID: PMC9854059 DOI: 10.1186/s43058-023-00392-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 01/09/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The literature on perceptual differences between managers and staff regarding social dynamic factors (e.g., leadership, climate) in nursing settings is sparse. Addressing this gap in knowledge is critical for informing implementation efforts and improving patient and organizational outcomes. The purpose of this study was to test the perceptual differences regarding implementation leadership and implementation climate between nursing staff and their managers. METHODS This study was a secondary analysis of cross-sectional survey data collected in 2016-2017. The setting included 22 adult medical-surgical units nested in 7 acute care hospitals in the Eastern and Midwestern United States. Participants were registered nurses (N = 261) and nurse managers (N = 22) who completed an electronic survey consisting of the Implementation Leadership Scale (ILS), the Implementation Climate Scale (ICS), and demographic items. Differences in perception were analyzed at the unit level using structural equation modeling to develop latent difference score models (LDS). We assessed associations of the LDSs with manager ILS and ICS scores, years of nursing experience, and years of experience working on the current unit. The association of ILS LDS with the observed nursing staff ICS scores was also analyzed. RESULTS Higher manager scores on the ILS and ICS were associated with greater perceptual differences in implementation leadership and implementation climate. Greater years of experience as a nurse were associated with greater perceptual differences in ILS and ICS scores. Greater tenure on the unit was associated with smaller differences on the ILS knowledge domain. Greater perceptual differences regarding implementation leadership were associated with worse staff ratings of implementation climate. CONCLUSIONS Although this study observed significant relationships among manager ILS and ICS scores, staff-manager perceptual differences, and staff ratings of implementation climate in nursing settings, it is still unclear why perceptual differences in implementation leadership and climate exist and how to address them. Future studies are warranted to test the effect of perceptual differences on implementation and patient outcomes.
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Affiliation(s)
- Clayton J. Shuman
- grid.214458.e0000000086837370School of Nursing, University of Michigan, 400 N. Ingalls, Room 4162, Ann Arbor, MI 48109 USA ,grid.214458.e0000000086837370Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI USA ,grid.214458.e0000000086837370Center for the Study of Drugs, Alcohol, Smoking, and Health, University of Michigan School of Nursing, Ann Arbor, MI USA
| | - Mark G. Ehrhart
- grid.170430.10000 0001 2159 2859Department of Psychology, University of Central Florida, Orlando, FL USA
| | - Philip T. Veliz
- grid.214458.e0000000086837370School of Nursing, University of Michigan, 400 N. Ingalls, Room 4162, Ann Arbor, MI 48109 USA ,grid.214458.e0000000086837370Center for the Study of Drugs, Alcohol, Smoking, and Health, University of Michigan School of Nursing, Ann Arbor, MI USA
| | - Marita G. Titler
- grid.214458.e0000000086837370School of Nursing, University of Michigan, 400 N. Ingalls, Room 4162, Ann Arbor, MI 48109 USA ,grid.214458.e0000000086837370Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI USA
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Ramjan LM, Maneze D, Krstevska E, Pathrose SP, Lewis P. Educational programs to improve nurses' knowledge, attitude, and practice in adolescent and young adult health: An integrative review. NURSE EDUCATION TODAY 2022; 118:105510. [PMID: 36007324 DOI: 10.1016/j.nedt.2022.105510] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/20/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Nurses working in adolescent health often lack educational opportunities to develop their knowledge and practical skills to address the challenges faced by adolescents and young adults. This integrative review synthesised the evidence from peer-reviewed research that focused on educational programs to improve nurses' knowledge, attitude, and practice in adolescent and young adult health. DESIGN The five-stage framework by Whittemore and Knafl guided the integrative literature review and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. DATA SOURCES A single search strategy was replicated across five electronic databases (CINAHL Plus, APA PsycInfo, PubMed, Scopus, and ERIC). Studies of educational interventions or training programs for nurses on adolescent and young adult health, published in English in the last 10 years were included. REVIEW METHODS All studies found were reviewed for relevance independently by two authors, who likewise critically appraised the quality using the "Critical appraisal checklist for an article on an educational intervention" adapted from Morrison et al. (1999), with a third author providing consensus. Data were extracted using study specific standardised proforma and thematically analysed. RESULTS Seven studies met the inclusion criteria. Topics covered included cancer care, mental health and self-harm, with only one program including general adolescent health. A mix of face-to-face and digital asynchronous mode of delivery was employed in these programs with multi-strategic approaches used to enhance accessibility and engagement. While all studies reported improvement in knowledge and practice, including enhanced communication skills, some studies reported limited change in attitude. Success of the interventions was attributed to the flexibility of programs to accommodate nurses' workloads. CONCLUSION Education interventions for nurses delivering care to adolescent and young adults enhance knowledge and skills, however, programs with institutional support for flexibility and accessibility are needed to influence a positive change in attitude.
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Affiliation(s)
- Lucie M Ramjan
- Western Sydney University, School of Nursing and Midwifery, Centre for Oral Health Outcomes and Research Translation (COHORT), Ingham Institute for Applied Medical Research, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Della Maneze
- Western Sydney University, School of Nursing and Midwifery, South Western Sydney Local Health District, Centre for Oral Health Outcomes and Research Translation (COHORT), Ingham Institute for Applied Medical Research, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Elena Krstevska
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Sheeja Perumbil Pathrose
- NSW Centre for Evidence Based Health Care-JBI Affiliated Group, Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW, Australia.
| | - Peter Lewis
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia.
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Cullen L, Laures E, Hanrahan K, Edmonds S. The Coat Hook Analogy and the Precision Implementation Approach® Solution. J Perianesth Nurs 2022; 37:732-736. [PMID: 36182248 DOI: 10.1016/j.jopan.2022.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Laura Cullen
- Nursing Research and Evidence-Based Practice, Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, Iowa City, IA.
| | - Elyse Laures
- Nursing Research and Evidence-Based Practice, Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, Iowa City, IA
| | - Kirsten Hanrahan
- Nursing Research and Evidence-Based Practice, Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, Iowa City, IA
| | - Stephanie Edmonds
- Nursing Research and Evidence-Based Practice, Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, Iowa City, IA
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Exploring integrated threshold concept knowledge as a route to understanding the epistemic nature of the evidence-based practice mindset. J Prof Nurs 2022; 42:34-45. [DOI: 10.1016/j.profnurs.2022.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/18/2022] [Accepted: 05/26/2022] [Indexed: 11/18/2022]
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Shin HD, Cassidy C, Weeks LE, Campbell LA, Drake EK, Wong H, Donnelly L, Dorey R, Kang H, Curran JA. Interventions to change clinicians' behavior related to suicide-prevention care in the emergency department: a scoping review. JBI Evid Synth 2021; 20:788-846. [PMID: 34907133 DOI: 10.11124/jbies-21-00149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this scoping review was to explore, characterize, and map the literature on interventions and intervention components implemented to change emergency department clinicians' behavior related to suicide prevention using the Behaviour Change Wheel as a guiding theoretical framework. INTRODUCTION An emergency department is a critical place for suicide prevention, yet patients are often discharged without proper suicide risk assessments and/or referrals. In response, we must support emergency department clinicians' behavior change to follow evidence-based suicide prevention strategies. However, reviews to date have yet to systematically and theoretically examine interventions' functional characteristics and how they can influence emergency department clinicians' behaviors related to suicide-prevention care. INCLUSION CRITERIA This review considered interventions that targeted emergency department clinicians' behavior change related to suicide prevention. Behavior change referred to observable practice changes as well as proxy measures of behavior change, including changes in knowledge and attitude. METHODS This review followed JBI methodology for scoping reviews. Searches included PubMed, PsycINFO, CINAHL, Embase, and gray literature, including targeted Google searches for relevant organizations/websites, ProQuest Dissertations and Theses Global, and Scopus conference papers (using a specific filter). This review did not apply any date limits, but our search was limited to the English language. Data extraction was undertaken using a charting table developed specifically for the review objective. Narrative descriptions of interventions were coded using the Behavior Change Wheel's intervention functions. Reported outcome measures were categorized. Findings are tabulated and synthesized narratively. RESULTS Forty-one studies were included from the database searches, representing a mixture of experimental (n = 2), quasi-experimental (n = 24), non-experimental (n = 12), qualitative (n = 1), and mixed methods (n = 2) approaches. An additional 29 citations were included from gray literature searches. One was a pilot mixed methods study, and the rest were interventions. In summary, this review included a total of 70 citations, describing 66 different interventions. Identified interventions comprised a wide range of Behaviour Change Wheel intervention functions to change clinicians' behavior: education (n = 48), training (n = 40), enablement (n = 36), persuasion (n = 21), environmental restructuring (n = 18), modeling (n = 7), and incentivisation (n = 2). Based on the Behaviour Change Wheel analysis, many interventions targeted more than one determinant of behavior change, often employing education and training to improve clinicians' knowledge and skills simultaneously. Among the 42 studies that reported outcome measures, effectiveness was measured at clinician (n = 38), patient (n = 4), and/or organization levels (n = 6). Few studies reported implementation outcomes, such as measures of reach (n = 4), adoption (n = 5), or fidelity (n = 1). There were no evaluation data reported on the interventions identified through Google searches. CONCLUSIONS Interventions included in this review were diverse and leveraged a range of mechanisms to change emergency department clinicians' behavior. However, most interventions relied solely on education and/or training to improve clinicians' knowledge and/or skills. Future research should consider diverse intervention functions to target both individual- and/or organization-level barriers for a given context. Secondly, the ultimate goal for changing emergency department clinicians' behavior is to improve patient health outcomes related to suicide-related thoughts and behaviors, but current research has most commonly evaluated clinicians' behavior in isolation of patient outcomes. Future studies should consider reporting patient-level outcomes alongside clinician-level outcomes.
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Affiliation(s)
- Hwayeon Danielle Shin
- School of Nursing, Dalhousie University, Halifax, NS, Canada Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada Faculty of Health, Dalhousie University, Halifax, NS, Canada Nova Scotia Health Authority, Halifax, NS, Canada
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