Sample records for providing evidence-based nursing

  1. [Acupressure and Evidence-Based Nursing]. (United States)

    Chen, Li-Li; Lin, Jun-Dai


    Acupressure is a traditional Chinese medicine approach to disease prevention and treatment that may be operated by nurses independently. Therefore, acupressure is being increasingly applied in clinical nursing practice and research. Recently, the implementation of evidence-based nursing (EBN) in clinical practice has been encouraged to promote nursing quality. Evidence-based nursing is a method-ology and process of implementation that applies the best-available evidence to clinical practice, which is acquired through the use of empirical nursing research. Therefore, in this paper, we address the topic of acupressure within the context of empirical nursing practice. We first introduce the current status of acupressure research and provide the locations of common acupoints in order to guide future empirical nursing research and to help nurses use these acupoints in clinical practice. Finally, we describe the steps that are necessary to apply the current empirical information on acupressure as well as provide suggestions to promote safety and efficacy in order to guide nurses in the accurate application of acupressure in nursing practice.

  2. Adaptation and validation of the Evidence-Based Practice Belief and Implementation scales for French-speaking Swiss nurses and allied healthcare providers. (United States)

    Verloo, Henk; Desmedt, Mario; Morin, Diane


    To evaluate two psychometric properties of the French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales, namely their internal consistency and construct validity. The Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales developed by Melnyk et al. are recognised as valid, reliable instruments in English. However, no psychometric validation for their French versions existed. Secondary analysis of a cross sectional survey. Source data came from a cross-sectional descriptive study sample of 382 nurses and other allied healthcare providers. Cronbach's alpha was used to evaluate internal consistency, and principal axis factor analysis and varimax rotation were computed to determine construct validity. The French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales showed excellent reliability, with Cronbach's alphas close to the scores established by Melnyk et al.'s original versions. Principal axis factor analysis showed medium-to-high factor loading scores without obtaining collinearity. Principal axis factor analysis with varimax rotation of the 16-item Evidence-Based Practice Beliefs scale resulted in a four-factor loading structure. Principal axis factor analysis with varimax rotation of the 17-item Evidence-Based Practice Implementation scale revealed a two-factor loading structure. Further research should attempt to understand why the French Evidence-Based Practice Implementation scale showed a two-factor loading structure but Melnyk et al.'s original has only one. The French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales can both be considered valid and reliable instruments for measuring Evidence-Based Practice beliefs and implementation. The results suggest that the French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales are valid and reliable and can therefore be used to

  3. Evidence-Based Practice and School Nursing (United States)

    Adams, Susan; McCarthy, Ann Marie


    School nurses need to demonstrate that their practice is based on the best evidence available, which is usually data obtained from research. Evidence-based practice involves combining the best evidence available with nursing expertise and patient and family preferences to determine optimum care. Evidence-based practice guidelines are developed by…

  4. Evidence Based Nursing. A new perspective for Greek Nursing


    Christina Ouzouni; Konstantinos Nakakis


    Despite the fact that nursing research has been developed in Greece, nevertheless the provision of nursing care is not based on current research findings, but rather on the knowledge gained by nurses during their undergraduate education. The transition of medicine in the last decade towards evidence based practice had definitely an impact on the nursing profession.The aim of this article is to briefly present evidence based nursing as a process and perspective to Greek nurses.Method: A litera...

  5. [Transformative Care Rooted in Evidence-Based Nursing]. (United States)

    Chiang, Li-Chi; Liao, Mei-Nan


    As clinical scientists on the interdisciplinary healthcare team, nurses use the art and science of current nursing knowledge to provide evidence-based healthcare to each patient and his/her family. Nurses not only comprise the largest contingent of medical personnel and provide 24-hour patient care but are also professional scientists that develop unique nursing knowledge through reflective practice. Five strategies for expanding the body of current evidence-based nursing scientific knowledge include: (1) reflecting empirically on the practice-service domain, (2) developing nursing knowledge using rigorous methodology, (3) emancipating nursing knowledge using innovative transformation, (4) using collaborative interdisciplinary healthcare that is based in patient-centered care, and (5) initiating innovative transformation in nursing education. Nurses are critical healthcare providers that make important contributions to today's healthcare system. Nursing scientists provide frontline, evidence-based transforming care that deserves to be respected and valued on an equal basis with the care and services that are provided by other medical personnel.

  6. [Strategy for promoting evidence-based nursing practice in hospital]. (United States)

    Chen, Yu-Chih; Tang, Lee-Chun; Chou, Shin-Shang


    Evidence-based practice has been demonstrated to improve quality of care, increase patients' satisfaction, and reduce the costs of medical care. Therefore, evidence-based practice is now central to the clinical decision-making process and to achieving better quality of care. Today, it is one of the important indicators of core competences for healthcare providers and accreditation for healthcare and educational systems. Further, evidence-based practice encourages in-school and continuous education programs to integrate evidence-based elements and concepts into curricula. Healthcare facilities and professional organizations proactively host campaigns and encourage healthcare providers to participate in evidence-based related training courses. However, the clinical evidence-based practice progress is slow. The general lack of a model for organizational follow-up may be a key factor associated with the slow adoption phenomenon. The authors provide a brief introduction to the evidence-based practice model, then described how it may be successfully translated through a staged process into the evidence-based practices of organizational cultures. This article may be used as a reference by healthcare facilities to promote evidence-based nursing practice.

  7. Evaluation of Evidence-based Nursing Pain Management Practice. (United States)

    Song, Wenjia; Eaton, Linda H; Gordon, Debra B; Hoyle, Christine; Doorenbos, Ardith Z


    It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. The aim of this study was to modify and test an evaluation tool for nursing cancer pain documentation, and describe the frequency and quality of nursing pain documentation in one oncology unit via the electronic medical system. A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Medical records were examined for 37 adults hospitalized during April and May 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score ranging from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  8. Collaborating across services to advance evidence-based nursing practice. (United States)

    Kenny, Deborah J; Richard, Maggie L; Ceniceros, Xochitl; Blaize, Kelli


    Military medical treatment facilities offer a unique environment in which to develop a culture of evidence-based practice (EBP). Distinctive issues arise in the context of changed patient care demographics because of a war-injured population. These issues offer an opportunity to enhance the quality of care through the use and adaptation of research findings in this special nursing environment. In addition, the colocation of two military medical centers offers the prospect of collaborative efforts to create a regional culture for nursing EBP. The purposes of this study were to describe the processes of a collaborative project to train nurses in EBP and to share resources in developing and implementing evidence-based clinical nursing guidelines in two large military medical centers in the Northeastern United States and to discuss the collective efforts of nurse researchers, leadership, advanced practice nurses, and staff nurses in each hospital to facilitate the EBP process. A description of the organizational structure and the climate for EBP of each facility is provided followed by discussion of training efforts and the inculcation of an organizational culture for EBP. Contextual barriers and facilitators were encountered throughout the project. The two nurse researchers leading the projects were able to overcome the barriers and capitalize on opportunities to promote EBP. Three evidence-based clinical practice guidelines were developed at each facility and are currently in various stages of implementation. Despite the barriers, EBP continues to be at the forefront of military nursing practice in the U.S. National Capital Region. Clear communication and regular meetings were essential to the success of the collaborative project within and between the two military hospitals. Military-specific barriers to EBP included high team attrition and turnover because of the war mission and the usual high staff turnover at military hospitals. Military facilitators included a

  9. Evidence-Based Practice Guidelines and School Nursing (United States)

    Adams, Susan; McCarthy, Ann Marie


    The use of evidence-based practice (EBP) has become the standard of health care practice. Nurses are expected to use best evidence on a wide range of topics, yet most nurses have limited time, resources, and/or skills to access and evaluate the quality of research and evidence needed to practice evidence-based nursing. EBP guidelines allow nurses…

  10. Determining registered nurses' readiness for evidence-based practice. (United States)

    Thiel, Linda; Ghosh, Yashowanto


    As health care systems worldwide move toward instituting evidence-based practice (EBP), its implementation can be challenging. Conducting a baseline assessment to determine nurses' readiness for EBP presents opportunities to plan strategies before implementation. Although a growing body of research literature is focused on implementing EBP, little attention has been paid to assessing nurses' readiness for EBP. The purpose of this study was to assess registered nurses' readiness for EBP in a moderate-sized acute care hospital in the Midwestern United States before implementation of a hospital-wide nursing EBP initiative. A descriptive cross-sectional survey design was used; 121 registered nurses completed the survey. The participants (n= 121) completed the 64-item Nurses' Readiness for Evidence-Based Practice Survey that allowed measurement of information needs, knowledge and skills, culture, and attitudes. Data were analyzed using descriptive statistics and a post hoc analysis. The majority (72.5%) of respondents indicated that when they needed information, they consulted colleagues and peers rather than using journals and books; 24% of nurses surveyed used the health database, Cumulative Index to Nursing & Allied Health Literature (CINAHL). The respondents perceived their EBP knowledge level as moderate. Cultural EBP scores were moderate, with unit scores being higher than organizational scores. The nurses' attitudes toward EBP were positive. The post hoc analysis showed many significant correlations. Nurses have access to technological resources and perceive that they have the ability to engage in basic information gathering but not in higher level evidence gathering. The elements important to EBP such as a workplace culture and positive attitudes are present and can be built upon. A "site-specific" baseline assessment provides direction in planning EBP initiatives. The Nurses' Readiness for EBP Survey is a streamlined tool with established reliability and

  11. Supporting evidence-based practice for nurses through information technologies. (United States)

    Doran, Diane M; Haynes, R Brian; Kushniruk, André; Straus, Sharon; Grimshaw, Jeremy; Hall, Linda McGillis; Dubrowski, Adam; Di Pietro, Tammie; Newman, Kristine; Almost, Joan; Nguyen, Ha; Carryer, Jennifer; Jedras, Dawn


    To evaluate the usability of mobile information terminals, such as personal digital assistants (PDAs) or Tablet personal computers, to improve access to information resources for nurses and to explore the relationship between PDA or Tablet-supported information resources and outcomes. The authors evaluated an initiative of the Nursing Secretariat, Ontario Ministry of Health and Long-Term Care, which provided nurses with PDAs and Tablet PCs, to enable Internet access to information resources. Nurses had access to drug and medical reference information, best practice guidelines (BPGs), and to abstracts of recent research studies. The authors took place over a 12-month period. Diffusion of Innovation theory and the Promoting Action on Research Implementation in Health Services (PARIHS) model guided the selection of variables for study. A longitudinal design involving questionnaires was used to evaluate the impact of the mobile technologies on barriers to research utilization, perceived quality of care, and on nurses' job satisfaction. The setting was 29 acute care, long-term care, home care, and correctional organizations in Ontario, Canada. The sample consisted of 488 frontline-nurses. Nurses most frequently consulted drug and medical reference information, Google, and Nursing PLUS. Overall, nurses were most satisfied with the Registered Nurses Association of Ontario (RNAO) BPGs and rated the RNAO BPGs as the easiest resource to use. Among the PDA and Tablet users, there was a significant improvement in research awareness/values, and in communication of research. There was also, for the PDA users only, a significant improvement over time in perceived quality of care and job satisfaction, but primarily in long-term care settings. It is feasible to provide nurses with access to evidence-based practice resources via mobile information technologies to reduce the barriers to research utilization.

  12. Factors influencing evidence-based nursing utilization intention in Korean practice nurses. (United States)

    Park, Jee-Won; Ahn, Jeong-Ah; Park, Mi-Mi


    The purpose of this study was to describe Korean nurses' perceptions, attitudes and utilization intention for evidence-based nursing (EBN), and to explore what factors influence utilization intention. We conducted a cross-sectional survey in 2012. Registered nurses directly involved in clinical practice were recruited at a medical centre in Korea. A total of 420 nurses completed a self-report questionnaire. Results showed that participants reported moderate scores regarding their perceptions and attitudes towards EBN, and rated themselves as higher than the median for utilization intention. Furthermore, this study revealed that perceptions of and attitudes towards EBN, occupational view and previous EBN education were significant factors affecting utilization intention. Nurse educators and managers should encourage nurses to have better attitudes towards EBN, help them be more satisfied with their work and provide them with appropriate education for EBN to establish evidence-based practice as a part of daily nursing care. © 2014 Wiley Publishing Asia Pty Ltd.

  13. The state of evidence-based practice in US nurses: critical implications for nurse leaders and educators. (United States)

    Melnyk, Bernadette Mazurek; Fineout-Overholt, Ellen; Gallagher-Ford, Lynn; Kaplan, Louise


    This descriptive survey assessed the perception of evidence-based practice (EBP) among nurses in the United States. Although evidence-based healthcare results in improved patient outcomes and reduced costs, nurses do not consistently implement evidence-based best practices. A descriptive survey was conducted with a random sample of 1015 RNs who are members of the American Nurses Association. Although nurses believe in evidence-based care, barriers remain prevalent, including resistance from colleagues, nurse leaders, and managers. Differences existed in responses of nurses from Magnet® versus non-Magnet institutions as well as nurses with master's versus nonmaster's degrees. Nurse leaders and educators must provide learning opportunities regarding EBP and facilitate supportive cultures to achieve the Institute of Medicine's 2020 goal that 90% of clinical decisions be evidence-based.

  14. Infusion Nursing: An Evidence-Based Approach - Third edition Alexander Mary Infusion Nursing: An Evidence-Based Approach - Third edition 625pp Elsevier 9781416064107 1416064109 [Formula: see text]. (United States)


    This book considers all aspects of infusion therapy and provides a solid evidence base. Its 30 chapters are well organised into six sections covering physiological considerations, infusion therapies and nursing practice.

  15. Clinical librarians as facilitators of nurses' evidence-based practice. (United States)

    Määttä, Sylvia; Wallmyr, Gudrun


    The aim of this study was to explore nurses' and ward-based clinical librarians' reflections on ward-based clinical librarians as facilitators for nurses' use of evidences-based practice. Nurses' use of evidence-based practice is reported to be weak. Studies have suggested that clinical librarians may promote evidence-based practice. To date, little is known about clinical librarians participating nurses in the wards. A descriptive, qualitative design was adopted for the study. In 2007, 16 nurses who had been attended by a clinical librarian in the wards were interviewed in focus groups. Two clinical librarians were interviewed by individual interviews. In the analysis, a content analysis was used. Three themes were generated from the interviews with nurses: 'The grip of everyday work', 'To articulate clinical nursing issues' and 'The clinical librarians at a catalyst'. The nurses experienced the grip of everyday work as a hindrance and had difficulties to articulate and formulate relevant nursing issues. In such a state, the nurses found the clinical librarian presence in the ward as enhancing the awareness of and the use of evidence-based practice. Three themes emerged from the analysis with the librarians. They felt as outsiders, had new knowledge and acquired a new role as ward-based clinical librarians. Facilitation is needed if nurses' evidence-based practice is going to increase. The combined use of nurses and clinical librarians' knowledge and skills can be optimised. To achieve this, nurses' skills in consuming and implementing evidence ought to be strengthened. The fusion of the information and knowledge management skill of the ward-based clinical librarian and the clinical expertise of the nurses can be of value. With such a collaborative model, nurse and ward-based clinical librarian might join forces to increase the use of evidence-based practice. © 2010 Blackwell Publishing Ltd.

  16. Nursing Students’ Competencies in Evidence-Based Practice and Its Related Factors


    Ashktorab; Pashaeypoor; Rassouli; Alavi-Majd


    Background Evidence-Based Practice (EBP) is one of the nursing professional roles that can lead them to provide the best and more effective care. However, no studies are available on nursing students’ competencies in EBP. Objectives This study aimed to investigate the nursing students’ knowledge, attitude and intention to implement EBP and its related factors in two nursing and midwifery faculties in Tehran, Iran. ...

  17. Evidence-based care: an innovation to improve nursing practice ...

    African Journals Online (AJOL)

    Evidence-Based Nursing (EBN) permits the highest quality of care in meeting the multifaceted needs of clients using the best available evidence from research findings, expert ideas from specialists in the various health care sectors and feedback from clients. However, in many instances, various challenges need to be ...

  18. Nursing faculties’ knowledge and attitude on evidence-based practice (United States)

    Mehrdad, Neda; Joolaee, Soodabeh; Joulaee, Azadeh; Bahrani, Naser


    Background: Evidence-based practice (EBP) is one of the main professional competencies for health care professionals and a priority for medicine and nursing curriculum as well. EBP leads to improve effective and efficient care and patient outcomes. Nurse educators have responsibility to teach the future nurses, and an opportunity to promote patient outcomes. Therefore, the aim of this study was to describe nurse educators’ knowledge and attitude on EBP. Materials and Methods: This was a descriptive study conducted in nursing faculties of two major universities of medical sciences affiliated to Ministry of Health and Medical Sciences in Tehran, Iran. Data were gathered using a three-section questionnaire. Content and face validity was further enhanced by submitting it to nursing research and education experts. Statistical analysis was carried out using SPSS 11 software. Results: According the results, nursing faculties’ knowledge of EBP was mainly moderate (47.1%). Significant statistical relationship was found between the level of knowledge with education and teaching experience in different nursing programs. Nurses generally held positive attitudes toward EBP (88.6%) and there was no statistical significant relationship with demographic variables. Conclusion: Nursing educators are in a position to influence nursing research in clinical practice in the future. Therefore, it is critical to achieve implementation of EBP and be a change agent for a paradigm shift toward EBP. PMID:23922597

  19. Relevant nursing leadership: an evidence-based programmatic response. (United States)

    Eddy, Linda L; Doutrich, Dawn; Higgs, Zana R; Spuck, Janet; Olson, Margie; Weinberg, Stephen


    Community and student demand for relevant nursing leadership graduate programs provided the impetus for this study. The aims were to identify components of highly competent nursing leadership, and strategies to integrate those components into education and practice. Nursing leaders gathered in five focus groups. A semi-structured interview guide was used to elicit narratives about nursing leadership. Interpretive analysis proceeded from identification of themes to uncovering of paradigm cases. Essential nursing leadership competencies comprised communication skills such as listening, conflict resolution, the ability to communicate a vision, motivate, and inspire. Additionally, leaders needed technological adroitness, fiscal dexterity, and the courage to be proactive during rapid change. Implications included a revision in the leadership focus of the nursing masters program, and the necessity that nurse retention should be enhanced by better educated nurse leaders who are grounded in practice and ready to provide a vision for the future.

  20. Effects of the Evidence-Based Nursing Care Algorithm of Dysphagia for Nursing Home Residents. (United States)

    Park, Yeonhwan; Oh, Seieun; Chang, Heekyung; Bang, Hwal Lan


    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at To obtain contact hours you must: 1. Read the article, "Effects of the Evidence-Based Nursing Care Algorithm of Dysphagia for Nursing Home Residents" found on pages 30-39, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until October 31, 2018. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Explain the development and testing of the Evidence-Based Nursing Care Algorithm of

  1. Hospital nurses' information retrieval behaviours in relation to evidence based nursing: a literature review. (United States)

    Alving, Berit Elisabeth; Christiansen, Janne Buck; Thrysoe, Lars


    The purpose of this literature review is to provide an overview of the information retrieval behaviour of clinical nurses, in terms of the use of databases and other information resources and their frequency of use. Systematic searches carried out in five databases and handsearching were used to identify the studies from 2010 to 2016, with a populations, exposures and outcomes (PEO) search strategy, focusing on the question: In which databases or other information resources do hospital nurses search for evidence based information, and how often? Of 5272 titles retrieved based on the search strategy, only nine studies fulfilled the criteria for inclusion. The studies are from the United States, Canada, Taiwan and Nigeria. The results show that hospital nurses' primary choice of source for evidence based information is Google and peers, while bibliographic databases such as PubMed are secondary choices. Data on frequency are only included in four of the studies, and data are heterogenous. The reasons for choosing Google and peers are primarily lack of time; lack of information; lack of retrieval skills; or lack of training in database searching. Only a few studies are published on clinical nurses' retrieval behaviours, and more studies are needed from Europe and Australia. © 2018 Health Libraries Group.

  2. Apprehensions of nurse managers on evidence-based practice

    Directory of Open Access Journals (Sweden)

    Fernanda Carolina Camargo


    Full Text Available Abstract Objective: To analyze the apprehensions of nurse managers in the implementation of the Evidence Based Practice in a Teaching Hospital of Triângulo Mineiro. Method: Qualitative research guided by the Theory of the Diffusion of Innovations. Five workshops were conducted per focal group (n = 18 participants, conducted by hermeneutic-dialectic interactions between August and September/2016. Textual records resulting from each workshop were analyzed by semantic categories. Results: Aspects conditioning to the implementation of the Evidence Based Practice permeate from elements related to the fragmentation of the care network to the necessary expansion of the governability of the nurse managers to put changes into practice in their sectors. Most importantly, timely access to the results of research conducted at the teaching hospital was mentioned as crucial to guide better practices. Final considerations: The approach allowed the recognition of contextual conditions for the implementation of the Evidence-Based Practice, which may coincide with similar scenarios, as well as increase the national scientific production on the subject, which is still scarce.

  3. Evidence-based Nursing in the IED: From Caring to Curing?

    National Research Council Canada - National Science Library

    Jette Ernst


    .... It is illuminated how two opposing approaches to nursing of hhumanisticallyand pluralistically oriented caring, and evidence-based scientifically oriented curing inform nursing in the department...

  4. Promoting Evidence-Based Practice at a Primary Stroke Center: A Nurse Education Strategy. (United States)

    Case, Christina Anne

    before and after the educational intervention. This modification ensured that the responses for each individual participant in this group were matched. Registered nurses reported a significant increase in perceived confidence in ability to explain how standardized stroke order sets reflect current evidence after the intervention (n = 20, P strategy increased RNs' confidence in ability to explain the path from evidence to bedside nursing care by demonstrating how evidence-based clinical practice guidelines provide current evidence used to create standardized order sets. Although further evaluation of the intervention's effectiveness is needed, this educational intervention has the potential for generalization to different types of standardized order sets to increase nurse confidence in utilization of evidence-based practice.

  5. Abilities and barriers to practicing evidence-based nursing for burn specialist nurses. (United States)

    Yue, Liqing; Fan, Xuegong; Peng, Huan


    To explore the abilities and barriers of practicing evidence-based nursing (EBN) for burn specialist nurses so as to provide rationales for its clinical training and practice. From January 2016 to March 2016, a cross-sectional survey was conducted with a self-designed questionnaire among burn specialist nurses in Hunan Province. Data analysis was performed with SPSS software (version 20). Burn specialist nurses in Hunan Province had diminished EBN abilities. The three procedures of EBN with the lowest score were "summarizing evidence through systematic reviews", "rigorous evaluations of evidence" and "systematic literature searches". And the three procedures of "clarifying problems", "disseminating evidence" and "introducing evidence" scored the highest. The systematic literature retrieval ability of nurses at class III general hospitals was higher than that of class II counterparts (P=0.001). Thus EBN ability was positively correlated with barriers to practicing EBN, English proficiency, research experiences and educator status. Burn specialist nurses at classes III & II general hospitals in Hunan Province had poor EBN abilities. Influencing factors of EBN ability included barriers to practicing EBN, English proficiency, research experiences and educator status. Therefore it is imperative to implement targeted trainings and integrated managements for improved ability of practicing EBN. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  6. [Evidence-based practice competence in undergraduate Nursing Degree students]. (United States)

    Ruzafa-Martínez, María; Molina-Salas, Yolanda; Ramos-Morcillo, Antonio Jesús


    Evidence-based practice (EBP) learning has become a key issue for nurses. An EPB subject was included in the 4(th) year in the new syllabus of the Nursing Degree at University of Murcia (UM). To know the competence level in EBP of undergraduate nursing students at UM and compare the results between all four years. Observational descriptive study with a cross-sectional approach. undergraduate nursing students from all four years at Nursing Degree at the Faculty of Social and Healthcare Science at UM in the year 2013-14. EBP evaluation of competence of the nursing students consisted of attitude, skills and knowledge on EBP. A validated questionnaire, the EBP-COQ, was used. The scale range is 1 point «lowest level» to 5 points «higher level».The SPSS 21.0 program has been used to carry out descriptive and bivariate analyses. 144 students were included, 76.4% was female, and the median age was 23 years, 84.7% attended more than 75% class hours. The mean differences in the questionnaire between first and fourth years were 0.58 points in attitude, 0.60 in skills, 1.6 in knowledge and 0.83 in global competence in EBP. Significant differences in mean scores between the fourth and the remaining years in the global competence in EBP were observed, as well as in the three dimensions (p <0.05). The undergraduate-nursing students studied here have acquired an appropriate competence level in EBP, with a gradual increase by year. The biggest increase was in the fourth year students. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  7. Evidence-based nursing interventions and guidelines for prone ...

    African Journals Online (AJOL)

    Although the prone positioning of a critically ill patient poses a challenge to nursing interventions, it remains the responsibility of nurses to develop a way to provide the same basic and intensive care to those patients lying prone as to those lying supine. The purpose of this study was firstly to conduct a systematic review of ...

  8. Implementing and Sustaining Evidence Based Practice Through a Nursing Journal Club. (United States)

    Gardner, Kevin; Kanaskie, Mary Louise; Knehans, Amy C; Salisbury, Sarah; Doheny, Kim K; Schirm, Victoria


    The outcomes based emphasis in nursing and health care delivery requires identification of best available evidence in order to produce quality, safe, and effective patient care. Finding, critiquing, and ultimately implementing the best available evidence for practice is a formidable task for many clinical nurses. Development and implementation of a nursing journal club (NJC) became one organization's successful attempt to help clinical nurses better understand and use best available evidence in actual practice. The process and structure for the NJC evolved from an additional activity scheduled outside of work to a fully established endeavor of Nursing Research and Evidence Based Practice Council (NR&EBP). The Nursing Professional Practice Model was foundational to establishing the NJC as a formal component within the NR&EBP Council shared governance structure. Efforts to embed the NJC included taking advantage of resources available at an academic medical center and incorporating them into the council structure. Successful outcomes of the NJC include a quarterly schedule, with topics selected in advance that are based on nursing department as well as organizational driven goals and initiatives. The structure and process in place has eliminated frequently mentioned deterrents to evidence based practice such as not enough time, lack of knowledge, or no immediate application to practice. Incorporating the NJC as a component of NR&EBP Council has provided clinical nurses time away from clinical care that supports scholarship for nursing practice. Committed leadership and garnering of available resources have been key factors for success. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. What is the relationship between nurses' attitude to evidence based practice and the selection of wound care procedures? (United States)

    Dugdall, Hayley; Watson, Roger


    To investigate qualified nurses' attitudes to evidence-based practice and whether this influenced their selection of wound care products. The literature shows that previous studies on attitudes to evidence-based practice tended to be part of a wider study. The general consensus was that there was a positive attitude to evidence-based practice. However, there appeared to be no published studies specifically addressing nurses' attitudes to evidence-based wound care. Survey design using a questionnaire completed by 156 qualified nurses working in three UK National Health Trusts. A statistically significant difference was seen between those nurses with a tissue viability link nurse role (p = 0.002) and those without a link nurse role; those educated to first degree (p attitude to evidence-based practice (p Nurses who had attained a higher level academic qualification, had a tissue viability link nurse role and those who had received formal tissue viability training scored generally higher in the wound care knowledge tests and in attitude to evidence-based practice. The care received by patients in relation to wound care could be dependent upon factors that are related to the individual characteristics of the nurse providing the care and these factors, in turn, are related to education and training with respect to wound care. Better general education and better specific training in wound care could lead to better wound care.

  10. Synthesizing Quantitative Evidence for Evidence-based Nursing: Systematic Review

    Directory of Open Access Journals (Sweden)

    Eui Geum Oh, PhD, RN


    Full Text Available As evidence-based practice has become an important issue in healthcare settings, the educational needs for knowledge and skills for the generation and utilization of healthcare evidence are increasing. Systematic review (SR, a way of evidence generation, is a synthesis of primary scientific evidence, which summarizes the best evidence on a specific clinical question using a transparent, a priori protocol driven approach. SR methodology requires a critical appraisal of primary studies, data extraction in a reliable and repeatable way, and examination for validity of the results. SRs are considered hierarchically as the highest form of evidence as they are a systematic search, identification, and summarization of the available evidence to answer a focused clinical question with particular attention to the methodological quality of studies or the credibility of opinion and text. The purpose of this paper is to introduce an overview of the fundamental knowledge, principals and processes in SR. The focus of this paper is on SR especially for the synthesis of quantitative data from primary research studies that examines the effectiveness of healthcare interventions. To activate evidence-based nursing care in various healthcare settings, the best and available scientific evidence are essential components. This paper will include some examples to promote understandings.

  11. Professional values and competencies as explanatory factors for the use of evidence-based practice in nursing. (United States)

    Skela-Savič, Brigita; Hvalič-Touzery, Simona; Pesjak, Katja


    To establish the connection between values, competencies, selected job characteristics and evidence-based practice use. Nurses rarely apply evidence-based practice in everyday work. A recent body of research has looked at various variables explaining the use of evidence-based practice, but not values and competencies. A cross-sectional, non-experimental quantitative explorative research design. Standardized instruments were used (Nurse Professional Values Scale-R, Nurse Competence Scale, Evidence-Based Practice Beliefs and Implementation Scale). The sample included 780 nurses from 20 Slovenian hospitals. The data were collected in 2015. The study identifies two new variables contributing to a better understanding of beliefs on and implementation of evidence-based practice, thus broadening the existing research evidence. These are the values of activism and professionalism and competencies aimed at the development and professionalization of nursing. Values of caring, trust and justice and competencies expected in everyday practice do not influence the beliefs and implementation of evidence-based practice. Respondents ascribed less importance to values connected with activism and professionalism and competencies connected with the development of professionalism. Nurses agree that evidence-based practice is useful in their clinical work, but they lack the knowledge to implement it in practice. Evidence-based practice implementation in nursing practice is low. Study results stress the importance of increasing the knowledge and skills on professional values of activism and professionalism and competencies connected to nursing development. The study expands the current understanding of evidence-based practice use and provides invaluable insight for nursing managers, higher education managers and the national nursing association. © 2017 John Wiley & Sons Ltd.

  12. Development and evaluation of evidence-based nursing (EBN) filters and related databases. (United States)

    Lavin, Mary A; Krieger, Mary M; Meyer, Geralyn A; Spasser, Mark A; Cvitan, Tome; Reese, Cordie G; Carlson, Judith H; Perry, Anne G; McNary, Patricia


    Difficulties encountered in the retrieval of evidence-based nursing (EBN) literature and recognition of terminology, research focus, and design differences between evidence-based medicine and nursing led to the realization that nursing needs its own filter strategies for evidence-based practice. This article describes the development and evaluation of filters that facilitate evidence-based nursing searches. An inductive, multistep methodology was employed. A sleep search strategy was developed for uniform application to all filters for filter development and evaluation purposes. An EBN matrix was next developed as a framework to illustrate conceptually the placement of nursing-sensitive filters along two axes: horizontally, an adapted nursing process, and vertically, levels of evidence. Nursing diagnosis, patient outcomes, and primary data filters were developed recursively. Through an interface with the PubMed search engine, the EBN matrix filters were inserted into a database that executes filter searches, retrieves citations, and stores and updates retrieved citations sets hourly. For evaluation purposes, the filters were subjected to sensitivity and specificity analyses and retrieval set comparisons. Once the evaluation was complete, hyperlinks providing access to any one or a combination of completed filters to the EBN matrix were created. Subject searches on any topic may be applied to the filters, which interface with PubMed. Sensitivity and specificity for the combined nursing diagnosis and primary data filter were 64% and 99%, respectively; for the patient outcomes filter, the results were 75% and 71%, respectively. Comparisons were made between the EBN matrix filters (nursing diagnosis and primary data) and PubMed's Clinical Queries (diagnosis and sensitivity) filters. Additional comparisons examined publication types and indexing differences. Review articles accounted for the majority of the publication type differences, because "review" was accepted by

  13. Breaking Bad News: An Evidence-Based Review of Communication Models for Oncology Nurses. (United States)

    Bumb, Meridith; Keefe, Joanna; Miller, Lindsay; Overcash, Janine


    A diagnosis of cancer is a stressful, difficult, and life-altering event. Breaking bad news is distressing to patients and families and is often uncomfortable for the nurse delivering it. Evidence-based communication models have been developed and adapted for use in clinical practice to assist nurses with breaking bad news.

. The purpose of this article is to provide an overview on breaking bad news and to review the utility of the SPIKES and PEWTER evidence-based communication models for oncology nurses.
. Perceptions of breaking bad news from the nurse and patient perspectives, as well as barriers and consequences to effective communication, will be presented. Clinical examples of possible situations of breaking bad news will demonstrate how to use the SPIKES and PEWTER models of communication when disclosing bad news to patients and their families.
. By using the evidence-based communication strategies depicted in this article, oncology nurses can support the delivery of bad news and maintain communication with their patients and their patients' families in an effective and productive manner.

  14. Evidence-based practice councils: potential path to staff nurse empowerment and leadership growth. (United States)

    Brody, Abraham Aizer; Barnes, Kathi; Ruble, Cheryl; Sakowski, Julie


    This study aimed to examine the effects of participation in staff nurse-led practice councils on nurse job satisfaction and professional development. Although evidence-based practice (EBP) has become a key component of improving the quality of care, few studies have examined how implementation of staff nurse led councils model affect the involved nurses. A 3-stage evaluation involving ethnography, semi-structured phenomenological private interviews and a 10-item survey were conducted with nurses, managers and executives participating in or involved with EBP councils tasked with improving patient outcomes at 6 community hospitals in a single non-profit hospital system. Five themes were identified as outcomes: empowerment, meaningfulness, leadership growth, exposure to quality improvement, and vision. Staff-led councils have the potential to improve quality of care, job satisfaction, vision and leadership provided that managers and executives are sufficiently prepared to work with and support the councils.

  15. Implementation of evidence-based nursing practice for diabetic patients: an Iranian experience. (United States)

    Varaei, Shokoh; Salsali, Mahvash; Cheraghi, Mohammad Ali


    Evidence-based nursing is recognized as an indicator of quality in nursing practice, a basis for accountability and the gold standard of professional nursing care. The aim of this study was to explore nurses' experiences and perceptions about evidence-based nursing practice in giving care to patients with diabetic foot ulcers. A qualitative research design was adopted, and content analysis was used to analyse data. Semistructured interviews were held with 19 bachelor-degree nurses working in a teaching hospital in an urban area of Iran. During data analysis, two main themes developed: 'structural backgrounds of the organization' and 'empowerment'. Accordingly, it was concluded that successful implementation of evidence-based nursing requires the reconfiguration of the administrative structure in the hospital. In addition, it requires the support of nurse leaders to facilitate the implementation of evidence-based nursing in the practice. © 2013 Wiley Publishing Asia Pty Ltd.

  16. The History of Evidence-Based Practice in Nursing Education and Practice. (United States)

    Mackey, April; Bassendowski, Sandra

    Beginning with Florence Nightingale in the 1800s and evolving again within the medical community, evidence-based practice continues to advance along with the nursing discipline. Evidence-based practice is foundational to undergraduate and graduate nursing education and is a way for the nursing discipline to minimize the theory to practice gap. This article discusses the concept of evidence-based practice from a historical perspective as it relates to nursing in the educational and practice domains. The concept evidence-based practice is defined, and the similarities and differences to evidence-based medicine are discussed. It is crucial that registered nurses be proactive in their quest for research knowledge, so the gap between theory and practice continues to close. Utilizing nursing best practice guidelines, reviewing and implementing applicable research evidence, and taking advantage of technological advances are all ways in which nursing can move forward as a well-informed discipline. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Synthesizing Knowledge about Nursing Shift Handovers: Overview and Reflections from Evidence-Based Literature

    Directory of Open Access Journals (Sweden)

    Efstratios Athanasakis


    Full Text Available Background: Nursing shift handovers consider to be a pattern of communication that is applied in everyday clinical nursing practice, in order to be fulfilled the goals of organization, continuity, consistency and safety of care that nurses provide to patients.Aim: The aim of this review was the evaluation of the body of current research evidence examined issues concerning shift handovers in nursing.Methodology: A combination of various search terms: nurses, nursing, shift handovers and bedside handovers were used to search the Pubmed database. Also, a manual search contributed to the detection of more articles. For the introduction of an article in the existing review,specific inclusion criteria were set.Results: A total of 19 original research articles were included. A table of shift handover models and another one of the basic characteristics of the research articles are presented. Analysis of the research findings provided three major themes related to the aim of the review, as follows:′handovers' components′,′change type of handover′ and ′handovers' standardization′. A large part of the research literature looked at the exploration of the elements that handovers are composed of.Conclusions: This review highlighted evidence-based literature of fundamental information for nursing shift handovers. Effective communication practices among nurses entail effective handovers, effective patient care quality and patient safety maintenance. Nursing shift handovers are a multifaceted activity, which needs deeply understanding. Further knowledge development of handovers is required

  18. Dutch practice nurses' adherence to evidence-based smoking cessation treatment guidelines

    NARCIS (Netherlands)

    de Ruijter, D.; Smit, E.S.; de Vries, H.; Hoving, C.


    Background: Practice nurses in general practice sub-optimally adhere to evidence-based smoking cessation treatment guidelines, but factors explaining their adherence have not yet been investigated. Understanding such factors is important to develop interventions improving practice nurses' smoking


    Directory of Open Access Journals (Sweden)

    Sivasangari Subramaniam


    Full Text Available In the nursing profession, EBP makes a positive contribution to healthcare outcomes, care delivery, clinical teaching and research. The research objective was to determine the nurses' knowledge, attitude, practice towards EBP and barriers to use EBP in four (4 Government Hospitals in Malaysia, Hospital Universiti Sains Malaysia (HUSM, Hospital Pulau Pinang (HPP, Hospital Sultan Abdul Halim (HSAH and Hospital Seberang Jaya (HSJ. A cross-sectional study was conducted from January until December 2012 among (n=600 nurses working in all disciplines, on shift or day time duties in four selected hospitals. The questionnaire was adapted from a Singapore study (Majid, 2011. Results showed that among the nurses working in 4 different Malaysian hospitals, close to fifty percent (53 % knew what the evidence based practice meant. The items assessing the attitude showed a large number nurses responding that they did neither agree nor disagree with statements provided. The majority of the remaining nurses tended to show a rather positive attitude except when asked about how the workload interfered with their EBP practice. The practice level of EBP scored a mean of more than 3 out of maximal five for most items. Most nurses recognized there were many barriers to EBP in their working place. In conclusion, this study may have helped to increase our understanding of knowledge, attitudes, practice and barriers towards to use of EBP to the utilization of research by nurses through an exploration of perceived barriers and facilitators on the part of nurses.

  20. Importance of nursing leadership in advancing evidence-based nursing practice. (United States)

    Bradshaw, Wanda G

    Our patients depend on us to do the best on their behalf. If we do not take accountability for our practice, continually examining what is the best way to deliver care, we are limiting our role to technical skills and not fully actualizing our professional role. [Evidence-based practice] is essential to practicing safely as nurses (p. 53).1.

  1. Systematic implementation of evidence-based practice in a clinical nursing setting: a participatory action research project. (United States)

    Friesen-Storms, Jolanda H H M; Moser, Albine; van der Loo, Sandra; Beurskens, Anna J H M; Bours, Gerrie J J W


    To describe the process of implementing evidence-based practice in a clinical nursing setting. Evidence-based practice has become a major issue in nursing, it is insufficiently integrated into daily practice and its implementation is complex. Participatory action research. The main participants were nurses working in a lung unit of a rural hospital. A multi-method process of data collection was used during the observing, reflecting, planning and acting phases. Data were continuously gathered during a 24-month period from 2010 to 2012, and analysed using an interpretive constant comparative approach. Patients were consulted to incorporate their perspective. A best-practice mode of working was prevalent on the ward. The main barriers to the implementation of evidence-based practice were that nurses had little knowledge of evidence-based practice and a rather negative attitude towards it, and that their English reading proficiency was poor. The main facilitators were that nurses wanted to deliver high-quality care and were enthusiastic and open to innovation. Implementation strategies included a tailored interactive outreach training and the development and implementation of an evidence-based discharge protocol. The academic model of evidence-based practice was adapted. Nurses worked according to the evidence-based practice discharge protocol but barely recorded their activities. Nurses favourably evaluated the participatory action research process. Action research provides an opportunity to empower nurses and to tailor evidence-based practice to the practice context. Applying and implementing evidence-based practice is difficult for front-line nurses with limited evidence-based practice competencies. Adaptation of the academic model of evidence-based practice to a more pragmatic approach seems necessary to introduce evidence-based practice into clinical practice. The use of scientific evidence can be facilitated by using pre-appraised evidence. For clinical practice

  2. Evidence-based practice beliefs and implementation before and after an initiative to promote evidence-based nursing in an ambulatory oncology setting. (United States)

    Underhill, Meghan; Roper, Kristin; Siefert, Mary Lou; Boucher, Jean; Berry, Donna


    The purpose of evidence-based practice (EBP) in nursing is to improve patient outcomes, providing the best and most up-to-date care practices. In 2011, a nurse-led committee convened to develop an institute-wide initiative to promote EBP with oncology nurses at the Dana-Farber Cancer Institute. Compare and describe oncology nurse beliefs and perceived implementation of EBP and explore beliefs and implementation before and after implementing an institutional EBP initiative. Based on the Advancing Research and Clinical practice through close Collaboration (ARCC) Model, the Evidence-Based Practice Beliefs (EBP-B) and Implementation (EBP-I) scales were distributed to all Dana-Farber Cancer Institute registered and advanced practice nurses through an online survey in 2011 (T1) and again in 2013 (T2) after the implementation of an institute-wide nursing EBP initiative (orientation, poster presentations, education). Descriptive and correlation statistics were completed on total scores and demographics. Differences in beliefs and implementation scores based on demographics were analyzed with Mann-Whitney U tests. Open-ended item responses at each time point (T) were summarized for EBP barriers and promoters. Thirty-two percent (n = 112 at T1; n = 113 at T2) of 350 nurses began the survey. A history of formal EBP education and nurse role were associated with higher EBP-B and EBP-I scores (p nurses reported valuing EBP. Respondents acknowledged a lack of full preparation in the EBP process to engage in and implement EBP consistently. Nurse role, formal EBP education, and highest level of education were associated with perceptions of EBP beliefs and implementation. Nurses should be provided the mentorship and support to obtain continuing education about how to engage in EBP and about implementing EBP change. © 2015 Sigma Theta Tau International.

  3. Nursing-led management of side effects of radiation: evidence-based recommendations for practice

    Directory of Open Access Journals (Sweden)

    Poirier P


    Full Text Available Patricia PoirierUniversity of Maine School of Nursing, Orono, ME, USAAbstract: It has been estimated that 50%–60% of patients diagnosed with cancer will receive radiation therapy at some point in their treatment. Although radiation therapy can play a significant role in the cure or control of cancer, and the palliation of symptoms, it also has side effects. Side effects of radiation therapy can interfere with patient quality of life and daily functioning. Severe side effects can lead to delays in treatment, potentially affecting the outcome of treatment. All patients receiving radiation therapy are at risk of fatigue and skin reactions in the area of the body being treated. Other side effects of radiation therapy are specific to the part of the body being treated. Radiation therapy to the head and neck area may cause oral mucositis, dryness, and nutritional deficiencies. Radiation therapy to the chest or lung area may lead to difficulty in swallowing and eating. Radiation therapy to the pelvis frequently causes diarrhea. There are many nursing interventions available to manage the side effects of treatment based on best available evidence and expert opinion. Nurses in all settings are essential in helping patients manage the side effects of treatment and maintain their quality of life. The purpose of this review is to provide nurses with evidence-based recommendations and suggestions for managing common acute side effects of radiation therapy.Keywords: evidence-based practice, radiation therapy, side effects, nursing management

  4. Adopting evidence-based practice in clinical decision making: nurses' perceptions, knowledge, and barriers (United States)

    Majid, Shaheen; Foo, Schubert; Luyt, Brendan; Zhang, Xue; Theng, Yin-Leng; Chang, Yun-Ke; Mokhtar, Intan A


    Objective: Evidence-based practice (EBP) provides nurses with a method to use critically appraised and scientifically proven evidence for delivering quality health care to a specific population. The objective of this study was to explore nurses' awareness of, knowledge of, and attitude toward EBP and factors likely to encourage or create barriers to adoption. In addition, information sources used by nurses and their literature searching skills were also investigated. Method: A total of 2,100 copies of the questionnaire were distributed to registered nurses in 2 public hospitals in Singapore, and 1,486 completed forms were returned, resulting in a response rate of 70.8%. Results: More than 64% of the nurses expressed a positive attitude toward EBP. However, they pointed out that due to heavy workload, they cannot keep up to date with new evidence. Regarding self-efficacy of EBP-related abilities, the nurses perceived themselves to possess moderate levels of skills. The nurses also felt that EBP training, time availability, and mentoring by nurses with EBP experience would encourage them to implement EBP. The top three barriers to adopting EBP were lack of time, inability to understand statistical terms, and inadequate understanding of the jargon used in research articles. For literature searching, nurses were using basic search features and less than one-quarter of them were familiar with Boolean and proximity operators. Conclusion: Although nurses showed a positive attitude toward EBP, certain barriers were hindering their smooth adoption. It is, therefore, desirable that hospital management in Southeast Asia, particularly in Singapore, develop a comprehensive strategy for building EBP competencies through proper training. Moreover, hospital libraries should also play an active role in developing adequate information literacy skills among the nurses. PMID:21753915

  5. Defining an evidence-based work environment for nursing in the USA. (United States)

    Kotzer, Anne Marie; Arellana, Kerry


    To describe and compare staff nurses' perceptions of their real and ideal work environment in a tertiary paediatric facility; to provide administrators with research evidence for identifying areas for improvement. The workforce shortage of hospital nurses is a global problem having an impact on the financial resources and efficient operations of an organisation and the quality of care delivered to patients. A direct relationship exists between job satisfaction, retention, turnover and elements of the nurses' work environment. Research identifying specific elements of the current work setting that are in conflict with nurses' views of their preferred practice milieu can help define an evidence-based work environment for nursing. Using a descriptive survey design, a convenience sample of 385 nurses on five inpatient units and the float team completed two forms (real and ideal) of the work environment scale. The work environment scale consists of 10 subscales within three dimensions: relationship, personal growth and system maintenance and change. A consistent pattern was seen across all units with reported high levels of involvement, peer cohesion, task orientation and managerial control. Scores for work pressure and autonomy were moderate-high and physical comfort, supervisor support, clarity and innovation were moderate. Overall, highest scores were reported for involvement and lowest for physical comfort. Significant differences were found between real and ideal subscale scores suggesting that staff were able to identify areas for improvement. Despite moderate work pressure, staff affirmed a highly positive work environment on their units. Specific areas in their current work setting that were not congruent with their preferred work environment were identified and targeted for change. Understanding dimensions of the nurses' work environment needing improvement and involving staff in making and evaluating change supports an evidence-based environment to attract and

  6. Improve nursing in evidence-based practice: How Chinese nurses' read and comprehend scientific literature

    Directory of Open Access Journals (Sweden)

    Fei-Fei Huang


    Conclusions: The survey of the current status of literature education among Chinese nurses suggests that providing protected time, training for critical thinking, and incentive mechanisms will help improve nurses' engagement in literature and create a culture of academic inquiry.

  7. Nursing Students' Competencies in Evidence-Based Practice and Its Related Factors. (United States)

    Ashktorab, Tahereh; Pashaeypoor, Shahzad; Rassouli, Maryam; Alavi-Majd, Hamid


    Evidence-Based Practice (EBP) is one of the nursing professional roles that can lead them to provide the best and more effective care. However, no studies are available on nursing students' competencies in EBP. This study aimed to investigate the nursing students' knowledge, attitude and intention to implement EBP and its related factors in two nursing and midwifery faculties in Tehran, Iran. In this cross-sectional study, 170 undergraduate nursing students were selected from two faculties of nursing and midwifery in Tehran, Iran. A census sampling method was applied and they were all before graduation in 2013. The Rubin and Parrish questionnaire was used to assess the students' knowledge, attitude and intention to implement EBP as well as factors affecting the implementation of EBP. Students completed the instrument through self-report. Descriptive statistics, Independent sample t-test and Pearson correlation coefficient were used to analyze the data. The students mean scores of knowledge, attitude and intention to implement EBP was 31.08 ± 5.77, 50.40 ± 9.58, 36.01 ± 4.64, respectively. The students' age was inversely correlated with their scores of knowledge, attitude and intention to use EBP (P research methods (P research methods nor familiarity with EBP could significantly affect the students' intention to implement EBP. The present study showed that nursing students have not a high mean score in the three subscales of knowledge, attitude and intention to implement EBP. It is essential for faculties and nurse managers not only to focus on education of EBP, but also to support nurses and nursing students to implement it in the process patient care.

  8. Nurses' Evidence-Based Practice Beliefs and the Role of Evidence-Based Practice Mentors at University Hospitals in Finland. (United States)

    Saunders, Hannele; Vehviläinen-Julkunen, Katri


    Although systematic implementation of evidence-based practice (EBP) is essential to effectively improve patient outcomes, quality, and value of care, nurses do not consistently use evidence in practice. Uptake is hampered by lack of nurses' readiness for EBP, including nurses' EBP beliefs and lack of EBP mentors. Favorable EBP beliefs are foundational to Registered Nurses' (RNs) use and integration of best evidence into clinical decision making, whereas EBP mentors are in a key role for strengthening RNs' beliefs in the value of EBP and confidence in their ability to implement EBP. Although nurses' EBP beliefs and role of BP mentors have been widely studied in countries leading the EBP movement, less is known about them in the non-English-speaking world. To determine RNs EBP beliefs and the role of EBP mentors at Finnish university hospitals and to explore the associations between RNs' EBP beliefs and sociodemographic factors. A cross-sectional descriptive survey was conducted in November-December 2014 at every university hospital in Finland with a convenience sample (n = 943) of practicing RNs. The data were collected via an electronic survey, and analyzed using descriptive and inferential statistics. RNs reported low levels of EBP beliefs in the degree to which they believed that clinical nursing practice and their own practice were based on evidence. EBP mentors worked in many professional nursing roles. Several significant differences were found between RN's EBP beliefs and sociodemographic variables. Although RNs were familiar with and believed in the value of EBP in improving care quality and patient outcomes, their ratings were low about the degree to which they believed that clinical nursing practice and their own practice were based on evidence, indicating a modest level of individual EBP readiness among Finnish RNs required for integrating best evidence into clinical care delivery. © 2016 Sigma Theta Tau International.

  9. Stuck in tradition - A qualitative study on barriers for implementation of evidence-based nutritional care perceived by nursing staff

    DEFF Research Database (Denmark)

    O Connell, Malene Barfod; Jensen, Pia Søe; Andersen, Signe Lindgård


    AIM: To explore the barriers for nutritional care as perceived by nursing staff at an acute orthopedic ward, aiming to implement evidence-based nutritional care. BACKGROUND: Previous studies indicate that nurses recognize nutritional care as important, but interventions are often lacking. These s......AIM: To explore the barriers for nutritional care as perceived by nursing staff at an acute orthopedic ward, aiming to implement evidence-based nutritional care. BACKGROUND: Previous studies indicate that nurses recognize nutritional care as important, but interventions are often lacking....... These studies show that a range of barriers influence the attempt to optimize nutritional care. Before the implementation of evidence-based nutritional care, we examined barriers for nutritional care among the nursing staff. DESIGN: Qualitative study. METHODS: Four focus groups with thirteen members......-based practice. Barriers for nutritional care are grounded in lack of knowledge among nursing staff and insufficient collaboration between nursing staff and the doctors. There is a need for nutritional education for the nursing staff and better support from the organisation to help nursing staff provide evidence...

  10. Evidence-based training in the era of evidence-based practice: Challenges and opportunities for training of PTSD providers. (United States)

    Rosen, Raymond C; Ruzek, Josef I; Karlin, Bradley E


    There is a pressing global need for trained and competent mental health clinicians to deliver evidence-based psychological therapies to millions of trauma survivors in need of care. Three model, large-scale training programs were initiated a decade ago, one in the United Kingdom (U.K.), and two in the United States (U.S.), to disseminate high-quality, evidence-based psychological care to traumatized children and adults in need of assistance. Milestone contributions to implementation science have been made by each of these training programs, although limitations and challenges remain to be considered. In contrast, culturally adapted and simplified PTSD interventions and therapy training programs have also been developed and tested during the past decade, three of which show particular promise for broader implementation. These simplified but evidence-based interventions have been developed for use by lay counsellors or health technicians with minimal or no prior mental health training. Finally, a growing range of technology-based and technology-assisted training models for PTSD providers have also been developed and disseminated in the past decade. This trend is expected to accelerate as more providers become accustomed to acquiring clinical training in this modality or format, although significant barriers to technology-based training will need to be overcome. Copyright © 2016. Published by Elsevier Ltd.

  11. Using evidence-based leadership initiatives to create a healthy nursing work environment. (United States)

    Nayback-Beebe, Ann M; Forsythe, Tanya; Funari, Tamara; Mayfield, Marie; Thoms, William; Smith, Kimberly K; Bradstreet, Harry; Scott, Pamela


    In an effort to create a healthy nursing work environment in a military hospital Intermediate Care Unit (IMCU), a facility-level Evidence Based Practice working group composed of nursing.Stakeholders brainstormed and piloted several unit-level evidence-based leadership initiatives to improve the IMCU nursing work environment. These initiatives were guided by the American Association of Critical Care Nurses Standards for Establishing and Sustaining Healthy Work Environments which encompass: (1) skilled communication, (2) true collaboration, (3) effective decision making, (4) appropriate staffing, (5) meaningful recognition, and (6) authentic leadership. Interim findings suggest implementation of these six evidence-based, relationship-centered principals, when combined with IMCU nurses' clinical expertise, management experience, and personal values and preferences, improved staff morale, decreased staff absenteeism, promoted a healthy nursing work environment, and improved patient care.

  12. Effect of Evidence-Based Practice Programs on Individual Barriers of Workforce Nurses: An Integrative Review. (United States)

    Middlebrooks, Reginald; Carter-Templeton, Heather; Mund, Angela R


    HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at In order to obtain contact hours you must: 1. Read the article, "Effect of Evidence-Based Practice on Individual Barriers of Workforce Nurses: An Integrative Review" found on pages 398-406, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until August 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Identify individual barriers in the implementation of evidence-based practice (EBP) by nurses

  13. Attitudes, Awareness, and Barriers Regarding Evidence-Based Surgery Among Surgeons and Surgical Nurses

    NARCIS (Netherlands)

    Knops, A.M.; Vermeulen, H.; Legemate, D.A.; Ubbink, D.T.


    Evidence-based surgery (EBS) is stressed to increase efficiency and health care quality, but not all surgeons and surgical nurses use EBS in clinical practice. To define future tailor-made interventions to improve evidence-based behavior, the aim of this study was to determine the attitude and

  14. Teaching Evidence-Based Practice to Undergraduate Nursing Students: Overcoming Obstacles (United States)

    Martin, Sharon D.


    Evidence-based practice is highly valued in health care literature at this time. But research suggests that U.S. RNs face many obstacles when implementing evidence-based practice including a lack of value for research in practice (Pravikoff et al, 2005). Additional obstacles may exist for traditional U.S. BSN nursing students who may not value the…

  15. Facilitating the implementation of evidence-based practice through contextual support and nursing leadership

    Directory of Open Access Journals (Sweden)

    Kueny A


    Full Text Available Angela Kueny,1 Leah L Shever,2 Melissa Lehan Mackin,3 Marita G Titler4 1Luther College, Decorah, IA, 2The University of Michigan Hospital and Health Center, Ann Arbor, MI, 3University of Iowa College of Nursing, Iowa City, IA, 4University of Michigan School of Nursing, Ann Arbor, MI, USA Background/purpose: Nurse managers (NMs play an important role promoting evidence-based practice (EBP on clinical units within hospitals. However, there is a dearth of research focused on NM perspectives about institutional contextual factors to support the goal of EBP on the clinical unit. The purpose of this article is to identify contextual factors described by NMs to drive change and facilitate EBP at the unit level, comparing and contrasting these perspectives across nursing units. Methods: This study employed a qualitative descriptive design using interviews with nine NMs who were participating in a large effectiveness study. To stratify the sample, NMs were selected from nursing units designated as high or low performing based on implementation of EBP interventions, scores on the Meyer and Goes research use scale, and fall rates. Descriptive content analysis was used to identify themes that reflect the complex nature of infrastructure described by NMs and contextual influences that supported or hindered their promotion of EBP on the clinical unit. Results: NMs perceived workplace culture, structure, and resources as facilitators or barriers to empowering nurses under their supervision to use EBP and drive change. A workplace culture that provides clear communication of EBP goals or regulatory changes, direct contact with CEOs, and clear expectations supported NMs in their promotion of EBP on their units. High-performing unit NMs described a structure that included nursing-specific committees, allowing nurses to drive change and EBP from within the unit. NMs from high-performing units were more likely to articulate internal resources, such as quality

  16. Embedding evidence-based practice among nursing undergraduates: Results from a pilot study. (United States)

    André, Beate; Aune, Anne G; Brænd, Jorunn A


    Evidence-based practice is currently one of the most important developments in health care. Research in nursing science is rapidly growing; however, translating the knowledge based on this research into clinical practice is often hampered, and may be dependent on reflective skills. The aim of this study was to see how undergraduate nursing students in nursing should increase their skills and knowledge related to evidence-based practice through participation in clinical research projects. A qualitative approach was used in collecting and analyzing the data. Students participated in a pilot clinical research project and a received guidance related to their bachelor thesis. After the project was completed, all students filled in a questionnaire. The students' motivation to participate in this study was reported to be high, but they reported low knowledge related to evidence-based practice. All students reported that their attitude towards evidence-based practice changed in a positive direction during their participation in the project. Evidence-based practice influenced nursing practices by putting more focus on critical thinking, increasing pride and giving a sense of ownership in the clinical field. The curricula and the pedagogical perspectives in nursing education can influence the attitude towards evidence-based practice and skills among nursing bachelor students. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Impact of Online Education on Nurses' Delivery of Smoking Cessation Interventions With Implications for Evidence-Based Practice. (United States)

    Bialous, Stella A; Sarna, Linda; Wells, Marjorie J; Brook, Jenny K; Kralikova, Eva; Pankova, Alexandra; Zatoński, Witold; Przewozniak, Krzysztof


    Tobacco use is the leading cause of preventable disease and death in Europe and worldwide. Nurses, if properly educated, can contribute to decreasing the burden of tobacco use in the region by helping smokers quit smoking. To assess: (a) the feasibility of an online program to educate nurses in Czech Republic and Poland on evidence-based smoking cessation interventions for patients and (b) self-reported changes in practices related to consistently (usually or always) providing smoking cessation interventions to smokers, before and 3 months after participation in the program. A prospective single-group pre-post design. A total of 280 nurses from Czech Republic and 156 from Poland completed baseline and follow-up surveys. At 3 months, nurses were significantly more likely to provide smoking cessation interventions to patients who smoke and refer patients for cessation services (p Nurses significantly improved their views about the importance of nursing involvement in tobacco control. Education about tobacco control can make a difference in clinical practice, but ongoing support is needed to maintain these changes. Health system changes can also facilitate the expectation that delivering evidence-based smoking cessation interventions should be routine nursing care. Educating nurses on cessation interventions and tobacco control is pivotal to decrease tobacco-related disparities, disease, and death. Online methods provide an accessible way to reach a large number of nurses. © 2017 Sigma Theta Tau International.

  18. The Influence of Social Capital on Nurse-Perceived Evidence-Based Practice Implementation in South Korea. (United States)

    Shin, Ji In; Lee, Eunjoo


    To examine the relationship between evidence-based practice (EBP) adoption and social capital in nurses and to determine how social capital affected EBP adoption in South Korea. A cross-sectional, correlational design was used. In total, 432 registered nurses from two university-affiliated teaching hospitals in South Korea completed the questionnaire, which included demographic items, the Developing Evidence-Based Practice Questionnaire, and the Social Capital Outcomes for Nurses scale. Data were analyzed using hierarchical regression to identify the predictors of EBP adoption. Nurses with higher social capital scores reported fewer perceived barriers to finding and reviewing evidence, and changing practice. Higher social capital scores were associated with higher levels of perceived facilitators of EBP adoption and skills appraisal in finding and reviewing evidence. Social capital was a significant predictor of EBP adoption. Nurses with greater opportunities to exchange and communicate their ideas freely are more likely to accept new evidence through diverse channels and trust-based relationships between nurses, which allows healthcare organizations to promote innovations such as EBP adoption. Therefore, social capital in nurses could serve as a driving force for EBP adoption and should provide a healthy foundation for changes in patient care practices. Nurses with higher social capital are tending to adopt EBP willingly. High trust enables nurses to facilitate and support change in practice. Therefore, to improve EBP adoption in patient care, it needs to be monitored that relationships between nurses are carefully structured and that they foster mutual interaction. © 2017 Sigma Theta Tau International.

  19. Contributing to a Quality Patient Experience: Applying Evidence Based Practice to Support Changes in Nursing Dress Code Policies (United States)

    West, Margaret Mary; Wantz, Debra; Campbell, Patricia; Rosler, Greta; Troutman, Dawn; Muthler, Crystal


    The public image of nurse professionalism is important. Attributes of a professional nurse, such as caring, attentive, empathetic, efficient, knowledgeable, competent, and approachable, or lack thereof, can contribute positively or negatively to the patient experience. Nurses at a hospital in central northeast Pennsylvania offer their story as they considered the impact of a wide variety of individual uniform and dress choices. This article describes an evidence based practice project and survey created to increase understanding of patient perceptions regarding the professional image of nurses in this facility. Exploring patient perception of nurse image provided insight into what patients view as important. A team approach included the voice of nurses at different levels in the process. Ultimately, this work informed a revision of the health system nursing dress code. The study team also reflects on challenges, next steps in the process, and offers recommendations based on their experiences.

  20. The role of organizational context and individual nurse characteristics in explaining variation in use of information technologies in evidence based practice

    National Research Council Canada - National Science Library

    Doran, Diane; Haynes, Brian R; Estabrooks, Carole A; Kushniruk, André; Dubrowski, Adam; Bajnok, Irmajean; Hall, Linda McGillis; Li, Mingyang; Carryer, Jennifer; Jedras, Dawn; Bai, Yu Qing Chris


    ...) model provided the framework for studying the impact of providing nurses with PDA-supported, evidence-based practice resources, and for studying the organizational, technological, and human resource...

  1. evidence-based care: an innovation to improve nursing practice ...

    African Journals Online (AJOL)



    Oct 13, 2014 ... Thus, as important as the practice of nursing that is based on evidence could be, there are however contending issues that should be addressed for success to be achieved. As a fairly new concept, Stetler, Brunnel,. Giuliano, Morsi, Prince and Newell-Stokes (2008) asserted that its meaning is not always ...

  2. Validation of evidence-based clinical practice guideline: Nursing ...

    African Journals Online (AJOL)

    The overall assessment of the guideline revealed that two-thirds of academic appraisers strongly recommended the guideline to be used in practice and most of practitioner nurses and practitioner physicians recommended the guideline to be in practice. Conclusion: The development of this guideline was based on the ...

  3. Perception Of Nursing Middle Managers About The Evidence-Based Management

    Directory of Open Access Journals (Sweden)

    Wilza Carla Spiri


    Full Text Available Objective: to comprehend the experience of nursing middle managers of an accredited public hospital, from São Paulo state, about the evidence-based management. Method: case study and analysis of thematic content in the stages of unity of meaning, condensed meaning unity, interpretation of the underlying meaning, sub-theme and theme. Nine manager nurses participated. The data collection was done through a script with questions that, according to the convenience of the participants, were answered by electronic mail. The data were analyzed in the light of the theoretical reference of the managerial process in nursing and the evidence-based management. Results: six themes were revealed: Evidence-based management and management process; Evidence-based management strengths; Evidence-based management challenges; the leader and the Evidence-based management; Hospital accreditation and evidence-based management and Experiences with the evidence-based management. Conclusion: the scientific knowledge and the experiences in the work are sources of evidences that interfere, positively, in the quality and safety of the patient. Leadership training, planning, team empowerment and involvement are essential for the development of this practice. Strategies need to be discussed and implemented so that the management process is based on evidences.

  4. A university and health care organization partnership to prepare nurses for evidence-based practice. (United States)

    Missal, Bernita; Schafer, Beth Kaiser; Halm, Margo A; Schaffer, Marjorie A


    This article describes a partnership model between a university and health care organizations for teaching graduate nursing research from a framework of evidence-based practice. Nurses from health care organizations identified topics for graduate students to search the literature and synthesize evidence for guiding nursing practice. Nurse educators mentored graduate students in conducting critical appraisals of the literature. Students learned how to search for the evidence, summarize the existing research findings, and translate the findings into practice recommendations. Through presenting and discussing their findings with key stakeholders, students learned how nurses planned to integrate the evidence into practice. Nurses used the evidence-based results to improve their practice in the two partner hospitals. The partnership stimulated action for further inquiry into best practices.

  5. A unique collaborative nursing evidence-based practice initiative using the Iowa model: a clinical nurse specialist, a health science librarian, and a staff nurse's success story. (United States)

    Krom, Zachary R; Batten, Janene; Bautista, Cynthia


    The purpose of this article was to share how the collaboration of a clinical nurse specialist (CNS), a health science librarian, and a staff nurse can heighten staff nurses' awareness of the evidence-based practice (EBP) process. The staff nurse is expected to incorporate EBP into daily patient care. This expectation is fueled by the guidelines established by professional, accrediting, and regulatory bodies. Barriers to incorporating EBP into practice have been well documented in the literature. A CNS, a health science librarian, and a staff nurse collaborated to develop an EBP educational program for staff nurses. The staff nurse provides the real-time practice issues, the CNS gives extensive knowledge of translating research into practice, and the health science librarian is an expert at retrieving the information from the literature. The resulting collaboration at this academic medical center has increased staff nurse exposure to and knowledge about EBP principles and techniques. The collaborative relationship among the CNS, health science librarian, and staff nurse effectively addresses a variety of barriers to EBP. This successful collaborative approach can be utilized by other medical centers seeking to educate staff nurses about the EBP process.

  6. Irish psychiatric nurses' self-reported barriers, facilitators and skills for developing evidence-based practice.

    LENUS (Irish Health Repository)

    Yadav, B L


    Evidence-based practice places an emphasis on integration of clinical expertise with available best evidence, patient\\'s clinical information and preferences, and with local health resources. This paper reports the findings of a study that investigated the barriers, facilitators and skills in developing evidence-based practice among psychiatric nurses in Ireland. A postal survey was conducted among a random sample of Irish psychiatric nurses and survey data were collected using the Development of Evidence-Based Practice Questionnaire. Respondents reported that insufficient time to find and read research reports and insufficient resources to change practice were the greatest barriers to the development of evidence-based practice. Practice development coordinators were perceived as the most supportive resource for changing practice. Using the Internet to search for information was the highest-rated skill and using research evidence to change practice was the lowest-rated skill for developing evidence-based practice. Nurses\\' precursor skills for developing evidence-based practice, such as database searching and information retrieval, may be insufficient in themselves for promoting evidence-based practice if they cannot find evidence relating to their particular field of practice or if they do not have the time, resources and supports to develop their practice in response to evidence.

  7. Exploring the contribution of the Clinical Librarian to facilitating evidence-based nursing. (United States)

    Tod, Angela M; Bond, Beverly; Leonard, Niamh; Gilsenan, Irene J; Palfreyman, Simon


    To examine the potential role of the Clinical Librarian in facilitating evidence-based practice of nurses in acute hospital settings and develop a model for the role. There is a growing policy and professional expectation that nurses will seek out and apply evidence in their clinical practice. Studies have demonstrated that nurses experience barriers in working with an evidence-based approach. The role of Clinical Librarian has been used in other countries and within medicine to overcome some of the barriers to evidence-based practice. There are limitations in the previous work in terms of rigour of evaluation, scope of the Clinical Librarian role and application to nursing in a UK setting. A qualitative consultation of 72 nurses in acute care settings. Six consultation group interviews of between 4-19 participants. Written records were recorded by the scribe. Content analysis was undertaken to identify the range and frequency of comments. Clinical questions currently go unanswered because of barriers of time, skills deficits and access to resources. Literature searching, skills training and evidence dissemination were the main areas of work the staff requested that a Clinical Librarian should undertake. It was anticipated that the Clinical Librarian could interact and work productively with nursing staff with a limited but regular presence on the ward. Interim communication could be via e-mail, phone and written suggestions and requests for work. It was seen to be vital that the Clinical Librarian worked in partnership with staff to build evidence-based practice capacity and ensure clinical relevance of the work. This study has generated the first model for the Clinical Librarian role with an emphasis on nursing. It is derived from the views of clinical nurses. Recommendations are made for the implementation and evaluation of such a role. The Clinical Librarian could be an invaluable support to promoting evidence-based nursing.

  8. Taking Root: a grounded theory on evidence-based nursing implementation in China. (United States)

    Cheng, L; Broome, M E; Feng, S; Hu, Y


    Evidence-based nursing is widely recognized as the critical foundation for quality care. To develop a middle-range theory on the process of evidence-based nursing implementation in Chinese context. A grounded theory study using unstructured in-depth individual interviews was conducted with 56 participants who were involved in 24 evidence-based nursing implementation projects in Mainland China from September 2015 to September 2016. A middle-range grounded theory of 'Taking Root' was developed. The theory describes the evidence implementation process consisting of four components (driving forces, process, outcome, sustainment/regression), three approaches (top-down, bottom-up and outside-in), four implementation strategies (patient-centred, nurses at the heart of change, reaching agreement, collaboration) and two patterns (transformational and adaptive implementation). Certain perspectives may have not been captured, as the retrospective nature of the interviewing technique did not allow for 'real-time' assessment of the actual implementation process. The transferability of the findings requires further exploration as few participants with negative experiences were recruited. This is the first study that explored evidence-based implementation process, strategies, approaches and patterns in the Chinese nursing practice context to inform international nursing and health policymaking. The theory of Taking Root described various approaches to evidence implementation and how the implementation can be transformational for the nurses and the setting in which they work. Nursing educators, managers and researchers should work together to improve nurses' readiness for evidence implementation. Healthcare systems need to optimize internal mechanisms and external collaborations to promote nursing practice in line with evidence and achieve clinical outcomes and sustainability. © 2017 International Council of Nurses.

  9. Negotiating concepts of evidence-based practice in the provision of good service for nursing and allied health professionals. (United States)

    McTavish, Jill


    The principles of evidence-based medicine have been critiqued by the 'caring' professions, such as nursing and social work, and evidence-informed medicine has been proposed as a more client-centred, integrative approach to practice. The purpose of this study was to explore how Canadian health science librarians who serve nurses and allied health professionals define good service and how they negotiate evidence-based principles in their searching strategies. Twenty-two librarians completed a 30 minute, semi-structured phone interview about strategies for providing good service and supporting evidence-based services. Participants were also asked to respond to three challenging search scenarios. Analysis of results used grounded theory methods. Participants' definitions of good service and strategies for supporting evidence-based practice involved discussions about types of services provided, aspects of the librarian providing the service and aspects of the information provided during the service. Analysis of search scenarios revealed four justifications librarians rely upon when providing evidence that is in opposition to what their patron hopes to receive (evidentiary, ethical, practice-based and boundaries of the profession). The findings of this study suggest that health science librarians are both constrained and enabled by the principles of evidence-based medicine and especially by understandings of 'best evidence'. © 2017 Health Libraries Group.

  10. Barriers and facilitators to evidence-based nursing in Colombia: perspectives of nurse educators, nurse researchers and graduate students. (United States)

    DeBruyn, Rebecca R; Ochoa-Marín, Sandra Catalina; Semenic, Sonia


    To identify and describe the perceptions of nursing researchers, educators, and graduate students regarding the barriers to, and facilitators for, EBN in Medellín, Colombia. Using a qualitative descriptive design, in-depth semi-structured interviews were conducted with 12 participants associated with a large university faculty of nursing in Medellín, and one member of the National Association of Nurses. Qualitative content analysis was used to analyze the interview transcripts. Several barriers to EBN were reported, including: lack of recognition of nursing as an autonomous profession; a lack of incentives for nurses to pursue advanced education or engage in research; limited availability and utility of nursing evidence; and a lack of communication between academic and clinical practice environments. Perceived facilitators included an increase in nurses pursuing advanced education opportunities; the current healthcare accreditation process; access to international research and research collaborations; and clinical and research partnerships between universities and clinical institutions. Effective implementation of evidence-based nursing practices is a necessity to translate the vast amount of health-related research, knowledge, and experience into positive changes in healthcare quality.

  11. Barriers and Facilitators to Evidence-Based Nursing in Colombia: Perspectives of Nurse Educators, Nurse Researchers and Graduate Students

    Directory of Open Access Journals (Sweden)

    Rebecca R. DeBruyn


    Full Text Available Objective. To identify and describe the perceptions of nursing researchers, educators, and graduate students regarding the barriers to, and facilitators for, EBN in Medellín, Colombia. Methodology. Using a qualitative descriptive design, in-depth semi-structured interviews were conducted with 12 participants associated with a large university faculty of nursing in Medellín, and one member of the National Association of Nurses. Qualitative content analysis was used to analyze the interview transcripts. Results. Several barriers to EBN were reported, including: lack of recognition of nursing as an autonomous profession; a lack of incentives for nurses to pursue advanced education or engage in research; limited availability and utility of nursing evidence; and a lack of communication between academic and clinical practice environments. Perceived facilitators included an increase in nurses pursuing advanced education opportunities; the current healthcare accreditation process; access to international research and research collaborations; and clinical and research partnerships between universities and clinical institutions. Conclusion. Effective implementation of evidence-based nursing practices is a necessity to translate the vast amount of health-related research, knowledge, and experience into positive changes in healthcare quality.

  12. Bringing Evidence-Based Practice to Latin America: Transforming Nursing Education and Practice. (United States)

    Visovsky, Constance; Maguire, Denise J; Zambroski, Cheryl; Palacios, Linette


    Evidence-based practice (EBP) continues to gain global attention. In the Latin American country of Panama, nursing practice has largely been guided by oral tradition and clinical experience rather than the use of best evidence. The authors used a conference-based approach in a joint effort between the University of South Florida and the University of Panama to introduce EBP to nursing leaders in Panama to bring change to the nursing curricula and, ultimately, change in nursing practice. J Contin Educ Nurs. 2017;48(11):512-516. Copyright 2017, SLACK Incorporated.

  13. [Bibliometric analysis of scientific articles on evidence-based nursing of burn in the mainland of China]. (United States)

    Yue, L Q; Pi, X Q; Fan, X G


    To analyze the current research status of evidence-based nursing of burn in the mainland of China, in order to provide basis for the improvement of scientificity of burn nursing practice. Chinese scientific articles on evidence-based nursing of burn in the mainland of China published from January 1997 to December 2015 were retrieved from Chinese Biology Medicine disc, Chinese Journals Full-text Database, Wanfang Database, and VIP Database. From the results retrieved, date with regard to publication year, region of affiliation of the first author, journal distribution, literature type, literature quality assessment, topic of evidence-based research, fund program support, implementation of evidence-based practice steps, and language and quantity of reference. Data were processed with Microsoft Excel software. A total of 50 articles conforming to the criteria were retrieved. (1) Articles about evidence-based nursing of burn arose in 2004. Compared with that in the previous year, there was no obvious increase in the number of relevant articles in each year from 2004 to 2011. The number of literature in 2012 was obviously increased than that in each year from 2004 to 2011, while the number of literature in each year from 2012 to 2015 was not obviously increased compared with that in the previous year. (2) The regions of affiliation of the first author were distributed in 13 provinces, 3 minority autonomous regions, and 3 municipalities, with the largest distribution in East China, and Northwest China and Southwest China in the follow. (3) The articles were published in 32 domestic journals, with 9 (28.12%) nursing journals, 5 (15.62%) burn medical related journals, and 18 (56.25%) other journals. Twenty (40%) articles were published in Source Journal for Chinese Scientific and Technical Papers. (4) Regarding the literature type, 31 (62%) articles dealt with clinical experiences, 17 (34%) articles dealt with scientific research, and 2 (4%) articles dealt with case report

  14. Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice. (United States)

    Canada, Amanda N


    HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at In order to obtain contact hours you must: 1. Read the article, "Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice," found on pages 161-168, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until March 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. • Describe the key components and characteristics related to evidence-based

  15. Evidence-based medicine: medical librarians providing evidence at the point of care. (United States)

    Yaeger, Lauren H; Kelly, Betsy


    Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. .. by best available external clinical evidence we mean clinically relevant research.' Health care reform authorized by the Affordable Care Act is based on the belief that evidence-based practice (EBP) generates cost savings due to the delivery of more effective care.2 Medical librarians, skilled in identifying appropriate resources and working with multiple complex interfaces, can support clinicians' efforts to practice evidence based medicine by providing time and expertise in articulating the clinical question and identifying the best evidence.

  16. Achieving evidence-based nursing practice: impact of the Caledonian Development Model. (United States)

    Tolson, Debbie; Booth, Jo; Lowndes, Andrew


    To determine the impact of the Caledonian Development Model, designed to promote evidence-based practice. The model features practice-development activities, benchmarking, knowledge pooling and translation through membership of a community of practice and a virtual college. Twenty-four nurses, from 18 practice sites formed three communities of practice, each selecting evidence-based guidance to implement. A modified group supervision framework empowered nurses to champion local implementation. Outcomes were determined at 6 months. Eighty per cent of the patient-related criteria and 35% of the facilities criteria were achieved. The Revised Nursing Work Index indicated these nurses experienced greater autonomy (P = 0.019) and increased organizational support (P = 0.037). Focus groups revealed a deepening organizational support for the initiative over time, illuminated work-based learning challenges and overall enthusiasm for the approach. Implementation of the model effectively promoted evidence-based practice, most notably at the level of the individual patient. Time and budgetary constraints necessitate smart, value for money approaches to developing evidence-based practice and improved care standards. This work demonstrates an effective model that strikes a balance between individual and group learning, virtual and real-time activities, coupled with resource pooling across organizations and sectors.

  17. An Integrative Literature Review of Evidence-Based Teaching Strategies for Nurse Educators. (United States)

    Breytenbach, Cecile; Ten Ham-Baloyi, Wilma; Jordan, Portia J

    The aim of the study was to explore and describe the best available literature on evidence-based teaching strategies that can be used by nurse educators. Evidence-based teaching strategies in nursing education are fundamental to promote an in-depth understanding of information. Although some teaching strategies for nurse educators were identified, no integrative literature review was found summarizing the best teaching strategies for nurse educators. Integrative literature review. Sixteen studies were included encompassing eight teaching strategies (e-learning, concept mapping, Internet-based learning, web-based learning, gaming, problem-based learning, case studies, and evidence-based learning). Of these, three (concept mapping, Internet-based learning, and evidence-based learning) significantly increased student knowledge. All teaching strategies increased knowledge in some way, indicating that faculties should use a variety of teaching strategies. However, more research is needed to compare the impact of a variety of teaching strategies and the best use of different teaching strategies.

  18. Envisaging the use of evidence-based practice (EBP): how nurse academics facilitate EBP use in theory and practice across Australian undergraduate programmes. (United States)

    Malik, Gulzar; McKenna, Lisa; Griffiths, Debra


    culture for nurses and students to apply evidence-based practice principles, and collaboration between academia and practice will make facilitation by academics practical and meaningful for students. Findings from this study point to a number of initiatives for clinical leadership to provide infrastructure and support for academics, practising nurses and undergraduate students to adopt evidence-based practice in practice settings, thereby influencing practice outcomes. © 2016 John Wiley & Sons Ltd.

  19. Evidence-Based Practice Beliefs and Implementation in Doctor of Nursing Practice Students. (United States)

    Singleton, Joanne K


    Doctors of Nursing Practice focus on leadership in evidence-based practice (EBP). EBP is influenced by one's beliefs in and implementation of EBP. Little is known to date about the EBP beliefs and implementation of Doctor of Nursing Practice students and outcomes of Doctor of Nursing Practice education. Guided by the Advancing Research and Clinical practice through close Collaboration (ARCC) Model, the Evidence-Based Practice Beliefs (EBPB) and Implementation (EBPI) tools were used to assess the impact of EBP as a program pillar, curricular thread, and content area on EBPB and EBPI of Doctor of Nursing Practice-Family Nurse Practitioner students. Five cohorts who completed the same curriculum were studied. Fifty-four of the 89 students across the five cohorts began and completed the study. Paired t-test for group effects showed statistical significance from pre- to post-measure in students overall EBPB, t = 4.4 (52), p students who are educated to be EBP leaders must have a curriculum that supports them in the knowledge and skill-set needed to translate evidence into practice. The ARCC Model can guide faculty in EBP curriculum development. EBPB and EBPI are valid and reliable measures to assess for gains across a curriculum. Through educational outcomes, educators can assess desired student outcomes for EBP across a curriculum and can build an evidence base for ongoing curriculum development. © 2017 Sigma Theta Tau International.

  20. Creating infrastructure supportive of evidence-based nursing practice: leadership strategies. (United States)

    Newhouse, Robin P


    Nursing leadership is the cornerstone of successful evidence-based practice (EBP) programs within health care organizations. The key to success is a strategic approach to building an EBP infrastructure, with allocation of appropriate human and material resources. This article indicates the organizational infrastructure that enables evidence-based nursing practice and strategies for leaders to enhance evidence-based practice using "the conceptual model for considering the determinants of diffusion, dissemination, and implementation of innovations in health service delivery and organization." Enabling EBP within organizations is important for promoting positive outcomes for nurses and patients. Fostering EBP is not a static or immediate outcome, but a long-term developmental process within organizations. Implementation requires multiple strategies to cultivate a culture of inquiry where nurses generate and answer important questions to guide practice. Organizations that can enable the culture and build infrastructure to help nurses develop EBP competencies will produce a professional environment that will result in both personal growth for their staff and improvements in quality that would not otherwise be possible.

  1. Comparison of four teaching methods on Evidence-based Practice skills of postgraduate nursing students. (United States)

    Fernandez, Ritin S; Tran, Duong Thuy; Ramjan, Lucie; Ho, Carey; Gill, Betty


    The aim of this study was to compare four teaching methods on the evidence-based practice knowledge and skills of postgraduate nursing students. Students enrolled in the Evidence-based Nursing (EBN) unit in Australia and Hong Kong in 2010 and 2011 received education via either the standard distance teaching method, computer laboratory teaching method, Evidence-based Practice-Digital Video Disc (EBP-DVD) teaching method or the didactic classroom teaching method. Evidence-based Practice (EBP) knowledge and skills were evaluated using student assignments that comprised validated instruments. One-way analysis of covariance was implemented to assess group differences on outcomes after controlling for the effects of age and grade point average (GPA). Data were obtained from 187 students. The crude mean score among students receiving the standard+DVD method of instruction was higher for developing a precise clinical question (8.1±0.8) and identifying the level of evidence (4.6±0.7) compared to those receiving other teaching methods. These differences were statistically significant after controlling for age and grade point average. Significant improvement in cognitive and technical EBP skills can be achieved for postgraduate nursing students by integrating a DVD as part of the EBP teaching resources. The EBP-DVD is an easy teaching method to improve student learning outcomes and ensure that external students receive equivalent and quality learning experiences. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Supporting influenza vaccination intent among nurses: effects of leadership and attitudes toward adoption of evidence-based practice. (United States)

    Paparone, Pamela


    The leadership styles of healthcare organizations and the attitudes of nurses toward the adoption of evidence-based practice (EBP) were examined to provide a predictor of influenza vaccination intent (VI) and improve the current inadequate vaccination rate among nurses. Influenza is a costly and potentially serious disease. The United States has set a benchmark of a 90% influenza vaccination rate among healthcare personnel by 2020. A sample of 354 registered nurses completed a survey assessing demographic data, the leadership styles of their organization, their attitudes toward EBP, and their VI. A significant positive correlation was found between transformational leadership and VI, but not between transactional leadership and VI. Attitudes toward EBP correlated weakly, but insignificantly, with VI. Transformational leadership can predict and positively influence vaccination rates among nurses, thus decreasing vaccine preventable illness and improving patient outcomes.

  3. Effectiveness of a Brief, Basic Evidence-Based Practice Course for Clinical Nurses. (United States)

    Ramos-Morcillo, Antonio J; Fernández-Salazar, Serafín; Ruzafa-Martínez, María; Del-Pino-Casado, Rafael


    Barriers to the implementation of evidence-based practice (EBP) by nursing professionals include a lack of knowledge, inadequate skills in searching for and appraising evidence, and consulting research articles. However, few studies have addressed the effectiveness of educational interventions to improve their competence. To evaluate the effectiveness of a brief basic online and face-to-face educational intervention to promote EBP attitudes, knowledge and skills, and practice in clinical care nurses. This study was quasi-experimental, pretest-posttest design with a comparison group. The sample included registered nurses enrolled in the free continuing education courses offered in 2013 by the Nursing Council of Jaén (Spain). The study included 109 participants (54 in the intervention group and 55 in the comparison group). The intervention was a brief, basic EBP course with online and face-to-face learning. The comparison group received an educational intervention with different content. The evidence-based practice questionnaire (EBPQ) was used to evaluate EBP attitude, knowledge and skills, and practice before the intervention, and at 21 and 60 days following the intervention. Two-way mixed analysis of variance was conducted. There was a significant difference between intervention and comparison groups in the knowledge and skills dimension. The difference between groups was not significant in the EBP practice dimension. Both groups had high scores in the attitude dimension that did not change after the intervention. A brief basic educational intervention on EBP with online and face-to-face learning can produce improvements in the knowledge and skills of clinical nurses. © 2015 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

  4. Evidence, virulence, and the disappearance of nursing knowledge: A critique of the evidence-based dogma. (United States)

    Holmes, Dave; Perron, Amélie; O'Byrne, Patrick


    Within the domain of health care, the new discourse of evidence-based practice has appeared and gained momentum, giving rise to a plethora of correlates such as specialized scientific journals and best practice guidelines. Following the crowd, nursing has jumped onto this trend's bandwagon. Although some scholars and clinicians have tried to expand these notions, few have considered a deconstructive approach to do so. Drawing on the works of continental postmodern thinkers such as Baudrillard, Deleuze & Guattari, and Foucault, this paper critically examines the rise of the evidence-based nursing (EBN) movement in order to deconstruct the "taken-for-granted" assumption that EBN is in and of itself the favored path to the sound development of nursing knowledge. We argue against the hierarchical differentiation of varied research approaches so as to allow diverse methodologies to guide research and ultimately practice. The status quo is challenged, where research agendas are currently dominated by one paradigm of knowledge development; that of post-positivism in which randomized control trials are portrayed as superior evidence. There is a hazard in excluding many other venues to build nursing knowledge and in oversimplifying the complexity of clinical nursing practice. Furthermore, we argue that this preferred path of knowledge development contradicts nursing academics' efforts to distance itself from the medical model of health care provision and research.

  5. [Obstacles perceived by nurses for evidence-based practice: a qualitative study]. (United States)

    Sánchez-García, Inmaculada; López-Medina, Isabel M; Pancorbo-Hidalgo, Pedro L


    To examine the obstacles perceived by nurses to implement an evidence-based clinical practice. A qualitative study through semi-structured interviews conducted in 2010-2011 including 11 nurses purposively selected from public hospitals and community centres in Jaén and Córdoba (Spain). A content analysis was performed, using Miles and Huberman as a reference and comprising the following steps: data reduction, data presentation, and data conclusion/verification. Data saturation was reached in these categories (obstacles). The obstacles perceived by nurses to introduce an evidence-based clinical practice (EBCP) were grouped into 3 major categories: obstacles related with professionals (routine-based practice, unwilling and stagnant attitudes, and lack of training in EBCP), obstacles related to the social context (reluctance from other professionals and from patients or families), and obstacles related to the organization (obsolete cultures that do not promote innovation in nursing care). This study highlights the persistence of various factors that hinder the use of research findings in clinical practice. The results underline the need to change the culture of healthcare organizations, to motivate professionals, and to break some of the resistance attitudes that hinder the implementation of evidence-based practice. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  6. Evidence-based education and nursing pressure ulcer prevention textbooks: does it match? (United States)

    Wilborn, Doris; Halfens, Ruud J; Dassen, Theo


    The education of nurses has influenced the way of nursing practice for a long time. Nurse educators are required to offer up-to-date educational material, and textbooks are the most frequently used sources of knowledge during a nurse's education. In this study, researchers investigated the extent to which textbooks were evidence based regarding preventing pressure ulcers and knowing what recommendations to make for nursing students and publishers of nursing textbooks. Educators at nursing schools in Germany were contacted by telephone to identify the most often used nursing textbooks. The recommendations of the German Expert Standard of Pressure Ulcer Prevention were compared with the content of the textbooks in a content analysis. Additionally, teachers were asked what additional material they were using to help prepare lectures. Only one of the four analysed textbooks complied with the recommendations of the German Expert Standard. Contents of the other books were incomplete. The authors of some books did not mention any up-to-date scientific evidence. The teachers often used additional material such as the German Expert Standard and research articles to prepare their lectures. German nursing textbooks were classified into research-based and authoritative texts. Because of the fast development and availability of research findings, one recommendation is that new forms of "textbooks" such as CD ROMs should be considered.

  7. Modeling Evidence-Based Application: Using Team-Based Learning to Increase Higher Order Thinking in Nursing Research

    Directory of Open Access Journals (Sweden)

    Bridget Moore


    Full Text Available Nursing practice is comprised of knowledge, theory, and research [1]. Because of its impact on the profession, the appraisal of research evidence is critically important. Future nursing professionals must be introduced to the purpose and utility of nursing research, as early exposure provides an opportunity to embed evidence-based practice (EBP into clinical experiences. The AACN requires baccalaureate education to include an understanding of the research process to integrate reliable evidence to inform practice and enhance clinical judgments [1]. Although the importance of these knowledge competencies are evident to healthcare administrators and nursing leaders within the field, undergraduate students at the institution under study sometimes have difficulty understanding the relevance of nursing research to the baccalaureate prepared nurse, and struggle to grasp advanced concepts of qualitative and quantitative research design and methodologies. As undergraduate nursing students generally have not demonstrated an understanding of the relationship between theoretical concepts found within the undergraduate nursing curriculum and the practical application of these concepts in the clinical setting, the research team decided to adopt an effective pedagogical active learning strategy, team-based learning (TBL. Team-based learning shifts the traditional course design to focus on higher thinking skills to integrate desired knowledge [2]. The purpose of this paper is to discuss the impact of course design with the integration of TBL in an undergraduate nursing research course on increasing higher order thinking. [1] American Association of Colleges of Nursing, The Essentials of Baccalaureate Education for Professional Nursing Practice, Washington, DC: American Association of Colleges of Nursing, 2008. [2] B. Bloom, Taxonomy of Educational Objectives, Handbook I: Cognitive Domain, New York: McKay, 1956.

  8. "Keeping on track"-Hospital nurses' struggles with maintaining workflow while seeking to integrate evidence-based practice into their daily work: A grounded theory study. (United States)

    Renolen, Åste; Høye, Sevald; Hjälmhult, Esther; Danbolt, Lars Johan; Kirkevold, Marit


    practices into their daily work: "task juggling", "pausing for considering" and "struggling along with quality improvement". The "keeping on track" theory contributes to the body of knowledge regarding clinical nurses' experiences with evidence-based practice integration. The nurses endeavoured to minimize workflow interruptions to avoid decreasing the quality of patient care provided, and evidence-based practices were seen as a consideration that was outside of their ordinary work duties. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. [Approaches, knowledge and capabilities of nurses and physicians regarding evidence-based clinical practice in the Imbadura province (Ecuador)]. (United States)

    Molina Mula, Jesús; Muñoz Navarro, Paulina; Vaca Auz, Janeth; Cabascango Cabascango, Carmita; Cabascango Cabascango, Katty


    The research raises the need to increase understanding of organizational and personal factors that influence the attitude and aptitude of each professional, with respect to evidence-based clinical practice. The aim of this study is to describe the transfer of knowledge into clinical practice in hospital units in Imbabura (Ecuador) identifying the obstacles to implementing evidence-based clinical practice validated questionnaire EBPQ-19. A cross-sectional observational study was conducted in hospitals of the Ministry of Public Health of Imbabura of Ecuador took place, including a total of 281 nurses and physicians. Nurses and physicians showed positive attitudes toward evidence-based clinical practice (EBCP) and their use to support clinical decision-making. This research evidences perceptions of professionals on strategies for knowledge transfer and obstacles to carry it out. Significant differences between the perception of the use of EBCP strategies between nurses and physicians are observed. Physicians consider they use them frequently, while nurses acknowledge using them less (chi-square: 105.254, P=.018). In conclusion, we can say that these factors should be considered as necessary to improve the quality of care that is provided to users based on the best available evidence. It is necessary to start developing change interventions in this regard to remedy the current situation of clinical practice based not on evidence, but rather on experience only. Experimental studies demonstrating the effectiveness of strategies to eliminate barriers to scientific evidence-based clinical practice should be conducted. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  10. An evidence-based structure for transformative nurse executive practice: the model of the interrelationship of leadership, environments, and outcomes for nurse executives (MILE ONE). (United States)

    Adams, Jeffrey M; Erickson, Jeanette Ives; Jones, Dorothy A; Paulo, Lisa


    Identifying and measuring success within the chief nurse executive (CNE) population have proven complex and challenging for nurse executive educators, policy makers, practitioners, researchers, theory developers, and their constituents. The model of the interrelationship of leadership, environments, and outcomes for nurse executives (MILE ONE) was developed using the concept of consilience (jumping together of ideas) toward limiting the ambiguity surrounding CNE success. The MILE ONE is unique in that it links existing evidence and identifies the continuous and dependent interrelationship among 3 content areas: (1) CNE; (2) nurses' professional practice and work environments; and (3) patient and organizational outcomes. The MILE ONE was developed to operationalize nurse executive influence, define measurement of CNE success, and provide a framework to articulate for patient, workforce, and organizational outcome improvement efforts. This article describes the MILE ONE and highlights the evidence base structure used in its development.

  11. Evidence-based mental health nursing in Australia: our history and our future. (United States)

    Warelow, Philip; Edward, Karen-Leigh


    This paper will develop a discussion related to evidence-based knowledge for mental health nursing, arguing for a historical component to be included in the comprehensive degree programme that will offer significant insights into mental health nursing knowledge from historical information and constructing implications for contemporary practice. Our understanding of the present is clearer by this looking back and forth and by adding meaning (and what the meanings mean) to what historically preceded. It allows the history of psychiatry to be a much more productive, useful, and a continual source of wisdom for the here and now. This blending of past knowledge with contemporary inquiry can offer depth in mental health nursing practices by forming a context for practice for the beginning nurse practitioner.

  12. Tools for evidence-based vascular nursing practice: Achieving information literacy for lifelong learning. (United States)

    Jameson, Jodi; Walsh, M Eileen


    Information literacy is essential in facilitating evidence-based practice (EBP) activities. In vascular nursing, the implementation of EBP is of utmost importance. Best practice grounded in research evidence can contribute to improved patient care outcomes for individuals with vascular disease. The following paper discusses information literacy competencies for nurses to develop in the context of EBP, with an emphasis on formulating a clinical question and searching for evidence. Relevant health science information resources are described, including their value and purpose in the 6S model of evidence. Also discussed are practical and supportive solutions with proven effectiveness in ensuring nurses' success with EBP. Copyright © 2017 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.

  13. An evidence-based oral hygiene education program for nursing staff. (United States)

    Forsell, Marianne; Kullberg, Erika; Hoogstraate, Janet; Johansson, Olle; Sjögren, Petteri


    Increasing evidence shows strong statistical correlations between improved oral hygiene and reduction in the incidence, and mortality, from health care-associated pneumonia among elderly. Therefore, it is important that nursing staff are well educated in oral hygiene. The objective was to describe the design of a new oral hygiene educational program for nursing staff, where the theoretical parts of the education were integrated with evidence about the preventive effect of improved oral care on respiratory tract infections and health care-associated pneumonia among hospitalized or nursing home resident older people. An educational model was translated into three educational steps: hands-on training, group discussions, and a theoretical lecture including scientific evidence about the preventive effect of oral hygiene on respiratory tract infections, and health care-associated pneumonia, among older people. Evidence-based oral hygiene education seems to be a feasible way to increase the motivation for daily oral care tasks among nursing staff, and thus to improve the oral hygiene status among the nursing home resident elderly. Further studies are, however, needed to further evaluate the effect of evidence-based oral hygiene educations in different health care settings and over longer time periods. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Evidence-based nursing leadership: Evaluation of a Joint Academic-Service Journal Club. (United States)

    Duffy, Joanne R; Thompson, Diane; Hobbs, Terry; Niemeyer-Hackett, Nancy Lee; Elpers, Susan


    This article describes the importance of evidence-based nursing leadership in the development and evaluation of a joint academic-service nursing leadership journal club. The use of scientific evidence and the embracing of an environment of continuous learning are essential to quality practice; however, nursing leadership has been slow to apply evidence-based practice to their own work. A noontime monthly meeting schedule, incentivized by lunch, was organized as a nursing leadership journal club. Articles were selected and reviewed monthly, and the process was formally evaluated using a written evaluation at the end of year 1. Eighteen articles were appraised by the group with 6 topics identified. Positive results included increased knowledge, competence of the leader, and attainment of goals. Recommendations include revision of goals, plans to share leadership of the group, development of a rigorous evaluation of outcomes, and dissemination of findings. The journal club was valuable in increasing awareness of nursing leadership research, promoting leadership development, and improving competence in the performance of research appraisals. Process improvement and further study are needed to increase understanding regarding the benefits of leadership journal clubs.

  15. Nursing Home Staff Adherence to Evidence-Based Pain Management Practices


    Jablonski, Anita; Ersek, Mary


    The purpose of this study was to determine the extent to which nursing home staff adhere to current evidence-based guidelines to assess and manage persistent pain experienced by elderly residents. A retrospective audit was conducted of the medical records of 291 residents of 14 long-term care facilities in western Washington State. Data revealed a gap between actual practice and current best practice. Assessment of persistent pain was limited primarily to intensity and location. Although pres...

  16. Optimizing nursing care by integrating theory-driven evidence-based practice. (United States)

    Pipe, Teri Britt


    An emerging challenge for nursing leadership is how to convey the importance of both evidence-based practice (EBP) and theory-driven care in ensuring patient safety and optimizing outcomes. This article describes a specific example of a leadership strategy based on Rosswurm and Larrabee's model for change to EBP, which was effective in aligning the processes of EBP and theory-driven care.

  17. [The journal club as a teaching strategy to develop evidence-based practice for undergraduate students in nursing]. (United States)

    Chouinard, Maud-christine; Lavoie, Mélissa; Poitras, Marie-éve; Sasseville, Maxime; De Jordy, Louise Catherine; Girard, Ariane


    Contemporary nursing practice requires constant updating of knowledge, especially in regards to research results found in academic or scientific papers. As part of the university curriculum in nursing, students must develop their skills in relation to the understanding and evaluation of research evidence. The objective of this study was to explore the appreciation and effects of a new teaching approach, the use of a journal club within a nursing research course, with undergraduate students in nursing sciences. As part of a qualitative exploratory descriptive design, a questionnaire with open-ended questions about their appreciation and perception of the effects of the journal club was administered to the participating students (n = 41) at the end of the course. Participation in the journal club appears to have provided an introduction to the scientific area of nursing, to have improved several skills related to the evaluation of scientific articles and has increased motivation to adopt evidence-based practice. The use of a journal club within an undergraduate research course in nursing was a relevant teaching method that aroused great interest in the undergraduate students in nursing.

  18. Shared decision making in chronic care in the context of evidence based practice in nursing. (United States)

    Friesen-Storms, Jolanda H H M; Bours, Gerrie J J W; van der Weijden, Trudy; Beurskens, Anna J H M


    In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient's values. In reality, evidence-based practice usually focuses on research evidence (which may be translated into clinical practice guidelines) and clinical expertise without considering the individual patient's values. The shared decision-making model seems to be helpful in the integration of the individual patient's values in evidence-based practice. We aim to discuss the relevance of shared decision making in chronic care and to suggest how it can be integrated with evidence-based practice in nursing. We start by describing the following three possible approaches to guide the decision-making process: the paternalistic approach, the informed approach, and the shared decision-making approach. Implementation of shared decision making has gained considerable interest in cases lacking a strong best-treatment recommendation, and when the available treatment options are equivalent to some extent. We discuss that in chronic care it is important to always invite the patient to participate in the decision-making process. We delineate the following six attributes of health care interventions in chronic care that influence the degree of shared decision making: the level of research evidence, the number of available intervention options, the burden of side effects, the impact on lifestyle, the patient group values, and the impact on resources. Furthermore, the patient's willingness to participate in shared decision making, the clinical expertise of the nurse, and the context in which the decision making takes place affect the shared decision-making process. A knowledgeable and skilled nurse with a positive attitude towards shared decision making—integrated with evidence-based practice—can facilitate the shared decision-making process. We conclude that nurses as well as other

  19. Psychometric analysis of two new scales: the evidence-based practice nursing leadership and work environment scales. (United States)

    Pryse, Yvette; McDaniel, Anna; Schafer, John


    Those in nursing have been charged with practicing to the full extent of their education and training by the Institute of Medicine. Therefore, evidence-based practice (EBP) has never been more important to nursing than in the current healthcare environment. Frequently the burden of EBP is the responsibility of the bedside practitioner, but has been found to be a process that requires leadership and organizational support. A key underlying component of a strong EBP environment includes effective communications and collaboration among staff and nursing leadership. Developing measurement tools that examine the milieu and nursing leadership in which the staff nurse practices is an important component of understanding the factors that support or hinder EBP. The aim of this study is to report on the development and analysis of two new scales designed to explore leadership and organizational support for EBP. The EBP Nursing Leadership Scale (10 items) examines the staff nurses perception of support provided by the nurse manager for EBP, and the EBP Work Environment Scale (8 items) examines organizational support for EBP. Staff nurses who worked at least .5 FTE in direct patient care, from two inner city hospitals (n = 422) completed the scales. The scales were evaluated for internal consistency reliability with the Cronbach alpha technique, content validity using a panel of experts, and construct validity by The content validity index computed from expert rankings was .78 to 1.0 with an average of.96. Cronbach's alpha was .96 (n = 422) for the EBP Nursing Leadership Scale and .86 (n = 422) for the EBP Work Environment Scale. Factor analysis confirmed that each scale measured a unidimensional construct (p Leadership Scale and the EBP Work Environment Scale are psychometrically sound instruments to examine organizational influences on EBP. © 2014 Sigma Theta Tau International.

  20. Knowledge, Attitude and Use of Evidence-Based Practice among nurses active on the Internet

    Directory of Open Access Journals (Sweden)

    M. Amparo Pérez-Campos


    Full Text Available Objective. to determine the evidence-based practice (EBP competence of Spanish and Latin-American nurses participating in professional forums on the Internet and estimate the influence of socio-demographic and professional factors on their competence, which was defined as knowledge of, attitude towards, and implementation of EBP. Methodology: An online survey was administered to a convenience sample of nurses active in Internet forums, comprising validated Spanish versions of the Evidence-Based Practice Questionnaire (EBPQ and Practice Environment Scale of the Nursing Work Index (PES-NWI and socio-demographics and professional variables. Results: 314 questionnaires were obtained (76.96%. The mean EBPQ score was 5.02 out of 7 (95%CI, 4.89-5.14. The variables associated with a higher competence in EBP were academic level, (p<03001, professional category (p=0.001, country of work (p<0.001, perception of practice environment (p=0,018 and research activities (p<0,036. Conclusions: These nurses showed a moderate level of EBP competence. They revealed a positive attitude towards EBP and achieved intermediate scores in both EBP-related skills and knowledge and their implementation. Higher academic levels and professional categories were associated with greater EBP competence. A practice environment perceived to be unfavorable has a negative influence on EBP implementation.

  1. Evidence-based nursing: a stereotyped view of quantitative and experimental research could work against professional autonomy and authority. (United States)

    Bonell, C


    In recent years, there have been calls within the United Kingdom's National Health Service (NHS) for evidence-based health care. These resonate with long-standing calls for nursing to become a research-based profession. Evidence-based practice could enable nurses to demonstrate their unique contribution to health care outcomes, and support their seeking greater professionalization, in terms of enhanced authority and autonomy. Nursing's professionalization project, and, within this, various practices comprising the 'new nursing', whilst sometimes not delivering all that was hoped of them, have been important in developing certain conditions conducive to developing evidence-based practice, notably a critical perspective on practice and a reluctance merely to follow physicians' orders. However, nursing has often been hesitant in its adoption of quantitative and experimental research. This hesitancy, it is argued, has been influenced by the propounding by some authors within the new nursing of a stereotyped view of quantitative/experimental methods which equates them with a number of methodological and philosophical points which are deemed, by at least some of these authors, as inimical to, or problematic within, nursing research. It is argued that, not only is the logic on which the various stereotyped views are based flawed, but further, that the wider influence of these viewpoints on nurses could lead to a greater marginalization of nurses in research and evidence-based practice initiatives, thus perhaps leading to evidence-based nursing being led by other groups. In the longer term, this might result in a form of evidence-based nursing emphasizing routinization, thus--ironically--working against strategies of professional authority and autonomy embedded in the new nursing. Nursing research should instead follow the example of nurse researchers who already embrace multiple methods. While the paper describes United Kingdom experiences and debates, points raised about

  2. Korean Nursing Students' Acquisition of Evidence-Based Practice and Critical Thinking Skills. (United States)

    Kim, Sang Suk; Kim, Eun Joo; Lim, Ji Young; Kim, Geun Myun; Baek, Hee Chong


    Evidence-based practice (EBP) is essential for enhancing nurses' quality of care. We identified Korean nursing students' practices, attitudes, and knowledge concerning EBP, as well as their critical thinking disposition (CTD). The EBP Questionnaire (EBPQ) was administered to a convenience sample of 266 nursing students recruited from four nursing schools in Seoul and its metropolitan area. Average EBPQ and CTD total scores were 4.69 ± 0.64 and 3.56 ± 0.32, respectively. Students who were ages ⩾23 years, male, and satisfied with their major demonstrated higher EBPQ and CTD scores. EBPQ scores were significantly correlated with CTD scores (r = .459, p < .01), and CTD was an explanatory factor of EBP (adjusted R2 = 0.200). It is necessary to develop comprehensive teaching strategies to help nursing students improve their CTD and information utilization skills, as well as integrate EBP in undergraduate programs to enhance nurses' EBP abilities. [J Nurs Educ. 2018;57(1):21-27.]. Copyright 2018, SLACK Incorporated.

  3. Evidence-based Nursing in the IED: From Caring to Curing?

    Directory of Open Access Journals (Sweden)

    Jette Ernst


    Full Text Available Danish hospitals are major sites of healthcare reform, and new public management accountability and performance management tools have been applied to improve the quality and efficiency of services. One consequence of this is that nurses’ work in hospitals is increasingly standardized through medical evidence. Using Bourdieu’s theory of practice in combination with an ethnographic field study, it is analyzed how the nurses of a Danish Integrated Emergency Department respond to the changing conditions of work. It is illuminated how two opposing approaches to nursing of humanistically and pluralistically oriented caring, and evidence-based scientifically oriented curing inform nursing in the department. The curing approach is however trumping the caring approach. Curing creates new nursing career pathways and is by some nurses embraced with enthusiasm. For others, the new situation creates tension and distress. It is illustrated how the nurses position their practice in relation to the changing working conditions taking sides for either curing or caring, or finding a way to maneuver in between the two. The article argues that the normative enforcement of the curing approach may carry unintended side effects to the goals of quality and efficiency enhancements.

  4. Integrity of Evidence-Based Practice: Are Providers Modifying Practice Content or Practice Sequencing?


    Park, Alayna L.; Chorpita, Bruce F.; Regan, Jennifer; Weisz, John R


    This study examined patterns of evidence-based treatment (EBT) implementation within community settings by evaluating integrity along separate dimensions of practice content (PC; a session included the prescribed procedure) and practice sequencing (a session occurred in the prescribed sequence) within a recent randomized effectiveness trial. We measured whether sessions showed integrity to PC and to flexible or linear practice sequences. Findings revealed that providers tended to incorporate ...

  5. Musical Memories: translating evidence-based gerontological nursing into a children's picture book. (United States)

    Gerdner, Linda A; Buckwalter, Kathleen C


    Individuals with Alzheimer's disease (AD) are often cared for within multigenerational families. More specifically, 26% of family caregivers have children younger than 18 living with them. This article describes an innovative model for translation of an evidence-based intervention into an engaging, realistic picture book that serves as a teaching tool for children and their families. The book, Musical Memories, focuses on the relationship between a granddaughter and her grandmother who has AD. The story applies basic principles of the Progressively Lowered Stress Threshold model to explain the underlying cause of grandmother's behaviors and models the evidence-based guideline "Individualized Music for Elders with Dementia" to empower the granddaughter in maintaining a relationship with her grandmother. Musical Memories is intended to serve as a valuable resource for families and the gerontological nurses who serve them. Copyright 2013, SLACK Incorporated.

  6. Falls prevention for elders in acute care: an evidence-based nursing practice initiative. (United States)

    Murphy, Tamara H; Labonte, Paula; Klock, Monica; Houser, Larry


    The purpose of this article is to describe and measure the impact of a multifaceted program developed to reduce the falls rate on an acute medical unit at an academic tertiary care center. According to national benchmarks, this unit was one of the hospital's top 3 units for numbers of falls for several years. That distinction drove the hospital and unit leadership and a staff-led unit practice council to develop an evidence-based intervention plan. Interventions included a campaign to raise geriatric awareness, creation of "falls tool boxes," education of staff and family, and implementation of a structured hourly patient rounds schedule. The success of these interventions is discussed, including the effect on the falls rate benchmark. The discussion addresses implications and outcomes associated with the empowerment of nursing staff to respond to benchmarking measures, implement evidence-based practices, and use the same benchmarking procedure to measure outcomes.

  7. A rapid evidence-based service by librarians provided information to answer primary care clinical questions. (United States)

    McGowan, Jessie; Hogg, William; Rader, Tamara; Salzwedel, Doug; Worster, Danielle; Cogo, Elise; Rowan, Margo


    A librarian consultation service was offered to 88 primary care clinicians during office hours. This included a streamlined evidence-based process to answer questions in fewer than 20 min. This included a contact centre accessed through a Web-based platform and using hand-held devices and computers with Web access. Librarians were given technical training in evidence-based medicine, including how to summarise evidence. To describe the process and lessons learned from developing and operating a rapid response librarian consultation service for primary care clinicians. Evaluation included librarian interviews and a clinician exit satisfaction survey. Clinicians were positive about its impact on their clinical practice and decision making. The project revealed some important 'lessons learned' in the clinical use of hand-held devices, knowledge translation and training for clinicians and librarians. The Just-in-Time Librarian Consultation Service showed that it was possible to provide evidence-based answers to clinical questions in 15 min or less. The project overcame a number of barriers using innovative solutions. There are many opportunities to build on this experience for future joint projects of librarians and healthcare providers.

  8. Knowledge, Attitude and Use of Evidence-Based Practice among nurses active on the Internet. (United States)

    Pérez-Campos, M Amparo; Sánchez-García, Inmaculada; Pancorbo-Hidalgo, Pedro L


    to determine the evidence-based practice (EBP) competence of Spanish and Latin-American nurses participating in professional forums on the Internet and estimate the influence of socio-demographic and professional factors on their competence, which was defined as knowledge of, attitude towards, and implementation of EBP. An online survey was administered to a convenience sample of nurses active in Internet forums, comprising validated Spanish versions of the Evidence-Based Practice Questionnaire (EBPQ) and Practice Environment Scale of the Nursing Work Index (PES-NWI) and socio-demographics and professional variables. 314 questionnaires were obtained (76.96%). The mean EBPQ score was 5.02 out of 7 (95%CI, 4.89-5.14). The variables associated with a higher competence in EBP were academic level, (pnurses showed a moderate level of EBP competence. They revealed a positive attitude towards EBP and achieved intermediate scores in both EBP-related skills and knowledge and their implementation. Higher academic levels and professional categories were associated with greater EBP competence. A practice environment perceived to be unfavorable has a negative influence on EBP implementation.

  9. [Evidence-based practice in nursing curricula: the experience of nursing degree course of Reggio Emilia. A pilot study]. (United States)

    Finotto, Stefano; Chiesi, Ivens; Mecugni, Daniela; Casali, Patrizia; Doro, Lucia Maria Grazia; Lusetti, Simona


    Given the lack of evidence in literature concerning the presence of Evidence-Based Practice (EBP) in nursing curricula, but considering its importance in order to educate future nurses to use critical thinking and to base their practice on scientific evidence, tutors and nursing teachers of the Nursing Degree Course of Reggio Emilia (Università degli Studi di Modena e Reggio Emilia), have decided to introduce a three-year laboratory of EBP. The purposes of this project are: to describe the three-year EBP laboratory of Nursing Degree, its objectives, its structure, its integration with practical training and nursing subjects and its students evaluation strategies; to get students verify the perception of the usefulness of the three-year EBP laboratory regarding the elaboration of the graduation thesis, the search for appropriatem answers for patients met during clinical trainings and the usefulness of the EBP process in view of the development of their professional career. The design of research of this pilot study is correlation-descriptive. It has been selected a sample of convenience consisting of 56 nurses graduated in the autumn session of the academic year 2007-2008. For data collection we have used an electronic questionnaire (Microsoft Word with closed fields) structured for the purpose. The laboratory has been effective in learning to use the database to search for evidences and to use the database to search for evidences related to nursing problems met in training placements. Finally, graduated nurses consider the EBP process an essential element of professional nursing luggage. Although the sample is restricted the results indicates the good educational choice made by our Nursing Degree Course of integrating the EBP Laboratory in the curriculum.

  10. Can Nursing Students Practice What Is Preached? Factors Impacting Graduating Nurses' Abilities and Achievement to Apply Evidence-Based Practices. (United States)

    Blackman, Ian R; Giles, Tracey M


    In order to meet national Australian nursing registration requisites, nurses need to meet competency requirements for evidence-based practices (EBPs). A hypothetical model was formulated to explore factors that influenced Australian nursing students' ability and achievement to understand and employ EBPs related to health care provision. A nonexperimental, descriptive survey method was used to identify self-reported EBP efficacy estimates of 375 completing undergraduate nursing students. Factors influencing participants' self-rated EBP abilities were validated by Rasch analysis and then modeled using the partial least squares analysis (PLS Path) program. Graduating nursing students' ability to understand and apply EBPs for clinical improvement can be directly and indirectly predicted by eight variables including their understanding in the analysis, critique and synthesis of clinically based nursing research, their ability to communicate research to others and whether they had actually witnessed other staff delivering EBP. Forty-one percent of the variance in the nursing students' self-rated EBP efficacy scores is able to be accounted for by this model. Previous exposure to EBP studies facilitates participants' confidence with EBP, particularly with concurrent clinical EBP experiences. © 2017 Sigma Theta Tau International.

  11. Partnering to Promote Evidence-Based Practice in a Community Hospital: Implications for Nursing Professional Development Specialists. (United States)

    Highfield, Martha E F; Collier, Andrea; Collins, Mara; Crowley, Melanie


    Nursing professional development specialists working in community hospitals face significant barriers to evidence-based practice that academic medical centers do not. This article describes 7 years of a multifaceted, service academic partnership in a large, urban, community hospital. The partnership has strengthened the nursing professional development role in promoting evidence-based practice across the scope of practice and serves as a model for others.

  12. Nurses' knowledge, attitudes and practices regarding evidence-based practice in the prevention of mother-to-child transmission of HIV programme in Malawi. (United States)

    Mulenga, Chisomo; Naidoo, Joanne R


    HIV continues to be a global public health concern with Malawi being among the worst affected countries. The prevalence of HIV among pregnant women is also very high, thereby raising concerns of mother-to-child transmission of the virus. Prevention of mother-to-child transmission (PMTCT) of HIV is therefore a priority in the efforts to curb the HIV pandemic. Keeping in mind that the area of HIV management is rapidly evolving, underpinning nursing care with evidence-based practice is essential and has been reported to reduce mother-to-child transmission. The aim of the study was to explore and describe the knowledge, attitudes and practices of nurses regarding evidence-based practice in PMTCT at a selected hospital in Malawi. An exploratory descriptive quantitative design was used, and 81 nurses working in paediatric, obstetrics and gynaecology departments completed a self-administered questionnaire. Data were analysed using Predictive Analytics Software. The results showed that nurses had average knowledge of evidence-based practice and although their attitudes were favourable, their practice was very low. Certain sociodemographic variables had an influence on the respondent's knowledge, attitudes and practices. Furthermore, the results have indicated that evidence-based practice was mainly hampered by insufficient resources and difficulties in accessing research articles. It emerged from the study that mentoring, training and access to literature could facilitate evidence-based practice in PMTCT among nurses. Nurses need to be provided with the necessary support including education and resources if evidence-based practice in PMTCT is to be promoted.

  13. Evidence-Based Health Promotion in Nursing Homes: A Pilot Intervention to Improve Oral Health (United States)

    Cadet, Tamara J.; Berrett-Abebe, Julie; Burke, Shanna L.; Bakk, Louanne; Kalenderian, Elsbeth; Maramaldi, Peter


    Nursing home residents over the age of 65 years are at high risk for poor oral health and related complications such as pneumonia and adverse diabetes outcomes. A preliminary study found that Massachusetts' nursing homes generally lack the training and resources needed to provide adequate oral health care to residents. In this study, an…

  14. Making a Difference: Evidence Based Palliative Care Education for Neonatal Nurses (United States)

    Pye, Sherry Elaine


    The death of a neonate is a life-changing and tragic experience for the individuals involved in the final moments of the infant's life. As the frontline provider in this clinical scenario, the bedside nurse supports the patient and family through their individual journey of loss. If the nurse does not possess the palliative care educational…

  15. Development of an evidence-based fall risk assessment tool and evaluation of interrater reliability and nurses' perceptions of the tool's clarity and usability. (United States)

    Higaonna, Miki; Enobi, Maki; Nakamura, Shizuka


    To develop and test interrater reliability of an evidence-based fall risk assessment tool for nurses and to investigate how nurses perceived the clarity and usability of the tool. In phase 1, an evidence-based fall risk assessment tool was developed based on a literature review and expert discussion. The finalized tool assessed 11 risk factors and comprised 23 items. In phase 2, reliability testing was done. Two nurses out of a possible 125 participating nurses independently assessed each participating patient on admission with the assessment tool. The nurses then provided feedback on the clarity and usability of the tool. The interrater reliability was estimated by the percentage agreement, Cohen's kappa, and prevalence- and bias-adjusted kappa. Of the 164 patients who were recruited, 114 patients participated. After adjustment for prevalence and bias, only "frequent urination" and "night-time toileting" showed a less-than-substantial interrater agreement. Assessment of the items "cognitive impairment" and "night-time toileting" were most frequently reported to be problematic. The evidence-based fall risk assessment tool requires further modification and re-examination of interrater reliability is warranted. In particular, the cognitive impairment items need to be reconsidered in order to enable nurses to better assess patient cognition on the admission day. © 2016 Japan Academy of Nursing Science.

  16. Towards evidence-based palliative care in nursing homes in Sweden: a qualitative study informed by the organizational readiness to change theory. (United States)

    Nilsen, Per; Wallerstedt, Birgitta; Behm, Lina; Ahlström, Gerd


    Sweden has a policy of supporting older people to live a normal life at home for as long as possible. Therefore, it is often the oldest, most frail people who move into nursing homes. Nursing home staff are expected to meet the existential needs of the residents, yet conversations about death and dying tend to cause emotional strain. This study explores organizational readiness to implement palliative care based on evidence-based guidelines in nursing homes in Sweden. The aim was to identify barriers and facilitators to implementing evidence-based palliative care in nursing homes. Interviews were carried out with 20 managers from 20 nursing homes in two municipalities who had participated along with staff members in seminars aimed at conveying knowledge and skills of relevance for providing evidence-based palliative care. Two managers responsible for all elderly care in each municipality were also interviewed. The questions were informed by the theory of Organizational Readiness for Change (ORC). ORC was also used as a framework to analyze the data by means of categorizing barriers and facilitators for implementing evidence-based palliative care. Analysis of the data yielded ten factors (i.e., sub-categories) acting as facilitators and/or barriers. Four factors constituted barriers: the staff's beliefs in their capabilities to face dying residents, their attitudes to changes at work as well as the resources and time required. Five factors functioned as either facilitators or barriers because there was considerable variation with regard to the staff's competence and confidence, motivation, and attitudes to work in general, as well as the managers' plans and decisional latitude concerning efforts to develop evidence-based palliative care. Leadership was a facilitator to implementing evidence-based palliative care. There is a limited organizational readiness to develop evidence-based palliative care as a result of variation in the nursing home staff's change efficacy

  17. Systematic implementation of evidence-based practice in a clinical nursing setting : a participatory action research project

    NARCIS (Netherlands)

    Sandra van der Loo; Gerrie Bours; Anna Beurskens; Albine Moser; Jolanda Friesen-Storms


    Aims and objectives: To describe the process of implementing evidence-based practice (EBP) in a clinical nursing setting. Background: EBP has become a major issue in nursing, it is insufficiently integrated in daily practice and its implementation is complex. Design: Participatory action

  18. Evidence-based nursing: effects of a structured nursing program for the health promotion of Korean women with Hwa-Byung. (United States)

    Choi, Yun-Jung; Lee, Kwang-Ja


    The objectives of this study were to develop a culturally tailored nursing program for patients with Hwa-Byung (HB) and to test the effects of the nursing intervention. The structured nursing intervention program was based on a transcultural theoretical framework in which patients with HB received therapies consisting of music therapy, drama, and group therapy. Hwa-Byung is a culture-bound syndrome, literally translated as anger syndrome, attributed to the suppression of anger. Individuals experience a decrease in quality of life as a result of insufficient treatment. Current health care programs do not meet the needs of these individuals, who still need nursing interventions. A culturally tailored therapy is effective and appropriate for patients with illnesses related to their cultural background. Evidence-based nursing is a crucial approach in verifying the effects of nursing care and in enhancing the body of knowledge on nursing science. A nonequivalent, nonsynchronized, and controlled study design was applied to experimental and control groups of an even number of women. The nursing program was generally effective in the mental health condition test; the mental health condition of the experimental group was significantly more improved as compared with that of the control group. The program was particularly effective in the categories of somatization, depression, psychoticism, and hostility. The data indicate that the mental health of patients with HB could be improved with the use of nursing intervention programs. Nurses need to understand the cultural background of patients and provide culture-sensitive interventions for effective patient-oriented care.

  19. Training medical providers in evidence-based approaches to suicide prevention. (United States)

    DeHay, Tamara; Ross, Sarah; McFaul, Mimi


    Suicide is a significant issue in the United States and worldwide, and its prevention is a public health imperative. Primary care practices are an important setting for suicide prevention, as primary care providers have more frequent contact with patients at risk for suicide than any other type of health-care provider. The Western Interstate Commission for Higher Education, in partnership with the Suicide Prevention Resource Center, has developed a Suicide Prevention Toolkit and an associated training curriculum. These resources support the education of primary care providers in evidence-based strategies for identifying and treating patients at risk for suicide. The application of this curriculum to post-graduate medical training is presented here. © The Author(s) 2015.

  20. Perceived knowledge, skills, attitude and contextual factors affecting evidence-based practice among nurse educators, clinical coaches and nurse specialists. (United States)

    Malik, Gulzar; McKenna, Lisa; Plummer, Virginia


    Evidence-based practice (EBP) in the clinical setting is recognized as an approach that leads to improved patient outcomes. Nurse educators (NEs), clinical coaches (CCs) and nurse specialists are in key positions to promote and facilitate EBP within clinical settings and have opportunities to advance practice. Therefore, it is important to understand their perceptions of factors promoting EBP and perceived barriers in facilitating EBP in clinical settings, before developing educational programmes. This paper reports findings from a study that aimed to explore NEs' , CCs' and nurse specialists' knowledge, skills and attitudes associated with EBP. This study used a questionnaire containing quantitative and a small number of qualitative questions to capture data collected from NEs, CCs and nurse specialists working at a tertiary health-care facility in Victoria, Australia. The questionnaire was distributed to a total of 435 people, of whom 135 responded (31%). Findings revealed that the three senior nurse groups relied heavily on personal experience, organizational policies and protocols as formal sources of knowledge. Furthermore, they had positive attitudes towards EBP. However, participants demonstrated lack of knowledge and skills in appraising and utilizing evidence into practice. They indicated a desire to seek educational opportunities to upskill themselves in the process of EBP. © 2014 Wiley Publishing Asia Pty Ltd.

  1. Pediatric Nurse Practitioner Management of Child Anxiety in a Rural Primary Care Clinic With the Evidence-Based COPE Program. (United States)

    Kozlowski, Jessica L; Lusk, Pamela; Melnyk, Bernadette M


    Anxiety is the most common mental health disorder in children. Many communities have shortages of mental health providers, and the majority of children with anxiety are not receiving the evidence-based treatment they need. The purpose of this pilot study was to assess the feasibility and effects of a brief seven-session cognitive behavioral skills-building intervention, Creating Opportunities for Personal Empowerment (COPE), which was delivered to anxious children by a pediatric nurse practitioner in a primary care setting. A pre-experimental, one-group, pretest and post-test design was used. Children who participated had a significant decrease in anxiety symptoms (13.88 points, SD = 17.96, 95% confidence interval [CI] = -1.13-28.89), as well as an increase in knowledge of cognitive-behavioral coping skills (M = 11.38, CI = 5.99-8.26, p = .00) and improved functioning (at school and at home). Evaluations by parents and children were positive. COPE is a promising evidence-based intervention for children with anxiety with feasible delivery by pediatric nurse practitioners in primary care. Published by Elsevier Inc.

  2. Evidence-based nursing: the role of the advanced practice registered nurse in the management of heart failure patients in the outpatient setting. (United States)

    Case, Rachel; Haynes, Donna; Holaday, Bonnie; Parker, Veronica G


    Heart failure (HF) is a chronic debilitating illness that affects millions of Americans each year. Patients with HF are faced with chronic physical symptoms, emotional strain, and significant socioeconomic burden. Goals in the management of HF are to slow the disease progression, decrease symptom acuity, and prevent exacerbations that lead to hospital readmission. Management of HF remains a challenge for healthcare providers. There is a fine balance between optimizing patient functioning and minimizing healthcare expenditures. With the incidence of HF increasing annually, it is important to have effective disease management strategies in place. In any disease management program, it is important to follow those guidelines outlined by evidence-based practice. The purpose of this systematic review was to evaluate current evidence-based practice and determine what benefit exists of having an advanced practice registered nurse assist in the management of patients with HF.

  3. Information seeking and retrieval skills of nurses: Nurses readiness for evidence based practice in hospitals of a medical university in Iran. (United States)

    Farokhzadian, Jamileh; Khajouei, Reza; Ahmadian, Leila


    With the explosion of medical information, and emergence of evidence-based practice (EBP) in healthcare system, searching, retrieving and selecting information for clinical decision-making are becoming required skills for nurses. The aims of this study were to examine the use of different medical information resources by nurses and their information searching and retrieving skills in the context of EBP. A descriptive, cross-sectional study was conducted in four teaching hospitals in Iran. Data were collected from 182 nurses using a questionnaire in 2014. The nurses indicated that they use more human and printed resources than electronic resources to seek information (mean=2.83, SD=1.5; mean=2.77, SD=1.07; and mean=2.13, SD=0.88, respectively). To search online resources, the nurses use quick/basic search features more frequently (mean=2.45, SD=1.15) than other search features such as advanced search, index browsing and MeSH term searching. (1.74≤mean≤2.30, SD=1.01). At least 80% of the nurses were not aware of the purpose or function of search operators such as Boolean and proximity operators. In response to the question measuring skills of the nurses in developing an effective search statement by using Boolean operators, only 20% of them selected the more appropriate statement, using some synonyms of the concepts in a given subject. The study showed that the information seeking and retrieval skills of the nurses were poor and there were clear deficits in the use of updated information resources. To compensate their EBP incompetency, nurses may resort to human resources. In order to use the latest up to date evidence independently, nurses need to improve their information literacy. To reach this goal, clinical librarians, health information specialists, nursing faculties, and clinical nurse educators and mentors can play key roles by providing educational programs. Providing access to online resources in clinical wards can also encourage nurses to learn and use

  4. Nurse practitioners and physician assistants in the intensive care unit: an evidence-based review. (United States)

    Kleinpell, Ruth M; Ely, E Wesley; Grabenkort, Robert


    Advanced practitioners including nurse practitioners and physician assistants are contributing to care for critically ill patients in the intensive care unit through their participation on the multidisciplinary team and in collaborative physician practice roles. However, the impact of nurse practitioners and physician assistants in the intensive care unit setting is not well known. To identify published literature on the role of nurse practitioners and physician assistants in acute and critical care settings; to review the literature using nonquantitative methods and provide a summary of the results to date incorporating studies assessing the impact and outcomes of nurse practitioner and physician assistant providers in the intensive care unit; and to identify implications for critical care practice. We conducted a systematic search of the English-language literature of publications on nurse practitioners and physician assistants utilizing Ovid MEDLINE, PubMed, and the Cumulative Index of Nursing and Allied Health Literature databases from 1996 through August 2007. None. Over 145 articles were reviewed on the role of the nurse practitioner and physician assistant in acute and critical care settings. A total of 31 research studies focused on the role and impact of these practitioners in the care of acute and critically ill patients. Of those, 20 were focused on nurse practitioner care, six focused on both nurse practitioner and physician assistant care, and five were focused on physician assistant care in acute and critical care settings. Fourteen focused on intensive care unit care, and 17 focused on acute care including emergency room, trauma, and management of patients with specific acute care conditions such as stroke, pneumonia, and congestive heart failure. Most studies used retrospective or prospective study designs and nonprobability sampling techniques. Only two randomized control trials were identified. The majority examined the impact of care on patient

  5. Ensuring evidence-based practices for falls prevention in a nursing home setting. (United States)

    Gama, Zenewton A S; Medina-Mirapeix, Francesc; Saturno, Pedro J


    To evaluate the effectiveness of an ad hoc multifaceted program to improve structure, professional behavior, and outcomes related to falls prevention. Internal quality improvement cycle. Nursing home in Spain. An institution with 130 residents. Local building of quality criteria, audit and feedback, and a specific intervention to improve based on educational and sensitization activities and changes in the process and recording systems. Quality of falls prevention was assessed using reliable evidence-based criteria (4 of structure and 9 of process), at baseline and 6 months after a specific intervention to improve. Number of falls was recorded in a random sample (n = 60) of residents (≥ 65 years) during a 1-year follow-up and summarized fortnightly as an indicator analyzed using a statistical control chart. Baseline structure and fall prevention practices were poor. After the intervention, all structure criteria were present and 8 of 9 process criteria improved significantly. Thirty-two falls occurred 6 months before and 21 after the intervention started, showing a significant decrease in the fortnightly incidence (P < .01). Adherence to evidence-based recommendations was poor in our setting, but the internal quality improvement cycle was useful in ensuring safe practices and in achieving better outcomes. Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

  6. Cervical cancer screening in adolescents: an evidence-based internet education program for practice improvement among advanced practice nurses. (United States)

    Choma, Kim; McKeever, Amy E


    The literature reports great variation in the knowledge levels and application of the recent changes of cervical cancer screening guidelines into clinical practice. Evidence-based screening guidelines for the prevention and early detection of cervical cancer offers healthcare providers the opportunity to improve practice patterns among female adolescents by decreasing psychological distress as well as reducing healthcare costs and morbidities associated with over-screening. The purpose of this pilot intervention study was to determine the effects of a Web-based continuing education unit (CEU) program on advanced practice nurses' (APNs) knowledge of current cervical cancer screening evidence-based recommendations and their application in practice. This paper presents a process improvement project as an example of a way to disseminate updated evidence-based practice guidelines among busy healthcare providers. This Web-based CEU program was developed, piloted, and evaluated specifically for APNs. The program addressed their knowledge level of cervical cancer and its relationship with high-risk human papillomavirus. It also addressed the new cervical cancer screening guidelines and the application of those guidelines into clinical practice. Results of the study indicated that knowledge gaps exist among APNs about cervical cancer screening in adolescents. However, when provided with a CEU educational intervention, APNs' knowledge levels increased and their self-reported clinical practice behaviors changed in accordance with the new cervical cancer screening guidelines. Providing convenient and readily accessible up-to-date electronic content that provides CEU enhances the adoption of clinical practice guidelines, thereby decreasing the potential of the morbidities associated with over-screening for cervical cancer in adolescents and young women. © 2014 Sigma Theta Tau International.

  7. Relationship of Evidence-Based Practice and Treatments: A Survey of Community Mental Health Providers (United States)

    DiMeo, Michelle A.; Moore, G. Kurt; Lichtenstein, Carolyn


    Evidence-based treatments (EBTs) are "interventions" that have been proven effective through rigorous research methodologies. Evidence-based practice (EBP), however, refers to a "decision-making process" that integrates the best available research, clinician expertise, and client characteristics. This study examined community mental health service…

  8. The Role of Evidence Based Nursing in Prevention of Gastrointestinal Side Effects of Chemotherapy in Children with Cancer

    Directory of Open Access Journals (Sweden)

    Z Pouresmail


    Full Text Available Introduction: Today, due to the broad spectrum of pediatric cancers are treated by the chemotherapy drugs, but these drugs have side effects and gastrointestinal toxicity is the most prevalent. One of the main roles of nurses is to better health through patient education and care for him. Evidence-based nursing is a process during which the nurse can use the available research evidence, their clinical expertise and the patient has to take appropriate decisions. This study reviews the role of evidence-based nursing in the prevention of gastrointestinal side effects of chemotherapy in children with cancer was conducted.   Materials and Methods: Seeking information was performing through databases PubMed, SID, Since Direct, magiran, Ovid and etc. Within the years 2014-2002, the key issues in terms of evidence-based nursing, gastrointestinal side effect, chemotherapy was performed and 20 were studied English equivalents.   Results: The most common gastrointestinal side effects in children undergoing chemotherapy are oral ulcers, vomiting, diarrhea, and dysphagia. Different strategies for prevention studies suggest that these effects need to perform their roles in teaching and nursing care. Nurses can use the results of studies such as music, ginger, semi sitting positions during chemotherapy, use of ice and etc. To prevent vomiting, the use of  Persica for oral wound healing, hygiene perform especially hand washing for preventing diarrhea. The most important roles of nursing are recommended, Education on prevention of chemotherapy complications, adverse effects of proper nutrition and etc.   Conclusion: Nurses can play an effective role in the education and care to relieve symptoms and prevent progression of gastrointestinal side effects of chemotherapy.   Key words: Evidence-based nursing, Gastrointestinal side effects, Chemotherapy, Cancer  

  9. Information literacy as the foundation for evidence-based practice in graduate nursing education: a curriculum-integrated approach. (United States)

    Jacobs, Susan Kaplan; Rosenfeld, Peri; Haber, Judith


    As part of a system-wide initiative to advance evidence-based practice among clinicians, graduate students, and educators, the New York University Division of Nursing embarked on a curricular initiative to integrate components of information literacy in all core courses of the master's program. Increasing competency in information literacy is the foundation for evidence-based practice and provides nursing professionals with the skills to be literate consumers of information in an electronic environment. Competency in information literacy includes an understanding of the architecture of information and the scholarly process; the ability to navigate among a variety of print and electronic tools to effectively access, search, and critically evaluate appropriate resources; synthesize accumulated information into an existing body of knowledge; communicate research results clearly and effectively; and appreciate the social issues and ethical concerns related to the provision, dissemination, and sharing of information. In collaboration with the New York University Division of Libraries' Health Sciences Librarian, instructional modules in information literacy relevant to each of the 5 core nursing master's courses were developed, complemented by a Web-based tutorial: The Web site is multifaceted, with fundamentals for the beginner, as well as more complex content for the advanced user. Course assignments were designed to promote specific competencies in information literacy and strategies for evaluating the strength of the evidence found. A survey of information literacy competencies, which assessed students' knowledge, misconceptions, and use of electronic information resources, was administered when students entered the program and at 1-year intervals thereafter.

  10. Improving evidence based practice in postgraduate nursing programs: A systematic review: Bridging the evidence practice gap (BRIDGE project). (United States)

    Hickman, Louise D; DiGiacomo, Michelle; Phillips, Jane; Rao, Angela; Newton, Phillip J; Jackson, Debra; Ferguson, Caleb


    The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment. To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities. Systematic review that conforms to the PRISMA statement. Master's Nursing programs that include elements of a capstone project within a university setting. MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English. Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements. There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice. Copyright © 2018. Published by Elsevier Ltd.

  11. Evidence-based nursing-sensitive indicators for patients hospitalized with depression in Thailand. (United States)

    Thapinta, Darawan; Anders, Robert L; Mahatnirunkul, Suwat; Srikosai, Soontaree


    The aim of this study was to develop and validate nursing-sensitive indicators for patients hospitalized with depression in Thailand. The initial draft, consisting of 12 categories with 37 subcategories, was then evaluated by experts in the US and Thailand. Hospital records were then utilized to evaluate the feasibility and efficacy of the indicators. The finalized instrument consisted of 11 categories with 43 items with a validity of .98 and internal consistency of .88. This is the first set of indicators developed to evaluate nursing-sensitivity for patients hospitalized with a diagnosis of depression in Thailand. Having nursing indicators for depressed patients provides nurses with concrete tools to evaluate their work with depressed patients, allowing these staff to assess their work in a very specific, methodical, and consistent manner. When problems are discovered, both the staff and administration can work to address these issues through training, procedural changes, and departmental shifts.

  12. Medicare Provider Payment Data - Skilled Nursing Facilities (United States)

    U.S. Department of Health & Human Services — The Skilled Nursing Facility Utilization and Payment Public Use File (Skilled Nursing Facility PUF) provides information on services provided to Medicare...

  13. Are internet sites providing evidence-based information for patients suffering with Trigeminal Neuralgia? (United States)

    Demetriades, Andreas K; Alg, Varinder Singh; Hardwidge, Carl


    Trigeminal neuralgia has a variety of treatments with variable efficacy. Sufferers present to a spectrum of disciplines. While traditional delivery of medical information has been by oral/printed communication, up to 50-80% patients access the internet for information. Confusion, therefore, may arise when seeking treatment for trigeminal neuralgia. We evaluated the quality of information on the internet for trigeminal neuralgia using the DISCERN© instrument. Only 54% websites had clear objectives; 42% delivered on these. A total of 71% provided relevant information on trigeminal neuralgia, 54% being biased/unbalanced; 71% not providing clear sources of information. No website detailed the side-effect profile of treatments; 79% did not inform patients of the consequences/natural history if no treatment was undertaken; it was unclear if patients could anticipate symptoms settling or when treatment would be indicated. Internet information on trigeminal neuralgia is of variable quality; 83% of sites assessed were of low-to-moderate quality, 29% having 'serious shortcomings.' Only two sites scored highly, only one being in the top 10 search results. Websites on trigeminal neuralgia need to appreciate areas highlighted in the DISCERN© instrument, in order to provide balanced, reliable, evidence-based information. To advise patients who may be misguided from such sources, neurosurgeons should be aware of the quality of information on the internet.

  14. Information exchange networks of health care providers and evidence-based cardiovascular risk management: an observational study. (United States)

    Heijmans, Naomi; van Lieshout, Jan; Wensing, Michel


    Although a wide range of preventive and clinical interventions has targeted cardiovascular risk management (CVRM), outcomes remain suboptimal. Therefore, the question is what additional determinants of CVRM and outcomes can be identified and addressed to optimize CVRM. In this study, we aimed to identify new perspectives for improving healthcare delivery and explored associations between information exchange networks of health care providers and evidence-based CVRM. This observational study was performed parallel to a randomized clinical trial which aimed to improve professional performance of practice nurses in the Netherlands. Information exchange on medical policy for CVRM ("general information networks") and CVRM for individual patients ("specific information networks") of 180 health professionals in 31 general practices was measured with personalized questionnaires. Medical record audit was performed concerning 1620 patients in these practices to document quality of care delivery and two risk factors (systolic blood pressure (SBP) and LDL cholesterol level). Hypothesized effects of five network characteristics (density, frequency of contact, centrality of CVRM-coordinators, homophily on positive attitudes for treatment target achievement, and presence of an opinion leader for CVRM) constructed on both general and specific information exchange networks were tested and controlled for practice and patient factors using logistic multilevel analyses. Odds for adequate performance were enhanced in practices with an opinion leader for CVRM (OR 2.75, p based CVRM is associated with homophily of clinical attitudes and presence of opinion leaders in primary care teams. These results signal the potential of social networks to be taken into account in further attempts to improve the implementation of evidence-based care for CVRM. Future research is needed to identify and formulate optimal strategies for using opinion leaders to improve CVRM. Future interventions may be

  15. The missing link: information literacy and evidence-based practice as a new challenge for nurse educators. (United States)

    Courey, Tamra; Benson-Soros, Johnett; Deemer, Kevin; Zeller, Richard A


    The evolution of nursing as a profession requires the development of evidence-based practice based on outcomes and the ability by nurses to access and evaluate professional literature, both in print and on the Internet. To educate nurses to apply current research outcomes to nursing practice, an information literacy program was designed and implemented for first-semester associate degree nursing students in conjunction with a foundations in nursing course. The effectiveness of the program was evaluated using a 22-item questionnaire, both prior to the course and immediately after. A control group, students who did not receive the intervention, was also tested at both time points. Data analysis revealed that the information literacy program had both a positive effect on students' literacy skills and a negative effect on their attitudes toward the need for using these skills in nursing practice.

  16. Utilization of evidence-based practice knowledge, attitude, and skill of clinical nurses in the planning of professional development programming. (United States)

    Williamson, Kathleen M; Almaskari, Mohammed; Lester, Zanet; Maguire, Deborah


    This collaborative study explored nurses' knowledge, attitudes, and skills related to the evidence-based practice (EBP) process. It also explored the nurses' perceptions of the barriers and facilitators that they face related to fully using EBP in the workplace. Findings will afford the healthcare system the information to develop, plan, and restructure the educational services to meet the demand of enhancing EBP strategies and utilization.

  17. Review for librarians of evidence-based practice in nursing and the allied health professions in the United States (United States)

    Kronenfeld, Michael; Stephenson, Priscilla L.; Nail-Chiwetalu, Barbara; Tweed, Elizabeth M.; Sauers, Eric L.; McLeod, Tamara C. Valovich; Guo, Ruiling; Trahan, Henry; Alpi, Kristine M.; Hill, Beth; Sherwill-Navarro, Pamela; Allen, Margaret (Peg); Stephenson, Priscilla L.; Hartman, Linda M.; Burnham, Judy; Fell, Dennis; Kronenfeld, Michael; Pavlick, Raymond; MacNaughton, Ellen W.; Nail-Chiwetalu, Barbara


    Objective: This paper provides an overview of the state of evidence-based practice (EBP) in nursing and selected allied health professions and a synopsis of current trends in incorporating EBP into clinical education and practice in these fields. This overview is intended to better equip librarians with a general understanding of the fields and relevant information resources. Included Professions: Professions are athletic training, audiology, health education and promotion, nursing, occupational therapy, physical therapy, physician assisting, respiratory care, and speech-language pathology. Approach: Each section provides a description of a profession, highlighting changes that increase the importance of clinicians' access to and use of the profession's knowledgebase, and a review of each profession's efforts to support EBP. The paper concludes with a discussion of the librarian's role in providing EBP support to the profession. Conclusions: EBP is in varying stages of growth among these fields. The evolution of EBP is evidenced by developments in preservice training, growth of the literature and resources, and increased research funding. Obstacles to EBP include competing job tasks, the need for additional training, and prevalent attitudes and behaviors toward research among practitioners. Librarians' skills in searching, organizing, and evaluating information can contribute to furthering the development of EBP in a given profession. PMID:17971887

  18. Review for librarians of evidence-based practice in nursing and the allied health professions in the United States. (United States)

    Kronenfeld, Michael; Stephenson, Priscilla L; Nail-Chiwetalu, Barbara; Tweed, Elizabeth M; Sauers, Eric L; McLeod, Tamara C Valovich; Guo, Ruiling; Trahan, Henry; Alpi, Kristine M; Hill, Beth; Sherwill-Navarro, Pamela; Allen, Margaret Peg; Stephenson, Priscilla L; Hartman, Linda M; Burnham, Judy; Fell, Dennis; Kronenfeld, Michael; Pavlick, Raymond; MacNaughton, Ellen W; Nail-Chiwetalu, Barbara; Ratner, Nan Bernstein


    This paper provides an overview of the state of evidence-based practice (EBP) in nursing and selected allied health professions and a synopsis of current trends in incorporating EBP into clinical education and practice in these fields. This overview is intended to better equip librarians with a general understanding of the fields and relevant information resources. INCLUDED PROFESSIONS: Professions are athletic training, audiology, health education and promotion, nursing, occupational therapy, physical therapy, physician assisting, respiratory care, and speech-language pathology. Each section provides a description of a profession, highlighting changes that increase the importance of clinicians' access to and use of the profession's knowledgebase, and a review of each profession's efforts to support EBP. The paper concludes with a discussion of the librarian's role in providing EBP support to the profession. EBP is in varying stages of growth among these fields. The evolution of EBP is evidenced by developments in preservice training, growth of the literature and resources, and increased research funding. Obstacles to EBP include competing job tasks, the need for additional training, and prevalent attitudes and behaviors toward research among practitioners. Librarians' skills in searching, organizing, and evaluating information can contribute to furthering the development of EBP in a given profession.

  19. Nursing staff's experiences of working in an evidence-based designed ICU patient room-An interview study. (United States)

    Sundberg, Fredrika; Olausson, Sepideh; Fridh, Isabell; Lindahl, Berit


    It has been known for centuries that environment in healthcare has an impact, but despite this, environment has been overshadowed by technological and medical progress, especially in intensive care. Evidence-based design is a concept concerning integrating knowledge from various research disciplines and its application to healing environments. The aim was to explore the experiences of nursing staff of working in an evidence-based designed ICU patient room. Interviews were carried out with eight critical care nurses and five assistant nurses and then subjected to qualitative content analysis. The experience of working in an evidence-based designed intensive care unit patient room was that the room stimulates alertness and promotes wellbeing in the nursing staff, fostering their caring activities but also that the interior design of the medical and technical equipment challenges nursing actions. The room explored in this study had been rebuilt in order to create and evaluate a healing environment. This study showed that the new environment had a great impact on the caring staffs' wellbeing and their caring behaviour. At a time when turnover in nurses is high and sick leave is increasing, these findings show the importance of interior design ofintensive care units. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. [Mixed Method Research Investigating Evidence-Based Practice Self-efficacy, Course Needs, Barriers, and Facilitators: From the Academic Faculty and Clinical Nurse Preceptors]. (United States)

    Oh, Eui Geum; Yang, You Lee; Yoo, Jae Yong; Lim, Ji Yun; Sung, Ji Hyun


    The current challenges faced by nurses in providing high quality and evidence-based practice (EBP) supported care require profound changes in nursing education. To understand the changes needed to strengthen EBP education, the researchers examined EBP self-efficacy, course needs, barriers, and facilitators for academic faculty and clinical nurse preceptors to teach EBP in undergraduate nursing curricula. For this study, mixed-method approach was used with survey data collected from 73 academic faculty members from 54 universities. Further, 17 clinical nurse preceptors in three academic hospitals provided qualitative data for exploration of barriers and facilitators to teaching EBP. Data analysis used SPSS/WIN 21.0 and content analysis. Quantitative data showed that although the overall level of self-efficacy among faculty was moderate, the implementation levels were relatively low. Most faculty members agreed with the need to integrate EBP courses into undergraduate nursing curricula. The qualitative data showed that the barriers to teaching EBP were lack of knowledge, skill, and initial investment for teaching EBP; hierarchical, rules-oriented nursing culture; potential learner overloads in processing EBP; limited research dissemination and application. Facilitators were identified as the importance of EBP to the profession of nursing; collaboration in schools and hospitals; and continuing education in teaching/utilizing EBP. The findings indicate that for successful integration of EBP ni nursing education there is a need for faculty training and integrated EBP courses.

  1. Beliefs, Knowledge, Implementation, and Integration of Evidence-Based Practice Among Primary Health Care Providers: Protocol for a Scoping Review. (United States)

    Pereira, Filipa; Salvi, Mireille; Verloo, Henk


    The adoption of evidence-based practice (EBP) is promoted because it is widely recognized for improving the quality and safety of health care for patients, and reducing avoidable costs. Providers of primary care face numerous challenges to ensuring the effectiveness of their daily practices. Primary health care is defined as: the entry level into a health care services system, providing a first point of contact for all new needs and problems; patient-focused (not disease-oriented) care over time; care for all but the most uncommon or unusual conditions; and coordination or integration of care, regardless of where or by whom that care is delivered. Primary health care is the principal means by which to approach the main goal of any health care services system: optimization of health status. This review aims to scope publications examining beliefs, knowledge, implementation, and integration of EBPs among primary health care providers (HCPs). We will conduct a systematic scoping review of published articles in the following electronic databases, from their start dates until March 31, 2017: Medical Literature Analysis and Retrieval System Online (MEDLINE) via PubMed (from 1946), Embase (from 1947), Cumulative Index to Nursing and Allied Health Literature (CINAHL; from 1937), the Cochrane Central Register of Controlled Trials (CENTRAL; from 1992), PsycINFO (from 1806), Web of Science (from 1900), Joanna Briggs Institute (JBI) database (from 1998), Database of Abstracts of Reviews of Effects (DARE; from 1996), Trip medical database (from 1997), and relevant professional scientific journals (from their start dates). We will use the predefined search terms of, "evidence-based practice" and, "primary health care" combined with other terms, such as, "beliefs", "knowledge", "implementation", and "integration". We will also conduct a hand search of the bibliographies of all relevant articles and a search for unpublished studies using Google Scholar, ProQuest, Mednar, and World

  2. Changes in nursing students' perceptions of research and evidence-based practice after completing a research course. (United States)

    Keib, Carrie N; Cailor, Stephanie M; Kiersma, Mary E; Chen, Aleda M H


    Nurses need a sound education in research and evidence-based practice (EBP) to provide patients with optimal care, but current teaching methods could be more effective. To evaluate the changes in nursing students 1) perceptions of research and EBP, 2) confidence in research and EBP, and 3) interest in research participation after completing a course in research and EBP. A pre-post assessment design was utilized to compare changes in students. This project was conducted at a small, private liberal arts institution with Bachelor of Science (BSN) students. Two cohorts of third-year BSN students (Year 1 N=55, Year 2 N=54) who were taking a required, semester-long Nursing Research and EBP course. Students' perceptions of and confidence in research and EBP were assessed pre- and post-semester using the Confidence in Research and EBP survey, which contained 7 demographic items, 9 Research Perceptions items, and 19 Confidence in Research items (5-point Likert scale; 1=Not at all confident, 5=Extremely confident). Two years of data were collected and analyzed in SPSS v.24.0. Wilcoxon signed-ranks tests and Mann-Whitney-U tests were utilized to examine the data. Students had significant improvements in perceptions of and confidence in research and EBP (pstudents' plans to perform research or plans to participate in research in the future. A Research and EBP course is an effective way to improve student perceptions of and confidence in research and EBP, increasing the likelihood of applying these skills to future nursing practice. Copyright © 2017. Published by Elsevier Ltd.

  3. Educational Intervention for an Evidence-Based Nursing Practice of Skin-to-Skin Contact at Birth (United States)

    Turenne, Jeanne Pigeon; Héon, Marjolaine; Aita, Marilyn; Faessler, Joanne; Doddridge, Chantal


    ABSTRACT This article presents the development and evaluation of an educational intervention aiming at an evidence-based practice of skin-to-skin contact at birth among nurses of a maternity care unit. Based on the Iowa Model of Evidence-Based Practice to Promote Quality Care, four educational sessions were developed according to an active-learning pedagogy. Even if the nurses’ practice did not fully meet the recommendations for skin-to-skin contact, a pre- and postintervention evaluation showed some positive results, such as a longer duration of skin-to-skin contact immediately after birth, delivery of some routine care directly on mothers’ chest, and improved parent education. The educational intervention seems to have enacted some evidence-based nursing practice changes regarding skin-to-skin contact at birth. PMID:27445449

  4. Adoption of Evidence-Based Practices among Substance Abuse Treatment Providers (United States)

    Haug, Nancy A.; Shopshire, Michael; Tajima, Barbara; Gruber, Valerie; Guydish, Joseph


    This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals' readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support…

  5. Rectal cancer: An evidence-based update for primary care providers (United States)

    Gaertner, Wolfgang B; Kwaan, Mary R; Madoff, Robert D; Melton, Genevieve B


    Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advances have been made in the diagnosis and management of rectal cancer. These include clinical staging with imaging studies such as endorectal ultrasound and pelvic magnetic resonance imaging, operative approaches such as transanal endoscopic microsurgery and laparoscopic and robotic assisted proctectomy, as well as refined neoadjuvant and adjuvant therapies. For stage II and III rectal cancers, combined chemoradiotherapy offers the lowest rates of local and distant relapse, and is delivered neoadjuvantly to improve tolerability and optimize surgical outcomes, particularly when sphincter-sparing surgery is an endpoint. The goal in rectal cancer treatment is to optimize disease-free and overall survival while minimizing the risk of local recurrence and toxicity from both radiation and systemic therapy. Optimal patient outcomes depend on multidisciplinary involvement for tailored therapy. The successful management of rectal cancer requires a multidisciplinary approach, with the involvement of enterostomal nurses, gastroenterologists, medical and radiation oncologists, radiologists, pathologists and surgeons. The identification of patients who are candidates for combined modality treatment is particularly useful to optimize outcomes. This article provides an overview of the diagnosis, staging and multimodal therapy of patients with rectal cancer for primary care providers. PMID:26167068

  6. Evidence-based use of electronic clinical tracking systems in advanced practice registered nurse education: an integrative review. (United States)

    Branstetter, M Laurie; Smith, Lynette S; Brooks, Andrea F


    Over the past decade, the federal government has mandated healthcare providers to incorporate electronic health records into practice by 2015. This technological update in healthcare documentation has generated a need for advanced practice RN programs to incorporate information technology into education. The National Organization of Nurse Practitioner Faculties created core competencies to guide program standards for advanced practice RN education. One core competency is Technology and Information Literacy. Educational programs are moving toward the utilization of electronic clinical tracking systems to capture students' clinical encounter data. The purpose of this integrative review was to evaluate current research on advanced practice RN students' documentation of clinical encounters utilizing electronic clinical tracking systems to meet advanced practice RN curriculum outcome goals in information technology as defined by the National Organization of Nurse Practitioner Faculties. The state of the science depicts student' and faculty attitudes, preferences, opinions, and data collections of students' clinical encounters. Although electronic clinical tracking systems were utilized to track students' clinical encounters, these systems have not been evaluated for meeting information technology core competency standards. Educational programs are utilizing electronic clinical tracking systems with limited evidence-based literature evaluating the ability of these systems to meet the core competencies in advanced practice RN programs.

  7. Nutrition and dementia care: developing an evidence-based model for nutritional care in nursing homes. (United States)

    Murphy, Jane L; Holmes, Joanne; Brooks, Cindy


    There is a growing volume of research to offer improvements in nutritional care for people with dementia living in nursing homes. Whilst a number of interventions have been identified to support food and drink intake, there has been no systematic research to understand the factors for improving nutritional care from the perspectives of all those delivering care in nursing homes. The aim of this study was to develop a research informed model for understanding the complex nutritional problems associated with eating and drinking for people with dementia. We conducted nine focus groups and five semi-structured interviews with those involved or who have a level of responsibility for providing food and drink and nutritional care in nursing homes (nurses, care workers, catering assistants, dietitians, speech and language therapists) and family carers. The resulting conceptual model was developed by eliciting care-related processes, thus supporting credibility from the perspective of the end-users. The seven identified domain areas were person-centred nutritional care (the overarching theme); availability of food and drink; tools, resources and environment; relationship to others when eating and drinking; participation in activities; consistency of care and provision of information. This collaboratively developed, person-centred model can support the design of new education and training tools and be readily translated into existing programmes. Further research is needed to evaluate whether these evidence-informed approaches have been implemented successfully and adopted into practice and policy contexts and can demonstrate effectiveness for people living with dementia.

  8. Nursing journal clubs: A literature review on the effective teaching strategy for continuing education and evidence-based practice. (United States)

    Lachance, Carly


    This literature review on nursing journal clubs evaluates the efficacy of the teaching strategy within the clinical setting. Peer-reviewed articles were retrieved using an online journal database. Inclusion criteria incorporated information on efficacy of the teaching strategy, evidence-based practices, and continuing education as they related to nursing journal club initiatives. The literature cited numerous benefits and proved to be in favor of nursing journal clubs. The most common benefits found were nurses remaining abreast of current research, skill development in reading and critically appraising research, and incorporation of evidenice-based practices to patient care. Due to the self-motivated and voluntary nature of this teaching strategy, a limitation commonly identified was lack of participation, and further research on this limitation often was suggested. Nursing journal clubs proved to be an effective teaching strategy; a finding that remains consistent with the medical pioneers of the movement.

  9. Evidence-based practice implementation: The impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice

    Directory of Open Access Journals (Sweden)

    Sommerfeld David H


    Full Text Available Abstract Background The goal of this study is to extend research on evidence-based practice (EBP implementation by examining the impact of organizational type (public versus private and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use. Methods Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170. Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use. Results Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice. Conclusion This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in

  10. Shared decision making in chronic care in the context of evidence based practice in nursing

    NARCIS (Netherlands)

    Friesen-Storms, J.H.; Bours, G.J.; Weijden, T.T. van der; Beurskens, A.J.


    In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient's values. In reality, evidence-based practice usually focuses on research evidence (which may be

  11. Shared decision making in chronic care in the context of evidence based practice in nursing

    NARCIS (Netherlands)

    GJ Bours; T van der Weijden; JH Friesen-Storms; AJ Beurskens


    In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient’s values. In reality, evidence-based practice usually focuses on research evidence (which may be

  12. Evaluation of an Evidence-Based Practice Tutorial for Nurses: A Useful Tool and Some Lessons Learned. (United States)

    Miglus, Jennifer D; Froman, Robin D


    Although evidence-based practice (EBP) and research is important to hospitals and nursing staff interested in achieving Magnet status, a more important purpose is the improvement of patient care. As the nursing staff of UConn Health and its John Dempsey Hospital began its initial assessment prior to embarking on the journey for Magnet status, staff nurses were found to lack skills in searching vetted sources of EBP literature and appraising the results of a search. To address this need, a librarian at UConn Health, in collaboration with the hospital's Nursing Research steering committee, developed an online, self-paced EBP tutorial. The EBP tutorial used the iterative (Analysis, Design, Development, Implementation, and Evaluation) model of instructional design in development and assessment. This article describes the development and implementation of the tutorial, its evaluation, and lessons learned. J Contin Educ Nurs. 2016;47(6):266-271. Copyright 2016, SLACK Incorporated.

  13. Design of an Evidence-Based "Second Victim" Curriculum for Nurse Anesthetists. (United States)

    Daniels, Regina G; McCorkle, Ruth


    The "second victim" phenomenon--when a healthcare provider experiences adverse events because of the adverse events of a patient--is not well known or understood among healthcare professionals, including Certified Registered Nurse Anesthetists (CRNAs). No published research is currently available on the impact of second victim specifically in CRNAs, but it is known that second victim poses major challenges for healthcare professionals. Therefore, it is important to acknowledge its occurrence and to develop an educational curriculum based on the available evidence in order to promote peer and organizational support infrastructures. A comprehensive literature review was conducted, 6 educational domains on second victim were developed, and an expert panel validated the content.

  14. Moderating effects of nurses' organizational justice between organizational support and organizational citizenship behaviors for evidence-based practice. (United States)

    Chang, Ching-Sheng


    Lack of existing literature on the correlation among organizational justice, organizational support, and organizational citizenship behaviors has created a research gap in previous evidence-based practice (EBP) studies on nursing personnel. To investigate whether organizational justice among nurses has a moderating effect between their organizational support and organizational citizenship behaviors in order to bridge such a gap of existing literature with the EBP study on nursing personnel. Nursing staff of one large and influential hospital in Taiwan was surveyed. Four hundred questionnaires were distributed, and 386 were collected with a valid response rate of 96.50%. SPSS 17.0 and Amos 17.0 statistical software packages were used for data analysis. Nurses' organizational support positively influences their organizational citizenship behaviors, and their organizational justice perception has a positive moderating effect between organizational support and organizational citizenship behaviors. Results call hospitals' attention to the type of individual behaviors that may improve organizational performance. When nursing staff perceive fair and impartial treatment by the organization and supportive emotional attachment, behaviors beneficial for the organization are expressed in return. Subjective perceptions of nursing staff play an important role in organizational exchange relationship; the higher the degree of nursing staff's perceived organizational justice, the higher the degree of their organizational support, perception, and exhibition of organizational citizenship behaviors such as altruistic behavior and dedication to the work. © 2014 Sigma Theta Tau International.

  15. Current state of evidence-based practice education for undergraduate nursing students in Taiwan: A questionnaire study. (United States)

    Hung, Hsiao-Ying; Huang, Yu-Fang; Tsai, Jing-Jane; Chang, Ying-Ju


    Evidence-based practice (EBP) has been emphasized as the core competency of undergraduate nursing students and must be cultivated before graduation. However, there is limited information of EBP education for undergraduate nursing students in Taiwan. The purpose of this study was to investigate the current state of EBP education for undergraduate nursing students in Taiwan. A self-developed questionnaire, validated by experienced educators, was designed to explore curriculum design, teaching resources, qualification of teachers, and barriers regarding EBP education. A total of 21 nursing schools and colleges participated. The chair of each recommended a faculty member involved in teaching EBP as the school's representative to fill out the questionnaire. Among the 21 nursing schools and colleges, 18 (85.7%) had implemented EBP education in the curriculum. Among these schools, 22.2% conducted an independent EBP course, 50% incorporated EBP concepts into other courses, and the remainder offered both kinds of EBP courses. Multiple strategies were incorporated to teach the EBP. Less than 35% of the schools had designed or adopted standardized teaching materials and evaluated students' learning outcomes. Although 55.6% of the schools reimbursed faculty for participation in EBP training, 39% of their faculty members who taught EBP did not receive any EBP training. Shortage of qualified faculty and limited opportunity to involve students in evidence-based applications were reported as major obstacles to teaching EBP. EBP education has already gained the attention of nursing schools in Taiwan. However, lack of comprehensive EBP training among teachers and the difficulty of teaching clinical application of EBP require special consideration. In order to promote EBP education in undergraduate nursing curriculums, we suggest that nursing schools reinforce and support faculty to participate in formal EBP training. Also needed is a systematic curriculum design with multiple

  16. The impact of research education on student nurse attitude, skill and uptake of evidence-based practice: a descriptive longitudinal survey. (United States)

    Leach, Matthew J; Hofmeyer, Anne; Bobridge, Amanda


    To measure the impact of an undergraduate research education program on the attitude, skill and uptake of evidence-based practice among undergraduate student nurses. The contribution of evidence-based practice to clinical decision-making, quality of care and patient outcomes is well-documented. One approach to improving evidence-based practice uptake in clinical practice is through the provision of undergraduate research education; notwithstanding, the impact of research training on nursing practice is poorly established. Descriptive longitudinal survey. Three hundred and fifty four third-year nursing students enrolled in a Bachelor of Nursing program of a large Australian University were invited. Pre- (Phase 1) and post-completion (Phase 2) of a 16-week research education program, participants were asked to complete the Evidence-Based Practice Attitude and Utilization Survey; an 82-item online questionnaire measuring attitudes, skills and use of evidence-based practice, and barriers and facilitators of evidence-based practice uptake. The survey was completed by 84 (24%) participants in Phase 1 and 33 (39% of Phase 1) participants in Phase 2. Program exposure resulted in a significant improvement in median skill and use subscores, but not median attitude subscore. Participants perceived inadequate skills in the interpretation, appraisal and application of research findings to clinical practice as being less of a barrier to evidence-based practice uptake posteducation, and access to online critical appraisal tools as being significantly more useful in facilitating evidence-based practice uptake posteducation. The findings suggest that undergraduate research education may have a significant effect on nursing students' research skills and use of evidence-based practice, and minimise barriers to evidence-based practice uptake posteducation. Undergraduate research education may play an important role in improving student nurse uptake of evidence-based practice; whether

  17. The nurse-family partnership: An evidence-based preventive intervention. (United States)

    Olds, David L


    Pregnancy and the early years of the child's life offer an opportune time to prevent a host of adverse maternal, child, and family outcomes that are important in their own right, but that also reflect biological, behavioral, and social substrates in the child and family that affect family formation and future life trajectories. This article summarizes a 27-year program of research that has attempted to improve early maternal and child health and future life options with prenatal and infancy home visiting by nurses. The program is designed for low-income mothers who have had no previous live births. The home-visiting nurses have three major goals: to improve the outcomes of pregnancy by helping women improve their prenatal health, to improve the child's health and development by helping parents provide more sensitive and competent care of the child, and to improve parental life course by helping parents plan future pregnancies, complete their education, and find work. The program has been tested in three separate large-scale, randomized controlled trials with different populations living in different contexts. Results from these trials indicate that the program has been successful in achieving two of its most important goals: (a) the improvement of parental care of the child as reflected in fewer injuries and ingestions that may be associated with child abuse and neglect and better infant emotional and language development; and (b) the improvement of maternal life course, reflected in fewer subsequent pregnancies, greater work-force participation, and reduced dependence on public assistance and food stamps. The impact on pregnancy outcomes is equivocal. In the first trial, the program also produced long-term effects on the number of arrests, convictions, emergent substance use, and promiscuous sexual activity of 15-year-old children whose nurse-visited mothers were low-income and unmarried when they registered in the study during pregnancy. In general, the impact of

  18. Incorporating the National Guideline Clearinghouse into evidence-based nursing practice. (United States)

    Cassey, Margaret Z


    The National Guideline Clearinghouse (NGC) can be used as a means of integrating the constantly growing and changing body of scientific clinical evidence into the artful practice of nursing. The NGC offers an extensive collection of peer-reviewed, current, scientific standards to support clinical decision making in nursing practice. Nurse leaders should take a leadership role in bringing these relevant resources and new nursing knowledge to policy and procedure committees for active consideration.

  19. Multicultural Nursing: Providing Better Employee Care. (United States)

    Rittle, Chad


    Living in an increasingly multicultural society, nurses are regularly required to care for employees from a variety of cultural backgrounds. An awareness of cultural differences focuses occupational health nurses on those differences and results in better employee care. This article explores the concept of culturally competent employee care, some of the non-verbal communication cues among cultural groups, models associated with completing a cultural assessment, and how health disparities in the workplace can affect delivery of employee care. Self-evaluation of the occupational health nurse for personal preferences and biases is also discussed. Development of cultural competency is a process, and occupational health nurses must develop these skills. By developing cultural competence, occupational health nurses can conduct complete cultural assessments, facilitate better communication with employees from a variety of cultural backgrounds, and improve employee health and compliance with care regimens. Tips and guidelines for facilitating communication between occupational health nurses and employees are also provided. © 2015 The Author(s).

  20. Evaluation of evidence-based methods used to teach nursing students to critically appraise evidence. (United States)

    Smith-Strøm, Hilde; Nortvedt, Monica W


    This study evaluated whether students can learn to critically appraise a scientific article through evidence-based teaching methods. The course trains students in three steps of evidence-based practice--formulating a question, searching the evidence, and critically appraising the evidence. We gave the students two scientific articles. The articles were divided into sections, and 1 to 2 days were spent on each section. Every day had the same structure: a brief lecture on the relevant part of the article, group work, and interactive plenary discussions. At the end of the course, the students had a group examination in which they critically appraised a new scientific article. Most students reported that having learned steps one, two, and three involved in evidence-based practice was useful in critically appraising a scientific article. The results from the examination supported this. Knowledge about evidence-based practice can increase students' critical attitudes toward the evidence and their own practice.

  1. ICU nurses' experiences in providing terminal care. (United States)

    Espinosa, Laura; Young, Anne; Symes, Lene; Haile, Brenda; Walsh, Teresa


    At least 1 in 5 Americans die while using intensive care service-a number that is expected to increase as society ages. Many of these deaths involve withholding or withdrawing life-sustaining therapies. In these situations, the role of intensive care nurses shifts from providing aggressive care to end-of-life care. While hospice and palliative care nurses typically receive specialized support to cope with death and dying, intensive care nurses usually do not receive this support. Understanding the experiences of intensive care nurses in providing care at the end of life is an important first step to improving terminal care in the intensive care unit (ICU). This phenomenological research study explores the experiences of intensive care nurses who provide terminal care in the ICU. The sample consisted of 18 registered nurses delivering terminal care in an ICU that participated in individual interviews and focus groups. Colaizzi's steps for data analysis were used to identify themes within the context of nursing. Three major themes consisted of (1) barriers to optimal care, (2) internal conflict, and (3) coping. Providing terminal care creates significant personal and professional struggles among ICU nurses.

  2. Providing Evidence-Based, Intelligent Support for Flood Resilient Planning and Policy: The PEARL Knowledge Base

    Directory of Open Access Journals (Sweden)

    George Karavokiros


    Full Text Available While flood risk is evolving as one of the most imminent natural hazards and the shift from a reactive decision environment to a proactive one sets the basis of the latest thinking in flood management, the need to equip decision makers with necessary tools to think about and intelligently select options and strategies for flood management is becoming ever more pressing. Within this context, the Preparing for Extreme and Rare Events in Coastal Regions (PEARL intelligent knowledge-base (PEARL KB of resilience strategies is presented here as an environment that allows end-users to navigate from their observed problem to a selection of possible options and interventions worth considering within an intuitive visual web interface assisting advanced interactivity. Incorporation of real case studies within the PEARL KB enables the extraction of (evidence-based lessons from all over the word, while the KB’s collection of methods and tools directly supports the optimal selection of suitable interventions. The Knowledge-Base also gives access to the PEARL KB Flood Resilience Index (FRI tool, which is an online tool for resilience assessment at a city level available to authorities and citizens. We argue that the PEARL KB equips authorities with tangible and operational tools that can improve strategic and operational flood risk management by assessing and eventually increasing resilience, while building towards the strengthening of risk governance. The online tools that the PEARL KB gives access to were demonstrated and tested in the city of Rethymno, Greece.

  3. [Evidence-Based Knowledge Translation: From Scientific Evidence to Clinical Nursing Practice]. (United States)

    Chen, Kee-Hsin; Kao, Ching-Chiu; Chen, Chiehfeng


    In 1992, Gordon Guyatt coined the term "evidence-based medicine", which has since attracted worldwide attention. In 2007, the Institute of Medicine's Roundtable on Evidence-Based Medicine set the goal that 90% of clinical decisions would be supported by accurate, timely, and up-to-date clinical information and would reflect the best available evidence by 2020. However, the chasm between knowing and doing remains palpable. In 2000, the Canadian Institute of Health Research applied the term "knowledge translation" to describe the bridge that is necessary to cross the gap between research knowledge and clinical practice. The present paper outlines the conceptual framework, barriers, and promotion strategies for evidence-based knowledge translation and shares clinical experience related to overcoming the seven layers of leakage (aware, accepted, applicable, able, acted on, agreed, and adhered to). We hope that this paper can enhance the public well-being and strengthen the future health care system.

  4. Effectiveness of an Online Educational Module in Improving Evidence-Based Practice Skills of Practicing Registered Nurses. (United States)

    Moore, Lora


    Implementation of evidence-based practice (EBP) at the bedside has been difficult to achieve. Significant gaps between current research and actual practice have been identified and must be addressed in effort to increase utilization of EBP. The purpose of this study was to evaluate the efficacy of an online EBP educational intervention and to examine the relationship between educational preparation and years of nursing experience on nurses' practice, attitudes, and knowledge and skills of EBP. An experimental pretest-posttest design study with three randomized groups utilizing the EBPQ instrument was conducted. No significant differences were noted in EBPQ subscale scores of practice, attitude, or knowledge and skills from pre- to posttest. In addition, no statistical difference in EBPQ subscale scores regarding educational preparation or years of experience were noted. While nurses report positive attitudes toward EBP, their perceptions of practice and knowledge and skills score much lower. Educational interventions are needed for practicing nurses to overcome this knowledge deficit to successfully implement EBP. However, the use of online, independent, computer-based learning modules, while cost-efficient and offer several benefits when educating nurses, may not necessarily be the most effective method for teaching EBP knowledge and skills to practicing nurses. © 2017 Sigma Theta Tau International.

  5. Facilitation as a role and process in achieving evidence-based practice in nursing: a focused review of concept and meaning. (United States)

    Dogherty, Elizabeth J; Harrison, Margaret B; Graham, Ian D


    Facilitation is proposed as an important strategy to assist practitioners to implement evidence into practice. However, from a front-line nursing perspective, what is actually involved in facilitation, particularly in regards to research utilization, is poorly understood. To examine the current state of knowledge surrounding the concept of facilitation as a role and process in the implementation of research findings within the nursing context. Building on a previous concept analysis, we examined how facilitation has evolved over the last decade, particularly focusing on the practical elements (e.g., what it entails to operationalize and implement facilitation in nursing). A systematic search of electronic databases identified theory and research-based nursing papers explicitly focused on facilitation in research utilization. Through a content analysis, we examined how the concept is being used, described, and applied within nursing. Facilitation continues to be described as supporting and enabling practitioners to improve practice through evidence implementation. Certain aspects of the role and the strategies being employed to promote change are more evident. It was possible to formulate these into a taxonomy. Key findings include: * facilitation is now being viewed as an individual role as well as a process involving individuals and groups; * project management/leadership are important components; * no matter which approach is selected, tailoring facilitation to the local context is critical; * there is a growing emphasis on evaluation, particularly linking outcomes to nursing actions. Further understanding of what facilitators are actually doing to enable changes in nursing practice based on research findings will provide the groundwork for the design and evaluation of practical strategies for evidence-based practice in nursing. Research is needed to clarify how facilitation may be used to implement change in nursing practice along with evaluation of the

  6. Nursing Home Response to Nursing Home Compare: The Provider Perspective. (United States)

    Perraillon, Marcelo Coca; Brauner, Daniel J; Konetzka, R Tamara


    Nursing Home Compare (NHC) publishes composite quality ratings of nursing homes based on a five-star rating system, a system that has been subject to controversy about its validity. Using in-depth interviews, we assess the views of nursing home administrators and staff on NHC and unearth strategies used to improve ratings. Respondents revealed conflicting goals and strategies. Although nursing home managers monitor the ratings and expend effort to improve scores, competing goals of revenue maximization and avoidance of litigation often overshadow desire to score well on NHC. Some of the improvement strategies simply involve coding changes that have no effect on resident outcomes. Many respondents doubted the validity of the self-reported staffing data and stated that lack of risk adjustment biases ratings. Policy makers should consider nursing home incentives when refining the system, aiming to improve the validity of the self-reported domains to provide incentives for broader quality improvement.

  7. Mind-Body Exercises for Nurses with Chronic Low Back Pain: An Evidence-Based Review

    Directory of Open Access Journals (Sweden)

    Pinky Budhrani-Shani


    Full Text Available Background. Chronic low back pain (CLBP among nurses is a growing health concern. The multimodal nature of mind-body exercises has potential to impact physiological and psychological processes associated with chronic pain, affording possible advantages over conventional unimodal therapies. This paper summarizes the prevalence of and risk factors for CLBP among nurses, reviews the effectiveness in treating pain and disability of mind-body exercises (yoga and tai chi for CLBP among the general and nursing population, and describes implications. Methods. Articles, published during or prior to 2015, were systematically identified through the PubMed/MEDLINE, Web of Science, and ScienceDirect databases using the following search terms: nurses, mind-body, integrative, biopsychosocial, yoga, tai chi, back pain, and/or risk factors. Results. Prevalence estimates of CLBP among nurses ranged from 50% to 80%. Associated risk factors for CLBP included lifestyle and physical, psychological, psychosocial, and occupational factors. No published studies were identified that evaluated yoga or tai chi for nurses with CLBP. Studies in the general population suggested that these interventions are effective in reducing pain and disability and may improve factors/processes predictive of CLBP. Conclusion. This review suggests that evaluating the impact of multimodal interventions such as yoga and tai chi for nurses with CLBP warrants investigation.

  8. Motivating nurses' organizational citizenship behaviors by customer-oriented perception for evidence-based practice. (United States)

    Chang, Ching Sheng; Chang, Hae Ching


    There is a gap in the literature about the influence of customer-oriented perception on nursing personnel's organizational citizenship behaviors. Organizational citizenship behaviors are the type of contextual behaviors that are difficult to observe and measure as such behaviors are usually generated in quite subtle and unpredictable ways. This study tested the hypothesis: Customer-oriented perception is associated with increased organizational citizenship behaviors for nurses. If nursing personnel's customer-oriented perception can increase their willingness to display organizational citizenship behaviors, it may facilitate hospital operation and enhance organizational effectiveness. A cross-sectional design using a questionnaire survey of nurses in 10 medical centers was used. Five hundred copies of the questionnaire were distributed, and 232 effective copies were retrieved, with a valid response rate of 46.4%. Structural equation modeling was performed in SPSS 11.0 and Amos 7.0 (SPSS Inc., Chicago, IL, USA) statistical software packages. The main finding was that favorable customer-oriented perception is associated with increased organizational citizenship behaviors for nurses. Extensive training and customer-oriented performance evaluation are proposed in the hope of creating customer-oriented perception among nursing personnel and subsequently inspiring the display of organizational citizenship behaviors. ©2010 Sigma Theta Tau International.

  9. Nursing Home Regulations Redefined: Implications for Providers. (United States)

    Unroe, Kathleen T; Ouslander, Joseph G; Saliba, Debra


    The Centers for Medicare and Medicaid Services (CMS) finalized a comprehensive update to nursing home requirements of participation in October 2016. Nearly 10,000 public comments were received regarding the proposed rule, and CMS made multiple modifications based on comments from providers, advocacy organizations, and others before issuing the final rule. The final rule describing nursing home requirements of participation modernizes nursing home regulation. It is being implemented in three phases-beginning in November 2016, November 2017, and November 2019. There are multiple provisions that have implications for clinicians caring for nursing home residents, particularly in terms of management of infections, medication prescribing and monitoring, and delegation of medical orders. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  10. Predicting utilization of evidence-based parenting interventions with organizational, service-provider and client variables. (United States)

    Sanders, Matthew R; Prinz, Ronald J; Shapiro, Cheri J


    Multidisciplinary service providers (N = 611) who underwent training in the Triple P-Positive Parenting Program participated in a structured interview 6 months following training to determine their level of post-training program use and to identify any facilitators and barriers to program use. Findings revealed that practitioners who had received training in Group Triple P, received positive client feedback, had experienced only minor barriers to implementation, and had consulted with other Triple P practitioners following training were more likely to become high users of the program. Practitioners were less likely to use the program when they had lower levels of confidence in delivering Triple P and in consulting with parents in general, had difficulties in incorporating Triple P into their work, and where there was low workplace support. These findings highlight the importance of considering the broader post training work environment of service providers as a determinant of subsequent program use.

  11. Community psychiatric nurses and the care co-ordinator role: squeezed to provide 'limited nursing'. (United States)

    Simpson, Alan


    This paper reports a study illuminating the factors that either facilitate or constrain the ability of community psychiatric nurses, in their role as care co-ordinators, to meet service users' and carers' needs. The Care Programme Approach is the key policy underpinning community-focused mental health services in England, but has been unevenly implemented and is associated with increased inpatient bed use. The care co-ordinator role is central to the Care Programme Approach and is most often held by community psychiatric nurses, but there has been little research into how this role is performed or how it affects the work of community psychiatric nurses and their ability to meet the needs of service users. A multiple case study of seven sectorised community mental health teams was employed over 2 years using predominantly qualitative methods including participant observation, semi-structured interviews and document review. The data were collected in one National Health Service trust in south England between 1999 and 2001. Additional duties and responsibilities specifically associated with the care co-ordinator role and multidisciplinary working, combined with heavy workloads, produced 'limited nursing', whereby community psychiatric nurses were unable to provide evidence-based psychosocial interventions that are recognized to reduce relapse amongst people with severe mental illness. The role of the Care Programme Approach care co-ordinator was not designed to support the provision of psychosocial interventions. Consequently, community psychiatric nurses in the co-ordinator role are faced with competing demands and are unable to provide the range of structured, evidence-based interventions required. This may partially account for the increased inpatient bed use associated with the Care Programme Approach.

  12. Providing Continuing Education for International Nurses. (United States)

    Case, Debra L


    In an increasingly globalized world, providing continuing education (CE) for nurses is becoming a more common opportunity for U.S. educators. It is important for educators to provide CE programs in a culturally competent and sensitive environment. The challenges involved include effective communication, appropriate teaching methodologies, contextually appropriate content, and awareness of cultural-specific needs and customs. Copyright 2015, SLACK Incorporated.

  13. Professional e-mail communication among health care providers: proposing evidence-based guidelines. (United States)

    Malka, S Terez; Kessler, Chad S; Abraham, John; Emmet, Thomas W; Wilbur, Lee


    E-mail is now a primary method of correspondence in health care, and proficiency with professional e-mail use is a vital skill for physicians. Fundamentals of e-mail courtesy can be derived from lay literature, but there is a dearth of scientific literature that addresses the use of e-mail between physicians. E-mail communication between providers is generally more familiar and casual than other professional interactions, which can promote unprofessional behavior or misunderstanding. Not only e-mail content but also wording, format, and tone may influence clinical recommendations and perceptions of the e-mail sender. In addition, there are serious legal and ethical implications when unprofessional or unsecured e-mails related to patient-identifying information are exchanged or included within an electronic medical record. The authors believe that the appropriate use of e-mail is a vital skill for physicians, with serious legal and ethical ramifications and the potential to affect professional development and patient care. In this article, the authors analyze a comprehensive literature search, explore several facets of e-mail use between physicians, and offer specific recommendations for professional e-mail use.

  14. How do nurse academics value and engage with evidence-based practice across Australia: Findings from a grounded theory study. (United States)

    Malik, Gulzar; McKenna, Lisa; Griffiths, Debra


    Integrating evidence-based practice (EBP) into undergraduate education and preparing future nurses to embrace EBP in clinical practice becomes paramount in today's complex and evolving healthcare environment. The role that EBP plays in the practical lives of nursing students will depend on the degree to which it is promoted by academics, how it is incorporated into courses and its application to clinical setting. Hence, nursing academics play a crucial role in influencing its integration into curricula. Drawn from a larger doctoral study, this paper presents findings discussing how nurse academics value and engage with EBP. Grounded theory was employed to explore processes used by nursing academics while incorporating EBP into teaching and learning practices. Twenty-three academics across Australian universities were interviewed. Nine were also observed while teaching undergraduate students. Data were collected from semi-structured interviews and non-participant observation. In keeping with the tenets of grounded theory, data collection and analysis continued until theoretical saturation was reached. In total, four categories emerged. This paper focuses on the category conceptualised as Valuing and Engaging with EBP. How nursing academics valued and engaged with EBP was closely associated with meanings they constructed around understanding it, attitudes and commitment to implementation while teaching and working clinically. Different opinions also existed in regard to what actually constituted EBP. However, they engaged with and valued EBP by keeping themselves up-to-date, being involved in research activities, using evidence in teaching, therefore leading by example. Participants identified a number of barriers influencing their engagement with EBP including heavy workloads, limited time, lack of commitment within their schools, lack of confidence with teaching EBP, and complexity of EBP application. Faculty clinical practice, committed academics, workload

  15. Sustaining Nurse-Led Task-Shifting Strategies for Hypertension Control: A Concept Mapping Study to Inform Evidence-Based Practice. (United States)

    Blackstone, Sarah; Iwelunmor, Juliet; Plange-Rhule, Jacob; Gyamfi, Joyce; Quakyi, Nana Kofi; Ntim, Micheal; Ogedegbe, Gbenga


    The use of task-shifting is an increasingly widespread delivery approach for health interventions targeting prevention, treatment, and control of hypertension in adults living in sub-Saharan Africa (SSA). Addressing a gap in the literature, this research examined the sustainability of an ongoing task-shifting strategy for hypertension (TASSH) from the perspectives of community health nurses (CHNs) implementing the program. We used concept-mapping, a mixed-methods participatory approach to understand CHNs' perceptions of barriers and enablers to sustaining a task-shifting program. Participants responded to focal prompts, eliciting statements regarding perceived barriers and enablers to sustaining TASSH, and then rated these ideas based on importance to the research questions and feasibility to address. Twenty-eight community health nurses (21 women, 7 men) from the Ashanti region of Ghana completed the concept-mapping process. Factors influencing sustainability were grouped into five categories: Limited Drug Supply, Financial Support, Provision of Primary Health Care, Personnel Training, and Patient-Provider Communication. The limited supply of antihypertensive medication was considered by CHNs as the most important item to address, while providing training for intervention personnel was considered most feasible to address. This study's findings highlight the importance of examining nurses' perceptions of factors likely to influence the sustainability of evidence-based, task-shifting interventions. Nurses' perceptions can guide the widespread uptake and dissemination of these interventions in resource-limited settings. © 2017 Sigma Theta Tau International.

  16. Flipping the Classroom without Flipping Out the Students: Working with an Instructional Designer in an Undergraduate Evidence-Based Nursing Practice Course (United States)

    Matsuda, Yui; Azaiza, Khitam; Salani, Deborah


    The flipped classroom approach is an innovative teaching method to promote students' active learning. It has been used in nursing education and has showed positive results. The purpose of this article is to describe the process of developing a flipped classroom approach for an undergraduate evidence-based nursing practice course and discuss…

  17. The role of organizational context and individual nurse characteristics in explaining variation in use of information technologies in evidence based practice (United States)


    Background There is growing awareness of the role of information technology in evidence-based practice. The purpose of this study was to investigate the role of organizational context and nurse characteristics in explaining variation in nurses’ use of personal digital assistants (PDAs) and mobile Tablet PCs for accessing evidence-based information. The Promoting Action on Research Implementation in Health Services (PARIHS) model provided the framework for studying the impact of providing nurses with PDA-supported, evidence-based practice resources, and for studying the organizational, technological, and human resource variables that impact nurses’ use patterns. Methods A survey design was used, involving baseline and follow-up questionnaires. The setting included 24 organizations representing three sectors: hospitals, long-term care (LTC) facilities, and community organizations (home care and public health). The sample consisted of 710 participants (response rate 58%) at Time 1, and 469 for whom both Time 1 and Time 2 follow-up data were obtained (response rate 66%). A hierarchical regression model (HLM) was used to evaluate the effect of predictors from all levels simultaneously. Results The Chi square result indicated PDA users reported using their device more frequently than Tablet PC users (p = 0.001). Frequency of device use was explained by ‘breadth of device functions’ and PDA versus Tablet PC. Frequency of Best Practice Guideline use was explained by ‘willingness to implement research,’ ‘structural and electronic resources,’ ‘organizational slack time,’ ‘breadth of device functions’ (positive effects), and ‘slack staff’ (negative effect). Frequency of Nursing Plus database use was explained by ‘culture,’ ‘structural and electronic resources,’ and ‘breadth of device functions’ (positive effects), and ‘slack staff’ (negative). ‘Organizational culture’ (positive), ‘breadth of device functions’ (positive), and

  18. The role of organizational context and individual nurse characteristics in explaining variation in use of information technologies in evidence based practice

    Directory of Open Access Journals (Sweden)

    Doran Diane


    Full Text Available Abstract Background There is growing awareness of the role of information technology in evidence-based practice. The purpose of this study was to investigate the role of organizational context and nurse characteristics in explaining variation in nurses’ use of personal digital assistants (PDAs and mobile Tablet PCs for accessing evidence-based information. The Promoting Action on Research Implementation in Health Services (PARIHS model provided the framework for studying the impact of providing nurses with PDA-supported, evidence-based practice resources, and for studying the organizational, technological, and human resource variables that impact nurses’ use patterns. Methods A survey design was used, involving baseline and follow-up questionnaires. The setting included 24 organizations representing three sectors: hospitals, long-term care (LTC facilities, and community organizations (home care and public health. The sample consisted of 710 participants (response rate 58% at Time 1, and 469 for whom both Time 1 and Time 2 follow-up data were obtained (response rate 66%. A hierarchical regression model (HLM was used to evaluate the effect of predictors from all levels simultaneously. Results The Chi square result indicated PDA users reported using their device more frequently than Tablet PC users (p = 0.001. Frequency of device use was explained by ‘breadth of device functions’ and PDA versus Tablet PC. Frequency of Best Practice Guideline use was explained by ‘willingness to implement research,’ ‘structural and electronic resources,’ ‘organizational slack time,’ ‘breadth of device functions’ (positive effects, and ‘slack staff’ (negative effect. Frequency of Nursing Plus database use was explained by ‘culture,’ ‘structural and electronic resources,’ and ‘breadth of device functions’ (positive effects, and ‘slack staff’ (negative. ‘Organizational culture’ (positive, ‘breadth of device functions

  19. Diet Assessment Methods in the Nurses' Health Studies and Contribution to Evidence-Based Nutritional Policies and Guidelines. (United States)

    Hu, Frank B; Satija, Ambika; Rimm, Eric B; Spiegelman, Donna; Sampson, Laura; Rosner, Bernard; Camargo, Carlos A; Stampfer, Meir; Willett, Walter C


    To review the contribution of the Nurses' Health Studies (NHSs) to diet assessment methods and evidence-based nutritional policies and guidelines. We performed a narrative review of the publications of the NHS and NHS II between 1976 and 2016. Through periodic assessment of diet by validated dietary questionnaires over 40 years, the NHSs have identified dietary determinants of diseases such as breast and other cancers; obesity; type 2 diabetes; cardiovascular, respiratory, and eye diseases; and neurodegenerative and mental health disorders. Nutritional biomarkers were assessed using blood, urine, and toenail samples. Robust findings, from the NHSs, together with evidence from other large cohorts and randomized dietary intervention trials, have contributed to the evidence base for developing dietary guidelines and nutritional policies to reduce intakes of trans fat, saturated fat, sugar-sweetened beverages, red and processed meats, and refined carbohydrates while promoting higher intake of healthy fats and carbohydrates and overall healthful dietary patterns. The long-term, periodically collected dietary data in the NHSs, with documented reliability and validity, have contributed extensively to our understanding of the dietary determinants of various diseases, informing dietary guidelines and shaping nutritional policy.

  20. A failed model-based attempt to implement an evidence-based nursing guideline for fall prevention. (United States)

    Semin-Goossens, Astrid; van der Helm, Jelle M J; Bossuyt, Patrick M M


    An evidence-based nursing guideline had been locally developed in 1993 to reduce fall incidence rates, creating a 30% reduction. Implementation had failed though. Between 1999 and 2001 the guideline was updated. A multifaceted intervention was chosen based on a model for implementing change. The study was performed in 2 wards. All recommendations of Grol's 5-step implementation model were followed. The aim was a reduction of 30% in fall incidence within a year. Data on falls were extracted from nursing records and Incidence Report Forms (IRFs). In a pilot study an average of 9 falls per 1000 patients per day had been recorded in the department of internal medicine and 16 in the neurology ward. Given the desired reduction of 30%, the target averages were 6 and 11 falls respectively. During the intervention year the average incidences were 8 and 13 falls (95% CI: 6-11 and 10-15). There was a changeable pattern over time without any declining trend. The percentage filled in IRFs varied strongly, with an average of 52% in the department of internal medicine and 60% in the neurology department. There has been no durable decrease in monthly falls despite the use of a model-based procedure for implementing change. Neither did we observe any improvement in filling in IRFs. It can be questioned if the nurses themselves did experience patient falls to be troublesome enough. Investigating this is difficult though. Although the most successful strategy still appears to be changing attitudes of nurses in order to increase fall prevention, there is no clear strategy on how to create this successfully.

  1. [Miraculous low carbohydrate or carbophobic diets: evidence-based nursing perspective]. (United States)

    Casado Dones, María José; Fraile Villar, María Isabel; Juárez Bonilla, Mónica; Moreno González, Cristina; Martín Rodríguez, María


    Given the obesity epidemic in Western society today, as well as its influence on population's health as a risk factor for the most pressing health problems, diet treatment to control overweight ought to be considered as a priority in the specialized and primary health nursing care. A review of some supposedly miraculous diets, based on drastic reduction of consumed carbohydrates, as well as the available scientific evidence show that such diets pose a health hazard besides being ineffective to control excess weight in the short- and long-term. The negative consequences of a reduction of the percentage of consumed carbohydrates, thus resulting in an increase of proteins in the diet are set forth. Besides, suitable recommendations for patients to get loss weight are presented in an effective and safe manner. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  2. Initial emergency nursing management of patients with severe traumatic brain injury: development of an evidence-based care bundle for the Thai emergency department context. (United States)

    Damkliang, Jintana; Considine, Julie; Kent, Bridie; Street, Maryann


    Thai emergency nurses play a vital role in caring for patients with severe TBI, and are an important part of the healthcare team throughout the resuscitation phase. They are also responsible for continuous physiological monitoring, and detecting deterioration associated with increased intracranial pressure and preventing secondary brain injury. However, there is known variation in Thai nurses' knowledge and care practices for patients with severe TBI. In addition, there are no specific evidence-based practice guidelines available for emergency nursing management of patients with severe TBI. The aim of this paper is to describe the development of an evidence-based care bundle for initial emergency nursing management of patients with severe TBI for use in a Thai ED context. An evidence-based care bundle focused on seven major elements: (1) establish a secure airway along with c-spine protection, (2) maintain adequacy of oxygenation and ventilation, (3) maintain circulation and fluid balance, (4) assessment of GCS, and pupil size and reactivity, (5) maintain cerebral venous outflow, (6) management of pain, agitation, and irritability, and (7) administer for urgent CT scan. A care bundle is one method of promoting consistent, evidence-based emergency nursing care of patients with severe TBI, decreasing unnecessary variations in nursing care and reducing the risk of secondary brain injury from suboptimal care. Implementation of this evidence-based care bundle developed specifically for the Thai emergency nursing context has the potential to improve the care of the patients with severe TBI. Copyright © 2014 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  3. Characteristics of Quality Improvement Champions in Nursing Homes: A Systematic Review With Implications for Evidence-Based Practice. (United States)

    Woo, Kyungmi; Milworm, Gvira; Dowding, Dawn


    Improving care quality while reducing cost has always been a focus of nursing homes. Certified nursing assistants comprise the largest proportion of the workforce in nursing homes and have the potential to contribute to the quality of care provided. Quality improvement (QI) initiatives using certified nursing assistants as champions have the potential to improve job satisfaction, which has been associated with care quality. To identify the role, use and preparation of champions in a nursing home setting as a way of informing future QI strategies in nursing homes. A systematic literature review. Medical Subject Headings and text words for "quality improvement" were combined with those for "champion*" to search Medline, CINAHL, Joanna Briggs Institute, MedLine In-Process, and other Nonindexed Citations. After duplicates were removed, a total of 337 potential articles were identified for further review. After full text review, seven articles from five original studies met inclusion criteria and were included in the synthesis. Various types of QI initiatives and implementation strategies were used together with champions. Champions were identified by study authors as one of the single most effective strategies employed in all studies. The majority of studies described the champion role as that of a leader, who fosters and reinforces changes for improvement. Although all the included studies suggested that implementing nurse or aid champions in their QI initiatives were important facilitators of success, how the champions were selected and trained in their role is either missing or not described in any detail in the studies included in the review. Utilizing certified nursing assistants as QI champions can increase participation in QI projects and has the potential to improve job satisfaction and contribute to improve quality of care and improved patient outcomes in nursing homes. © 2017 Sigma Theta Tau International.

  4. Development of a Website Providing Evidence-Based Information About Nutrition and Cancer: Fighting Fiction and Supporting Facts Online. (United States)

    van Veen, Merel Rebecca; Beijer, Sandra; Adriaans, Anika Maria Alberdina; Vogel-Boezeman, Jeanne; Kampman, Ellen


    Although widely available, the general public, cancer patients, and cancer survivors have difficulties accessing evidence-based information on nutrition and cancer. It is challenging to distinguish myths from facts, and sometimes conflicting information can be found in different places. The public and patients would benefit from evidence-based, correct, and clear information from an easily recognizable source. The aim of this project is to make scientific information available for the general public, cancer patients, and cancer survivors through a website. The aim of this paper is to describe and evaluate the development of the website as well as related statistics 1st year after its launch. To develop the initial content for the website, the website was filled with answers to frequently asked questions provided by cancer organizations and the Dutch Dietetic Oncology Group, and by responding to various fiction and facts published in the media. The website was organized into 3 parts, namely, nutrition before (prevention), during, and after cancer therapy; an opportunity for visitors to submit specific questions regarding nutrition and cancer was included. The website was pretested by patients, health care professionals, and communication experts. After launching the website, visitors' questions were answered by nutritional scientists and dieticians with evidence- or eminence-based information on nutrition and cancer. Once the website was live, question categories and website statistics were recorded. Before launch, the key areas for improvement, such as navigation, categorization, and missing information, were identified and adjusted. In the 1st year after the launch, 90,111 individuals visited the website, and 404 questions were submitted on nutrition and cancer. Most of the questions were on cancer prevention and nutrition during the treatment of cancer. The website provides access to evidence- and eminence-based information on nutrition and cancer. As can be

  5. Development of a Website Providing Evidence-Based Information About Nutrition and Cancer: Fighting Fiction and Supporting Facts Online (United States)

    Beijer, Sandra; Adriaans, Anika Maria Alberdina; Vogel-Boezeman, Jeanne; Kampman, Ellen


    Background Although widely available, the general public, cancer patients, and cancer survivors have difficulties accessing evidence-based information on nutrition and cancer. It is challenging to distinguish myths from facts, and sometimes conflicting information can be found in different places. The public and patients would benefit from evidence-based, correct, and clear information from an easily recognizable source. Objective The aim of this project is to make scientific information available for the general public, cancer patients, and cancer survivors through a website. The aim of this paper is to describe and evaluate the development of the website as well as related statistics 1st year after its launch. Methods To develop the initial content for the website, the website was filled with answers to frequently asked questions provided by cancer organizations and the Dutch Dietetic Oncology Group, and by responding to various fiction and facts published in the media. The website was organized into 3 parts, namely, nutrition before (prevention), during, and after cancer therapy; an opportunity for visitors to submit specific questions regarding nutrition and cancer was included. The website was pretested by patients, health care professionals, and communication experts. After launching the website, visitors’ questions were answered by nutritional scientists and dieticians with evidence- or eminence-based information on nutrition and cancer. Once the website was live, question categories and website statistics were recorded. Results Before launch, the key areas for improvement, such as navigation, categorization, and missing information, were identified and adjusted. In the 1st year after the launch, 90,111 individuals visited the website, and 404 questions were submitted on nutrition and cancer. Most of the questions were on cancer prevention and nutrition during the treatment of cancer. Conclusions The website provides access to evidence- and eminence

  6. Building the capacity for evidence-based clinical nursing leadership: the role of executive co-coaching and group clinical supervision for quality patient services. (United States)

    Alleyne, Jo; Jumaa, Mansour Olawale


    The general aims of this article were to facilitate primary care nurses (District Nurse Team Leaders) to link management and leadership theories with clinical practice and to improve the quality of the service provided to their patients. The specific aim was to identify, create and evaluate effective processes for collaborative working so that the nurses' capacity for clinical decision-making could be improved. This article, part of a doctoral study on Clinical Leadership in Nursing, has wider application in the workplace of the future where professional standards based on collaboration will be more critical in a world of work that will be increasingly complex and uncertain. This article heralds the type of research and development activities that the nursing and midwifery professions should give premier attention to, particularly given the recent developments within the National Health Service in the United Kingdom. The implications of: Agenda for Change, the Knowledge and Skills Framework, 'Our Health, Our Care, Our Say' and the recent proposals from the article 'Modernising Nursing Career', to name but a few, are the key influences impacting on and demanding new ways of clinical supervision for nurses and midwives to improve the quality of patient management and services. The overall approach was based on an action research using a collaborative enquiry within a case study. This was facilitated by a process of executive co-coaching for focused group clinical supervision sessions involving six district nurses as co-researchers and two professional doctoral candidates as the main researchers. The enquiry conducted over a period of two and a half years used evidence-based management and leadership interventions to assist the participants to develop 'actionable knowledge'. Group clinical supervision was not practised in this study as a form of 'therapy' but as a focus for the development of actionable knowledge, knowledge needed for effective clinical management and

  7. The effect of integrating constructivist and evidence-based practice on baccalaureate nursing student's cognitive load and learning performance in a research course. (United States)

    Hsieh, Suh-Ing; Hsu, Li-Ling; Huang, Tzu-Hsin


    Baccalaureate nursing students perceive research as unattractive, doubt the value of nursing research, and do not appreciate the link of research with practice. No studies have examined students' cognitive load during an evidence-based practice research course versus a traditional research course. To assess the effect of integrating constructivist theories and evidence-based practice on student cognitive load and learning performance in a research course. A true experimental study. A Registered Nurse-to-Bachelor of Science in Nursing program. Six classes of second-year students. Students were randomly allocated to the control group (two classes) or the experimental group (two classes) using cluster randomization. The control group underwent "traditional research"; the experimental group experienced "integrating evidence-based practice into research." Instruments for outcome assessment include the Cognitive Load Scale, cognitive test, team critique paper, and qualitative feedback on course satisfaction. The between-subjects effects were compared by Analysis of Covariance. The experimental group had significantly higher mental load (8.74 vs. 7.27, presearch knowledge (70.61 vs. 44.92, pwriting (89.40%). Some experimental learners expressed satisfaction with learning evidence-based practice (17.78%) and critiquing a research article (7.78%). Integrating evidence-based practice into a research course not only improved the research knowledge of baccalaureate nursing students, but also increased their mental load, mental effort, and mental efficiency. Additional studies may track learners' responses to different learning systems using the developed instrument to measure the three types of cognitive load. These findings may help educators design more effective and interesting curricula for integrating research and evidence-based practice into the studies of student nurses. Copyright © 2016. Published by Elsevier Ltd.

  8. Educational support for research utilization and capability beliefs regarding evidence-based practice skills: a national survey of senior nursing students. (United States)

    Florin, Jan; Ehrenberg, Anna; Wallin, Lars; Gustavsson, Petter


    The aim of the study was to investigate Swedish university nursing students' experience of educational support for research utilization and capability beliefs regarding evidence-based practice skills. Nursing programmes are offered at 26 universities in Sweden and even though there are common regulations for nursing education at the national level, substantial variations are found in local curricula. Little is known about students' capability beliefs regarding evidence-based practice skills, particularly in comparison across universities. A cross-sectional survey design using self-administered postal questionnaires was conducted in 2006. A total of 1440 students (from 26 different universities) participated, constituting 68% of the national population of nursing students in their 6th and final semester. Campus education supported the students to a greater extent than clinical education in following the development of knowledge in an area of interest, using research findings, and acquiring knowledge on how to pursue changes in clinical practice. Perceived support during campus education varied between universities. Students reported high capability beliefs regarding evidence-based practice skills, but large differences were found between universities for: stating a searchable question, seeking out relevant knowledge and critically appraising and compiling best knowledge. The identified differences between universities concerning the students' perceived support for research utilization and their capability beliefs regarding evidence-based practice skills have implications for curricula, pedagogical perspectives in nursing education and the potential to implement evidence-based practice in healthcare settings. Further studies are warranted to investigate students' individual characteristics and organizational characteristics as determinants of research utilization support and capability beliefs regarding evidence-based practice skills. © 2011 The Authors. Journal of

  9. Trust in the health-care provider-patient relationship: a systematic mapping review of the evidence base. (United States)

    Brennan, Nicola; Barnes, Rebecca; Calnan, Mike; Corrigan, Oonagh; Dieppe, Paul; Entwistle, Vikki


    Trust is important for patients and may be used as an indicator and potential 'marker' for how patients evaluate the quality of health care. The review aimed to classify the current evidence base on trust in the patient-provider relationship in order to identify strengths and weaknesses and to point towards areas for future research. Nine electronic databases were searched from 2004 onwards using text and subject heading keywords relating to 'trust' and 'health care' and 'relationships'. Abstracts were identified for empirical studies carried out in health-care settings that explicitly examined trust or reported trust-related findings as a secondary outcome. Data extraction Two review authors assessed the relevance of abstracts and extracted data relating to year published, country of study, clinical speciality, and participants. Five hundred and ninety-six abstracts were included. Most reported on patients' trust in providers; were carried out in the USA; collected data in family care or oncology/palliative care settings; used questionnaires and interviews and elicited patients' perspectives. Only one study explicitly set out to examine providers' trust in patients and patients. Providers' trust in patients remains a neglected area on the trust research agenda. Empirical studies examining the factors that influence providers' trust in patients and how this might affect the quality of care and patient health-related behaviours are urgently needed to readdress this imbalance. Further exploration of this area using observational methods is recommended.

  10. Provider-agency fit in substance abuse treatment organizations: implications for learning climate, morale, and evidence-based practice implementation. (United States)

    Ramsey, Alex T; van den Berk-Clark, Carissa


    Substance abuse agencies have been slow to adopt and implement evidence-based practices (EBPs), due in part to poor provider morale and organizational climates that are not conducive to successful learning and integration of these practices. Person-organization fit theory suggests that alignment, or fit, between provider- and agency-level characteristics regarding the implementation of EBPs may influence provider morale and organizational learning climate and, thus, implementation success. The current study hypothesized that discrepancies, or lack of fit, between provider- and agency-level contextual factors would negatively predict provider morale and organizational learning climate, outcomes shown to be associated with successful EBP implementation. Direct service providers (n = 120) from four substance abuse treatment agencies responded to a survey involving provider morale, organizational learning climate, agency expectations for EBP use, agency resources for EBP use, and provider attitudes towards EBP use. Difference scores between combinations of provider- and agency-level factors were computed to model provider-agency fit. Quadratic regression analyses were conducted to more adequately and comprehensively model the level of the dependent variables across the entire "fit continuum". Discrepancies, or misfit, between agency expectations and provider attitudes and between agency resources and provider attitudes were associated with poorer provider morale and weaker organizational learning climate. For all hypotheses, the curvilinear model of provider-agency discrepancies significantly predicted provider morale and organizational learning climate, indicating that both directions of misfit (provider factors more favorable than agency factors, and vice-versa) were detrimental to morale and climate. However, outcomes were most negative when providers viewed EBPs favorably, but perceived that agency expectations and resources were less supportive of EBP use. The

  11. Factors that influence evidence-based program sustainment for family support providers in child protection services in disadvantaged communities. (United States)

    Hodge, Lauren M; Turner, Karen M T; Sanders, Matthew R; Forster, Michell


    This paper evaluates program, workplace and process factors associated with implementation and sustainment of an evidence-based parenting support program (EBP) in disadvantaged communities. Correlation analyses and binary logistic regressions were used to assess the associations between key implementation support factors and program implementation (at 18 months) and sustainment (at 36 months) post training with (N=35) Australian Aboriginal and Torres Strait Islander family support providers using the Triple P - Positive Parenting Program in Indigenous child protection agencies. This study demonstrated that for implementation at 18 months, there was a trend for implementing providers to report higher levels of partnership support, perceived program benefit, workplace support and workplace cohesion. However, the only significant relationship was with partnership support (r=.31 pprogram implementation. For sustained implementation at 36 months, no relationship was found between sustainment and program characteristics, workplace characteristics, supervision and peer support or sustainability planning. Supportive coaching was the only significant correlate (r=0.46, pp=0.009] in the program sustainment model. Overall, these findings suggest the need for further exploration of program and workplace variables and provide evidence to consider incorporating partnership support and supportive coaching in real world implementation models to improve the likelihood of EBP implementation and sustainment in Indigenous communities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Perception of evidence-based practice and the professional environment of Primary Health Care nurses in the Spanish context: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    González-Torrente Susana


    Full Text Available Abstract Background The study of the factors that encourage evidence-based clinical practice, such as structure, environment and professional skills, has contributed to an improvement in quality of care. Nevertheless, most of this research has been carried out in a hospital context, neglecting the area of primary health care. The main aim of this work was to assess the factors that influence an evidence-based clinical practice among nursing professionals in Primary Health Care. Methods A multicentre cross-sectional study was designed, taking the 619 Primary Care staff nurses at the Balearic Islands’ Primary Health Care Service, as the study population. The methodology applied consisted on a self-administered survey using the instruments Evidence-Based Practice Questionnaire (EBPQ and Nursing Work Index (NWI. Results Three hundred and seventy seven surveys were received (60.9% response rate. Self-assessment of skills and knowledge, obtained 66.6% of the maximum score. The Knowledge/Skills factor obtained the best scores among the staff with shorter professional experience. There was a significant difference in the Attitude factor (p = 0.008 in favour of nurses with management functions, as opposed to clinical nurses. Multivariate analysis showed a significant positive relationship between NWI and level of evidence-based practice (p  Conclusions Institutions ought to undertake serious reflection on the lack of skills of senior nurses about Evidence-Based Clinical Practice, even when they have more professional experience. Leadership emerge as a key role in the transferral of knowledge into clinical practice.

  13. Tactics for Teaching Evidence-Based Practice: Enhancing Active Learning Strategies With a Large Class of Graduate EBP Research in Nursing Students. (United States)

    Vetter, Mary Jo; Latimer, Beth


    This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning and implementation of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at © 2017 Sigma Theta Tau International.

  14. Emergent Life Events During Youth Evidence-Based Treatment: Impact on Future Provider Adherence and Clinical Progress. (United States)

    Guan, Karen; Park, Alayna L; Chorpita, Bruce F


    Emergent life events (ELEs)-unexpected stressors disclosed in psychotherapy that have a significant negative impact on the client-commonly occur in community populations of youth and are associated with decreased provider adherence to evidence-based treatment (EBT) in session. The present study extends previous research by examining longer term associations of ELEs with (a) provider adherence to planned EBT practices in subsequent sessions and (b) clinical progress. Data were drawn from the modular EBT condition (MATCH) of the Child STEPs California trial conducted with primarily Latino youth, ages 5-15, who were 54% male (Chorpita et al., 2017). Study 1 utilized data from 57 MATCH participants who reported at least one ELE during treatment. Provider adherence was measured by identifying whether planned practices were covered in either the session in which the ELE was reported or the following session using the MATCH Consultation Record. In Study 2, clinical progress for 78 MATCH participants was assessed using weekly youth- and caregiver-ratings of symptomatology (Brief Problem Checklist) and functioning (Top Problems Assessment). Study 1 revealed that ELEs were associated with reduced adherence to planned practices for at least two sessions. Study 2 demonstrated that each disruptive ELE (i.e., an ELE for which no EBT content was covered) was associated with a 14%-20% slower rate of clinical improvement, with greater declines for functioning and externalizing symptoms. Findings suggest that ELEs can be a major barrier to the effectiveness of an EBT and require further research in order to be addressed effectively.

  15. Providing support to nursing students in the clinical environment: a nursing standard requirement. (United States)

    Anderson, Carina; Moxham, Lorna; Broadbent, Marc


    This discussion paper poses the question 'What enables or deters Registered Nurses to take up their professional responsibility to support undergraduate nursing students through the provision of clinical education?'. Embedded within many nursing standards are expectations that Registered Nurses provide support and professional development to undergraduate nursing students undertaking clinical placements. Expectations within nursing standards that Registered Nurses provide support and professional development to nursing students are important because nursing students depend on Registered Nurses to help them to become competent practitioners. Contributing factors that enable and deter Registered Nurses from fulfilling this expectation to support nursing students in their clinical learning include; workloads, preparedness for the teaching role, confidence in teaching and awareness of the competency requirement to support students. Factors exist which can enable or deter Registered Nurses from carrying out the licence requirement to provide clinical education and support to nursing students.

  16. Addiction treatment provider attitudes on staff capacity and evidence-based clinical training: results from a national study. (United States)

    Lundgren, Lena; Amodeo, Maryann; Krull, Ivy; Chassler, Deborah; Weidenfeld, Rachel; de Saxe Zerden, Lisa; Gowler, Rebekah; Lederer, Jaime; Cohen, Alexander; Beltrame, Clelia


    This national study of addiction-treatment organizations' implementation of evidence-based practices examines: (1) organizational/leadership factors associated with director (n = 212) attitudes regarding staff resistance to organizational change, and (2) organizational/staff factors associated with staff (n = 312) attitudes regarding evidence-based clinical training. Linear regression analyses, controlling for type of treatment unit, leadership/staff characteristics and organizational readiness to change, identified that directors who perceived their organization needed more guidance and had less staff cohesion and autonomy rated staff resistance to organizational change significantly higher. Staff with higher levels of education and greater agreement that their organization supported change had greater preference for evidence-based trainings. Federal addiction treatment policy should both promote education and training of treatment staff and organizational development of treatment CBOs.  © American Academy of Addiction Psychiatry.

  17. Student nurse perceptions on evidence-based practice and research: an exploratory research study involving students from the University of Greenwich, England and the Faculty of Health Care Jesenice, Slovenia. (United States)

    Brooke, Joanne; Hvalič-Touzery, Simona; Skela-Savič, Brigita


    The importance of evidence-based practice (EBP) and research within nursing has been acknowledged since the 1970s. Research proficiencies for nurses include the abilities to search for and evaluate evidence, disseminate findings and apply findings to practice within the context of caring. However, there is a lack of information on how new undergraduate nursing curriculums have impacted on student nurses' perceptions on and importance of EBP and research. The study aimed to explore student nurses' perceptions on and importance of EBP and research. Data were collected via focus groups in 2013 with undergraduate student nurses from the University of Greenwich, England (n=7) and the Faculty of Health Care Jesenice, Slovenia (n=3). Cross-sectional sampling included focus groups with 1st year nursing students (4, n=22), 2nd year (4, n=38) and 3rd year (2, n=10). Data were analysed using Interpretative Phenomenological Analysis (IPA). Four emergent themes regarding students' perceptions of EBP and research were 'provided confidence, knowledge and empowerment in clinical practice', 'vital for improvements in patient care and safety', students' 'responsibility to develop nursing as a profession' and 'realities of research in clinical practice'. Student nurses found EBP and research daunting and difficult to understand, although perceived EBP and research as necessary for their current and future practice. However, student nurses highlighted the lack of clinical nurses' involvement in research and therefore struggled to conceptualise how they could maintain their EBP and research skills on leaving the academic setting. The importance of EBP and research was realised by student nurses across the two institutions. However, further development and involvement of clinical nurses with EBP and research is required to enable students to develop a clear understanding of how to take these skills forward in their future careers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. The effect of a multifaceted evidence-based practice programme for nurses on knowledge, skills, attitudes, and perceived barriers: A cohort study. (United States)

    van der Goot, Wieke E; Keers, Joost C; Kuipers, Ruud; Nieweg, Roos M B; de Groot, Martijn


    The Dutch professional nursing standard of 2012 stipulates that Dutch nursing practices are to be evidence-based. Not all practicing nurses can satisfy these requirements, therefore, an educational programme about Evidence-Based Practice (EBP) was developed for a Dutch teaching hospital. The aim of this study was to measure the effects of a six month in-house EBP programme on knowledge, skills, attitudes, and perceived barriers of nurses (four European Credits equals two US Credit Hours). A multiple-cohort study was conducted with a pre-post-test design. In the period of 2011-2015, a total of 58 nurses (9 cohorts) followed the programme. Baseline and follow-up assessments consisted of three questionnaires each: the Dutch Modified Fresno, the two subscales of the McColl questionnaire, and the BARRIER scale to assess knowledge and skills, attitudes, and perceived barriers, respectively. Fifty nurses completed both assessments. The results demonstrated that actual knowledge and skills significantly increased by approximately 40%. Self-perceived knowledge increased significantly, while attitudes towards EBP remained (moderately) positive. Perceived barriers did not notably change except for the Research subscale which received many "no opinion" responses prior to the programme but fewer afterwards. Our multifaceted in-house EBP programme led to a significant improvement of approximately 40% in EBP knowledge and skills of participating nurses. Most nurses who followed the EBP programme are currently applying their knowledge and skills in practice. Managerial support and allocated time for EBP are important facilitators for its implementation. Furthermore, to maintain and expand nurses' EBP knowledge and skills and translate them into practice, follow-up interventions, such as journal clubs, may well be beneficial. Based on the positive results of our programme, we will implement it throughout the hospital with an emphasis on training more groups of nurses. Copyright

  19. Study of 23 advanced-practice nurses suggest that their ability to facilitate evidence-based practice among frontline nurses is influenced by their personal attributes, relationships with stakeholders, responsibility and workload and organisational context. (United States)

    van Soeren, Mary


    Implications for practice and research: Role development of advance practice nurses (APNs) and organisational culture are important contributing factors for the adoption of evidence-based practice (EBP) by nurses. Nursing and APN workload were factors limiting adoption of EBPs. Education on EBP, leadership and facilitation should be part of all APN education. Further research across a range of settings is needed to determine additional factors that may influence adoption of EBP.

  20. Providing education on evidence-based practice improved knowledge but did not change behaviour: a before and after study

    Directory of Open Access Journals (Sweden)

    Lovarini Meryl


    Full Text Available Abstract Background Many health professionals lack the skills to find and appraise published research. This lack of skills and associated knowledge needs to be addressed, and practice habits need to change, for evidence-based practice to occur. The aim of this before and after study was to evaluate the effect of a multifaceted intervention on the knowledge, skills, attitudes and behaviour of allied health professionals. Methods 114 self-selected occupational therapists were recruited. The intervention included a 2-day workshop combined with outreach support for eight months. Support involved email and telephone contact and a workplace visit. Measures were collected at baseline, post-workshop, and eight months later. The primary outcome was knowledge, measured using the Adapted Fresno Test of Evidence-Based Practice (total score 0 to 156. Secondary outcomes were attitude to evidence-based practice (% reporting improved skills and confidence; % reporting barriers, and behaviour measured using an activity diary (% engaging/not engaging in search and appraisal activities, and assignment completion. Results Post-workshop, there were significant gains in knowledge which were maintained at follow-up. The mean difference in the Adapted Fresno Test total score was 20.6 points (95% CI, 15.6 to 25.5. The change from post-workshop to follow-up was small and non-significant (mean difference 1.2 points, 95% CI, -6.0 to 8.5. Fewer participants reported lack of searching and appraisal skills as barriers to evidence-based practice over time (searching = 61%, 53%, 24%; appraisal 60%, 65%, 41%. These differences were statistically significant (p = 0.0001 and 0.010 respectively. Behaviour changed little. Pre-workshop, 6% engaged in critical appraisal increasing to 18% post-workshop and 18% at follow-up. Nearly two thirds (60% were not reading any research literature at follow-up. Twenty-three participants (20.2% completed their assignment. Conclusion Evidence-based

  1. Teaching Evidence Assimilation for Collaborative Health Care (TEACH) 2009-2014: Building Evidence-Based Capacity within Health Care Provider Organizations. (United States)

    Wyer, Peter C; Umscheid, Craig A; Wright, Stewart; Silva, Suzana A; Lang, Eddy


    Clinical guidelines, prediction tools, and computerized decision support (CDS) are underutilized outside of research contexts, and conventional teaching of evidence-based practice (EBP) skills fails to change practitioner behavior. Overcoming these challenges requires traversing practice, policy, and implementation domains. In this article, we describe a program's conceptual design, the results of institutional participation, and the program's evolution. Next steps include integration of instruction in principles of CDS. Teaching Evidence Assimilation for Collaborative Health Care (TEACH) is a multidisciplinary annual conference series involving on- and off-site trainings and facilitation within health care provider organizations (HPOs). Separate conference tracks address clinical policy and guideline development, implementation science, and foundational EBP skills. The implementation track uses a model encompassing problem delineation, identifying knowing-doing gaps, synthesizing evidence to address those gaps, adapting guidelines for local use, assessing implementation barriers, measuring outcomes, and sustaining evidence use. Training in CDS principles is an anticipated component within this track. Within participating organizations, the program engages senior administration, middle management, and frontline care providers. On-site care improvement projects serve as vehicles for developing ongoing, sustainable capabilities. TEACH facilitators conduct on-site workshops to enhance project development, integration of stakeholder engagement and decision support. Both on- and off-site components emphasize narrative skills and shared decision-making. Since 2009, 430 participants attended TEACH conferences. Delegations from five centers attended an initial series of three conferences. Improvement projects centered on stroke care, hospital readmissions, and infection control. Successful implementation efforts were characterized by strong support of senior administration

  2. Providing Relevance in Chemistry for Nursing Students (United States)

    Jones, Theodore H. D.


    Describes an introductory chemistry course for nurses in which students learn basic chemical principles by performing 12 chemical analyses that are routinely conducted on body fluids and listed on a patient's clinical laboratory chart. (MLH)

  3. Evidence-based solution-focused care for school-age children experiencing cyberbullying: using the Omaha System to guide and document psychiatric nursing interventions. (United States)

    Kvarme, Lisbeth Gravdal; Monsen, Karen A; Eboh, Winifred Oluchukwu


    Cyberbullying is a global phenomenon. The experiences of bullied children are the same across cultures and languages, and psychiatric nursing interventions are known to be effective. It is critical to widely disseminate effective interventions to identify and address cyberbullying. Therefore, evidence-based care plans addressing cyberbullying at the individual and community levels were developed using the Omaha System, a terminology that is used internationally to guide and document care. This article presents a case study in which an evidence-based intervention was used to help a bullied child arrive at a solution, and demonstrates the use of the Omaha System to document evidence-based cyberbullying interventions with individuals and communities. Copyright 2014, SLACK Incorporated.

  4. Evidence-based nursing education: effective use of instructional design and simulated learning environments to enhance knowledge transfer in undergraduate nursing students. (United States)

    Robinson, Bridget K; Dearmon, Valorie


    Much confidence has been placed in the nursing profession's potential to positively impact the U.S. health care system. However, concerns about patient safety and quality beckon health care providers to reassess traditional practices. Professional nursing programs aim to prepare novice nurses with strong clinical skills to effectively and safely care for patients. Faculty shortages and fewer clinical sites for students present challenges to faculty. Limited exposure in the clinical practice setting hinders the development of intuition. In addition, new graduates often enter practice with an unclear understanding of their role at the bedside. Educators are challenged to find innovative teaching strategies to effectively prepare new graduates for entering the workforce. Simulation has been shown to be a valuable teaching-learning strategy. Using an instructional design model that is student centered as the basis for simulation activities in an undergraduate curriculum is one method to effectively provide much needed clinical experience in a safe learning environment. This article details the application of the ADDIE (analysis, design, development, implementation, evaluation) model of instructional design to the use of simulation in nursing education in an effort to facilitate improved clinical performance in new graduate nurses. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Attitude, Knowledge, and Practice on Evidence-Based Nursing among Registered Nurses in Traditional Chinese Medicine Hospitals: A Multiple Center Cross-Sectional Survey in China

    Directory of Open Access Journals (Sweden)

    Fen Zhou


    Full Text Available Objective. This study was to describe RNs’ attitude, knowledge, and practice on evidence-based practice (EBP in traditional Chinese nursing field and to estimate the related sociodemographic and professional factors. Methods. A multiple institutional cross-sectional survey design with self-reported EBP Questionnaire (EBPQ and self-designed questionnaires were used. Results. The average scores of the total EBPQ were with a mean of 4.24 (SD = 0.79. The score of attitude was the highest one, followed by the knowledge score, and the lowest one is practice. RNs with longer experience reported stronger EBP knowledge (H=6.64, P<0.05. And RNs under higher working pressure reported less positive attitudes (ρ=0.17, P<0.001, whereas RNs holding negative professional attitude reported lower scores (Spearman’s ρ: 0.12 to 0.15, P<0.001. Significant statistics were found between RNs with research experience and without in attitude (t=-2.40, P<0.05 and knowledge (t=-2.43, P<0.05. Conclusions. Respondents generally viewed EBP positively and their attitudes towards EBP tended to be more positive than knowledge and practice of EBP. Data also showed that longer working experience, having administrative position, research experience, lighter working load, and better professional attitude might facilitate EBP.

  6. Outcomes From the First Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare Invitational Expert Forum. (United States)

    Melnyk, Bernadette Mazurek; Gallagher-Ford, Lynn; Zellefrow, Cindy; Tucker, Sharon; Van Dromme, Laurel; Thomas, Bindu Koshy


    Even though multiple positive outcomes are the result of evidence-based care, including improvements in healthcare quality, safety, and costs, it is not consistently delivered by clinicians in healthcare systems throughout the world. In an attempt to accelerate the implementation of evidence-based practice (EBP) across the United States, an invitational Interprofessional National EBP Forum to determine major priorities for the advancement of EBP was held during the launch of the newly established Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at The Ohio State University College of Nursing. Interprofessional leaders from national organizations and federal agencies across the United States were invited to participate in the Forum. A pre-Forum survey was disseminated to participants to assess their perceptions of the state of EBP and actions necessary to speed the translation of research into real-world clinical settings. Findings from a pre-Forum survey (n = 47) indicated ongoing low implementation of EBP in U.S. healthcare settings. These findings were shared with leaders from 45 organizations and agencies who attended the Forum. Breakout groups on practice, education, implementation science, and policy discussed the findings and responded to a set of standardized questions. High-priority action tactics were identified, including the need for: (a) enhanced reimbursement for EBP, (b) more interprofessional education and skills building in EBP, and (c) leaders to prioritize EBP and fuel it with resources. The delivery of and reimbursement for evidence-based care must become a high national priority. Academic faculty across all healthcare disciplines need to teach EBP, healthcare systems must invest in EBP resources, and payers must attach reimbursement to care that is evidence-based. An action collaborative of the participating organizations has been formed to accelerate EBP across the United States to achieve the

  7. Expanding research to provide an evidence base for nutritional interventions for the management of inborn errors of metabolism. (United States)

    Camp, Kathryn M; Lloyd-Puryear, Michele A; Yao, Lynne; Groft, Stephen C; Parisi, Melissa A; Mulberg, Andrew; Gopal-Srivastava, Rashmi; Cederbaum, Stephen; Enns, Gregory M; Ershow, Abby G; Frazier, Dianne M; Gohagan, John; Harding, Cary; Howell, R Rodney; Regan, Karen; Stacpoole, Peter W; Venditti, Charles; Vockley, Jerry; Watson, Michael; Coates, Paul M


    A trans-National Institutes of Health initiative, Nutrition and Dietary Supplement Interventions for Inborn Errors of Metabolism (NDSI-IEM), was launched in 2010 to identify gaps in knowledge regarding the safety and utility of nutritional interventions for the management of inborn errors of metabolism (IEM) that need to be filled with evidence-based research. IEM include inherited biochemical disorders in which specific enzyme defects interfere with the normal metabolism of exogenous (dietary) or endogenous protein, carbohydrate, or fat. For some of these IEM, effective management depends primarily on nutritional interventions. Further research is needed to demonstrate the impact of nutritional interventions on individual health outcomes and on the psychosocial issues identified by patients and their families. A series of meetings and discussions were convened to explore the current United States' funding and regulatory infrastructure and the challenges to the conduct of research for nutritional interventions for the management of IEM. Although the research and regulatory infrastructure are well-established, a collaborative pathway that includes the professional and advocacy rare disease community and federal regulatory and research agencies will be needed to overcome current barriers. Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  8. Cognitive-behavioral therapy: How medical providers can increase patient and family openness and access to evidence-based multimodal therapy for pediatric migraine (United States)

    Ernst, Michelle M.; O’Brien, Hope; Powers, Scott W.


    While evidence supports the recommendation for cognitive behavioral therapy (CBT) for pediatric migraine, few children actually receive this evidence-based intervention. In this article we briefly review the most recent empirical evidence supporting CBT. We then identify both provider/system-related barriers as well as patient-related barriers. Finally, we provide practical solutions to addressing these barriers in the service of facilitating children receiving optimal comprehensive management of their headaches. PMID:26198185

  9. Explaining unexplained pain to fibromyalgia patients: finding a narrative that is acceptable to patients and provides a rationale for evidence based interventions


    Hyland, ME; Hinton, C.; Hill, C.; Whalley, B; Jones,RC; Davies, AF


    As the cause of fibromyalgia is controversial, communicating with patients can be challenging, particularly if the patient adopts the narrative ‘I am damaged and so I need a more powerful pain killer’. Research shows that providing patients with alternative narratives can be helpful, but it remains unclear what particular narratives are most acceptable to patients and at the same time provide a rationale for evidence based psychological and exercise interventions. This article described the d...

  10. Evaluation of an evidence-based guidance on the reduction of physical restraints in nursing homes: a cluster-randomised controlled trial [ISRCTN34974819

    Directory of Open Access Journals (Sweden)

    Haastert Burkhard


    Full Text Available Abstract Background Physical restraints are regularly applied in German nursing homes. Their frequency varies substantially between centres. Beneficial effects of physical restraints have not been proven, however, observational studies and case reports suggest various adverse effects. We developed an evidence-based guidance on this topic. The present study evaluates the clinical efficacy and safety of an intervention programme based on this guidance aimed to reduce physical restraints and minimise centre variations. Methods/Design Cluster-randomised controlled trial with nursing homes randomised either to the intervention group or to the control group with standard information. The intervention comprises a structured information programme for nursing staff, information materials for legal guardians and residents' relatives and a one-day training workshop for nominated nurses. A total of 36 nursing home clusters including approximately 3000 residents will be recruited. Each cluster has to fulfil the inclusion criteria of at least 20% prevalence of physical restraints at baseline. The primary endpoint is the number of residents with at least one physical restraint at six months. Secondary outcome measures are the number of falls and fall-related fractures. Discussion If successful, the intervention should be implemented throughout Germany. In case the intervention does not succeed, a three-month pre-post-study with an optimised intervention programme within the control group will follow the randomised trial. Trial registration ISRCTN34974819

  11. Nursing students' self-efficacy in providing transcultural care. (United States)

    Lim, Janet; Downie, Jill; Nathan, Pauline


    The aim of any health care service is to provide optimal quality care to clients and families regardless of their ethnic group. As today's Australian society comprises a multicultural population that encompasses clients with different cultural norms and values, this study examined undergraduate nursing students' self-efficacy in providing transcultural nursing care. A sample of 196 nursing students enrolled in the first and fourth year of a pre-registration nursing program in a Western Australian University were invited to participate in a survey incorporating a transcultural self-efficacy tool (TSET) designed by Jeffery [Unpublished instrument copyrighted by author, 1994]. The findings revealed that fourth year students, exposed to increased theoretical information and clinical experience, had a more positive perception of their self-efficacy in providing transcultural nursing skills than the first year students. In addition, the study found that age, gender, country of birth, languages spoken at home and previous work experience did not influence the nursing students' perception of self-efficacy in performing transcultural care. The study supports the notion that educational preparation and relevant clinical experience is important in providing nursing students with the opportunity to develop self-efficacy in performing effective and efficient transcultural nursing in today's multicultural health care system. It is for this reason that educators need to focus on providing students with relevant theoretical information and ensure sufficient clinical exposure to support student learning in the undergraduate program.

  12. Nurses' Knowledge, Perception, and Self-Confidence Regarding Evidence-Based Antibiotic Use in the Long-Term Care Setting. (United States)

    Hale, LaDonna S; Votaw, Lindsey L; Mayer, Janell E; Sobota, Kristen F


    Describe knowledge, perceptions, and self-confidence of nurses in the long-term care setting before and after online antibiotic stewardship education, and assess effectiveness and satisfaction with the education. Pre-/postsurvey. Three long-term care facilities, Topeka, Kansas. Convenience sample of 140 licensed practical and registered nurses. Nurses viewed a 12-minute online module developed by long-term care consultant pharmacists. The module discussed risks of antibiotic use and the Loeb minimum criteria for initiation of antibiotics in long-term care residents for urinary and respiratory tract infections and explored other conditions contributing to suspicion of these infections. Knowledge, perceptions, and self-confidence were measured using a 5-point Likert-scale survey modified from the Minnesota Department of Health taken before and after the module. Response rate was 45% (63/140) pre-education and 41% (57/140) post-education. Nurses had high baseline self-confidence (mean 4.2 to 4.5/5.0) and pre/post scores did not change significantly. Statistically significant improvements in knowledge and perceptions were seen in 15 of the 33 indices related to assumptions regarding antibiotic use, risks, and indicators of urinary and respiratory bacterial infections. Nurses rated the education as high quality (95%), applicable to practice (95%), and felt very likely to change practice (91%). Although baseline self-confidence was high, key misperceptions were identified, indicating that nurses may not be aware of their knowledge deficits or misperceptions. This low-cost, 12-minute, online education was highly valued and effectively improved nurses' knowledge and perceptions.

  13. Strategic Communication Intervention to Stimulate Interest in Research and Evidence-Based Practice: A 12-Year Follow-Up Study With Registered Nurses. (United States)

    Morténius, Helena; Hildingh, Cathrine; Fridlund, Bengt


    Bridging the research-practice gap is a challenge for health care. Fostering awareness of and interest in research and development (R & D) can serve as a platform to help nurses and others bridge this gap. Strategic communication is an interdisciplinary field that has been used to achieve long-term interest in adopting and applying R & D in primary care. The aim of the study was to evaluate the impact of a strategic communication intervention on long-term interest in R & D among primary care staff members (PCSMs) in general and registered nurses (RNs) in particular. This prospective intervention study included all members of the PCSMs, including RNs, in a Swedish primary care area. The interest of PCSMs in R & D was measured on two occasions, at 7 and 12 years, using both bivariate and multivariate tests. A total of 99.5% of RNs gained awareness of R & D after the first 7 years of intervention versus 95% of the remaining PCSMs (p = .004). A comparison of the two measurements ascertained stability and improvement of interest in R & D among RNs, compared with all other PCSMs (odds ratio 1.81; confidence interval 1.08-3.06). Moreover, the RNs who did become interested in R & D also demonstrated increased intention to adopt innovative thinking in their work over time (p = .005). RNs play an important role in reducing the gap between theory and practice. Strategic communication was a significant tool for inspiring interest in R & D. Application of this platform to generate interest in R & D is a unique intervention and should be recognized for future interventions in primary care. Positive attitudes toward R & D may reinforce the use of evidence-based practice in health care, thereby making a long-term contribution to the patient benefit. © 2015 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

  14. Evidence-based dermatology

    Directory of Open Access Journals (Sweden)

    Ching-Chi Chi


    Full Text Available Evidence-based medicine (EBM has become a hot topic in medical practice, education, and research. However, a large number of senior doctors did not have an opportunity to learn EBM in medical schools. Firstly, this article addresses the history of EBM and the principle of practicing EBM, i.e., asking, acquiring, appraisal, application, and auditing. Secondly, this article also provides a brief introduction to evidence-based dermatology and compares the introduction of clinical practice guidelines between Europe, the UK, and the US. Finally, this article addresses the present condition and future perspective of evidence-based dermatology in Taiwan.

  15. New Graduate Nurses' Developmental Trajectories for Capability Beliefs Concerning Core Competencies for Healthcare Professionals: A National Cohort Study on Patient-Centered Care, Teamwork, and Evidence-based Practice. (United States)

    Ehrenberg, Anna; Gustavsson, Petter; Wallin, Lars; Boström, Anne-Marie; Rudman, Ann


    This study aimed to describe the developmental trajectories of registered nurses' capability beliefs during their first 3 years of practice. The focus was on three core competencies for health professionals-patient-centered care, teamwork, and evidence-based practice. A national cohort of registered nurses (n = 1,205) was recruited during their nursing education and subsequently surveyed yearly during the first 3 years of working life. The survey included 16 items on capability beliefs divided into three subscales for the assessment of patient-centered care, teamwork, and evidence-based practice, and the data were analyzed with linear latent growth modeling. The nurses' capability beliefs for patient-centered care increased over the three first years of working life, their capability beliefs for evidence-based practice were stable over the 3 years, and their capability beliefs for teamwork showed a downward trend. Through collaboration between nursing education and clinical practice, the transition to work life could be supported and competence development in newly graduated nurses could be enhanced to help them master the core competencies. Future research should focus on determining which factors impact the development of capability beliefs in new nurses and how these factors can be developed by testing interventions. © 2016 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

  16. A Guide to Writing a Qualitative Systematic Review Protocol to Enhance Evidence-Based Practice in Nursing and Health Care. (United States)

    Butler, Ashleigh; Hall, Helen; Copnell, Beverley


    The qualitative systematic review is a rapidly developing area of nursing research. In order to present trustworthy, high-quality recommendations, such reviews should be based on a review protocol to minimize bias and enhance transparency and reproducibility. Although there are a number of resources available to guide researchers in developing a quantitative review protocol, very few resources exist for qualitative reviews. To guide researchers through the process of developing a qualitative systematic review protocol, using an example review question. The key elements required in a systematic review protocol are discussed, with a focus on application to qualitative reviews: Development of a research question; formulation of key search terms and strategies; designing a multistage review process; critical appraisal of qualitative literature; development of data extraction techniques; and data synthesis. The paper highlights important considerations during the protocol development process, and uses a previously developed review question as a working example. This paper will assist novice researchers in developing a qualitative systematic review protocol. By providing a worked example of a protocol, the paper encourages the development of review protocols, enhancing the trustworthiness and value of the completed qualitative systematic review findings. Qualitative systematic reviews should be based on well planned, peer reviewed protocols to enhance the trustworthiness of results and thus their usefulness in clinical practice. Protocols should outline, in detail, the processes which will be used to undertake the review, including key search terms, inclusion and exclusion criteria, and the methods used for critical appraisal, data extraction and data analysis to facilitate transparency of the review process. Additionally, journals should encourage and support the publication of review protocols, and should require reference to a protocol prior to publication of the

  17. Experience of adapting and implementing an evidence-based nursing guideline for prevention of diaper dermatitis in a paediatric oncology setting. (United States)

    Espirito Santo, Anelise; Choquette, Anne


    Diaper dermatitis is one of the most common skin problems in children often caused by irritants that promote skin breakdown, such as moisture and faecal enzymes. It has been estimated that the incidence of diaper dermatitis is as high as 50% in children receiving chemotherapy. The scientific literature suggests a variety of preventative measures, but only a minority are systematically tested and supported by clinical evidence. The purpose of this paper is to adapt and implement a skincare guideline to better prevent diaper dermatitis in the paediatric oncology population. The Knowledge to Action process was used to guide the adaptation and implementation of the new guideline. As part of this process, different tools were used to identify and review selected knowledge (Appraisal of Guidelines Research Evaluation instrument), to tailor and adapt knowledge to the local context (ADAPTE process), to implement interventions (Registered Nurses' Association of Ontario toolkit) and to evaluate outcomes (qualitative analysis). The main outcomes measured included implementation of the guideline and nursing practice change. The guideline was successfully implemented as reported by nurses in focus group sessions and as measured by changes in nursing documentation. The implementation of the guideline was successful on the account of the interplay of three core elements: The level and nature of the evidence; the context in which the research was placed; the method in which the process was facilitated. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

  18. Experiences of nursing students of Evidence-Based Practice Education according to Rogers' Diffusion of Innovation Model: A Directed Content Analysis. (United States)

    Pashaeypoor, Shahzad; Ashktorab, Tahereh; Rassouli, Maryam; Alavi Majd, Hamid


    Evidence based practice (EBP) education is essential in promoting of clinical care, but an effective educational strategy for teaching EBP in nursing faculties is not available. The aim of this study was to explore the experiences of nursing students of EBP Education according to Rogers' Diffusion of Innovation Model. This qualitative study was carried out using a directed content analysis method and purposeful sampling. Data were collected until saturation by fourteen semi-structured face-to-face individual interviews and two focus group discussions with nursing students from two nursing faculties in Tehran, Iran. Rogers' Model was used in this study. Data were classified into five themes and 11 categories according to the Rogers's Model. Themes and main categories were knowledge (educational enrichment, new strategy for education), persuasion (internalization of education, improvement of motivation), decision (acceptance, use in the future), implementation (objectivity, consolidation of learning) and confirmation (learning and teaching, achieving a goal, self-confidence). EBP Education, based on the teaching strategy of Rogers's Model, leads to an improved EBP learning. All the necessary steps for a better education of it are included in this educational approach which can be used to teach any new subject like EBP.

  19. Evidence-Based Development

    DEFF Research Database (Denmark)

    Hertzum, Morten; Simonsen, Jesper


    Systems development is replete with projects that represent substantial resource investments but result in systems that fail to meet users’ needs. Evidence-based development is an emerging idea intended to provide means for managing customer-vendor relationships and working systematically toward...... and electronic patient records for diabetes patients, this paper reports research in progress regarding the prospects and pitfalls of evidence-based development....

  20. Web-Based Evidence Based Practice Educational Intervention to Improve EBP Competence among BSN-Prepared Pediatric Bedside Nurses: A Mixed Methods Pilot Study (United States)

    Laibhen-Parkes, Natasha


    For pediatric nurses, their competence in EBP is critical for providing high-quality care and maximizing patient outcomes. The purpose of this pilot study was to assess and refine a Web-based EBP educational intervention focused on improving EBP beliefs and competence in BSN-prepared pediatric bedside nurses, and to examine the feasibility,…

  1. Evidence based practice readiness: A concept analysis. (United States)

    Schaefer, Jessica D; Welton, John M


    To analyse and define the concept "evidence based practice readiness" in nurses. Evidence based practice readiness is a term commonly used in health literature, but without a clear understanding of what readiness means. Concept analysis is needed to define the meaning of evidence based practice readiness. A concept analysis was conducted using Walker and Avant's method to clarify the defining attributes of evidence based practice readiness as well as antecedents and consequences. A Boolean search of PubMed and Cumulative Index for Nursing and Allied Health Literature was conducted and limited to those published after the year 2000. Eleven articles met the inclusion criteria for this analysis. Evidence based practice readiness incorporates personal and organisational readiness. Antecedents include the ability to recognize the need for evidence based practice, ability to access and interpret evidence based practice, and a supportive environment. The concept analysis demonstrates the complexity of the concept and its implications for nursing practice. The four pillars of evidence based practice readiness: nursing, training, equipping and leadership support are necessary to achieve evidence based practice readiness. Nurse managers are in the position to address all elements of evidence based practice readiness. Creating an environment that fosters evidence based practice can improve patient outcomes, decreased health care cost, increase nurses' job satisfaction and decrease nursing turnover. © 2018 John Wiley & Sons Ltd.

  2. Knowledge of Pediatric Critical Care Nurses Regarding Evidence Based Guidelines for Prevention of Ventilator Associated Pneumonia (VAP) (United States)

    Ahmed, Gehan EL Nabawy; Abosamra, Omyma Mostafa


    Ventilator associated pneumonia (VAP) is a costly, preventable, and often fatal consequence of medical therapy that increases hospital and intensive care stays in mechanically ventilated patients. The prevention of VAP is primarily the responsibility of the bedside nurse whose knowledge, beliefs, and practices influence the health outcome of ICU…

  3. Role of nursing leadership in providing compassionate care. (United States)

    Quinn, Barry


    This article encourages nurses to explore the concept of leadership in the constantly changing field of health and social care. All nurses have an important role in leadership, and they should consider what type of leader they want to be and what leadership skills they might wish to develop. This article examines what leadership might involve, exploring various leadership styles and characteristics and how these could be applied in nurses' practice. A core component of nursing and nursing leadership is the ability to provide compassionate care. This could correspond with the idea of servant leadership, an approach that moves the leader from a position of power to serving the team and supporting individuals to develop their potential. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  4. Exploring sensitive boundaries in nursing education: attitudes of undergraduate student nurses providing intimate care to patients. (United States)

    Crossan, M; Mathew, T K


    Nursing students often feel challenged and intimidated to provide intimate care to patients in the health care setting. Student nurses in particular are faced with social, professional, academic and peer expectations and experience high levels of stress when providing this intimate care. Explore student nurses attitudes to providing intimate care. Year two and year three students of a three year undergraduate nursing programme completed a descriptive Nursing Students Intimate Care (NSIC) survey with open ended questions. This study discusses student responses to the question: Did you feel it was appropriate for a nurse to provide intimate care to a patient of the opposite sex? Three major themes were identified: societal and self-determined role expectations, comfort and discomfort providing intimate care, and age and gender of the carer and recipient. Student nurses face numerous challenges when having to provide intimate care to patients. These challenges are influenced by the age, gender, levels of comfort of the nurse and the patient and is related to the nature of intimate care being provided. Student nurses will benefit from pre-clinical simulated training experiences in providing intimate care. This training needs to specifically consider being sensitive to the needs of the patient, maintaining patient dignity, negotiating, accommodating and implementing plan of care while being competent and professional in their approach to providing intimate care. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Toward an evidence-based patient-provider communication in rehabilitation: linking communication elements to better rehabilitation outcomes. (United States)

    Jesus, Tiago Silva; Silva, Isabel Lopes


    There is a growing interest in linking aspects of patient-provider communication to rehabilitation outcomes. However, the field lacks a conceptual understanding on: (a) 'how' rehabilitation outcomes can be improved by communication; and (b) through 'which' elements in particular. This article elaborates on the conceptual developments toward informing further practice and research. Existing models of communication in healthcare were adapted to rehabilitation, and its outcomes through a comprehensive literature review. After depicting mediating mechanisms and variables (e.g. therapeutic engagement, adjustment toward disability), this article presents the '4 Rehab Communication Elements' deemed likely to underpin rehabilitation outcomes. The four elements are: (a) knowing the person and building a supportive relationship; (b) effective information exchange and education; (c) shared goal-setting and action planning; and (d) fostering a more positive, yet realistic, cognitive and self-reframing. This article describes an unprecedented, outcomes-oriented approach toward the design of rehabilitation communication, which has resulted in the development of a new intervention model: the '4 Rehab Communication Elements'. Further trials are needed to evaluate the impact of this whole intervention model on rehabilitation outcomes. © The Author(s) 2015.

  6. Organizational change strategies for evidence-based practice. (United States)

    Newhouse, Robin P; Dearholt, Sandi; Poe, Stephanie; Pugh, Linda C; White, Kathleen M


    Evidence-based practice, a crucial competency for healthcare providers and a basic force in Magnet hospitals, results in better patient outcomes. The authors describe the strategic approach to support the maturation of The Johns Hopkins Nursing evidence-based practice model through providing leadership, setting expectations, establishing structure, building skills, and allocating human and material resources as well as incorporating the model and tools into undergraduate and graduate education at the affiliated university.

  7. Providing nursing leadership in a community residential mental health setting. (United States)

    Hughes, Frances A; Bamford, Anita


    The worldwide burden of mental illness is increasing. Strong leadership is increasingly emerging as a core component of good mental health nursing. The aim of this article is to demonstrate the ways in which nurses can provide strong and consistent leadership in a values-based practice environment that embodies respect for individuals' dignity and self-determination within a community residential mental health service, which provides a structural foundation for effective action. This is accomplished through the presentation of two vignettes, which highlight how the seemingly impossible becomes possible when an economic paradigm such as agency theory is exchanged for a sociological and psychological paradigm found in leadership as stewardship at the point of service. It is through stronger nursing leadership in mental health that stigma and discrimination can be reduced and better access to treatments and services can be gained by those with mental illness. Nurse leadership in mental health services is not new, but it is still relatively uncommon to see residential services for "high needs" individuals being led by nurses. How nurses meet the challenges faced by mental health services are often at the heart of effective leadership skills and strategies. Copyright 2011, SLACK Incorporated.

  8. Assisting undergraduate nursing students to learn evidence-based practice through self-directed learning and workshop strategies during clinical practicum. (United States)

    Zhang, Qi; Zeng, Tieying; Chen, Ying; Li, Xiaopan


    To equip undergraduate nursing students with basic knowledge and skills and foster positive attitudes toward evidence-based practice (EBP), a pilot learning program during their clinical practicum was developed in a teaching hospital in China. This article describes the specific learning process through which self-directed learning and workshop strategies were used, and a pre- and post-intervention survey were conducted to evaluate the effectiveness of the learning strategies. The findings show a significant improvement in their perceptions of EBP knowledge, attitudes and beliefs, and behavior levels. Beginning competencies in EBP were achieved. Participants reported great satisfaction and have found this program helpful in promoting their analytical and problem-solving abilities, independent learning ability, and cooperative and communication abilities as well. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. [EBM Service: evidence-based answers provided by general practitioners to questions asked by general practitioners--a project from South Tyrol/Italy]. (United States)

    Piccoliori, Giuliano; Kostner, Simon; Abholz, Heinz-Harald


    General practices also require more and more evidence-based decision-making. But knowledge is increasing rapidly and guidelines produced to help doctors to find answers to their problems seem to exclude a number of problems that are important in general practices. Here we report on the introduction and activities of an EbM Service provided by general practitioners to answer questions of their colleagues. The aim is to give EBM answers, but also, in doing so, to teach the application of EBM and--in the long run--to enable the users themselves to find EBM answers. The provision of EBM answers is fairly pragmatic: after using the service the inquiring physician should be better informed, i.e., have more evidence-based information, but sometimes this need not be the "ultimate truth" that experts might deliver. EBM answers are published both on the homepage of the College of General Practitioners and in their journal. It took quite a while to implement this service, and the number of those using it has increased slowly but constantly.

  10. Do prehospital providers and emergency nurses agree on triage assignment?

    DEFF Research Database (Denmark)

    Skjøt-Arkil, Helene; Pontoppidan, Louise L; Laursen, Jens O


    OBJECTIVES: The aim of this study was to investigate the agreement on triage level between prehospital providers and emergency department (ED) nurses in clinical practice when using the same triage system. The objectives were as follows: (a) What is the agreement of triage between prehospital...... providers and ED nurses, when using Danish Emergency Process Triage (DEPT) correctly? (b) Which part of the triage process yields the highest agreement regarding the final triage? METHODS: The study was a prospective and observational efficacy study. Patients transported to the ED by ambulances were...... included. They were triaged by prehospital providers while being transported by ambulance to the ED, and by ED nurses upon arrival. Triage was done using the DEPT - a five-level triage system based on vital signs and a presenting complaint algorithm. An agreement analysis was performed. RESULTS: DEPT...

  11. Perceptions of speech-language pathologists linked to evidence-based practice use in skilled nursing facilities. (United States)

    Douglas, Natalie F; Hinckley, Jacqueline J; Haley, William E; Andel, Ross; Chisolm, Theresa H; Eddins, Ann C


    This study explored whether perceptions of evidence or organizational context were associated with the use of external memory aids with residents with dementia in skilled nursing facilities (SNFs). A survey design, supplemented by a small sample of exploratory interviews, was completed within the Promoting Action on Research Implementation in Health Services framework. Ninety-six speech-language pathologists (SLPs) and 68 facility rehabilitation directors (FRDs) completed the Organizational Readiness to Change Assessment (Helfrich, Li, Sharp, & Sales, 2009) in relationship to the use of external memory aids. Five SLPs completed an interview exploring perceptions of evidence and context in relationship to memory aid use. SLPs and FRDs had favorable perceptions of evidence supporting memory aids. FRDs perceived the organizational context of the SNF more favorably than SLPs. SLP participants used external memory aids in the past 6 months in 45.89% of cases of residents with dementia. For SLP participants, a 26% (p practice implementation may be influenced by clinician perceptions. Efforts to increase implementation of external memory aids in SNFs should address these clinician perceptions.

  12. Transdisciplinary collaboration and endorsement of pharmacological and psychosocial evidence-based practices by medical and psychosocial substance abuse treatment providers in the United States. (United States)

    Pinto, Rogério M; Spector, Anya Y; Yu, Gary; Campbell, Aimee N C

    To examine the relative contribution of providers' professional affiliation (medical vs. non-medical), involvement in research, and training needs for associations with endorsement of the following evidence-based practices (EBPs): (1) pharmacological - buprenorphine treatment and (2) psychosocial - Cognitive Behavioural Therapy (CBT). Secondary analysis from a 2008 survey of a national sample (n = 571) of substance abuse treatment providers (medical, social workers, psychologists and counsellors) affiliated with the United States National Institute on Drug Abuse's National Drug Abuse Treatment Clinical Trials Network. Multivariate linear regression models to analyze cross-sectional survey data. Results demonstrated that medical providers and providers with previous research involvement more strongly endorsed the effectiveness of buprenorphine over CBT. Compared to medical providers, psychosocial providers more strongly endorsed CBT. There was a positive association between needing training in rapport with patients and endorsement of buprenorphine and a negative association with CBT. There was a positive association between needing training in behavioural management and needs assessment and endorsement of CBT. Results underscore the importance of providers' involvement in research and the need for training medical and non-medical providers in practice areas that can purposely enhance their use of pharmacological and psychosocial EBPs.

  13. Evidence-based obstetrics in four hospitals in China: An observational study to explore clinical practice, women's preferences and provider's views

    Directory of Open Access Journals (Sweden)

    Liang Ji


    Full Text Available Abstract Background Evidence-based obstetric care is widely promoted in developing countries, but the success of implementation is not known. Using selected childbirth care procedures in four hospitals in Shanghai, we compared practice against evidence-based information, and explored user and provider views about each procedure. Methods Observational study. Using the Cochrane Library, we identified six procedures that should be avoided as routine and two that should be encouraged. Procedure rate determined by exit interviews with women, verified using hospital notes. Views of women and providers explored with in depth interviews. The study sites were three hospitals in Shanghai and one in neighbouring province of Jiangsu. 150 women at each centre for procedure rate, and 48 in-depth interviews with women and providers. Results Vaginal births were 50% (303/599 of the total. Of the six practices where evidence suggests they should be avoided as routine, three were performed with rates above 70%: pubic shaving (3 hospitals, rectal examination (3 hospitals, and episiotomy (3 hospitals. Most women delivered lying down, pain relief was rarely given, and only in the urban district hospital did women routinely have a companion. Most women wanted support or companionship during labour and to be given pain relief; but current practice is insufficient to meet women's needs. Conclusion Obstetric practice is not following best available evidence in the hospitals studied. There is a need to adjust hospital policy to support the use of interventions proven to be of benefit to women during childbirth, and develop approaches that ensure clinical practice changes.

  14. Cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS (PLWHA) in China. (United States)

    Williams, Ann B; Wang, Honghong; Burgess, Jane; Li, Xianhong; Danvers, Karina


    Adapting nursing interventions to suit the needs and culture of a new population (cultural adaptation) is an important early step in the process of implementation and dissemination. While the need for cultural adaptation is widely accepted, research-based strategies for doing so are not well articulated. Non-adherence to medications for chronic disease is a global problem and cultural adaptation of existing evidence-based interventions could be useful. This paper aims to describe the cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS and to offer recommendations for adaptation of interventions across cultures and borders. SITE: The intervention, which demonstrated efficacy in a randomized controlled trial in North America, was adapted for the cultural and social context of Hunan Province, in south central China. The adaptation process was undertaken by intervention stakeholders including the original intervention study team, the proposed adaptation team, and members of a Community Advisory Board, including people living with HIV/AIDS, family members, and health care workers at the target clinical sites. The adaptation process was driven by quantitative and qualitative data describing the new population and context and was guided by principles for cultural adaptation drawn from prevention science research. The primary adaptation to the intervention was the inclusion of family members in intervention activities, in response to the cultural and social importance of the family in rural China. In a pilot test of the adapted intervention, self-reported medication adherence improved significantly in the group receiving the intervention compared to the control group (p=0.01). Recommendations for cultural adaptation of nursing interventions include (1) involve stakeholders from the beginning; (2) assess the population, need, and context; (3) evaluate the intervention to be adapted with attention to

  15. Providing structure. Unraveling and building a psychiatric nursing intervention

    NARCIS (Netherlands)

    Voogt, L.A.


    Psychiatric nurses commonly refer to ‘providing structure’ (PS) as a key intervention. But, no consensus exists about what PS entails. PS can be understood as a complex intervention. In five studies a definition, activities and context-variables were described. On the basis of results of a

  16. Problems experienced by professional nurses providing care for HIV ...

    African Journals Online (AJOL)

    The purpose of this study was to describe the problems experienced by professional nurses providing health care to patients living with HIV and AIDS in the public hospitals of Polokwane municipality, Limpopo province. A qualitative descriptive, contextual and phenomenology design was used to described the problems ...

  17. The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. (United States)

    Melnyk, Bernadette Mazurek; Gallagher-Ford, Lynn; Long, Lisa English; Fineout-Overholt, Ellen


    Although it is widely known that evidence-based practice (EBP) improves healthcare quality, reliability, and patient outcomes as well as reduces variations in care and costs, it is still not the standard of care delivered by practicing clinicians across the globe. Adoption of specific EBP competencies for nurses and advanced practice nurses (APNs) who practice in real-world healthcare settings can assist institutions in achieving high-value, low-cost evidence-based health care. The aim of this study was to develop a set of clear EBP competencies for both practicing registered nurses and APNs in clinical settings that can be used by healthcare institutions in their quest to achieve high performing systems that consistently implement and sustain EBP. Seven national EBP leaders developed an initial set of competencies for practicing registered nurses and APNs through a consensus building process. Next, a Delphi survey was conducted with 80 EBP mentors across the United States to determine consensus and clarity around the competencies. Two rounds of the Delphi survey resulted in total consensus by the EBP mentors, resulting in a final set of 13 competencies for practicing registered nurses and 11 additional competencies for APNs. Incorporation of these competencies into healthcare system expectations, orientations, job descriptions, performance appraisals, and clinical ladder promotion processes could drive higher quality, reliability, and consistency of healthcare as well as reduce costs. Research is now needed to develop valid and reliable tools for assessing these competencies as well as linking them to clinician and patient outcomes. © 2014 Sigma Theta Tau International.

  18. Clinical nurse specialist leadership in computerized provider order entry design. (United States)

    Roggow, Darla J; Solie, Carol J; Tracy, Mary Fran; Gjere, Niki


    The purpose of this clinical project was to design and implement a computerized provider order entry system. Well-designed clinical computer systems can advance best practice and quality decision making, leading to improvements in patient and organizational outcomes. An Orders Design Group composed of clinical nurse specialists (CNSs), staff nurses, and information management personnel was formed. CNSs used competencies in the system sphere to lead the integration of the needs of patients, nurses, and organizations into new technologies. CNSs facilitated implementation of a collaboratively designed interdisciplinary computerized order entry process. Evaluation of the design and implementation process demonstrated greater success with the order entry system under the leadership of CNSs than past initiatives where CNSs were not in leadership roles. CNS competencies in designing and implementing innovative system-level solutions are key to clinical information systems design.

  19. Are women and providers satisfied with antenatal care? Views on a standard and a simplified, evidence-based model of care in four developing countries

    Directory of Open Access Journals (Sweden)

    Ba'aqeel Hassan


    Full Text Available Abstract Background This study assessed women and providers' satisfaction with a new evidence-based antenatal care (ANC model within the WHO randomized trial conducted in four developing countries. The WHO study was a randomized controlled trial that compared a new ANC model with the standard type offered in each country. The new model of ANC emphasized actions known to be effective in improving maternal or neonatal health, excluded other interventions that have not proved to be beneficial, and improved the information component, especially alerting pregnant women to potential health problems and instructing them on appropriate responses. These activities were distributed within four antenatal care visits for women that did not need any further assessment. Methods Satisfaction was measured through a standardized questionnaire administered to a random sample of 1,600 pregnant women and another to all antenatal care providers. Results Most women in both arms expressed satisfaction with ANC. More women in the intervention arm were satisfied with information on labor, delivery, family planning, pregnancy complications and emergency procedures. More providers in the experimental clinics were worried about visit spacing, but more satisfied with the time spent and information provided. Conclusions Women and providers accepted the new ANC model generally. The safety of fewer visits for women without complications with longer spacing would have to be reinforced, if such a model is to be introduced into routine practice.

  20. A constructivist model for teaching evidence-based practice. (United States)

    Rolloff, Mary


    The Institute of Medicine has reported that it takes roughly 17 years for evidence generated through research to move into clinical practice. Bridging that gap is an urgent need and will require educators to rethink how nurses are prepared for evidence-based practice. The constructivist theory for learning--in which it is assumed that students construct knowledge and meaning for themselves as they learn--may provide a framework for a redesigned baccalaureate curriculum, one that supports evidence-based practice throughout a nursing student's education.

  1. Evidence-Based Toxicology. (United States)

    Hoffmann, Sebastian; Hartung, Thomas; Stephens, Martin

    Evidence-based toxicology (EBT) was introduced independently by two groups in 2005, in the context of toxicological risk assessment and causation as well as based on parallels between the evaluation of test methods in toxicology and evidence-based assessment of diagnostics tests in medicine. The role model of evidence-based medicine (EBM) motivated both proposals and guided the evolution of EBT, whereas especially systematic reviews and evidence quality assessment attract considerable attention in toxicology.Regarding test assessment, in the search of solutions for various problems related to validation, such as the imperfectness of the reference standard or the challenge to comprehensively evaluate tests, the field of Diagnostic Test Assessment (DTA) was identified as a potential resource. DTA being an EBM discipline, test method assessment/validation therefore became one of the main drivers spurring the development of EBT.In the context of pathway-based toxicology, EBT approaches, given their objectivity, transparency and consistency, have been proposed to be used for carrying out a (retrospective) mechanistic validation.In summary, implementation of more evidence-based approaches may provide the tools necessary to adapt the assessment/validation of toxicological test methods and testing strategies to face the challenges of toxicology in the twenty first century.

  2. Do public nursing home care providers deliver higher quality than private providers? Evidence from Sweden. (United States)

    Winblad, Ulrika; Blomqvist, Paula; Karlsson, Andreas


    Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers. We also look at a special category of for-profit providers; private equity companies. The source of data is a national survey conducted by the Swedish National Board of Health and Welfare in 2011 at 2710 nursing homes. Data from 14 quality indicators are analyzed, including structure and process measures such as staff levels, staff competence, resident participation, and screening for pressure ulcers, nutrition status, and risk of falling. The main statistical method employed is multiple OLS regression analysis. We differentiate in the analysis between structural and processual quality measures. The results indicate that public nursing homes have higher quality than privately operated homes with regard to two structural quality measures: staffing levels and individual accommodation. Privately operated nursing homes, on the other hand, tend to score higher on process-based quality indicators such as medication review and screening for falls and malnutrition. No significant differences were found between different ownership categories of privately operated nursing homes. Ownership does appear to be related to quality outcomes in Swedish nursing home care, but the results are mixed and inconclusive. That staffing levels, which has been regarded as a key quality indicator in previous research, are higher in publicly operated homes than private is consistent with earlier

  3. Evidence-Based Yoga Interventions for Patients With Cancer. (United States)

    Sisk, Angela; Fonteyn, Marsha


    Introducing patients with cancer to the practice of yoga can be beneficial for coping with the side effects of treatment and the psychological aspects of cancer that are often difficult and distressing for patients. Oncology nurses can learn to use simple yoga techniques for themselves and as interventions with their patients. This article provides details about the development and implementation of a yoga class for patients with cancer and provides details about other ways nurses can integrate yoga into oncology nursing and cancer care. Current research literature was reviewed and synthesized to provide support for the use of yoga as an evidence-based nursing intervention. A detailed approach for implementing yoga into professional practice was delineated. Yoga techniques can be easily integrated into nursing practice and have been shown to be beneficial for patients and nurses.

  4. Explaining unexplained pain to fibromyalgia patients: finding a narrative that is acceptable to patients and provides a rationale for evidence based interventions. (United States)

    Hyland, Michael E; Hinton, Claire; Hill, Charlotte; Whalley, Ben; Jones, Rupert Cm; Davies, Anthony F


    As the cause of fibromyalgia is controversial, communicating with patients can be challenging, particularly if the patient adopts the narrative 'I am damaged and so I need a more powerful pain killer'. Research shows that providing patients with alternative narratives can be helpful, but it remains unclear what particular narratives are most acceptable to patients and at the same time provide a rationale for evidence based psychological and exercise interventions. This article described the development of a new narrative and the written comments made about the narrative by fibromyalgia patients. The narrative derives from a complexity theory model and provides an alternative to biogenic and psychogenic models. The model was presented to 15 patients whose comments about comprehensibility led to the final format of the narrative. In the final form, the body is presented as 'a very, very clever computer' where fibromyalgia is caused by a software rather than a hardware problem. The software problem is caused by the body adapting when people have to 'keep going' despite 'stop signals', such as pain and fatigue. The narrative provides a rationale for engaging in psychological and exercise interventions as a way of correcting the body's software. This way of explaining fibromyalgia was evaluated by a further 25 patients attending a 7-week 'body reprogramming' intervention, where the therapy was presented as correcting the body's software, and included both exercise and psychological components. Attendance at the course was 85%. Thematic analysis of written patient feedback collected after each session showed that patients found the model believable and informative, it provided hope and was empowering. Patients also indicated that they had started to implement lifestyle change with perceived benefit. Fibromyalgia patients appear to respond positively to a technology-derived narrative based on the analogy of the body as a computer.

  5. Retaining the next generation of nurses: the Wisconsin nurse residency program provides a continuum of support. (United States)

    Bratt, Marilyn Meyer


    Because of the high costs associated with new graduate nurse turnover, an academic-service partnership developed a nurse residency program that provides a comprehensive support system that spans 15 months. Now in its fourth year, involving more than 50 urban and rural hospitals of varying sizes and geographic locations, the program provides formalized preceptor training, monthly daylong educational sessions, and mentoring by clinical coaches. Key factors contributing to the success of this program are a dedicated, cohesive planning team of individuals who embrace a common agenda, stakeholder buy-in, appropriate allocation of resources, and clear articulation of measures of success, with associated data collection. Successful elements of the monthly educational sessions are the use of interactive teaching methods, inclusion of content tailored to the unique needs of the nurse residents, and storytelling to facilitate learning from practice. Finally, training to advance the skill development of preceptors, coaches, educators, and facilitators has provided organizations with enduring benefits. Copyright 2009, SLACK Incorporated.

  6. A Knowledge-Modeling Approach to Integrate Multiple Clinical Practice Guidelines to Provide Evidence-Based Clinical Decision Support for Managing Comorbid Conditions. (United States)

    Abidi, Samina


    Clinical management of comorbidities is a challenge, especially in a clinical decision support setting, as it requires the safe and efficient reconciliation of multiple disease-specific clinical procedures to formulate a comorbid therapeutic plan that is both effective and safe for the patient. In this paper we pursue the integration of multiple disease-specific Clinical Practice Guidelines (CPG) in order to manage co-morbidities within a computerized Clinical Decision Support System (CDSS). We present a CPG integration framework-termed as COMET (Comorbidity Ontological Modeling & ExecuTion) that manifests a knowledge management approach to model, computerize and integrate multiple CPG to yield a comorbid CPG knowledge model that upon execution can provide evidence-based recommendations for handling comorbid patients. COMET exploits semantic web technologies to achieve (a) CPG knowledge synthesis to translate a paper-based CPG to disease-specific clinical pathways (CP) that include specialized co-morbidity management procedures based on input from domain experts; (b) CPG knowledge modeling to computerize the disease-specific CP using a Comorbidity CPG ontology; (c) CPG knowledge integration by aligning multiple ontologically-modeled CP to develop a unified comorbid CPG knowledge model; and (e) CPG knowledge execution using reasoning engines to derive CPG-mediated recommendations for managing patients with comorbidities. We present a web-accessible COMET CDSS that provides family physicians with CPG-mediated comorbidity decision support to manage Atrial Fibrillation and Chronic Heart Failure. We present our qualitative and quantitative analysis of the knowledge content and usability of COMET CDSS.

  7. Leading change: evidence-based transition. (United States)

    Lewis, Brennan; Allen, Stephanie


    The purpose of this article was to provide a framework for evidence-based transition of patient populations within an acute care pediatric institution. Transition within a hospital is foreseeable, given the ever-changing needs of the patients within an evolving healthcare system. These changes include moving patient populations because of expansion, renovation, or cohorting similar patient diagnoses to provide care across a continuum. Over the past 1 to 2 years, Children's Health Children's Medical Center Dallas has experienced a wide variety of transition. To provide a smooth transition for patients and families into new care areas resulting in a healthy work environment for all team members. The planning phase for patient population moves, and transition should address key aspects to include physical location and care flow, supplies and equipment, staffing model and human resources (HR), education and orientation, change process and integrating teams, and family preparation. It is imperative to consider these aspects in order for transitions within a healthcare system to be successful. During a time of such transitions, the clinical nurse specialist (CNS) is a highly valuable team member offering a unique perspective and methodological approach, which is central to the new initiative's overall success. The themes addressed in this article on evidence-based transition are organized according to the CNS spheres of influence: system/organization, patient/family, and nursing. An evidence-based transition plan was developed and implemented successfully with the support from the CNS for 3 patient populations. Organizational leadership gained an increased awareness of the CNS role at the conclusion of each successful transition. The CNS plays a pivotal role as clinical experts and proponents of evidence-based practice and effects change in the system/organization, nursing, and patient/family spheres of influence. While transitions can be a source of stress for leaders

  8. An Evidence-Based Alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) Curriculum for Emergency Department (ED) Providers Improves Skills and Utilization (United States)

    Bernstein, Edward; Bernstein, Judith; Feldman, James; Fernandez, William; Hagan, Melissa; Mitchell, Patricia; Safi, Clara; Woolard, Robert; Mello, Mike; Baird, Janette; Lee, Cristina; Bazargan-Hejazi, Shahrzad; Broderick, Kerry; LaPerrier, Kathryn A.; Kellermann, Arthur; Wald, Marlena M.; Taylor, Robert E.; Walton, Kim; Grant-Ervin, Michelle; Rollinson, Denise; Edwards, David; Chan, Theodore; Davis, Dan; Marshall, Jean Buchanan; Aseltine, Robert; James, Amy; Abu-Hasaballah, Khamis; Schilling, Elizabeth; Baumann, Brigitte M.; Boudreaux, Edwin D.; Maio, Ronald; Cunningham, Rebecca; Murrell, Teresa; Doezema, David; Bauer, Michael J.; Anglin, Deirdre; Eliassen, Adriana; Martin, Marcus; Pines, Jesse; Buchanan, Leslie; Turner, James; D'Onofrio, Gail; Degutis, Linda C.; Owens, Patricia


    SUMMARY Objective Emergency Departments (EDs) offer an opportunity to improve the care of patients with at-risk and dependent drinking by teaching staff to screen, perform brief intervention and refer to treatment (SBIRT). We describe here the implementation at 14 Academic EDs of a structured SBIRT curriculum to determine if this learning experience improves provider beliefs and practices. Methods ED faculty, residents, nurses, physician extenders, social workers, and Emergency Medical Technicians (EMTs) were surveyed prior to participating in either a two hour interactive workshops with case simulations, or a web-based program ( A pre-post repeated measures design assessed changes in provider beliefs and practices at three and 12 months post-exposure. Results Among 402 ED providers, 74% reported < 10 hours of prior professional alcohol-related education and 78% had < 2 hours exposure in the previous year. At 3-month follow-up, scores for self-reported confidence in ability, responsibility to intervene, and actual utilization of SBIRT skills all improved significantly over baseline. Gains decreased somewhat at 12 months, but remained above baseline. Length of time in practice was positively associated with SBIRT utilization, controlling for gender, race and type of profession. Persistent barriers included time limitations and lack of referral resources. Conclusions ED providers respond favorably to SBIRT. Changes in utilization were substantial at three months post-exposure to a standardized curriculum, but less apparent after 12 months. Booster sessions, trained assistants and infrastructure supports may be needed to sustain changes over the longer term. PMID:18077305

  9. Las organizaciones ¿favorecen o dificultan una práctica enfermera basada en la evidencia? Health care organizations: favouring or hindering the practise of evidence based nursing?

    Directory of Open Access Journals (Sweden)

    Joan Ernest de Pedro Gómez


    positioning of Health care Organizations is needed for promoting a statement in order to change the current nursing practice models, because of their impact on health outcomes. Health Organizations have to leave out of date practice models that do not help to excellence in nursing. Research results implementation is a crucial issue in this purpose, for a better defining of nursing services and human resources. Health Organizations must establish the conditions for an integrated care model, with symmetric collaboration among professionals. If this position is not reached, the nursing potential can be underestimated and underdeveloped, precisely, in a continuous changing environment, with raising demands on health and dependency. Health Organizations must be directed to nursing practice models implementation research-orientated, supported in evidence-based nursing, as essential component of quality of care.

  10. What kind of evidence is it that Evidence-Based Medicine advocates want health care providers and consumers to pay attention to?

    Directory of Open Access Journals (Sweden)

    Haynes R Brian


    Full Text Available Abstract Background In 1992, Evidence-Based Medicine advocates proclaimed a "new paradigm", in which evidence from health care research is the best basis for decisions for individual patients and health systems. Hailed in New York Times Magazine in 2001 as one of the most influential ideas of the year, this approach was initially and provocatively pitted against the traditional teaching of medicine, in which the key elements of knowing for clinical purposes are understanding of basic pathophysiologic mechanisms of disease coupled with clinical experience. This paper reviews the origins, aspirations, philosophical limitations, and practical challenges of evidence-based medicine. Discussion EBM has long since evolved beyond its initial (misconception, that EBM might replace traditional medicine. EBM is now attempting to augment rather than replace individual clinical experience and understanding of basic disease mechanisms. EBM must continue to evolve, however, to address a number of issues including scientific underpinnings, moral stance and consequences, and practical matters of dissemination and application. For example, accelerating the transfer of research findings into clinical practice is often based on incomplete evidence from selected groups of people, who experience a marginal benefit from an expensive technology, raising issues of the generalizability of the findings, and increasing problems with how many and who can afford the new innovations in care. Summary Advocates of evidence-based medicine want clinicians and consumers to pay attention to the best findings from health care research that are both valid and ready for clinical application. Much remains to be done to reach this goal.

  11. Geriatric Hospital Nurses' Perceived Barriers to Research Utilization and Empowerment


    Kang, Hyunwook


    Purpose: The quality of nursing care in geriatric hospitals has been of concern. Nurses need to provide evidence-based nursing using best available research findings in order to maximize the quality of care. Research utilization is a major part of evidence-based nursing practice. Empowerment is an important factor that may influence the context of nursing practice. The purpose of this study was to identify the barriers to research utilization in nursing practice and its relationship to empowe...

  12. Evidence based medical imaging (EBMI)

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Tony [Senior Lecturer in Medical Radiation Science, University Department of Rural Health, School of Health Sciences, Faculty of Health, University of Newcastle, Locked Bag 9783 NEMSC, Tamworth, NSW 2348 (Australia)], E-mail:


    Background: The evidence based paradigm was first described about a decade ago. Previous authors have described a framework for the application of evidence based medicine which can be readily adapted to medical imaging practice. Purpose: This paper promotes the application of the evidence based framework in both the justification of the choice of examination type and the optimisation of the imaging technique used. Methods: The framework includes five integrated steps: framing a concise clinical question; searching for evidence to answer that question; critically appraising the evidence; applying the evidence in clinical practice; and, evaluating the use of revised practices. Results: This paper illustrates the use of the evidence based framework in medical imaging (that is, evidence based medical imaging) using the examples of two clinically relevant case studies. In doing so, a range of information technology and other resources available to medical imaging practitioners are identified with the intention of encouraging the application of the evidence based paradigm in radiography and radiology. Conclusion: There is a perceived need for radiographers and radiologists to make greater use of valid research evidence from the literature to inform their clinical practice and thus provide better quality services.

  13. Evidence based practice

    DEFF Research Database (Denmark)

    Hjørland, Birger


    Evidence-based practice (EBP) is an influential interdisciplinary movement that originated in medicine as evidence-based medicine (EBM) about 1992. EBP is of considerable interest to library and information science (LIS) because it focuses on a thorough documentation of the basis for the decision...

  14. Nursing Care of Adult Hematopoietic Stem Cell Transplant Patients and Families in the Intensive Care Unit: An Evidence-based Review. (United States)

    Young, Linda K; Mansfield, Brianne; Mandoza, Jared


    This article addresses evidence-based practice related to adult hematopoietic stem cell transplant (HSCT) patients when admitted to the intensive care unit. Specifically, it addresses non-HSCT staff, patient, and family needs and the strategies to address those needs. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Health-related quality of life and working conditions among nursing providers


    Amanda Aparecida Silva; José Maria Pacheco de Souza; Flávio Notarnicola da Silva Borges; Frida Marina Fischer


    OBJECTIVE: To evaluate working conditions associated with health-related quality of life (HRQL) among nursing providers. METHODS: Cross-sectional study conducted in a university hospital in the city of São Paulo, Southeastern Brazil, during 2004-2005. The study sample comprised 696 registered nurses, nurse technicians and nurse assistants, predominantly females (87.8%), who worked day and/or night shifts. Data on sociodemographic information, working and living conditions, lifestyles, and hea...

  16. Leadership facilitation strategies to establish evidence-based practice in an acute care hospital. (United States)

    Hauck, Sheila; Winsett, Rebecca P; Kuric, Judy


    To assess the impact of leadership facilitation strategies on nurses' beliefs of the importance and frequency of using evidence in daily nursing practice and the perception of organizational readiness in an acute care hospital. Integrating evidence in practice is a prominent issue for hospital nursing as knowledge and skills, beliefs, organizational infrastructure and nursing leadership must all be addressed. Prospective, descriptive comparative. Three surveys were used in this prospective descriptive comparative study. Evidence-Based Practice Beliefs Scale, the Implementation Scale and Organizational Culture & Readiness for System-Wide Integration Survey measured change before and after facilitating strategies for evidence-based practice enculturation. Data were collected in December 2008 (N = 427) and in December 2010 (N = 469). Leadership facilitated infrastructure development in three major areas: incorporating evidence-based practice outcomes in the strategic plan; supporting mentors; and advocating for resources for education and outcome dissemination. With the interventions in place, the total group scores for beliefs and organizational readiness improved significantly. Analyses by job role showed that direct care nurses scores improved more than other role types. No differences were found in the implementation scores. Successful key strategies were evidence-based practice education and establishing internal opportunities to disseminate findings. Transformational nursing leadership drives organizational change and provides vision, human and financial resources and time that empowers nurses to include evidence in practice. © 2012 Blackwell Publishing Ltd.

  17. Building nursing intellectual capital for safe use of information technology: a before-after study to test an evidence-based peer coach intervention. (United States)

    Poe, Stephanie S; Abbott, Patricia; Pronovost, Peter


    Use of peer coaches may be effective in building and maintaining competencies bedside nurses need to safely use electronic health records (EHRs). A nonexperimental design with before-after measures was used to evaluate the effectiveness of peer coaches in increasing learner satisfaction and confidence in EHR use on 9 units at an academic medical center. Survey findings suggested that nurses experienced higher than expected satisfaction with training and increased self-confidence in the EHR use following program implementation.

  18. Spiritual care competence for contemporary nursing practice: A quantitative exploration of the guidance provided by fundamental nursing textbooks. (United States)

    Timmins, Fiona; Neill, Freda; Murphy, Maryanne; Begley, Thelma; Sheaf, Greg


    Spirituality is receiving unprecedented attention in the nursing literature. Both the volume and scope of literature on the topic is expanding, and it is clear that this topic is of interest to nurses. There is consensus that the spiritual required by clients receiving health ought to be an integrated effort across the health care team. Although undergraduate nurses receive some education on the topic, this is ad hoc and inconsistent across universities. Textbooks are clearly a key resource in this area however the extent to which they form a comprehensive guide for nursing students and nurses is unclear. This study provides a hitherto unperformed analysis of core nursing textbooks to ascertain spirituality related content. 543 books were examined and this provides a range of useful information about inclusions and omissions in this field. Findings revealed that spirituality is not strongly portrayed as a component of holistic care and specific direction for the provision of spiritual care is lacking. Fundamental textbooks used by nurses and nursing students ought to inform and guide integrated spiritual care and reflect a more holistic approach to nursing care. The religious and/or spiritual needs of an increasingly diverse community need to be taken seriously within scholarly texts so that this commitment to individual clients' needs can be mirrored in practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. AORN nurse leaders provide insight into management issues. (United States)

    Hahn, Jean J; Butz, K Penelope; Gavin, Jeanette G; Mills, Regina S; Welter, Clara J


    Different people have different ideas about what makes a good manager. No matter what managers' attributes are, they bring a unique set of talents to their organizations. This article explores what winners of AORN's Award for Outstanding Achievement in Perioperative Nursing Management have to say about managing in today's health care climate.

  20. Enfermagem baseada em evidências: princípios e aplicabilidades Enfermería basada en evidencia: princípios y aplicabilidad Evidence based nursing: principles and applicability

    Directory of Open Access Journals (Sweden)

    Edvane Birelo Lopes De Domenico


    Full Text Available O trabalho discorre sobre a enfermagem baseada em evidências, como um novo modelo operacional integralizador da competência clínica individual, com os achados clínicos gerados pelas pesquisas científicas, e analisa a inserção dessa prática no modelo profissional vigente na enfermagem.El presente trabajo trae la práctica basada en evidencias como un nuevo modelo operacional integralizador de la competencia clínica individual con los avances clínicos generadas por las investigaciones científicas y analiza la inclusión de esta practica en el modelo profesional vigente en enfermería.The work considers the evidence based nursing as a new operational model that integrates individual clinical competencies, through clinical finding generated by scientific research and analyzes the inclusion of this practice to the actual nursing professional model.

  1. Who should provide continuous renal replacement therapies? Nephrology nurses are better prepared to provide CRRT. (United States)

    Ellis, Kathy


    Although critical care nurses are fully capable of learning CRRT, there are substantial, irrefutable challenges to achieving and sustaining proficiency. There is also diminished opportunity and motivation for critical care nurses to advance CRRT practice through quality initiatives, education, or research when it is a small piece of their practice. Consequently, I believe that it is incumbent upon acute care nephrology nurses to clarify the magnitude and value of what we do and to support our critical care colleagues in doing what they do best. The debate as to who should perform CRRT began in an effort to explore the better opportunity for cost-saving; but, in the end, it really boils down to the better opportunity for life-saving. I suspect improving outcomes for patients requiring CRRT will ultimately save hospitals more money than the short-sighted gains from critical care nurses performing tasks outside of universally-applied critical care RN processes.

  2. Ethical issues for nurses providing perinatal care in community settings. (United States)

    Moore, M L


    Ethical issues in perinatal nursing are complex in that two patients--mother and fetus--are considered. This work considers six areas of potential ethical conflict: conflict between the mother and fetus, informed consent, confidentiality, cultural conflicts, conflicts associated with managed care, and conflicts in childbirth education. Ethical principles of autonomy, beneficence, and justice are included. Strategies for resolving ethical conflicts in community practice settings are suggested.

  3. Nursing students' practice in providing oral hygiene for patients. (United States)

    McAuliffe, Ann

    To explore and identify precedent factors that may influence nursing students' oral hygiene practice in hospitalised patients, by using an adaptation of the Precede Model. A quantitative approach with a descriptive design was adopted in this pilot study. A questionnaire was designed and implemented as a self-report method of data collection. A convenience sample of 37 second-year diploma nursing students in an Irish teaching hospital participated in the study. The clinical area and the practices within it are influential factors in the provision of oral hygiene. Students are exposed to and influenced by outdated and non-research-based practices. Role modelling is an effective means of motivating and reinforcing student practices. However, qualified nurses' practices need to be critically reviewed before assuming that they can act as role models in assisting students to implement research-based oral hygiene. Formal education, current practices, socialisation and role modelling may influence students' behaviour in relation to oral hygiene. The results should be tentatively reviewed by clinical staff as an indication of current practices.

  4. Is there still an indication for nursing patients with prolonged neutropenia in protective isolation? An evidence-based nursing and medical study of 4 years experience for nursing patients with neutropenia without isolation

    NARCIS (Netherlands)

    Mank, Arno; van der Lelie, Hans


    Patients with severe neutropenia due to high-dose chemotherapy and/or total-body irradiation are at risk of serious infections and are frequently nursed in strict protective isolation. This is a costly procedure and results in a psychological burden for the patient and its significance has been

  5. Organizational readiness for evidence-based practice. (United States)

    Gale, Barbara Van Patter; Schaffer, Marjorie A


    This study explored factors that affect the adoption or rejection of evidence-based practice (EBP) changes and differences in nurse manager and staff nurse perceptions about those factors. Roger's Diffusion of Innovations Theory explains relevant organizational strategies for guiding practice change. The primary author developed the Evidence-Based Practice Changes Survey consisting of 12 items, completed by 92 nurses at a level 1 trauma center. Top barriers to EBP were insufficient time, lack of staff, and not having the right equipment and supplies. Top reasons to adopt EBP were having personal interest in the practice change, avoiding risk of negative consequences to the patient, and personally valuing the evidence. Several statistically significant differences emerged for demographic variables. Planning for EBP change must address barriers and facilitators to practice change and emphasize the benefit for patients and value of the practice change to nurses.

  6. Empowering Nurses in Providing Palliative Care to Cancer Patients: Action Research Study. (United States)

    Taleghani, Fariba; Shahriari, Mohsen; Alimohammadi, Nasrollah


    Chronic diseases such as cancer would lead to various health needs in patients and their families. To meet needs, developing new educational nursing courses is necessary. Therefore this study was conducted to empower nurses through designing and conducting short-term educational courses for training palliative care nurses. This study was a community-based action research which was conducted at Isfahan hospitals that provide services for cancer patients during 2015 at four stages (planning, acting, reflection, and evaluation). Participants (33 samples) included nurses, head nurses, managers of nursing services, nursing professors and professors of oncology department. Data were gathered through individual and group interviews and analyzed using content analysis. Data analysis resulted in 3 categories of "professional development of nursing in palliative care" which included subcategories of: knowledge-based performance and positive change in attitude, "obstacles to provide palliative care" with subcategories of: insufficient professional responsibility, insufficient ability in managing some of patients' symptoms and inappropriate interaction between nurses and physicians and "strategies for improving provision of palliative care" with subcategories of: improving the interactions between physicians and nurses, continuous trainings for palliative care and the necessity of developing palliative care in the country. To facilitate the process of providing palliative care to cancer patients, necessary actions and measures must be conducted including improvement of interaction between the members of health team, organizing continuing educational courses on palliative care and development of providing palliative care all over the country by managers of health centers.

  7. Empowering nurses in providing palliative care to cancer patients: Action research study

    Directory of Open Access Journals (Sweden)

    Fariba Taleghani


    Full Text Available Background: Chronic diseases such as cancer would lead to various health needs in patients and their families. To meet needs, developing new educational nursing courses is necessary. Therefore this study was conducted to empower nurses through designing and conducting short-term educational courses for training palliative care nurses. Materials and Methods: This study was a community-based action research which was conducted at Isfahan hospitals that provide services for cancer patients during 2015 at four stages (planning, acting, reflection, and evaluation. Participants (33 samples included nurses, head nurses, managers of nursing services, nursing professors and professors of oncology department. Data were gathered through individual and group interviews and analyzed using content analysis. Results: Data analysis resulted in 3 categories of "professional development of nursing in palliative care" which included subcategories of: knowledge-based performance and positive change in attitude, "obstacles to provide palliative care" with subcategories of: insufficient professional responsibility, insufficient ability in managing some of patients' symptoms and inappropriate interaction between nurses and physicians and "strategies for improving provision of palliative care" with subcategories of: improving the interactions between physicians and nurses, continuous trainings for palliative care and the necessity of developing palliative care in the country. Conclusions: To facilitate the process of providing palliative care to cancer patients, necessary actions and measures must be conducted including improvement of interaction between the members of health team, organizing continuing educational courses on palliative care and development of providing palliative care all over the country by managers of health centers.


    Directory of Open Access Journals (Sweden)

    Fitri Arofiati


    Full Text Available Background: Capability to provide care can be recognized as the combination of nursing knowledge, skills, and attitude of care which is dynamic. Objective: This study aims to explore the perceptions of practical nurses towards updating capability to provide care. Methods: A descriptive qualitative study was conducted to explore the deep understanding of practical nurses towards updating capability to provide care. Data were gathered using in-depth interview with 25 practical nurses from different areas of practices, three times focus group discussion (FGD and participant-observation. Qualitative content analysis model was applied to anaylze the data. Result: There were two themes emerged from data: 1 Internal perceptions of updating capacity to provide care, with three subthemes: Having great expectation, Being confidence as a professional nurse, and Developing Self-Initiation, 2 External contexts driving perception of practicing nurses, with two subthemes: Giving best care and Acquiring requirement. Conclusions: The findings indicated that updating capacity to provide care supports practical nurses to provide better nursing services to patients and meet the regulation of nursing professionalism.

  9. Barriers to nurses providing psychosocial care in the Australian rural context. (United States)

    Kenny, Amanda; Allenby, Ann


    This study in Victoria, Australia examined issues that rural nurses face in the provision of psychosocial care. Researchers, across a diversity of fields, have argued that psychosocial care is inadequate. Current knowledge of psychosocial care in rural areas is limited, despite the centrality of nurses in the provision of this care. Using an interpretive descriptive design, four focus groups were conducted with 22 nurses from five rural hospitals. Thematic analysis resulted in the emergence of five organising themes that impact on the provision of psychosocial care: constructive relationships, professional isolation, multiskilling expectations, client interaction, and competing demands. The global theme, "Managing multiple roles, demands and relationships" reflected the notion that the provision of psychosocial care is impacted on by the multiple roles and tasks that rural nurses undertake and the impact of contextual and interpersonal relationships. Strategies are needed to support nurses in their role and while clinical supervision has been identified as potentially useful, attention must be given to strong leadership, the development of a positive culture, recognition of the centrality of client care, and evidence-based education. © 2012 Wiley Publishing Asia Pty Ltd.

  10. Evidence-based radiography

    Energy Technology Data Exchange (ETDEWEB)

    Hafslund, Bjorg [Institute of Radiography, Faculty of Health and Social Sciences, Bergen University College, P.O. Box 7030, N-5020 Bergen (Norway)], E-mail:; Clare, Judith; Graverholt, Birgitte; Wammen Nortvedt, Monica [Centre for Evidence Based Practice, Faculty of Health and Social Sciences, Bergen University College, Bergen (Norway)


    Evidence-based practice (EBP) offers the integration of the best research evidence with clinical knowledge and expertise and patient values. EBP is a well known term in health care. This paper discusses the implementation of EBP into radiography and introduces the term evidence-based radiography. Evidence-based radiography is radiography informed and based on the combination of clinical expertise and the best available research-based evidence, patient preferences and resources available. In Norway, EBP in radiography is being debated and radiographers are discussing the challenges of implementing EBP in both academic and clinical practice. This discussion paper explains why EBP needs to be a basis for a radiography curriculum and a part of radiographers' practice. We argue that Norwegian radiographers must increase participation in research and developing practice within their specific radiographic domain.

  11. Toward More Evidence-Based Practice


    Hotelling, Barbara A.


    Childbirth educators are responsible for providing expectant parents with evidence-based information. In this column, the author suggests resources where educators can find evidence-based research for best practices. Additionally, the author describes techniques for childbirth educators to use in presenting research-based information in their classes. A sample of Web sites and books that offer evidence-based resources for expectant parents is provided.

  12. "There's rural, and then there's rural": advice from nurses providing primary healthcare in northern remote communities. (United States)

    Martin Misener, Ruth; MacLeod, Martha L P; Banks, Kathy; Morton, A Michel; Vogt, Carolyn; Bentham, Donna


    Nursing practice in remote northern communities is highly complex, with unique challenges created by isolation, geography and cultural dynamics. This paper, the second of two focusing on the advice offered by nurses interviewed in the national study, The Nature of Nursing Practice in Rural and Remote Canada, considers suggestions from outpost nurses. Their advice to new nurses was: know what you are getting into; consider whether your personal qualities are suited for northern practice; learn to listen and listen to learn; expect a steep learning curve, even if you are experienced; and take action to prevent burnout. Recommendations for educators were to offer programs that prepare nurses for the realities of outpost nursing and provide opportunities for accessible, flexible, relevant continuing education. The outpost nurses in this study counselled administrators to stay in contact with and listen to the perspectives of nurses at the "grassroots," and not merely to fill positions but instead to recruit outpost nurses effectively and remunerate them fairly. The study findings highlighted the multiple interrelated strategies that nurses, educators and administrators can use to optimize practice in remote northern communities.

  13. Nursing students’ perception of clinical learning experiences as provided by the nursing staff in the wards

    Directory of Open Access Journals (Sweden)

    N. R. C. TIakula


    Full Text Available A descriptive survey was carried out, using convenience and systematic sampling in order to better understand the manner in which student nurses perceive their clinical experience in the hospital. Data were collected from 80 subjects in 4 nursing colleges using a critical incident technique. Positive and negative experiences are described,

  14. Alternative scenarios: harnessing mid-level providers and evidence-based practice in primary dental care in England through operational research


    Wanyonyi, Kristina L.; Radford, David R.; Harper, Paul R.; Gallagher, Jennifer E.


    Background: In primary care dentistry, strategies to reconfigure the traditional boundaries of various dental professional groups by task sharing and role substitution have been encouraged in order to meet changing oral health needs. Aim: The aim of this research was to investigate the potential for skill mix use in primary dental care in England based on the undergraduate training experience in a primary care team training centre for dentists and mid-level dental providers. Methods: An opera...

  15. An observational study of providing structure as a psychiatric nursing intervention

    NARCIS (Netherlands)

    Voogt, L.A.; Goossens, P.J.J.; Nugter, A.; Achterberg, T. van


    PURPOSE: To observe the actions of psychiatric nurses when providing structure and identify results in order to better understand providing structure as a complex nursing intervention. DESIGN AND METHOD: Participant observation data were collected on a dual diagnosis ward and a crisis intervention

  16. Awareness and Attitude of Nurses in Regard to Providing Hospice Care. (United States)

    Aghdam, Alireza Mohajjel; Aghaei, Mir Hossein; Hassankhani, Hadi; Rahmani, Azad


    Awareness and attitudes of nurses regarding end of life care are important factors in providing hospice care. In an extensive literature review, we found no related articles investigating Iranian nurses awareness and attitudes about providing such care. The aims of this study were to investigate the awareness and attitudes of Iranian nurses in providing hospice care. In this descriptive-correlational study, 240 nurses employed in six educational centers were selected by non-randomized stratified sampling. The data collection instruments included an awareness test and attitudes regarding providing end of life care in hospice questionnaire. The data were analyzed using descriptive statistics and independent sample t-tests, one-way ANOVA, and Pearson correlation tests. The nurses' awareness score was 14.3 out of 29 and 55.7% of them stated that they had not received any education in providing end of life care. Also, by obtaining the score of 91.7 out of 120 the attitudes of participants in providing end of life care in hospices were positive. In addition, the highest attitudes score of nurses were in the dimensions of benefits of implementation and health care team. Considering low awareness of nurses about end of life care in hospices, continuing education should be provided for them in this regard. Especially, by considering the positive attitude of nurses, providing such programs could help develop hospice care in Iran.

  17. Barriers and facilitators to the implementation of an evidence-based electronic minimum dataset for nursing team leader handover: A descriptive survey. (United States)

    Spooner, Amy J; Aitken, Leanne M; Chaboyer, Wendy


    There is widespread use of clinical information systems in intensive care units however, the evidence to support electronic handover is limited. The study aim was to assess the barriers and facilitators to use of an electronic minimum dataset for nursing team leader shift-to-shift handover in the intensive care unit prior to its implementation. The study was conducted in a 21-bed medical/surgical intensive care unit, specialising in cardiothoracic surgery at a tertiary referral hospital, in Queensland, Australia. An established tool was modified to the intensive care nursing handover context and a survey of all 63 nursing team leaders was undertaken. Survey statements were rated using a 6-point Likert scale with selections from 'strongly disagree' to 'strongly agree', and open-ended questions. Descriptive statistics were used to summarise results. A total of 39 team leaders responded to the survey (62%). Team leaders used general intensive care work unit guidelines to inform practice however they were less familiar with the intensive care handover work unit guideline. Barriers to minimum dataset uptake included: a tool that was not user friendly, time consuming and contained too much information. Facilitators to minimum dataset adoption included: a tool that was user friendly, saved time and contained relevant information. Identifying the complexities of a healthcare setting prior to the implementation of an intervention assists researchers and clinicians to integrate new knowledge into healthcare settings. Barriers and facilitators to knowledge use focused on usability, content and efficiency of the electronic minimum dataset and can be used to inform tailored strategies to optimise team leaders' adoption of a minimum dataset for handover. Copyright © 2017 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  18. Multidimensional cost-benefit analysis to guide evidence-based environmental enrichment: providing bedding and foraging substrate to pen-housed monkeys. (United States)

    Bennett, Allyson J; Corcoran, Christopher A; Hardy, Vickie A; Miller, Leslie R; Pierre, Peter J


    Refinement of animal care and housing is an important shared goal-and challenge-of the team of research, veterinary, and animal care personnel charged with ensuring the wellbeing of laboratory animals. This study addresses 2 issues central to decision-making and implementation of environmental enhancement: methods for useful and comprehensive cost analysis and evaluation of engineering, husbandry, and facilities considerations. The study was undertaken to analyze the feasibility and cost of providing wood shavings as a floor cover for pen-housed monkeys. The beneficial effects of bedding for the welfare of laboratory-housed animals have long been validated. Our study illustrates a workable team-based procedure for comprehensive cost analysis of an important environmental enhancement and demonstrates that the animal welfare benefit is accompanied by decreased husbandry costs. An engineering solution to the potential challenge that wood shavings pose in terms of clogging water pipes was successful. Another successful outcome was the reduction in water (estimated at 192,000 gal annually) and chemicals used to clean housing areas. Emphasis on rigorous evaluation and objective measures of cost and benefit, as well as inclusion of the many factors and teams involved in animal research, holds strong potential for building a better foundation from which to contribute effective changes and improvements in laboratory animal welfare. Taken together, the findings of this study demonstrate that team-based, integrative, and scientific evaluation of environmental enhancement is an effective approach to guide selection of strategies with maximal potential for improving animal welfare.

  19. Multidimensional Cost–Benefit Analysis to Guide Evidence-Based Environmental Enrichment: Providing Bedding and Foraging Substrate to Pen-Housed Monkeys (United States)

    Bennett, Allyson J; Corcoran, Christopher A; Hardy, Vickie A; Miller, Leslie R; Pierre, Peter J


    Refinement of animal care and housing is an important shared goal—and challenge—of the team of research, veterinary, and animal care personnel charged with ensuring the wellbeing of laboratory animals. This study addresses 2 issues central to decision-making and implementation of environmental enhancement: methods for useful and comprehensive cost analysis and evaluation of engineering, husbandry, and facilities considerations. The study was undertaken to analyze the feasibility and cost of providing wood shavings as a floor cover for pen-housed monkeys. The beneficial effects of bedding for the welfare of laboratory-housed animals have long been validated. Our study illustrates a workable team-based procedure for comprehensive cost analysis of an important environmental enhancement and demonstrates that the animal welfare benefit is accompanied by decreased husbandry costs. An engineering solution to the potential challenge that wood shavings pose in terms of clogging water pipes was successful. Another successful outcome was the reduction in water (estimated at 192,000 gal annually) and chemicals used to clean housing areas. Emphasis on rigorous evaluation and objective measures of cost and benefit, as well as inclusion of the many factors and teams involved in animal research, holds strong potential for building a better foundation from which to contribute effective changes and improvements in laboratory animal welfare. Taken together, the findings of this study demonstrate that team-based, integrative, and scientific evaluation of environmental enhancement is an effective approach to guide selection of strategies with maximal potential for improving animal welfare. PMID:20858357

  20. Prevention of central venous catheter-associated bloodstream infections: A questionnaire evaluating the knowledge of the selected 11 evidence-based guidelines by Polish nurses. (United States)

    Dedunska, Karina; Dyk, Danuta


    This study evaluated the questionnaire testing nurses' knowledge about the maintenance of a central venous catheter (CVC) and assessed it with regard to age, work experience, type of ward, frequency of trainings, and postgraduate education. There were 1,180 questionnaires (N = 784; 66.4% of the total sample) distributed in several regions of Poland for a period of 7 months. The difficulty level for each question ranged from 0.22-0.88. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Oncology nursing: educating advanced practice nurses to provide culturally competent care. (United States)

    Yeo, Theresa Pluth; Phillips, Janice; Delengowski, Anne; Griffiths, Margaret; Purnell, Larry


    More than 37 million persons or 12.4% of the U.S. population are older than 65 years. These numbers are expected to reach 71.5 million (20% of the population) by 2030. This older population is becoming more racially and ethnically diverse as the overall minority and culturally diverse populations increase. Although the incidence and mortality rates from several major cancers have declined due to advances in cancer care, these advances have lagged among the underserved and more vulnerable racially and culturally diverse populations. Moreover, the disparity between the gender and the racial mix of nurses and the overall population continues to widen. Thus, a growing need for professional nurses and advanced practice nurses with formal educational preparation in all areas of oncology nursing exists. This article (a) highlights significant cancer disparities among diverse populations, (b) describes how cultural belief systems influence cancer care and decision making, and (c) explicates the need to prepare advanced practice nurses for careers that include cancer care of diverse and vulnerable populations through formal oncology educational programs. The "Top 10" reasons for becoming an advanced practice nurse specializing in the oncologic care of patients from diverse and underserved populations are presented. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Content of Orthopedic Patient Education Provided by Nurses in Seven European Countries. (United States)

    Charalambous, Andreas; Papastavrou, E; Valkeapää, K; Zabalegui, A; Ingadóttir, B; Lemonidou, C; Fatkulina, N; Jouko, K; Leino-Kilpi, H


    Patients' and their significant others' education during the perioperative phase is an important and challenging aspect of care. This study explored the content of education provided by nurses to arthroplasty patients and their significant others. Data were collected with the Education of Patients-NURSE content (EPNURSE-Content), Received Knowledge of Hospital Patient (RKhp), and Received Knowledge of Significant Other (RKso) scales. The results showed that the content of education emphasized biophysiological and functional needs, differed between countries, and was related to how physically demanding nurses found their job to be and the amount of education provided. There is congruence between the received knowledge of patients and their significant others in relation to the content of education provided by nurses. The findings can support nurses in developing aid material for patients and significant others explaining the nature of education and advising them what to expect and how to optimize their participation in the process.

  3. Providing grief resolution as an oncology nurse retention strategy: a literature review. (United States)

    Hildebrandt, Lori


    Oncology nurses play a pivotal role in optimizing care provided to patients at the end of life (EOL). Although oncology nurses commonly provide EOL care and witness deaths of patients that they have maintained long-standing relationships with, they are frequently excluded from grief resolution endeavors. With a worldwide shortage of oncology nurses, retention is paramount to ensuring that the care patients with cancer receive is not jeopardized. Various strategies were identified to resolve grief and increase nurse retention, including creating supportive work environments, debriefing with colleagues, providing EOL and grief education, and altering patient care assignments. Future research on emerging technologies and their effects on oncology nurse coping and retention strategies also was suggested.

  4. School Nurses' Perceptions of Self-Efficacy in Providing Diabetes Care (United States)

    Fisher, Kelly L.


    The purpose of this study was to measure school nurses' perceived self-efficacy in providing diabetes care and education to children and to identify factors that correlate with higher self-efficacy levels in the performance of these tasks. The results of this study revealed that the surveyed school nurses perceived a moderate level of…

  5. [Training future nurses in providing care for patients who committed criminal acts]. (United States)

    Corvest, Karina; Royer, Gilles Ripaille-Le; Dugardin, Thierry


    Providing care for patients who have carried out criminal acts is a source of questioning for caregivers, who must position themselves in this specific care relationship. For three years, the nursing training institute (IFSI) in Orthez has offered students an optional module in criminology. Through discussions and critical reflection, its aim is to enable future nurses to be better prepared.

  6. A systematic review of the literature to support an evidence-based precepting program. (United States)

    Mann-Salinas, Elizabeth; Hayes, Elizabeth; Robbins, Johnnie; Sabido, Jean; Feider, Laura; Allen, David; Yoder, Linda


    To provide a systematic review of the literature regarding development of an evidence-based Precepting Program for nurses transitioning to burn specialty practice. Burned patients are admitted to specialty Burn Centers where highly complex nursing care is provided. Successful orientation and integration into such a specialized work environment is a fundamental component of a nurse's ability to provide safe and holistic patient care. A systematic review of the literature was performed for the period 1995-2011 using electronic databases within PUBMED and Ovid search engines. Databases included Medline, CINHAL, ProQuest for Dissertations and Thesis, and Cochran Collaboration using key search terms: preceptor, preceptee, preceptorship, precept*, nurs*, critical care, personality types, competency-based education, and learning styles. Nurses graded the level and quality of evidence of the included articles using a modified 7-level rating system and the Johns Hopkins Nursing Quality of Evidence Appraisal during journal-club meetings. A total of 43 articles related to competency (n=8), knowledge acquisition and personality characteristics (n=8), learning style (n=5), preceptor development (n=7), and Precepting Programs (n=14). A significant clinical gap existed between the scientific evidence and actual precepting practice of experienced nurses at the Burn Center. Based on this extensive review of the literature, it was determined that a sufficient evidence base existed for development of an evidence-based Precepting Program. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  7. Marketing evidence-based practice: what a CROC™! (United States)

    Boyington, Alice R; Ferrall, Sheila M; Sylvanus, Terry


    Nurses should be engaged in evidence-based practice (EBP) to ensure that nursing care is efficient and effective. This article describes one cancer center's use of the Marketing Mix framework to educate staff nurses with the CROC™: Clinging Rigidly to Outdated Care campaign. As a result of the campaign, five EBP projects have been initiated in the cancer center.

  8. Nurse-midwifery education through graduate programs to provide a sufficient number of high quality nurse-midwives

    Directory of Open Access Journals (Sweden)

    Kyung Hye Lee


    Full Text Available There is a decrease in the number of new midwives, resulting from the shutdown of midwifery education program in hospitals due to a decrease in birthrate in the Republic of Korea. To solve this problem, the current medical laws on midwifery education system in Korea should be revised; nurse-midwifery specialist programs must be established in educational institutes with nursing programs. To support this argument, the midwifery education programs of America, Europe, Australia, and Japan have been discussed, and a nurse-midwifery specialist curriculum at the master s level, based on the nurse-practitioner system of Korea, has been suggested. Since this assertion is very important and urgent for solving the future population problem of Korea and providing health care for women and children, it should be realized into action immediately.

  9. Adaptation of evidence-based surgical wound care algorithm. (United States)

    Han, Jung Yeon; Choi-Kwon, Smi


    This study was designed to adapt a surgical wound care algorithm that is used to provide evidence-based surgical wound care in a critical care unit. This study used, the 'ADAPTE process', an international clinical practice guideline development method. The 'Bonnie Sue wound care algorithm' was used as a draft for the new algorithm. A content validity index (CVI) targeting 135 critical care nurses was conducted. A 5-point Likert scale was applied to the CVI test using a statistical criterion of .75. A surgical wound care algorithm comprised 9 components: wound assessment, infection control, necrotic tissue management, wound classification by exudates and depths, dressing selection, consideration of systemic factors, wound expected outcome, reevaluate non-healing wounds, and special treatment for non-healing wounds. All of the CVI tests were ≥.75. Compared to existing wound care guidelines, the new wound care algorithm provides precise wound assessment, reliabilities of wound care, expands applicability of wound care to critically ill patients, and provides evidence and strength of recommendations. The new surgical wound care algorithm will contribute to the advancement of evidence-based nursing care, and its use is expected as a nursing intervention in critical care.

  10. Evidence-based practice models for organizational change: overview and practical applications. (United States)

    Schaffer, Marjorie A; Sandau, Kristin E; Diedrick, Lee


    To provide an overview, summary of key features and evaluation of usefulness of six evidence-based practice models frequently discussed in the literature. The variety of evidence-based practice models and frameworks, complex terminology and organizational culture challenges nurses in selecting the model that best fits their practice setting. The authors: (1) initially identified models described in a predominant nursing text; (2) searched the literature through CINAHL from 1998 to current year, using combinations of 'evidence', 'evidence-based practice', 'models', 'nursing' and 'research'; (3) refined the list of selected models based on the initial literature review; and (4) conducted a second search of the literature on the selected models for all available years to locate both historical and recent articles on their use in nursing practice. Authors described model key features and provided an evaluation of model usefulness based on specific criteria, which focused on facilitating the evidence-based practice process and guiding practice change. The evaluation of model usefulness can be used to determine the best fit of the models to the practice setting. The Johns Hopkins Model and the Academic Center for Evidence-Based Practice Star Model emphasize the processes of finding and evaluating evidence that is likely to appeal to nursing educators. Organizations may prefer the Promoting Action on Research Implementation in Health Services Framework, Advancing Research and Clinical Practice Through Close Collaboration, or Iowa models for their emphasis on team decision-making. An evidence-based practice model that is clear to the clinician and fits the organization will guide a systematic approach to evidence review and practice change. © 2012 Blackwell Publishing Ltd.

  11. The meaning of providing caring to obese patients to a group of nurses

    Directory of Open Access Journals (Sweden)

    Emilly Souza Marques


    Full Text Available This qualitative study was performed with six nurses of a public hospital, with the objective to describe their view of the meaning of providing care to obese patients. Interviews were conducted using a semi-structured script. The data were organized under themes extracted from the subjects’ statements, after being thoroughly read. Symbolic Interactionism was adopted to interpret the findings. The results from the analysis were organized under the following themes: Being obese is excessive, it is not healthy; Providing care to the obese is a structural issue; Obese patients are troublesome, they require care, no big deal; Providing care to the obese requires teamwork. The grasped meanings can interfere in the care provided. The nurses, however, recognize the need to work as a team to deliver comprehensive care. Making positive changes to the meanings found in this study is possible, thus, contributing to providing prejudice-free nursing care to obese patients. Descriptors: Obesity; Nursing Care; Hospital Care.

  12. Nurses' attitude and practice in providing tobacco cessation care to patients. (United States)

    Sreedharan, J; Muttappallymyalil, J; Venkatramana, M


    Patients respond very positively with nurses when they talk to them about their health related problems. This cross sectional study was carried out among nurses working in Gulf Medical College hospital and Research centre, Ajman, UAE to assess the their attitude in providing tobacco cessation counselling or advise to their patients and potential barriers they face in providing tobacco cessation care. 108 nurses participated in the study. Among the nurses 87% were females, the majority were aged between 25 and 34 years, and 46.3% had a work experience of less than 5 years. Among the nurses who participated in the survey, 99.1% felt that the hospital stay was a suitable time for nurses to create awareness on tobacco and health to the patients and had a positive attitude towards creating awareness on tobacco and health to the patients. Only 0.9% had a negative attitude towards creating awareness on tobacco and health and they felt that patients might not listen to them. All nurses, irrespective of their socio-demographic characteristics had a positive attitude to motivating patients to quit tobacco use. Currently, 70.4% regularly advise their patients to avoid tobacco products. Potential barriers pointed out by nurses were: lack of time (6.3%) patients may not appreciate it (90.6%) and not part of their job (3.1%). The study concludes that nurses have a positive attitude in providing tobacco cessation care to their patients and they can utilize their unique knowledge and know-how to promote tobacco cessation and prevent the spread of this public health crisis. Providing advice and support for tobacco cessation by nurses would increase the chance of patients stopping tobacco use. This will create an enabling environment and greater potential for public health persons to fight the epidemic with greater vigour

  13. Weathering the storm: challenges to nurses providing care to nursing home residents during hurricanes. (United States)

    Hyer, Kathryn; Brown, Lisa M; Christensen, Janelle J; Thomas, Kali S


    This article documents the experience of 291 Florida nursing homes during the 2004 hurricane season. Using quantitative and qualitative methods, the authors described and compared the challenges nurses encountered when evacuating residents with their experiences assisting residents of facilities that sheltered in place. The primary concerns for evacuating facilities were accessing appropriate evacuation sites for residents and having ambulance transportation contracts honored. The main issue for facilities that sheltered in place was the length of time it took for power to be restored. Barriers to maintaining resident health during disasters for those who evacuated or sheltered in place are identified.

  14. The experiences of nurses in providing psychosocial support to ...

    African Journals Online (AJOL)

    The study was conducted in the surgical ICUs of two private hospitals and one public hospital in the Durban metropolitan area. Findings. Four main themes emerged from the data: cultural awareness, communication challenges, providing assistance, and lack of training. Conclusion. These findings provide implications for ...

  15. Evaluation of Basic Life Support Training Program Provided for Nurses in A University Hospital

    Directory of Open Access Journals (Sweden)

    Banu Terzi


    Full Text Available Aims: This study was conducted to assess the efficiency of the basic life support (BLS training program provided for nurses in a university hospital. To evaluate the efficiency of the BLS training program provided for nurses in a university hospital. Methods: In this a quasi-experimental study, a total of 404 nurses who received BLS training were enrolled. The study was performed in two stages. In stage one, the participant nurses were given a pre-test that consisted of 25 questions, four points each, before the training on the first day of the 2-day BLS training. The post-test was conducted in addition to practical exams on manikins to determine nurses’ practice skills on BLS. Results: There was a statistically significant difference between the nurses with previous BLS training and the difference between their pre- and post-test results (p<0.05, and high statistically significant difference was found between the nurses with previous advanced life support (ALS training and the difference between their pre- and post-test results (p<0.001. Conclusion: Nurses should receive BLS training in hospitals and the training should be repeated on a regular basis. The BLS training that the nurses received in this study was effective and increased their knowledge level on BLS

  16. A systematic review on barriers, facilities, knowledge and attitude toward evidence-based medicine in Iran

    Directory of Open Access Journals (Sweden)

    Morteza Ghojazadeh


    Full Text Available Introduction: Evidence-based medicine (EBM is the ability and skill in using and integration of the best up-to-date evidences. The aim of this study was a systematic review of barriers, facilities, knowledge and attitude of EBM in Iran. Methods: In this study, database and manual search was used with keywords such as, "evidence-based, EBM, evidence-based nursing, evidence-based practice, evidence-based care, evidence-based activities, evidence-based education" and their combination with the keywords of the barrier, facilitator, attitude, awareness, prospective, knowledge, practice and Iran. The databases of SID (Scientific information database, Magiran, MEDLIB, PubMed, Google scholar, IranMedex and CINAHL (Cumulative index to nursing and allied health literature were used for data collection. Results: Finally, 28 papers were included in this study. The lack of facilities, time and skill in research methodology were the most important barriers to EBM. The most and least important factors were orderly creating ample opportunity and detecting needs and problems. The degree of familiarity with the terminology of evidence-based performance was low (44.2%. The textbooks have been considered as the most significant source of obtaining information. The level of awareness, knowledge, and evidence-based performance was less than 50.0%. Conclusion: There are many various barriers in use of EBM and healthcare providers despite the positive attitude toward EBM had a low level knowledge in EBM setting. Consideration of the importance of EBM proper planning and effective intervention are necessary to removing the barriers and increase the knowledge of healthcare providers.

  17. Nurses' experiences providing bereavement follow-up: an exploratory study using feminist poststructuralism. (United States)

    MacConnell, Grace; Aston, Megan; Randel, Pat; Zwaagstra, Nick


    To describe the experiences of nurses who provided bereavement follow-up with families after the death of a child or a pregnancy loss and explore facilitators, barriers and challenges. Bereavement follow-up after the death of a child has been identified as an indicator of quality end of life care by families and health care professionals. Research suggests communication with bereaved families can be challenging and intimidating for nurses, particularly those who have had limited experience. In-depth information about the personal, professional and institutional experiences of nurses providing this care is lacking. Eight registered nurses with experience in providing bereavement follow-up to families were interviewed. Purposive sampling provided information rich cases. Feminist poststructuralism was the guiding theory and methodology used to uncover underlying discourses. This methodology uses the concepts of discourse analysis, subjectivity and agency to enable a critical understanding of the relationships. The nurses described complex interactions between themselves, the families, hospital practices and policy, and social norms around the discourses of death and professionalism. The importance of relationship, self-care and closure, professional boundaries, invisible nature of the practice and institutional support were prominent themes. Insights into the challenges and rewards of providing bereavement follow-up are discussed in the context of power relations, and recommendations for change are offered. Nurses in the study were strongly committed to providing ongoing care to families who had experienced the death of a child or a pregnancy loss. Relationships were important to bereavement follow-up care, and the connections with families were often emotional for the nurses. Nurses and other health professionals would benefit from increased support and education related to bereavement and communication with grieving families. Clarity related to institutional

  18. [Implementation of nurse demand managment in primary health care service providers in Catalonia]. (United States)

    Brugués Brugués, Alba; Cubells Asensio, Irene; Flores Mateo, Gemma


    To describe and analyse the implementaction of nurse demand managment (NDM) among health care providers in Catalonia from 2005 to 2014. Cross sectional survey. Participants All service providers in Catalonia (n=37). Main measurements Interviews with nurse manager of each health care provides about ht barriers and facilitators concerning NDM. Facilitators and barriers were classified into 3 types: (i)health professional (competence, attitudes, motivation for change and individual characteristics); (ii)social context (patients and companions), and (iii)system related factors (organization and structure, economic incentives). Of the 37 providers, 26 (70.3%) have implemented the Demand Management Nurse (NDM). The main barriers identified are the nurse prescriptin regulation, lack of knowledge and skills of nurses, and the lack of protocols at the start of implantation. Among the facilitators are the specific training of professionals, a higher ratio of nurses to doctors, consensus circuits with all professionals and linking the implementation of NDM to economic incentives. NDM is consolidated in Catalonia. However, the NDM should be included in the curricula of nursing degree and continuing education programs in primary care teams. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  19. Occupational stress in intensive care nurses who provide direct care to critical patients

    National Research Council Canada - National Science Library

    Inoue, Kelly Cristina; Versa, Gelena Lucinéia Gomes da Silva; Murassaki, Ana Cláudia Yassuko; Melo, Willian Augusto de; Matsuda, Laura Misue


    In order to identify the stress level of nurses that provide direct care to critically ill patients, it was carried out a descriptive and exploratory study in five hospitals of the western region of the state of Paraná...

  20. Evaluating the impact of palliative or hospice care provided in nursing homes. (United States)

    Cimino, Nina M; McPherson, Mary Lynn


    Palliative and hospice care are increasingly being provided in nursing home settings. The current article reviews the existing evidence relevant to nursing homes to provide practitioners with a greater understanding of the impact of palliative and hospice care on clinical care outcomes (e.g., pain, symptom management), processes of care outcomes (e.g., hospitalizations, cost of care), and family member or health care proxy perceptions of care. Overall, the provision of hospice or palliative care in nursing facilities can improve the clinical care residents receive, reduce hospitalizations, and improve family members' perception of care. Copyright 2014, SLACK Incorporated.

  1. Evidence-based medicine for all: what we can learn from a programme providing free access to an online clinical resource to health workers in resource-limited settings. (United States)

    Valtis, Yannis K; Rosenberg, Julie; Bhandari, Sudip; Wachter, Keri; Teichman, Marie; Beauvais, Sophie; Weintraub, Rebecca


    The rapidly changing landscape of medical knowledge and guidelines requires health professionals to have immediate access to current, reliable clinical resources. Access to evidence is instrumental in reducing diagnostic errors and generating better health outcomes. UpToDate, a leading evidence-based clinical resource is used extensively in the USA and other regions of the world and has been linked to lower mortality and length of stay in US hospitals. In 2009, the Global Health Delivery Project collaborated with UpToDate to provide free subscriptions to qualifying health workers in resource-limited settings. We evaluated the provision of UpToDate access to health workers by analysing their usage patterns. Since 2009, ∼2000 individual physicians and healthcare institutions from 116 countries have received free access to UpToDate through our programme. During 2013-2014, users logged into UpToDate ∼150 000 times; 61% of users logged in at least weekly; users in Africa were responsible for 54% of the total usage. Search patterns reflected local epidemiology with 'clinical manifestations of malaria' as the top search in Africa, and 'management of hepatitis B' as the top search in Asia. Our programme demonstrates that there are barriers to evidence-based clinical knowledge in resource-limited settings we can help remove. Some assumed barriers to its expansion (poor internet connectivity, lack of training and infrastructure) might pose less of a burden than subscription fees.

  2. Exploring consumer views of care provided by the Macmillan nurse using the critical incident technique. (United States)

    Cox, K; Bergen, A; Norman, I J


    This study focuses on descriptive accounts of one Macmillan nurse's work, as provided by key individuals coming into contact with this specialist professional service. Twenty respondents (eight patients, five carers, five district nurses and two general practitioners) were interviewed using a variation of the critical incident technique. Data were analysed in terms of meaningful observed events (critical happenings) that were perceived as effective or ineffective with respect to the delivery of high-quality nursing care. Some variations were found between groups of respondents in their perception of the nurse's role. However, there was a general emphasis on the possession of specialist knowledge of terminal cancer care and the positive impact of interventions to both the patient and to lay and professional carers. The critical incident technique was found to be a valuable method for eliciting detailed accounts of the work of the nurse in this specialized field of practice.

  3. Peer mentoring supports the learning needs of nurses providing palliative care in a rural acute care setting. (United States)

    Rabbetts, Lyn


    A specific set of assessment scales can underpin the management of distressing symptoms of patients requiring palliative care. A research assistant supported nurses working in a rural hospital setting during the introduction of these scales. A secondary analysis was conducted to further explore the qualitative data of a previously reported mixed-method study. In particular, the experiences of nurses working alongside a research assistant in the facilitation of using a new assessment form. Purposeful sampling was employed: participating nurses were invited to attend one of three focus group meetings. Data analysis revealed three main themes: a contact person, coach/mentor and extra help initiatives. Three to four subthemes corresponded with each main theme. Findings suggest nurses benefit from having someone to assist in learning about new documentation. Nurses respond positively to mentorship and practical guidance when integrating a new assessment form into routine evidence-based practice.

  4. Increasing Access to Health Care Providers with Nurse Practitioner Competencies (United States)

    Grace, Del Marjorie


    Emergency department visits increased from 102.8 million to 136.1 million in 2009, resulting in crowding and increased wait times, affecting U.S. hospitals' ability to provide safe, timely patient care resulting in dangerous delays and serious health problems shown by research. The purpose of this project was to determine if competencies developed…

  5. Can a sustainability and health scenario provide a realistic challenge to student nurses and provoke changes in practice? An evaluation of a training intervention. (United States)

    Grose, J; Richardson, J


    Climate change and limited natural resources will impact on the sustainable supply and disposal of materials used in health care. Healthcare students need opportunities to reflect on the ecological footprint of health services to mitigate against negative effects on service delivery. In order to raise awareness of these issues, there is a need for evidence-based teaching tools which are relevant and meaningful to nursing practice. An evidence-based sustainability skills teaching session was delivered to 293 nursing students from child and adult health disciplines. Following the sessions, evaluation sheets were distributed to the participants, of which 290 responded. The majority of nurses valued both the delivery and the content of the training and some were motivated to complete further study. The evaluation provided valuable information on how to deliver sustainability education and important insights into where more information and support was needed in order to change practice. Embedding sustainability teaching in skill sessions appears to be a realistic way of informing and motivating learners to consider current and best practice. Following training, further evaluation of practice-based behaviour is needed. © 2015 Wiley Publishing Asia Pty Ltd.

  6. Mutual Expectations of Mothers of Hospitalized Children and Pediatric Nurses Who Provided Care: Qualitative Study. (United States)

    Konuk Şener, Dilek; Karaca, Aysel

    This study attempted to identify the mutual expectations of mothers whose children were hospitalized in the pediatric department of a university hospital and nurses who provided care. A descriptive phenomenological design has been used in this study. Data were obtained through tape-recorded semi-structured interviews. This study was conducted at a pediatric clinic, at a university hospital in a small city in Turkey. Participants comprised five nurses working in the children's clinic and 24 mothers who accompanied their children to the hospital. The six major themes that emerged were mothers' feelings and thoughts about the hospital experience, mothers' expectations for attention and support during hospitalization, mothers' expectations for invasive procedures, issues regarding physical comfort and hospital infrastructure, nurses' feelings and thoughts about working in the pediatric clinic, and nurses' expectations of the mothers. Mothers expected nurses to provide physical support including medication administration, and installing/applying IV and nebulizer treatments; and emotional support in terms of having a friendly, rather than critical attitude, and being approachable and receptive of mothers' questions and anxieties. Nurses stated that they were aware of these expectations but needed mothers to be understanding and tolerant, considering their difficult working conditions. Children's hospitalization is a stressful experience for parents. Open and therapeutic communication and relationships between parents and nurses contribute to improving the quality of care provided to children and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Evidence-based management reconsidered. (United States)

    Kovner, Anthony R; Rundall, Thomas G


    Reports of medical mistakes have splashed across newspapers and magazines in the United States. At the same time, instances of overuse, underuse, and misuse of management tactics and strategies receive far less attention. The sense of urgency associated with improving the quality of medical care does not exist with respect to improving the quality of management decision making. A more evidence-based approach would improve the competence of the decision-makers and their motivation to use more scientific methods when making a decision. The authors of this article consider a study of 68 U.S. health services managers that found a low level of evidence-based management behaviors. From the findings, four strategies are suggested to increase health systems managers' use of research evidence to improve decision making: focusing evidence-based decision making on strategically important issues, developing committees and other structures to diffuse management research throughout the organization, building a management culture that values research, and training managers in the competencies required to apply research evidence to health services management decisions. To aid the manager in understanding and applying an evidenced-based approach to decision making, the article provides practical tools, techniques, and resources for immediate use.

  8. To embed or not to embed? A longitudinal study exploring the impact of curriculum design on the evidence-based practice profiles of UK pre-registration nursing students. (United States)

    Scurlock-Evans, Laura; Upton, Penney; Rouse, Joanne; Upton, Dominic


    The use of Evidence-Based Practice (EBP) is increasingly emphasized within healthcare. However, little research has focused on nurses' pre-registration training; particularly regarding the impact of curriculum-design on learning EBP. This study compared the impact of embedding EBP throughout the curriculum, with modular-based teaching, on pre-registration nursing students' EBP profiles. A longitudinal panel study. A convenience sample of fifty-six pre-registration nursing students (55.4% studying an embedded EBP-curriculum and 44.6% studying a modular EBP-curriculum), were recruited from a UK University between 2011 and 2014. Participants completed the Student Evidence-Based Practice Questionnaire (S-EBPQ) in the first, second and third year of their course. This questionnaire measures four EBP domains: frequency of use, attitude, knowledge and skills in retrieving and reviewing evidence, and knowledge and skills in applying and sharing evidence. Two-way mixed between-within Analyses of Variance revealed significant improvements across all domains, except attitude (which remained broadly positive across all years), for both curriculum-groups. No significant differences in this improvement were identified between the two curricula overall. However, the direction and rate of change of scores on the retrieving and applying subscales (but not frequency of use) for the two groups differed across time; specifically those on the embedded curriculum showed a dip in scores on these subscales in year 2. This appeared to be related to associated features of the course such as the timing of placements and delivery of theory. Taking a modular or embedded approach to EBP may have little impact on students' final EBP profiles. However, careful consideration should be given to the timing of related course features which may play a key role in students' perceptions of their knowledge and skills in its application. Further research should explore how curriculum-design might build on

  9. Providing travel health care--the nurses' role: an international comparison. (United States)

    Bauer, Irmgard; Hall, Sheila; Sato, Nahoko


    In many countries, the responsibility for travel health lies with medical practitioners who delegate certain tasks to nursing staff. Elsewhere, nurses have taken a leading role and work independently in private or hospital-based clinics, occupational health departments and general practices. The purpose of this study was to examine the roles and challenges faced by nurses providing travel health care in Australia, Japan and the UK, and to compare educational and professional needs. Nurses involved in travel health care were invited to complete an online questionnaire with multiple choice, open-ended, and Likert Scale questions. SurveyMonkey's statistical facilities analysed quantitative data; thematic content analysis was applied to qualitative responses. Differences and similarities between the three countries were conveyed by 474 participants focusing on current positions, work arrangements, and educational and practical concerns. Clinical practice issues, including vaccination and medication regulations, were highlighted with the differences between countries explained by the respective history of travel health care development and the involvement within their nursing profession. The call for more educational opportunities, including more support from employers, and a refinement of the role as travel health nurse appears to be international. Nurses require support networks within the field, and the development of a specialist "travel health nurse" would give a stronger voice to their concerns and needs for specific education and training in travel health care. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Visualization studies on evidence-based medicine domain knowledge (series 3): visualization for dissemination of evidence based medicine information. (United States)

    Shen, Jiantong; Yao, Leye; Li, Youping; Clarke, Mike; Gan, Qi; Li, Yifei; Fan, Yi; Gou, Yongchao; Wang, Li


    To identify patterns in information sharing between a series of Chinese evidence based medicine (EBM) journals and the Cochrane Database of Systematic Reviews, to determine key evidence dissemination areas for EBM and to provide a scientific basis for improving the dissemination of EBM research. Data were collected on citing and cited from the Chinese Journal of Evidence-Based Medicine (CJEBM), Journal of Evidence-Based Medicine (JEBMc), Chinese Journal of Evidence Based Pediatrics (CJEBP), and the Cochrane Database of Systematic Reviews (CDSR). Relationships between citations were visualized. High-frequency key words from these sources were identified, to build a word co-occurrence matrix and to map research subjects. CDSR contains a large collection of information of relevance to EBM and its contents are widely cited across many journals, suggesting a well-developed citation environment. The content and citation of the Chinese journals have been increasing in recent years. However, their citation environments are much less developed, and there is a wide variation in the breadth and strength of their knowledge communication, with the ranking from highest to lowest being CJEBM, JEBMc and CJEBP. The content of CDSR is almost exclusively Cochrane intervention reviews examining the effects of healthcare interventions, so it's contribution to EBM is mostly in disease control and treatment. On the other hand, the Chinese journals on evidence-based medicine and practice focused more on areas such as education and research, design and quality of clinical trials, evidence based policymaking, evidence based clinical practice, tumor treatment, and pediatrics. Knowledge and findings of EBM are widely communicated and disseminated. However, citation environments and range of knowledge communication differ greatly between the journals examined in this study. This finds that Chinese EBM has focused mainly on clinical medicine, Traditional Chinese Medicine, pediatrics, tumor

  11. Patients' and nurses' views on providing psychological support within cardiac rehabilitation programmes: a qualitative study. (United States)

    Turner, Katrina M; Winder, Rachel; Campbell, John L; Richards, David A; Gandhi, Manish; Dickens, Chris M; Richards, Suzanne


    To explore patients' and nurses' views on the feasibility and acceptability of providing psychological care within cardiac rehabilitation services. In-depth interviews analysed thematically. 18 patients and 7 cardiac nurses taking part in a pilot trial (CADENCE) of an enhanced psychological care intervention delivered within cardiac rehabilitation programmes by nurses to patients with symptoms of depression. Cardiac services based in the South West of England and the East Midlands, UK. Patients and nurses viewed psychological support as central to good cardiac rehabilitation. Patients' accounts highlighted the significant and immediate adverse effect a cardiac event can have on an individual's mental well-being. They also showed that patients valued nurses attending to both their mental and physical health, and felt this was essential to their overall recovery. Nurses were committed to providing psychological support, believed it benefited patients, and advocated for this support to be delivered within cardiac rehabilitation programmes rather than within a parallel healthcare service. However, nurses were time-constrained and found it challenging to provide psychological care within their existing workloads. Both patients and nurses highly value psychological support being delivered within cardiac rehabilitation programmes but resource constraints raise barriers to implementation. Consideration, therefore, should be given to alternative forms of delivery which do not rely solely on nurses to enable patients to receive psychological support during cardiac rehabilitation. ISCTRN34701576. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Experiences of Parish Nurses in Providing Diabetes Education and Preconception Counseling to Women With Diabetes. (United States)

    Devido, Jessica A; Doswell, Willa M; Braxter, Betty J; Spatz, Diane L; Dorman, Janice S; Terry, Martha Ann; Charron-Prochownik, Denise

    To explore the role and experiences of the parish nurse in providing diabetes education and preconception counseling to women with diabetes. Mixed-methods concurrent embedded design. Focus groups of community-based parish nurses accessed from a regional database (Pennsylvania, Florida, Ohio, New York, Arizona, and Minnesota). Forty-eight parish nurses recruited from the Parish Nurse and Health Ministry Program database in Western Pennsylvania. The primary method was focus groups using face-to-face, teleconference, and videoconferencing formats. A secondary method used a quantitative descriptive design with three self-report measures (demographic, preconception counseling self-efficacy, and preconception counseling knowledge). Qualitative content analysis techniques were conducted and combined with descriptive analysis. Forty-eight parish nurses participated in 1 of 11 focus groups. Eight qualitative themes emerged: Awareness, Experience, Formal Training, Usefulness, Willingness, Confidence, "Wise Women," and Preconception Counseling Tool for Patients. Participants provided recommendations for training and resources to increase their knowledge and skills. Parish nurses' knowledge scores were low (mean = 66%, range = 40%-100%) with only moderate levels of self-efficacy (mean = 99, range = 27-164). Self-efficacy had a significantly positive association with knowledge (r = .29, p = .05). Quantitative results were consistent with participants' qualitative statements. Parish nurses were unaware of preconception counseling and lacked knowledge and teaching self-efficacy as it related to preconception counseling and diabetes education. Understanding parish nurses' experiences with women with diabetes and identifying their needs to provide education and preconception counseling will help tailor training interventions that could affect maternal and fetal outcomes. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published

  13. Providing oral care in haematological oncology patients: nurses' knowledge and skills. (United States)

    Potting, Carin M J; Mank, Arno; Blijlevens, Nicole M A; Donnelly, J Peter; van Achterberg, Theo


    In the international literature, the most commonly recommended intervention for managing oral mucositis is good oral care, assuming that nurses have sufficient knowledge and skills to perform oral care correctly. The aim of the present study was to investigate if knowledge and skills about oral care improve when education in oral care is provided to nurses in charge of patients who are at risk of oral mucositis. This intervention study consists of a baseline test on the knowledge and skills of nurses of the haematology wards of two different hospitals. Oral care education sessions were given in one hospital and follow-up tests were performed in both hospitals. Nursing records were examined and observations of nurses performing oral care were made at baseline as well as at follow-up. The results show significant differences in the scores for knowledge and skills before and after the education, whereas there was no difference in scores at the two points in time for the comparison hospital, where no education had taken place. The records test showed no differences at baseline or follow-up for the two groups. Observations showed that nurses who followed the education session implemented the oral care protocol considerably better than those who did not attended. Education in oral care has a positive influence on the knowledge and skills of nurses who care for patient at risk of oral mucositis, but not on the quality of oral care documentation.

  14. Evidence-based playground design

    DEFF Research Database (Denmark)

    Refshauge, Anne Dahl; Stigsdotter, Ulrika K.; Lamm, Bettina


    This paper develops, explores and evaluates an evidence-based approach to playground design, with a public park playground (playlab Cph) in Copenhagen as a case study. In the increasingly urbanised world, park playgrounds are valuable places that support healthy child development by providing...... opportunities for play, nature exploration and sensory stimulation. As it is increasingly expected that designers base their decisions on research evidence, there is a need to develop approaches to facilitate this, which also applies to playground design. The design of PlayLab Cph was based on relevant evidence...

  15. Healthcare Provider Views on Transitioning From Task Shifting to Advanced Practice Nursing in Tanzania. (United States)

    Mboineki, Joanes Faustine; Zhang, Weihong

    The Tanzanian health sector suffers from shortages of healthcare workers as well as uneven distribution of healthcare workers in urban and rural areas. Task shifting-delegation of tasks from professionals to other healthcare team members with less training, such as medical attendants-is practiced, compromising quality of care. Advanced practice nursing is underutilized. The purpose of this study was to explore the views of nurses and physicians on current responses to shortages of healthcare workers and the potential for utilization of advanced practice nurses. A descriptive, qualitative design was used. Purposeful sampling was used to select 20 participants. An in-depth interview guide was used to obtain information. Interviews were conducted in Swahili or English. Content analysis was used to identify themes. Shortage of human resources in rural primary healthcare facilities was identified as a major rationale for implementation of the advanced practice nurse practitioner role because the current health providers in rural health facilities are less trained and doctors are not ready to work in these settings. Opposition from physicians is expected during the course of implementing the nurse practitioner role. Professional bodies and government should reach consensus before the implementation of this role in such a way that they should agree on scope and standards of practice of nurse practitioners in Tanzania. Shortage of human resources for health is greater in rural primary healthcare facilities. Task shifting in Tanzania is neither effective nor legally recognized. Transition to advanced practice nursing roles-particularly the nurse practitioner role-can facilitate provision of optimal care. Nurse practitioners should be prepared to work in rural primary healthcare facilities.

  16. Nurse, physician, and consumer role responsibility perceived by health care providers. (United States)

    Hammond, K; Bandak, A; Williams, M


    The article describes a study that addressed perceptions of unilateral and egalitarian role functions for nurses, physicians, and consumers in a long-term, 345-bed psychiatric facility in the western United States. Findings indicated that physicians desired to retain authority for health care decisions and that nurses, social workers, and hospital administrators preferred collaborative practice. Support for shared responsibility increased among psychiatric technicians with years of experience. Experience did not alter the attitudes of physicians, occupational therapists, and recreational therapists for physician dominance. With experience, nurses increased their belief in nurse responsibility. Despite evidence for collaborative decision making, results of this study indicate that attitudes of health care providers may prevent this tenet from being actualized.

  17. A changing landscape: mapping provider organisations for community nursing services in England. (United States)

    Spilsbury, Karen; Pender, Sue


    To scope the provision of community nursing services in England after implementation of the Transforming Community Services Programme. Over the past decade, significant UK policy initiatives have shaped the structure, organisation and responsibilities of community nursing services. Understanding these organisational changes is important in the context of organisations seeking to deliver 'care closer to home'. A systematic mapping exercise to scope and categorise community nursing service organisation provider models. There are 102 provider organisations representing a range of organisational models. Two-thirds of these organisations have structurally integrated with another NHS Trust. Smaller numbers reorganised to form community trusts or community interest companies. Only a few services have been tendered to an accredited willing provider while a small number have yet to establish their new service model. Local discretion appears to have dominated the choice of organisational form. National policies have driven the reorganisation of community nursing services and we have been able to describe, for the first time, these 'transformed' structures and organisations. Providing detail of these 'new' models of service provision, and where these have been introduced, is new information for nurse managers, policy makers and organisational leaders, as well as researchers. © 2013 John Wiley & Sons Ltd.

  18. Maximizing federal Medicaid dollars: nursing home provider tax adoption, 2000-2004. (United States)

    Miller, Edward Alan; Wang, Lili


    Since Medicaid is jointly financed by the federal and state governments, state officials have sought to offset state expenditures by maximizing federal contributions. One such strategy is to adopt a provider tax, which enables states to collect revenues from providers; those revenues are then used to pay for services rendered to Medicaid recipients, thereby leveraging federal matching dollars without concomitant increases in state expenditures. The number of states adopting a nursing home tax increased from thirteen to thirty-one between 2000 and 2004. This study seeks to identify the factors that spurred the rapid increase in nursing home provider taxes following implementation of the Balanced Budget Act of 1997. Results indicate that states with more powerful nursing home lobbies, lower proportions of private pay nursing home residents, worse fiscal health, weaker fiscal capacity, broader Medicaid eligibility, and nursing home supply restrictions were more likely to adopt. This implies that state officials react rationally to prevailing fiscal and programmatic circumstances when formulating policy under Medicaid and that providers seek relief, in part, from the adverse fiscal consequences of federal policy changes by promoting policy change at the state level.

  19. Sicily statement on evidence-based practice

    Directory of Open Access Journals (Sweden)

    Hopayian Kevork


    Full Text Available Abstract Background A variety of definitions of evidence-based practice (EBP exist. However, definitions are in themselves insufficient to explain the underlying processes of EBP and to differentiate between an evidence-based process and evidence-based outcome. There is a need for a clear statement of what Evidence-Based Practice (EBP means, a description of the skills required to practise in an evidence-based manner and a curriculum that outlines the minimum requirements for training health professionals in EBP. This consensus statement is based on current literature and incorporating the experience of delegates attending the 2003 Conference of Evidence-Based Health Care Teachers and Developers ("Signposting the future of EBHC". Discussion Evidence-Based Practice has evolved in both scope and definition. Evidence-Based Practice (EBP requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources. Health care professionals must be able to gain, assess, apply and integrate new knowledge and have the ability to adapt to changing circumstances throughout their professional life. Curricula to deliver these aptitudes need to be grounded in the five-step model of EBP, and informed by ongoing research. Core assessment tools for each of the steps should continue to be developed, validated, and made freely available. Summary All health care professionals need to understand the principles of EBP, recognise EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence. Without these skills, professionals and organisations will find it difficult to provide 'best practice'.

  20. Identifying attitudes, beliefs and reported practices of nurses and doctors as immunization providers. (United States)

    Pielak, Karen L; McIntyre, Cheryl C; Tu, Andrew W; Remple, Valencia P; Halperin, Beth; Buxton, Jane A


    This paper is a report of a study conducted to examine the attitudes, beliefs, behavioural intentions and self-reported behaviour of nurses and physicians relating to key immunization behaviours and compare the findings for nurses and physicians. Immunization is an important and effective public health intervention. Understanding immunization providers' attitudes and beliefs toward immunization has the potential to improve educational efforts and lead to behavioural change. A postal survey was conducted with all immunization providers in British Columbia, Canada, in 2005. The survey elicited data on demographics, practice characteristics, attitudes, perceived social norms and perceived behavioural control related to key immunization behaviours. Responses were received from 344 nurses and 349 physicians. The response rate was 67% for nurses and 22% for physicians. More nurses than physicians thought that administering all recommended vaccines at one visit was important (89.2% vs. 63.2%P vaccines (82.4% vs. 48.7%P vaccines at one visit (98.8% vs. 73.8%P vaccine each year was important (88.9%, 87.1% respectively P = 0.65). The foundational work done to develop the survey tool can be used to modify it so that survey findings can be validated according to the Theory of Planned Behaviour. The results could inform the development of behavioural change interventions targeting the identified determinants of immunization provider behaviour.

  1. Transformational leadership required to design and sustain evidence-based practice: a system exemplar. (United States)

    Everett, Linda Q; Sitterding, Mary Cathryn


    In a pay-for-performance environment, implementing and sustaining evidence-based practice (EBP) is no longer a luxury but a necessity. A critical driving force for EBP is that our communities-the people we serve-expect to receive care based on the best available evidence. Transformational nursing leadership is required to create an infrastructure that influences organizational factors, processes and expectations, thus enabling the sustainability of EBP. The American Nurses Credentialing Center and the American Organization of Nurse Executives provide a framework for nursing leaders to consider when designing EBP implementation structures. This exemplar illustrates nursing leadership competencies with regard to implementation and sustainability of EBP within a multihospital system.

  2. Evidence-Based Dentistry in Everyday Practice. (United States)

    Gudray, Kiran; Walmsley, Anthony Damien


    This article informs readers of a method of implementing evidence-based dentistry in practice. Following these steps, practitioners should be able to use this skill in an efficient manner. The importance of evidence-based dentistry and its relevance to situations encountered in everyday practice is also highlighted. Clinical relevance: This article highlights a series of steps to be followed by practitioners to ensure that treatment provided is supported by the most recent, good quality evidence.

  3. Hospital readiness for undertaking evidence-based practice: A survey. (United States)

    Nguyen, Thi Ngoc Minh; Wilson, Anne


    Despite the fact that evidence-based practice has increasing emphasis in health care, organizations are not always prepared for its implementation. Identifying organizational preparedness for implementing evidence-based practice is desirable prior to application. A cross-sectional survey was developed to explore nurses' perception of organizational support for evidence-based practice and was implemented via a self-enumerated survey completed by 234 nurses. Data were analyzed with descriptive and inferential statistics. Nurses reported that implementation of evidence-based practice is complex and fraught with challenges because of a lack of organizational support. A conceptual framework comprising three key factors: information resources, nursing leadership, and organizational infrastructure was proposed to assist health authorities in the implementation of evidence-based practice. Suggestions of how organizations can be more supportive of research utilization in practice include establishing a library, journal clubs/mentoring programs, nurses' involvement in decision-making at unit level, and a local nursing association. © 2016 John Wiley & Sons Australia, Ltd.

  4. Evidence based contraceptive choices. (United States)

    Scott, Alison; Glasier, Anna


    People who attend for contraceptive advice have usually formulated an idea of the type of contraceptive that will suit them best. They may wish to use a method that is long, short or medium acting. These are defined as follows: Long-acting method requires renewal no more frequently than every 3 months (e.g. injectable or intrauterine). Short-acting method used daily or with every act of intercourse (e.g. pills, condoms) Medium-acting method requires renewal weekly or monthly (e.g. ring, patch). For men the choice is limited to condoms or vasectomy. Some women do not wish to use hormonal preparations or have an intrauterine device (IUD) or implant inserted. There may also be cultural influences making certain methods of contraception unacceptable. Each of these factors influences the final decision of which method of contraception is decided upon. In addition to taking a full medical and sexual history to identify any risks to the individual's health, which might be increased by a particular contraceptive, time must be spent discussing the options available. It is important to ensure that there is a full understanding of the advantages and disadvantages of each method. The most successful contraceptive method is likely to be the one that the woman (or man) chooses, rather than the one the clinician chooses for them. Access for women to contraception can be improved by having convenient clinic times and service developments such as nurse prescribing and Patient Group Directions.

  5. Accreditation and certification for evidence-based design. (United States)

    Stichler, Jaynelle F


    The Evidence-Based Design Accreditation and Certification (EDAC) is a professional certification that validates that individuals have a core body of knowledge and experience necessary to lead and engage in an evidence-based design process for healthcare facilities. This bimonthly department expands nurse leaders' knowledge and competencies in health facility design and enables them to lead in design efforts. In this article, the vision and mission of EDAC and specific content are shared to increase nurse leaders' awareness of the certification when interviewing prospective architectural firms or for nurse leaders who aspire to have a career in the healthcare design field.

  6. Moral distress among Ugandan nurses providing HIV care: a critical ethnography. (United States)

    Harrowing, Jean N; Mill, Judy


    The phenomenon of moral distress among nurses has been described in a variety of high-income countries and practice settings. Defined as the biopsychosocial, cognitive, and behavioural effects experienced by clinicians when their values are compromised by internal or external constraints, it results from the inability to provide the desired care to patients. No research has been reported that addresses moral distress in severely resource-challenged regions such as sub-Saharan Africa. To describe the manifestation and impact of moral distress as it was experienced by Ugandan nurses who provided care to HIV-infected or -affected people. A critical ethnography was conducted with 24 acute care and public health nurses at a large referral centre in Uganda. Data were collected through interviews, observation, and focus group discussions. Participants described their passion for nursing and commitment to patients. They experienced moral distress when a lack of resources put patients' wellbeing at risk. The trauma imposed by systemic challenges on the nursing profession was acknowledged, as was the perception that the public blamed nurses for poor patient outcomes. However, participants were determined to serve to the best of their abilities and to take satisfaction from any contributions they were able to make. They cited the importance of education in the development of their capacity to provide care with a positive attitude, and demonstrated a collective resilience as they discussed strategies for addressing issues that affected them and their colleagues. The experience of moral distress among nurses in Uganda differed somewhat from the experience of nurses in high-income countries. Constraints imposed by the inability to implement skills and knowledge to their fullest extent, as well as a lack of resources and infrastructure may result in the omission of care for patients. Moral distress appears to manifest within a relational and contextual environment and

  7. The Price per Prospective Consumer of Providing Therapist Training and Consultation in Seven Evidence-Based Treatments within a Large Public Behavioral Health System: An Example Cost-Analysis Metric

    Directory of Open Access Journals (Sweden)

    Kelsie H. Okamura


    Full Text Available ObjectivePublic-sector behavioral health systems seeking to implement evidence-based treatments (EBTs may face challenges selecting EBTs given their limited resources. This study describes and illustrates one method to calculate cost related to training and consultation to assist system-level decisions about which EBTs to select.MethodsTraining, consultation, and indirect labor costs were calculated for seven commonly implemented EBTs. Using extant literature, we then estimated the diagnoses and populations for which each EBT was indicated. Diagnostic and demographic information from Medicaid claims data were obtained from a large behavioral health payer organization and used to estimate the number of covered people with whom the EBT could be used and to calculate implementation-associated costs per consumer.ResultsFindings suggest substantial cost to therapists and service systems related to EBT training and consultation. Training and consultation costs varied by EBT, from Dialectical Behavior Therapy at $238.07 to Cognitive Behavioral Therapy at $0.18 per potential consumer served. Total cost did not correspond with the number of prospective consumers served by an EBT.ConclusionA cost-metric that accounts for the prospective recipients of a given EBT within a given population may provide insight into how systems should prioritize training efforts. Future policy should consider the financial burden of EBT implementation in relation to the context of the population being served and begin a dialog in creating incentives for EBT use.

  8. The use of position statements in teaching best practices in nursing. (United States)

    De Natale, Mary Lou; Malloy, Suzanne E


    The use of nursing position statements to guide nursing students' discovery of nursing practice was found to be an effective teaching strategy in preparing future clinicians. Nurse educators, seeking to develop strategies for applying research to practice, can use nursing specialty organizations' position statements to promote nursing knowledge dissemination and provide an avenue for sharing evidence-based practice. This article reports on the development of position statements, obstacles to their dissemination, and offers recommendations for nurse educators.

  9. The Nursing Dimension of Providing Palliative Care to Children and Adolescents with Cancer

    Directory of Open Access Journals (Sweden)

    Sharron L. Docherty


    Full Text Available Palliative care for children and adolescents with cancer includes interventions that focus on the relief of suffering, optimization of function, and improvement of quality of life at any and all stages of disease. This care is most effectively provided by a multidisciplinary team. Nurses perform an integral role on that team by identifying symptoms, providing care coordination, and assuring clear communication. Several basic tenets appear essential to the provision of optimal palliative care. First, palliative care should be administered concurrently with curative therapy beginning at diagnosis and assuming a more significant role at end of life. This treatment approach, recommended by many medical societies, has been associated with numerous benefits including longer survival. Second, realistic, objective goals of care must be developed. A clear understanding of the prognosis by the patient, family, and all members of the medical team is essential to the development of these goals. The pediatric oncology nurse is pivotal in developing these goals and assuring that they are adhered to across all specialties. Third, effective therapies to prevent and relieve the symptoms of suffering must be provided. This can only be accomplished with accurate and repeated assessments. The pediatric oncology nurse is vital in providing these assessments and must possess a working knowledge of the most common symptoms associated with suffering. With a basic understanding of these palliative care principles and competency in the core skills required for this care, the pediatric oncology nurse will optimize quality of life for children and adolescents with cancer.

  10. Development of the Psychiatric Nursing Intervention Providing Structure: An International Delphi Study

    NARCIS (Netherlands)

    Voogt, L.A.; Nugter, A.; Achterberg, T. van; Goossens, P.J.J.


    BACKGROUND: Psychiatric nurses commonly refer to "providing structure" (PS) as a key intervention. But no consensus exists about what PS entails. PS can be understood as a complex intervention. In four previous studies, a definition, activities, and context variables were described that were

  11. Corroborating evidence-based medicine. (United States)

    Mebius, Alexander


    Proponents of evidence-based medicine (EBM) have argued convincingly for applying this scientific method to medicine. However, the current methodological framework of the EBM movement has recently been called into question, especially in epidemiology and the philosophy of science. The debate has focused on whether the methodology of randomized controlled trials provides the best evidence available. This paper attempts to shift the focus of the debate by arguing that clinical reasoning involves a patchwork of evidential approaches and that the emphasis on evidence hierarchies of methodology fails to lend credence to the common practice of corroboration in medicine. I argue that the strength of evidence lies in the evidence itself, and not the methodology used to obtain that evidence. Ultimately, when it comes to evaluating the effectiveness of medical interventions, it is the evidence obtained from the methodology rather than the methodology that should establish the strength of the evidence. © 2014 John Wiley & Sons, Ltd.

  12. The epidemiology of skin care provided by nurses at home: a multicentre prevalence study. (United States)

    Kottner, Jan; Boronat, Xavier; Blume-Peytavi, Ulrike; Lahmann, Nils; Suhr, Ralf


    The aim of this study was to estimate the frequencies and patterns of skin care and applied skin care products in the home care nursing setting in Germany. Skin care belongs to the core activities of nursing practice. Especially in aged and long-term care settings, clients are vulnerable to various skin conditions. Dry skin is one of the most prevalent problems. Using mild skin cleansers and the regular application of moisturizing leave-on products is recommended. Until today, there are no quantitative empirical data about nursing skin care practice at home in the community. A multicentre cross-sectional study was conducted in July 2012. Home care clients from the German home care nursing setting were randomly selected. Instructed nurse raters performed the data collection using standardized forms. Variables included demographics, skin care needs and skin caring activities. Approximately 60% of home care clients received skin care interventions. The majority were washed and two-thirds received a leave-on product once daily. There was large heterogeneity in cleansing and skin care product use. Most often the product labels were unknown or product types were selected haphazardly. Skin care interventions play a significant role in home care and nurses have a considerable responsibility for skin health. Skin care provided does not meet recent recommendations. The importance of targeted skin cleansing and care might be underestimated. There are a confusing variety of skin care products available and often the labels provide little information regarding the ingredients or guidance about how they affect skin health. © 2014 John Wiley & Sons Ltd.

  13. Educating advanced practice nurses for collaborative practice in the multidisciplinary provider team. (United States)

    Spain, Margaret P; DeCristofaro, Claire; Smith, Carol A


    To describe the use of a clinical decision-making work sheet as a tool to teach communication skills to advanced practice nurse (APN) students. Achievement of competencies in communication and documentation that utilize language and communication strategies that are shared with other health professionals promotes effective collaborative practice among members of the multidisciplinary provider team. Review of the recent Institute of Medicine report on health professions education and other health professional literature. The Clinical Decision-Making Work Sheet helps APN students effectively communicate in real-world clinical settings. The clinical work sheet allows nurse practitioner students to communicate more effectively and efficiently, using a vocabulary that is shared with other members of the multidisciplinary health care provider team. Use of the tool in students' clinical-rotation settings facilitates effective application and refinement of the clinical decision-making skills that students learned in the advanced health assessment course. Faculty have the responsibility to assist nurses as they transition from traditional nursing to APN roles. The work sheet facilitates learning the common language for data collection, clinical decision making, documentation, and reporting that is shared with other health professionals. Using the tool, students learn to efficiently organize information that supports communication and documentation that enhances their clinical problem-solving skills. Case presentation and documentation using the work sheet provide a basis for preceptor and student interaction and for student evaluation.

  14. Sources of moral distress for nursing staff providing care to residents with dementia. (United States)

    Spenceley, Shannon; Witcher, Chad Sg; Hagen, Brad; Hall, Barry; Kardolus-Wilson, Arron


    The World Health Organization estimates the number of people living with dementia at approximately 35.6 million; they project a doubling of this number by 2030 and tripling by 2050. Although the majority of people living with a dementia live in the community, residential facility care by nursing care providers is a significant component of the dementia journey in most countries. Research has also shown that caring for persons with dementia can be emotionally, physically, and ethically challenging, and that turnover in nursing staff in residential care settings tends to be high. Moral distress has been explored in a variety of settings where nurses provide acute or intensive care. The concept, however, has not previously been explored in residential facility care settings, particularly as related to the care of persons with dementia. In this paper, we explore moral distress in these settings, using Nathaniel's definition of moral distress: the pain or anguish affecting the mind, body, or relationships in response to a situation in which the person is aware of a moral problem, acknowledges moral responsibility, makes a moral judgment about the correct action and yet, as a result of real or perceived constraints, cannot do what is thought to be right. We report findings from a qualitative study of moral distress in a single health region in a Canadian province. Our aim in this paper is to share findings that elucidate the sources of moral distress experienced by nursing care providers in the residential care of people living with dementia.

  15. Information provision in medical libraries: An evidence based ...

    African Journals Online (AJOL)

    The paper examined information provision in special libraries such as medical libraries. It provides an overview of evidence based practice as a concept for information provision by librarians. It specifically proffers meaning to the term evidence as used in evidence based practice and to evidence based medicine from where ...

  16. Evidence-based clinical practice

    DEFF Research Database (Denmark)

    Gluud, Christian


    Evidence-based medicine combines the patient's preferences with clinical experience and the best research evidence. Randomized clinical trials are considered the most valid research design for evaluating health-care interventions. However, empirical research shows that intervention effects may...... practice. By investments in education, applied research, and The Cochrane Collaboration, evidence-based medicine may form a stronger basis for clinical practice....

  17. [Experience of an interdisciplinary anesthesiology and nursing team for providing anesthesia outside the operating room]. (United States)

    Peláez, R; Aguilar, J L; Segura, C; Fermández, S; Mendiola, M A; Forner, J C


    To report on the creation and development of an interdisciplinary anesthesiology and nursing team to provide anesthesia outside the operating room. We describe the creation of an interdisciplinary team and preanesthesia evaluation protocols for using nurses specializing in anesthesia for procedures outside the operating room. We analyzed the anesthetic procedures performed outside the operating room, the rate of suspensions due to failure of the procedure, and their impact on the rate of associated complications, from October 2006 to October 2007. Since the start of the project, 586 procedures outside the operating room have been performed. No suspensions or delays were observed that were due to comorbidity not detected in the preanesthesia evaluation carried out by the nurses. The incidences of complications and inadequate sedations were comparable to those reported for other similar interdisciplinary groups in this area. The creation of an interdisciplinary team of anesthesiologists and specialized nurses for providing anesthesia outside the operating room optimizes resources and improves routine clinical practice. It has allowed for universal preanesthesia evaluation, improved the distribution of resources, and proven a stimulus to the care-giving process.

  18. “Evidence of me” in evidence based medicine?


    Lockwood, Susan


    Evidence based medicine provides independent, validated advice about treatment options, but does it take sufficient account of individual patients' values to provide them with an optimal health outcome?

  19. Evidence-based guidelines

    DEFF Research Database (Denmark)

    Rovira, Àlex; Wattjes, Mike P; Tintoré, Mar


    The clinical use of MRI in patients with multiple sclerosis (MS) has advanced markedly over the past few years. Technical improvements and continuously emerging data from clinical trials and observational studies have contributed to the enhanced performance of this tool for achieving a prompt...... diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal...... of MRI in clinical practice for the diagnosis of MS....

  20. Evidence-Based Medicine: Rhinoplasty. (United States)

    Lee, Matthew K; Most, Sam P


    Evidence-based medicine has become increasingly prominent in the climate of modern day healthcare. The practice of evidence-based medicine involves the integration of the best available evidence with clinical experience and expertise to help guide clinical decision-making. The essential tenets of evidence-based medicine can be applied to both functional and aesthetic rhinoplasty. Current outcome measures in functional and aesthetic rhinoplasty, including objective, subjective, and clinician-reported measures, is summarized and the current data is reviewed. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Nurses' attitudes toward aging and older adults--examining attitudes and practices among health services providers in Australia. (United States)

    Wells, Yvonne; Foreman, Peter; Gething, Lindsay; Petralia, Walter


    Data from an applied research project on ageism among health professionals were used to examine nurses' attitudes toward aging and working with older adults. Nurses were compared with groups of other health professionals, and sources of variation within the nurses (e.g., employer, work setting, gerontology education) were examined. Nurses had less accurate knowledge of aging than other health professionals. Nurses expressed higher anxiety about aging and were more likely to believe working with older adults was associated with low esteem in the profession. Nurses were more likely to hold positive attitudes if they worked for a service provider rather than an employment agency, had gerontology education, and worked outside the residential care sector. Improving education in gerontology is an important strategy in improving the attitudes of the profession toward older adults and could help to address nursing shortages in this sector.

  2. Psychosocial Care Provided by Physicians and Nurses in Palliative Care: A Mixed Methods Study. (United States)

    Fan, Sheng-Yu; Lin, I-Mei; Hsieh, Jyh-Gang; Chang, Chih-Jung


    Psychosocial care is an important component of palliative care, which is also provided by physicians and nurses. The aim of this study was to explore the experiences of physicians and nurses in palliative care regarding the process of psychosocial care, the difficulties, and the support needs from "psychosocial care professionals." A two-phase mixed methods study was conducted. In the first phase, 16 physicians and nurses with palliative care experience were recruited. A semi-structured interview was used to collect data about their experience of providing psychosocial care, and these were analyzed using thematic analysis. In the second phase, 88 physicians and nurses completed an online survey that was developed from the qualitative results. Qualitative results revealed three themes: 1) the contents of psychosocial care included not only disease-related events but also emotional and family support, 2) providing psychosocial care was a dynamic process including assessment, interventions, and evaluation, and 3) there were difficulties from the participants themselves, patients and families, and the system. Participants also reflected on what they did and the influences of providing care on themselves. Quantitative results showed that the most common psychosocial care was discussion about the progress of the disease and future care plan; the difficulty was the long-term problems in families; and the psychosocial care professionals most needed were social workers and clinical/counseling psychologists. Understanding the process of psychosocial care and integrating it with specialized mental health care in a team could improve the quality of psychosocial care in palliative care. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  3. The diffusion of innovation in nursing regulatory policy: removing a barrier to medication administration training for child care providers. (United States)

    Torre, Carolyn T; Crowley, Angela A


    Safe medication administration is an essential component of high-quality child care. Its achievement in New Jersey was impeded by a controversy over whether teaching child care providers medication administration involves registered nurses in the process of nursing delegation. Through the theoretical framework of the Diffusion of Innovation, this paper examines how the interpretation of regulatory policy related to nursing practice in New Jersey was adjusted by the Board of Nursing following a similar interpretation of regulatory policy by the Board of Nursing in Connecticut. This adjustment enabled New Jersey nurses to continue medication administration training for child care providers. National data supporting the need for training child care providers in medication administration is presented, the Diffusion of Innovation paradigm is described; the Connecticut case and the New Jersey dilemma are discussed; the diffusion process between the two states is analyzed and an assessment of the need for further change is made.

  4. Australian practice nurses' perceptions of their role and competency to provide nutrition care to patients living with chronic disease. (United States)

    Cass, Sarah; Ball, Lauren; Leveritt, Michael


    Nutrition is important in the management of chronic disease, and practice nurses in the Australian primary care setting are increasingly providing nutrition care to patients living with chronic disease. The aim of the present study was to investigate practice nurses' perceptions of their role and competency to provide nutrition care to patients living with chronic disease in Australia. Twenty practice nurses currently employed in general practice participated in an individual semi-structured telephone interview. Interviews were transcribed verbatim and thematically analysed. Practice nurses perceived themselves to be in a prime position to provide opportunistic nutrition care to patients. Participants perceived that the ideal role of a practice nurse is to advocate for nutrition and provide a basic level of nutrition care to patients; however, the interpretation of the term 'basic' varied between participants. Participants perceived that practice nurses are highly trusted and approachable, which they valued as important characteristics for the provision of nutrition care. Barriers to providing nutrition care included time constraints, lack of nutrition knowledge and lack of confidence. Participants were concerned about the availability and accessibility of nutrition education opportunities for practice nurses. The present study has demonstrated that practice nurses perceive themselves as having a significant role in the provision of nutrition care to patients with chronic disease in the Australian primary care setting. Further investigation of strategies to enhance the effectiveness of nutrition care provision by practice nurses is warranted.

  5. Evidence-based cancer imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shinagare, Atul B.; Khorasani, Ramin [Dept. of Radiology, Brigham and Women' s Hospital, Boston (Korea, Republic of)


    With the advances in the field of oncology, imaging is increasingly used in the follow-up of cancer patients, leading to concerns about over-utilization. Therefore, it has become imperative to make imaging more evidence-based, efficient, cost-effective and equitable. This review explores the strategies and tools to make diagnostic imaging more evidence-based, mainly in the context of follow-up of cancer patients.

  6. Nurse care manager collaboration with community-based physicians providing diabetes care: a randomized controlled trial. (United States)

    Hiss, Roland G; Armbruster, Betty A; Gillard, Mary Lou; McClure, Leslie A


    The purpose of this study was to demonstrate the potential value of close collaboration at the office level of a nurse care manager with community-based primary care physicians in the care of adult patients with type 2 diabetes, particularly those physicians not affiliated with an integrated care system that some managed care organizations provide. Patients with type 2 diabetes were recruited from the general population of a large metropolitan area. Each received a comprehensive evaluation of his or her diabetes with results reported to patients and their physicians (basic intervention). A random one-half of patients were additionally assigned to individual counseling, problem identification, care planning, and management recommendations by a nurse care manager (individualized intervention). The patients receiving only the basic intervention served as the control group to those receiving the individualized intervention. Re-evaluation of all patients at 6 months after their entry into the study determined the effectiveness of the nurse-directed individualized intervention using A1C, blood pressure, and cholesterol as outcome measures. Of 220 patients recruited, 197 had type 2 diabetes, randomly assigned only the basic intervention (102 patients) or individualized intervention (95 patients). Postintervention data were obtained on 164 patients (83%). Significant improvement occurred in mean systolic blood pressure and A1C of all patients in the individualized but not the basic intervention only group. Patients with a systolic blood pressure>or=130 mm Hg at baseline showed improvement if they had more than 2 contacts with the study nurse but not if they had less than 2 contacts. A nurse care manager collaborating at the office level with community-based primary care physicians can enhance the care provided to adult patients with type 2 diabetes. For those many physicians not affiliated with an integrated care system featured by some managed care organizations, this

  7. Nurses' perception of the quality of care they provide to hospitalized drug addicts: testing the theory of reasoned action. (United States)

    Natan, Merav Ben; Beyil, Valery; Neta, Okev


    A correlational design was used to examine nursing staff attitudes and subjective norms manifested in intended and actual care of drug users based on the Theory of Reasoned Action. One hundred and thirty-five nursing staff from three central Israeli hospitals completed a questionnaire examining theory-based variables as well as sociodemographic and professional characteristics. Most respondents reported a high to very high level of actual or intended care of drug users. Nurses' stronger intentions to provide quality care to drug users were associated with more positive attitudes. Nursing staff members had moderately negative attitudes towards drug users. Nurses were found to hold negative stereotypes of drug addict patients and most considered the management of this group difficult. Positive attitudes towards drug users, perceived expectations of others and perceived correctness of the behaviour are important in their effect on the intention of nurses to provide high-quality care to hospitalized patients addicted to drugs.

  8. Stressors experienced by nurses providing end-of-life palliative care in the intensive care unit. (United States)

    Gélinas, Céline; Fillion, Lise; Robitaille, Marie-Anik; Truchon, Manon


    The purpose of this study was to describe stressors experienced by nurses in providing end-of-life palliative care (EoL/PC) in intensive care units (ICUs). A descriptive qualitative design was used. A total of 42 nurses from 5 ICUs in the province of Quebec, Canada, participated in 10 focus groups. Stressors were found to be clustered in 3 categories: organizational, professional, and emotional. The major organizational stressors were lack of a palliative care approach, interprofessional difficulty, lack of continuity in life-support and treatment plans, and conflicting demands. Professional stressors included lack of EoL/PC competencies and difficulty communicating with families and collaborating with the medical team. Emotional stressors were described as value conflicts, lack of emotional support, and dealing with patient and family suffering.The authors conclude that providing EoL/PC is stressful for ICU nurses and that education and support programs should be developed to ensure quality EoL/PC in the critical care environment.

  9. A model program: neonatal nurse practitioners providing community health care for high-risk infants. (United States)

    Vasquez, Elias Provencio; Pitts, Kathleen; Mejia, Nilson Enrique


    Perinatal drug exposure costs our communities millions of dollars each year in hospital fees and in services such as foster care, child protection, and drug treatment. Infants and their families in this group require substantial long-term health care and community resources. Neonatal health care providers should take an active role in developing and implementing home visitation programs to support early hospital discharge and continuity of care for these high-risk infants and their families. Neonatal nurse practitioners should prepare in the future to practice not only in secondary-- and tertiary--level neonatal centers, but also in follow-up clinics, long-term developmental centers, and the community This article describes a home intervention program delivered by neonatal nurse practitioners for high-risk infants and their mothers. The target population is infants exposed prenatally to drugs and/or alcohol.

  10. "Providing structure" as a psychiatric nursing intervention: a review of the literature. (United States)

    Voogt, L Amar; Nugter, Annet; Goossens, Peter J J; van Achterberg, Theo


    The focus is on a nursing intervention called "providing structure" (PS). This label does not exist in the Nursing Interventions Classification. The following three questions were asked: (a) How is PS defined? (b) What are the goals of PS? and (c) What is the evidence regarding the effectiveness of PS? A systematic literature review. Forty articles, predominantly qualitative studies of PS, were selected for review. Regarding PS, three elements were mentioned: to impose and maintain rules and limits; to assess the condition of the patient; and to interact with the patient. The goals for PS related to patient security, making expectations explicit, and recovering from illness. Major findings were reviewed, but little was found about the effectiveness of PS. © 2013 Wiley Periodicals, Inc.

  11. Evidence-based periodontal therapy: An overview (United States)

    Vijayalakshmi, R.; Anitha, V.; Ramakrishnan, T.; Sudhakar, Uma


    Dentists need to make clinical decisions based on limited scientific evidence. In clinical practice, a clinician must weigh a myriad of evidences every day. The goal of evidence-based dentistry is to help practitioners provide their patients with optimal care. This is achieved by integrating sound research evidence with personal clinical expertise and patient values to determine the best course of treatment. Periodontology has a rich background of research and scholarship. Therefore, efficient use of this wealth of research data needs to be a part of periodontal practice. Evidence-based periodontology aims to facilitate such an approach and it offers a bridge from science to clinical practice. The clinician must integrate the evidence with patient preference, scientific knowledge, and personal experience. Most important, it allows us to care for our patients. Therefore, evidence-based periodontology is a tool to support decision-making and integrating the best evidence available with clinical practice. PMID:20142947

  12. [Providing grief counseling to a major depressive elderly widower: a nurse's experience]. (United States)

    Chu, Hsiu-Ching; Chow, Philip C


    The death of a spouse is both a major loss and a tremendous life stressor for the partner left behind. Such has been shown to be particularly hard on the elderly. This article describes a nurse's experience caring for an elderly patient suffering from major depression resulting from the death of his wife. While providing nursing care to the client, the author, employing holistic nursing assessment, identified a reciprocal influence between his depressive symptoms and grief reaction. In applying the Inventory of Complicated Grief to ascertain grief reaction intensity to help the client discern between major depressive symptoms and grief reaction, the author found that the client (1) could not accept the loss of his wife, (2) had difficulty adjusting to life after his wife's death, and (3) faced a tense and distant relationship with his son. Such resulted in suicidal ideation and planning and feelings of loneliness, helplessness, hopelessness and incapability, which triggered major depression and a complicated grief reaction. Therefore, the author applied grief counseling to help the client accept the loss of his spouse, communicate his grief, overcome the difficult adjustment to life after his spouse's death, bid farewell to his wife, and establish new relationships. Such counseling gradually helped the client accept the inevitability of death and his wife's passing. To help the client establish new relationships under existing circumstances of negligible external support systems, the author encouraged the client to establish a new relationship with himself and integrate the old-age stage of life cycle naturally into his daily routine. Based on this care experience, we recommend psychiatric nurses assess cautiously the loss experience and grief reaction in elderly widowers under their care in order to provide timely grief counseling intervention to help the client pass quickly through the grieving phase and free him or her from the haze of depression.

  13. Factors associated with end-of-life by home-visit nursing-care providers in Japan. (United States)

    Nakanishi, Miharu; Niimura, Junko; Nishida, Atsushi


    Home-visit nursing-care services in Japan are expected to provide home hospice services for older patients with non-cancer diseases. The aim of the present study was to examine factors that contribute to the provision of end-of-life care by home-visit nursing-care providers in Japan. The present retrospective study was carried out using nationally representative cross-sectional data from the 2007, 2010, and 2013 Survey of Institutions and Establishments for Long-Term Care. A total of 138 008 randomly sampled home-visit nursing-care service users were included in this analysis. End-of-life care (study outcome) was defined as the provision of nursing-care within the last month of life. Of the 138 008 patients at home, 2280 (1.7%) received home-based nursing care within the last month of life, and end-of-life care was offered primarily to cancer patients (n = 1651; 72.4%). After accounting for patient characteristics, patients were more likely to receive end-of-life care when they used home-visit nursing-care providers that had a greater number of nursing staff or were located in a region with fewer hospital beds. Among home-visit nursing-care providers, the nursing staff ratio and the availability of hospital beds were related to the provision of end-of-life care. Home-visit nursing-care providers should establish specialist hospice care teams with enhanced staffing ratios to allow for the adequate provision of home-based end-of-life care. A community-based network between home-visit nursing-care providers and hospitals should also be established to attain an integrated end-of-life care system for elderly populations in regions with more hospital beds. Geriatr Gerontol Int 2017; 17: 991-998. © 2016 Japan Geriatrics Society.

  14. Diabetes nurse educators' experiences of providing care for women, with gestational diabetes mellitus, from disadvantaged backgrounds. (United States)

    Carolan, Mary


    To explore diabetes nurse educators' experiences of providing care for women, with gestational diabetes mellitus, from disadvantaged backgrounds and to gather information which would assist with the development of an educational programme that would support both women and diabetes educators. Rates of gestational diabetes mellitus have increased dramatically in recent years. This is concerning as gestational diabetes mellitus is linked to poorer pregnancy outcomes including hypertension, stillbirth, and nursery admission. Poorest outcomes occur among disadvantaged women. gestational diabetes mellitus is also associated with maternal type 2 diabetes and with child obesity and type 2 diabetes among offspring. Effective self-management of gestational diabetes mellitus reduces these risks. Diabetes nurse educators provide most education and support for gestational diabetes mellitus self-management. An interpretative phenomenological analysis approach, as espoused by Smith and Osborn (Qualitative Psychology: A Practical Guide to Research Methods, 2008, Sage, London, 51), provided the framework for this study. The views of six diabetes educators were explored through in-depth interviewing. Interviews were transcribed verbatim and analysed according to steps outlined by Smith and Osborn (Qualitative Psychology: A Practical Guide to Research Methods, 2008, Sage, London, 51). Three themes emerged from the data: (1) working in a suboptimal environment, (2) working to address the difficulties and (3) looking to the future. Throughout, the diabetes nurse educators sought opportunities to connect with women in their care and to make the educational content understandable and meaningful. Low literacy among disadvantaged women has a significant impact on their understanding of gestational diabetes mellitus information. In turn, catering for women with low literacy contributes to increased workloads for diabetes nurse educators, making them vulnerable to burnout. There is a need

  15. Professional quality of life of Japanese nurses/midwives providing abortion/childbirth care. (United States)

    Mizuno, Maki; Kinefuchi, Emiko; Kimura, Rumiko; Tsuda, Akiko


    This study explored the relationship between professional quality of life and emotion work and the major stress factors related to abortion care in Japanese obstetric and gynecological nurses and midwives. Between October 2011 and January 2012, questionnaires that included questions concerning eight stress factors, the Professional Quality of Life Scale, and the Japanese version of the Frankfurt Emotional Work Scale, were answered by 255 nurses and midwives working in abortion and childbirth services. Professional Quality of Life scores (compassion fatigue, compassion satisfaction, burnout) were significantly associated with stress factors and emotion work. Multiple regression analysis revealed that of all the evaluated variables, the Japanese version of the Frankfurt Emotional Work Scale score for negative emotions display was the most significant positive predictor of compassion fatigue and burnout. The stress factors "thinking that the aborted fetus deserved to live" and "difficulty in controlling emotions during abortion care" were associated with compassion fatigue. These findings indicate that providing abortion services is a highly distressing experience for nurses and midwives.

  16. Regrets associated with providing healthcare: qualitative study of experiences of hospital-based physicians and nurses.

    Directory of Open Access Journals (Sweden)

    Delphine S Courvoisier

    Full Text Available BACKGROUND: Regret is an unavoidable corollary of clinical practice. Physicians and nurses perform countless clinical decisions and actions, in a context characterised by time pressure, information overload, complexity and uncertainty. OBJECTIVE: To explore feelings associated with regretted clinical decisions or interventions of hospital-based physicians and nurses and to examine how these regrets are coped with. METHOD: Qualitative study of a volunteer sample of 12 physicians and 13 nurses from Swiss University Hospitals using semi-structured interviews and thematic analysis RESULTS: All interviewees reported at least one intense regret, which sometimes led to sleep problems, or taking sickness leave. Respondents also reported an accumulation effect of small and large regrets, which sometimes led to quitting one's unit or choosing another specialty. Respondents used diverse ways of coping with regrets, including changing their practices and seeking support from peers and family but also suppression of thoughts related to the situation and ruminations on the situation. Another coping strategy was acceptance of one's limits and of medicine's limits. Physicians reported that they avoided sharing with close colleagues because they felt they could lose their credibility. CONCLUSIONS: Since regret seems related to both positive and negative consequences, it is important to learn more about regret coping among healthcare providers and to determine whether training in coping strategies could help reduce negative consequences such as sleep problems, absenteeism, or turnover.

  17. A qualitative study on feedback provided by students in nurse education. (United States)

    Chan, Zenobia C Y; Stanley, David John; Meadus, Robert J; Chien, Wai Tong


    This study aims to help nurse educators/academics understand the perspectives and expectations of students providing their feedback to educators about teaching performance and subject quality. The aim of this study is to reveal students' voices regarding their feedback in nurse education in order to shed light on how the current student feedback practice may be modified. A qualitative study using focus group inquiry. Convenience sampling was adopted and participants recruited from one school of nursing in Hong Kong. A total of 66 nursing students from two pre-registration programs were recruited for seven focus group interviews: one group of Year 1 students (n=21), two groups of Year 3 students (n=27), and four groups of Final Year students (n=18). The interviews were guided by a semi-structured interview guideline and the interview narratives were processed through content analysis. The trustworthiness of this study was guaranteed through peer checking, research meetings, and an audit trail. The participants' privacy was protected throughout the study. Four core themes were discerned based on the narratives of the focus group interviews: (1) "timing of collecting feedback at more than one time point"; (2) "modify the questions being asked in collecting student feedback"; (3) "are electronic means of collecting feedback good enough?; and (4) "what will be next for student feedback?". This study is significant in the following three domains: 1) it contributed to student feedback because it examined the issue from a student's perspective; 2) it explored the timing and channels for collecting feedback from the students' point of view; and 3) it showed the preferred uses of student feedback. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  18. Impact of advanced practice providers (nurse practitioners and physician assistants) on surgical residents' critical care experience. (United States)

    Kahn, Steven A; Davis, Sarah A; Banes, Caroline T; Dennis, Bradley M; May, Addison K; Gunter, Oliver D


    Teaching hospitals often employ advanced practice providers (nurse practitioners and physician assistants or APPs) to counteract residents' work-hour restrictions. With increased utilization of APPs in labor-intense areas, such as intensive care units (ICUs), APPs may have an impact on resident education and experience. No studies have investigated the direct role an APP plays on the training experience of a surgical resident in the ICU. An institutional review board-approved survey was emailed to residents in Accreditation Council for Graduate Medical Education-accredited general surgery programs. Surveys asked about demographics, residency and/or ICU characteristics, and the effects of APPs on patient care, workflow, and educational experience. Regression analysis determined predictors of resident perception. A total of 354 of 1178 residents responded to the survey (30%). Some residents felt that nurses calling APPs preferentially for patient-care issues interfered with education (17%) and residents' ability to follow patients (12%) and was associated with overall detrimental effects to ICU experience on regression (odds ratio, 3.7; confidence interval, 1.5-9.1). Most residents reported positive effects of APPs, such as reduced resident workload (79.8%), teaching protocols and/or guidelines (60.3%), enhanced patient care (60.3%), and enhanced communication (50.5%). When asked how APPs affected their overall ICU experience, 48.4% reported positive effects, 20.6% reported "no effect," and 31% reported detrimental effects. Only a minority of residents perceived that APPs detract from training, particularly those who felt excluded when nurses preferentially contact APPs with patient-care issues. APPs have the potential to enhance training and ICU experience, as reflected in many of the responses. Strategies to maintain direct nurse and resident communication might preserve residents' perception of the educational value of APPs. Copyright © 2015 Elsevier Inc. All

  19. Emergency medical service, nursing, and physician providers' perspectives on delirium identification and management. (United States)

    LaMantia, Michael A; Messina, Frank C; Jhanji, Shola; Nazir, Arif; Maina, Mungai; McGuire, Siobhan; Hobgood, Cherri D; Miller, Douglas K


    Purpose of the study The study objective was to understand providers' perceptions regarding identifying and treating older adults with delirium, a common complication of acute illness in persons with dementia, in the pre-hospital and emergency department environments. Design and methods The authors conducted structured focus group interviews with separate groups of emergency medical services staff, emergency nurses, and emergency physicians. Recordings of each session were transcribed, coded, and analyzed for themes with representative supporting quotations identified. Results Providers shared that the busy emergency department environment was the largest challenge to delirium recognition and treatment. When describing delirium, participants frequently detailed hyperactive features of delirium, rather than hypoactive features. Participants shared that they employed no clear diagnostic strategy for identifying the condition and that they used heterogeneous approaches to treat the condition. To improve care for older adults with delirium, emergency nurses identified the need for more training around the management of the condition. Emergency medical services providers identified the need for more support in managing agitated patients when in transport to the hospital and more guidance from emergency physicians on what information to collect from the patient's home environment. Emergency physicians felt that delirium care would be improved if they could have baseline mental status data on their patients and if they had access to a simple, accurate diagnostic tool for the condition. Implications Emergency medical services providers, emergency nurses, and emergency physicians frequently encounter delirious patients, but do not employ clear diagnostic strategies for identifying the condition and have varying levels of comfort in managing the condition. Clear steps should be taken to improve delirium care in the emergency department including the development of mechanisms

  20. Provider category and quality of care in the Norwegian nursing home industry

    Directory of Open Access Journals (Sweden)

    Astri Drange Hole


    Full Text Available This paper examines empirically if there is a link between quality of care in the Norwegian nursing home industry and exposure of the industry to competition. Exposing public care to competition implies that the responsibility for providing care services is shared between public authorities and private actors. In Norway, exposure to competition means tender competition. Suppliers bid for a contract issued by the Norwegian authorities for a limited number of years. Quality of care in an institution is the major competitive factor. The provider categories of elderly care are: 1 care provided by institutions run by municipalities, 2 care provided by institutions run by private companies, which have won a tender competition, 3 care provided by institutions run by private companies owned by private families, voluntary religious or idealistic organizations. Nurse-to-patient ratio is used as a proxy for quality of care. The regression analysis indicates a relationship between quality of care and exposure to competition. The quality of care in provider category 2 is significantly lower than in provider category 1, but there are more variations in the quality of care in provider category 1 than in provider category 2. We find the lowest quality of care in provider category 1. There is also a relationship between the quality of care in an institution and the educational level of the staff, the location, the workforce, and the size of an institution. Finally, there is a relationship between the quality of care in an institution and the real and the required capacity, and the financial status in a region.

  1. Influenza vaccination and decisional conflict among regulated and unregulated direct nursing care providers in long-term-care homes. (United States)

    Sullivan, Shannon M; Pierrynowski-Gallant, Donna; Chambers, Larry; O'Connor, Annette; Bowman, Sherry; McNeil, Shelly; Strang, Robert; Knoefel, Frank


    The purpose of this study was to determine whether direct nursing care providers have decisional conflict about receiving influenza vaccinations and characteristics associated with decisional conflict. The researchers used a self-administered questionnaire mailed to direct nursing care providers in two long-term-care organizations. Most direct nursing care providers in both organizations (80% and 93%, respectively) intended to get the influenza vaccine. Unregulated direct nursing care providers had more decisional conflict than regulated providers, especially related to feeling uninformed about the pros and cons of influenza vaccination. Unclear valuing of the pros and cons of influenza vaccination was related to the age of the direct care providers in both organizations. Decisional conflict and influenza vaccination practices may be determined, in part, by age and by the culture of a health care organization. A decision aid to improve knowledge and clarify values may improve decision quality and increase influenza vaccination rates.

  2. Evidence-based medicine Training: Kazakhstan experience. (United States)

    Kamalbekova, G; Kalieva, M


    Understanding principles of evidence-based medicine is of vital importance for improving quality of care, promoting public health and health system development. Understanding principles of evidence-based medicine allows using the most powerful information source, which have ever existed in medicine. To evaluate the effectiveness of teaching Evidence-Based Medicine, including long-term outcomes of training. The study was conducted at the Medical University of Astana, where the Scientific and Educational Center of Evidence-Based Medicine was established in 2010 with the help of the corresponding project of the World Bank. The participants of the study were the faculty trained in Evidence-Based Medicine at the workshop "Introduction to Evidence-Based Medicine" for the period of 2010-2015 years. There were a total of 16 workshops during the period, and 323 employees were trained. All participants were asked to complete our questionnaire two times: before the training - pre-training (to determine the initial level of a listener) and after the training - post-training (to determine the acquired level and get the feedback). Questionnaires were prepared in such a way, that the majority of questions before and after training were identical. Thus, it provided a clear picture of the effectiveness of training. Questions in the survey were open-ended so that the respondents had the opportunity to freely and fully express their views. The main part of the questionnaires included the following questions: "Do you understand what evidence-based medicine is", "how do you understand what the study design means", "what is randomization", "how research is classified", "do you know the steps of decision-making according to Evidence-Based Medicine, list them", "what literature do you prefer to use when searching for information (print, electronic, etc.)", "what resources on the Internet do you prefer to use". Only 30-35% of respondents gave correct answers to the questions on

  3. Evidence Based Practice: Valuable and Successful Examples from ...

    African Journals Online (AJOL)

    While research is needed and necessary, promoting the value of evidence-based practice (EBP), quality improvement (QI) and project evaluation (PE) initiatives could rapidly and economically further the development of nursing and midwifery disciplines globally, perhaps especially in resource constrained settings.

  4. A Quality Improvement Project to Improve Education Provided by Nurses to ED Patients Prescribed Opioid Analgesics at Discharge. (United States)

    Waszak, Daria L; Mitchell, Ann M; Ren, Dianxu; Fennimore, Laura A


    The opioid crisis continues to take an unprecedented number of lives and is the top cause of injury death in the United States. The emergency department is a setting where patients with pain seek care and may be prescribed an opioid, yet many patients do not receive evidence-based education about taking their opioid safely. Like many communities across the country, Allegheny County, Pennsylvania, has experienced an increased rate of opioid overdoses; from 2015-2016, the number of opioid-related overdose deaths in the county increased by 44%. This quality improvement project is the implementation of a nurse-delivered, evidence-based education initiative for patients prescribed an opioid in an emergency department. Nurses were briefly trained on opioid safety and patient education, then over 12 weeks, delivered the dual-modal (verbal and written) education with a patient teach-back to verify comprehension. Nurses who completed the project training on opioid safety and patient education had a statistically significant improvement in their knowledge. Patient satisfaction surveys showed 100% of patients reported clear understanding of how to take their pain medication, and out of the patients receiving the opioid pain education for the first time, 88.2% learned something new about how to safely take, store, or dispose of their pain medication. Improving the delivery of opioid prescription education at emergency department discharge will enhance patient knowledge and promote safety, which may help mitigate the opioid crisis by reducing the rate of opioid use disorder and accidental overdoses. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Feasibility of Providing Safe Mouth Care and Collecting Oral and Fecal Microbiome Samples from Nursing Home Residents with Dysphagia: Proof of Concept Study. (United States)

    Jablonski, Rita A; Winstead, Vicki; Azuero, Andres; Ptacek, Travis; Jones-Townsend, Corteza; Byrd, Elizabeth; Geisinger, Maria L; Morrow, Casey


    Individuals with dysphagia who reside in nursing homes often receive inadequate mouth care and experience poor oral health. From a policy perspective, the combination of absent evidence-based mouth care protocols coupled with insufficient dental coverage create a pool of individuals at great risk for preventable infectious illnesses that contribute to high health care costs. The purpose of the current study was to determine (a) the safety of a mouth care protocol tailored for individuals with dysphagia residing in nursing homes without access to suction equipment, and (b) the feasibility of collecting oral and fecal samples for microbiota analyses. The mouth care protocol resulted in improved oral hygiene without aspiration, and oral and fecal samples were safely collected from participants. Policies supporting ongoing testing of evidence-based mouth care protocols for individuals with dysphagia are important to improve quality, demonstrate efficacy, and save health care costs. [Journal of Gerontological Nursing, 43(9), 9-15.]. Copyright 2017, SLACK Incorporated.

  6. Evidence based practice: perspectives of Iranian urologists. (United States)

    Hajebrahimi, Sakineh; Sadeghi-Ghyassi, Fatemeh; Olfati, Nahid; Dastgiri, Saeed; Maghbouli, Leili


    To determine the attitudes and beliefs of Iranian urologists toward Evidence Based Medicine (EBM) and investigation of the barriers of evidence based practice (EBP). A self- administrated, Likert scale questionnaire designed in Persian and filled up by censuses selected urologist from Iranian Urology Association (IUA). Data were entered to Predictive Analytics Soft Ware version 18.0 and descriptive statistics were obtained for all parts of the questionnaire. A total of 111 out of 500 Iranian urologists who attended in IUA annual meeting, responded to the questionnaires. Mean attitude score of respondents was 30.4 (SD: 5.7, range 16-40). Attitude score showed statistically significant association to previous participation in EBM workshops (P = .01). Of participants 96% believed EBP will improve patient care and 76.2% of them appreciated the impact of use of research utilization and application of evidence based guidelines on clinical decision making and the outcome of surgery. The main barriers to EBP stated as lack of time (64.8%), facilities (53.4%), and training in EBM (29.4%). The urologists have positive attitudes towards EBP. However, regarding lack of time, pre-appraised databases or EBP guidelines can be helpful. Evidence based workshops and familiarity with evidence databases is recommended for Iranian urologists. In addition, health care system and policy makers could play a major role to provide a culture of EBP.

  7. Implementation of Symptom Protocols for Nurses Providing Telephone‐Based Cancer Symptom Management: A Comparative Case Study (United States)

    Green, Esther; Ballantyne, Barbara; Tarasuk, Joy; Skrutkowski, Myriam; Carley, Meg; Chapman, Kim; Kuziemsky, Craig; Kolari, Erin; Sabo, Brenda; Saucier, Andréanne; Shaw, Tara; Tardif, Lucie; Truant, Tracy; Cummings, Greta G.; Howell, Doris


    ABSTRACT Background The pan‐Canadian Oncology Symptom Triage and Remote Support (COSTaRS) team developed 13 evidence‐informed protocols for symptom management. Aim To build an effective and sustainable approach for implementing the COSTaRS protocols for nurses providing telephone‐based symptom support to cancer patients. Methods A comparative case study was guided by the Knowledge to Action Framework. Three cases were created for three Canadian oncology programs that have nurses providing telephone support. Teams of researchers and knowledge users: (a) assessed barriers and facilitators influencing protocol use, (b) adapted protocols for local use, (c) intervened to address barriers, (d) monitored use, and (e) assessed barriers and facilitators influencing sustained use. Analysis was within and across cases. Results At baseline, >85% nurses rated protocols positively but barriers were identified (64‐80% needed training). Patients and families identified similar barriers and thought protocols would enhance consistency among nurses teaching self‐management. Twenty‐two COSTaRS workshops reached 85% to 97% of targeted nurses (N = 119). Nurses felt more confident with symptom management and using the COSTaRS protocols (p nursing requires a tailored approach. A multifaceted intervention approach increased nurses’ use of evidence‐informed protocols during telephone calls with patients about symptoms. Training and other interventions improved nurses’ confidence with using COSTaRS protocols and their uptake was evident in some documented telephone calls. Protocols could be adapted for use by patients and nurses globally. PMID:27243574

  8. [Living With Tolerable Burden: Exploring the Ethical Self of Nurses Who Provide End-of-Life Care]. (United States)

    Liu, Ying-Chun; Tai, Yu-Lun; Chiang, Hsien-Hsien


    Providing end-of-life (EOL) care elicits complex emotions in nurses in the context of modern medicine. Nurses must not only watch their patients succumb to disease and death but also witness their suffering. This qualitative study adopted the perspective of "the other", as proposed by Emmanuel Levinas, to understand the experience of nurses who provide EOL care and the possibilities of nurses build up their ethical selves within the context of modern medicine. The study used interpretative phenomenology and group dialogue. Thirteen nurses who had EOL care experience were included. Data were drawn from the six transcripts of the group sessions, the researcher's diaries, and participants' feedback sheets. Interpretative phenomenological analysis was used to analyze the data. The findings showed that nurses not only execute medical procedures but are also capable of self-molding into ethical subjects. The categories of participant experiences included: (1) encountering the death; (2) encountering my inner self; and (3) greeting the death. EOL nursing does not require abstract or decontextualized knowledge, but rather requires more experiential knowledge. EOL care may inspire nurses to become ethical persons and to gain wisdom if they shift away from a self-centered perspective to receive "the other". This study illustrates that EOL care should not depend solely on ethical codes or principles but should also adopt the attitudes of "for the other".

  9. Evidence-based resources and the role of librarians in developing evidence-based practice curricula. (United States)

    Klem, Mary L; Weiss, Patricia M


    The implementation of evidence-based practice (EBP) requires acquisition and use of a complex set of skills, including the ability to locate and critically evaluate clinically relevant research literature. In this article, we discuss information resources and tools that may be of value to educators faced with the task of teaching students to search for and evaluate research-based evidence. In addition, we discuss how health sciences librarians, with the use of new models of information instruction and delivery, can work with nursing faculty in developing curricula for training students in EBP.

  10. Knowledge of nursing students about the care provided to people with neoplastic wounds

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    Roseane Ferreira Gomes


    Full Text Available Objective: To investigate the knowledge of nursing students about the care provided to patients with neoplastic wound. Method: This is an exploratory research of a qualitative nature, which was attended by 15 students of the Bachelor's Degree in Nursing from the Center of Education and Health of the Federal University of Campina Grande, campus Cuité - PB, in the period from October to November 2015. For data collection, we used a form for an interview. The data were analyzed through the Technique of Thematic Analysis of Minayo. Results: From the analysis of the empirical material emerged the following thematic categories: Category 1 - Defining neoplastic wounds; Category 2 - Knowledge incipient on ‘neoplastic wounds’ for academic and professional practice; Category 3 - Envisioning the theme "neoplastic wound" in the Academy; Category 4 - Knowledge about methods of evaluation of neoplastic wounds and Category 5 - Knowledge of therapeutic modalities of neoplastic wounds. Conclusions: The academics know the evaluative method of a patient with neoplastic wound as integralizadora unit of care process; recognize palliative care as the best therapeutic modality for these customers, especially when they are in completion and indicate the products contraindicated in the treatment of these lesions; however, do not mention the covers and recommended substances for the control of the signs and symptoms of these injuries. In this context, it is believed that the creation of academic projects of extension, with the aim of creating opportunities for integration between theory and practice, is one of the ways to improve the knowledge.   Keywords: Knowledge; Students of Nursing; Skin Neoplasms.

  11. Effects of Provided Trainings Regarding Non-Invasive Mechanical Ventilation on the Knowledge Level of Nurses

    Directory of Open Access Journals (Sweden)

    Sonay Göktaş


    Full Text Available Objective: Having experienced members in the team for obtaining successful outcomes in non-invasive mechanical ventilation (NIMV is important. The aim of our study is to determine the effectiveness of training on nurse’s level of knowledge about NIMV Methods: This study was done with 70 nurses who were working at an university hospital. The data collection tools that were used were form for individual characteristics and knowledge test questions form consisting of multiple-choice for NIMV. Firstly, Pre-tests have been collected in the survey. Secondly, courses regarding NIMV indications, contraindications and patients management topics were given verbally by researchers. Finally, final tests were performed and data were collected. Analyzing for data were used frequency, percentage, wilcoxon and dependent samples Mc Nemar tests. Results: Mean age were 33.2±7.3, 87.1% were female, 68.6% had bachelor degrees. Of 47.1% were working in intensive care. 54.3% often provide care to NIMV applied patients. 94.7% mentioned that they don’t have any knowledge of NIMV applications. The differences between the pre-post training scores were higher statistically (p<0.001. It was determined that knowledge levels of nurses about NIMV indications and contraindications after training increased statistically significantly. (p<0.05. Conclusion: In our research it was understood that nurses’ knowledge has increased significantly after the training for non-invasive applications. By means of these trainings that will develop the affective, cognitive and psychomotor skills of nurses, it is expected to reveal the results of the extensive research and successful outcomes for NIMV applications will increase.

  12. The nurse match instrument: Exploring professional nursing identity and professional nursing values for future nurse recruitment. (United States)

    Mazhindu, Deborah M; Griffiths, Lauren; Pook, Carol; Erskine, Allen; Ellis, Roger; Smith, Fleur


    From April 1st 2015 it will be mandatory for Higher Education Institutions (HEI) in the United Kingdom (UK) providing pre-qualifying health care higher education to use a Values Based Recruitment (VBR) tool, to ensure only the candidates with the "right" personal identity and values commensurate with the Professional Identity of Nursing (PIN) are accepted for nurse education. "Nurse Match" instrument was developed to enhance the recruitment and selection of candidates for pre-qualifying nursing. Action Research into PIN commenced with voluntary, purposive, convenience samples of qualified nurses (n = 30), Service Users (N = 10), postgraduate diploma nurses in mental health (N = 25), third year mental health branch students (N = 20) and adult and child student nurses in years 2 and 3 (N = 20) in Focus Groups. Data collection and analysis occurred concomitantly between July 2013 and October 2014, aided by NVivo 10 software and revealed Key Quality Indicators (KQIs) of the social construction of PIN. Construct development included a literature review spanning the last fifteen years, which identified four main themes; 1. Nursing's ethics and values. 2. Nursing's professional identity and caring. 3. Nursing's emotional intelligence. 4. Nursing's professionalism. Nurse Match offers an evidence-based enhancement to VBR, for future nurse recruitment locally, nationally and internationally. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Assessment of the Nurses Performance in Providing Care to Patients Undergoing Nasogastric Tube in Suez Canal University Hospital

    National Research Council Canada - National Science Library

    Magda Abdelaziz Mohammed; Mahmoud el Prince Mahmoud; Hamdy A Sleem; Mariam Sabry Shehab


    .... In general, tube feeding is a technique used for those who are unable to eat on their own. The aim of the present study is to assess nurses' performance in providing care to patients undergoing nasogastric tube...

  14. Factors That Impact Registered Nurses' Decisions to Continue Providing Care to Older Adults (United States)

    Bosfield, Saundra


    The purpose of this study was to investigate if there is a significant difference in the following: (a) nurses' likelihood to remain in geriatrics between age groups (those over 40 years of age and those under 40 years of age); (b) nurses' likelihood to remain in geriatrics and personality traits; (c) nurses' likelihood to remain in geriatrics…

  15. TQM/CQI: providing a steady supply of nurses for the future. (United States)

    Neuhs, H P


    The recent emphasis on total quality management and continuous quality improvement (TQM/CQI) is a positive way to improve the professional status of nurses and minimize repetitive cycles of nursing shortages. The author reviews the history and the current status of the supply and demand for nursing personnel, and suggests solutions for preventing shortages that incorporate TQM/CQI strategies.

  16. Providing Assistance to the Victims of Adolescent Dating Violence: A National Assessment of School Nurses' Practices (United States)

    Khubchandani, Jagdish; Telljohann, Susan K.; Price, James H.; Dake, Joseph A.; Hendershot, Candace


    Background: This study assessed the perceptions and practices of school nurses regarding adolescent dating violence (ADV). Methods: The membership list of the National Association of School Nurses was used to identify a national random cross-sectional sample of high school nurses in the United States (N?=?750). A valid and reliable survey…

  17. Nurses’ knowledge, attitudes and practices regarding evidence-based practice in the prevention of mother-to-child transmission of HIV programme in Malawi

    Directory of Open Access Journals (Sweden)

    Chisomo Mulenga


    Full Text Available Background: HIV continues to be a global public health concern with Malawi being among the worst affected countries. The prevalence of HIV among pregnant women is also very high, thereby raising concerns of mother-to-child transmission of the virus. Prevention of mother-to-child transmission (PMTCT of HIV is therefore a priority in the efforts to curb the HIV pandemic. Keeping in mind that the area of HIV management is rapidly evolving, underpinning nursing care with evidence-based practice is essential and has been reported to reduce mother-to-child transmission.Objectives: The aim of the study was to explore and describe the knowledge, attitudes and practices of nurses regarding evidence-based practice in PMTCT at a selected hospital in Malawi.Methods: An exploratory descriptive quantitative design was used, and 81 nurses working in paediatric, obstetrics and gynaecology departments completed a self-administered questionnaire. Data were analysed using Predictive Analytics Software.Results: The results showed that nurses had average knowledge of evidence-based practice and although their attitudes were favourable, their practice was very low. Certain sociodemographic variables had an influence on the respondent’s knowledge, attitudes and practices. Furthermore, the results have indicated that evidence-based practice was mainly hampered by insufficient resources and difficulties in accessing research articles. It emerged from the study that mentoring, training and access to literature could facilitate evidence-based practice in PMTCT among nurses.Conclusion: Nurses need to be provided with the necessary support including education and resources if evidence-based practice in PMTCT is to be promoted.

  18. Delegation decision-making by registered nurses who provide direct care for patients with spinal cord impairment. (United States)

    Parsons, Lynn C


    Delegation and coordination of patient care are critical skills for registered nurses (RN). Most educational programs and clinical experiences in nursing school have not prepared nurses to function in a delegation decision-making capacity. Nurses caring for individuals with spinal cord impairment (SCI) are especially challenged to provide partial or total assistance to meet the requisite care needs of this patient population. Hospital length of stay has decreased for individuals with SCI. RNs employed in long-term care (LTC) facilities have found admissions of patients with SCI occur more frequently with the onset of managed care and the increased longevity of Americans. Capitated markets within managed care require a nursing care delivery model that safely and judiciously uses nursing personnel to their fullest potential. Conger's (1993) Delegation Decision-Making Model (DDMM) utilizes all levels of personnel to their maximum potential while staying within the confines of individuals state nurse practice acts. The ability of RNs to direct the health care team is crucial to affect positive patient outcomes. The purpose of this descriptive comparative study was to ascertain baseline information on nurse delegation decision-making knowledge, job satisfaction, and level of comfort with this skill for RNs practicing in hospital and LTC settings. After reading a case study on a patient with SCI, RNs in the hospital and LTC facilities used Conger's (1993) DDMM. Scores for delegation decision-making were determined using the Nursing Assessment Decision Grid. Delegation knowledge scores were the same for RNs practicing in the hospital and LTC settings. Of interest was that RNs practicing in LTC settings cited learning delegation skills "on the job" 50% of the time compared to hospital nurses who reported learning these skills on the job 19% of the time. Additional research in the area of nurse delegation with this patient population needs to be investigated to support the

  19. Effectiveness of health instruction provided by student nurses in rural secondary schools of Zimbabwe: a feasibility study. (United States)

    Munodawafa, D; Marty, P J; Gwede, C


    This demonstration project used student nurses (n = 12) on community deployment to provide health instruction among rural school-age populations in Zimbabwe. A quasi-experimental (pre- and post-test), non-equivalent control group design was used and consisted of 141 school pupils in the intervention group and 144 pupils in the comparison group (N = 285). The curriculum focused on prevention of STDs, HIV/AIDS and drugs (alcohol, tobacco and marijuana). A gain in health knowledge scores among the intervention group was reported at post-test. More than 70% of the pupils who received health instruction from student nurses gave a high approval rating of student nurses' performance. Further, student nurses, teachers and tutors all support school health instruction by student nurses although tutors and teachers differ on teaching about condoms.

  20. Evidence-based practice: the importance of education and leadership. (United States)

    Johansson, Birgitta; Fogelberg-Dahm, Marie; Wadensten, Barbro


    To describe evidence-based practice among head nurses and to explore whether number of years of duty is associated with such activities. Further to evaluate the effects of education on evidence-based practice and perceived support from immediate superiors. Registered nurses in Sweden are required by law to perform care based on research findings and best experiences. In order to achieve this, evidence-based practice (EBP) is of key importance. All 168 head nurses at two hospitals were asked to participate. Ninety-nine (59%) completed the survey. Data were collected using a study-specific web-based questionnaire. The majority reported a positive attitude towards EBP, but also a lack of time for EBP activities. A greater number of years as a head nurse was positively correlated with research utilization. Education in research methods and perceived support from immediate superiors were statistically and significantly associated with increased EBP activities. The present study highlights the value of education in research methods and the importance of supportive leadership. Education is an important factor in the employment of head nurses. We recommend interventions to create increased support for EBP among management, the goal being to deliver high-quality care and increase patient satisfaction.

  1. Evidence-based hypnotherapy for depression. (United States)

    Alladin, Assen


    Cognitive hypnotherapy (CH) is a comprehensive evidence-based hypnotherapy for clinical depression. This article describes the major components of CH, which integrate hypnosis with cognitive-behavior therapy as the latter provides an effective host theory for the assimilation of empirically supported treatment techniques derived from various theoretical models of psychotherapy and psychopathology. CH meets criteria for an assimilative model of psychotherapy, which is considered to be an efficacious model of psychotherapy integration. The major components of CH for depression are described in sufficient detail to allow replication, verification, and validation of the techniques delineated. CH for depression provides a template that clinicians and investigators can utilize to study the additive effects of hypnosis in the management of other psychological or medical disorders. Evidence-based hypnotherapy and research are encouraged; such a movement is necessary if clinical hypnosis is to integrate into mainstream psychotherapy.

  2. The role of UK district nurses in providing care for adult patients with a terminal diagnosis: a meta-ethnography. (United States)

    Offen, John


    To explore the role of UK district nurses in providing care for adult patients with a terminal diagnosis by reviewing qualitative research. Meta-ethnography was used to conduct the synthesis. CINAHL, MEDLINE and British Nursing Index (BNI) were searched comprehensively for primary research relating to the role of UK district nurses in palliative care. The abstracts and titles of 700 papers were screened against inclusion criteria, of these 97 full papers were appraised. Some 24 studies reported in 25 papers were selected for inclusion in the synthesis. In total, five key themes were identified: valuing the role; practical role; relationships with patients and families; providing psychological support; and role uncertainty. Further synthesis yielded two 'lines of argument'. The concept of the 'expert friend' argues that the atypical relationship district nurses cultivate with patients underpins district nurses' provision of palliative care and profoundly influences the nature of psychological support given. Secondly, the concept of 'threat and opportunity' encapsulates the threat district nurses can feel to their traditional role in palliative care through changing health and social policy, while recognising the benefits that access to specialist knowledge and better training can bring. The findings have implications for understanding the motivators and barriers experienced by district nurses delivering palliative care in a time of unprecedented change to community health services.

  3. [Glocalization: the outlook for Taiwan evidence based health care]. (United States)

    Chen, Chiehfeng


    Public attention to evidence-based health care (EBHC) has increased significantly in recent years. Key problems related to applying EBHC in current healthcare practice include the timely update of up-to-date knowledge and skills and the methodology used to implement EBHC in clinical settings. EBHC has been introduced to the Taiwan healthcare system for the past two decades. The annual EBM (Evidence based medicine) National Competition is a unique and important EBHC activity in Taiwan. EBHC has been promoted widely in medicine, nursing, pharmacy, public health and other professions, and EBHC-related organizations such as the Taiwan Evidence Based Medicine Association (TEBMA), and Taiwan Evidence Based Nursing Association (TEBNA), have increased in number and grown in membership. In addition to domestic developments, Taiwan is also actively involved in global organizations, such as the Cochrane Collaboration, East Asian Cochrane Alliance (EACA), and the International Society for Evidence Based Health Care (ISEHC). In Taiwan, most medical professionals work cooperatively to promote EBHC, which facilitates the gradual improvement of healthcare quality.

  4. Frequent attenders in general practice: problem solving treatment provided by nurses [ISRCTN51021015

    Directory of Open Access Journals (Sweden)

    van Oppen P


    Full Text Available Abstract Background There is a need for assistance from primary care mental health workers in general practice in the Netherlands. General practitioners (GPs experience an overload of frequent attenders suffering from psychological problems. Problem Solving Treatment (PST is a brief psychological treatment tailored for use in a primary care setting. PST is provided by nurses, and earlier research has shown that it is a treatment at least as effective as usual care. However, research outcomes are not totally satisfying. This protocol describes a randomized clinical trial on the effectiveness of PST provided by nurses for patients in general practice. The results of this study, which currently being carried out, will be presented as soon as they are available. Methods/design This study protocol describes the design of a randomized controlled trial to investigate the effectiveness and cost-effectiveness of PST and usual care compared to usual care only. Patients, 18 years and older, who present psychological problems and are frequent attenders in general practice are recruited by the research assistant. The participants receive questionnaires at baseline, after the intervention, and again after 3 months and 9 months. Primary outcome is the reduction of symptoms, and other outcomes measured are improvement in problem solving skills, psychological and physical well being, daily functioning, social support, coping styles, problem evaluation and health care utilization. Discussion Our results may either confirm that PST in primary care is an effective way of dealing with emotional disorders and a promising addition to the primary care in the UK and USA, or may question this assumption. This trial will allow an evaluation of the effects of PST in practical circumstances and in a rather heterogeneous group of primary care patients. This study delivers scientific support for this use and therefore indications for optimal treatment and referral.

  5. Physicians' and Nurses' Opinions about the Impact of a Computerized Provider Order Entry System on Their Workflow. (United States)

    Ayatollahi, Haleh; Roozbehi, Masoud; Haghani, Hamid


    In clinical practices, the use of information technology, especially computerized provider order entry (CPOE) systems, has been found to be an effective strategy to improve patient care. This study aimed to compare physicians' and nurses' views about the impact of CPOE on their workflow. This case study was conducted in 2012. The potential participants included all physicians (n = 28) and nurses (n = 145) who worked in a teaching hospital. Data were collected using a five-point Likert-scale questionnaire and were analyzed using SPSS version 18.0. The results showed a significant difference between physicians' and nurses' views about the impact of the system on interorganizational workflow (p = .001) and working relationships between physicians and nurses (p = .017). Interorganizational workflow and working relationships between care providers are important issues that require more attention. Before a CPOE system is designed, it is necessary to identify workflow patterns and hidden structures to avoid compromising quality of care and patient safety.

  6. The evidence base for diabetes care

    National Research Council Canada - National Science Library

    Williams, D. R. R. (David Robert Rhys)


    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix 1. The Evidence Base for Diabetes Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rhys Williams, William Herman, Ann-Louise Kinmonth...

  7. Partnership working by default: district nurses and care home staff providing care for older people. (United States)

    Goodman, Claire; Robb, Nadia; Drennan, Vari; Woolley, Rosemary


    Older people residents in care homes that only offer residential care rely on primary health care services for medical and nursing needs. Research has investigated the demands that care homes staff and residents make on general practice, but not the involvement of other members of the primary health care team. This paper describes two consecutive studies completed in 2001 and 2003 that involved focus groups and survey methods of enquiry conducted in two settings: an England shire and inner London. The research questions that both studies had in common were (1) What is the contribution of district nursing and other primary care services to care homes that do not have on-site nursing provision? (2) What strategies promote participation and collaboration between residents, care home staff and NHS primary care nursing staff? and (3) What are the current obstacles and aids to effective partnership working and learning? A total of 74 community-based nurses and care home managers and staff took part in 10 focus groups, while 124 care home managers (73% of the 171 surveyed) and 113 district nurse team leaders (80% of the 142 surveyed) participated in the surveys. Findings from both studies demonstrated that nurses were the most frequent NHS professional visiting care homes. Although care home managers and district nurses believed that they had a good working relationship, they had differing expectations of what the nursing contribution should be and how personal and nursing care were defined. This influenced the range of services that older people had access to and the amount of training and support care home staff received from district nurses and the extent to which they were able to develop collaborative and reciprocal patterns of working. Findings indicate that there is a need for community-based nursing services to adopt a more strategic approach that ensures older people in care homes can access the services they are entitled to and receive equivalent health care to

  8. Does the Use of Nursing-Care Services Reduce the Information about Dementia Patients Provided by Their Caregivers

    Directory of Open Access Journals (Sweden)

    Yu Nakamura


    Full Text Available Background: The rate of use of nursing-care services has been increasing dramatically in recent years with the upgrading of the public long-term care insurance system in Japan. We addressed how the increased use of the nursing-care services might affect the information on the patients provided by their caregivers. Methods: A questionnaire survey of 531 family caregivers caring for dementia patients at home was carried out to investigate how the use of these services might affect the information about the patients provided by the caregivers. The survey revealed that the use of the nursing-care services reduced the burden (quality, quantity, time of nursing care, and feeling on the caregivers. Results: According to the observation provided by the caregivers, the patients’ behaviors and activities at home tended to decrease. These results indicated that the use of the nursing-care services resulted in a reduction in the opportunity for and the time spent on observation of the patients by the caregivers, making it more difficult for the caregiver to provide an appropriate assessment of the patient’s condition. Conclusions: We discussed the impact of the use of the nursing-care services on the Clinician’s Interview-Based Impression of Change plus (CIBIC-plus rating. Due to the reduction in the time spent on nursing care and in the opportunity for observation of the patient’s activities of daily living by the caregiver resulting from the use of the nursing-care services, it is difficult to obtain an accurate picture of the patient’s clinical condition using the CIBIC-plus, probably leading to an inappropriate CIBIC-plus rating.

  9. Attitudes of Saudi Nursing Students on AIDS and Predictors of Willingness to Provide Care for Patients in Central Saudi Arabia


    Abolfotouh, Mostafa A.; Samar A. Al Saleh; Mahfouz, Aisha A.; Sherif M. Abolfotouh; Haya M. Al Fozan


    This study aimed to assess acquired immune deficiency syndrome (AIDS)-related knowledge, attitudes, and risk perception among Saudi nursing students, and to identify predictors of their willingness to provide care for patients with AIDS. A cross-sectional study of 260 baccalaureate nursing students at King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, was done using a previously validated ins...

  10. Evidence-Based Treatment and Stuttering--Historical Perspective (United States)

    Prins, David; Ingham, Roger J.


    Purpose: To illustrate the way in which both fluency shaping (FS) and stuttering management (SM) treatments for developmental stuttering in adults are evidence based. Method: A brief review of the history and development of FS and SM is provided. It illustrates that both can be justified as evidence-based treatments, each treatment seeking…

  11. How Comprehensively Is Evidence-Based Practice Represented in Australian Health Professional Accreditation Documents? A Systematic Audit. (United States)

    McEvoy, Maureen P; Crilly, Mike; Young, Taryn; Farrelly, Jane; Lewis, Lucy Kate


    PHENONENON: In many developed countries, accreditation documents, which reflect the practice standards of health professions, form the basis for evaluation of education programs for meeting the requirements for registration. The 2005 Sicily statement proposed a 5-step model of training in evidence-based practice (ask, access, appraise, apply, and assess). A key recommendation was that evidence-based practice should be incorporated into entry-level health professional training and registration. No previous research has assessed the extent to which this has occurred. We undertook a systematic audit of the accreditation documents for the registered health professions in Australia. The 11 health professional disciplines included in the audit were medicine, nursing and midwifery, pharmacy, physiotherapy, dentistry, psychology, occupational therapy, optometry, podiatry, osteopathy, and chiropractic. Two investigators independently identified the occurrence of the term evidence that related to "evidence-based practice" and the occurrences of terms related to the 5 steps in the accreditation documents. Occurrence of the term evidence as it relates specifically to "evidence-based practice" ranged from 0 (pharmacy, dentistry and occupational therapy) to 8 (physiotherapy) in the accreditation documents. Overall, there were 77 occasions when terms relating to any of the 5 steps of evidence-based practice were used across all 11 accreditation documents. All 5 steps were included in the physiotherapy and psychology documents; 4 steps in medicine and optometry; 3 steps in pharmacy; 2 steps each in documents for chiropractic, osteopathy, and podiatry; and 1 step for nursing. There was no inclusion of terms relating to any of the 5 steps in the dentistry and occupational therapy documents. Insights: Terminology relating explicitly to evidence-based practice and to the 5 steps of evidence-based practice appears to be lacking in the accreditation documents for health professions

  12. Barriers and facilitators in providing oral health care to nursing home residents, from the perspective of care aides-a systematic review protocol. (United States)

    Hoben, Matthias; Hu, Huimin; Xiong, Tianyuan; Kent, Angelle; Kobagi, Nadia; Yoon, Minn N


    Unregulated care aides provide up to 80 % of direct resident care in nursing homes. They have little formal training, manage high workloads, frequently experience responsive behaviours from residents, and are at high risk for burnout. This affects quality of resident care, including quality of oral health care. Poor quality of oral health care in nursing homes has severe consequences for residents and the health care system. Improving quality of oral health care requires tailoring interventions to identified barriers and facilitators if these interventions are to be effective. Identifying barriers and facilitators from the care aide's perspective is crucial. We will systematically search the databases MEDLINE, Embase, Evidence Based Reviews-Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science. We will include qualitative and quantitative research studies and systematic reviews published in English that assess barriers and facilitators, as perceived by care aides, to providing oral health care to nursing home residents. Two reviewers will independently screen studies for eligibility. We will also search by hand the contents of key journals, publications of key authors, and reference lists of all the studies included. Two reviewers will independently assess the methodological quality of the studies included using four validated checklists appropriate for different research designs. Discrepancies at any stage of review will be resolved by consensus. We will conduct a thematic analysis of barriers and facilitators using all studies included. If quantitative studies are sufficiently homogeneous, we will conduct random-effects meta-analyses of the associations of barriers and facilitators with each other, with care aide practices in resident oral health care, and with residents' oral health. If quantitative study results cannot be pooled, we will present a narrative synthesis of the results. Finally, we will compare quantitative findings to

  13. Comparing doctors' and nurses' accounts of how they provide emotional care for parents of children with acute lymphoblastic leukaemia. (United States)

    Forsey, Mary; Salmon, Peter; Eden, Tim; Young, Bridget


    Despite the emphasis that communication skills training (CST) programmes place on attending to the emotional care of patients, evidence suggests that practitioners neglect this aspect of patient care. We describe and compare doctors' and nurses' accounts of managing the emotional care of parents of children with leukaemia, with the overall objective of examining how their accounts might inform training and policy. Audio-recorded qualitative interviews with 30 doctors and nurses working in six UK paediatric oncology and haematology treatment centres were analysed interpretatively, drawing on the constant comparative method. Doctors' and nurses' descriptions of managing emotional care differed markedly. Doctors described reassuring parents through their ongoing clinical care of the child and by explaining the potentially curative nature of treatment. Doctors did not think they could reassure parents by eliciting and explicitly discussing parents' fears. In contrast, nurses relied on psychological skills and explicit discussion of parents' emotions to provide reassurance. Both doctors and nurses relied on each other to ensure that parents' emotional needs were met by the multidisciplinary team rather than by individual practitioners. Nurses' accounts of providing emotional care resembled the emphasis on explicit emotional talk in CST. However, doctors' accounts indicated that they provided emotional care in ways that diverged markedly from expectations in CST but that were more consistent with their biomedical and authoritative role in patient care. These findings may have implications for CST in future revisions of guidelines, but work is first needed to explore parents' perspectives on emotional care. Copyright © 2011 John Wiley & Sons, Ltd.

  14. Integrating Systems Thinking Into Nursing Education. (United States)

    Phillips, Janet M; Stalter, Ann M


    A critical need exists for nursing leadership in current complex health care settings. Systems thinking can be incorporated into nursing education at all levels by using evidence-based principles in education. Teaching tips are provided using a systems awareness model to guide nurse educators in the assessment and integration of systems thinking and engaging learners in interprofessional education and practice. J Contin Educ Nurs. 2016;47(9):395-397. Copyright 2016, SLACK Incorporated.

  15. Adaptive Practice: Next Generation Evidence-Based Practice in Digital Environments. (United States)

    Kennedy, Margaret Ann


    Evidence-based practice in nursing is considered foundational to safe, competent care. To date, rigid traditional perceptions of what constitutes 'evidence' have constrained the recognition and use of practice-based evidence and the exploitation of novel forms of evidence from data rich environments. Advancements such as the conceptualization of clinical intelligence, the prevalence of increasingly sophisticated digital health information systems, and the advancement of the Big Data phenomenon have converged to generate a new contemporary context. In today's dynamic data-rich environments, clinicians have new sources of valid evidence, and need a new paradigm supporting clinical practice that is adaptive to information generated by diverse electronic sources. This opinion paper presents adaptive practice as the next generation of evidence-based practice in contemporary evidence-rich environments and provides recommendations for the next phase of evolution.

  16. Meta-analysis provides evidence-based interpretation guidelines for the clinical significance of mean differences for the FACT-G, a cancer-specific quality of life questionnaire

    Directory of Open Access Journals (Sweden)

    Madeleine T King


    Full Text Available Madeleine T King1, David Cella2, David Osoba3, Martin Stockler4, David Eton5, Joanna Thompson6, Amy Eisenstein71Psycho-oncology Co-operative Research Group School of Psychology, University of Sydney, New South Wales, Australia; 2Department of Medical Social Sciences, Northwestern University, Illinois, USA; 3QOL Consulting, Vancouver, British Columbia, Canada; 4NHMRC Clinical Trials Centre, University of Sydney, New South Wales, Australia; 5Mayo Clinic, Rochester, Minnesota, USA; 6Centre for Health Economics Research and Evaluation, University of Technology, Sydney, New South Wales, Australia; 7Center on Outcomes Research and Education (CORE, Evanston Northwestern Healthcare (ENH, Evanston, Illinois, USAAbstract: Our aim was to develop evidence-based interpretation guidelines for the Functional Assessment of Cancer Therapy-General (FACT-G, a cancer-specific health-related quality of life (HRQOL instrument, from a range of clinically relevant anchors, incorporating expert judgment about clinical significance. Three clinicians with many years’ experience managing cancer patients and using HRQOL outcomes in clinical research reviewed 71 papers. Blinded to the FACT-G results, they considered the clinical anchors associated with each FACT-G mean difference, predicted which dimensions of HRQOL would be affected, and whether the effects would be trivial, small, moderate, or large. These size classes were defined in terms of clinical relevance. The experts’ judgments were then linked with FACT-G mean differences, and inverse-variance weighted mean differences were calculated for each size class. Small, medium, and large differences (95% confidence interval from 1,118 cross-sectional comparisons were as follows: physical well-being 1.9 (0.6–3.2, 4.1 (2.7–5.5, 8.7 (5.2–12; functional well-being 2.0 (0.5–3.5, 3.8 (2.0–5.5, 8.8 (4.3–13; emotional well-being 1.0 (0.1–2.6, 1.9 (0.3–3.5, no large differences; social well-being 0.7 (-0.7 to 2

  17. Service Learning: Providing the Building Blocks for a Socially Responsible Nursing Role (United States)

    Johnson, Judith M.


    An explanatory correlational study was conducted to explore whether and to what extent a relationship between hours of participation in service learning and commitment to social responsibility exists for students enrolled in pre-licensure baccalaureate-nursing programs currently participating in the Nursing Licensure Compact. The convenience…

  18. The Role of the School Nurse in Providing School Health Services (United States)

    Journal of School Nursing, 2008


    The school nurse has a crucial role in the seamless provision of comprehensive health services to children and youth. Increasing numbers of students enter schools with chronic health conditions that require management during the school day. This policy statement describes for pediatricians the role of the school nurse in serving as a team member…

  19. Windows to the Future: Can the United Nations Sustainable Development Goals Provide Opportunities for Nursing? (United States)

    Benton, David C; Ferguson, Stephanie L


    Windows of opportunity are wide open for the nursing profession to actively participate and engage in the policy implementation, evaluation, and achievement of the United Nations Sustainable Development Goals. Nurses bring valuable perspectives as members of diverse governance structures and offer a range of solutions that can help governments pursue and achieve the Sustainable Development Goals and targets by 2030.

  20. Educational needs of nurses to provide genetic services in prenatal care: A cross-sectional study from Turkey. (United States)

    Seven, Memnun; Eroglu, Kafiye; Akyüz, Aygül; Ingvoldstad, Charlotta


    The latest advances in genetics/genomics have significantly impacted prenatal screening and diagnostic tests. This cross-sectional descriptive study was conducted in inpatient and outpatient obstetric clinics in 24 hospitals in Turkey to determine knowledge of genetics related to prenatal care and the educational needs of perinatal nurses. A total of 116 nurses working in these clinics agreed to participate. The results included the level of knowledge among nurses was not affected by sociodemographic factors. Also, there is a lack of knowledge and interest in genetics among prenatal nurses and in clinical practice to provide education and counseling related to genetics in prenatal settings as a part of prenatal care. © 2017 John Wiley & Sons Australia, Ltd.

  1. Impact of computerised provider order entry system on nursing workflow, patient safety, and medication errors: perspectives from the front line. (United States)

    Alsweed, Fatimah; Alshaikh, Anwar; Ahmed, Anwar; Yunus, Faisel; Househ, Mowafa


    There is a paucity of research on the impact of computerised provider order entry (CPOE) system on the front line staff. We assessed nurses perspectives of the impact of CPOE system implementation on their workflow, patient safety and medication errors in a Saudi Arabian hospital. We conducted a cross-sectional survey involving 112 nurses between April and May 2012. The workflow was easy to manage for nurses who rated CPOE training as of good quality (p = 0.001) and they found that CPOE helped in reducing medication errors (p = 0.001). The nurses who rated CPOE training as of good quality also stated that patient safety was better with CPOE implementation and its use (p workflow, patient safety and medication errors, and is critical in the success of CPOE use and its long-term adoption.

  2. The nurse's role in providing information to surgical patients and family members in Turkey: a descriptive study. (United States)

    Sayin, Yazile; Aksoy, Güler


    In 2008, we conducted a nonexperimental, cross-sectional, descriptive study in the surgical services department of a hospital in Istanbul, Turkey, with the aim of determining how much information was required by perioperative patients and their family members, the extent to which this information was provided, and the role that nurses play in this process. We included a total of 394 outpatients and inpatients and their family members (ie, 197 patients, 197 family members) and 30 nurses in the study. We collected the research data by using one questionnaire for patients, a second for family members of patients, and a third for nurses. We discovered that the patients and their family members wanted to be given more information about the surgical process than they had received. Patients wanted more information about the intraoperative period, whereas their family members wanted more information about the postoperative period. We also found that nurses were aware that they did not play an effective role in providing information to patients and their family members because of a lack of knowledge about what information they were responsible for providing and insufficient staffing. We concluded that nurses should know what education they are responsible for providing, put more effort into understanding patient and family member information needs, and plan a better means of providing information to meet those needs. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  3. Evidence-based radiology: why and how?

    Energy Technology Data Exchange (ETDEWEB)

    Sardanelli, Francesco; Di Leo, Giovanni [Universita degli Studi di Milano, Dipartimento di Scienze Medico-Chirurgiche, Unita di Radiologia, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, Milan (Italy); Hunink, Myriam G. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Epidemiology, Rotterdam (Netherlands); Harvard School of Public Health, Program for Health Decision Science, Boston, MA (United States); Gilbert, Fiona J. [University of Aberdeen, Aberdeen Biomedical Imaging Centre, Aberdeen (United Kingdom); Krestin, Gabriel P. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands)


    To provide an overview of evidence-based medicine (EBM) in relation to radiology and to define a policy for adoption of this principle in the European radiological community. Starting from Sackett's definition of EBM we illustrate the top-down and bottom-up approaches to EBM as well as EBM's limitations. Delayed diffusion and peculiar features of evidence-based radiology (EBR) are defined with emphasis on the need to shift from the demonstration of the increasing ability to see more and better, to the demonstration of a significant change in treatment planning or, at best, of a significant gain in patient outcome. The ''as low as reasonably achievable'' (ALARA) principle is thought as a dimension of EBR while EBR is proposed as part of the core curriculum of radiology residency. Moreover, we describe the process of health technology assessment in radiology with reference to the six-level scale of hierarchy of studies on diagnostic tests, the main sources of bias in studies on diagnostic performance, and levels of evidence and degrees of recommendations according to the Centre for Evidence-Based Medicine (Oxford, UK) as well as the approach proposed by the GRADE working group. Problems and opportunities offered by evidence-based guidelines in radiology are considered. Finally, we suggest nine points to be actioned by the ESR in order to promote EBR. Radiology will benefit greatly from the improvement in practice that will result from adopting this more rigorous approach to all aspects of our work. (orig.)

  4. Evidence-Based Medicine in Facial Trauma. (United States)

    Dougherty, William M; Christophel, John Jared; Park, Stephen S


    This article provides the reader with a comprehensive review of high-level evidence-based medicine in facial trauma and highlights areas devoid of high-level evidence. The article is organized in the order one might approach a clinical problem: starting with the workup, followed by treatment considerations, operative decisions, and postoperative treatments. Individual injuries are discussed within each section, with an overview of the available high-level clinical evidence. This article not only provides a quick reference for the facial traumatologist, but also allows the reader to identify areas that lack high-level evidence, perhaps motivating future endeavors. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Perception of primary care doctors and nurses about care provided to sickle cell disease patients (United States)

    Xavier Gomes, Ludmila Mourão; de Andrade Barbosa, Thiago Luis; Souza Vieira, Elen Débora; Caldeira, Antônio Prates; de Carvalho Torres, Heloísa; Viana, Marcos Borato


    Objective To analyze the perception of primary care physicians and nurses about access to services and routine health care provided to sickle cell disease patients. Methods This descriptive exploratory study took a qualitative approach by surveying thirteen primary care health professionals who participated in a focus group to discuss access to services and assistance provided to sickle cell disease patients. The data were submitted to thematic content analysis. Results Access to primary care services and routine care for sickle cell disease patients were the categories that emerged from the analysis. Interaction between people with sickle cell disease and primary care health clinics was found to be minimal and limited mainly to scheduling appointments. Patients sought care from the primary care health clinics only in some situations, such as for pain episodes and vaccinations. The professionals noted that patients do not recognize primary care as the gateway to the system, and reported that they feel unprepared to assist sickle cell disease patients. Conclusion In the perception of these professionals, there are restrictions to accessing primary care health clinics and the primary care assistance for sickle cell disease patients is affected. PMID:26190428

  6. LGBT Cultural Competence and Interventions to Help Oncology Nurses and Other Health Care Providers. (United States)

    Radix, Asa; Maingi, Shail


    To define and give an overview of the importance of lesbian, gay, bisexual, and transgender (LGBT) cultural competency and offer some initial steps on how to improve the quality of care provided by oncology nurses and other health care professionals. A review of the existing literature on cultural competency. LGBT patients experience cancer and several other diseases at higher rates than the rest of the population. The reasons for these health care disparities are complex and include minority stress, fear of discrimination, lower rates of insurance, and lack of access to quality, culturally competent care. Addressing the health care disparities experienced by LGBT individuals and families requires attention to the actual needs, language, and support networks used by patients in these communities. Training on how to provide quality care in a welcoming and non-judgmental way is available and can improve health equity. Health care professionals and institutions that acquire cultural competency training can improve the overall health of LGBT patients who currently experience significant health care disparities. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Clinical Skills for Nursing Practice Moore Tina and Cunningham Sheila (Eds) Clinical Skills for Nursing Practice 596pp £39.99 Routledge 9780273767947 0273767941 [Formula: see text]. (United States)


    Drawing on the evidence base on the core clinical skills and competencies required by newly qualified nurses, this comprehensive text provides useful learning outcomes, activities to encourage reflection, and top tips to expand readers' knowledge and practice.

  8. An Integrated Curriculum of Nursing, Nutrition, Exercise, and Drugs for Health Care Providers of the Elderly (Project NNED). (United States)

    Summit-Portage Area Health Education Network, Akron, OH.

    This document is intended to give health care providers interdisciplinary information concerning drugs, nutrition, and exercise to help them enhance health maintenance of the elderly. Prepared as part of Project NNED, (Nursing, Nutrition, Exercise, and Drugs), an integrated curriculum for health care providers of the elderly, the document includes…

  9. Evidence-Based Practice Point-of-Care Resources: A Quantitative Evaluation of Quality, Rigor, and Content. (United States)

    Campbell, Jared M; Umapathysivam, Kandiah; Xue, Yifan; Lockwood, Craig


    Clinicians and other healthcare professionals need access to summaries of evidence-based information in order to provide effective care to their patients at the point-of-care. Evidence-based practice (EBP) point-of-care resources have been developed and are available online to meet this need. This study aimed to develop a comprehensive list of available EBP point-of-care resources and evaluate their processes and policies for the development of content, in order to provide a critical analysis based upon rigor, transparency and measures of editorial quality to inform healthcare providers and promote quality improvement amongst publishers of EBP resources. A comprehensive and systematic search (Pubmed, CINAHL, and Cochrane Central) was undertaken to identify available EBP point-of-care resources, defined as "web-based medical compendia specifically designed to deliver predigested, rapidly accessible, comprehensive, periodically updated, and evidence-based information (and possibly also guidance) to clinicians." A pair of investigators independently extracted information on general characteristics, content presentation, editorial quality, evidence-based methodology, and breadth and volume. Twenty-seven summary resources were identified, of which 22 met the predefined inclusion criteria for EBP point-of-care resources, and 20 could be accessed for description and assessment. Overall, the upper quartile of EBP point-of-care providers was assessed to be UpToDate, Nursing Reference Centre, Mosby's Nursing Consult, BMJ Best Practice, and JBI COnNECT+. The choice of which EBP point-of-care resources are suitable for an organization is a decision that depends heavily on the unique requirements of that organization and the resources it has available. However, the results presented in this study should enable healthcare providers to make that assessment in a clear, evidence-based manner, and provide a comprehensive list of the available options. © 2015 Sigma Theta Tau

  10. The professional portfolio: an evidence-based assessment method. (United States)

    Byrne, Michelle; Schroeter, Kathryn; Carter, Shannon; Mower, Julie


    Competency assessment is critical for a myriad of disciplines, including medicine, law, education, and nursing. Many nurse managers and educators are responsible for nursing competency assessment, and assessment results are often used for annual reviews, promotions, and satisfying accrediting agencies' requirements. Credentialing bodies continually seek methods to measure and document the continuing competence of licensees or certificants. Many methods and frameworks for continued competency assessment exist. The portfolio process is one method to validate personal and professional accomplishments in an interactive, multidimensional manner. This article illustrates how portfolios can be used to assess competence. One specialty nursing certification board's process of creating an evidence-based portfolio for recertification or reactivation of a credential is used as an example. The theoretical background, development process, implementation, and future implications may serve as a template for other organizations in developing their own portfolio models. Copyright 2009, SLACK Incorporated.

  11. Iowa Model of Evidence-Based Practice: Revisions and Validation. (United States)

    Buckwalter, Kathleen C; Cullen, Laura; Hanrahan, Kirsten; Kleiber, Charmaine; McCarthy, Ann Marie; Rakel, Barbara; Steelman, Victoria; Tripp-Reimer, Toni; Tucker, Sharon


    The Iowa Model is a widely used framework for the implementation of evidence-based practice (EBP). Changes in health care (e.g., emergence of implementation science, emphasis on patient engagement) prompted the re-evaluation, revision, and validation of the model. A systematic multi-step process was used capturing information from the literature and user feedback via an electronic survey and live work groups. The Iowa Model Collaborative critically assessed and synthesized information and recommendations before revising the model. Survey participants (n = 431) had requested access to the Model between years 2001 and 2013. Eighty-eight percent (n = 379) of participants reported using the Iowa Model and identified the most problematic steps as: topic priority, critique, pilot, and institute change. Users provided 587 comments with rich contextual rationale and insightful suggestions. The revised model was then evaluated by participants (n = 299) of the 22nd National EBP Conference in 2015. They validated the model as a practical tool for the EBP process across diverse settings. Specific changes in the model are discussed. This user driven revision differs from other frameworks in that it links practice changes within the system. Major model changes are expansion of piloting, implementation, patient engagement, and sustaining change. The Iowa Model-Revised remains an application-oriented guide for the EBP process. Intended users are point of care clinicians who ask questions and seek a systematic, EBP approach to promote excellence in health care. © 2017 University of Iowa Hospitals and Clinics, Worldviews on Evidence-Based Nursing © 2017 Sigma Theta Tau International.

  12. Evidence-based Science Communication (United States)

    Kahan, D.


    This presentation will describe a concrete strategy for bridging the gap between the *science* of science communication and the practice of it. In recent years, social scientists have made substantial progress in identifying the psychological influences that shape public receptivity to scientific information relating to climate change and other public policy issues. That work, however, has consisted nearly entirely of laboratory experiments and public opinion surveys; these methods identify general mechanisms of information processing but do not yield concrete prescriptions for communication in field settings. In order to integrate the findings of the science of science communication with the practice of it, field communication must now be made into a meaningful site of science communication research. "Evidence-based science communication" will involve collaborative work between social scientists and practitioners aimed at formulating and testing scientifically informed communication strategies in real-world contexts.

  13. Workplace health and safety issues among community nurses: a study regarding the impact on providing care to rural consumers (United States)

    Terry, Daniel; Lê, Quynh; Nguyen, Uyen; Hoang, Ha


    Objectives The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client’s homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and

  14. The meaning of mental health nurses experience of providing one-to-one observations: a phenomenological study. (United States)

    Rooney, C


    There has been much recent literature about the need for appropriate policies and approaches to ensure that patient's rights and standards of care are safeguarded. The focus from national policy is on suicide reduction and prevention, and the nursing literature has concentrated on the importance of engaging the patient and ensuring that there is the least amount of restriction possible. A research study was carried out to explore the perspective of mental health nurses working in these intensive situations, using a purposive sample of nursing staff from the local National Health Service Trust's acute units. A phenomenological approach to the study was chosen to allow an in-depth exploration of the issues--'seeing things up close'--using the philosophy of Husserl as a base. The key areas of enquiry were: to explore and amplify the experiences of nurses undertaking constant observations, including any effects that may have on nurses; to gain further understanding of the dynamics and processes involved; to discover information that can inform and support development needs. Individual taped interviews were carried out with six nurses working in an acute admission ward, and these were then transcribed and analysed using Giorgi's method of analysis. The results of this analysis showed that nurses are keenly aware of some of the professional and ethical tensions involved in the process of keeping patients safe while trying to promote recovery. Results have implications for policies, preparation and support of staff, and provide some further insights into the nature of this experience for nursing staff who are caring for patients who are presenting with risks to themselves.

  15. What support do nurses need to provide palliative care for people with dementia? (United States)

    Champion, Elizabeth


    The aim of this project was to identify the support required by registered nurses and unregistered healthcare support workers to provide palliative care for people with dementia in an acute hospital in England. A quantitative approach was taken and participants were asked to fill in a questionnaire. Data were collated and analysed to identify support needs and any emerging themes. Respondents were confident in identifying the different stages of dementia. There was less confidence in identifying a patient with dementia for palliative care referral compared with a patient without dementia. Further needs were identified by respondents in supporting the family/carer of the person with dementia and being aware of available support to facilitate palliative care for people with dementia and support for end of life care (EoLC) planning. The findings suggest that further work is required in relation to dementia and EoLC. Practical and educational collaboration with EoLC/palliative care practitioners and dementia leads would be beneficial.

  16. NLM Evidence-based Information at Your Fingertips - NBNA

    Energy Technology Data Exchange (ETDEWEB)

    Womble, R.


    The workshop titled, National Library of Medicine: Evidence-based Information At Your Fingertips, is a computer training class designed to meet the needs of nurses who require access to information on specific medical topics and on the adverse health effects of exposure to hazardous substances. The Specialized Information Services Division of the National Library of Medicine (NLM) is sponsoring this workshop for the National Black Nurses Association to increase the awareness of health professionals of the availability and value of the free NLM medical, environmental health, and toxicology databases.

  17. MDS 3.0 for Nursing Homes and Swing Bed Providers (United States)

    U.S. Department of Health & Human Services — The MDS is a powerful tool for implementing standardized assessment and for facilitating care management in nursing homes (NHs) and non-critical access hospital...

  18. Value of intensified nursing


    Frank, Wilhelm; Konta, Brigitte; Prusa, Nina; Raymann, Cornelia


    The concept "intensified nursing" is mentioned in differentiation to concepts of "nursing care" or "nursing" which intensifies resources or patient contact. Especially psychic and social needs of patients are very appreciated in nursing. A similar type of nursing is known under the concept "advanced nursing practice" (ANP) which means, that a specialised, academically trained nurse offers an extended nursing care in which a focus on the published knowledge of evidence based research is made. ...

  19. Moral Distress in Nurses Providing Direct Patient Care at an Academic Medical Center. (United States)

    Sirilla, Janet; Thompson, Kathrynn; Yamokoski, Todd; Risser, Mark D; Chipps, Esther


    Moral distress is the psychological response to knowing the appropriate action but not being able to act due to constraints. Previous authors reported moral distress among nurses, especially those that work in critical care units. The aims of this study were: (1) to examine the level of moral distress among nurses who work at an academic health system, (2) to compare the level of moral distress in nurses who work across specialty units at an academic health system, (3) to compare moral distress by the demographic characteristics of nurses and work experience variables, and (4) to identify demographic characteristics and type of clinical setting that may predict which nurses are at high risk for moral distress. A cross-sectional survey design was used with staff nurses who work on inpatient units and ambulatory units at an academic medical center. The moral distress scale-revised (MDS-R) was used to assess the intensity and frequency of moral distress. The overall mean MDS-R score in this project was low at 94.97 with mean scores in the low to moderate range (44.57 to 134.58). Nurses who work in critical care, perioperative services, and procedure areas had the highest mean MDS-R scores. There have been no previous reports of higher scores for nurses working in perioperative and procedure areas. There was weak positive correlation between MDS-R scores and years of experience (Rho = .17, p = .003) but no correlation between age (Rho = .02, p = .78) or education (Rho = .05, p = .802) and moral distress. Three variables were found useful in predicting moral distress: the type of unit and responses to two qualitative questions related to quitting their job. Identification of these variables allows organizations to focus their interventions. © 2017 Sigma Theta Tau International.

  20. Can Scholarly Communication be Evidence Based? (Editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis


    disseminate their work, the role of research funding bodies that use public funds, the added value brought to the work by publishers, the role of peer reviewers, the economics of various models, and simply what works best.Research has been done on many of these issuesii and much of that work has then been critically appraised and debated post-publication on mailing listsiii and social networking media such as blogs.ivThe BMJ is one scholarly publication that has committed itself to becoming an “evidence based publisher” and is carrying out research on aspects of scholarly publishing to help guide their processes (Schroter, n.d.. Research on scholarly communication is a hot topic indeed; and for librarians, an area of information overload if there ever was one. How to sort out the good from the bad; the research that is high quality from that which is biased?At this point in time, it is my view that the research does not yet provide a definitive answer for how libraries should approach new models of scholarly communication. We are in the middle of a debate, in the middle of a surge of research, and an ever-changing lens in which we view and approach this topic. But evidence based practice has always been about more than just research – it considers what is needed by our users, and is guided by our professional judgement. Putting those elements together allows us to sort through the research and make informed decisions about our approach to collections, and how we do liaison work. For anyone looking for a research idea, there are certainly a couple of systematic reviews possible on these issues that would benefit practitioners immensely.The decision to start EBLIP was not an evidence based one. It was based in a desire to give the topic a home for discussion, and that in order to facilitate discussion, the widest audience possible must be reached. Hence, barriers such as cost needed to be reduced, and the decision to be open access was made. This was a decision based on

  1. School Librarianship and Evidence Based Practice: Progress, Perspectives, and Challenges

    Directory of Open Access Journals (Sweden)

    Ross J. Todd


    Full Text Available Objective – This paper provides an overview of progress and developments surrounding evidence based practice in school librarianship, and seeks to provide a picture of current thinking about evidence based practice as it relates to the field. It addresses current issues and challenges facing the adoption of evidence based practice in school librarianship.Methods – The paper is based on a narrative review of a small but growing body of literature on evidence based practice in school librarianship, set within a broader perspective of evidence based education. In addition, it presents the outcomes of a collaborative process of input from 200 school libraries leaders collected at a School Library summit in 2007 specifically to address the emerging arena of evidence based practice in this field.Results – A holistic model of evidence based practice for school libraries is presented, centering on three integrated dimensions of evidence: evidence for practice, evidence in practice, and evidence of practice.Conclusion – The paper identifies key challenges ahead if evidence based school librarianship is to develop further. These include: building research credibility within the broader educational environment; the need for ongoing review and evaluation of the diverse body of research in education, librarianship and allied fields to make quality evidence available in ways that can enable practicing school librarians to build a culture of evidence based practice; development of tools, strategies, and exemplars to use to facilitate evidence based decision-making; and, ensuring that the many and diverse advances in education and librarianship become part of the practice of school librarianship.

  2. Nursing care provided to young people in two health centers compared with Watson Theory

    Directory of Open Access Journals (Sweden)

    María Alejandra Pichardo Meza


    Full Text Available This article has as objective to present the analysis of the care given by the nursing personnel to the young adult population in the Clinic of Pain Control and Palliative Care and in the Onco-hematology Service of the Max Peralta Hospital, related to Jean Watson’s theoretical proposal. The study corresponds to a joint research of parallel type with concurrent triangulation. The study populations were made up by twenty-six young adult people (who face morbid process health or chronic pain condition and four nursing professionals who worked in the Clinic of Pain Control and Palliative Care and in the Onco-hematology Service of the Max Peralta Hospital. A self-executed questionnaire and a semi-structured interview were used to collect the information, which was analyzed using the “SPSS” program and the qualitative categories, respectively. Results: The ten elements of the “Human Care Theory” can be included in the care given by the nursing personnel to the young adult population who faces morbid process health or chronic pain condition. The nursing care mainly focuses on the young adult population quality of life throughout education and pain management. The young adult population perceives a warm, pleasant and human nursing care. Conclusion: Nursing personnel put into practice elements of the Jean Watson’s theoretical proposal even when they do not know it.

  3. Knowledge and perceptions on toxoplasmosis among pregnant women and nurses who provide prenatal in primary care. (United States)

    Sousa, Jayra Adrianna da Silva; Corrêa, Rita da Graça Carvalhal Frazão; Aquino, Dorlene Maria Cardoso de; Coutinho, Nair Portela Silva; Silva, Marcos Antonio Custódio Neto da; Nascimento, Maria do Desterro Soares Brandão


    Toxoplasmosis is an infection that affects almost a third of the world population. In adults, it is often asymptomatic, although having important manifestation in children- infected by placental transmission. The prenatal is an important moment, requiring actions in women's care during pregnancy, in order to prevent diseases that could compromise the mother and the child's life. This is a descriptive study of qualitative approach aimed to understand the perception of nurses and pregnant women about toxoplasmosis during primary - prenatal care. The study was conducted in five selected primary health care units, in the municipality of São Luis - MA. The sample consisted of 15 nurses working in nursing consultation and 15 pregnant women attended in prenatal care. For data collection, a semi-structured questionnaire and an interview guide covering issues related to knowledge and conduct on toxoplasmosis were used. For analysis, the content analysis technique was used. The answers were transcribed, organized and grouped thematically, where the following categories emerged: knowledge about examination requests; knowledge about toxoplasmosis; guidance during prenatal consultation; knowledge of nurses about the avidity test; procedures and guidelines on reagent cases. Pregnant women showed unawareness about toxoplasmosis and its effects. Nurses, although having basic knowledge about the subject, showed little applicability regarding pregnant women's guidance. The nurse plays an important role in educational activities regarding pregnant women, contributing to the quality of prenatal care. Pregnant women were shown to have some knowledge about toxoplasmosis, although they said they did not have assurance about prevention.

  4. Moral distress in nurses providing direct care on inpatient oncology units. (United States)

    Sirilla, Janet


    Moral distress is defined as knowing the right thing to do when policy constraints do not allow for appropriate choices. The purpose of the current study was to explore the existence of moral distress in oncology nurses with a cross-sectional survey completed by nurses working on inpatient units at a midwestern cancer hospital. Investigators distributed the Moral Distress Scale-Revised to all direct care staff nurses. The main research variables were moral distress, level of education, age, and type of unit. Most of the 73 nurses had low to moderate scores, and two had high scores. No significant correlations were observed among age or years of experience. Type of unit and level of moral distress were correlated, and an inverse relationship between level of education and moral distress was found. Moral distress exists in nurses who work on oncology units irrespective of experience in oncology or the specific unit. Nurses must be aware of the existence of moral distress and finds ways to reduce potential emotional problems.

  5. The Relationship Among Evidence-Based Practice and Client Dyspnea, Pain, Falls, and Pressure Ulcer Outcomes in the Community Setting


    Doran, Diane; Lefebre, Nancy; O'Brien-Pallas, Linda; Estabrook, Carole A; White, Peggy; Carryer, Jennifer; Sun, Winnie; Qian, Gan; Bai, Yu Qing; Li, Mingyang


    Background There are gaps in knowledge about the extent to which home care nurses’ practice is based on best evidence and whether evidence-based practice impacts patient outcomes. Aim The purpose of this study was to investigate the relationship between evidence-based practice and client pain, dyspnea, falls, and pressure ulcer outcomes in the home care setting. Evidence-based practice was defined as nursing interventions based on best practice guidelines. Methods The Nursing Role Effectivene...

  6. Evidence-Based Advances in Rabbit Medicine. (United States)

    Summa, Noémie M; Brandão, João


    Rabbit medicine has been continuously evolving over time with increasing popularity and demand. Tremendous advances have been made in rabbit medicine over the past 5 years, including the use of imaging tools for otitis and dental disease management, the development of laboratory testing for encephalitozoonosis, or determination of prognosis in rabbits. Recent pharmacokinetic studies have been published, providing additional information on commonly used antibiotics and motility-enhancer drugs, as well as benzimidazole toxicosis. This article presents a review of evidence-based advances for liver lobe torsions, thymoma, and dental disease in rabbits and controversial and new future promising areas in rabbit medicine. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Evidence-based practice for pain management for cancer patients in an acute care setting. (United States)

    Choi, Mona; Kim, Hee Sun; Chung, Su Kyoung; Ahn, Mee Jung; Yoo, Jae Yong; Park, Ok Sun; Woo, So Rah; Kim, So Sun; Kim, Sun Ah; Oh, Eui Geum


    The purpose of this study is to implement an evidence utilization project using an audit and feedback approach to improve cancer pain management. A three-phased audit and feedback approach was used. A 46-bed oncology nursing unit in the university's cancer centre was selected as a research site. Nursing records extracted from 137 patients (65 for the baseline assessment and 72 for the follow-up audit) were used to examine nurse compliance with four audit criteria derived from best practice guidelines related to the assessment and management of pain. We observed a significant improvement in compliance from baseline to follow-up for the following criteria: documenting the side effects of opioids (2-83%), use of a formalized pain assessment tool (22-75%), and providing education for pain assessment and management to patients and caregivers (0-47%). The audit and feedback method was applicable to the implementation of clinical practice guidelines for cancer pain management. Leadership from both administrative personnel and staff nurses working together contributes to the spread of an evidence-based practice culture in clinical settings. As it was conducted in a single oncology nursing unit and was implemented over a short period of time, the results should be carefully interpreted. © 2013 Wiley Publishing Asia Pty Ltd.

  8. Parents' experiences of family functioning, health and social support provided by nurses--a pilot study in paediatric intensive care. (United States)

    Hakio, Nora; Rantanen, Anja; Åstedt-Kurki, Päivi; Suominen, Tarja


    The objective of this study was to describe parents' experiences of family functioning, health and social support provided by nursing personnel, while their child was in intensive care, and to determine how social support was associated with family functioning and family health. Cross-sectional study. The data were collected by a self-administered questionnaire from 31 parents of critically ill children from 2010 to 2011. The data were analysed statistically. The parents considered their family functioning, health and social support provided by the nursing personnel to be good. The sub-area of family functioning that rated the lowest was strengths of family, whereas the lowest rated sub-area of family health was ill-being. Child's previous hospital treatments were associated with family health. Parents, whose child had already been in hospital care, reported more well-being and less ill-being than parents with children hospitalised for the first time. Parents' education was associated with family functioning, family health and social support given by the nurses. Weak positive correlation was also found between social support given by nurses and family health experienced by parents. There is a need to discuss how nursing care can further support parental resources. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. 3. Neurological & Psychiatric Society of Zambia's Evidence-Based ...

    African Journals Online (AJOL)


    ”. No evidence provided. Not evidence-based and impractical for a resource .... European Federation of. Neurological Sciences. Task Force[18]. Non-acute headache. EEG is not routinely indicated in the diagnostic evaluation of headache.

  10. Evidence-Based Practice in Psychology (United States)

    American Psychologist, 2006


    The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes…

  11. Evidence Based Practice: Science? Or Art? (Editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis


    , experience, tacit knowledge, reflection, creativity, values, people-skillsBoth science and art are important and I hope we do not measure their worth against one another. Rather, we need to recognize that both elements contribute to good decision making and practice improvement. Without taking research evidence into consideration, we would be lacking scientific knowledge that helps us gain a deeper understanding of our profession. This needs to be continually renewed and paid attention. However, without the art side of the equation, meaning and context may easily be lost. Someone can gather all the best evidence, but not know how to effectively implement it. Or if you are overly reliant on perfect evidence before you make a decision that is in the best interest of your community, you will likely lag behind and not serve people’s needs. No research study, no matter how perfectly conducted is going to provide all the answers for what we do in practice.We need to embrace both the science and the art of evidence based practice – otherwise, we will overlook important elements of the whole situation that practitioners work within. Doing so is not neat and tidy, but does that really matter? LIS is a social science, and the "social" implies "messy" because people and real-life situations are not easily controlled. The art of our craft allows us to embrace the messy situation, find ways to be creative, put our professional judgements to use and find the best solutions to meet the needs of individual users by applying the best of what we find in the research literature together with the best of what we know is likely to help this person.My purely unscientific judgement as a practitioner is that LIS practice is probably 30% science and 70% art (more or lessdepending upon the specific topic. As such, I think that we cannot ignore the art of evidence based practice, and in fact should begin thinking about ways to be better artists as well as better scientists. Within this journal

  12. [Evidence-based TEP technique]. (United States)

    Köckerling, F


    The guidelines of all international hernia societies recommend as procedures of choice the laparoendoscopic techniques total extraperitoneal patch plasty (TEP) and transabdominal preperitoneal patch plasty (TAPP) as well as the open Lichtenstein operation for elective inguinal hernia repair. The learning curve associated with the laparoendoscopic techniques, in particular TEP, is longer than that for the open Lichtenstein technique due to the complexity of the procedures. Accordingly, for laparoendoscopic techniques it is particularly important that the operations are conducted in a standardized manner in compliance with the evidence-based recommendations given for the technical details. When procedures are carried out in strict compliance with the guidelines of the international hernia societies, low rates of perioperative complications, complication-related reoperations, recurrences and chronic pain can be expected for TEP. Compliance with the guidelines can also positively impact mastery of the learning curve for TEP. The technical guidelines on TEP are based on study results and on the experiences of numerous experts; therefore, it is imperative that they are implemented in routine surgical practice.

  13. Teachers' Accounts of Their Perceptions and Practices of Providing Written Feedback to Nursing Students on Their Assignments (United States)

    Iqbal, Sajid; Gul, Raisa; Lakhani, Arusa; Rizvi, Nusrat Fatima


    Written feedback can facilitate students' learning in several ways. However, the teachers' practices of written feedback may be affected by various factors. This study aimed to explore the nurse teachers' accounts of their perceptions and practices of providing written feedback. A descriptive exploratory design was employed in the study. A…

  14. Attitudes of Saudi Nursing Students on AIDS and Predictors of Willingness to Provide Care for Patients in Central Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mostafa A. Abolfotouh


    Full Text Available This study aimed to assess acquired immune deficiency syndrome (AIDS-related knowledge, attitudes, and risk perception among Saudi nursing students, and to identify predictors of their willingness to provide care for patients with AIDS. A cross-sectional study of 260 baccalaureate nursing students at King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, was done using a previously validated instrument. Students’ knowledge percentage mean score (PMS on AIDS was 72.93 ± 10.67 reflecting an average level of knowledge. There were many misconceptions about how AIDS is transmitted, for example, use of same toilets and bathrooms and washing clothes together (24.9%, swimming (53.7%, and coughing and sneezing (49.6%. Nursing students reported an overall negative attitude toward AIDS, with a PMS of 43.48 ± 9.21. The majority of students agreed that AIDS patients should be isolated from other patients (83%, and should not share the room with other noninfected patients (81.8%, and some reported that people living with AIDS deserve what has happened to them (24.7%. After controlling for confounders, students’ poor knowledge and negative attitude were associated only with having never been given nursing education as their primary university education “Stream 2 students” (p = .012 and p = .01, respectively. These findings have implications for development of teaching strategies and curricular approaches for nursing to address this health care issue.

  15. Knowledge and perceptions on toxoplasmosis among pregnant women and nurses who provide prenatal in primary care

    Directory of Open Access Journals (Sweden)

    Jayra Adrianna da Silva Sousa

    Full Text Available ABSTRACT Background Toxoplasmosis is an infection that affects almost a third of the world population. In adults, it is often asymptomatic, although having important manifestation in children- infected by placental transmission. The prenatal is an important moment, requiring actions in women’s care during pregnancy, in order to prevent diseases that could compromise the mother and the child’s life. Methods This is a descriptive study of qualitative approach aimed to understand the perception of nurses and pregnant women about toxoplasmosis during primary – prenatal care. The study was conducted in five selected primary health care units, in the municipality of São Luis - MA. The sample consisted of 15 nurses working in nursing consultation and 15 pregnant women attended in prenatal care. For data collection, a semi-structured questionnaire and an interview guide covering issues related to knowledge and conduct on toxoplasmosis were used. For analysis, the content analysis technique was used. Results The answers were transcribed, organized and grouped thematically, where the following categories emerged: knowledge about examination requests; knowledge about toxoplasmosis; guidance during prenatal consultation; knowledge of nurses about the avidity test; procedures and guidelines on reagent cases. Pregnant women showed unawareness about toxoplasmosis and its effects. Nurses, although having basic knowledge about the subject, showed little applicability regarding pregnant women’s guidance. Conclusion The nurse plays an important role in educational activities regarding pregnant women, contributing to the quality of prenatal care. Pregnant women were shown to have some knowledge about toxoplasmosis, although they said they did not have assurance about prevention.

  16. Partnering with community agencies to provide nursing students with cultural awareness experiences and refugee health promotion access. (United States)

    Sullivan, Catherine H


    Refugees' cultural beliefs, communication barriers, and low health literacy may lead to health disparities within the Western health care system. This article describes a teaching-learning strategy emphasizing the community partnership between a baccalaureate school of nursing, an immigrant-refugee program, and a community literacy program in a rural state. Senior community health nursing students partnered with an immigrant-refugee program and a community literacy program to provide health promotion and prevention services to recently immigrated Hmong and Russian refugees. Priority health needs were identified and culturally appropriate health promotion and prevention education modules were designed and implemented by students. Students collaborated with community agencies and businesses to increase access to health resources for these vulnerable populations. Outcomes were the provision of cultural awareness experiences for nursing students and access to health care with increased knowledge of Western health care practices and beliefs for refugees.

  17. Do evidence-based guidelines change clinical practice patterns?

    DEFF Research Database (Denmark)

    Kessel, Line; Erngaard, Ditte; Flesner, Per


    In 2013, the Danish Health and Medicines Authorities published a National Clinical Guideline on the treatment of age-related cataracts. The guideline provided evidence-based recommendations on the indication for cataract surgery, cataract surgery in patients with age-related macular degeneration...... medicine. Thus, evidence-based guidelines do change practice patterns unless they are counteracted by the reimbursement system....... likely to prescribe non-steroidal anti-inflammatory eye drops and to not prescribe topical antibiotic eye drops after the guideline was published. Other parameters, most notably the use of toric IOLs and use of postoperative examinations were more guided by reimbursement standards than by evidence-based...

  18. Evidence-based guidelines for fall prevention in Korea (United States)

    Kim, Kwang-Il; Jung, Hye-Kyung; Kim, Chang Oh; Kim, Soo-Kyung; Cho, Hyun-Ho; Kim, Dae Yul; Ha, Yong-Chan; Hwang, Sung-Hee; Won, Chang Won; Lim, Jae-Young; Kim, Hyun Jung; Kim, Jae Gyu


    Falls and fall-related injuries are common in older populations and have negative effects on quality of life and independence. Falling is also associated with increased morbidity, mortality, nursing home admission, and medical costs. Korea has experienced an extreme demographic shift with its population aging at the fastest pace among developed countries, so it is important to assess fall risks and develop interventions for high-risk populations. Guidelines for the prevention of falls were first developed by the Korean Association of Internal Medicine and the Korean Geriatrics Society. These guidelines were developed through an adaptation process as an evidence-based method; four guidelines were retrieved via systematic review and the Appraisal of Guidelines for Research and Evaluation II process, and seven recommendations were developed based on the Grades of Recommendation, Assessment, Development, and Evaluation framework. Because falls are the result of various factors, the guidelines include a multidimensional assessment and multimodal strategy. The guidelines were developed for primary physicians as well as patients and the general population. They provide detailed recommendations and concrete measures to assess risk and prevent falls among older people. PMID:28049285

  19. Mammographic image quality in relation to positioning of the breast: A multicentre international evaluation of the assessment systems currently used, to provide an evidence base for establishing a standardised method of assessment. (United States)

    Taylor, K; Parashar, D; Bouverat, G; Poulos, A; Gullien, R; Stewart, E; Aarre, R; Crystal, P; Wallis, M


    Optimum mammography positioning technique is necessary to maximise cancer detection. Current criteria for mammography appraisal lack reliability and validity with a need to develop a more objective system. We aimed to establish current international practice in assessing image quality (IQ), of screening mammograms then develop and validate a reproducible assessment tool. A questionnaire sent to centres in countries undertaking population screening identified practice, participants for an expert panel (EP) of radiologists/radiographers and a testing panel (TP) of radiographers. The EP developed category criteria and descriptors using a modified Delphi process to agree definitions. The EP scored 12 screening mammograms to test agreement then a main set of 178 cases. Weighted scores were derived for each descriptor enabling calculation of numerical parameters for each new category. The TP then scored the main set. Statistical analysis included ANOVA, t-tests and Kendall's coefficient. 11 centres in 8 countries responded forming an EP of 7 members and TP of 44 members. The EP showed moderate agreement when the scoring the mini test set W = 0.50 p < 0.001 and the main set W = 0.55 p < 0.001, 'posterior nipple line' being the most difficult descriptor. The weighted total scores differentiated the 4 new categories Perfect, Good, Adequate and Inadequate (p < 0.001). We have developed an assessment tool by Delphi consensus and weighted consensus criteria. We have successfully tabulated a range of numerical scores for each new category providing the first validated and reproducible mammography IQ scoring system. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  20. Practice nurses mental health provide space to patients to discuss unpleasant emotions

    NARCIS (Netherlands)

    Griep, E.C.; Noordman, J.; Dulmen, S. van


    WHAT IS KNOWN ON THE SUBJECT?: A core skill of practice nurses' mental health is to recognize and explore patients' unpleasant emotions. Patients rarely express their unpleasant emotions directly and spontaneously, but instead give indirect signs that something is worrying them. WHAT THIS PAPER ADDS

  1. Practice nurses mental health provide space to patients to discuss unpleasant emotions.

    NARCIS (Netherlands)

    Griep, E.C.M.; Noordman, J.; Dulmen, A.M. van


    WHAT IS KNOWN ON THE SUBJECT? A core skill of practice nurses' mental health is to recognize and explore patients' unpleasant emotions. Patients rarely express their unpleasant emotions directly and spontaneously, but instead give indirect signs that something is worrying them.

  2. Providing oral care in haematological oncology patients: nurses' knowledge and skills

    NARCIS (Netherlands)

    Potting, Carin M. J.; Mank, Arno; Blijlevens, Nicole M. A.; Donnelly, J. Peter; van Achterberg, Theo


    In the international literature, the most commonly recommended intervention for managing oral mucositis is good oral care, assuming that nurses have sufficient knowledge and skills to perform oral care correctly. The aim of the present study was to investigate if knowledge and skills about oral care

  3. Providing oral care in haematological oncology patients: nurses' knowledge and skills.

    NARCIS (Netherlands)

    Potting, C.M.J.; Mank, A.; Blijlevens, N.M.A.; Donnelly, J.P.; Achterberg, T. van


    In the international literature, the most commonly recommended intervention for managing oral mucositis is good oral care, assuming that nurses have sufficient knowledge and skills to perform oral care correctly. The aim of the present study was to investigate if knowledge and skills about oral care

  4. Social Media Providing an International Virtual Elective Experience for Student Nurses

    Directory of Open Access Journals (Sweden)

    Paula M. Procter


    Full Text Available The advances in social media offer many opportunities for developing understanding of different countries and cultures without any implications of travel. Nursing has a global presence and yet it appears as though students have little knowledge of the health and social care needs and provision outside their local environment. Our collaboration across three countries, New Zealand, United Kingdom, and the United States of America, brought the two themes together with the aim of senior student nurses having a communication channel to explore public health issues in each country. Using a closed Facebook™ page, third year undergraduate adult nursing students were invited to take part in a three month pilot study to test the feasibility of virtual collaboration through exchanging public health issues. Here we report upon the collaboration, operation of the social media, and main findings of the study. Three core areas will be reported upon, these being the student’s views of using social media for learning about international perspectives of health, seeing nursing as a global profession and recommendations for future development of this positively reviewed learning technique. To conclude consideration will be given to further development of this work by the collaborative team expanding the countries involved.

  5. Development of skills-based competencies for forensic nurse examiners providing elder abuse care. (United States)

    Du Mont, Janice; Kosa, Daisy; Macdonald, Sheila; Elliot, Shannon; Yaffe, Mark


    As a critical step in advancing a comprehensive response to elder abuse built on existing forensic nursing-led hospital-based programmes, we developed a list of skills-based competencies for use in an Elder Abuse Nurse Examiner curriculum. Programme leaders of 30 hospital-based forensic nursing-led sexual assault and domestic violence treatment centres. 149 verbatim recommendations for components of an elder abuse response were identified from a systematic scoping review. In 2 online Delphi consensus survey rounds, these components of care were evaluated by an expert panel for their overall importance to the elder abuse intervention under development and for their appropriateness to the scope of practice of an elder abuse nurse examiner. The components retained after evaluation were translated into skills-based competencies using Bloom's Taxonomy of Learning and, using the Nominal Group Technique, were subsequently reviewed and revised by a subset of members of the expert panel in a consensus meeting. Of the 148 recommendations evaluated, 119 were rated as important and achieved consensus or high level of agreement. Of these, 101 were determined to be within the scope of practice of an Elder Abuse Nurse Examiner and were translated into skills-based competencies. Following review and revision by meeting experts, 47 final competencies were organised by content into 5 metacompetencies: documentation, legal and legislative issues; interview with older adult, caregiver and other relevant contacts; assessment; medical and forensic examination; and case summary, discharge plan and follow-up care. We determined the skills-based competencies of importance to training forensic nurse examiners to respond to elder abuse in the context of a hospital-based intervention. These findings may have implications for violence and abuse treatment programmes with a forensic nursing component that are considering the provision of a dedicated response to the abuse of older women and men

  6. PROSPECT: evidence-based, procedure-specific postoperative pain management. (United States)

    Kehlet, Henrik; Wilkinson, Roseanne C; Fischer, H Barrie J; Camu, Frederic


    Existing general guidelines for perioperative pain management do not consider procedure-specific differences in analgesic efficacy or applicability of a given analgesic technique. For the clinician, an evidence-based, procedure-specific guideline for perioperative pain management is therefore desirable. This chapter reviews the methodology and results of a public web site ( which provides information and recommendations for evidence-based procedure-specific postoperative pain management.

  7. Evidence-Based Medicine: Mandible Fractures. (United States)

    Pickrell, Brent B; Hollier, Larry H


    After reading this article, the participant should be able to: 1. Explain the epidemiology of mandible fractures. 2. Discuss preoperative evaluation of the patient with a mandible fracture. 3. Compare the various modalities of fracture fixation. 4. Identify common complications after fracture repair. In this Maintenance of Certification/Continuing Medical Education article, the reader is provided with a review of the epidemiology, preoperative evaluation, perioperative management, and surgical outcomes of mandible fractures. The objective of this series is to present a review of the literature so that the practicing physician can remain up-to-date on key evidence-based guidelines to enhance management and improve outcomes. The physician can also seek further in-depth study of the topic through the references provided.

  8. Leadership for evidence-based practice: strategic and functional behaviors for institutionalizing EBP. (United States)

    Stetler, Cheryl B; Ritchie, Judith A; Rycroft-Malone, Jo; Charns, Martin P


    Making evidence-based practice (EBP) a reality throughout an organization is a challenging goal in healthcare services. Leadership has been recognized as a critical element in that process. However, little is known about the exact role and function of various levels of leadership in the successful institutionalization of EBP within an organization. To uncover what leaders at different levels and in different roles actually do, and what actions they take to develop, enhance, and sustain EBP as the norm. Qualitative data from a case study regarding institutionalization of EBP in two contrasting cases (Role Model and Beginner hospitals) were systematically analyzed. Data were obtained from multiple interviews of leaders, both formal and informal, and from staff nurse focus groups. A deductive coding schema, based on concepts of functional leadership, was developed for this in-depth analysis. Participants' descriptions reflected a hierarchical array of strategic, functional, and cross-cutting behaviors. Within these macrolevel "themes," 10 behavioral midlevel themes were identified; for example, Intervening and Role modeling. Each theme is distinctive, yet various themes and their subthemes were interrelated and synergistic. These behaviors and their interrelationships were conceptualized in the framework "Leadership Behaviors Supportive of EBP Institutionalization" (L-EBP). Leaders at multiple levels in the Role Model case, both formal and informal, engaged in most of these behaviors. Supportive leadership behaviors required for organizational institutionalization of EBP reflect a complex set of interactive, multifaceted EBP-focused actions carried out by leaders from the chief nursing officer to staff nurses. A related framework such as L-EBP may provide concrete guidance needed to underpin the often-noted but abstract finding that leaders should "support" EBP. © 2014 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of

  9. [Do nursing homes with higher quality ratings provide a better quality of care? : Empirical study based on administrative data]. (United States)

    Przylog, Adam; Stroka, Magdalena A; Engel, Susanne; Linder, Roland


    In 2009 a new system for the objective evaluation of nursing homes was introduced in Germany. The so-called nursing transparency agreement (Pflege-Transparenzvereinbarungen) was introduced to provide a reliable tool for an objective comparison of inpatient (PTVS) and outpatient (PTVA) care; however, the new regulations have been the subject of a broad discussion regarding reliability, efficiency and objectivity. To overcome the lack of objective health outcomes, this study used administrative data from Germany's largest health insurance fund, the Techniker Krankenkasse, in order to analyze the association between the quality ratings and objective quality measures on an individual level. This is the first study that provides empirical evidence on this topic using administrative data. The administrative dataset contained information on several individual characteristics as well as data on injuries, poisoning and other extrinsic effects on care-dependent individuals over the age of 64 years who were living in a nursing home in 2009. Based on these data an objective measure was constructed to test whether higher quality ratings of nursing homes led to a better quality of care of the respective patients using non-linear regression models. The results of the estimated models showed no significant evidence of such a relationship, neither considering the probability nor the number of injuries, poisoning and other extrinsic effects. Significant effects were only observed for gender and specific diseases. The results of this study support the argument that the current rating procedure for nursing homes has to be refined. Using quality indicators in combination with the administrative data could possibly contribute to such an enhancement.

  10. What is the evidence based public health?


    Hernández F., Luis J.


    Evidence based Public Health is the execution and evaluation of the efficiency of interventions, plans, programs, projects and politics in public health through the application of the scientific principles of reasoning, including the systematic use of information and information systems. Evidence based public health involves the use of methodologies similar to those applied in evidence-based clinical medicine, but differs in its contents. In public health two types of evidence are described. ...

  11. Emergency Nurses' Perceptions of Providing End-of-Life Care in a Hong Kong Emergency Department: A Qualitative Study. (United States)

    Tse, Johnson Wai Keung; Hung, Maria Shuk Yu; Pang, Samantha Mei Che


    Provision of end-of-life (EOL) care in the emergency department has improved globally in recent years and has a different scope of interventions than traditional emergency medicine. In 2010, a regional hospital established the first ED EOL service in Hong Kong. The aim of this study was to understand emergency nurses' perceptions regarding the provision of EOL care in the emergency department. A qualitative approach was used with purposive sampling of 16 nurses who had experience in providing EOL care. Semi-structured, face-to-face interviews were conducted from May to October, 2014. All the interviews were transcribed verbatim for content analysis. Four themes were identified: (1) doing good for the dying patients, (2) facilitating family engagement and involvement, (3) enhancing personal growth and professionalism, and (4) expressing ambiguity toward resource deployment. Provision of EOL care in the emergency department can enhance patients' last moment of life, facilitate the grief and bereavement process of families, and enhance the professional development of staff in emergency department. It is substantiated that EOL service in the emergency department enriches EOL care in the health care system. Findings from this study integrated the perspectives on ED EOL services from emergency nurses. The integration of EOL service in other emergency departments locally and worldwide is encouraged. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  12. Communication between office-based primary care providers and nurses working within patients' homes: an analysis of process data from CAPABLE. (United States)

    Smith, Patrick D; Boyd, Cynthia; Bellantoni, Julia; Roth, Jill; Becker, Kathleen L; Savage, Jessica; Nkimbeng, Manka; Szanton, Sarah L


    To examine themes of communication between office-based primary care providers and nurses working in private residences; to assess which methods of communication elicit fruitful responses to nurses' concerns. Lack of effective communication between home health care nurses and primary care providers contributes to clinical errors, inefficient care delivery and decreased patient safety. Few studies have described best practices related to frequency, methods and reasons for communication between community-based nurses and primary care providers. Secondary analysis of process data from 'Community Aging in Place: Advancing Better Living for Elders (CAPABLE)'. Independent reviewers analysed nurse documentation of communication (phone calls, letters and client coaching) initiated for 70 patients and analysed 45 letters to primary care providers to identify common concerns and recommendations raised by CAPABLE nurses. Primary care providers responded to 86% of phone calls, 56% of letters and 50% of client coaching efforts. Primary care providers addressed 86% of concerns communicated by phone, 34% of concerns communicated by letter and 41% of client-raised concerns. Nurses' letters addressed five key concerns: medication safety, pain, change in activities of daily living, fall safety and mental health. In letters, CAPABLE nurses recommended 58 interventions: medication change; referral to a specialist; patient education; and further diagnostic evaluation. Effective communication between home-based nurses and primary care providers enhances care coordination and improves outcomes for home-dwelling elders. Various methods of contact show promise for addressing specific communication needs. Nurses practicing within patients' homes can improve care coordination by using phone calls to address minor matters and written letters for detailed communication. Future research should explore implementation of Situation, Background, Assessment and Recommendation in home care to promote

  13. Reverse Engineering: Strategy to Teach Evidence-Based Practice to Online RN-to-BSN Students. (United States)

    Gary, Jodie C; Hudson, Cindy E


    This article describes an innovative approach to introducing RN-to-BSN students to nursing research and evidence-based practice (EBP). Reverse engineering updates an existing EBP project to better emphasize the role of research and evidence to practicing RNs enrolled in an RN-to-BSN program. Reverse engineering of a nursing practice guideline offers a method for teaching an appreciation of research and supporting nursing practice with best evidence.

  14. COPE for Depressed and Anxious Teens: A Brief Cognitive-Behavioral Skills Building Intervention to Increase Access to Timely, Evidence-Based Treatment (United States)

    Lusk, Pamela; Melnyk, Bernadette Mazurek


    TOPIC Evidence–based CBT skills building intervention – COPE -for depressed and anxious teens in brief 30 minute outpatient visits. PURPOSE Based on COPE training workshops, this paper provides an overview of the COPE program, it’s development, theoretical foundation, content of the sessions and lessons learned for best delivery of COPE to individuals and groups in psychiatric settings, primary care settings and schools. SOURCES Published literature and clinical examples CONCLUSION With the COPE program, the advanced practice nurse in busy outpatient practice can provide timely, evidence-based therapy for adolescents and use the full extent of his/her advanced practice nursing knowledge and skills. PMID:23351105

  15. Strengthening PNP curricula in mental/behavioral health and evidence-based practice. (United States)

    Melnyk, Bernadette Mazurek; Hawkins-Walsh, Elizabeth; Beauchesne, Michelle; Brandt, Patricia; Crowley, Angela; Choi, Myunghan; Greenburg, Edward


    The incidence of mental health/behavioral and developmental problems in children and teens is escalating. However, many primary care providers report inadequate skills to accurately screen, identify, and manage these problems using an evidence-based approach to care. Additionally, educational programs that prepare pediatric nurse practitioners (PNPs) have been slow to incorporate this content into their curriculums. The purpose of this project was to implement and evaluate a strengthened curriculum in 20 PNP programs from across the United States that focused on: (a) health promotion strategies for optimal mental/behavioral health and developmental outcomes in children, and (b) screening and evidence-based interventions for these problems. An outcomes evaluation was conducted with faculty and graduating students from the participating programs along with faculty and students from 13 PNP programs who did not participate in the project. Participating schools varied in the speed at which components of the strengthened curriculum were incorporated into their programs. Over the course of the project, faculty from participating programs increased their own knowledge in the targeted areas and reported that their students were better prepared to assess and manage these problems using an evidence-based approach. Although reports of screening for certain problems were higher in the graduating students from the participating schools than the non-participating schools, the overall use of screening tools by students in clinical practice was low. There is a need for educational programs to strengthen their curricula and clinical experiences to prepare students to screen for, accurately identify, prevent, and provide early evidence-based interventions for children and teens with mental health/behavioral and developmental problems. This project can serve as a national model for curriculum change.

  16. Underdetermination in evidence-based medicine. (United States)

    Chin-Yee, Benjamin H


    This article explores the philosophical implications of evidence-based medicine's (EBM's) epistemology in terms of the problem of underdetermination of theory by evidence as expounded by the Duhem-Quine thesis. EBM hierarchies of evidence privilege clinical research over basic science, exacerbating the problem of underdetermination. Because of severe underdetermination, EBM is unable to meaningfully test core medical beliefs that form the basis of our understanding of disease and therapeutics. As a result, EBM adopts an epistemic attitude that is sceptical of explanations from the basic biological sciences, and is relegated to a view of disease at a population level. EBM's epistemic attitude provides a limited research heuristic by preventing the development of a theoretical framework required for understanding disease mechanism and integrating knowledge to develop new therapies. Medical epistemology should remain pluralistic and include complementary approaches of basic science and clinical research, thus avoiding the limited epistemic attitude entailed by EBM hierarchies. © 2014 John Wiley & Sons, Ltd.

  17. Psychoneuroimmunology and health from a nursing perspective. (United States)

    Langley, Pauline; Fonseca, Jenny; Iphofen, Ron

    Psychoneuroimmunology is the science that links psychological processes and the immune system. It is important to nursing as it offers underpinning theory to support good caring and empathetic nursing. This article describes the science of psychoneuroimmunology (PNI) and provides an overview of how interactions between psychological states and physiological function take place and some of the consequences for health status. It also reviews the relevance of research to nursing and considers its potential to strengthen the evidence base for therapeutic nursing and complementary therapies.

  18. A conceptual model for growing evidence-based practice. (United States)

    Vratny, Amy; Shriver, Deb


    Nursing administration at a small medical center is developing and implementing an evidence-based practice (EBP) model of care to support a culture of quality care, clinical excellence, cost-effectiveness, critical thinking, empowerment of staff, and professional growth. The purpose of this article is to describe a conceptual model for EBP that addresses how to overcome barriers to implementation. Clinician expertise and values, experience, patient preference and expectation, and caring become grounded in a practice environment that must strive to become rooted in clinical research to evolve into a practice that is evidence-based. Education helps to nourish EBP, but leadership, enthusiasm, mentorship, clinical inquiry, and reflective practice make EBP thrive. The EBP ambassadors branch out to each department to grow journal clubs, EBP Web pages, EBP projects, research utilization projects, and staff-led practice reviews. The fruits are quality patient care and outcomes, clinical excellence, cost-effectiveness, critical thinking, empowerment of staff, and professional growth.

  19. Jordanian nurses' knowledge and responsibility for enteral nutrition in the critically ill. (United States)

    Al Kalaldeh, Mahmoud; Watson, Roger; Hayter, Mark


    Poor nursing adherence to evidence-based guidelines has negative consequences leading to higher mortality rates, delayed recovery and longer length of stay. Evidence-based practice has the potential to minimize complications and discrepancies between nurses. This study aimed to assess nurses' practice and perception of their knowledge and responsibility in relation to enteral nutrition (EN) in the critically ill. This descriptive correlational design was applied to nurses working in intensive care units (ICUs) from three health care sectors in Jordan (Governmental, Military and Private sectors). Nurses were recruited using a stratified sampling technique. A pre-prepared questionnaire focusing on nurses' practice and perception towards EN was used. A total of 253 ICU nurses completed the questionnaire. Nurses revealed a tendency to undertake nutritional care despite the recognition clinical nutrition is a secondary role. In terms of nursing processes, nurses showed greater levels of knowledge and responsibility for 'preventing complications' and 'evaluation' more than 'assessment' and 'identifying goals'. Nurses inadequately assess both gastric residuals and tube placement before feeding. Diarrhoea was the most frequent complication followed by abdominal pain, vomiting, tube dislodgment and weight loss. However, nurses realized that the incidences of complications is less likely when applying evidence-based protocol. It is necessary to establish a preliminary assessment for patients' nutritional needs prior to using EN. Aspiration reduction measures are still deficient and need further attention. An evidence-based protocol for EN should be adopted in the critically ill. This article provides insight into the current practice of Jordanian intensive care nurses in different health care sectors. The study can contribute to redirect the perception of nurses towards nutrition in the critically ill in addition to enhance positive adherence to evidence base. © 2013

  20. Use of Robotic Pets in Providing Stimulation for Nursing Home Residents with Dementia. (United States)

    Naganuma, M; Ohkubo, E; Kato, N


    Trial experiments utilized robotic pets to facilitate self-reliance in nursing home residents. A remote-control robot modeled clear and meaningful behaviors to elderly residents. Special attention was paid to its effects on mental and social domains. Employing the robot as a gaze target and center of attention created a cue to initiate a communication channel between residents who normally show no interest in each other. The Sony AIBO robot in this study uses commercially available wireless equipment, and all its components are easily accessible to any medical or welfare institution interested in additional practice of these activities.

  1. Nursing care provided to young people in two health centers compared with Watson Theory


    María Alejandra Pichardo Meza; María Catalina Zúñiga Rodríguez


    This article has as objective to present the analysis of the care given by the nursing personnel to the young adult population in the Clinic of Pain Control and Palliative Care and in the Onco-hematology Service of the Max Peralta Hospital, related to Jean Watson’s theoretical proposal. The study corresponds to a joint research of parallel type with concurrent triangulation. The study populations were made up by twenty-six young adult people (who face morbid process health or chronic p...

  2. Preparing tomorrow's nursing home nurses: the wisconsin long term care clinical scholars program. (United States)

    Nolet, Kim; Roberts, Tonya; Gilmore-Bykovskyi, Andrea; Roiland, Rachel; Gullickson, Colleen; Ryther, Brenda; Bowers, Barbara J


    Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This article reports on the development, implementation, and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working both with older adults and in nursing homes, while increasing the capacity of nursing homes to provide a positive student experience.

  3. Preparing Tomorrow’s Nursing Home Nurses: The Wisconsin-Long Term Care Clinical Scholars Program (United States)

    Nolet, Kim; Roberts, Tonya; Gilmore-Bykovskyi, Andrea; Roiland, Rachel; Gullickson, Colleen; Ryther, Brenda; Bowers, Barbara J.


    Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly-skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This paper reports on development, implementation and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working with older adults and in nursing homes, while concurrently increasing the capacity of nursing homes to provide a positive student experience. PMID:25162659

  4. Registered Nurses' Experiences With Individuals With Low Health Literacy: A Qualitative Descriptive Study. (United States)

    Toronto, Coleen E; Weatherford, Barbara


    The nursing profession is charged to provide effective communication and education to patients. A qualitative descriptive study that explored what nurses experience when interacting with patients thought to possess low health literacy was performed. Findings suggest that nurses are promoting health literacy using several evidence-based strategies. Major barriers encountered by nurses were limited cultural and linguistic resources within their healthcare organizations. This study provides nursing professional development specialists information about the educational gaps of nurses in practice related to health literacy and the identification of systems barriers.

  5. Nurses as information providers: facilitating understanding and communication of statistical information. (United States)

    Hanoch, Yaniv; Pachur, Thorsten


    Nurses are increasingly being called upon to be the conveyers of important statistical information to patients. This trend is particularly evident in the domains of genetics and cancer screening. These new roles, however, demand new competencies, such as the ability to solve statistical problems, and the skill to communicate the answers effectively, as effective communication is an important ingredient in shared decision making. Genetic testing, perhaps more than other medical domains, relies heavily on the use of statistics. Being able to convey statistical information effectively is vital. In this paper, we illustrate the problems health care professionals have had in tackling and communicating statistical information. We introduce the natural frequencies method of solving Bayesian inference problems and review empirical evidence that shows the superiority of this format. Being able to transform probabilities into natural frequencies facilitates correct Bayesian inferences. It is argued that the conventional approach to educating nurses in Bayesian problem solving should be reconsidered and their statistical curriculum should be supplemented with instruction in using the natural frequency format.

  6. Towards Evidence Based Usability in Health Informatics?

    NARCIS (Netherlands)

    Marcilly, Romaric; Peute, Linda W.; Beuscart-Zephir, Marie-Catherine; Jaspers, Monique W.


    In a Health Information Technology (HIT) regulatory context in which the usability of this technology is more and more a critical issue, there is an increasing need for evidence based usability practice. However, a clear definition of evidence based usability practice and how to achieve it is still

  7. Evidence Base Update for Autism Spectrum Disorder. (United States)

    Smith, Tristram; Iadarola, Suzannah


    This evidence base update examines the level of empirical support for interventions for children with autism spectrum disorder (ASD) younger than 5 years old. It focuses on research published since a previous review in this journal (Rogers & Vismara, 2008 ). We identified psychological or behavioral interventions that had been manualized and evaluated in either (a) experimental or quasi-experimental group studies or (b) systematic reviews of single-subject studies. We extracted data from all studies that met these criteria and were published after the previous review. Interventions were categorized across two dimensions. First, primary theoretical principles included applied behavior analysis (ABA), developmental social-pragmatic (DSP), or both. Second, practice elements included scope (comprehensive or focused), modality (individual intervention with the child, parent training, or classrooms), and intervention targets (e.g., spoken language or alternative and augmentative communication). We classified two interventions as well-established (individual, comprehensive ABA and teacher-implemented, focused ABA + DSP), 3 as probably efficacious (individual, focused ABA for augmentative and alternative communication; individual, focused ABA + DSP; and focused DSP parent training), and 5 as possibly efficacious (individual, comprehensive ABA + DSP; comprehensive ABA classrooms; focused ABA for spoken communication; focused ABA parent training; and teacher-implemented, focused DSP). The evidence base for ASD interventions has grown substantially since 2008. An increasing number of interventions have some empirical support; others are emerging as potentially efficacious. Priorities for future research include improving outcome measures, developing interventions for understudied ASD symptoms (e.g., repetitive behaviors), pinpointing mechanisms of action in interventions, and adapting interventions for implementation with fidelity by community providers.

  8. Cardiac Radiofrequency Ablation: A Clinical Update for Nurses. (United States)

    Shoulders, Bridget; Mauriello, Jillian; Shellman, Tamika; Follett, Corrinne


    The field of electrophysiology (EP) has rapidly evolved from a focus on diagnostic procedures to an emphasis on interventions. Many cardiac arrhythmias traditionally treated with antiarrhythmic agents, cardioversion, or cardiac surgery are now routinely cured with cardiac ablation. To optimally manage the care of cardiac ablation patients, it is essential that nurses have an understanding of the EP procedures and related nursing implications. There are extensive evidence-based resources available in the medical literature; however, there are limited publications geared toward nurses caring for cardiac ablation patients.This article provides an overview of EP diagnostic and cardiac radio-frequency ablation procedures for select atrial and ventricular tachyarrhythmias. Evidence-based nursing practices related to postprocedure care will be addressed. The objective of this article is to increase nurses' knowledge of common cardiac ablation procedures and the nursing management of the patient postprocedure.

  9. Diabetes Mellitus Care Provided by Nurse Practitioners vs Primary Care Physicians. (United States)

    Kuo, Yong-Fang; Goodwin, James S; Chen, Nai-Wei; Lwin, Kyaw K; Baillargeon, Jacques; Raji, Mukaila A


    To compare processes and cost of care of older adults with diabetes mellitus cared for by nurse practitioners (NPs) with processes and cost of those cared for by primary care physicians (PCPs). Retrospective cohort study. Primary care in communities. Individuals with a diagnosis of diabetes mellitus in 2009 who received all their primary care from NPs or PCPs were selected from a national sample of Medicare beneficiaries (N = 64,354). Propensity score matching within each state was used to compare these two cohorts with regard to rate of eye examinations, low-density lipoprotein cholesterol (LDL-C) and glycosylated hemoglobin (HbA1C) testing, nephropathy monitoring, specialist consultation, and Medicare costs. The two groups were also compared regarding medication adherence and use of statins, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (for individuals with a diagnosis of hypertension), and potentially inappropriate medications (PIMs). Nurse practitioners and PCPs had similar rates of LDL-C testing (odds ratio (OR) = 1.01, 95% confidence interval (CI) = 0.94-1.09) and nephropathy monitoring (OR = 1.05, 95% CI = 0.98-1.03), but NPs had lower rates of eye examinations (OR = 0.89, 95% CI = 0.84-0.93) and HbA1C testing (OR = 0.88, 95% CI = 0.79-0.98). NPs were more likely to have consulted cardiologists (OR = 1.29, 95% CI = 1.21-1.37), endocrinologists (OR = 1.64, 95% CI = 1.48-1.82), and nephrologists (OR = 1.90, 95% CI = 1.67-2.17) and more likely to have prescribed PIMs (OR = 1.07, 95% CI = 1.01-1.12). There was no statistically significant difference in adjusted Medicare spending between the two groups (P = .56). Nurse practitioners were similar to PCPs or slightly lower in their rates of diabetes mellitus guideline-concordant care. NPs used specialist consultations more often but had similar overall costs of care to PCPs. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  10. [Burn out in health care providers: a Tunisian study about 142 nurses]. (United States)

    Aloulou, Jihen; Damak, Rahma; Masmoudi, Fatma; Sidhom, Oussama; Amami, Othman


    Burnout is a syndrome which affects preferentially help professions, having a strong emotional interpersonal implication. To assess the prevalence of burn out in a sample of Tunisian nurses, and to determine its causes and perceived repercussions. In a first step, we assessed the work conditions, the perceived burn out and its possible consequences in 142 nurses from 12 different wards. In a second step, we used the Malasch Burn Inventory to assess the burn out symptoms in ours ample. More than two thirds (69%) of our sample had a burn out. Forty five point eight percent of the affected professionals had a high level of emotional distress, 36.6% had a high level of depersonalization and 22.5% had a low level of professional fulfillment. The high caseload was the first cause of burn out (72.5% of professionals) and was associated to a moderate level of burn out (OR=3.80; 95%IC: 1.079-13.420 ; p = 0.038). Role ambiguity and undefined responsibilities were associated to a high level of emotional distress (p=0.04) and depersonalization (p=0.03), and a low level of professional fulfillment (p=0.0001). High scores of emotional distress were associated to a high number of work hours (p=0.006) and less than 10 years in carrier duration (p=0.008). In our study, feelings of uselessness were associated to high levels of emotional distress (p=0.05) and depersonalization (p=0.002) on the one hand, and to a lower level of personal fulfillment on the other hand (p=0.04). Moreover, we found that cases with suicide ideations had a higher level of burn out (p=0.04). Concerning physical symptoms, emotional distress was associated to multiples somatic complains. Our results corroborate partially with those of the literature and illustrate some parameters that can be the cause of burnout, such as working conditions, role ambiguity, and lack of experience among the young nurse. Therefore, it is important to take into consideration this various factors had their impact on quality of life

  11. Evaluation of the Effect of Nursing Services Provided in a Correctional Institution on the Physical Health Levels and Health Behaviors of Female Inmates


    Şenay Pehli̇van; Gülümser Kublay


    Female inmates placed in a Correctional Institution (CI) have more physical health problems than other women and their male counterparts. Thus, they require more health care services in the CI and nursing services in particular. CI nurses also have the opportunity to teach behaviors which will protect and improve their health to these women who are difficult to reach in the community. The aim of this study was to evaluate effect of nursing services provided in a CI on the physical health leve...

  12. Personal Communication Device Use by Nurses Providing In-Patient Care: Survey of Prevalence, Patterns, and Distraction Potential. (United States)

    McBride, Deborah L; LeVasseur, Sandra A


    Coincident with the proliferation of employer-provided mobile communication devices, personal communication devices, including basic and enhanced mobile phones (smartphones) and tablet computers that are owned by the user, have become ubiquitous among registered nurses working in hospitals. While there are numerous benefits of personal communication device use by nurses at work, little is known about the impact of these devices on in-patient care. Our aim was to examine how hospital-registered nurses use their personal communication devices while doing both work-related and non‒work-related activities and to assess the impact of these devices on in-patient care. A previously validated survey was emailed to 14,797 members of two national nursing organizations. Participants were asked about personal communication device use and their opinions about the impact of these devices on their own and their colleagues' work. Of the 1268 respondents (8.57% response rate), only 5.65% (70/1237) never used their personal communication device at work (excluding lunch and breaks). Respondents self-reported using their personal communication devices at work for work-related activities including checking or sending text messages or emails to health care team members (29.02%, 363/1251), as a calculator (25.34%, 316/1247), and to access work-related medical information (20.13%, 251/1247). Fewer nurses reported using their devices for non‒work-related activities including checking or sending text messages or emails to friends and family (18.75%, 235/1253), shopping (5.14%, 64/1244), or playing games (2.73%, 34/1249). A minority of respondents believe that their personal device use at work had a positive effect on their work including reducing stress (29.88%, 369/1235), benefiting patient care (28.74%, 357/1242), improving coordination of patient care among the health care team (25.34%, 315/1243), or increasing unit teamwork (17.70%, 220/1243). A majority (69.06%, 848/1228) of

  13. Evidence-Based Medicine: Liposuction. (United States)

    Chia, Christopher T; Neinstein, Ryan M; Theodorou, Spero J


    After studying this article, the participant should be able to: 1. Review the appropriate indications and techniques for suction-assisted lipectomy body contouring surgery. 2. Accurately calculate the patient limits of lidocaine for safe dosing during the tumescent infiltration phase of liposuction. 3. Determine preoperatively possible "red flags" or symptoms and signs in the patient history and physical examination that may indicate a heightened risk profile for a liposuction procedure. 4. Provide an introduction to adjunctive techniques to liposuction such as energy-assisted liposuction and to determine whether or not the reader may decide to add them to his or her practice. With increased focus on one's aesthetic appearance, liposuction has become the most popular cosmetic procedure in the world since its introduction in the 1980s. As it has become more refined with experience, safety, patient selection, preoperative assessment, fluid management, proper technique, and overall care of the patient have been emphasized and improved. For the present article, a systematic review of the relevant literature regarding patient workup, tumescent fluid techniques, medication overview, and operative technique was conducted with a practical approach that the reader will possibly find clinically applicable. Recent trends regarding energy-assisted liposuction and body contouring local anesthesia use are addressed. Deep venous thromboembolism prophylaxis is mentioned, as are other common and less common possible complications. The article provides a literature-supported overview on liposuction techniques with an emphasis on preoperative assessment, medicines used, operative technique, and outcomes.

  14. Newly graduated nurses' use of knowledge sources

    DEFF Research Database (Denmark)

    Voldbjerg, Siri Lygum; Grønkjaer, Mette; Sørensen, Erik Elgaard


    . The synthesis accentuates that for use of newly graduated nurses' qualifications and skills in evidence-based practice, clinical practice needs to provide a supportive environment which nurtures critical thinking and questions and articulates use of multiple knowledge sources....... underscoring progression in knowledge use and perception of competence and confidence among newly graduated nurses. CONCLUSION: The transition phase, feeling of confidence and ability to use critical thinking and reflection, has a great impact on knowledge sources incorporated in clinical decisions...

  15. Experiences of mental health nursing staff at occupational stressors in a service provider institution in Cali, Colombia

    Directory of Open Access Journals (Sweden)

    Ana María Ruíz


    Full Text Available Introduction: Nursing staff, who attend psychiatric patients, are confronted with differentiated occupational stressors. Objective: Interpret the experiences of mental health nursing staff when facing occupational stressors, ranging from three transactional cut stress models and Goffman paper theory. Materials and methods: A qualitative and phenomenological study was conducted. Semi-structured interviews were carried out with nurses from a health care institution. The analysis of content and map of the association of ideas was employed for the analysis. Results: The main occupational stressors found were: unfavorable physical resource