Cultivating evidence-based practice through mentorship.

BACKGROUND: Nurses' use of evidence-based practice (EBP) improves patient outcomes through provision of optimal patient care. AIM: The Evidence-Based Practice Mentorship Program (EBPMP) is a self-directed, year-long immersion program implemented for staff nurses to experience the EBP process with close mentor support. The aim of this program is to bolster a culture of EBP at a single large pediatric quaternary care hospital in the Northeast. RESULTS: A total of 81 nurses across 4 cohorts participated in this organization wide program from 2016 to 2019. To date the program has produced 46 internally and externally disseminated EBP projects. Of the graduates, 7-nurse mentees have become formal EBPMP mentor's, 3 have applied and been accepted into the organizational based Nursing Science Fellowship to carry out clinical inquiry projects to fill important literary gaps, and 6 have received promotions or career advancements. Most importantly, graduates have anecdotally reported that program participation inspired deeper critical reflection of patient care. SUMMARY: Utilizing mentorship to facilitate EBP was a key educational strategy for the busy mentors and mentees, as many of the nurse participants were direct care providers. This self-directed program resulted in a high project completion rate leading to continued organizational support for the program, which is now in its fourth year.

Effect of airborne-particle abrasion on 3-dimensional surface roughness and characteristic failure load of fiber-reinforced posts.

STATEMENT OF PROBLEM: Debonding is the most common complication of fiber-reinforced posts (FRPs). Airborne-particle abrasion (APA) has been suggested to increase resin cement adhesion to the surface of FRPs. However, which abrasion protocol is the most favorable is unclear. PURPOSE: The purpose of this in vitro study was to compare the surface roughness and characteristic failure load of three FRP systems following different APA protocols. MATERIAL AND METHODS: A total of 150 posts from 3 manufacturers (glass FRP, quartz FRP, and zirconia-enriched glass FRP) were randomly assigned to different surface treatments (NT: no treatment-control; E0: cleaned with 96% ethanol solution; E2: APA for 2 seconds/mm2-ethanol cleaned, E5: APA for 5 seconds/mm2-ethanol cleaned; and E10: APA for 10 seconds/mm2-ethanol cleaned) forming 15 groups in total. APA was performed with 50-µm aluminum oxide. Each post was observed under a 3-dimensional (3D) laser microscope, and average 3D surface roughness (Sa) was measured. Failure was induced with a universal testing machine. Two specimens per group were evaluated under the same microscope to evaluate failure patterns. Surface roughness data were analyzed with the Welch ANOVA (α=.05), followed by the post hoc Games-Howell test. Failure load differences were determined by 2-parameter Weibull statistics and likelihood ratio contour plots (95% confidence bounds). RESULTS: Statistically significant differences were found in the mean surface roughness among the groups (Welch ANOVA, P<.001). APA resulted in a significant surface roughness increase in all tested post systems. No surface roughness difference was found between surface treatments E2, E5, and E10 in any tested post systems. Weibull statistics and likelihood contour plots revealed a significant decrease in the characteristic failure load for glass FRP after surface treatment E2 (88.7 N) compared with the control (95.3 N). Quartz FRP showed a significant decrease in the characteristic failure load after surface treatment E5 (103.6 N) compared with the control (108.9 N). Zirconia-enriched glass FRP showed no significant decrease in the characteristic failure load after any of the tested surface treatments. Qualitative morphological changes and failure pattern differences were observed among the tested post systems after the different surface treatments. CONCLUSIONS: APA significantly increased surface roughness in all post systems. APA effects on characteristic failure load were dependent on the material used.

Evaluation of an evidence-based practice mentorship programme in a paediatric quaternary care setting.

BACKGROUND: Evidence-based practice (EBP) is essential for clinical decision-making, improving care, reducing costs and achieving optimal patient outcomes. The Evidence-based Practice Mentorship Program (EBPMP) is a flexible, self-directed programme whereby participants carry out EBP projects guided by expert mentors. AIMS: To evaluate EBPMP effectiveness and participant experience. METHODS: To evaluate effectiveness, as measured by changes in EBP value, knowledge and implementation, participants completed pre- and post-EBPMP Quick-EBP-Value, Implementation and Knowledge (VIK) surveys. To understand participants' experiences individual and group interviews were conducted at the end of the programme and analysed using qualitative content analysis. RESULTS: Most participants were over 50 years old, Caucasian, inpatient staff nurses, baccalaureate prepared, with over 11 years' experience. Statistically significant improvements were observed in the post Quick-EBP-VIK knowledge and implementation domains. Individual and group participant interviews revealed four categories of importance to the experience: 1. perceived benefits of EBP, 2. time as a barrier to EBP, 3. desire for more cohort interaction and 4. positive mentee-mentor experience. CONCLUSIONS: EBPMP can improve participants' knowledge and implementation of EBP in an environment that values EBP; however, opportunities exist to implement programme modifications that address barriers identified by participants including project time and increased participant interactions.

Pediatric nurses' perceptions of preparedness for global health fieldwork.

OBJECTIVES: The purpose of this qualitative descriptive research study was to understand the current state, perceived content, and experiential needs of pediatric nurses preparing for global health (GH) fieldwork experience. This study aimed to inform stakeholders about the standard and unique preparation needs of pediatric GH nurses. STUDY DESIGN AND METHODS: One group and five individual interviews were held with nurses from a large pediatric quaternary care facility in the Northeast United States. Data from the interviews were transcribed verbatim, eliminating personal data. Only deidentified transcripts were used for data analysis. Members of the study team used content analysis to systematically code and analyze the data. RESULTS: Qualitative content analysis revealed five categories: (1) identifying clear objectives, (2) understanding the practice environment, (3) self-assessment of clinical skills, cultural competencies, and adaptability, (4) safety and logistics planning, and (5) psychological self-care and reentry anticipatory guidance. CONCLUSIONS: Findings can provide a basis for program planning to prepare pediatric nurses for GH fieldwork. Program planning must account for the unique features of the site and situation. Organizational and personal preparation can influence the perceived success of the GH experience.