A systematic review of the outcomes of educational interventions relevant to nurses with simultaneous strategies for guideline implementation.

AIMS AND OBJECTIVES: To systematically review the literature on the outcomes of educational interventions relevant to nurses with regard to guideline implementation. BACKGROUND: Previous reviews on interventions to implement guidelines have focused on particular clinical problems, but only one included nursing studies. DESIGN: A systematic review based on the procedure of the Centre for Reviews and Dissemination. METHODS: We searched for papers published from 1 January 2008 to 26 February 2015 using the Cochrane, CINAHL and PubMed MEDLINE databases and paper references were searched manually. Quality appraisal was conducted with tools developed by Thomas et al.(Worldviews on Evidence-based Nursing, 1, 2004, 176) and National Heart, Lung, and Blood Institute. Data were analysed with qualitative content analysis and narrative synthesis. RESULTS: The data included 13 studies based on a quasi-experimental study design of 13 different educational interventions, described according to their development and realisation, learning content and teaching and learning methods. Seven interventions were supported by simultaneous strategies, 12 studies reported statistically significant outcomes for the interventions on at least one measurement area and six studies reported improvements in the quality of patient care. Interventions with multi-dimensional content, teaching and learning methods produced several good outcomes. CONCLUSION: Guidelines were implemented in a heterogeneous way and the interventions were delivered once and mainly on a local basis. In the future, we need to test these interventions in different nursing contexts, measure the outcomes on patient care and carry out randomised controlled trials on their effectiveness. It is important to standardise interventions, as this will allow them to be replicated and compared. RELEVANCE TO CLINICAL PRACTICE: Educational interventions to implement guidelines could be beneficial in enhancing nurses' evidence-based decision-making and care practice. The combination of teaching and learning methods proved useful, and educational interventions should be supported with simultaneous strategies. There remains a lack of strong evidence on the subject.

A Systematic Review of Journal Clubs for Nurses.

BACKGROUND: Two previous systematic reviews describe studies on journal clubs from 1995 to 2007. AIMS: To gather, assess, and synthesize the current empirical evidence on implementation of journal clubs, influencing factors, and outcomes of journal clubs in promoting evidence-based nursing. DESIGN: A systematic review based on the procedure of the Centre for Reviews and Dissemination. DATA SOURCES AND METHODS: Cochrane, CINAHL, and PubMed Medline databases were sought from 2008 to 2015. The final data consisted of 10 studies. Articles' references were searched manually. The quality appraisal was made according to study design. Data were analyzed by qualitative content analysis and narrative synthesis. RESULTS: The analyses produced four main categories with 14 subcategories that described the journal clubs: organization, conduct of meetings, influencing factors, and intervention outcomes. Journal clubs had been carried out in a fairly uniform manner in different nursing communities. There remains a lack of evidence on journal clubs' impact on evidence-based nursing (EBN) implementation, which challenges the development of journal clubs' content and methods. LINKING EVIDENCE TO ACTION: Because journal clubs have achieved a uniform and easy-to-follow manner that is suitable for different nursing contexts and provide multiple positive outcomes, they are recommended for EBN. In work communities, journal clubs should be combined with other well-known factors that promote EBN implementation. The assessment of the outcomes of journal clubs should cover all learning categories of EBN with a focus on medium- to long-term effectiveness. The evaluation of the effectiveness of journal clubs on patient care is of great importance for future studies.

Nursing students learning to utilize nursing research in clinical practice.

The purpose of the study was to examine the significance of a learning assignment in relation to research skills and learning of nursing students in clinical practice. The learning assignment included an oral presentation of a nursing research article, which the students gave to their fellow students and ward nurses. The students also chaired the discussion after the presentation. The target group for the study was nursing students of a Finnish polytechnic who had been studying for 2-2 1/2 years and had accomplished a minimum of 120 ECTS credits of the total of 210 ECTS credits. When participating in the study, the students were completing a six-week clinical practice of optional studies. The data were collected with a questionnaire designed for the study. It consisted of six open-ended questions. Three of the questions were related to learning of research skills. Two questions were concerned with learning during the ongoing clinical practice. The final question inquired the students' views on the development of the learning assignment. The students received the questionnaire before the commencement of their clinical practice, and they returned it to the other researcher after their clinical practice. The questionnaire was given to 80 students, of which 50 returned it; the response rate was 63%. The data were analysed by content analysis question by question. According to the results, the learning assignment advanced the understanding of research concepts for the majority of the students. In particular, the students reported that the oral presentation clarified the research concepts, and the structure of a scientific article was also elucidated. The students stated that the assignment generated ideas concerning the development of nursing care. In relation to the ongoing clinical practice, the assignment advanced patient encounters and interaction, and bearing responsibility the most. Proposals for the further development of the learning assignment were expressed by more than half of the nursing students. Half of them suggested ensuring the interest in the topic from the ward.

Educational interventions on evidence-based nursing in clinical practice: A systematic review with qualitative analysis.

AIMS: To gather, assess and synthesise the currently available evidence of educational interventions on evidence-based nursing (EBN). BACKGROUND: Previous systematic reviews have focused on the items used in reporting educational interventions for facilitating evidence-based practices in medicine and health care or teaching research literacy in nursing as well as on the outcomes of these interventions. DESIGN: A systematic review based on a procedure of the Centre for Reviews and Disseminations for conducting a systematic review of health interventions. DATA SOURCES AND METHODS: Texts from 2008 to 2015 were sought from the Cochrane, CINAHL and PubMed Medline databases. Eight studies were selected for the final data and reviewed for quality. Data were analysed with narrative synthesis including qualitative content analysis. RESULTS: Four main categories and sixteen subcategories were identified. The learning contents included principles of EBN and research, the process of EBN, and planning a change in practice. The most popular teaching/learning methods were lectures/didactic presentations and group work. The interventions encouraged learners to critically examine and evaluate their practice. The interventions also improved participants' capacity to identify the need for research evidence in clinical practice. CONCLUSION: The educational interventions were fairly similar and had promising results. However, as the level of evidence was modest in the studies, there are several development needs for interventions and further research challenges. Interventions should provide participants with sufficient competences for implementing every step of EBN, with special focus on the implementation of evidence in patient care. The assessment of the outcomes of interventions should cover all learning categories of EBN with focus on medium to long-term effectiveness. The influence of different teaching/learning methods and learning contexts and settings should be investigated further.

Evaluation of learning outcomes in a research process and the utilization of research knowledge from the viewpoint of nursing students.

The purpose of this descriptive study was to evaluate the learning that takes place in a research process of nursing students when writing their Bachelor's theses and to describe the learning outcomes in utilizing research knowledge. The sample comprised nursing students from a Finnish polytechnic. All of them worked with their Bachelor's theses. The data were collected by a questionnaire constructed for this study and 257 nursing students participated in the study. The data were analysed by SPSS 10.0 software. The students knew the steps of the research process moderately well. Most of the students responded that research results had been implemented in nursing practice. More than half of the students found the attitudes towards research positive in their clinical placements. Students' self-evaluation of learning outcomes was positive and they felt able to use research knowledge. The results indicated improving learning outcomes during the working process of the Bachelor's thesis. Working with the Bachelor's thesis is an effective way to lead the students to use research knowledge. The results are useful in guiding the students through their Bachelor's theses as well as in developing the curriculum and working life.

Journal club intervention in promoting evidence-based nursing: perceptions of nursing students.

This study focused on nursing journal clubs as an intervention in promoting evidence-based nursing. Nursing journal clubs refer to arranged meetings where nurses convene to discuss the use of research knowledge in nursing practice. Researchers and directors of a university hospital planned the intervention. The study aimed to assess learning and utilization of research knowledge after implementation of nursing journal clubs from the perspective of nursing students. In journal clubs, answers were sought from scientific nursing articles to solve nursing problems specified by each ward/outpatient unit. Nursing students paired up to make an oral presentation of a research article to staff nurses. After the presentation, they acted as chairpersons in the discussion. The students had a vocational nursing diploma and were aiming at bachelor's degree in nursing. After the final club meeting, the students (n = 53) responded to a questionnaire. The results indicated that the students were not able to utilize the studies to the same extent as they learnt from them. Age, work experience and participation in research and development activities were connected to learning. Despite limitations, the results may be used to develop nursing journal clubs as a learning and collaboration method between nurse education and health care.

International student nurses' experiences of clinical practice in the Finnish health care system.

The purpose of this qualitative study was to describe international student nurses' experiences of their clinical practice in the Finnish health care system. The data were collected by semi-structured interviews. Fourteen international student nurses of African and Asian origin were interviewed, and the data were then analysed by qualitative content analysis. The results indicated that appreciative orientation, sense of belonging to the team, enhancing independent working, growing towards professionalism and working as a member of the team were descriptions of positive experiences. Descriptions of negative experiences were related to restricted learning and compromised human dignity, which lead to negative feelings of being an outsider, decreased self-esteem, sense of giving up and anticipation of difficulties. Despite the small sample size, the results indicate a need to develop clinical practice arrangements when the language of the learning environment is other than that of the student nurse. As the number of international students has increased in the Finnish health care sector and in nursing education, it is important to recognise the factors related to positive and negative experiences in clinical practice.