Use of Evidence-based Practice Models and Research Findings in Magnet-Designated Hospitals Across the United States: National Survey Results.

BACKGROUND: All nurses have responsibilities to enculturate evidence-based practice (EBP) and translate and implement research findings into nursing care, practices, and procedures. AIMS: To report EBP-related findings from the national Hospital-Based Nursing Research Characteristics, Care Delivery Outcomes, and Economic Impact Survey questionnaire. METHODS: In this cross-sectional survey research study of 181 nursing research leaders, 127 responded to these questions: "Has your hospital adopted or does it use a model of evidence-based practice?" "If yes, what is the name of the model and how is it used?" "Does your hospital implement (translate) findings from nursing research into clinical practice?" "Describe how your hospital implements these findings and whose responsibility it is." "What factors do you believe facilitate the implementation of findings from nursing research into clinical practice at your hospital?" Qualitative content analyses were used. RESULTS: Over 90% of nursing research leaders specified that their hospital used an EBP model and implements findings into practice. The most frequently reported models were the Iowa Model of Evidence-Based Practice, Johns Hopkins Nursing Evidence-Based Practice Model, and Advancing Research and Clinical Practice Through Close Collaboration Model. EBP models were used most frequently for education and training, nurse residency programs, and EBP and research fellowships. Findings were implemented through policy and procedure committee processes, shared governance structures, and EBP processes. Those responsible for implementing findings were project leads, nursing professional practice councils, and clinical nurse specialists and advanced practice nurses. Implementation facilitators were nursing leadership, dissemination of findings, and engaged and educated nurses. LINKING EVIDENCE TO ACTION: These new findings report >90% EBP model use and implementation. All nurses, especially our leaders, have responsibilities to evaluate EBP and how nursing research findings are implemented (translated) into practice. Ideally, engaged and educated nurses who enculturate, support, and sustain EBP will facilitate advancing nursing practice to improve patient and work environment-related outcomes.

Mentoring students engaging in scholarly projects and dissertations in doctoral nursing programs.

BACKGROUND: Doctor of Nursing Practice (DNP) programs in the US have grown exponentially, outnumbering Doctor of Philosophy (PhD) in Nursing programs. Faculty are mentoring increasing numbers of students on DNP projects or PhD dissertations. PURPOSE: This descriptive study explored faculty characteristics and examined support, engagement, and outcomes of American Association of Colleges of Nursing member nursing faculty mentoring student DNP projects or PhD dissertations. METHOD: A researcher-developed survey tool was emailed to 550 Deans and Program Directors of AACN doctoral programs for distribution to their doctoral faculty. Survey data were analyzed using descriptive statistics. FINDINGS: 177 DNP and 53 PhD (N=230) program surveys were completed. Faculty described challenges in the mentoring role including: time constraints, workload allocation, resources, faculty role preparation, student readiness, and variability in student outcomes. CONCLUSIONS: Additional dialogue and consensus is required to promote mentoring of students in nursing doctoral programs to ensure rigor of scholarly outcomes.

National Study of Nursing Research Characteristics at Magnet®-Designated Hospitals.

OBJECTIVE: To describe the research infrastructure, culture, and characteristics of building a nursing research program in Magnet®-designated hospitals. BACKGROUND: Magnet recognition requires hospitals to conduct research and implement evidence-based practice (EBP). Yet, the essential characteristics of productive nursing research programs are not well described. METHODS: We surveyed 181 nursing research leaders at Magnet-designated hospitals to assess the characteristics in their hospitals associated with research infrastructure, research culture, and building a nursing research program. RESULTS: Magnet hospitals provide most of the needed research infrastructure and have a culture that support nursing research. Higher scores for the 3 categories were found when hospitals had a nursing research director, a research department, and more than 10 nurse-led research studies in the past 5 years. CONCLUSIONS: While some respondents indicated their nurse executives and leaders support the enculturation of EBP and research, there continue to be barriers to full implementation of these characteristics in practice.

Implementing the Brøset Violence Checklist in the ED.

ABSTRACT: The emerging field of implementation science (IS) facilitates the sustainment of evidence-based practice in clinical care. This article, the second in a series on applying IS, describes how a nurse-led IS team at a multisite health system implemented the Brøset Violence Checklist-a validated, evidence-based tool to predict a patient's potential to become violent-in the system's adult EDs, with the aim of decreasing the rate of violence against staff. The authors discuss how they leveraged IS concepts, methods, and tools to achieve this goal.

National survey of hospital nursing research, part 2: facilitators and hindrances.

OBJECTIVE: The aim of this study was to describe the facilitators and hindrances associated with the conduct of registered nurse-led research in US hospitals. BACKGROUND: Hospital-based nursing research programs are growing in response to increasing emphasis on evidence-based practice. Concerns existed about institutional regulations prohibiting staff nurses' ability to be principal investigators of their research studies. METHODS: Comments from the Hospital-Based Nursing Research Requirements and Outcomes national survey regarding facilitators and hindrances of conducting nursing research in hospitals were analyzed using content analysis. RESULTS: Comments from 95% of surveys were classified into 24 facilitator and hindrance codes. Both Magnet and non-Magnet hospitals identified the presence of a research mentor as the top facilitator. In non-Magnet hospitals, the top hindrance was a lack of a research mentor as compared with Magnet hospitals, which reported lack of time. CONCLUSIONS: The presence of a research mentor is the most important facilitator for hospital nursing research. Findings provide data to inform research program development.

National survey of hospital nursing research, part 1: research requirements and outcomes.

OBJECTIVE: The aim of this study was to describe program requirements and scholarly outcomes for registered nurse (RN)-led research in US hospitals. BACKGROUND: Magnet recognition emphasis on evidence-based practice and research has stimulated the growth of hospital-based nursing research programs. Hospital policies stipulating whether RNs can lead studies as principal investigators (PIs) varied among members of a regional nursing research consortium. METHODS: Members of the consortium conducted a national survey of hospitals regarding their requirements for RN-led research and associated scholarly outcomes. RESULTS: Most (87.1%) of the hospitals (N = 160) reported no minimum educational requirements for nurses to be PIs. Mentoring, training, and peer review/approval requirements differed between Magnet and non-Magnet hospitals. On average, hospitals reported an annual total of 4 studies initiated, 4 disseminated via podium or poster presentation, 1 published, and 2 funded. CONCLUSIONS: Findings from this study provide a prototype and benchmark information for nursing administrators planning to establish, evaluate, and/or expand nursing research programs.

A Nurse-Led Implementation Science Specialist Program.

ABSTRACT: A well-known challenge in health care is integrating evidence into practice. Implementation science (IS) is a growing field that promotes the sustainable application of evidence-based practice (EBP) to clinical care. Health care organizations have an opportunity to support sustainable change by creating robust IS infrastructures that engage nurses in the clinical environment. Integrating IS into a nursing shared governance model is an ideal vehicle to empower direct care nurses to sustain EBP. Importantly, an IS infrastructure may also promote nurse retention and increase interdisciplinary collaboration. This article, the first in a series on applying IS, describes how a multisite health care organization developed a systemwide nurse-led IS Specialist program within a shared governance model.

Universal Design for Learning: A Framework for Blended Learning in Nursing Education.

BACKGROUND: Blended learning (BL), the combining of face-to-face and online learning, is gaining prominence in nursing education in response to advances in evidence-based learning using technology, the diverse and evolving needs of nursing learners, and unpredictable events impacting nursing education. PROBLEM: Blended learning requires nursing learners and educators to adapt to new modalities and educators to re-envision learning environments. However, BL lacks an educational framework to guide implementation and is not well explored in the nursing literature. APPROACH: Universal design for learning (UDL) is applied as a framework for BL in nursing education. CONCLUSIONS: Universal design for learning provides a framework for BL to enable nursing educators, learners, and educational institutions to reimagine teaching and learning in novel ways that incorporate emerging evidence and address new challenges. Blended learning, within the context of UDL, offers opportunities for diverse and inclusive learning. Research is needed to guide the implementation of BL best practices within a UDL framework.

Implementing Universal Design Instruction in Doctor of Nursing Practice Education.

BACKGROUND: Faculty in Doctor of Nursing Practice (DNP) programs identify challenges of increased enrollment and variances in previous student educational preparation and professional experiences that require innovative approaches to curriculum transformation. PURPOSE: This article informs nurse educators about the vibrant and inclusive approach of universal design for instruction (UDI), a framework to conceptualize and implement learning strategies in the DNP curriculum. APPROACH: UDI is guided by 9 instructional principles that anticipate diverse learners and is intentionally inclusive of multiple ways of learning. Principles of UDI were synergized into several DNP didactic courses and the scholarly project process. CONCLUSION: Integration of UDI into the DNP curriculum included precourse assessments, multiple modalities of content delivery, options to present acquired knowledge, and supporting the adult learner through the iterative work of the scholarly project.