ABSTRACT
ABSTRACT Objective: To analyze knowledge, attitudes, practices, and frequent barriers to the implementation of the Evidence-Based Practice among nursing assistants in the hospital. Method: This is an integrative review, whose search for primary studies occurred in the PubMed, CINAHL and LILACS databases. For the analysis, cross-sectional observational studies were included in English, Portuguese and Spanish, published in nursing journals, from January 2007 to July 2016. Results: The search resulted in 363 articles, including nine primary studies. The sources of recurrent evidence among care nurses were: personal experience and local care protocols. These professionals presented weaknesses in the implementation of the Evidence-Based Practice related to the lack of knowledge for evidence evaluation, work overload and resistance to change of practice. Final considerations Nurses presented favorable attitudes, however, with little knowledge to perform the Evidence-Based Practice. Results can support interventions for its implementation in the hospital.
RESUMEN Objetivo: Analizar conocimientos, actitudes, prácticas y barreras frecuentes para la implementación de la Práctica Basada en Evidencias entre enfermeros asistenciales en el contexto hospitalario. Método: Se trata de una revisión integrativa, cuya búsqueda de los estudios primarios ocurrió en las bases PubMed, CINAHL y LILACS. Para el análisis se incluyeron estudios observacionales, en corte transversal, en inglés, español, portugués y publicados en revistas de enfermería a partir del enero 2007 hasta el julio 2016. Resultado: La búsqueda resultó en 363 artículos, siendo incluidos nueve estudios primarios. Las fuentes de evidencia recurrentes entre los enfermeros asistenciales fueron: la experiencia personal y los protocolos asistenciales locales. Estos profesionales presentaron fragilidades para la implementación de la Práctica Basada en Evidencias relacionadas al poco conocimiento para evaluación de evidencias, sobrecarga de trabajo y resistencia al cambio de prácticas. Consideraciones finales: Los enfermeros presentaron actitudes favorables; sin embargo, tenían poco conocimiento para desempeñar la Práctica Basada en Evidencias. Los resultados pueden subsidiar intervenciones para su implementación en el ámbito hospitalario.
RESUMO Objetivo: Analisar conhecimentos, atitudes, práticas e barreiras frequentes para a implementação da Prática Baseada em Evidências entre enfermeiros assistenciais no contexto hospitalar. Método: Trata-se de revisão integrativa, cuja busca dos estudos primários ocorreu nas bases PubMed, CINAHL e LILACS. Para análise foram incluídos estudos observacionais, tipo transversal, em inglês, português e espanhol, publicados em periódicos de enfermagem, no período de janeiro 2007 a julho 2016. Resultado: A busca resultou em 363 artigos, sendo incluídos nove estudos primários. As fontes de evidências recorrentes entre os enfermeiros assistenciais foram: a experiência pessoal e os protocolos assistenciais locais. Esses profissionais apresentaram fragilidades para a implementação da Prática Baseada em Evidências relacionadas ao pouco conhecimento para avaliação de evidências, sobrecarga de trabalho e resistência à mudança de práticas. Considerações finais: Enfermeiros apresentaram atitudes favoráveis, entretanto, pouco conhecimento para desempenharem a Prática Baseada em Evidências. Resultados podem subsidiar intervenções para sua implementação em âmbito hospitalar.
Subject(s)
Humans , Health Knowledge, Attitudes, Practice , Evidence-Based Nursing/standards , Nursing Care/methods , Clinical Competence/standards , Nursing Care/standardsABSTRACT
PURPOSE: The purposes of the study were to describe baseline data in the implementation of evidence-based clinical practices among health center partners as part of a community-wide teen pregnancy prevention initiative and to identify opportunities for health center improvement. METHODS: Health center partner baseline data were collected in the first year (2011) and before program implementation of a 5-year community-wide teen pregnancy prevention initiative. A needs assessment on health center capacity and implementation of evidence-based clinical practices was administered with 51 health centers partners in 10 communities in the United States with high rates of teen pregnancy. RESULTS: Health centers reported inconsistent implementation of evidence-based clinical practices in providing reproductive health services to adolescents. Approximately 94.1% offered same-day appointments, 91.1% had infrastructure to reduce cost barriers, 90.2% offered after-school appointments, and 80.4% prescribed hormonal contraception without prerequisite examinations or testing. Approximately three quarters provided visual and audio privacy in examination rooms (76.5%) and counseling areas (74.5%). Fewer offered a wide range of contraceptive methods (67.8%) and took a sexual health history at every visit (54.9%). Only 45.1% reported Quick Start initiation of hormonal contraception, emergency contraception (43.1%), or intrauterine devices (12.5%) were "always" available to adolescents. CONCLUSIONS: The assessment highlighted opportunities for health center improvement. Strategies to build capacity of health center partners to implement evidence-based clinical practices may lead to accessibility and quality of reproductive health services for adolescents in the funded communities.
