A Comparison of Evidence-Based Practice Training With and Without Postimmersion Follow-up.

OBJECTIVE: The aim of this study was to determine best practice for evidence-based practice (EBP) education that leads to implementation. BACKGROUND: Current methods of teaching EBP do not reliably translate to implementation. METHODS: Participants in an EBP immersion were compared with participants in EBP immersion plus a follow-up EBP course. RESULTS: The EBP immersion group implemented 18% of their initiatives. The EBP immersion plus the follow-up EBP course implemented 35% of their initiatives, and an additional 22% were in the process of implementation. CONCLUSION: Evidence-based practice education may not be sufficient in promoting EBP implementation. Additional ongoing support may be needed to bring EBP initiatives through implementation.

Validation of an instrument to measure knowledge, attitudes and skills towards Evidence-Based Practice in nursing students in Colombia.

BACKGOUND: Evidence-Based Practice (EBP) is crucial for the nursing profession, as it helps professionals make informed clinical decisions based on the best available evidence. Most EBP competency assessment tools focus on specific technical knowledge or skill components, and most have been tested on medical students. The Evidence-Based Practice Competence Questionnaire (EBP-COQ-E) is an instrument that assesses the competence in EBP in nursing students. The objective of the article was to evaluate the psychometric properties of the EBP-COQ-E instrument in final year nursing students in Colombia. DESIGN: A validation study was conducted using a cross-sectional design. METHODS: The population included nursing students from 19 programs in Colombia, who were selected during the years 2020 and 2021 based on their university enrollment in the last year of training in nursing programs with current qualified registration by the Ministry of Education and who had attended the least one subject related to research. The data were collected through a virtual platform and the researchers consolidated it into a general database. The EBP-COQ-E instrument consists of 25 items grouped into three factors: attitude towards EBP, skills for EBP and knowledge about EBP. The items were answered on a Likert-type scale from 1 to 5. An exploratory factor analysis was performed and an internal consistency analysis of the instrument. RESULTS: A total of 1021 final year students from 19 university nursing programs participated, with a mean age of 23 years and where 83% identified themselves as female. The results showed good internal consistency and construct validity for the instrument, with a Cronbach's alpha of 0.89. In the exploratory factor analysis, 3 factors were found that explained 51% of the variance of the data. Together these three factors had statistically significant positive correlations. CONCLUSION: The study contributes to the validation of the Evidence-Based Practice Competence Questionnaire (EBP-COQ-E) which is a valid and reliable tool to assess knowledge, attitudes and skills in EBP in nursing students in the Colombian context. Training in EBP is crucial to guarantee the quality of performance of future professionals in care practice and the EBP-COQ-E can be useful and applicable where it is necessary to evaluate this competence in training processes.

Standardizing Evidence-Based Practice Review Processes Across the Defense Health Agency Enterprise.

BACKGROUND: The Defense Health Agency (DHA) Campaign Plan identifies Ready Reliable Care (RRC) as one of the eight strategic initiatives. A critical aspect of RRC is standardizing evidence-based practice (EBP) across Military Health System to include training, technology, equipment, and processes. The TriService Nursing Research Program hosted an EBP Summit to address this expectation. METHODS: The EBP Summit evaluated capabilities and gaps critical for implementing EBP into the DHA. This article summarizes the capabilities and gaps associated with administrative processes and infrastructure standardization, specifically EBP review and approval support processes, as well as utilization of the electronic Institution Review Board (eIRB) software platform. RESULTS: The environmental scan across services revealed consistency in procuring Exempt Determination Official reviews and garnering formal determination letters before the start of EBP initiatives. The Army and Navy Nursing Centers for Clinical Inquiry report variability in the utilization of eIRB, although the Air Force centers consistently utilize eIRB to submit proposed EBP. However, there is variability across all services in how the proposal is categorized (EBP, process improvement, and quality assurance) and in the availability of mentoring support for the submission. CONCLUSION: Strategic recommendations to address the identified gaps are establishing a TriService Clinical Inquiry Working Group for process and product standardization, identifying EBP champions for each DHA market to educate and facilitate EBP review and submission processes, and establishing EBP review forums led by EBP subject matter experts. The authors suggest funding for program development and evaluation.

Use of Design Thinking to Grow the Reach and Relevance of Evidence-Based Practice Education Across a Health Care System.

Evidence-based practice (EBP) skill building among clinical nurses is a priority for nurses in professional development because it is well known that this approach to clinical decision-making results in safe, cost-effective, person-centered care. Recent studies indicate widespread lack of self-reported competency in EBP skills among nurses, demonstrating the importance of prioritizing programs that meet clinical nurses' needs for EBP education. The goal of this design thinking project was to expand and diversify an EBP skill building program to provide more widespread accessibility across a multi-hospital health care system. The team followed the five-step human-centered design thinking process to empathize, define, ideate, prototype, and test an innovation. Based on end user feedback, a dual-track EBP educational program, with options for an intensive yearlong hybrid EBP Scholars program and a three-session skill building webinar series, was implemented. Design thinking provides a rich framework for incorporating end user feedback to generate innovations to address challenges in health care. [J Contin Educ Nurs. 2023;54(8):360-366.].

Incorporating evidence-based practice education in nursing research curriculum of undergraduate nursing students: A quasi-experimental study.

AIM: To examine the effect of incorporating evidence-based practice (EBP) in Nursing Research curriculum on undergraduate nursing students. BACKGROUND: The competence of EBP is essential for nurses and it is an essential task for educators to implement EBP education in nursing students. DESIGN: A quasi-experimental study. METHODS: Based on Astin's Input-Environment-Outcome model, the study was conducted among 258 third-grade students of a four-year nursing bachelor's program between September through December 2022. The students were divided into two groups. Students in the intervention group received innovative teaching where EBP elements were incorporated in Nursing Research course in a natural, gradual and spiral way, while students in the control group attended conventional teaching. Effect of EBP teaching was examined in terms of students' EBP competence, learning experience and satisfaction and score of team-based research protocol assignment. RESULTS: Compared with conventional teaching, the innovative teaching characterized by EBP improved students' EBP competence in terms of attitudes and skills and enhanced student's comprehensive ability in nursing research. Students' learning experience and satisfaction were similarly favorable between the two groups. CONCLUSIONS: For undergraduate nursing students, the teaching strategy characterized by EBP is an appropriate and effective way to improve their EBP competence of attitudes and skills, as well as their nursing research ability.

Significance of an Online Evidence-Based Practice Education Module for Acute, Ambulatory, Public, and School Health Nurses.

Recent surveys of Magnet facilities and nurses found low rates of implementation of evidence-based practice in U.S. health care settings. Nursing Experts: Translating the Evidence (NExT) is a collaboration of nurses and librarians providing free online evidence-based practice nursing education benefiting nurses in all settings. The NExT online modules empowered participants to efficiently access valuable resources to inform and improve their practice in a convenient, accessible, self-paced format. Quantitative and qualitative evaluation methods and the value of collaboration are discussed. [J Contin Educ Nurs. 2023;54(4):176-184.].

Effective Strategies for Teaching Evidence-Based Practice in Undergraduate Nursing Programs.

BACKGROUND: Literature shows that nursing program graduates cannot apply skills related to evidence-based practice (EBP) on graduation. However, the influence of EBP on quality and safety in nursing is well documented and shows that innovative strategies for teaching the content need to be explored. PROBLEM: Teaching EBP in nursing programs is challenging due to students' attitudes and lack of engagement. These challenges are compounded when the program is accelerated or an undergraduate completion program. APPROACH: A literature search was conducted to identify best practices for improving the quality of EBP courses. The findings, along with the application of EBP 7 steps, were identified and implemented in the course redesign. CONCLUSIONS: A structured and sequential approach to learning core skills related to EBP may be an effective method of improving course quality and application of EBP skills upon graduation.

De-adopting low-value care: The missing step in evidence-based practice?

BACKGROUND: Low-value care provides little or no benefit to pediatric patients, has the potential to cause harm, waste healthcare resources, and increase healthcare costs. Nursing has a responsibility to identify and de-adopt low-value practices to help promote quality care. PURPOSE: 1) Describe the process of identifying and de-adopting low-value clinical practices guided by a conceptual model using a case study approach. 2) Identify facilitators and barriers to de-adoption practices, including levels of stakeholder engagement, organizational structures, and the quality of available scientific and non-scientific evidence. METHODOLOGY: An evidence-based practice (EBP) project investigating the efficacy of antihistamines in decreasing infusion reactions to infliximab identified a low-value practice within a pediatric infusion center. The Synthesis Model for the Process of De-adoption was then applied to guide the de-adoption of this low-value practice. Case study analysis highlighted facilitators and barriers to de-adoption efforts. CONCLUSIONS: The process for de-adopting care is an essential component of EBP and, as such, should be explicated through robust, standardized EBP processes and education. PRACTICE IMPLICATIONS: Nurses are best positioned to identify, assess and prioritize low-value practices and facilitate the de-adoption of low-value practice that impact pediatric patients and families. Models to support de-adoption and a focus on site-specific practices including a prepared nursing workforce, continuous evaluation of care processes and the use of resources to assess for contextual determinants facilitates success and sustainability of this essential EBP approach.

Using a Strategy Process Framework to Support the Implementation of an Evidence-Based Practice Initiative to Improve Clinical Judgment of Newly Hired Nurses.

Evidence-based practice (EBP) is foundational to nursing practice, but initiatives can be challenging to implement and sustain. A strategic process framework can successfully guide EBP initiatives. This column describes how nursing professional development specialists can teach nurses how to use a strategy process framework to guide an EBP initiative. [J Contin Educ Nurs. 2022;53(11):483-485.].

Predictors of evidence-based practice competency among Tunisian nursing students.

BACKGROUND: Evidence-based practice (EBP) is an important competency of undergraduate nursing students which should be cultivated before graduation by increasing future healthcare providers' knowledge, skills and attitudes towards EBP. This study aimed to describe nursing students' competencies (attitudes, knowledge, skills) in Evidence-based practice (EBP) and to determine factors predicting EBP competency. METHODS: A descriptive cross-sectional study was conducted at the Higher School of Health Sciences and Techniques of Sousse (Tunisia) among 365 nursing students. Data were collected using the validated Evidence Based Practice Competencies Questionnaire (EBP-COQ). Multiple linear regression was performed to determine factors predicting EBP competencies. RESULTS: The overall score of EBP-COQ questionnaire was 3.26 ± 0.53 out of 5. The attitude, skills and knowledge subscales received 4.04 ± 0.41; 3.05 ± 0.77 and 2.70 ± 0.74 as mean scores respectively. Multiple linear regression analysis (table 4) revealed that significant related factors were academic level (ß = 0.271, p = 0.001), English-language reading skills (ß = 0.435, p < 0.001), facing staff resistance in implementing a new evidence-based procedure (ß = - 0.081, p = 0.035) difficulties in obtaining full-text papers (ß = - 0.127, p < 0.001) and training in methodology (ß = 0.232, p < 0.001) and also in statistics (ß = 0.205, p < 0.001). CONCLUSIONS: These results help to understand students' attitudes, knowledge and skills in EBP and can be therefore a starting point to develop effective strategies for EBP curricula.

An Innovative Approach to Teaching Evidence-Based Practice: Use of PICO Pal.

BACKGROUND: An innovative remote learning intervention, PICO Pal, was implemented with groups of undergraduate nursing students in a nursing research course to promote interactive learning, collaboration, and information literacy. PROBLEM: Evidence-based practice (EBP) is a challenging topic to teach nursing students, especially in a remote learning environment. APPROACH: PICO Pal used Apple Numbers to facilitate remote group work on a PICOT poster. The approach was evaluated using pre- and posttest surveys with 50 undergraduate nursing students at a small private university in New Jersey. OUTCOMES: The evaluation showed positive perceptions of the assignment and gains with knowledge of EBP. However, there were no gains in the perceptions of group work. CONCLUSIONS: The assignment was effective at teaching aspects of the EBP process but should be reevaluated to maximize group work dynamics and comfort with use of technology.

Seeking to Understand: Qualitative Research on Sustainability of Evidence-Based Practice in Acute Care.

OBJECTIVE: The aim of this study was to describe cultural characteristics, values, and beliefs that influence sustainability of an evidence-based practice (EBP) intervention in the acute care clinical setting. BACKGROUND: There is an urgent need to identify best practices to sustain EBP to gain efficiencies in nursing care delivery and improve patient outcomes. METHODS: A focused ethnographic qualitative study was conducted in a community hospital with nurses that used Screening, Brief Intervention, and Referral to Treatment (SBIRT). RESULTS: Customizing the intervention to the unit culture evolved and was crucial for sustainability. Overlap in responsibilities, time, clinician confidence, and impact to workflow were noted as negative influences. The intervention was primarily viewed as a task to be checked off a list instead of a tool that informs the patient's plan of care. CONCLUSIONS: Assessing clinician experiences, beliefs, and values of an EBP should be incorporated into a strategic sustainability plan. Clinician understanding of how an EBP can advance the patient plan of care could promote ownership of professional practice and sustainment.

Teaching evidence-based practice: Knowledge to implementation in a BSN program, part 2.

BACKGROUND: Nursing education at the undergraduate level has started teaching the process of research integration through evidence-based practice (EBP) implementation rather than solely focusing on teaching nursing research. This is Part 2 of a two-part series. AIMS: To discuss strategy on how to teach undergraduate nursing students the process of implementing EBP over two courses and to assess their learning outcomes. This article focuses on Course 2, Leadership and Management, which takes place during senior year and builds on student learning from their junior year through application of an EBP capstone project. METHODS: The American Association of Colleges of Nursing's Essentials of Baccalaureate Education for Nursing Practice (2008) was used to guide the discussion and course development. An anonymous survey was used to measure the level of student perceived achievement of the learning objectives related to EBP. Students responded to statements using a 5-point Likert scale for level of agreement (1 = strongly disagree to 5 = strongly agree). RESULTS: In Course 2, Leadership and Management, senior year students focused on the remaining EBP steps (four through six) and completed an EBP capstone project with a nurse manager. A total of 83 students responded to the anonymous evaluation survey, and mean learning objective scores were 4.0 or above, indicating a high degree of perceived level of achievement. LINKING EVIDENCE TO ACTION: Teaching the EBP process with active learning strategies over two courses enhances student learning.

Impact of Evidence-Based Charge Nurse Education on Charge Nurse Skills and Nurse-Specific Metrics.

OBJECTIVE: This research study was designed to analyze the impact of an evidence-based charge nurse (CN) education program on novice and experienced CNs' self-confidence and satisfaction with the role, skill competencies, and nursing metrics. BACKGROUND: Charge nurses are critical to effective daily unit operations. However, executive nursing leadership found that unit performance varied by CN despite experience. METHODS: University faculty partnering with nurse leaders developed an evidence-based CN education program including a series of classes, coaching in skills and role responsibilities by nurse leaders, and evaluation of skills competencies before and after the CN education program. RESULTS: The CN program was associated with significant positive changes in CN performance, nurse-specific metrics, hospital-acquired events, and patient satisfaction. CONCLUSIONS: Interventions targeting frontline leaders positively impact CN performance.

Effectiveness of an Evidence-Based Practice Training Program for Nurse Educators: A Cluster-Randomized Controlled Trial.

BACKGROUND: Evidence-based practice (EBP) endeavors to integrate the best available evidence with clinical expertise and patient preference to enhance clinical outcomes. For nurses to effectively demonstrate EBP, the concepts of EBP should be systematically incorporated into the nursing curriculum, with nurse educators playing a pivotal role in execution. However, the effect of EBP training programs on nurse educators remains largely unexplored. AIM: To evaluate the effectiveness of an EBP training program on the knowledge, attitude, practice, and competency of nurse educators. METHODS: A pragmatic randomized controlled trial was conducted at a nursing education institution. Fifty-one nurse educators were cluster randomized into intervention and control groups. A 30-hour EBP training intervention was provided for nurse educators in the intervention group. The outcome variables were knowledge, attitude, practice, and competency regarding EBP. These outcomes were evaluated using the EBP knowledge and practice questionnaire, EBP attitude scale, and Fresno test. Data were collected at baseline, the end of 5 months, and the end of 10 months. RESULTS: Fifty-one eligible participants were enrolled in the study. The intervention and control group had three clusters each with 27 and 24 participants, respectively. Participants in both groups were comparable for variables such as age, years of experience, and educational background (p > .05). Between groups, outcome variables were compared using mixed linear multi-level modeling. Nurse educators who received the EBP training program demonstrated significant differences in knowledge (p < .05), attitude (p < .05), practice (p < .05), and competency scores (p < .05), than that of the control group, indicating the intervention effectiveness. LINKING EVIDENCE TO ACTION: EBP training programs are effective in improving the knowledge, attitude, practice, and competency of nurse educators.

Best of the 2021 ANCC PTAP Symposium: Create, Cultivate, Celebrate.

The American Nurses Credentialing Center (ANCC) Practice Transition Accreditation Program (PTAP) sponsors an annual symposium for participants to share in best practices across the globe. Due to COVID-19, the 2021 symposium was held virtually. With close to 700 participants, the ANCC PTAP team was challenged to provide an engaging virtual conference. This column speaks to the success of the symposium based on creating, cultivating, and celebrating best practices. [J Contin Educ Nurs. 2021;52(8):352-354.].

Providing an Online Nursing Journal Club and Ensuring the Rigor of the Experience.

Participation in nursing journal clubs has been correlated with increased familiarity among nurses with research processes and outcomes, as well as improved ability to critique research studies and apply evidence from the literature to practice. For nurses who are direct care providers, time and accessibility are barriers to participation in journal clubs. Providing a journal club using an online, asynchronous format increased participation. This article describes the inception of a nursing journal club and the steps taken to alter the format to increase participation.

Critical Care Considerations in Adult Patients With Influenza-Induced ARDS.

TOPIC: Acute respiratory distress syndrome is a complex respiratory disease that can be induced by influenza virus infection. Critical care providers are uniquely positioned to manage this pathological progression in adult patients through evidence-based practice. CLINICAL RELEVANCE: Influenza and subsequent acute respiratory distress syndrome are associated with extremely high morbidity and mortality in adult patients in the United States. Although evidence-based medical management strategies can alter the clinical trajectory of acute respiratory distress syndrome and improve outcomes, critical care providers do not always implement these measures. PURPOSE: To provide critical care providers with an overview of the pathological progression of influenza-induced acute respiratory distress syndrome and the current evidence-based strategies for management. CONTENT COVERED: This article reviews the epidemiology and pathophysiology associated with influenza-induced acute respiratory distress syndrome, the criteria for diagnosis, and the evidence-based medical management.

Impact of an extracurricular, student-led journal club on evidence-based practice among baccalaureate nursing students.

Objective Journal clubs are accepted as an effective strategy for promoting evidence-based practice (EBP). However, journal clubs are underutilized in nursing education, and little is known about the impact of extracurricular, student-led journal clubs on EBP implementation among baccalaureate nursing students. The purpose of this study was to estimate the impact of journal club attendance on EBP implementation. Methods A web-based survey was conducted in April 2019 following eight sessions of monthly journal club among senior nursing students (n=78). Results Fifteen students attended four or more extracurricular, student-led journal club sessions (19.2%). EBP practice score was significantly higher among frequent journal club attendees. In multivariate analysis, journal club attendance was the significant predictor of EBP practice (ß=0.34; p=0.006). Conclusion Graduating senior nursing students who attend extracurricular, student-led journal club sessions are more likely to carry out EBP practice. Participation in journal clubs may help increase their EBP competencies.