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.

Effect assessment of the application value of evidence-based nursing intervention in operating room nursing: A protocol for a systematic review and meta-analysis.

BACKGROUND: The advantages of evidence-based nursing (EBN) intervention in health care settings have been widely disseminated to nurses throughout the world. More researches are reporting the effectiveness of EBN intervention in operating room nursing. However, the results are inconsistent. This study focuses on conducting a meta-analysis and systematic evaluation aimed at determining the usefulness of EBN intervention in operating room nursing. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-analysis for Protocols criteria were used to write this paper. We will look for relevant studies from 2 Chinese databases (China National Knowledge Infrastructure and Wanfang database and also from 3 English databases such as Web of Science, Cochrane Library, PubMed, and EMBASE), to locate all relevant randomized controlled trials and observational studies assessing the application value of EBN intervention in operating room nursing from their commencement to June 2021. Separately, 2 authors will choose the studies, do the data extract and conduct the assessment probing into the likelihood of bias. If there is a disagreement, it will be resolved by the third author. RevMan 5.3 software and Stata 15.0 software will be used to conduct the meta-analysis. RESULTS: The usefulness of EBN intervention in operating room nursing will be assessed in this study. CONCLUSION: The purpose of this research is to conclude the value of EBN intervention in operating room nursing and the quality of current data. ETHICS AND DISSEMINATION: Since there is no requirement for data on the individual patient, hence there will be no need for ethical approval. OSF NUMBER: DOI 10.17605/OSF.IO/MSXNF.

Function of a Psychological Nursing Intervention on Depression, Anxiety, and Quality of Life in Older Adult Patients With Osteoporotic Fracture.

BACKGROUND: Osteoporotic fracture is a serious complication of osteoporosis. The long-term therapy process and the heavy restriction to physical activities give rise to a psychological burden on osteoporotic fracture patients, especially older adult patients. Psychological nursing interventions significantly alleviate negative emotional reactions in cancer patients. This research aimed to investigate the function of psychological nursing interventions in the reduction of depression and anxiety and the improvement of quality of life in older adult patients with osteoporotic fracture. METHODS: Osteoporotic fracture patients (n = 106) were divided into control group (n = 53) or intervention group (n = 53). In the control group, the participants were given conventional nursing care. In the intervention group, the participants were given psychological nursing interventions. Anxiety, depression, and quality of life were evaluated and compared between the two groups. RESULTS: After 5 weeks of psychological nursing intervention, the anxiety and depression scores significantly decreased in the intervention group. The Mental Function in Quality of Life Questionnaire of the European Foundation for Osteoporosis score also decreased in the intervention group. LINKING EVIDENCE TO ACTION: Psychological nursing interventions alleviate anxiety and depression in older adult osteoporotic fracture patients and enhance their mental function.

Psychometric Properties of the Short Versions of the EBP Beliefs Scale, the EBP Implementation Scale, and the EBP Organizational Culture and Readiness Scale.

BACKGROUND: Evidence-based practice (EBP) is a problem-solving approach to clinical decision making that leads to a higher quality and safety of health care. Three valid and reliable scales that measure EBP attributes, including the EBP Beliefs Scale, the EBP Implementation Scale, and the Organizational Culture and Readiness Scale for System-Wide Integration of EBP, are widely used but require approximately 5 min each to complete. Shorter valid and reliable versions of these scales could offer the benefit of less time for completion, thereby decreasing participant burden. AIM: The aim of this study was to determine the psychometric properties of the three shortened EBP scales, adapted from the longer versions. METHODS: This study used a descriptive survey design with 498 nurses who completed the three original EBP scales along with a shortened version of each scale. Exploratory factor analysis was conducted with principal components extracted to examine the factor structure of each EBP measure for the three shortened EBP scales. Item intercorrelations and the Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO) were used to confirm the validity of using factor analysis. Reliability of each scale using Cronbach's α was examined. Convergent validity of the three shortened EBP scales was assessed by correlating each shortened scale with its longer scale. RESULTS: Factor analysis supported the construct validity of each of the three shortened scales, as all item intercorrelations were greater than 0.40, and KMO values were 0.62 to 0.74. The shortened scales Cronbach alphas were 0.81 for the EBP Beliefs Scale, 0.89 for the EBP Implementation Scale, and 0.87 for the EBP Culture and Readiness Scale. The three shortened EBP scales had acceptable convergent validity (r = 0.42-.072) for the correlations between the shortened and longer scales. LINKING EVIDENCE TO ACTION: The three shortened EBP scales, which are valid and reliable, can be used as an alternative to the longer three scales to decrease participant burden when conducting program evaluations, research, or organizational assessments.

Adverse Health Effects of Frailty: Systematic Review and Meta-Analysis of Middle-Aged and Older Adults With Implications for Evidence-Based Practice.

BACKGROUND: Scholars have noted that frailty easily leads to functional deterioration and proneness to complications. Little literature addresses the stages of frailty in middle-aged and older adults and the effects of frailty on overall health. AIMS: This study explores the effect of different stages of frailty on the prospective health (falls, bone fractures, disability, dementia, hospitalization, and death) of middle-aged and older adults. In addition, different frailty indicators were compared to determine their usefulness in predicting future adverse health outcomes. METHODS: The authors of this study separately reviewed and extracted data from the literature obtained while searching the following keywords: "frailty" OR "frail" and "fall" OR "disability" OR "fracture" OR "hospitalization" OR "mortality" OR "cognitive function" "dementia" OR "Alzheimer's disease" and "middle-aged people" OR "older people" OR "elderly" OR "geriatric" OR "senior." The literature search was performed from January 2001 to November 2019 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Specifically, we performed a systematic literature search in multiple databases-Embase, PubMed, MEDLINE, CINAHL, and Cochrane Library-and analyzed all obtained literature results using a random-effects model. RESULTS: We collected a total of 29 prospective studies for the systematic literature review and meta-analysis. The main results indicated that the frail groups had significantly higher risks of adverse health effects (falls, bone fractures, disability, dementia, hospitalization, and death) than the robust or prefrail groups. LINKING EVIDENCE TO ACTION: Frailty is a crucial healthcare topic among geriatric syndromes. Considering that older adults with frailty are most likely to develop severe adverse health outcomes, professional nursing personnel should assess frailty among middle-aged and older adults and offer relevant care strategies to reduce the adverse effects of frailty in this population.

Best Practices to Verify Ongoing Placement of NG or OG Tube After Initial X-ray Confirmation.

BACKGROUND: Many patients in intensive care units (ICU) require nasogastric (NG) or orogastric (OG) tubes. These patients often require a combination of sedatives that can alter level of consciousness and impair cough or gag reflexes. Such factors can lead to NG/OG tube displacement. Using a misplaced tube can lead to aspiration, lung injury, infection, and even death. AIMS: To standardize ongoing verification of NG tube placement practices in our 34-bed Medical-Surgical ICU. METHODS: The Johns Hopkins Nursing Model was utilized to guide this project. A literature review and critical appraisal were performed to establish NG/OG tube best practices. Best practices were implemented and assessed (via a survey and charting audits). RESULTS: Fifteen publications were identified and appraised as Level 4 and 5 sources. Best evidence supported that at the time of radiographic confirmation of the tube site, it should be marked with inedible ink or adhesive tape where it exits the nares; tube location should be checked at 4-hour intervals; and placement/patency should be checked in patients who complain of pain, vomiting, or coughing. Following the practice change, N = 40 nurses indicated improvement in verification of NG/OG tube knowledge, "OK to use" order was verified for 89% of patients, and 63% of tubes were marked with tape at the exit site. LINKING ACTION TO EVIDENCE: Adherence to current, evidence-based strategies for NG/OG tube verification promotes patient safety. Monitoring practice changes is critical to determine whether a best practice is sustained. Electronic health records must be current to guide and support evidence-based nursing practice.

Assessing Evidence-Based Practice Knowledge: An Innovative Approach by a Nursing Research Council.

OBJECTIVE: The aim of this study was to describe the structure and processes implemented by nursing research councils to conduct a nurse-led research study at an urban community teaching hospital. BACKGROUND: We assessed nurses' knowledge, skills, and attitudes toward evidence-based practice (EBP) to inform development plans. METHODS: This is an institutional review board-approved single-site cross-sectional anonymous online survey (Evidence-Based Practice Questionnaire [EBPQ]) emailed to 850 participants. Data were analyzed using SPSS v25 (Armonk, New York). RESULTS: Initial response rate was 11%. Deployment of new strategies achieved an overall response rate of 57.5%. EBPQ subscale scores were highest for "attitude," followed by "knowledge/skills," and "practice." Lowest-scoring items included critical appraisal of literature, converting information needs into a question, time for new evidence, information technology, and research skills. CONCLUSIONS: Our EBPQ scores were consistent with prior findings. Our strategies provide a framework for other institutions in similar stages of implementing EBP and nurse-led research initiatives.

Interprofessional Communication: Integrating Evidence to Enhance Systems During a Pandemic.

BACKGROUND: The COVID-19 pandemic placed challenges on interprofessional communication patterns among clinical care teams at a time when effective communication was greatly needed. The development of enhanced systems for communication that integrate the latest evidence and communication technologies can offer a solution to this crisis. OBJECTIVES: This article provides a framework for ways in which nursing teams can develop evidence-based enhanced interprofessional communication systems during a pandemic. METHODS: Based on communication models and related technologies, this article reviews strategies to enhance interprofessional communication. Two case studies are included that illustrate how nursing teams can enhance communication during a pandemic. FINDINGS: To improve communication during a pandemic, clinicians can incorporate interprofessional communication models in clinical practice and apply enhanced communication strategies.

Desde la enfermería basada en evidencia: patrones de conocimiento: mirando su narrativa: fenómeno del cuidado / From nursing based nursing: patterns of knowledge: looking at his narrative: phenomenon of car / De enfermagem baseada em enfermagem: padrões do conhecimento: olhando

INTRODUCCIÓN: Desde la enfermería basada en evidencia, como procesos cognitivos que ponen en marcha frente a cada situación hacen evidente al proceso de Enfermería como herramienta fundamental para la dirección del cuidado. En el fenómeno de cuidado, surge la situación de enfermería como herramienta científica que permite poner en evidencia los patrones de conocimiento enfermero propuestos por Barbara Carper, los elementos del metaparadigma, así como las fases del proceso de enfermería. Para la operacionalización del mismo, se utilizó la taxonomía de diagnósticos propuestos por la NANDA, así como los resultados esperados (NOC) y las intervenciones sugeridas (NIC). METODOLOGÍA: Para precisar la realidad, se abordó desde el equipaje etnográfico focalizado como metodología analítica explorando desde el aspecto antropológico del cuidado, la enfermería basada en evidencia, patrones de conocimiento desde la narrativa del cuidado como base epistémica para los dominios y taxonomías, teniendo en cuenta la adecuación teórico- epistemológica fundamentado en el paradigma cualitativo- interpretativo a través del interaccionismo simbólico. RESULTADOS Y DISCUSIONES: La enfermería basada en evidencia, surge como el nuevo paradigma emergente, a través de los patrones de conocimiento, hacen parte de la enseñanza y de la práctica de enfermería, de tal forma que aumentan su complejidad y su diversidad epistemológica. Por lo tanto, cada patrón da una orientación de los problemas y las preguntas de la disciplina, reconociendo que los cambios son inherentes al desarrollo del conocimiento en enfermería. Propuestas metodológicas. El fenómeno del cuidado, emerge como necesidad la simbiosis entre el proceso de enfermería y su transcendencia en la investigación científica a través de la enfermería basada en evidencia, vista como un proceso único, individualizado de la práctica de enfermería a través de la narrativa, usando la herramientas de los patrones de conocimiento, teniendo en cuenta que las repuestas de salud-enfermedad de los seres humanos, forman parte del núcleo central del relato y de los significados que las personas les otorgan

INTRODUCTION: From nursing based on evidence, as cognitive processes that put in place in front of each situation make evident to the process of Nursing as a fundamental tool for the direction of care. In the care phenomenon, the nursing situation arises as a scientific tool that allows to put into evidence the patterns of nursing knowledge proposed by Barbara Carper, the elements of the metaparadigm, as well as the phases of the nursing process. For the operationalization of the same, the taxonomy of diagnoses proposed by the NANDA was used, as well as the expected results (NOC) and the suggested interventions (NIC). METHODOLOGY: To clarify reality, it was approached from the ethnographic baggage focused as analytical methodology, exploring from the anthropological aspect of care, evidence-based nursing, patterns of knowledge from the care narrative as an epistemic basis for domains and taxonomies, taking into account the theoretical-epistemological adaptation based on the qualitative-interpretive paradigm through symbolic interactionism. RESULTS AND DISCUSSIONS: Nursing based on evidence, emerges as the new emerging paradigm, through the knowledge patterns, are part of the teaching and practice of nursing, in such a way that they increase its complexity and its epistemological diversity. Therefore, each employer gives an orientation of the problems and the questions of the discipline, recognizing that the changes are inherent in the development of knowledge in nursing. Methodological proposals. The phenomenon of care, emerges as a need the symbiosis between the nursing process and its transcendence in scientific research through evidence-based nursing, seen as a unique, individualized process of nursing practice through the narrative, using the tools of knowledge patterns, taking into account that the health-illness responses of human beings are part of the central core of the story and the meanings that people give them

INTRODUÇÃO: A partir da enfermagem baseada em evidências, como processos cognitivos que se colocam à frente de cada situação, evidencia-se o processo de Enfermagem como uma ferramenta fundamental para a direção do cuidado. No fenômeno do cuidado, a situação de enfermagem surge como uma ferramenta científica que permite evidenciar os padrões de conhecimento de enfermagem propostos por Barbara Carper, os elementos do metaparadigma, bem como as fases do processo de enfermagem. Para a operacionalização dos mesmos, utilizou-se a taxonomia de diagnósticos proposta pela NANDA, bem como os resultados esperados (NOC) e as intervenções sugeridas (NIC). METODOLOGIA: Para esclarecer a realidade, foi abordada a partir da bagagem etnográfica focada como metodologia analítica, explorando desde o aspecto antropológico do cuidado, enfermagem baseada em evidências, padrões de conhecimento da narrativa do cuidado como base epistêmica para domínios e taxonomias, levando em consideração a adaptação teórico-epistemológica baseada no paradigma qualitativo-interpretativo através do interacionismo simbólico. RESULTADOS E DISCUSSÕES: A enfermagem baseada em evidências, emerge como o novo paradigma emergente, através dos padrões de conhecimento, fazem parte do ensino e prática de enfermagem, de forma a aumentar sua complexidade e sua diversidade epistemológica. Portanto, cada empregador dá uma orientação sobre os problemas e as questões da disciplina, reconhecendo que as mudanças são inerentes ao desenvolvimento do conhecimento em enfermagem. Propostas metodológicas. o fenômeno do cuidado, emerge como uma necessidade a simbiose entre o processo de enfermagem e sua transcendência na pesquisa científica por meio da enfermagem baseada em evidências, vista como um processo único e individualizado de prática de enfermagem através do narrativa, utilizando as ferramentas dos padrões de conhecimento, levando em conta que as respostas saúde-doença dos seres humanos fazem parte do núcleo central da história e dos significados que as pessoas lhes dão

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.

Institutional Challenges and Solutions to Evidence-Based, Patient-Centered Practice: Implementing ICU Diaries.

BACKGROUND: Although diaries are an evidence-based practice that improves the quality of life of patients in an intensive care unit and their loved ones, centers in the United States are struggling to successfully implement diary programs in intensive care units. Currently, few published recommendations address how to facilitate implementation of a diary program, and how to effectively sustain it, in an intensive care unit. OBJECTIVES: To discuss challenges with implementing diary programs in intensive care units at 2 institutions in the United States, and to identify solutions that were operationalized to overcome these perceived difficulties. METHODS: The teams from the 2 institutions identified local barriers to implementing diaries in their intensive care units. Both groups developed standard operating procedures that outlined the execution and evaluation phases of their implementation projects. RESULTS: Barriers to implementation include liability and patient privacy, diary program development, and implementation and sustainability concerns. Various strategies can help maintain clinical and family member engagement. CONCLUSION: Through a team's sustained dedication and a diligent assessment of perceived obstacles, a diary program can indeed be implemented within an intensive care unit.

Evidence-Based Practice Competencies for RNs and APNs: How Are We Doing?

As we approach the end of 2020, the Year of the Nurse and Nurse Midwife, it is a good time to reflect on our evidence-based practice (EBP) competencies through a review of a recent study by Melnyk and colleagues. Before describing these competencies, our progress in achieving EBP competency, and the effect competency status has on health care quality, safety, and patient outcomes, this column reviews the definition of EBP and provides a high-level overview of the steps of EBP as defined in Melnyk and Fineout-Overholt.

Depression treatment research in people with cancer does not reflect cancer prevalence: findings from a systematic review.

BACKGROUND: One in six people with cancer will develop depression at some point in their care. Untreated depression affects quality of life, cancer care satisfaction and healthcare expenditure. Treatments for this vulnerable heterogenous population should be evidence based and specific. A common sentiment is that psychiatric research does not reflect the prevalence of patients with cancer and comorbid depression and is biased towards certain cancers, but this has not been empirically shown. STUDY SELECTION AND ANALYSIS: A systematic review of studies on psychological and pharmacological treatments for depression in people with cancer was conducted. Of 4621 papers identified from a search of PubMed and PsycINFO up to 27 June 2020, 84 met inclusion criteria (eg, adults with cancer; depression diagnosis; treatment study) and comprised 6048 participants with depression with cancer. FINDINGS: Cancer types are not proportionally represented in depression research in accordance with their incidence. Breast cancer is over-represented (relative frequency in research 49.3%, but 11.7% of global cancer). Cancers of the head and neck and bone and soft tissue were close to parity. All other cancers are under-represented. Representativeness varied 40-fold across different cancers. CONCLUSIONS: The evidence base for depression treatments is dominated by a single cancer. Given heterogeneity in cancer populations (eg, stage of illness; psychological impact; cancer treatments), it is possible that depression treatments may not have the same benefits and harms across all cancers, impeding the ability to offer people with different cancers the best depression treatment. While the dominant opinion within this research field is that a cancer bias exists, this is the first study to demonstrate as such.

Evidence-Based Practice Competency and Related Factors Among Nurses Working in Public Hospitals.

This study aimed to describe the status and related factors of evidence-based practice (EBP) competency among nurses in China. A convenience sample of 1036 nurses were recruited from 13 public hospitals in Shanghai through an anonymous online survey. Nurses' demographic data, working data, and evidence-based nursing (EBN)-related conditions were collected by a structured questionnaire and EBP competency was assessed using the Chinese version of Evidence-based Nursing Competency Rating Scale (EBNCRS). The original score of EBNCRS among nurses was not good. The original score of evidence searching, critical appraisal, and synthesis subscale was lower than the original score of evidence transfer, situation assessment, and evidence implementation subscale. Nurses' age, hospital level, and perceived EBN knowledge were identified as significant related factors of EBP competency. There is an urgent need to upgrade the EBP competency of nurses in Shanghai, especially competency in evidence transfer, situation assessment, and evidence implementation.

Implantación de Guías de buenas prácticas en España a través del Programa de Centros Comprometidos con la Excelencia en Cuidados / The implementation of Best practice guidelines in Spain through the Programme of the Best Practice Spotlight Organizations

La aplicación de Guías de Buenas Prácticas es efectiva en la mejora de la práctica clínica y en la disminución de la variabilidad clínica. En España se implantan desde 2012 las Guías de Buenas Prácticas de la Asociación de Enfermeras de Ontario a través del Programa de Centros Comprometidos con la Excelencia en Cuidados®, siguiendo los principios del programa canadiense Best Practice Spotlight Organizations® (BPSO®). La Unidad de Investigación en Cuidados y Servicios de Salud (Investén-isciii) coordina dicho programa en España, tras ser nombrada BPSO Host por la Asociación de Enfermeras de Ontario. Se han seguido 4 estrategias: traducción de las Guías de Buenas Prácticas, difusión de las mismas y del programa, implantación de las GuÍas de Buenas Prácticas y evaluación de los resultados en centros seleccionados de forma competitiva, y, finalmente, desarrollo de mecanismos de sostenibilidad. La implantación se apoya en el modelo teórico Knowledge to Action, que establece un ciclo de 6 fases: identificación del problema y formación a Centros Comprometidos con la Excelencia en Cuidados® seleccionados; adaptación al contexto local; evaluación de los facilitadores y barreras; adaptación e implantación de las intervenciones; monitorización y evaluación de resultados, y sostenibilidad. En cada una de estas fases se incorporan aquellos elementos basados en la evidencia que favorecen la efectividad de la implantación, como son la concurrencia competitiva para ser seleccionado candidato a participar en el programa, la selección por la institución de las guías a implantar, el liderazgo por enfermeras con un enfoque multiprofesional, la planificación del proceso a partir de estructuras de trabajo no verticales, pero con apoyo de la institución, el uso de múltiples estrategias de forma simultánea, la evaluación continuada y la retroalimentación de resultados, todo ello tutorizado y apoyado desde el BPSO Host. Actualmente en España hay 27 instituciones de diferentes características que implantan en total 20 guías clínicas. Recientemente se ha ampliado el alcance y estructura del programa con centros coordinadores BPSO Host regionales, lo que ha ampliado el número de instituciones a 36 y el número de guías clínicas implantadas a 22. El programa ha tenido un impacto positivo a nivel de las organizaciones y el sistema, en los procesos de cuidados y en la salud de los pacientes. Se observa en el enriquecimiento de la práctica profesional basada en la evidencia, el fomento del trabajo colaborativo en red, así como en la mejora en los resultados de salud de los pacientes y en la calidad de los cuidados prestados

The implementation of Best practice guidelines is effective in improving clinical practice and reducing clinical variability. The Best Practice Guidelines of the Ontario Nurses Association have been implemented in Spain since 2012 following the principles of the Canadian programme of the Best Practice Spotlight Organisations® (BPSO®). The Nursing and Healthcare Research Unit (Investén-isciii) coordinates this programme in Spain, having been nominated BPSO Host by the Ontario Nurses Association. Four strategies were followed: translation of the Best Practice Guidelines, dissemination of same and of the programme, implementation of the Best Practice Guidelines and assessment of the results in competitively selected centres, and, finally, the development of sustainability mechanisms. Implementation is based on the theoretical Knowledge to Action model, which establishes a cycle of 6 phases: identification of the problem and training of selected BPSO®; adaptation to the local context; assessment of facilitators and barriers; adaptation and implementation of interventions; monitoring and evaluation of results, and sustainability. Each of these phases incorporate evidence-based elements that promote the effectiveness of implementation, such as the competitive selection of candidates to participate in the programme, selection by the institution of the guidelines to be implemented, leadership by nurses with a multi-professional approach, planning of the process from work structures that are non-vertical but with the support of the institution, the simultaneous use of multiple strategies, ongoing assessment and feedback of results. All of which is mentored and supported by the BPSO Host. There are currently 27 institutions in Spain of different characteristics that implement a total of 20 clinical guidelines. The scope and structure of the programme has recently been extended with regional BPSO Host coordinating centres, which has brought the number of institutions to 36 and the number of implemented clinical guidelines to 22. The programme has had a positive impact on organisations and the system, on care processes and on patient health. This is evidenced by enriched evidence-based professional practice, the promotion of collaborative networking and by improved patient health outcomes and the quality of care provided

Experiencia en la implantación y consolidación de las Guías de buenas prácticas de la Registered Nurses' Association of Ontario (RNAO) en el ámbito clínico y académico en Colombia / Experience on implementing and consolidating the Best practice guidelines of the Registered Nurses' Association of Ontario (RNAO) in clinical and academic scenarios in Colombia

Este artículo describe la experiencia de implantación y consolidación de las Guías de buenas prácticas clínicas (GBP) de la Registered Nurses' Association of Ontario (RNAO) en el ámbito clínico y académico, en Santander (Colombia) y su proyección futura. Para la implantación de las Guías de buenas prácticas en ambos contextos se utilizó la herramienta propuesta por la RNAO. En el ámbito clínico, la implantación de las guías ha permitido iniciar el proceso de estandarización del cuidado de forma transversal en la institución, con seguimiento sistemático de los indicadores, lo cual ha hecho posible la toma de decisiones y la visualización de la calidad del cuidado que prestan las enfermeras en sus diferentes roles. En el ámbito académico, la implantación de las guías ha potenciado la función docente e investigadora, y en menor proporción la función de extensión (entendida como educación continua o proyección social). En la fase de consolidación se han logrado avances en 10 componentes a nivel de docentes, estudiantes, escenarios de práctica clínica en instituciones de salud públicas/privadas, usuarios (paciente/cuidadores), profesionales sanitarios y vinculación a otros programas enfermeros a nivel nacional e internacional con la organización RNAO. Consecuentemente, la implantación de GBP ha favorecido la disminución de la brecha en la relación entre la docencia y los servicios clínicos, mejorando así la colaboración entre la asistencia y la academia, donde se potencia el trabajo colaborativo e interinstitucional en pro de la obtención de los mejores resultados en el paciente usando la evidencia disponible. Por tanto, se ha obtenido una trasformación de práctica enfermera a través del conocimiento, como pretende el programa de implantación de las GPC a través del establecimiento del programa Best Practice Spotlight Organizations (BPSO®) en nuestro entorno

This paper describes the results of the implementation, consolidation and future projection of the Best practice guidelines of the Registered Nurses' Association of Ontario (RNAO) in clinical and academic scenarios in Santander, Colombia. The tool proposed by the RNAO was used for the implementation of the guidelines in both clinical and academic settings. Preliminary results on the implementation of the guidelines are presented in this paper. In the clinical setting, the implementation of the guidelines has made it possible to start the process of standardizing care across the institution, with systematic follow-up based on indicators. This has allowed decision-making and visualization of the quality of nursing care provided by nurses in their different roles. In the academic scenario, implementing the guidelines has strengthened teaching and research functions, and, to a lesser extent, continuing education and social projection processes. In the consolidation phase, advances were achieved in 10 components, relevant to teachers, students, and practice scenarios of public / private health institutions, users (patients/caregivers), health personnel and other nursing programmes at a national and international level. Implementing the clinical practice guidelines has reduced the gap between the clinical and the academic scenarios, where collaborative and inter-institutional work is enhanced to obtain better patient outcomes, based on the available evidence

Evaluación de estrategias de implantación del Proyecto Centros Comprometidos con la Excelencia en Cuidados en España / Evaluation of implementation strategies of the Best Practices Spotlight Organisations (BPSO) Project in Spain

OBJETIVO: Identificar elementos favorecedores y barreras de implantación en el Programa de Centros Comprometidos con la Excelencia en Cuidados® que instauran guías de práctica clínica de la Registered Nurse' Association of Ontario, con el fin de que experiencias futuras pudieran beneficiarse de las apreciaciones expuestas. MÉTODO: Estudio de investigación evaluativa del proceso de implantación de guías en instituciones que componen las dos primeras cohortes del programa en España, mediante análisis de contenido de memorias de implantación y proceso inductivo, lectura, interpretación, codificación y categorización según estructura DAFO: debilidades, amenazas, fortalezas y oportunidades. RESULTADOS: Se han analizado memorias e informes de 18 centros de 12 Comunidades Autónomas, entre los cuales implantan 22 guías distintas. Como debilidades, destacan por frecuencia e intensidad, problemas relacionados con sistemas de información y su explotación. Se exponen otros elementos relacionados con difusión de resultados, profesionales, cuidados y factores relativos a la institución. Sobresalen como amenazas, la inestabilidad de plantillas y cambios continuados en la alta dirección o políticas corporativas. Entre las fortalezas, se distinguen la dedicación exclusiva de personal al proyecto y su vinculación a objetivos institucionales. Y por último, se identifica como oportunidades, destacan la posibilidad de comparación estandarizada de resultados propios con ajenos, así como la difusión de resultados. CONCLUSIÓN: Se configura un patrón útil para el abordaje de implantación en otras realidades, donde el cambio en la cultura profesional, su formación, comunicación y liderazgo, así como alinear intereses de gestores y políticos, facilitan unas condiciones ideales para la práctica basada en la evidencia

OBJECTIVE: To identify favourable elements and barriers to implementation in the Program of Best Practice Spotlight Organization® that establish clinical practice guidelines of the Registered Nurse' Association of Ontario, so that future experiences could benefit from the assessments presented here. METHOD: Evaluation research study of the process of implementing guidelines in institutions that make up the first two cohorts of the programme in Spain, through analysis of contents of implantation reports and inductive process, reading, interpretation, coding and categorized according to SWOT structure: Strengths, weaknesses, opportunities and threats. RESULTS: Reports from 18 centres in 12 Autonomous Communities have been analyzed, including 22 different guidelines. As weaknesses, problems related to information systems and their exploitation stand out for frequency and intensity. Other elements related to dissemination of results, to professionals, care and factors related to the institution are presented. Standing out as threats are the instability of staff and continued changes in Senior Management or corporate policies. Among the strengths, the exclusive dedication of personnel to the project and its link to institutional objectives are distinguished. As opportunities, the possibility of standardized comparison of own results with others, as well as the dissemination of results are highlighted. CONCLUSION: A useful pattern is set up to approach implementation in other scenarios, where changes in professional culture, training, communication and leadership, as well as aligning interests of managers and politicians, facilitate ideal conditions for Evidence-Based Practice

Oncology Nurse Informaticists: An Evolving Role to Support Nursing Practice.

Nursing informatics is an evolving field in the burgeoning context of technologic and digital advances in health care. Nurse informaticists are integral in translating these advances into evidence-based clinical practice to improve the quality and safety of patient care and professional practice. This article describes the role and operationalization of nurse informaticists in the oncology setting. A case study is presented to exemplify how nurse informaticists can lead interprofessional teams in evaluating opportunities for process or quality improvement and implementing and evaluating digital solutions to improve oncology care.