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2.
Worldviews Evid Based Nurs ; 18(4): 243-250, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34288388

RESUMO

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.


Assuntos
Atitude do Pessoal de Saúde , Enfermagem Baseada em Evidências/normas , Recursos Humanos de Enfermagem no Hospital/psicologia , Cultura Organizacional , Psicometria/normas , Inquéritos e Questionários/normas , Adulto , Estudos Transversais , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ohio , Reprodutibilidade dos Testes
3.
Worldviews Evid Based Nurs ; 18(4): 272-281, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34309169

RESUMO

BACKGROUND: The Advancing Research and Clinical practice through close Collaboration (ARCC© ) Model is a system-wide framework for implementing and sustaining evidence-based practice (EBP) in hospitals and healthcare systems. The model involves assessing organizational culture and readiness for EBP in addition to the development of a critical mass of EBP mentors who work with point-of-care clinicians to facilitate the implementation of evidence-based care. Determining how the various components of the ARCC© Model relate to one another is important for understanding how EBP culture and mentorship impact EBP implementation, nurses' job satisfaction, and intent to stay. AIMS: The current study aimed to test a model that could explain the relationships and direct pathways among eight key variables in the ARCC© Model: (1) EBP culture, (2) mentorship, (3) knowledge, (4) beliefs, (5) competency, (6) implementation, (7) nurses' job satisfaction, and (8) intent to stay. METHODS: Structural equation modeling was used to test relationships among the variables in the ARCC© Model with data obtained from an earlier cross-sectional descriptive study with 2,344 nurses from 19 hospitals and healthcare systems across the United States. RESULTS: The final structural equation model found that EBP culture and mentorship were key variables that positively impacted EBP knowledge, beliefs, competency, implementation, job satisfaction, and intent to stay among nurses. LINKING EVIDENCE TO ACTION: As described in the ARCC© Model, establishing a strong sustainable EBP culture along with a critical mass of EBP mentors is crucial for the development of EBP competency and consistent implementation of evidence-based care by nurses. A strong EBP culture along with EBP mentorship also can result in higher job satisfaction and intent to stay. Implementation of the ARCC© Model is a key strategy in assisting systems to reach health care's Quadruple Aim.


Assuntos
Enfermagem Baseada em Evidências/organização & administração , Satisfação no Emprego , Mentores , Recursos Humanos de Enfermagem no Hospital/psicologia , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Cultura Organizacional , Reorganização de Recursos Humanos/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Enfermagem , Inquéritos e Questionários
4.
Clin J Oncol Nurs ; 25(3): 282-289, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34019024

RESUMO

BACKGROUND: Evidence-based practice (EBP) is a clinical decision-making approach that improves quality and outcomes in health care but is not yet standard in clinical settings. OBJECTIVES: The purpose of this study was to determine EBP beliefs, knowledge, implementation strategy self-efficacy, and competencies among a national sample of oncology nurses. METHODS: Oncology nurses completed an online survey of EBP attributes and open-ended questions. Analyses were conducted on data collected from 893 participants from a range of healthcare organizations across a diverse geographic sample of the United States. FINDINGS: Respondents rated themselves competent to question clinical practice to improve quality care. Oncology nurses reported competency to question clinical practice but deficits in EBP knowledge and skills.

6.
Am J Nurs ; 120(8): 66-70, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32732486

RESUMO

This is the eighth article in a series about evidence-based practice (EBP) that builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.


Assuntos
Cateterismo Venoso Central , Prática Clínica Baseada em Evidências , Irrigação Terapêutica , Humanos , Processo de Enfermagem
7.
Worldviews Evid Based Nurs ; 17(4): 258-268, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32786053

RESUMO

BACKGROUND: Implementation of evidence-based practice (EBP) is necessary for healthcare systems to improve quality, safety, patient outcomes, and costs. Yet, EBP competency is lacking in many nurses and clinicians across the country. AIM: The purpose of this initiative was to determine whether nursing teams (Executive Leader, Clinical/Mid-level Leader, and Direct Care Nurse) attending a 5-day EBP continuing education skill-building program (immersion) was an effective strategy to build EBP competence, practice, and culture sustainability over time. The Advancing Research and Clinical Practice Through Close Collaboration Model was used to guide this initiative. METHODS: A project team was assembled, including leaders with EBP expertise from the Air Force Medical Service and The Helene Fuld Health Trust National Institute for EBP in Nursing and Healthcare at The Ohio State University. Five survey instruments were used to evaluate outcomes, including Organizational Culture and Readiness for System-Wide Implementation of Evidence-Based Practice, Evidence-Based Practice Beliefs, Evidence-Based Practice Implementation, and Evidence-Based Practice Competencies, as well as the Knowledge Assessment Questionnaire test. Nursing teams were invited to participate and complete the program with the implementation of EBP projects over the following year. RESULTS: Participants' EBP knowledge, skills, competencies, and beliefs were significantly improved and sustained over 12 months. LINKING EVIDENCE TO ACTION: A team-based EBP skill-building program was an effective strategy for building EBP competence, practice, and culture. This initiative demonstrated that the direct involvement of leadership and infrastructure to support EBP were crucial factors for building and sustaining an EBP culture.

8.
Worldviews Evid Based Nurs ; 17(2): 136-143, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32233009

RESUMO

BACKGROUND: Anecdotal reports from across the country highlight the fact that nurses are facing major challenges in moving new evidence-based practice (EBP) initiatives into the electronic health record (EHR). PURPOSE: The purpose of this study was to: (a) learn current processes for embedding EBP into EHRs, (b) uncover facilitators and barriers associated with rapid movement of new evidence-based nursing practices into the EHR and (c) identify strategies and processes that have been successfully implemented in healthcare organizations across the nation. METHODS: A qualitative study design was utilized. Purposive sampling was used to recruit nurses from across the country (N = 29). Nine focus group sessions were conducted. Semistructured interview questions were developed. Focus groups were conducted by video and audio conferencing. Using an inductive approach, each transcript was read and initial codes were generated resulting in major themes and subthemes. RESULTS: Five major themes were identified: (a) barriers to advancing EBP secondary to the EHR, (b) organizational structure and governing processes of the EHR, (c) current processes for prioritization of EHR changes, (d) impact on ability of clinicians to implement EBP and (e) wait times and delays. LINKING EVIDENCE TO ACTION: Delays in moving new EBP practice changes into the EHR are significant. These delays are sources of frustration and job dissatisfaction. Our results underscore the importance of a priori planning for anticipated changes and building expected delays into the timeline for EBP projects. Moreover, nurse executives must advocate for greater representation of nursing within informatics technology governance structures and additional resources to hire nurse informaticians.


Assuntos
Registros Eletrônicos de Saúde/normas , Prática Clínica Baseada em Evidências/métodos , Pesquisa em Enfermagem/instrumentação , Registros Eletrônicos de Saúde/tendências , Prática Clínica Baseada em Evidências/normas , Prática Clínica Baseada em Evidências/tendências , Grupos Focais/métodos , Humanos , Pesquisa em Enfermagem/métodos , Pesquisa em Enfermagem/tendências , Ohio , Pesquisa Qualitativa
9.
J Nurs Adm ; 50(5): 248-250, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32317566

RESUMO

The adoption of evidence-based decision-making and practice in healthcare has been slow. This article discusses the critical role of leaders in steering this transformative work.


Assuntos
Atenção à Saúde/organização & administração , Enfermagem Baseada em Evidências , Liderança , Inovação Organizacional , Tomada de Decisões Gerenciais , Humanos
10.
Am J Nurs ; 120(5): 58-62, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32332369

RESUMO

This is the seventh article in a new series about evidence-based practice (EBP) that builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.


Assuntos
Fibrose Cística , Prática Clínica Baseada em Evidências , Adesão à Medicação , Pâncreas/enzimologia , Autogestão , Adolescente , Criança , Fibrose Cística/tratamento farmacológico , Fibrose Cística/enzimologia , Humanos , Inovação Organizacional , Participação dos Interessados , Inquéritos e Questionários , Ganho de Peso
11.
Worldviews Evid Based Nurs ; 17(1): 71-81, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32017438

RESUMO

BACKGROUND AND SIGNIFICANCE: Evidence-based practice (EBP) is a systematic problem-solving approach to the delivery of health care that improves quality and population health outcomes as well as reduces costs and empowers clinicians to fully engage in their role, otherwise known as the quadruple aim in health care. The Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare at The Ohio State University College of Nursing has been offering 5-day EBP immersion programs since 2012. The goal of the program is for the participants to acquire EBP competence (e.g., knowledge, skills, and attitude) and sustain it over time. PURPOSE AND AIMS: The purpose of this study was to evaluate the effects of the 5-day EBP immersion (i.e., an education and skills building program) on EBP attributes and competence over time. METHOD AND DESIGN: A longitudinal pre-experimental study was conducted that gathered data with an anonymous online survey from 400 program attendees who attended 16 5-day immersions between September 2014 and May 2016. Participants completed five valid and reliable instruments at four points over 12 months, including EBP beliefs, implementation, competency, knowledge, and perception of organizational readiness and culture. RESULTS: Findings indicated statistically significant improvements in EBP attributes and competency over time. The results of this study support the hypotheses that EBP competency and attributes can be significantly improved and sustained by attending an intensive 5-day EBP educational and skills building program such as the one described in this study. This study can help leaders and organizations to mitigate many of the traditional barriers to EBP. LINKING EVIDENCE TO ACTION: The results of this study indicate that EBP attributes and competencies can be improved and sustained by attending an intensive 5-day EBP immersion, regardless of clinicians' prior educational preparation.


Assuntos
Prática Clínica Baseada em Evidências/normas , Desenvolvimento de Pessoal/normas , Adulto , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Prática Clínica Baseada em Evidências/métodos , Prática Clínica Baseada em Evidências/estatística & dados numéricos , Feminino , Humanos , Internet , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Desenvolvimento de Pessoal/métodos , Desenvolvimento de Pessoal/estatística & dados numéricos , Inquéritos e Questionários
12.
Am J Nurs ; 120(2): 44-48, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31977418

RESUMO

This is the sixth article in a new series about evidence-based practice (EBP) that builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.


Assuntos
Prática Clínica Baseada em Evidências/normas , Desenvolvimento de Programas/métodos , Bolsas de Estudo , Humanos
14.
Am J Nurs ; 119(12): 60-64, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31764058

RESUMO

This is the fifth article in a new series about evidence-based practice (EBP) that builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.


Assuntos
Desnutrição/prevenção & controle , Avaliação de Processos e Resultados em Cuidados de Saúde/normas , Readmissão do Paciente/estatística & dados numéricos , Melhoria de Qualidade , Benchmarking , Prestação Integrada de Cuidados de Saúde/organização & administração , Prática Clínica Baseada em Evidências/métodos , Humanos , Desnutrição/diagnóstico , Medição de Risco
15.
Am J Nurs ; 119(10): 45-48, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31567254

RESUMO

This is the fourth article in a new series about evidence-based practice (EBP) that builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.


Assuntos
Enfermagem Baseada em Evidências , Pacotes de Assistência ao Paciente , Lesão por Pressão/prevenção & controle , Higiene da Pele/enfermagem , Humanos , Ohio
17.
Am J Nurs ; 119(8): 60-63, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31356335

RESUMO

: This is the third article in a new series about evidence-based practice (EBP) that builds on AJN's awardwinning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.


Assuntos
Antineoplásicos/efeitos adversos , Medicina Baseada em Evidências/normas , Mucosite/induzido quimicamente , Mucosite/enfermagem , Assistência Centrada no Paciente/normas , Guias de Prática Clínica como Assunto , Medicina de Precisão/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Coleta de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
18.
Worldviews Evid Based Nurs ; 16(4): 281-288, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31162823

RESUMO

OBJECTIVES: To explore nurses' views and establish consensus on the key content of the essential evidence-based practice (EBP) competencies developed by Melnyk et al. (2014, Worldviews on Evidence-Based Nursing, 11, 5) for practicing registered nurses (RNs) and advanced practice nurses (APNs) among Finnish nurse panelists. BACKGROUND: Broad-based integration of best evidence into daily practice is central to effectively improving care quality and patient outcomes. EBP competencies allow healthcare professionals and organizations to clarify performance expectations regarding EBP and succinctly outline the expected competencies for successful application of best evidence to daily care. DESIGN: A modified Policy Delphi study design. METHODS: The Delphi panel was conducted in late 2017 among 14 Finnish nurse clinicians, educators, and leaders with a special interest in EBP. The data were collected using an eDelphi Internet application and the Argument Delphi method, highlighting the panelists' different perspectives. Standardized guidelines and descriptive statistics were used to translate the essential EBP competencies into Finnish and analyze the data. RESULTS: The Finnish Delphi panel endorsed and validated the essential EBP competencies for practicing RNs and APNs with a few minor modifications. Of the 13 essential EBP competencies for practicing RNs, consensus was established among the Delphi panelists over two rounds on all but one of the EBP competencies. Of the 11 additional essential EBP competencies for practicing APNs, consensus was established over two Delphi rounds on all the EBP competencies for APNs. LINKING EVIDENCE TO ACTION: As EBP is a shared competency and the key principles and steps of EBP implementation are universal, the international endorsement and validation of national consensus-based, clinical practice-oriented EBP competency sets establish an international quality standard for nurses to aspire to and attain on EBP and provide guidance for nurses in integrating best evidence into their daily practice, facilitating broad-based, consistent implementation of EBP worldwide.


Assuntos
Prática Clínica Baseada em Evidências/métodos , Enfermeiras e Enfermeiros/psicologia , Competência Profissional/normas , Consenso , Técnica Delfos , Prática Clínica Baseada em Evidências/estatística & dados numéricos , Finlândia , Humanos , Enfermeiras e Enfermeiros/normas , Competência Profissional/estatística & dados numéricos , Inquéritos e Questionários
19.
Am J Nurs ; 119(6): 62-66, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31135435

RESUMO

This is the second article in a new series about evidence-based practice (EBP) that builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series will feature exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.


Assuntos
Prática Clínica Baseada em Evidências/educação , Prática Clínica Baseada em Evidências/organização & administração , Recursos Humanos de Enfermagem no Hospital/educação , Recursos Humanos de Enfermagem no Hospital/organização & administração , Admissão e Escalonamento de Pessoal/organização & administração , Desenvolvimento de Pessoal/organização & administração , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
20.
Worldviews Evid Based Nurs ; 16(3): 176-185, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31074582

RESUMO

BACKGROUND: Evidence-based practice (EBP) competencies are essential for all practicing healthcare professionals to provide evidence-based, quality care, and improved patient outcomes. The multistep EBP implementation process requires multifaceted competencies to successfully integrate best evidence into daily healthcare delivery. AIMS: To summarize and synthesize the current research literature on practicing health professionals' EBP competencies (i.e., their knowledge, skills, attitudes, beliefs, and implementation) related to employing EBP in clinical decision-making. DESIGN: An overview of systematic reviews. METHODS: PubMed/MEDLINE, CINAHL, Scopus, and Cochrane Library were systematically searched on practicing healthcare professionals' EBP competencies published in January 2012-July 2017. A total of 3,947 publications were retrieved, of which 11 systematic reviews were eligible for a critical appraisal of methodological quality. Three independent reviewers conducted the critical appraisal using the Rapid Critical Appraisal tools developed by the Helene Fuld National Institute for Evidence-Based Practice in Nursing & Healthcare. RESULTS: Practicing healthcare professionals' self-reported EBP knowledge, skills, attitudes, and beliefs were at a moderate to high level, but they did not translate into EBP implementation. Considerable overlap existed in the source studies across the included reviews. Few reviews reported any impact of EBP competencies on changes in care processes or patient outcomes. Most reviews were methodologically of moderate quality. Significant variation in study designs, settings, interventions, and outcome measures in the source studies precluded any comparisons of EBP competencies across healthcare disciplines. LINKING EVIDENCE TO ACTION: As EBP is a shared competency, the development, adoption, and use of an EBP competency set for all healthcare professionals are a priority along with using actual (i.e., performance-based), validated outcome measures. The widespread misconceptions and misunderstandings that still exist among large proportions of practicing healthcare professionals about the basic concepts of EBP should urgently be addressed to increase engagement in EBP implementation and attain improved care quality and patient outcomes.


Assuntos
Revisões Sistemáticas como Assunto , Competência Clínica/normas , Prática Clínica Baseada em Evidências/educação , Prática Clínica Baseada em Evidências/métodos , Prática Clínica Baseada em Evidências/tendências , Humanos , Qualidade da Assistência à Saúde
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