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1.
J Nurs Care Qual ; 34(2): 133-138, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29975217

RESUMO

BACKGROUND: Evidence supports daily bathing using chlorhexidine gluconate (CHG) cloths to decrease preventable hospital-acquired central line-associated bloodstream infections (CLABSIs). However, implementation of this practice is inconsistent. Using multifaceted strategies to promote implementation is supported in the literature, yet there is a gap in knowing which strategies are most successful. PURPOSE: Using the Grol and Wensing Model of Implementation as a guide, the purpose of this study was to determine whether using tailored, multifaceted strategies would improve implementation of daily CHG bathing and decrease CLABSIs in a large neuro ICU. METHODS: An observational pre-/postdesign was used. RESULTS: Following implementation, infection rates decreased (P = .031). Statistically significant improvements were also seen across all process measures: bathing documentation, nursing knowledge, and perceived importance of CHG bathing. CONCLUSIONS: This study assists in closing the research-practice gap by using tailored, multifaceted implementation strategies to increase use of evidence-based nursing care for infection prevention practices.


Assuntos
Banhos/métodos , Prática Clínica Baseada em Evidências , Ciência da Implementação , Unidades de Terapia Intensiva , Anti-Infecciosos Locais/administração & dosagem , Infecções Relacionadas a Cateter/prevenção & controle , Cateterismo Venoso Central/efeitos adversos , Clorexidina/administração & dosagem , Clorexidina/análogos & derivados , Enfermagem de Cuidados Críticos , Infecção Hospitalar/prevenção & controle , Humanos , Neurologia
2.
Rehabil Nurs ; 43(1): 52-61, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-27781292

RESUMO

PURPOSE: The purpose of this study was to evaluate a bundle of implementation strategies (local opinion leaders, printed educational materials, and educational outreach) to increase neurocritical care nurses' knowledge of and adherence to spinal cord injury guidelines. DESIGN: A preprogram, postprogram, and follow-up design was used to evaluate outcomes. METHODS: Adherence was measured via self-reported anticipatory adherence; knowledge was measured by an author-developed assessment. Repeated-measures ANOVA was used for data analysis. FINDINGS: Improvements in nursing knowledge and adherence were found from preprogram to postprogram to follow-up time points. CONCLUSIONS: Outcomes noted in this study provide additional support for using this bundle of implementation strategies and were consistent with previous research documenting the usefulness of these strategies. CLINICAL RELEVANCE: Although further research is needed, this study highlighted a systematic way of implementing evidence-based practices to improve neurocritical care nurses' knowledge of and adherence to spinal cord injury guidelines.


Assuntos
Fidelidade a Diretrizes/normas , Guias como Assunto , Traumatismos da Medula Espinal/terapia , Adulto , Competência Clínica/normas , Prática Clínica Baseada em Evidências/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Enfermagem em Reabilitação/métodos , Recursos Humanos
3.
J Eval Clin Pract ; 23(1): 149-155, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27766734

RESUMO

RATIONALE: Program evaluation is essential to help determine the success of an evidence-based practice program and assist with translating these processes across settings. AIMS: The purpose of this study was to evaluate the usefulness of 2 competency programs that sought to improve neurocritical care nurses' knowledge of and adherence to evidence-based stroke and spinal cord injury guidelines. These programs consisted of 3 specific implementation strategies, including local opinion leaders, printed educational materials, and educational outreach. METHODS: A qualitative study using one-on-one interviews with 10 neurocritical care nurses was used. Semi-structured interview questions examined the nurses' perceptions of the competency programs and the implementation strategies used; themes were identified through first-level coding. The transcripts were deductively analyzed and categorized using a predetermined implementation outcomes framework, including the concepts of acceptability, appropriateness, adoption, and sustainability. RESULTS: Nurses reported that the 3 implementation strategies used for the competency programs were acceptable and appropriate. Further, the nurses perceived that the evidence-based practices reviewed during the programs were being adopted into practice and provided suggestions for sustaining improvements in nursing knowledge of and adherence to these evidence-based practices. CONCLUSIONS: Findings from this study support the success of the Stroke and Spinal Cord Injury Competency Programs, as well as the usefulness of the 3 implementation strategies used. This study provides insight for improvements for subsequent studies focused on implementing evidence-based practices.


Assuntos
Competência Clínica/normas , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/normas , Traumatismos da Medula Espinal/enfermagem , Desenvolvimento de Pessoal/organização & administração , Acidente Vascular Cerebral/enfermagem , Enfermagem de Cuidados Críticos/normas , Prática Clínica Baseada em Evidências , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Entrevistas como Assunto , Guias de Prática Clínica como Assunto , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa
4.
J Neurosci Nurs ; 48(6): 328-335, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27602532

RESUMO

BACKGROUND: Nurses play an integral part in providing evidence-based care to patients with stroke, yet some patients receive unnecessary or even harmful care. The literature supports the use of multifaceted strategies to promote implementation of evidence-based practice; however, there is a gap in knowing which combinations of strategies are most successful. PURPOSE: The purpose of this study was to determine if a tailored, multifaceted Stroke Competency Program would improve nurses' knowledge of and adherence to evidence-based practices in the care of patients with stroke. This program bundled implementation strategies of local opinion leaders, printed educational materials, and educational outreach. METHODS: This study used a pretest/posttest program design. Nursing adherence was measured via documentation audits with knowledge measured by an author-developed assessment. FINDINGS: Most participating nurses had approximately 10 years of nursing experience and were baccalaureate prepared; participation ranged from 32% to 58% (n = 88). Overall, an improvement in nursing adherence was noted after the program as well as significant improvements in nursing knowledge. CONCLUSION: Although the Stroke Competency Program improved nursing knowledge of and adherence to stroke guidelines, future research should seek to extend these findings to identify which bundle of strategies are most effective for implementing evidence into nursing practice using psychometrically sound outcome measures.


Assuntos
Fidelidade a Diretrizes/normas , Conhecimentos, Atitudes e Prática em Saúde , Enfermeiras e Enfermeiros , Acidente Vascular Cerebral/terapia , Enfermagem de Cuidados Críticos , Educação Continuada em Enfermagem , Avaliação Educacional , Medicina Baseada em Evidências , Humanos , Inquéritos e Questionários
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