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1.
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
2.
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.


Assuntos
Competência Clínica , Enfermagem Oncológica , Atitude do Pessoal de Saúde , Enfermagem Baseada em Evidências , Prática Clínica Baseada em Evidências , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Qualidade da Assistência à Saúde , Inquéritos e Questionários , Estados Unidos
3.
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.


Assuntos
Enfermeiras e Enfermeiros/normas , Desenvolvimento de Pessoal/métodos , Ensino/normas , Adulto , Atitude do Pessoal de Saúde , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Educação Continuada em Enfermagem/métodos , Educação Continuada em Enfermagem/normas , Educação Continuada em Enfermagem/estatística & dados numéricos , Prática Clínica Baseada em Evidências/métodos , Feminino , Humanos , Masculino , Enfermeiras e Enfermeiros/estatística & dados numéricos , Equipe de Assistência ao Paciente/normas , Equipe de Assistência ao Paciente/estatística & dados numéricos , Desenvolvimento de Pessoal/normas , Desenvolvimento de Pessoal/estatística & dados numéricos , Inquéritos e Questionários , Ensino/estatística & dados numéricos , Pesquisa Médica Translacional/métodos , Pesquisa Médica Translacional/normas , Pesquisa Médica Translacional/estatística & dados numéricos
4.
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
5.
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
6.
J Nanosci Nanotechnol ; 19(5): 2640-2648, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30501761

RESUMO

The purpose of this study is to minimize the negative impacts of synthetic procedures and to develop environmentally benign procedures for the synthesis of metallic nanoparticles. In the present study, Passiflora edulis f. flavicarpa (P. edulis) aqueous leaf extract mediated green synthesis of silver nanoparticles are described. The synthesized silver nanoparticles were characterized by UV-Vis Spectroscopy, Fluorescence Spectroscopy, Fourier Transform Infrared Spectroscopy (FTIR), X-ray diffraction (XRD), Scanning Electron Microscopy (SEM) Transmission Electron Microscopy (TEM) and Cyclic Voltammetry (CV). The silver nanoparticles (AgNPs) showed antibacterial activities against both gram positive (staphylococcus) and gram negative (Escherichia coli) bacteria. The efficacy of the synthesized silver nanoparticles (AgNPs) was demonstrated as catalyst in the photocatalytic degradation of Methyl Orange (MO) and Methylene Blue (MB) dyes which were measured spectrophotometrically. The study revealed that biosynthesized silver nanoparticles using Passiflora. edulis f. flavicarpa, plant extract was found to be very effective as antioxidant agent.


Assuntos
Nanopartículas Metálicas , Passiflora , Antibacterianos , Antioxidantes/farmacologia , Química Verde , Microscopia Eletrônica de Transmissão , Extratos Vegetais/farmacologia , Prata/farmacologia , Espectroscopia de Infravermelho com Transformada de Fourier , Difração de Raios X
7.
Worldviews Evid Based Nurs ; 15(1): 5-15, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29337427

RESUMO

BACKGROUND: Even though multiple positive outcomes are the result of evidence-based care, including improvements in healthcare quality, safety, and costs, it is not consistently delivered by clinicians in healthcare systems throughout the world. AIMS: In an attempt to accelerate the implementation of evidence-based practice (EBP) across the United States, an invitational Interprofessional National EBP Forum to determine major priorities for the advancement of EBP was held during the launch of the newly established Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at The Ohio State University College of Nursing. METHODS: Interprofessional leaders from national organizations and federal agencies across the United States were invited to participate in the Forum. A pre-Forum survey was disseminated to participants to assess their perceptions of the state of EBP and actions necessary to speed the translation of research into real-world clinical settings. RESULTS: Findings from a pre-Forum survey (n = 47) indicated ongoing low implementation of EBP in U.S. healthcare settings. These findings were shared with leaders from 45 organizations and agencies who attended the Forum. Breakout groups on practice, education, implementation science, and policy discussed the findings and responded to a set of standardized questions. High-priority action tactics were identified, including the need for: (a) enhanced reimbursement for EBP, (b) more interprofessional education and skills building in EBP, and (c) leaders to prioritize EBP and fuel it with resources. LINKING EVIDENCE TO ACTION: The delivery of and reimbursement for evidence-based care must become a high national priority. Academic faculty across all healthcare disciplines need to teach EBP, healthcare systems must invest in EBP resources, and payers must attach reimbursement to care that is evidence-based. An action collaborative of the participating organizations has been formed to accelerate EBP across the United States to achieve the quadruple aim in health care.


Assuntos
Congressos como Assunto , Enfermagem Baseada em Evidências/métodos , Qualidade da Assistência à Saúde/tendências , Atenção à Saúde/métodos , Atenção à Saúde/normas , Enfermagem Baseada em Evidências/organização & administração , Humanos , Inquéritos e Questionários
8.
Worldviews Evid Based Nurs ; 15(1): 16-25, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29278664

RESUMO

BACKGROUND: Tremendous variability in EBP persists throughout the United States even though research supports that implementation of EBP leads to high-quality cost-effective care. Although the first set of EBP competencies for nurses was published in 2014, the state of EBP competency in U.S. nurses is currently unknown. AIMS: The purposes of this study were to: (a) describe the state of EBP competency in nurses across the United States; and (b) determine important factors associated with EBP competency. METHODS: A cross-sectional descriptive study was conducted that gathered data from an anonymous online survey of practicing nurses throughout the U.S. Measures tapped EBP knowledge, beliefs, culture, mentorship, implementation, and reported competency for each of the 13 EBP competencies for practicing nurses and an additional 11 competencies for advanced practice nurses. RESULTS: A total of 2,344 nurses completed the survey from 19 hospitals or healthcare systems. Overall, the nurses reported that they were not yet competent in meeting any of the 24 EBP competencies. Younger nurses and those with higher levels of education reported higher EBP competency (p < .001). The EBP competency scores were not significantly different between nurses in Magnet and non-Magnet designated organizations (p = .28). There were strong positive associations between EBP competency with EBP beliefs (r = .66) and EBP mentorship (r = .69), a moderate positive association between EBP competency and EBP knowledge (r = .43), and a small positive association between EBP competency and culture (r = .29). LINKING EVIDENCE TO ACTION: There is a tremendous need to enhance nurses' skills so that they achieve competency in EBP in order to ensure the highest quality of care and best population health outcomes. Academic programs should ensure competency in EBP in students by the time of graduation and healthcare systems should set it as an expectation and standard for all clinicians.


Assuntos
Competência Clínica/normas , Enfermagem Baseada em Evidências/normas , Segurança do Paciente/normas , Qualidade da Assistência à Saúde/normas , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Enfermagem Baseada em Evidências/métodos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos
9.
J Nurses Prof Dev ; 33(4): 170-179, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28441160

RESUMO

Nursing professional development (NPD) practitioners are integral to implementing evidence-based practice (EBP). Research was conducted to describe NPD practitioners' EBP beliefs and competencies, frequency of implementing EBP, and perceptions of organizational culture and readiness for EBP. Relationships among NPD practitioner characteristics and organization outcomes were explored. Findings indicate that NPD practitioners must develop personal competence in EBP, become engaged in shared governance, collaborate with others, and use quality metrics to demonstrate the effectiveness and value of NPD activities.


Assuntos
Enfermagem Baseada em Evidências , Profissionais de Enfermagem/estatística & dados numéricos , Cultura Organizacional , Avaliação de Processos e Resultados em Cuidados de Saúde/organização & administração , Desenvolvimento de Pessoal/métodos , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Competência Profissional , Inquéritos e Questionários , Estados Unidos
10.
Worldviews Evid Based Nurs ; 13(1): 6-14, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26873371

RESUMO

BACKGROUND: Although findings from studies indicate that evidence-based practice (EBP) results in high-quality care, improved patient outcomes, and lower costs, it is not consistently implemented by healthcare systems across the United States and globe. AIMS: The purpose of this study was to describe: (a) the EBP beliefs and level of EBP implementation by chief nurse executives (CNEs), (b) CNEs' perception of their hospitals' EBP organizational culture, (c) CNEs' top priorities, (d) amount of budget invested in EBP, and (e) hospital performance metrics. METHODS: A descriptive survey was conducted. Two-hundred-seventy-six CNEs across the United States participated in the survey. Valid and reliable measures included the EBP Beliefs scale, the EBP Implementation scale, and the Organizational Culture and Readiness scale for EBP. The Centers for Medicare and Medicaid Services Core Measures and the National Database of Nursing Quality Indicators (NDNQI) were also collected. RESULTS: Data from this survey revealed that implementation of EBP in the practices of CNEs and their hospitals is relatively low. More than one-third of the hospitals are not meeting NDNQI performance metrics and almost one-third of the hospitals are above national core measures benchmarks, such as falls and pressure ulcers. LINKING EVIDENCE TO ACTION: Although CNEs believe that EBP results in high-quality care, it is ranked as a low priority with little budget allocation. These findings provide a plausible explanation for shortcomings in key hospital performance metrics. To achieve higher healthcare quality and safety along with decreased costs, CNEs and hospital administrators need to invest in providing resources and an evidence-based culture so that clinicians can routinely implement EBP as the foundation of care.


Assuntos
Atenção à Saúde/normas , Prática Clínica Baseada em Evidências , Conhecimentos, Atitudes e Prática em Saúde , Hospitais/normas , Enfermeiras Administradoras , Atitude do Pessoal de Saúde , Humanos , Cultura Organizacional , Inquéritos e Questionários , Estados Unidos
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