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1.
J Nurs Adm ; 49(7-8): 372-376, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31335519

RESUMO

Creating nurse-driven protocols empower nurses to practice at the top of their scope and provide early interventions. This article describes the development and implementation of an evidence-based, nurse-driven resuscitation protocol for cardiac surgical patients who suffer cardiac arrest using a theoretical framework and leadership-driven process. Readers will gain knowledge of the collaborative process required to develop and implement a complex practice change. Process measures, outcomes, and lessons learned are presented.


Assuntos
Enfermagem Baseada em Evidências , Implementação de Plano de Saúde/organização & administração , Enfermeiras Administradoras , Ressuscitação/métodos , Parada Cardíaca , Humanos , Unidades de Terapia Intensiva , Melhoria de Qualidade , Ressuscitação/estatística & dados numéricos , Sobrevida
2.
J Psychosoc Nurs Ment Health Serv ; 57(6): 9-13, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31162621

RESUMO

Since Sackett et al.'s epic throw down of the gauntlet in 1996, the hallmark of quality health care practice has been evidence-based clinical decision making. But what does it mean to base one's practice on evidence, and what are the barriers to evidence-based prescribing? The current article addresses these questions and offers suggestions to improve one's evidence-based practice. [Journal of Psychosocial Nursing and Mental Health Services, 57(6), 9-13.].


Assuntos
Prescrições de Medicamentos/enfermagem , Enfermagem Baseada em Evidências , Transtornos Mentais/tratamento farmacológico , Enfermagem Psiquiátrica , Prática Avançada de Enfermagem/métodos , Humanos , Neurofarmacologia/educação
3.
Nurs Womens Health ; 23(3): 183-184, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31059672

RESUMO

We strive to put evidence into action to promote optimal nursing care, regardless of whether those care practices are brand new or decades old.


Assuntos
Enfermagem Baseada em Evidências/normas , Humanos
5.
Rev Infirm ; 68(248): 32-33, 2019 Feb.
Artigo em Francês | MEDLINE | ID: mdl-30955538

RESUMO

By combining clinical reasoning and evidence-based practice, nurses can create a virtuous circle which can in turn increase the probability of obtaining satisfactory clinical results for patients. Nursing research must thereby benefit practice by producing scientific knowledge which can be used in day-to-day care.


Assuntos
Enfermagem Baseada em Evidências , Humanos
7.
Rev Bras Enferm ; 72(2): 354-359, 2019 Mar-Apr.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31017196

RESUMO

OBJECTIVE: To understand the repercussions of the nurse's clinical practice on Primary Health Care. METHOD: Qualitative research with the theoretical and methodological contribution of Grounded Theory. Data collection took place between May and October 2016 in Florianópolis' Primary Care service. The theoretical sample was comprised of 18 nurses divided into two groups. RESULTS: nurses' clinical practice has repercussions on the consolidation of the trust bond between individuals, families and communities, by amplifying the problem-solving efficacy of the Primary Health Care professional's clinical practice. This is due to the implementation of clinical nursing protocols, and also the use of the International Classification for Nursing Practice. FINAL CONSIDERATIONS: Nurses' clinical practice has positive repercussions on the health of Primary Health Care users.


Assuntos
Padrões de Prática Médica/normas , Atenção Primária à Saúde/métodos , Competência Clínica/normas , Enfermagem Baseada em Evidências , Teoria Fundamentada , Humanos , Papel do Profissional de Enfermagem/psicologia , Padrões de Prática Médica/tendências , Atenção Primária à Saúde/tendências , Pesquisa Qualitativa , Terminologia Padronizada em Enfermagem
8.
Clin Nurse Spec ; 33(3): 136-145, 2019 May/Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30946111

RESUMO

PURPOSE: This article describes the work of the National Association of Clinical Nurse Specialists (NACNS) Opioid/Pain Management Task Force and provides guidance for the clinical nurse specialist (CNS) in evidence-based pain management interventions and organizational program development. DESCRIPTION: In September 2016, the NACNS commissioned a group of pain management experts to identify the resources that CNSs need to address appropriate opioid use and pain management in various practice settings. Challenges faced by CNSs related to opioids and pain management were identified through NACNS Conference forums and a pain management survey of NACNS members. OUTCOME: On the basis of member input, the task force highlighted key components, or pain pillars, necessary for optimal pain management. Use of these pillars can guide the CNS and healthcare organizations to develop comprehensive pain management practices that provide the foundation for safe, effective, and individualized patient care. CONCLUSIONS: As an expert in clinical, professional, and systems leadership, the CNS is ideally suited to convene interprofessional groups focused on pain management including development of organizational philosophies, policies, and evidence-based care.


Assuntos
Analgésicos Opioides/uso terapêutico , Enfermeiras Clínicas , Manejo da Dor/enfermagem , Comitês Consultivos , Enfermagem Baseada em Evidências/organização & administração , Humanos , Guias de Prática Clínica como Assunto , Desenvolvimento de Programas , Sociedades de Enfermagem , Estados Unidos
9.
Nephrol Nurs J ; 46(2): 249-259, 2019 Mar-Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31009191

RESUMO

Evidence-based practice (EBP) is one of the essential components of nephrology nursing. Reviews of such evidence are important as a means to synthesize research findings into one meaningful form of data. Publication trends of evidence reviews in nephrology nursing are unknown. The purpose of this systematic review was to identify trends in publications of evidence reviews in the Nephrology Nursing Journal. Titles of all publications in the Nephrology Nursing Journal from January 2003 to September/October 2018 were reviewed. A total of 23 evidence reviews were identified and formed the basis of this systematic review. Narrative analysis and concept mapping were used to synthesize data. There was a trend toward systematic reviews of quantitative studies, as well as evidence reviews that focused on the topics of quality of life and access to health services. The need for systematic rigorous reporting is recommended for EBP, as well as future reviews on identified priority areas of research.


Assuntos
Enfermagem Baseada em Evidências , Enfermagem em Nefrologia/tendências , Publicações Periódicas como Assunto , Publicações/tendências , Humanos
11.
Enferm. intensiva (Ed. impr.) ; 30(1): 4-12, ene.-mar. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-181636

RESUMO

Objetivo: Evaluar la efectividad de la implantación de un protocolo de control glucémico del paciente crítico liderado por enfermeras, en términos de mantenimiento de un rango preestablecido de glucemias, reducción de hiperglucemia y prevención de hipoglucemia severa. Método: Estudio cuasiexperimental prospectivo «pre-pos» realizado en una unidad de cuidados intensivos polivalente. Se incluyeron pacientes adultos en tratamiento con insulina endovenosa. Se registraron todas las determinaciones de glucemia desde noviembre de 2014 a agosto de 2015 (preintervención) y desde noviembre de 2015 a agosto de 2016 (pos). La intervención consistió en la implementación de un protocolo basado en la evidencia, para conseguir rangos de glucemia entre 140-180mg/dl. Las variables principales incluyeron proporciones de glucemias dentro de rango, tasas de hipoglucemia severa (menos de 40mg/dl) y tasas de hiperglucemia superior a 200mg/dl. Resultados: Se evaluaron 7864 determinaciones de glucemia pertenecientes a 125 pacientes, 66 preintervención y 59 postintervención. La edad media fue de 66,24±13,99 años, el 64% eran hombres. La proporción de determinaciones dentro del rango fue superior en el grupo postintervención (38,82 vs. 44,34 p<0,001). Se identificó un caso de hipoglucemia severa, que sucedió en el grupo preintervención. La tasa de hiperglucemia severa resultó menor en el grupo postintervención (19,19 vs. 16,28 p=0,001). Conclusiones: Nuestra experiencia muestra que una implantación basada en la evidencia puede mejorar el control glucémico en pacientes críticos. Se observaron mayores tasas de glucemia dentro de rango. El protocolo resultó útil en la prevención de la hipoglucemia severa. El liderazgo del equipo de enfermería y la toma de decisiones autónomas basadas en datos clínicos permitió mejorar los resultados en salud de los pacientes


Aim: To assess the effectiveness of the implementation of a protocol for glycaemic control in critical care, in terms of maintenance of a pre-established target of blood glucose level, reduction of hyperglycaemia and prevention of severe hypoglycaemia. Method: Prospective "pre-post" quasi-experimental study carried out in a general critical care unit. Adult patients treated with intravenous insulin were included. We recorded all glycaemic tests performed from November 2014 to August 2015 (pre-intervention) and from November 2015 to August 2016 (post-intervention). The intervention consisted of the implementation of an evidence-based glycaemic control protocol to achieve glycaemic levels in a range of 140-180mg/dl. Main variables analysed were: proportion of glycaemic tests in the target range, proportions of severe hypoglycaemia (under 40mg/dl) and hyperglycaemia over 200mg/dl. Results: We analysed 7864 glycaemic tests from 125 patients, 66 pre-intervention and 59 post-intervention. Average age was 66.24±13.99 years, 64% of patients were male. The proportion of tests within the target range was higher in the intervention group (38.82 vs. 44.34 p<.001). Only one case of severe hypoglycaemia was identified, which happened in the pre-intervention period. The rate of severe hyperglycaemia was lower in the post-intervention group (19.19 vs. 16.28 p=.001). Conclusions: Our experience shows that implementation of evidence-based interventions can improve glycaemic control during critical illness. We found higher glycaemia levels in the target range. The protocol proved useful in the prevention of severe hypoglycaemia. Nurse-led interventions based on clinical data improved health results in our patients


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Avaliação de Eficácia-Efetividade de Intervenções , Enfermagem Baseada em Evidências , Hiperglicemia/prevenção & controle , Estresse Psicológico/complicações , Enfermagem de Cuidados Críticos , Avaliação em Enfermagem , Estudos Prospectivos , Unidades de Terapia Intensiva , Liderança , Tomada de Decisões
12.
J Prof Nurs ; 35(2): 101-104, 2019 Mar - Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30902400

RESUMO

Translating and integrating scholarship into practice is a difficult concept for students to embrace through a passive education model. Therefore, innovative teaching strategies were integrated into a translational science course for online graduate nursing students. The purpose of this project was to increase understanding of the research process and stimulate interest in translating nursing evidence into practice. The result was an effective educational strategy for teaching and learning about the research process in a virtual environment.


Assuntos
Projetos de Pesquisa , Ensino , Realidade Virtual , Educação a Distância/métodos , Educação de Pós-Graduação em Enfermagem , Enfermagem Baseada em Evidências , Humanos , Estudantes de Enfermagem
13.
J Prof Nurs ; 35(2): 105-111, 2019 Mar - Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30902401

RESUMO

Adverse childhood experiences (ACEs) devastate the lives of children, families and the community. Nearly 35 million children in the United States (US) have experienced one or more types of childhood trauma and nearly a third of youth between ages 12 and 17 have experienced two or more traumatic events. Adverse childhood experiences place an economic toll in the U.S., costing between $5.8 billion and $12.6 billion annually. Child maltreatment costs $124 billion, conservatively. Health Professionals play a major role to prevent and effectively intervene in ACEs. To this end, building a nursing workforce with necessary ACEs knowledge is critical as nursing graduates can make a sustainable impact as they translate knowledge in practice to improve health and health outcomes for children, families and communities. This paper describes how a College of Nursing initiated a systematic integration of ACEs knowledge across BSN curriculum from designing an ACEs Curriculum Integration Model, engaging and enabling faculty in the integration process and how ACEs concepts and contents were integrated. Suggestions are made for ongoing work and evaluations of the effects of ACEs curriculum integration.


Assuntos
Experiências Adversas da Infância/educação , Currículo , Educação em Enfermagem , Adolescente , Criança , Bem-Estar da Criança/psicologia , Enfermagem Baseada em Evidências , Humanos , Estados Unidos
14.
J Nurs Educ ; 58(3): 182-184, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30835808

RESUMO

BACKGROUND: Nursing students often lack the skills and confidence to intervene in the care of a deteriorating patient as they transition into clinical practice. Exposure to these situations is limited during their academic career. Our team sought to address this by embedding American Heart Association (AHA) advanced cardiac life support (ACLS) content into the curriculum and offering certification to senior-level students. METHOD: The senior skills course was redesigned to include education on current AHA ACLS guidelines and skills. ACLS algorithms were introduced and reinforced by mock code labs utilizing rapid cycle deliberate practice and interprofessional simulation. After completion of the semester, students were given the option to be ACLS certified. RESULTS: Students and stakeholders reported positively on the ability to certify in ACLS at our institution prior to graduation and reported increased confidence in their ability to manage patients with cardiopulmonary arrest. CONCLUSION: Providing simulated experiences for these clinical situations can reportedly increase confidence and improve preparedness in senior-level BSN students. [J Nurs Educ. 2019;58(3):182-184.].


Assuntos
Suporte Vital Cardíaco Avançado/educação , Bacharelado em Enfermagem/métodos , Papel do Profissional de Enfermagem , Estudantes de Enfermagem/psicologia , Competência Clínica , Currículo , Enfermagem Baseada em Evidências/métodos , Humanos
15.
MCN Am J Matern Child Nurs ; 44(3): 128-136, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30888987

RESUMO

OBJECTIVE: Develop a multidisciplinary, consensus-driven, evidence-based approach to oxytocin use, while adhering to national guidelines. DESIGN: This was a quality improvement project that used the Plan Do Study Act method to create cycles of change over several years. To initiate discussion, a survey was administered at a social event for providers from divergent community practices that addressed the controversial aspects of oxytocin use. Graphic feedback was provided showing divergences between answers and the evidence. The perinatal team directed design and implementation of this project with specific involvement of a nurse quality improvement coordinator and nurse educator. MEASURES: Process, outcome, and balancing measures were used to evaluate the program. Process measure: use of a standardized order-set. OUTCOME MEASURE: rate of adherence to the resultant protocol. Balancing measures: 1) maximum oxytocin dose, 2) time from oxytocin initiation to birth, 3) cesarean birth rates, and 4) Apgar scores. RESULTS: An initial increase in adherence to the protocol decreased with the loss of the "paper" order-set. Adherence improved when computerized physician order entry was adjusted: 2006: 73%, 2007: 95%; 2011: 57%, 2013: 100% (p = 0.007, 2006 vs. 2007) (p < 0.001, 2006 vs. 2013). Compliance with the protocol was associated with a decrease in maximum oxytocin dose and in time between oxytocin initiation and birth (p < 0.001). CONCLUSION: Consistency and safety in patient care can be accomplished using literature-based evidence and active consensus building among members of the perinatal team. A standardization process must be integrated into the electronic medical record to become a sustained part of a practice culture.


Assuntos
Enfermagem Baseada em Evidências/métodos , Ocitocina/uso terapêutico , Técnica Delfos , Guias como Assunto/normas , Humanos , Ocitocina/administração & dosagem , Melhoria de Qualidade , Inquéritos e Questionários
16.
Int J Nurs Educ Scholarsh ; 16(1)2019 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-30862759

RESUMO

To aim of this study was to explore undergraduate nursing student (n = 256) perceptions of clinical reasoning ability and learning transfer after participating in either a standard post simulation debriefing or a debriefing based on transfer of learning principles. BACKGROUND: It is assumed that students will transfer what they have learned from simulation to real world practice, however, some students are unable to identify the relevance of simulated learning experiences if scenarios are dissimilar to clinical placement settings. The nature and extent what is able to be transferred from simulated to real settings is unclear, particularly in relation to complex processes such as clinical reasoning. Transfer of learning to a new situation involves deliberate cognitive effort, including reflection and mindful abstraction of central attributes of a problem. As reflection is a key element in learning transfer, the debriefing element of simulation was seen to be a platform for this study. METHOD: A convergent parallel mixed methods design used a pre-test, post-test survey and focus group interviews. RESULTS: No statistically significant difference in post-test clinical reasoning scores between groups was found. There was a statistically significant improvement in 12 out of 15 criteria among the control group and in 8 of the criteria among the intervention group. Qualitative findings provided some evidence that learning had transferred to clinical settings. Evidence of "near" transfer was more evident than "far" transfer. CONCLUSION: Positive findings included that all students perceived they had transferred the skills of patient assessment and effective communication during episodes of patient care. The concept of a "framework" being verbalized by many of the intervention group during practice is a promising finding and may be a useful direction for further research focusing on the instructional demonstration of explicitly promoting a level of abstraction of problems and prompting participants to search for conceptual connections. This may indicate retained idea or concepts from the debriefing which may be useful in future practice.


Assuntos
Competência Clínica/normas , Avaliação em Enfermagem/organização & administração , Aprendizagem Baseada em Problemas/organização & administração , Estudantes de Enfermagem/psicologia , Adulto , Bacharelado em Enfermagem/métodos , Enfermagem Baseada em Evidências/métodos , Feminino , Grupos Focais , Humanos , Julgamento , Masculino , Pesquisa em Educação de Enfermagem , Resolução de Problemas , Adulto Jovem
17.
BMC Med Educ ; 19(1): 71, 2019 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-30832639

RESUMO

BACKGROUND: Although Evidence-Based Practice (EBP) should be introduced early on in nursing education to develop students' independence and self-learning ability, there are few such courses for undergraduate nursing students in Korea. This study examined the effects of the EBP education program for undergraduate nursing students (EBP-EPUNS) on nursing students' knowledge, skills, attitudes, competencies, and future use of EBP. METHODS: A quasi-experimental study design with pre-test, intervention, and post-test was used. The participants were 44 nursing students (experimental: 22, control: 22). A 20-h long EBP-EPUNS consisting of 5-step EBP components was provided through 8 sessions spread across 4 weeks. RESULTS: An independent t-test and a repeated-measures ANOVA showed that the experimental group had statistically significant higher post-test scores on EBP knowledge (p < 0.001), skills (p < 0.001), attitudes (p < 0.001), competencies (p < 0.001), future use of EBP (p = 0.001), and critical thinking (p < 0.001), compared to the control group. CONCLUSION: The EBP education program was effective in improving the knowledge, skills, attitudes, competencies, and future use of EBP among nursing students. Hence, we recommend the EBP education program as a general education course for undergraduate nursing students to promote needed proficiency in EBP.


Assuntos
Bacharelado em Enfermagem , Enfermagem Baseada em Evidências/educação , Pesquisa em Educação de Enfermagem , Estudantes de Enfermagem , Adulto , Competência Clínica , Currículo , Humanos , Avaliação de Programas e Projetos de Saúde , República da Coreia , Pensamento , Adulto Jovem
18.
Nurs Womens Health ; 23(2): 98-104, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30853510

RESUMO

Human trafficking is a significant women's health issue in the United States. Clinicians who provide care to women are often unaware of the signs and symptoms of human trafficking and are unprepared to provide appropriate care. Nurses represent one of the few agents of change who women may encounter while they are in captivity; this places nurses at the forefront of their care. To provide safe and effective care, nurses can use the ABCD treatment model, which stands for assessment, buy-in, case management, and diversion programming. Any gaps between recognition of women's health care needs and the provision of appropriate care must be closed. Integrating evidence-based human trafficking education and skill building into nursing curricula, standard nursing orientation, and continuing education is an essential step to help nurses transform care and advocate on behalf of those who have been trafficked.


Assuntos
Enfermagem Baseada em Evidências/métodos , Tráfico de Pessoas/psicologia , Adulto , Comportamento Criminoso , Enfermagem Baseada em Evidências/tendências , Feminino , Tráfico de Pessoas/tendências , Humanos , Estados Unidos , Saúde da Mulher/tendências
19.
Home Healthc Now ; 37(2): 79-87, 2019 Mar/Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30829785

RESUMO

Evidence-based practice (EBP) is becoming standard in today's healthcare arena and home care organizations are not exempt from integrating evidence into practice to improve patient outcomes. There is a scarcity of research literature that examines the behaviors and attitudes of home healthcare nurses (HHNs) regarding EBP. In this study, a descriptive survey design was used to investigate HHNs' a) information-seeking behaviors when providing nursing care, b) administrative support for EBP (as perceived by HHNs), c) attitudes toward EBP, and d) EBP engagement and confidence in providing EBP nursing care. Self-reported data were collected by internet and paper survey. The survey consisted of a 65-item questionnaire that included the Nurses' Attitudes Toward Evidence-Based Practice Scale, which has previously established validity and reliability. A convenience sample of 95 HHNs participated in the study. Results suggest HHNs' EBP attitudes are positive. A positive and significant relationship was found between attitudes and hours worked (r = 0.21, p = 0.047) and educational level (r = 0.45, p = 0.0001); 95% confidence level. Confidence levels in providing EBP care were moderate, and HHNs did not perceive EBP as an agency priority. HHNs need to be supported and encouraged in the facilitation of EBP, a task made easier when they are knowledgeable about EBP, have confidence in their EBP skills, and have the support of their organizations.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica , Prática Clínica Baseada em Evidências/normas , Enfermagem Domiciliar/métodos , Relações Enfermeiro-Paciente , Enfermagem Baseada em Evidências/normas , Feminino , Serviços de Assistência Domiciliar/organização & administração , Humanos , Masculino , Autoimagem , Inquéritos e Questionários , Estados Unidos
20.
J Nurs Adm ; 49(4): 208-214, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30882610

RESUMO

Integration of evidence-based practice (EBP) into the culture of a healthcare organization is essential to provide safe patient care and promote a thriving culture for the nurses within the healthcare organization. Collaboration and utilization of both clinical and academic experts facilitate the removal of barriers to EBP. This article describes the successful partnership between a healthcare system and school of nursing in executing a 3-phased multimodal approach to an EBP training program.


Assuntos
Fortalecimento Institucional/métodos , Enfermagem Baseada em Evidências/organização & administração , Recursos Humanos de Enfermagem no Hospital/educação , Parcerias Público-Privadas , Humanos , Pesquisa em Administração de Enfermagem , Recursos Humanos de Enfermagem no Hospital/organização & administração
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