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1.
J Nurs Adm ; 50(2): 63-65, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31977943

RESUMO

The 2019 Association for Leadership Science in Nursing International Conference, Disruptive Innovation, was held in Los Angeles, California, with attendees from 30 US states, Canada, Brazil, and China. Presenters discussed the need for nurse leaders to advocate for health equity, lead evidence-based innovation, how robots and other technology are generating disruptive innovations in healthcare, and building strong academic-practice partnerships to address nursing workforce challenges. This article will report on these important insights.


Assuntos
Enfermagem Baseada em Evidências/organização & administração , Equidade em Saúde/organização & administração , Invenções , Enfermeiras Administradoras/organização & administração , Recursos Humanos de Enfermagem/organização & administração , Inovação Organizacional , Brasil , Canadá , China , Humanos , Liderança , Estados Unidos
3.
J Nurs Adm ; 49(12): 617-623, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31725520

RESUMO

In healthcare, timely communication of critical information is imperative among workforce members. Nurse leaders struggle with how to reach clinical staff effectively when informing them of program updates, practice changes, or available resources. This article provides a review of the marketing and communication literature sharing best practices for improving visibility and program uptake for infrastructure supporting the conduct of inquiry projects among hospital employees using an evidence-based practice approach.


Assuntos
Comunicação , Enfermagem Baseada em Evidências/organização & administração , Disseminação de Informação/métodos , Pesquisa em Enfermagem/organização & administração , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
4.
BMC Health Serv Res ; 19(1): 469, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288801

RESUMO

BACKGROUND: Leadership style and organizational culture have often been studied independently in nursing research despite abundant evidence that the two factors both influence employee outcomes. Moreover, diverse theoretical typology and measuring instruments challenges generalizability of findings. Employees from different cultural, geographical, occupational settings were also reported to have varying interpretation on organizational culture and leadership style underlying constructs. This study aims to validate the Nursing Leadership and Organizational Culture (N-LOC) questionnaire, based on the two commonly used theoretical frameworks: Multifactor Leadership Theory and Competing Values Framework, on its applicability in an Asian hospital setting. METHODS: All full-time nurses from two distinctive Asian hospitals (H1: n = 295 and H2: n = 1146) were invited to participate in this questionnaire study. Exploratory factor analysis (EFA) was carried out when confirmatory factor analysis (CFA) fit indices were not satisfactory after model refinement to explore the actual underlying construct in sampled population. Part-time and outsourced nurses were excluded. 93 nurses from H1 were randomly selected for test-retest reliability 4 weeks post initial survey. Scale internal consistency, convergent and discriminant validity were also assessed. RESULTS: CFA results indicated that the proposed CVF organizational culture 4-factor structure was applicable to our sample but not the MLQ leadership 3-factor/9-factor structure. EFA revealed a 2-factor leadership style construct for our sample, named Confucius transformational and Laissez-Faire passive leadership. Transformational leadership traits already embedded in Confucius cultural values (self-sacrifice, stresses collective mission, instills pride) did not apply, the new Confucius transformational construct which resembles LMX theory paternalistic leadership style is deemed more suitable in an Asian context. A final 14-item 2-factor leadership and 13-item 4-factor organizational culture construct was yielded with satisfactory fit indices (CFI, TLI > 0.95, RMSEA < 0.08), internal consistency (Cronbach's alpha > 0.7), test-retest reliability (ICC > 0.4) and convergent and discriminant validity. CONCLUSION: A reliable N-LOC organizational culture and leadership questionnaire (N-LOC) has been validated in an Asian nurse context. Study results demonstrated the importance of scale validation in cross-cultural adaptation, as underlying scale constructs may change with specific cultural and contextual factors. Future studies are encouraged to test the adaptation of this scale in other cultural and occupational settings.


Assuntos
Enfermagem Baseada em Evidências/organização & administração , Liderança , Recursos Humanos de Enfermagem no Hospital/organização & administração , Hospitais de Ensino , Humanos , Pesquisa em Enfermagem , Recursos Humanos de Enfermagem no Hospital/educação , Cultura Organizacional , Projetos Piloto , Reprodutibilidade dos Testes , Inquéritos e Questionários
5.
Int J Evid Based Healthc ; 17 Suppl 1: S65-S67, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31283586

RESUMO

AIM: Evidence-based practices (EBPs) seek to promote the implementation of interventions that are effective, appropriate, feasible and meaningful for patients. The current demand for updated EBPs in Finland is shaped by national legislation. This study's aim was to describe nurses', nurse directors' and clinical nurse specialists' (CNSs') perceptions of how well EBPs are being implemented in nursing in Finland. METHODS: In this quantitative descriptive study, the data were collected with an e-questionnaire distributed in Finland in 2017 and analysed using descriptive statistical methods. RESULTS: A total of 1063 nurses and 340 nurse directors and CNSs participated. The majority of nurses (64%, n = 669) reported that evidence is not clearly used to develop clinical practices. Most nurses (67%, n = 702) and over half of nurse directors and CNSs (57%, n = 184) also observed that knowledge of evidence-based protocols is not widespread within their organizations. However, 39% of nurses (n = 407) and 53% of nurse directors and CNSs (n = 171) stated that they are developing EBPs. CONCLUSION: The results indicate that nurses need more support to implement EBPs.


Assuntos
Enfermagem Baseada em Evidências/estatística & dados numéricos , Atitude do Pessoal de Saúde , Enfermagem Baseada em Evidências/organização & administração , Finlândia , Humanos , Enfermeiras Administradoras/psicologia , Enfermeiras Clínicas/psicologia , Enfermeiras e Enfermeiros/psicologia , Inquéritos e Questionários
6.
Health Serv Res ; 54(5): 994-1006, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31215029

RESUMO

OBJECTIVE: To evaluate the implementation and outcomes of evidence-based fall-risk-reduction processes when those processes are implemented using a multiteam system (MTS) structure. DATA SOURCES/STUDY SETTING: Fall-risk-reduction process and outcome measures from 16 small rural hospitals participating in a research demonstration and dissemination study from August 2012 to July 2014. Previously, these hospitals lacked a fall-event reporting system to drive improvement. STUDY DESIGN: A one-group pretest-posttest embedded in a participatory research framework. We required hospitals to implement MTSs, which we supported by conducting education, developing an online toolkit, and establishing a fall-event reporting system. DATA COLLECTION: Hospitals used gap analyses to assess the presence of fall-risk-reduction processes at study beginning and their frequency and effectiveness at study end; they reported fall-event data throughout the study. PRINCIPAL FINDINGS: The extent to which hospitals implemented 21 processes to coordinate the fall-risk-reduction program and trained staff specifically about the program predicted unassisted and injurious fall rates during the end-of-study period (January 2014-July 2014). Bedside fall-risk-reduction processes were not significant predictors of these outcomes. CONCLUSIONS: Multiteam systems that effectively coordinate fall-risk-reduction processes may improve the capacity of hospitals to manage the complex patient, environmental, and system factors that result in falls.


Assuntos
Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Enfermagem Baseada em Evidências/organização & administração , Hospitais Rurais/estatística & dados numéricos , Pacientes Internados/estatística & dados numéricos , Equipe de Assistência ao Paciente/organização & administração , Adulto , Idoso , Idoso de 80 Anos ou mais , Comportamento Cooperativo , Enfermagem Baseada em Evidências/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos , Fatores de Risco
7.
Clin Nurse Spec ; 33(3): 136-145, 2019.
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
8.
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
9.
Nurs Forum ; 54(2): 183-191, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30628738

RESUMO

BACKGROUND: In Italy, there are still many barriers to the development of a culture of evidence-based practice (EBP) and nurses' knowledge of EBP is lacking. Additionally, in Italy there are still very few advanced practice registered nurses to significantly contribute to the development of EBP. AIM: This aims to identify the implications of a wide-scale nursing education intervention to engage clinical nurses in EBP through the Italian RN4CAST study. METHODS: A qualitative study based on a thematic analysis. A total of 800 clinical nurses actively participated in nine training sessions across Italy. At the end of each training session written feedback data were collected and then underwent thematic analysis. RESULTS: All participants were strongly motivated to engage in EBP thanks to their involvement in the RN4CAST project. With regard to the implications of EBP, the thematic analysis produced the following themes: Professional identity; Quality of care; Perceptions of patients and nurses; Research impact; and Organization. CONCLUSIONS: The involvement of a large number of clinical nurses in a research project raised their awareness about the advantages of engaging in EBP, and how evidence can be used to raise motivation to change current practice policies.


Assuntos
Assistência à Saúde/organização & administração , Enfermagem Baseada em Evidências/educação , Recursos Humanos de Enfermagem no Hospital/educação , Qualidade da Assistência à Saúde , Adulto , Atitude do Pessoal de Saúde , Enfermagem Baseada em Evidências/organização & administração , Feminino , Humanos , Itália , Masculino , Papel do Profissional de Enfermagem , Pesquisa em Educação de Enfermagem , Recursos Humanos de Enfermagem no Hospital/organização & administração , Pesquisa Qualitativa , Carga de Trabalho
10.
Oncol Nurs Forum ; 46(1): 11-14, 2019 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-30547954

RESUMO

Changes are underway at the Oncology Nursing Society to align resources so that scientists have the support needed to generate new knowledge and clinicians have access to tools needed to use evidence-based interventions that can speed the translation of research to transform cancer care.


Assuntos
Enfermagem Baseada em Evidências/organização & administração , Pesquisa em Enfermagem/organização & administração , Enfermagem Oncológica , Objetivos Organizacionais , Sociedades de Enfermagem/organização & administração , Humanos
11.
J Clin Nurs ; 28(9-10): 1614-1622, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30588686

RESUMO

AIMS AND OBJECTIVES: To produce changes in the therapeutic relationship between clinical practice nurses and patients in psychiatric units by implementing evidence-based practices through participatory action research. BACKGROUND: The therapeutic relationship is the cornerstone of nursing care in psychiatric units. The literature suggests that theoretical knowledge alone is insufficient to establish the therapeutic relationship in practice. Therefore, strategies are needed to adequately establish the therapeutic relationship in psychiatric units. DESIGN: Participatory action research. METHODS: Participants consisted of nurses from two psychiatric units of a university hospital. Data were collected through focus groups and reflective diaries, which were analysed using the content analysis method. The COREQ guidelines were followed to ensure rigour. RESULTS: Nurses conceptualised the therapeutic relationship in their practice, identifying facilitating elements and limitations. They were able to compare their clinical practice with the recommendations of scientific evidence and constructed three evidence-based proposals to improve the therapeutic relationship: (a) a customised nurse intervention space, (b) knowledge updating and (c) reflective groups, which they subsequently implemented and evaluated. CONCLUSIONS: This study shows that nurses in psychiatric units can generate changes and improvements in the therapeutic relationship. The process of implementing evidence-based practice enhanced participants' awareness of their clinical practice and allowed them to make changes and improvements. RELEVANCE TO CLINICAL PRACTICE: The process confirmed that the implementation of evidence-based practice through participatory methods, such as participatory action research, is valid and produces lasting changes. This study also reveals the need to rethink nurses' functions and competencies in current psychiatric units.


Assuntos
Enfermagem Baseada em Evidências/organização & administração , Relações Enfermeiro-Paciente , Enfermagem Psiquiátrica/organização & administração , Adulto , Feminino , Grupos Focais , Pesquisa sobre Serviços de Saúde/métodos , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
15.
J Contin Educ Nurs ; 49(7): 299-306, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-29939377

RESUMO

BACKGROUND: Baccalaureate-prepared nurses should be competent in accessing, evaluating, and implementing research evidence into nursing practice. The purpose of this study was to gain insight into nurses' experiences in accessing, evaluating, and implementing research into practice. METHOD: Researchers conducted a qualitative descriptive study. Data were collected through in-depth interviews and field notes. RESULTS: Thirteen nurses participated in individual interviews. Themes that emerged included awareness, motivation-empowering change, and barriers to evidence-based practice implementation (EBP). Several experienced nurses expressed the importance of EBP in practice but could not provide clear definitions of EBP. Personal and organizational barriers negatively influence EBP implementation in clinical practice. Nurses could be motivated to use EBP if it were translated in an easy way to understand. CONCLUSION: The information derived from this study can be used to design learning opportunities that prepare practicing nurses to appropriately appraise research and integrate evidence into practice. J Contin Educ Nurs. 2018;49(7):299-306.


Assuntos
Enfermagem Baseada em Evidências/organização & administração , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem no Hospital/psicologia , Transferência de Tecnologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
16.
Rev Esc Enferm USP ; 52: e03327, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29846488

RESUMO

OBJECTIVE: Understanding the actions and interactions required for developing clinical nursing practice in Primary Health Care. METHOD: A qualitative study anchored in the Grounded Theory. Data was collected between April and October 2016 with nurses divided into two sample groups. RESULTS: Eighteen (18) nurses participated in the study. The category "Recognizing the Systematization of Nursing Care as an essential element for clinical nursing practice" supports the "actions-interactions" component and it is composed of two subcategories: "Accomplishing clinical practice in nursing consultations", which presents the challenges encountered in performing clinical practice; and "Highlighting management tools for evidence-based clinical practice", which operates through strategies in response to the studied phenomenon. CONCLUSION: Care actions developed in clinical nursing practice are highlighted by the systematization of care in nursing consultations, a moment of direct interaction with the individual, thus contributing to improvement in the quality of care provided.


Assuntos
Teoria Fundamentada , Enfermagem/organização & administração , Atenção Primária à Saúde/organização & administração , Qualidade da Assistência à Saúde , Enfermagem Baseada em Evidências/organização & administração , Humanos , Enfermeiras e Enfermeiros/organização & administração , Enfermagem/normas , Atenção Primária à Saúde/normas , Pesquisa Qualitativa
17.
J Nurs Adm ; 48(5): 272-278, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29629909

RESUMO

OBJECTIVE: The study identifies what constitutes nurse manager (NM) support and other resources that enable clinical nurses (CNs) to engage in evidence-based practice (EBP). BACKGROUND: Clinical nurses report that NM support enables them to use EBP but what constitutes NM support is still unclear. METHODS: Nurse managers, CNs, and EBP mentors received specialized education and use a team approach for EBP. Data were collected preintervention, mid-intervention, and postintervention from observations, interviews, journaling, and surveys. RESULTS: Results demonstrate how NMs can perform their role responsibilities and still engage CNs to develop a spirit of inquiry, seek answers to their clinical questions using EBP, and advance their clinical performance to improve patient outcomes. Four NM supportive behaviors emerged: cultivating a shared EBP vision, ensuring use of EBP, communicating the value of EBP, and providing resources for EBP. CONCLUSION: Through education and support, NMs describe supportive behaviors necessary for the successful conduction of EBP by CNs.


Assuntos
Enfermagem Baseada em Evidências/organização & administração , Prática Clínica Baseada em Evidências/organização & administração , Enfermeiras Clínicas/organização & administração , Supervisão de Enfermagem/organização & administração , Educação Continuada em Enfermagem , Humanos , Mentores , Enfermeiras Administradoras , Inovação Organizacional , Estados Unidos
18.
J Clin Nurs ; 27(9-10): 2052-2061, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29518285

RESUMO

AIMS AND OBJECTIVES: To describe beliefs about evidence-based practice and record levels of implementation among community health nurses working independently and in community healthcare centres in the canton of Valais, Switzerland. BACKGROUND: In many settings, evidence-based practice is considered a key means of delivering better and secure health care. However, there is a paucity of published studies on the implementation of evidence-based practice in community health care. DESIGN: Cross-sectional descriptive study (n = 100). METHODS: Beliefs about evidence-based practice and levels of implementation were measured using validated scales developed by Melnyk et al. (Worldviews on Evidence-Based Nursing, 5, 2008, 208). Information on respondents' sociodemographic and professional characteristics was collected. Data were analysed using descriptive and inferential statistics. RESULTS: The final response rate was 32.3% (n = 100). More than half of respondents had previously heard about evidence-based practice; most believed in the value of using evidence to guide their practice and were prepared to improve their skills to be able to do so. However, the rate of implementation of evidence-based practice in daily practice in the 8 weeks before the survey was poor. Statistically significant positive associations were found between beliefs about evidence-based practice and how respondents had heard about it and between implementation rates and whether they had heard about evidence-based practice and how they had done so. Evidence-based practices requiring scientific knowledge and skills were implemented less frequently. Greater professional community healthcare experience and management roles did not increase implementation of evidence-based practice. CONCLUSIONS: The systematic implementation of evidence-based practice by community health nurses working independently and in healthcare centres in Valais was rare, despite their positive beliefs about it. RELEVANCE TO CLINICAL PRACTICE: These results revealed the level of implementation of evidence-based practice by nurses in community healthcare settings in Valais. Further research is required to better understand their needs and expectations and to develop suitable strategies that will allow the integration of evidence-based practice into nurses' daily practice.


Assuntos
Atitude do Pessoal de Saúde , Enfermagem Baseada em Evidências/organização & administração , Enfermeiras de Saúde Comunitária/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Suíça
19.
ANS Adv Nurs Sci ; 41(2): 137-144, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29595527

RESUMO

In today's era of nursing, the role of a unique disciplinary knowledge that is grounded in philosophy is essential to inform nursing practice, fill knowledge gaps, improve the quality of nursing education, and guide the theoretical development of nursing. Realism and relativism have contributed to the development of the nursing discipline by providing the basis of evidence-based nursing practice, nursing research, nursing education, and theoretical construction. This article explores the role of realism and relativism in the development of the discipline of nursing and presents their contributions to the work of nurse clinicians, nurse researchers, nurse educators, and nurse theorists.


Assuntos
Educação em Enfermagem/organização & administração , Relativismo Ético , Enfermagem Baseada em Evidências/organização & administração , Filosofia em Enfermagem , Humanos , Pesquisa em Enfermagem , Teoria de Enfermagem
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