The Perfect Storm: Patient Safety and Nursing Shortages Within the Context of Health Policy and Evidence-Based Practice

Evidence-based practice competences in nursing students at a university in Colombia

INTRODUCTION

Learning about evidence-based practice (EBP) is an essential and relevant aspect in the training of nursing professionals. This study aimed to determine competence level regarding EBP in nursing students at a private university in the city of Cali, Valle del Cauca.

METHOD

This was a correlational, descriptive, and observational study.

STUDY POPULATION

Senior students that were part of a nursing program in the city of Cali in 2020 were the study group. A validated CACH-EBP questionnaire was used for measuring competence in EBP and its related factors, such as attitude, skills, and knowledge.

RESULTS

A total of 207 students participated in the study, of which 84.5% were women. The overall instrument competence score was 3.4 out of 5. Factor scores were 3.7 for attitude, 3.0 for skills, and 3.1 for knowledge.

CONCLUSION

Nursing students have a positive attitude toward EBP, which can facilitate its implementation in practice.

Knowledge, skills and attitudes related to evidence-based practice among undergraduate nursing students: A survey at three universities in Colombia, Chile and Spain

Teaching nursing students about the model of evidence-based practice is a challenge for university faculty. The aim of this study was to measure knowledge, skills and attitudes related to evidence-based practice among undergraduate nursing students, as well as associated factors. The study involved a cross-sectional design using a survey of all students enrolled in a Bachelor of Nursing programme (1st to 4th year) in three nursing faculties of universities in Chile, Colombia and Spain. The Spanish version of the Evidence-Based Competence Questionnaire was used to measure knowledge, skills, attitudes and overall competency. In total, 875 students completed the questionnaire. The overall score of competency in evidence-based practice was similar in all three universities (range 1-5) (3.63 in Chile, 3.58 in Colombia and 3.68 in Spain). The score of self-rated attitudes was strongly correlated with the overall competency measured. More hours of training in research methods and reading nursing journals articles in the last month were the factors associated with higher scores in evidence-based practice competency. The undergraduate nursing students at the three universities surveyed obtained a high score in overall competency in evidence-based practice. No differences were found among them, despite the different approaches used in educational programmes.

Stories and Music for Adolescent/Young Adult Resilience During Transplant Partnerships: Strategies to Support Academic-Clinical Nurse Collaborations in Behavioral Intervention Studies

Evidence-based nursing is in the forefront of healthcare delivery systems. Federal and state agencies, academic institutions, and healthcare delivery systems recognize the importance of nursing research. This article describes the mechanisms that facilitate nursing partnerships yielding high-level research outcomes in a clinical setting. A phase-II multicenter behavioral intervention study with pediatric stem cell transplant patients was the context of this academic/clinical research partnership. Strategies to develop and maintain this partnership involved a thorough understanding of each nurse's focus and barriers. A variety of communication plans and training events maximized preexisting professional networks. Academic/clinical nurses' discussions identified barriers to the research process, the most significant being role conflict. Communication and validation of benefits to each individual and institution facilitated the research process during challenging times. Establishing strong academic/clinical partnerships should lead to evidence-based research outcomes for the nursing profession, healthcare delivery systems, and patients and families.

Evidence-Based Practice Beliefs and Implementation in Doctor of Nursing Practice Students

BACKGROUND

Doctors of Nursing Practice focus on leadership in evidence-based practice (EBP). EBP is influenced by one's beliefs in and implementation of EBP. Little is known to date about the EBP beliefs and implementation of Doctor of Nursing Practice students and outcomes of Doctor of Nursing Practice education.

AIMS

Guided by the Advancing Research and Clinical practice through close Collaboration (ARCC) Model, the Evidence-Based Practice Beliefs (EBPB) and Implementation (EBPI) tools were used to assess the impact of EBP as a program pillar, curricular thread, and content area on EBPB and EBPI of Doctor of Nursing Practice-Family Nurse Practitioner students.

METHODS

Five cohorts who completed the same curriculum were studied. Fifty-four of the 89 students across the five cohorts began and completed the study.

RESULTS

Paired t-test for group effects showed statistical significance from pre- to post-measure in students overall EBPB, t = 4.4 (52), p < .001, and EBPI, t = 8.4 (52), p < .001. A large effect size of .75 standard deviation (SD) gain above the mean for EBPB, and a very large effect size of 1 SD gain above the mean for EBPI were observed. Repeated measures ANOVA showed that all cohorts made gains across the curriculum. Effect sizes for EBPB ranged from .25 to 1 SD above the mean, and .75 to 1.5 for EBPI.

LINKING EVIDENCE TO ACTION

DNP students who are educated to be EBP leaders must have a curriculum that supports them in the knowledge and skill-set needed to translate evidence into practice. The ARCC Model can guide faculty in EBP curriculum development. EBPB and EBPI are valid and reliable measures to assess for gains across a curriculum. Through educational outcomes, educators can assess desired student outcomes for EBP across a curriculum and can build an evidence base for ongoing curriculum development.

A methodological quality synthesis of systematic reviews on computer-mediated continuing education for healthcare providers

BACKGROUND

Healthcare providers use continuing education (CE) to meet professional development requirements and to ensure optimal patient care. There has been a dramatic increase in computer-mediated CE (CMCE) programs.

AIMS

To synthesize the literature regarding the current state of the science on the efficacy of CMCE for healthcare professionals, particularly as it relates to provider learning and patient outcomes. Specifically, this review assesses the methodological quality of existing systematic reviews and meta-analyses.

METHODS

A literature search was conducted using Cochrane Library, PubMed, and CINAHL. Review articles evaluating the efficacy of CMCE for healthcare providers were included. Publications were searched between 2002 and 2013 and limited to those printed in English. An objective measurement tool, AMSTAR, was used to assess the methodological quality of each review. AMSTAR is an 11-item instrument, in which individual criteria were evaluated and a composite score of all 11 components was determined for each review. Outcomes of each review were also categorized based on Kirkpatrick's levels for summative evaluation: (i) Learner satisfaction, (ii) Learning outcomes, (iii) Performance improvement, (iv) Patient/health outcomes.

RESULTS

Starting with 231 articles, 11 met the inclusion criteria for this evaluation. AMSTAR quality scores of the reviews ranged from 7 to 11, with 11 indicating the strongest quality. Although weak research design of many studies and heterogeneous topics covered make summative evaluations difficult, there were some common themes covered in the articles reviewed. Healthcare providers were largely satisfied with using CMCE programs. Overall, the studies comparing CMCE to traditional CE methods found the impact on learning outcomes to be comparable, with neither method necessarily superior. Additionally, all reviews lacked evaluation of practice outcomes.

LINKING EVIDENCE TO ACTION

While results of this review show promise for CMCE, further evaluation and more rigorously conducted research is necessary. Particular focus is needed to determine the effects of CMCE on health outcomes.

Attitudes and beliefs of staff to feedback following the review of adverse events in clinical care

Objective To undertake a pilot project to determine how clinical and non-clinical staff perceive feedback given to them following clinical incident reviews. Methods An online survey was devised and sent as a link to staff across the Murrumbidgee Local Health District who would be likely to submit patient-related adverse incidents into the NSW Health Incident Information Management System. Results Two hundred and twenty-eight responses were received. Feedback was viewed as constructive and helpful. Medical staff were less enthusiastic about feedback and preferred formal feedback processes. Conclusions Feedback from clinical incident reviews closes the loop of the review process and creates a platform for necessary changes to be undertaken.

Nursing structures in New Zealand public hospitals: current configurations

This article reports research reviewing the configuration of nursing leadership in New Zealand public hospitals. It represents an analysis of Phase 1 of a larger study. Leadership in nursing is critical if the profession is to meet the challenges of health services in the 21st century. The research focuses on how leadership in public hospitals is structured at a strategic level. The preliminary summary of findings of this phase of the research show that reporting lines between directors of nursing (DON) and the chief executive officer (CEO) are not always direct, and organizational charts and nursing structures are not readily aligned. Clear financial or budget holding reporting lines by nursing leadership are not easily identified, or are professional and operational accountability lines clearly defined. From 15 total responses received, the organizations are structured differently both organizationally and in the nursing structures.