Evaluating Psychiatric Nurses' Awareness of Evidence-Based Nursing Publications

Evidence based practice among healthcare providers: a cross-sectional study

PURPOSE

Nowadays health systems in most of the countries are trying to build their healthcare provision system based on scientific knowledge based evidence. Evidence-based practice (EBP) is a crucial factor for quality improvement focusing on compliance with clinical standards. The purpose of this paper is to assess evidence-based knowledge and skills among healthcare providers in Qazvin hospitals in 2016.

DESIGN/METHODOLOGY/APPROACH

This was a descriptive study conducted among 300 health professionals working in hospitals affiliated by Qazvin University of Medical Sciences in 2016. A self-administered questionnaire was used to gather data on health providers' attitude, knowledge and skill regarding EBP. Descriptive statistics and multiple linear regressions were used to analyze data using SPSS 16 software.

FINDINGS

A total of 254 participants (84.6 percent) completed the questionnaire in which their attitude, knowledge and skill toward EBP were assessed at a low level. Study results indicated that among different occupational groups, physicians and those with greater awareness toward EBP terminology had a more positive attitude compared with others. Furthermore, a higher level of knowledge and skill toward EBP was associated with being a physician and having a positive attitude toward the issue.

PRACTICAL IMPLICATIONS

Given the importance of EBP and due to insufficient knowledge of healthcare providers about the issue, it is necessary to hold appropriate educational courses to empower health workforce in implementing EBP principles.

ORIGINALITY/VALUE

The authors applied a self-administered questionnaire to assess health workforce knowledge and skills toward EBP. The results obtaining from the analysis not only highlights weaknesses related to service providers' knowledge and capabilities to implement EBP but also reveals facilities required for realization of the subject in hospital settings.

Nursing Managers' Perspectives on the Facilitators and Barriers to Implementation of Evidence-Based Management

BACKGROUND

Evidence-based health management is defined as a new approach to improve the quality of hospital decisions by systematic application of the best available evidence. To use that, facilitators and barriers to implementation of evidence-based management (EBMgt) in the decision-making process need to be identified.

AIM

The purpose of this study was to assess nursing managers' perspectives on the facilitators and barriers to implementation of EBMgt in Tabriz hospitals, northwest Iran.

METHODS

A cross-sectional study design was used in 2017. The study was conducted in one state in Iran (Tabriz). A total of 276 nursing managers (e.g., matrons, supervisors, & head nurses [HNs]) were invited to participate from the Tabriz hospitals (N = 20); 212 completed and returned the survey, yielding a response rate of 76.81%. The EBMgt assessment questionnaire was used to collect data. The questionnaire consists of two parts. The first part includes barriers to EBMgt (five main domains and 46 questions). The second part includes the facilitators of EBMgt (five main domains and 42 questions). Data entry and analysis were carried out using SPSS-21 software.

RESULTS

Highest mean scores of barriers were observed for "training and research systems" (64.65 ± 12.42). "Lack of communication between knowledge producers and hospital decision-makers" (68.19 ± 17.32) had highest mean scores among all 46 barriers. Also, the results showed that mean scores for all the barriers were higher than 55. The highest mean scores were observed for "social/interpersonal factors" (65.84 ± 17.07). "Interest and willingness to scientific management principles" (68.62 ± 20.17) had highest mean scores among all 42 facilitators.

LINKING EVIDENCE TO ACTION

The aim of EBMgt is to provide the most effective healthcare outcomes. Identifying barriers and facilitators is essential for implementing EBMgt in hospitals. Building the facilitators and eliminating barriers are foundation of EBMgt. Filling the gap between knowledge producers and nursing managers can be a starting point for improvement of the decision-making process in nursing care.

Nurses' Knowledge and Barriers Regarding Pain Management

PURPOSE

The purpose of this study was to identify Polish nurses' experiences and perceptions about the barriers to postoperative pain management in older adults.

DESIGN

The study was conducted using a dedicated questionnaire.

METHODS

Eleven hospitals participated in this study. The project involved 1,602 nurses working on surgical hospital wards. A descriptive exploratory survey and a qualitative content analysis were used.

FINDINGS

Access to journals on evidence-based practice related to pain assessment and management in elderly patients was assessed as less important by the respondents. Knowledge drawn from the media and scientific and medical journals was assessed by the respondents as unsatisfactory. The greatest barrier to nurses was that scientific articles are published in English.

CONCLUSIONS

Nurses' awareness of evidence-based practice increases with their education. Among the key problems is the lack of available professional publications in the Polish literature, ignorance of English, shortage of time, and lack of support from chief physicians of the ward.

Sources of Knowledge and Barriers of Implementing Evidence-Based Practice Among Mental Health Nurses in Saudi Arabia

PURPOSES

The purposes of this study were to identify the sources of knowledge for nursing practices and to identify the barriers of using "evidence-based practice" (EBP).

DESIGN AND METHODS

Descriptive cross-sectional design was used to collect data from 164 Saudi mental health nurses by completing the Development of Evidence-Based Practice Questionnaire.

FINDINGS

The most frequently used sources of knowledge were relied on social interactions and the nurses' own experiences, while the least frequently used sources were external sources of knowledge and research evidences. Insufficient time to find research reports, difficulty in understanding research reports, and insufficient resources for evidences were the barriers of using EBP.

PRACTICE IMPLICATIONS

The organizations should encourage using EBP by providing adequate time, resources, knowledge, and skills for mental health nurses through conducting workshops and mentoring.

Polish nurses' perceived barriers in using evidence-based practice in pain management

AIM

The aim of this work was to present current practices, perceived barriers and perceived facilitators of Polish nurses in using EBP in the assessment and management of acute pain during the postoperative period in elderly patients.

BACKGROUND

Advances in the study of pain and the methods for its relief since the late 1980s have led to a rise in the role of the nurse in pain management and monitoring.

INTRODUCTION

The application of evidence-based practice associated with acute pain is on the increase in the world at large.

METHODS

Eleven hospitals participated in this study. The project involved 1300 nurses working on surgical hospital wards. In this study, case study research and qualitative content analysis were used. The study was conducted using a dedicated questionnaire.

RESULTS

Access to journals on evidence-based practice on the assessment and management of pain in elderly patients was assessed as less important by the respondents. Knowledge drawn from the media, scientific and medical journals was assessed by the respondents as unsatisfactory. The greatest barrier to nurses was the fact that scientific articles were published in English.

CONCLUSION

Nurses' awareness of evidence-based practice increases with their education. Among the key problems are the lack of available professional publications in Polish literature, ignorance of English, shortage of time and lack of support from chief physicians of the ward.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

There is a need for the introduction of innovative strategies of teaching and approaches to the problem of evidence-based practice in approach to pain management in elder people among the Polish nurses. It is necessary to promote these issues in Polish scientific literature.

Barriers to evidence-based practice utilization in psychiatric/mental health nursing

Many psychiatric/mental health nursing (PMHN) practices have been affected by old traditions and haphazard trial and error instead of by established scientific evidence. The purpose of this article is to explore and analyze the barriers surrounding evidence-based practice (EBP) in PMHN. I identify some strategies to overcome these barriers in an attempt to incorporate EBP within the framework of PMHN services. Barriers explain the lack of EBP in today's PMHN environment. The barriers identified in this research are: the nature of the evidence, the contribution of the psychiatric nursing researchers to EBP, the personal characteristics of psychiatric nurses, and organizational factors. While the barriers to EBP for PMHN practice are clearly apparent, the challenge, now, is to build up creative strategies through which psychiatric nurses are better able to provide EBP care as part of their everyday performance. Adaptation of a more dynamic form of EBP, increasing the number of PMHN researchers, conducting clinical research projects, choosing suitable journals for publication, training the psychiatric nurses about computer skills, integrating the EBP principles into nursing curricula, developing journal clubs, and offering organizational facilitators are essential prerequisites for the achievement of EBP in the PMHN field. It is no longer justifiable for psychiatric nurses to be deficient in knowledge and skill since the advantages of EBP for patients are well-documented.

Supporting evidence-based service delivery and organisation: a comparison of an emergent realistic appraisal technique with a standard qualitative critical appraisal tool

A major component of current policies aimed at promoting the delivery of an effective health service is to ensure that practitioners base their practice on research findings. Considerable attention has been focussed on the research community and developing appropriate methods and tools to support these objectives at the national and international level. The appraisal needs of individual practitioners, who might wish to inform local service delivery and organisation and who are often not methodological experts, has been hitherto ignored. This paper reports on the application and testing of a technique for the appraisal of evaluation studies, which is being developed for use by practitioners to inform local service delivery. This technique has previously been applied to a quantitative evaluation. In this paper we report on its application to the appraisal of a qualitative paper. Our aim is to compare it with a standard tool to establish which generates more meaningful information for use by practitioners for the purposes of informing service delivery and organisation. The emergent technique successfully extracted relevant methodological and contextual information, with developmental issues being identified.

Talking about sex as part of our role: making and sustaining practice change

Sexual issues are common for consumers of mental health services and have many adverse consequences for quality of life as well as impacting negatively on the mental illness itself. Nurses in mental health settings are well placed to assess for the presence of and provide interventions for sexual concerns. To date, little research has been undertaken to explore nurses' attitudes and whether sexual issues would be accepted as part of their care. This paper presents findings from the third stage of a qualitative, exploratory research study with mental health nurses working in an Australian mental health service. The findings from the first two stages suggested that the participants had tended to avoid discussion of sexual issues, but a brief education intervention had produced a greater willingness to address sexual issues as part of care. The aim of the third stage was to determine the degree to which changes in practice had continued over time. Two main themes that emerged from this data were: (i) holism, from rhetoric to reality; and (ii) part of what I do. Addressing sexual issues became part of practice, a change sustained 2 years following the intervention, because participants recognized its importance for holistic nursing care.

Evidence-based practice in a multiprofessional context

BACKGROUND

Healthcare today is a complex system with increasing needs of specific knowledge of evaluation of research and implementation into clinical practice. A critical issue is that we all apply evidence-based practice (EBP) with standardised methods and continuing and systematic improvements. EBP includes both scientific and critical assessed experience-based knowledge. For the individual, this means applying evidence-based knowledge to a specific situation, and for the organisation, it means catering for a systematic critical review and evaluation and compiling research into guidelines and programmes. In 2009, the County Council of Jönköping had approximately 335,000 inhabitants and the healthcare organisation had more than 10,000 employees. As the County Council actively promotes clinical improvement, it is interesting to explore how healthcare employees think about and act upon EBP. The aim of this survey was therefore to describe factors that facilitate or hinder the application of EBP in the clinical context.

METHOD

A quantitative study was performed with a questionnaire to healthcare staff employed in the County Council of Jönköping in 2009. The questionnaire consisted of questions concerning which factors are experienced to affect the development of evidence-based healthcare. There were 59 open and closed questions, divided into the following areas: • Sources of knowledge used in practice • Barriers to finding and evaluating research reports and guidelines • Barriers to changing practice on the basis of best evidence • Facilitating factors for changing practice on the basis of best evidence • Experience in finding, evaluating and using different sources of evidence. The participants were selected using the county council's staff database and included medical, caring and rehabilitative staff within hospitals, primary care, dentistry and laboratory medicine. The inclusion criteria were permanent employment and clinical work. Invitations were sent to 5787 persons to participate in the study and 1445 persons answered the questionnaire.

RESULTS

Knowledge used in daily clinical practice was mainly based on information about the patient, personal experience and local guidelines. Twenty per cent answered that they worked 'in the way they always had', and 11% responded that they used evidence from research as a basis for change. The participants experienced that EBP was not used enough in clinical healthcare and explained this with practical and structural barriers, which they thought should be better monitored by the organisation and directors.

CONCLUSION

Overall, the results indicate that the scientific evidence for healthcare is not used sufficiently as a base for decisions in daily practice as well as for changing practice. This is more prominent among assistant staff. As a consequence, this might affect the care of the patients in a negative way. Increased awareness of EBP and a stronger evidence-based approach are keys in the ongoing improvement work in the county. Local guidelines seem to be a way to implement knowledge. But, as the arena of activities is complex and the employees have diverse education levels, different strategies to facilitate and promote EBP are necessary.

Nurses' research utilization two years after graduation--a national survey of associated individual, organizational, and educational factors

Background

Nurses’ research utilization (RU) as part of evidence-based practice is strongly emphasized in today’s nursing education and clinical practice. The primary aim of RU is to provide high-quality nursing care to patients. Data on newly graduated nurses’ RU are scarce, but a predominance of low use has been reported in recent studies. Factors associated with nurses’ RU have previously been identified among individual and organizational/contextual factors, but there is a lack of knowledge about how these factors, including educational ones, interact with each other and with RU, particularly in nurses during the first years after graduation. The purpose of this study was therefore to identify factors that predict the probability for low RU among registered nurses two years after graduation.

Methods

Data were collected as part of the LANE study (Longitudinal Analysis of Nursing Education), a Swedish national survey of nursing students and registered nurses. Data on nurses’ instrumental, conceptual, and persuasive RU were collected two years after graduation (2007, n = 845), together with data on work contextual factors. Data on individual and educational factors were collected in the first year (2002) and last term of education (2004). Guided by an analytic schedule, bivariate analyses, followed by logistic regression modeling, were applied.

Results

Of the variables associated with RU in the bivariate analyses, six were found to be significantly related to low RU in the final logistic regression model: work in the psychiatric setting, role ambiguity, sufficient staffing, low work challenge, being male, and low student activity.

Conclusions

A number of factors associated with nurses’ low extent of RU two years postgraduation were found, most of them potentially modifiable. These findings illustrate the multitude of factors related to low RU extent and take their interrelationships into account. This knowledge might serve as useful input in planning future studies aiming to improve nurses’, specifically newly graduated nurses’, RU.

Getting BETTER: breaking the ice and warming to the inclusion of sexuality in mental health nursing care

Discussing sexual issues with consumers is considered a nursing role, yet it is commonly avoided. Research suggests that sexual issues and difficulties are particularly evident in mental health settings, and failure to address these issues represents a significant gap in care and treatment. Specific models for raising sexual issues have been used in oncology and cardiac care settings to assist clinicians. A descriptive, exploratory study was conducted with mental health nurses from Queensland, Australia. The aim of this research was to explore whether a specific model, the BETTER model (bring up, explain, tell, time, educate, record) was useful in assisting mental health nurses in raising the topic of sexuality with consumers. In-depth interviews explored participants' attitudes and experiences of discussing sexuality. Participants were introduced to the BETTER model, and were asked to trial the approach with consumers. They were then interviewed a second time. Two main themes emerged: greater awareness and becoming part of practice. Participants described a transformation of their practice from one of avoiding issues of sexuality with consumers, to a position of inclusion, which became embedded within practice. Participants did not tend to use the model in a structured way, and it appears that knowledge and awareness were more useful than the model itself.

Irish psychiatric nurses' self-reported barriers, facilitators and skills for developing evidence-based practice

Evidence-based practice places an emphasis on integration of clinical expertise with available best evidence, patient's clinical information and preferences, and with local health resources. This paper reports the findings of a study that investigated the barriers, facilitators and skills in developing evidence-based practice among psychiatric nurses in Ireland. A postal survey was conducted among a random sample of Irish psychiatric nurses and survey data were collected using the Development of Evidence-Based Practice Questionnaire. Respondents reported that insufficient time to find and read research reports and insufficient resources to change practice were the greatest barriers to the development of evidence-based practice. Practice development coordinators were perceived as the most supportive resource for changing practice. Using the Internet to search for information was the highest-rated skill and using research evidence to change practice was the lowest-rated skill for developing evidence-based practice. Nurses' precursor skills for developing evidence-based practice, such as database searching and information retrieval, may be insufficient in themselves for promoting evidence-based practice if they cannot find evidence relating to their particular field of practice or if they do not have the time, resources and supports to develop their practice in response to evidence.

Developing an instrument for evaluating implementation of clinical practice guidelines: a test-retest study

RATIONALE AND AIMS

This study focuses on the development of an instrument for the evaluation of clinical practice guidelines and is one part of a research project about the implementation and use of such guidelines among hospitals in the southern region of Sweden. The aim of the present paper was to investigate the test-retest reliability of a questionnaire.

METHOD

A questionnaire was designed to gather data about guidelines that have been implemented as well as information about factors, which, according to the Promoting Action on Research Implementation in Health Services (PARIHS)-model, influence the success of implementation. Thirty-nine health professionals at one of the hospitals included in the survey completed the questionnaire on two occasions within a mean time of 5.5 weeks. The test-retest reliability was analysed by means of Cohen's Kappa and percentage concordance.

RESULTS

Eight items had good agreement in terms of strength and high percentage concordance. With regard to the Kappa values, 13 items show moderate and two fair agreement.

CONCLUSIONS

The test-retest reliability scores show mainly acceptable results indicating a reasonable stability, thus suggesting the possibility of further developing the instrument. The factors described in the PARIHS-model seem relevant for use in evaluating implementation and use of guidelines. The instrument could benefit from a revision of the language in order to enhance clarity and make it less abstract.

Barriers to evidence-based nursing: a focus group study

AIM

This paper reports a study to explore the barriers to evidence-based nursing among Flemish (Belgian) nurses.

BACKGROUND

Barriers obstructing the call for an increase in evidence-based nursing have been explored in many countries, mostly through quantitative study designs. Authors report on lack of time, resources, evidence, authority, support, motivation and resistance to change. Relationships between barriers are seldom presented.

METHODS

We used a grounded theory approach, and five focus groups were organized between September 2004 and April 2005 in Belgium. We used purposeful sampling to recruit 53 nurses working in different settings. A problem tree was developed to establish links between codes that emerged from the data.

FINDINGS

The majority of the barriers were consistent with previous findings. Flemish (Belgian) nurses added a potential lack of responsibility in the uptake of evidence-based nursing, their 'guest' position in a patient's environment leading to a culture of adaptation, and a future 'two tier' nursing practice, which refers to the different education levels of nurses. The problem tree developed serves as (1) a basic model for other researchers who want to explore barriers within their own healthcare system and (2) a useful tool for orienting change management processes.

CONCLUSION

Despite the fact that the problem tree presented is context-specific for Flanders (Belgium), it gives an opportunity to develop clear objectives and targeted strategies for tackling obstacles to evidence-based nursing.

Iranian nurses' attitudes toward research utilisation

Research utilisation poses significant challenges for the nursing profession in Iran. Nurses' attitudes toward research and their motivation to engage in research utilisation have repeatedly been identified as potential barriers. Yet little is known about the attitudes of Iranian nurses' regarding research. Therefore, there is a need for a study that focuses particularly on Iranian nurses' attitudes toward research utilisation. The objective was to assess the attitude of Iranian clinical nurses and nurse educators towards nursing research. A self-administered questionnaire based on a cross-sectional survey conducted on 410 respondents from 15 educational hospitals and nursing schools affiliated to Tehran Medical Sciences University, Iran. According to the self-report, nurses generally held positive attitudes toward research. Education, professional role and research activities had a statistically significant relationship with their research attitudes. Although the attitudes towards research were positive, they do not perceive that research is relevant to the day-to-day work of nursing and research is not applicable to nursing as well. The majority of nurses are still not convinced of the importance of research to nursing practice and to the nursing profession. This, in turn, means that nurses do not implement research findings in clinical practice. There is an immediate need to improve research training in our teaching hospital to facilitate the development of the local literature both in terms of research utilisation and production.