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Darilek U, Finley E, McGrath J. A Narrative Review of NICU Implementation of Evidence-Based Early Relational Health Interventions. Adv Neonatal Care 2024; 24:253-267. [PMID: 38815279 DOI: 10.1097/anc.0000000000001151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
BACKGROUND Early relational health (ERH) interventions in the neonatal intensive care unit (NICU) buffer infants from toxic stress effects. Implementation science (IS) can guide successful uptake of evidence-based practice (EBP) ERH interventions. It is unknown if implementors of ERH interventions currently use the resources of IS to improve implementation. PURPOSE A narrative review of recent literature on implementation of ERH EBPs was completed to understand (a) which ERH interventions are currently being implemented in NICUs globally, (b) whether clinical implementors of ERH interventions have adopted the resources of IS, (c) existence of implementation gaps, and (d) implementation outcomes of ERH interventions in contemporary literature. DATA SOURCES Scopus, PubMed, and CINHAL were searched for original research regarding implementation of dyadic ERH interventions using key words related to IS and ERH. STUDY SELECTION For inclusion, ERH EBPs had to have been implemented exclusively in NICU settings, contained data addressing an IS domain, printed in English within the last 5 years. Twenty-four studies met inclusion criteria. DATA EXTRACTION Studies were distilled for intervention, IS domains addressed, location, aims, design, sample, and outcomes. RESULTS Eleven ERH interventions were described in the literature. Few studies utilized the resources of IS, indicating variable degrees of success in implementation. Discussions of implementation cost were notably missing. IMPLICATIONS FOR PRACTICE AND RESEARCH Implementors of ERH interventions appear to be largely unfamiliar with IS resources. More work is needed to reach clinicians with the tools and resources of IS to improve implementation outcomes.
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Affiliation(s)
- Umber Darilek
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas (Dr Darilek); Departments of Medicine and Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas (Dr Finley); Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California (Dr Finley); and School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas (Dr McGrath)
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Russell-Babin K, Friesen MA, O'Brien AM, McLaughlin MK, Messing J, Mowery B, Bettencourt AP, Graling PR. A Nurse-Led Implementation Science Specialist Program. Am J Nurs 2023; 123:38-45. [PMID: 37988023 DOI: 10.1097/01.naj.0000997228.84722.c7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
ABSTRACT A well-known challenge in health care is integrating evidence into practice. Implementation science (IS) is a growing field that promotes the sustainable application of evidence-based practice (EBP) to clinical care. Health care organizations have an opportunity to support sustainable change by creating robust IS infrastructures that engage nurses in the clinical environment. Integrating IS into a nursing shared governance model is an ideal vehicle to empower direct care nurses to sustain EBP. Importantly, an IS infrastructure may also promote nurse retention and increase interdisciplinary collaboration. This article, the first in a series on applying IS, describes how a multisite health care organization developed a systemwide nurse-led IS Specialist program within a shared governance model.
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Affiliation(s)
- Kathleen Russell-Babin
- Kathleen Russell-Babin is vice president of professional practice at Inova Health System in Falls Church, VA, where Mary Ann Friesen and Bernice Mowery are nursing research scientists, Maureen Kirkpatrick McLaughlin is an implementation science consultant, Jonathan Messing is an advanced practice provider manager, and Paula R. Graling is vice president of nursing, perioperative services. Anne-Marie O'Brien is an associate professor of nursing at Sonoma State University in Rohnert Park, CA. Amanda P. Bettencourt is an assistant professor in the University of Pennsylvania School of Nursing in Philadelphia and an implementation science consultant. Contact author: Paula R. Graling, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Reszel J, Daub O, Dunn SI, Cassidy CE, Hafizi K, Lightfoot M, Pervez D, Quosdorf A, Wood A, Graham ID. Planning and implementing practice changes in Ontario maternal-newborn hospital units: a secondary qualitative analysis. BMC Pregnancy Childbirth 2023; 23:735. [PMID: 37848826 PMCID: PMC10583424 DOI: 10.1186/s12884-023-06042-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Moving evidence into practice is complex, and pregnant and birthing people and their infants do not always receive care that aligns with the best available evidence. Implementation science can inform how to effectively move evidence into practice. While there are a growing number of examples of implementation science being studied in maternal-newborn care settings, it remains unknown how real-world teams of healthcare providers and leaders approach the overall implementation process when making practice changes. The purpose of this study was to describe maternal-newborn hospital teams' approaches to implementing practice changes. We aimed to identify what implementation steps teams take (or not) and identify strengths and potential areas for improvement based on best practices in implementation science. METHODS We conducted a supplementary qualitative secondary analysis of 22 interviews completed in 2014-2015 with maternal-newborn nursing leaders in Ontario, Canada. We used directed content analysis to code the data to seven steps in an implementation framework (Implementation Roadmap): identify the problem and potential best practice; assemble local evidence; select and customize best practice; discover barriers and drivers; tailor implementation strategies; field-test, plan evaluation, prepare to launch; launch, evaluate, and sustain. Frequency counts are presented for each step. RESULTS Participants reported completing a median of 4.5 of 7 Implementation Roadmap steps (range = 3-7), with the most common being identifying a practice problem. Other steps were described less frequently (e.g., selecting and adapting evidence, field-testing, outcome evaluation) or discussed frequently but not optimally (e.g., barriers assessment). Participants provided examples of how they engaged point-of-care staff throughout the implementation process, but provided fewer examples of engaging pregnant and birthing people and their families. Some participants stated they used a formal framework or process to guide their implementation process, with the most common being quality improvement approaches and tools. CONCLUSIONS We identified variability across the 22 hospitals in the implementation steps taken. While we observed many strengths, we also identified areas where further support may be needed. Future work is needed to create opportunities and resources to support maternal-newborn healthcare providers and leaders to apply principles and tools from implementation science to their practice change initiatives.
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Affiliation(s)
- Jessica Reszel
- School of Nursing, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada.
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
- Better Outcomes Registry & Network (BORN) Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
| | - Olivia Daub
- School of Communication Sciences and Disorders, Western University, 1201 Western Road, London, ON, N6G 1H1, Canada
| | - Sandra I Dunn
- School of Nursing, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
- Better Outcomes Registry & Network (BORN) Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Christine E Cassidy
- School of Nursing, Dalhousie University, 5869 University Avenue, Halifax, NS, B3H 4R2, Canada
- IWK Health Centre, 5980 University Avenue, Halifax, NS, B3K 6R8, Canada
| | - Kaamel Hafizi
- Better Outcomes Registry & Network (BORN) Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Marnie Lightfoot
- Women and Children's Health Network, Orillia Soldiers' Memorial Hospital, 170 Colborne St W, Orillia, ON, L3V 2Z3, Canada
| | | | - Ashley Quosdorf
- Neonatal Intensive Care Unit, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Allison Wood
- Better Outcomes Registry & Network (BORN) Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Ian D Graham
- School of Nursing, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
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Ten Hoor GA, Park J, Kok G. Ensuring the Use of Effective Interventions in Nursing and Health Science: Implementation Mapping. J Korean Acad Nurs 2023; 53:497-499. [PMID: 37977560 DOI: 10.4040/jkan.23128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Gill A Ten Hoor
- Department of Work & Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Jiyoung Park
- College of Nursing, Institute for Health Science Research, Inje University, Busan, Korea.
| | - Gerjo Kok
- Department of Work & Social Psychology, Maastricht University, Maastricht, Netherlands
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Hampton MD, Williams MY. Maximizing Nurse Scientist Role Potential in Health Care Organizations. Nurs Adm Q 2023; 47:338-349. [PMID: 37643233 DOI: 10.1097/naq.0000000000000594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Before Magnet designation, nurse scientists functioned primarily in academia. The Magnet model's emphasis on new knowledge required that health care organizations demonstrate knowledge generation to achieve and sustain designation. The nurse scientist role definition and function within health care organizations continues to evolve, which contributes to a lack of clarity about who and how nurses generate new knowledge. The purpose of this scoping review was to (1) identify nurse scientist role components in the context of 2 theoretical models (Thompson's Knowledge Brokering Model and Edward's Research Appreciation, Accessibility, and Application Model), (2) explore the strengths and barriers associated with existing nurse scientist practice models in US health care organizations, and (3) describe a unique, expanded practice model applied within Stanford Health Care's Office of Research and its implications for building new knowledge and innovation capacity with recommendations for ongoing role development.
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Monsees E, Wirtz AL, Krein S. Stewardship 2.0: Embracing elements of implementation science to enhance everyday antimicrobial Stewardship efforts. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e149. [PMID: 37771743 PMCID: PMC10523543 DOI: 10.1017/ash.2023.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 09/30/2023]
Abstract
This article explores the utility of implementation science (IS) as a method to promote the effective uptake of antimicrobial stewardship processes. Elements of IS can be readily incorporated into QI work and used as a platform to extend stewardship reach. As stewards are stretched to do more, IS can be a potential vehicle to ensure that our collective work is impactful, sustainable, and contributes more broadly to clinically relevant improvements.
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Affiliation(s)
- Elizabeth Monsees
- Performance Excellence, Children’s Mercy Hospital, Kansas City, MO, USA
- School of Medicine, University of Missouri, Kansas City, MO, USA
| | - Ann L. Wirtz
- Pharmacy, Children’s Mercy Hospital, Kansas City, MO, USA
| | - Sarah Krein
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
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Kelley L, Broadfoot K, McCreight M, Wills A, Leonard C, Connelly B, Gilmartin H, Burke RE. Implementation and Evaluation of a Training Curriculum for Experienced Nurses in Care Coordination: The VA Rural Transitions Nurse Training Program. J Nurs Care Qual 2023; 38:286-292. [PMID: 36857291 PMCID: PMC10205654 DOI: 10.1097/ncq.0000000000000698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND High-quality transitional care at discharge is essential for improved patient outcomes. Registered nurses (RNs) play integral roles in transitions; however, few receive structured training. PURPOSE We sought to create, implement, and evaluate an evidence-informed nursing transitional care coordination curriculum, the Transitions Nurse Training Program (TNTP). METHODS We conceptualized the curriculum using adult learning theory and evaluated with the New World Kirkpatrick Model. Self-reported engagement, satisfaction, acquired knowledge, and confidence were assessed using surveys. Clinical and communication skills were evaluated by standardized patient assessment and behavior sustainment via observation 6 to 9 months posttraining. RESULTS RNs reported high degrees of engagement, satisfaction, knowledge, and confidence and achieved a mean score of 92% on clinical and communication skills. Posttraining observation revealed skill sustainment (mean score 98%). CONCLUSIONS Results suggest TNTP is effective for creating engagement, satisfaction, acquired and sustained knowledge, and confidence for RNs trained in transitional care.
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Affiliation(s)
- Lynette Kelley
- Denver/Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Health Care System, Aurora CO, United States of America
- Geriatric Research Education and Clinical Center, VA Eastern Colorado Health Care System, Aurora CO, United States of America
| | - Kirsten Broadfoot
- University of Colorado School of Medicine, Center for Advancing Professional Excellence, University of Colorado Anschutz Medical Campus, Aurora CO, United States of America
| | - Marina McCreight
- Denver/Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Health Care System, Aurora CO, United States of America
| | - Ashlea Wills
- Denver/Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Health Care System, Aurora CO, United States of America
| | - Chelsea Leonard
- Denver/Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Health Care System, Aurora CO, United States of America
- Division of Health Care Policy and Research, University of Colorado School of Medicine, Aurora CO, United States of America
| | - Brigid Connelly
- Denver/Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Health Care System, Aurora CO, United States of America
| | - Heather Gilmartin
- Denver/Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Health Care System, Aurora CO, United States of America
- Health Systems, Management and Policy, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora CO, United States of America
| | - Robert E. Burke
- Center for Health Equity Research and Promotion (CHERP), Corporal Crescenz VA Medical Center, Philadelphia, PA, United States of America
- Division of General Internal Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine Philadelphia PA, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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Younas A. Uptake of Innovations in Nursing: The Necessity for Implementation Science. Creat Nurs 2023; 29:177-181. [PMID: 37800735 DOI: 10.1177/10784535231195426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Innovations are critical for improving clinical practice and nursing education, and for enhancing learning and practice change for frontline nurses and nursing students. Continuous innovation for delivering safe care and improving patient outcomes is needed. Merely demonstrating the effectiveness of research innovations is not enough to promote their uptake and use in practice. A 2021 study in cancer research reported that moving research into practice takes about 15 years. Implementation science, a systemic process of identifying the most relevant approaches to move research into practice, has emerged as an effective way to bridge the research-practice gap. The purpose of this article is to discuss why and how Implementation Science is necessary to promote the uptake of innovations in clinical and educational practice.
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Chipps E, Zadvinskis IM. Optimizing the Role of the Hospital-Based Nurse Scientist in a Changing Nursing Environment: Recommendations for Nurse Leaders. Nurs Adm Q 2023; 47:118-125. [PMID: 36745183 DOI: 10.1097/naq.0000000000000568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Nurses and nurse leaders directing clinical organizations can elevate scholarly inquiry by employing a PhD-prepared hospital-based nurse scientist (HBNS). This individual will shape the culture of clinical inquiry, leading and driving efforts to close the gap between knowledge and practice. As the nursing workforce struggles to recover from the COVID-19 pandemic, now more than ever, collaborations between HBNSs and nurse leaders are essential to explore and test new nursing care delivery systems. Given the national shortage in the PhD-prepared nurse scientist talent pool, attracting and hiring the right candidate is critical. The purpose of this article is to provide practical recommendations for nurse leaders to introduce an HBNS into an organization as an important building block for nursing science and improved clinical practice. The role of the HBNS has evolved in tandem with increased education in the nursing workforce, evidence-based practice, and the explosion of implementation science. Before recruiting an HBNS, the organization must create a job description that outlines responsibilities, paying attention to the HBNS position within the organizational structure. Additionally, leaders must consider the candidate's characteristics for interacting with clinical staff. The senior nursing leadership team must recognize and appreciate the HBNS as a scholar and advisor.
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Affiliation(s)
- Esther Chipps
- The Ohio State University College of Nursing, The Ohio State University Wexner Medical Center, Columbus (Dr Chipps); and The Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare, The Ohio State University College of Nursing, Columbus (Dr Zadvinskis)
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Implementation Science for the Practice-Oriented Nurse Leader. Nurs Adm Q 2023; 47:107-117. [PMID: 36862564 DOI: 10.1097/naq.0000000000000572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Senior nurse leaders are accountable for improving patient outcomes efficiently and cost-effectively. Nurse leaders often find heterogeneous patient outcomes across comparable nursing units in the same enterprise, presenting a challenge for nurse leaders tasked with making system-wide quality improvements. Implementation science (IS) offers a promising new approach to guide nurse leaders in understanding why certain implementation efforts meet with success or failure and the barriers faced in making practice changes. Knowledge of IS builds upon evidenced-based practice and quality improvement knowledge, adding to the armamentarium of tools at nurse leaders' disposal for improving nursing and patient outcomes. In this article, we demystify IS, differentiate it from evidence-based practice and quality improvement, describe IS concepts every nurse leader should be familiar with, and outline nurse leaders' role in building IS in their organizations.
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Kotronoulas G. Building on Health Care Professionals' Research Literacy for Sustained Quality Care. Semin Oncol Nurs 2023; 39:151400. [PMID: 36882334 DOI: 10.1016/j.soncn.2023.151400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 03/07/2023]
Affiliation(s)
- Grigorios Kotronoulas
- School of Medicine, Dentistry & Nursing, University of Glasgow,Glasgow, Scotland; Editor in Chief, Seminars in Nursing Oncology.
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Roberts NA, Young AM, Duff J. Using Implementation Science in Nursing Research. Semin Oncol Nurs 2023; 39:151399. [PMID: 36894448 DOI: 10.1016/j.soncn.2023.151399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVES Clinical research continues to build knowledge that can potentially improve clinical and health service outcomes; however, integrating evidence into routine care is challenging, resulting in a knowledge practice gap. The field of implementation science is a resource available for nurses to translate evidence into their practice. This article aims to provide nurses with an overview of implementation science, illustrate its value integrating evidence into practice, and show how it can be applied with high rigor in nursing research practice. DATA SOURCES A narrative synthesis of the implementation science literature was conducted. A series of case studies were purposively selected to demonstrate the application of commonly used implementation theories, models, and frameworks across health care settings relevant to nursing. These case studies demonstrate how the theoretical framework was applied and how the outcomes of the work reduced the knowledge practice gap. CONCLUSION Implementation science theoretical approaches have been used by nurses and multidisciplinary teams to better understand the gap between knowledge and practice for better informed implementation. These can be used to understand the processes involved, identify the determinants at play, and undertake an effective evaluation. IMPLICATIONS FOR NURSING PRACTICE By using implementation science research practice, nurses can also build a strong foundation of evidence about nursing clinical practice. As an approach, implementation science is practical and can optimize the valuable nursing resource.
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Affiliation(s)
- Natasha A Roberts
- University of Queensland, Metro North Health, Herston, QLD, Australia; University of Queensland, Brisbane, QLD, Australia; Queensland University of Technology, Brisbane, QLD, Australia.
| | - Adrienne M Young
- University of Queensland, Metro North Health, Herston, QLD, Australia; University of Queensland, Brisbane, QLD, Australia
| | - Jed Duff
- University of Queensland, Metro North Health, Herston, QLD, Australia; Queensland University of Technology, Brisbane, QLD, Australia
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Cao H, Song Y, Wu Y, Du Y, He X, Chen Y, Wang Q, Yang H. What is nursing professionalism? a concept analysis. BMC Nurs 2023; 22:34. [PMID: 36747180 PMCID: PMC9902819 DOI: 10.1186/s12912-022-01161-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 12/23/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Nursing professionalism plays an important role in clinical nursing. However, a clear conceptual understanding of nursing professionalism is lacking. METHOD Walker and Avant's strategy was used to analyse the concept of nursing professionalism. We searched electronic databases, including PubMed, Scopus, and CINAHL, for studies published from 1965 to 2021. Quantitative or qualitative studies published in English that focused on nursing professionalism were included in the study. RESULTS The three attributes of nursing professionalism are multidimensional, dynamic, and culture oriented. Based on the analysis, nursing professionalism is defined as providing individuals care based on the principles of professionalism, caring, and altruism. CONCLUSIONS This study offers a theoretical definition and conceptual model of nursing professionalism that may be applied to develop standardized assessment tools or nursing professionalism training programs.
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Affiliation(s)
- Huili Cao
- grid.263452.40000 0004 1798 4018Nursing College of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China ,grid.263452.40000 0004 1798 4018Linfen Hospital Affiliated to Shanxi Medical University (Linfen People’s Hospital), Linfen, 041000 Shanxi People’s Republic of China
| | - Yejun Song
- The Third Peoples Hospital of Taiyuan, Taiyuan, 030001 Shanxi People’s Republic of China
| | - Yanming Wu
- grid.263452.40000 0004 1798 4018Nursing College of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China
| | - Yifei Du
- grid.263452.40000 0004 1798 4018Nursing College of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China
| | - Xingyue He
- grid.263452.40000 0004 1798 4018Nursing College of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China
| | - Yangjie Chen
- grid.452461.00000 0004 1762 8478The First Hospital of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China
| | - Qiaohong Wang
- grid.263452.40000 0004 1798 4018Nursing College of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China ,grid.452461.00000 0004 1762 8478The First Hospital of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China
| | - Hui Yang
- Nursing College of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China. .,The First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.
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Research focused doctoral nursing education in the 21st century: Curriculum, evaluation, and postdoctoral considerations. J Prof Nurs 2023; 44:38-53. [PMID: 36746599 DOI: 10.1016/j.profnurs.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/03/2022] [Accepted: 11/05/2022] [Indexed: 12/13/2022]
Abstract
The AACN position statement on The Research-Focused Doctoral Program in Nursing: Pathways to Excellence was revised in 2022 by an AACN Task Force charged with creating a new vision for the PhD and similar programs in nursing. This document, which was informed by hundreds of academic nursing stakeholders, yields expectations and recommendations for PhD program curriculum, program evaluation, post-doctoral competencies, and resources. Results of an AACN 2021 survey indicated increased enrollment in PhD programs 2017-2000. Fifteen percent of students were enrolled in BSN-PhD, programs, 70 % of schools reported external review, and overall average time to degree completion was 5 years. Considerations for the education for the research doctorate include development of curriculum that fosters the scholarship of discovery and scientific inquiry and implements systematic evaluation of program outcomes while advancing postdoctoral competencies and resources, including the post-doctoral fellowship. Comprehensive assessment of the PhD program promotes ongoing program analysis and quality. Postdoctoral fellowships advance the science of nursing via the creation of a culture and workforce for nursing research. Successful postdoctoral programs have mentors, resources, and infrastructure to adequately enable the fellow to progress in their line of inquiry and develop as an investigator.
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Subrata SA, Phuphaibul R. The need for integration nursing theories into pressure ulcer care in the community. Br J Community Nurs 2022; 27:S6-S10. [PMID: 36519485 DOI: 10.12968/bjcn.2022.27.sup12.s6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Pressure ulcers are injuries to the skin requiring integrated care, particularly when patients are at home. Pressure ulcers have been a nursing concern for years, and several strategies have been proposed for its prevention and management. Nursing theory, which is essential for nursing practice, recommends plausible approaches to health problems. However, literature describing steps to integrate nursing theory into pressure ulcer care has not yet been explored. For this reason, this article discusses the six steps on how to apply nursing theory in community practice. A case study is also discussed to help gain a better understanding of these steps.
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Affiliation(s)
- Sumarno Adi Subrata
- Center of Research and Community Empowerment (LPPM); Wound Study Center (WOSCE); Nursing Lecturer, Universitas Muhammadiyah Magelang, Indonesia
| | - Rutja Phuphaibul
- Professor of Nursing, Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand
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Juckett LA, Bunger AC, McNett MM, Robinson ML, Tucker SJ. Leveraging academic initiatives to advance implementation practice: a scoping review of capacity building interventions. Implement Sci 2022; 17:49. [PMID: 35870930 PMCID: PMC9308361 DOI: 10.1186/s13012-022-01216-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Academic institutions building capacity for implementation scholarship are also well positioned to build capacity in real world health and human service settings. How practitioners and policy makers are included and trained in implementation capacity-building initiatives, and their impact on building implementation practice capacity is unclear. This scoping review identified and examined features of interventions that build implementation practice capacity across researchers and practitioners or practitioners-in-training.
Methods
Five bibliographic databases were searched. Eligible studies (a) described an implementation capacity building intervention with a connection to an academic institution, (b) targeted researchers and practitioners (including practitioners-in-training, students, or educators), and (c) reported intervention or participant outcomes. Articles that only described capacity building interventions without reporting outcomes were excluded. Consistent with Arksey and O’Malley’s framework, key study characteristics were extracted (target participants, core components, and outcomes) and analyzed using open coding and numerical analysis.
Results
Of 1349 studies identified, 64 met eligibility for full-text review, and 14 were included in the final analysis. Half of the studies described implementation capacity building interventions that targeted health or behavioral health researchers, practitioners, and practitioners-in-training together, and half targeted practitioners or practitioners-in-training only. The most common components included structured didactic activities offered in person or online, mentorship and expert consultation to support implementation, and practical application activities (e.g., field placements, case studies). Knowledge sharing activities and technical assistance were less common. All studies reported favorable outcomes related to knowledge attainment, increased ability to implement evidence, productivity, and satisfaction.
Conclusions
Building implementation capacity among practitioners is critical for integrating insights from implementation science into the field and preventing the “secondary” implementation research-to-practice gap. This scoping review identified several promising implementation practice capacity building interventions that tend to build practitioner capacity via expert led activities which may be relevant for academic institutions seeking to build implementation practice capacity. To avoid widening the implementation research-to-practice gap, implementation capacity building interventions are needed that target policy makers, expand beyond multiple practice settings, and leverage university/community partnerships or on-site academic medical centers. Future studies will also be needed to test the impact on service quality and public health outcomes.
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Figueiredo LDFD, Silva NCD, Prado MLD. Primary care nurses' learning styles in the light of David Kolb. Rev Bras Enferm 2022; 75:e20210986. [PMID: 36102474 DOI: 10.1590/0034-7167-2021-0986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to identify primary care nurses' learning styles in the light of David Kolb's Experiential Learning Theory. METHODS a descriptive and exploratory qualitative study. A semi-structured interview script was used for data collection and content analysis for data processing. RESULTS primary care nurses showed different learning styles: diverging, which combines active experimentation and reflective observation; assimilating, which combines reflective observation and abstract conceptualization; converging, which associates abstract conceptualization and concrete experience; and accommodating, which unites concrete experience and active experimentation. FINAL CONSIDERATIONS learning through experience requires that knowledge be understood and transformed. Nurses learn in different ways, as they have different learning styles. Therefore, recognizing nurses' learning styles is important to foster ongoing professional development and ensure safe nursing care.
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Building Capacity for Implementation Science in Precision Health and Society: Development of a Course for Professional and Graduate Students in Pharmacy. J Pers Med 2022; 12:jpm12091499. [PMID: 36143284 PMCID: PMC9502747 DOI: 10.3390/jpm12091499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/21/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Training in the field of implementation science is critical for future pharmacists and pharmaceutical scientists to successfully implement precision health interventions in pharmacy practice. We developed an elective course for second- and third-year students at the UNC Eshelman School of Pharmacy to develop foundational knowledge in implementation science with a focus on precision health implementation. The eight-week course used a flipped classroom format featuring lecture videos, suggested readings, quizzes, guest lectures from experts, case studies, and a group project. We evaluated course quality through class participation, a pre- and post-test on course content, and a mixed-methods survey completed by the students. Overall engagement in in the course was high and students demonstrated significant improvement in understanding of implementation science and precision health. Strengths of the course as identified by students were the use of expert guest speakers, pre-class lectures, and case study exercises, while the ordering of content and improved connection between content and guest lectures were identified as areas for improvement. In conclusion, the elective course was well-received and meets a critical need in the field of pharmacy to build implementation science capacity. Future work is needed to expand and refine education for the implementation of precision health for pharmacy professionals.
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Zuzelo PR. Changing Practice to Maximize Holistic Care Effects: Quality Improvement and Implementation Science. Holist Nurs Pract 2022; 36:185-186. [PMID: 35435881 DOI: 10.1097/hnp.0000000000000516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Patti Rager Zuzelo
- Doctorate of Nursing Practice (DNP) Program, Advanced Nursing Practice Department, College of Nursing & Health Professions, Drexel University, Philadelphia, Pennsylvania
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Smith-Miller CA. Implementing Evidence Informed Practice Changes: Barriers, Facilitators, and Work Environments. J Nurs Adm 2022; 52:203-210. [PMID: 35348484 DOI: 10.1097/nna.0000000000001132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study examined nurses' perspectives about the barriers and facilitators to implementing research findings and evidence into practice. BACKGROUND Work environments play an essential role in implementation and innovation; however, much of the research regarding evidence-based practice focuses on nurses' knowledge and skills, leaving the work environments unexamined. METHODS A mixed method survey design was used. Data collection included an electronic survey and open questions. Analysis included descriptive statistics and narrative analysis using the Consolidated Framework for Implementation Research. RESULTS Attitudes about implementing evidence into practice were positive. Identified barriers included lack of time and knowledge, change fatigue, and complex internal processes; facilitators included supportive colleagues, knowledgeable mentors, and access to libraries and other resources. CONCLUSIONS Implementing evidence into practice is facilitated by committing organizational resources, fostering supportive work environments, integrating evidence into quality improvement projects, offering continuing education, and reducing the complexity of translating evidence into practice and the number of institution-wide initiatives.
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Affiliation(s)
- Cheryl A Smith-Miller
- Author Affiliations: Nurse Scientist, Center for Nursing Excellence, UNC Medical Center, Chapel Hill, North Carolina; and Vice-Chair of Non-Biomedical IRB Committee E, Office of Human Research Ethics, University of North Carolina at Chapel Hill
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21
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Ricciardi R. Perspectives: Envisioning healthcare quality and safety in 2030. J Res Nurs 2022; 26:168-175. [PMID: 35251238 DOI: 10.1177/1744987121992911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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22
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Figueiredo LDFD, Silva NCD, Prado MLD. Estilos de aprendizagem de enfermeiros que atuam na atenção primária à luz de David Kolb. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2021-0986pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivos: identificar o estilo de aprendizagem dos enfermeiros de atenção primária à luz da Teoria da Aprendizagem Experiencial de David Kolb. Métodos: estudo qualitativo descritivo e exploratório. Utilizou-se um roteiro de entrevista semiestruturado para a coleta dos dados, e a análise de conteúdo, para o tratamento dos dados. Resultados: enfermeiras que atuam na atenção primária apresentaram diferentes estilos de aprendizagem: divergente, que combina experiência ativa e observação reflexiva; assimilador, que combina observação reflexiva e conceitualização abstrata; convergente, que associa conceitualização abstrata e experiência concreta; e acomodador, que une a experiência concreta e a experiência ativa. Considerações Finais: aprender pela experiência requer que o conhecimento seja compreendido e transformado. Enfermeiras aprendem de modos diferentes, pois apresentam diferentes estilos de aprendizagem. Portanto, reconhecer os estilos de aprendizagem dos enfermeiros é importante para fomentar o desenvolvimento profissional contínuo e garantir um cuidado de enfermagem seguro.
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Joseph ML, Nelson-Brantley HV, Caramanica L, Lyman B, Frank B, Hand MW, Parchment J, Ward DM, Weatherford B, Chipps E. Building the Science to Guide Nursing Administration and Leadership Decision Making. J Nurs Adm 2022; 52:19-26. [PMID: 34897205 DOI: 10.1097/nna.0000000000001098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to identify the challenges, barriers, and solutions for conducting nursing administration and leadership science (NALS) research. BACKGROUND Evidence from leadership science should be at the forefront of nurse leaders' decision making. Yet, challenges remain in building the evidence and moving it into nursing administration and leadership practice. METHODS This study used a Delphi technique with open-ended questions and direct content analysis to evaluate survey responses of members of the Association for Leadership Science in Nursing and American Organization for Nursing Leadership. RESULTS Open-ended responses were coded to yield super categories and supportive codes for areas with limited evidence to guide leadership practice and the challenges for conducting NALS research. CONCLUSIONS These findings provide future directions for continuously driving NALS research and for building and leveraging leadership science to support nursing administration decision making.
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Affiliation(s)
- M Lindell Joseph
- Author Affiliations: Clinical Professor and Director (Dr Joseph), Health Systems/Administration & MSN/CNL Programs, College of Nursing, The University of Iowa, Iowa City; Assistant Professor and Leadership Program Director (Dr Nelson-Brantley), University of Kansas School of Nursing, Kansas City; Professor (Dr Caramanica), Tanner Health System School of Nursing, University of West Georgia, Carrollton; Associate Professor (Dr Lyman), College of Nursing Brigham Young University, Provo, Utah; Professor Emerita (Dr Frank), School of Nursing, Indiana State University, Terre Haute; Associate Professor of Nursing (Dr Hand), College of Nursing and Health Professions, University of Southern Indiana, Evansville; Adjunct Faculty (Dr Parchment), College of Nursing, University of Central Florida, Orlando; Director (Ms Ward), AONL Foundation for Nursing Leadership Research and Education, Chicago, Illinois; Retired (Dr Weatherford), College of Nursing, University of Massachusetts, Dartmouth; Professor of Clinical Nursing and Clinical Nurse Scientist (Dr Chipps), The Ohio State University College of Nursing, The Ohio State University Wexner Medical Center, Columbus
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McCartney PR. The Translational Science Spectrum. J Obstet Gynecol Neonatal Nurs 2021; 50:655-658. [PMID: 34648752 DOI: 10.1016/j.jogn.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
MICRO-ABSTRACT The Associate Editor describes the importance of the adaptation of scientific knowledge to clinical practice.
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Linder LA, Ameringer S, Stegenga K, Macpherson CF, Erickson J. A Person-Centered Approach to Symptom Assessment and Management for Children and Adolescents Receiving Cancer Treatment. Semin Oncol Nurs 2021; 37:151164. [PMID: 34134924 DOI: 10.1016/j.soncn.2021.151164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Discuss the clinical assessment and management of symptoms for children and adolescents receiving treatment for cancer with attention to a person-centered approach to care. DATA SOURCES Review of currently published literature and guidelines pertaining to symptom assessment and management for children and adolescents receiving treatment for cancer. CONCLUSION Symptoms such as pain, nausea, and fatigue are commonly reported by children and adolescents receiving cancer treatment and are associated with greater symptom burden. Symptom assessment should be tailored to the child or adolescent and include the child's or adolescent's preference for reporting symptoms and attention to the symptoms that are of greatest priority. Evidence-based guidelines for the management of symptoms, including pain and nausea, are available to guide symptom management interventions and should be tailored to provide person-centered care. IMPLICATIONS FOR NURSING PRACTICE Nurses can lead efforts through clinical practice and research initiatives to advance person-centered symptom care for children and adolescents with cancer on a global level. Priorities for future work to advance person-centered symptom assessment and management include (1) identification of best practices for symptom assessment, (2) attention to social determinants of health and their subsequent influence on symptom outcomes, (3) compilation of evidence for management of less commonly reported symptoms, and (4) implementation of published clinical guidelines for symptom management in practice settings.
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Affiliation(s)
- Lauri A Linder
- College of Nursing, University of Utah, Salt Lake City; Primary Children's Hospital, Salt Lake City, UT.
| | | | | | | | - Jeanne Erickson
- Milwaukee College of Nursing, University of Wisconsin, Milwaukee
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Giuliano KK, Penoyer D, Middleton A, Baker D. Original Research: Oral Care as Prevention for Nonventilator Hospital-Acquired Pneumonia: A Four-Unit Cluster Randomized Study. Am J Nurs 2021; 121:24-33. [PMID: 33993136 DOI: 10.1097/01.naj.0000753468.99321.93] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Nonventilator hospital-acquired pneumonia (NV-HAP) presents a serious and largely preventable threat to patient safety in U.S. hospitals. There is an emerging body of evidence on the effectiveness of oral care in preventing NV-HAP. PURPOSE The primary aim of this study was to determine the effectiveness of a universal, standardized oral care protocol in preventing NV-HAP in the acute care setting. The primary outcome measure was NV-HAP incidence per 1,000 patient-days. METHODS This 12-month study was conducted on four units at an 800-bed tertiary medical center. Patients on one medical and one surgical unit were randomly assigned to receive enhanced oral care (intervention units); patients on another medical and another surgical unit received usual oral care (control units). RESULTS Total enrollment was 8,709. For the medical control versus intervention units, oral care frequency increased from a mean of 0.95 to 2.25 times per day, and there was a significant 85% reduction in the NV-HAP incidence rate. The odds of developing NV-HAP were 7.1 times higher on the medical control versus intervention units, a significant finding. For the surgical control versus intervention units, oral care frequency increased from a mean of 1.18 to 2.02 times per day, with a 56% reduction in the NV-HAP incidence rate. The odds of developing NV-HAP were 1.6 times higher on the surgical control versus intervention units, although this result did not reach significance. CONCLUSIONS These findings add to the growing body of evidence that daily oral care as a means of primary source control may have a role in NV-HAP prevention. The implementation of effective strategies to ensure that such care is consistently provided warrants further study. It's not yet known what degree and frequency of oral care are required to effect favorable changes in the oral microbiome during acute care hospitalization.
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Affiliation(s)
- Karen K Giuliano
- Karen K. Giuliano is an associate professor at the College of Nursing and the Institute for Applied Life Sciences, University of Massachusetts Amherst. Daleen Penoyer is the director of the Center for Nursing Research and Advanced Nursing Practice, Orlando Health, Orlando, FL. Aurea Middleton is the research coordinator for Orlando Health's Center for Nursing Research. Dian Baker is a professor at the School of Nursing, California State University, Sacramento. Financial support for this study was provided by Medline Industries (which supplied the kits used) and Orlando Health. Baker and Giuliano have also created a CE program on NV-HAP sponsored by Medline. An intervention toolkit is available from the authors. The authors acknowledge Joohyun Chung for her guidance and review of the statistical approach and analyses. Contact author: Karen K. Giuliano, . The authors have disclosed no other potential conflicts of interest, financial or otherwise
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Roberti J, Jorro F, Rodríguez V, Belizán M, Arias P, Ratto ME, Reina R, Ini N, Loudet C, García-Elorrio E. Theory-driven, rapid formative research on quality improvement intervention for critical care of patients with COVID-19 in Argentina. Glob Qual Nurs Res 2021; 8:23333936211015660. [PMID: 34026926 PMCID: PMC8120599 DOI: 10.1177/23333936211015660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 11/23/2022] Open
Abstract
The challenges of implementing interventions in healthcare settings have been more apparent during the COVID-19 pandemic. This pre-implementation evaluation used a rapid qualitative approach to explore barriers and facilitators to an intervention in intensive care units in Argentina, aimed to promote the use of personal protection equipment, provide emotional support for professionals, and achieve patient flow goals. Data were collected using semi-structured interviews with health professionals of 15 public hospitals in Argentina. Normalization Process Theory was used to guide content analysis of the data. Participants identified potential barriers such as the incorporation of non-specialist staff, shortage of resources, lack of communication between groups and shifts. Potential facilitators were also identified: regular feedback and communication related to implementation, adequate training for new and non-specialist staff, and incentives (e.g., scholarships). The immediacy of the pandemic demanded rapid qualitative research, sharing actionable findings in real time.
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Affiliation(s)
- Javier Roberti
- Institute for Clinical Effectiveness and Health Policy, (IECS), Buenos Aires, Argentina.,Centre for Research in Epidemiology and Public Health at National Scientific and Technical Research Council (CIESP - CONICET), Buenos Aires, Argentina
| | - Facundo Jorro
- Institute for Clinical Effectiveness and Health Policy, (IECS), Buenos Aires, Argentina
| | - Viviana Rodríguez
- Institute for Clinical Effectiveness and Health Policy, (IECS), Buenos Aires, Argentina
| | - María Belizán
- Institute for Clinical Effectiveness and Health Policy, (IECS), Buenos Aires, Argentina
| | - Pilar Arias
- Argentine Society of Intensive Care (SATI), Buenos Aires, Argentina
| | | | - Rosa Reina
- Argentine Society of Intensive Care (SATI), Buenos Aires, Argentina
| | - Natalí Ini
- Institute for Clinical Effectiveness and Health Policy, (IECS), Buenos Aires, Argentina.,Centre for Research in Epidemiology and Public Health at National Scientific and Technical Research Council (CIESP - CONICET), Buenos Aires, Argentina
| | - Cecilia Loudet
- Argentine Society of Intensive Care (SATI), Buenos Aires, Argentina
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Nelson-Brantley HV, Chipps E. Implementation Science and Nursing Leadership: Improving the Adoption and Sustainability of Evidence-Based Practice. J Nurs Adm 2021; 51:237-239. [PMID: 33882549 DOI: 10.1097/nna.0000000000001006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Increasingly, nurse executives are embracing evidence-based practice (EBP). Yet, it takes 17 years to move only 14% of research evidence into practice. Implementation science (IS) aims to reduce this gap through the study of factors that influence dissemination, adoption, implementation, and sustainability of evidence-based interventions. Nurse leaders aiming for EBP must be well equipped to support IS. This article introduces IS, leadership competencies essential for supporting implementation research and practice, and preparing an IS-ready workforce.
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Affiliation(s)
- Heather V Nelson-Brantley
- Author Affiliations: Leadership Program Director & Assistant Professor, University of Kansas School of Nursing (Dr Nelson-Brantley); and Clinical Nurse Scientist, The Ohio State University Wexner Medical Center & Associate Professor of Clinical Nursing, The Ohio State College of Nursing, Columbus (Dr Chipps)
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McNett M, Masciola R, Sievert D, Tucker S. Advancing Evidence-Based Practice Through Implementation Science: Critical Contributions of Doctor of Nursing Practice- and Doctor of Philosophy-Prepared Nurses. Worldviews Evid Based Nurs 2021; 18:93-101. [PMID: 33856116 DOI: 10.1111/wvn.12496] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Describe the evolution of implementation science and the roles and potential collaborations of doctorally prepared nurses to advance implementation science in practice settings. METHODS Review of academic preparation and areas of expertise for doctorally prepared nurses as it relates to implementation science and evidence-based practice (EBP). FINDINGS There have been substantial gains in the number of academic programs in healthcare that include content on EBP, resulting in healthcare teams that are motivated to align practices with best evidence. Unfortunately, many EBP initiatives stall during early stages of implementation, resulting in fragmented practices and persistent gaps between evidence and practice. Implementation science aims to bridge this gap and provides a structured, science-based approach to implementation. Few healthcare teams are familiar with implementation science, and many do not incorporate knowledge from the field when implementing EBPs. Doctorally prepared nurses are in a unique position to serve as leaders in EBP implementation due to the breadth and depth of academic preparation and their pivotal roles across practice settings. CONCLUSIONS Collaboratively aligning existing strengths of PhD and DNP prepared nurses with knowledge of implementation science can advance implementation of EBP across practice settings to effectively incorporate and sustain meaningful change to improve outcomes. LINKING EVIDENCE TO ACTION SECTION Doctorally prepared nurses are in a unique position to advance and apply the science of implementation in practice settings. Nurse scientists can generate evidence on effective strategies and outcomes among healthcare teams to successfully integrate evidence based practices into routine care. Nurse leaders and educators can apply these findings and use an implementation science approach when leading clinical teams in evidence-based practice changes.
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Affiliation(s)
- Molly McNett
- Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare, The Ohio State University College of Nursing, Columbus, OH, USA
| | - Randee Masciola
- Women's Health Nurse Practitioner, The Ohio State University College of Nursing, Columbus, OH, USA
| | - Deana Sievert
- Acute, Ambulatory and Provider Division, Fremont/Fostoria Hospitals, ProMedica, Toledo, OH, USA
| | - Sharon Tucker
- College of Nursing, Helene Fuld Health Trust National Institute for EBP, The Ohio State University, Columbus, OH, USA
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Vogel R, Bours G, Erkens P, Metzelthin S, Zwakhalen S, van Rossum E. The content of the nurses in the lead programme for empowering community nurse leadership in implementing evidence. Leadersh Health Serv (Bradf Engl) 2021; ahead-of-print. [PMID: 33834685 DOI: 10.1108/lhs-08-2020-0063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aims to provide a detailed description of the nurses in the lead (NitL) programme for empowering community nurse leadership in implementing evidence. DESIGN/METHODOLOGY/APPROACH The NitL programme is described using the template for intervention description and replication-checklist. FINDINGS The NitL programme consists of two components. The first component is a systematic approach with implementation steps and tools to empower community nurses in implementing evidence targeted at encouraging functional activities of older adults offered via a Web-based eLearning programme. The second component is training to empower community nurses in enabling team members to change their practice, which focussed on motivational interviewing, influencing behaviour, dealing with resistance to change and coaching delivered as a combination of group training in practice and background theory via a web-based eLearning programme. RESEARCH LIMITATIONS/IMPLICATIONS Further research is needed to evaluate the feasibility and effects of the NitL programme. PRACTICAL IMPLICATIONS The NitL programme has been developed in cooperation with community nurses to meet their needs in practice and has the potential to develop leadership for the core tasks of community nurses. ORIGINALITY/VALUE The NitL programme has been developed to empower the leadership of community nurses in implementing evidence targeted at encouraging functional activities of older adults. The leadership role of community nurses is key for delivering high-quality care and implementing evidence within the community care setting for encouraging functional activities of older adults to preserve their independence.
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Affiliation(s)
- Ruth Vogel
- Maastricht University, Maastricht, The Netherlands
| | - Gerrie Bours
- Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Petra Erkens
- Maastricht University, Maastricht, The Netherlands
| | | | | | - Erik van Rossum
- Zuyd University of Applied Sciences, Heerlen, The Netherlands
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Ridge RA. Leveraging the nurse scientist role through entrepreneurial innovation. Nurs Manag (Harrow) 2021; 52:32-38. [PMID: 33789330 DOI: 10.1097/01.numa.0000737620.13138.e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Richard A Ridge
- Richard A. Ridge is an assistant professor at the University of Virginia School of Nursing in Charlottesville, Va
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Tyndall DE, Firnhaber GC, Kistler KB. An integrative review of threshold concepts in doctoral education: Implications for PhD nursing programs. NURSE EDUCATION TODAY 2021; 99:104786. [PMID: 33549957 DOI: 10.1016/j.nedt.2021.104786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/05/2021] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To critically analyze published research addressing threshold concepts in doctoral education, explore factors affecting conceptual threshold crossing by doctoral students, and consider the application of these findings in doctoral nursing education. BACKGROUND Mastery of concepts specific to the research-focused doctorate is critical in order for doctoral students to become independent researchers. These threshold concepts can be challenging, or troublesome, and students may find themselves 'stuck' during the learning journey. Engaging with troublesome concepts may place a student in a state of liminality, a transitory space of uncertainty. DESIGN An integrative approach was adopted for this review. DATA SOURCES A combination of keywords was used to search PubMed, CINAHL Plus, PsycINFO, ProQuest Search, Education Research Complete, Scopus, and Science Direct for literature published through July 2019. REVIEW METHODS Integrative review methods described by Whittemore and Knafl (2005) were used to review and analyze a total of 20 qualitative studies identified based upon specific inclusion criteria. RESULTS The majority of identified threshold concepts emerge during the development stage of research, indicating a need for strategies to support students with navigation of the liminal spaces encountered early in the doctoral journey. Factors affecting conceptual threshold crossing include student writing development, presence of community, and faculty influences. CONCLUSION Doctoral program strategies are needed to support how to both teach and learn threshold concepts within safe spaces. Recommendations for strategies to develop student writing, support community building, and cultivate faculty-student relationships in doctoral nursing programs are provided. More intentionally incorporating threshold concept strategies into doctoral level nursing education has the potential to support both graduation rates and successful career transition to maintain a steady pipeline of nurse scientists.
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Affiliation(s)
- Deborah E Tyndall
- College of Nursing, East Carolina University, Health Sciences Building, Greenville, NC 27858, United States of America.
| | - Gina C Firnhaber
- College of Nursing, East Carolina University, Health Sciences Building, Greenville, NC 27858, United States of America.
| | - K Brooke Kistler
- College of Nursing, East Carolina University, Health Sciences Building, Greenville, NC 27858, United States of America.
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Leonard C, Gilmartin H, McCreight M, Kelley L, Mayberry A, Burke RE. Training registered nurses to conduct pre-implementation assessment to inform program scale-up: an example from the rural Transitions Nurse Program. Implement Sci Commun 2021; 2:28. [PMID: 33685521 PMCID: PMC7938579 DOI: 10.1186/s43058-021-00127-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 02/09/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Adapting evidence-based practices to local settings is critical for successful implementation and dissemination. A pre-implementation assessment evaluates local context to inform implementation, but there is little published guidance for clinician-implementers. The rural Transitions Nurse Program (TNP) is a care coordination intervention that facilitates care transitions for rural veterans. In year 1 of TNP, pre-implementation assessments were conducted by a centralized project team through multi-day visits at five sites nationwide. In year 2, we tested if local site TNP nurses could conduct pre-implementation assessments using evidence-based tools and coaching from the TNP team. This required developing a multicomponent pre-implementation strategy bundle to guide data collection and synthesis. We hypothesized that (1) nurses would find the pre-implementation assessment useful for tailoring TNP to local contexts and (2) nurses would identify similar barriers and facilitators to those identified at first year sites. METHODS The bundle included guides for conducting key informant interviews, brainwriting, process mapping, and reflective journaling. We evaluated TNP nurse satisfaction and perceived utility of the structure and process of the training and bundle through pre-post surveys. To assess the outcome of data collection efforts, we interviewed nurses 4 months after completion of the pre-implementation assessment to determine if and how they used pre-implementation findings to tailor implementation of TNP to local contexts. To further assess outcomes, all data that the nurses collected were analyzed thematically. Themes related to barriers and facilitators were compared across years. FINDINGS Five nurses at different VA medical centers used the pre-implementation strategy bundle to collect site-level data and completed pre-post surveys. Findings indicated that the pre-implementation assessment was highly recommended, and the bundle provided adequate training. Nurses felt that pre-implementation work oriented them to the local context and illustrated how to integrate TNP into existing processes. Barriers and facilitators identified by nurses were similar to those collected in year 1 by the TNP research team, including communication challenges, need for buy-in, and logistical concerns. CONCLUSIONS This proof-of-concept study suggests that evidence-based tools can effectively guide clinician-implementers through the process of conducting a pre-implementation assessment. This approach positively informed TNP implementation and oriented nurses to their local context prior to implementation.
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Affiliation(s)
- Chelsea Leonard
- Denver/Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Healthcare System, 1700 N Wheeling Street, Aurora, CO, 80045, USA.
| | - Heather Gilmartin
- Denver/Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Healthcare System, 1700 N Wheeling Street, Aurora, CO, 80045, USA.,Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Marina McCreight
- Denver/Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Healthcare System, 1700 N Wheeling Street, Aurora, CO, 80045, USA
| | - Lynette Kelley
- Denver/Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Healthcare System, 1700 N Wheeling Street, Aurora, CO, 80045, USA
| | - Ashlea Mayberry
- Denver/Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Healthcare System, 1700 N Wheeling Street, Aurora, CO, 80045, USA
| | - Robert E Burke
- Center for Health Equity Research and Promotion (CHERP), Corporal Crescenz VA Medical Center, Philadelphia, PA, USA.,Hospital Medicine Section, Division of General Internal Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Joseph PV, McCauley L, Richmond TS. PhD programs and the advancement of nursing science. J Prof Nurs 2021; 37:195-200. [PMID: 33674093 DOI: 10.1016/j.profnurs.2020.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/23/2020] [Accepted: 06/30/2020] [Indexed: 12/19/2022]
Abstract
Nurses are well-positioned to be groundbreaking researchers, scientists, leaders, and innovators to improve the health and well-being of individuals, families, and communities. Nurse scientists are needed to contribute to scientific discoveries that inform effective strategies to improve patient care and outcomes and to inform future policies. Thoughtful consideration is required about the preparation of nurse scientists to ensure they are equipped with the knowledge and skill sets to meet the needs of society. Evolving health needs and priority areas of inquiry along with an ever-increasing array of sophisticated methodologies and centrality of interdisciplinary teams to solve complex problems should drive how we prepare PhD students. This paper reflects a panel and subsequent dialogue with nurse leaders at the PhD summit held at the University of Pennsylvania in October 2019. Three aspects of PhD education and the advancement of nursing science are discussed 1) examining important elements to support nurse scientist development; 2) identifying key gaps in science that the discipline needs to address in educating the next generation of nurse scientists; and 3) preparing nurse scientists for the competitive funding environment.
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Affiliation(s)
- Paule V Joseph
- Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, National Institute of Nursing Research, United States of America
| | - Linda McCauley
- Nell Hodgson Woodruff School of Nursing, Emory University, United States of America
| | - Therese S Richmond
- Biobehavioral Health Sciences Department, School of Nursing, University of Pennsylvania, United States of America.
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Whalen M, Maliszewski B, Gardner H, Smyth S. Audit and Feedback: An Evidence-Based Practice Literature Review of Nursing Report Cards. Worldviews Evid Based Nurs 2021; 18:170-179. [PMID: 33512082 DOI: 10.1111/wvn.12492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND As more hospitals transition to electronic health records (EHR) and rely on technology to inform practice, what is done with that information is increasingly important. Performance report cards for physicians and nurses are not new, yet there is little recent evidence on nurse-specific audit and feedback. AIM The aim of the project was to conduct an evidence-based practice (EBP) review to answer the question, "Does implementing an individualized audit and feedback report tool for nurses improve compliance, adherence, and/or performance of nursing tasks?". METHODS Evidence was gathered from several databases. Reviewers read and appraised articles that answered the EBP question using the Johns Hopkins Nursing EBP Model. Data were then collated to synthesize and generate recommendations. RESULTS Of the initial 613 unique articles, eight (two research and six quality improvement) were included. Six articles demonstrated improvements while two did not. Articles analyzed nursing documentation (n = 3), tasks or skills (n = 2), and best practice compliance (n = 3). One manuscript utilized an EHR-generated report; all others were completed by hand. Overall, there was not consistent and compelling evidence to support individualized audit and feedback report tools in nursing. However, several themes emerged related to sustainability, timing of feedback, audit, and feedback in the context of quality improvement, and the methods of acquiring and distributing data. LINKING EVIDENCE TO ACTION The ubiquity and ease of the EHR make providing automated feedback to nurses tempting, yet it is not supported by the literature. More implementation science research is needed to explore audit and feedback reports in nursing. This article adds to the literature by highlighting a significant lack of consistent and compelling positive results from the well-established quality improvement strategy of audit and feedback in the nursing population. The absence of good data is as telling as its presence.
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Affiliation(s)
- Madeleine Whalen
- Evidence-Based Practice Program Coordinator, Johns Hopkins Health System, Baltimore, MD, USA
| | | | - Heather Gardner
- Clinical Informatics, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Sharon Smyth
- Academic Division of Emergency Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA
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Dykes PC, Lowenthal G, Faris A, Leonard MW, Hack R, Harding D, Huffman Whnp C, Hurley A, An P. An Implementation Science Approach to Promote Optimal Implementation, Adoption, Use, and Spread of Continuous Clinical Monitoring System Technology. J Patient Saf 2021; 17:56-62. [PMID: 33273399 DOI: 10.1097/pts.0000000000000790] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to apply implementation science tenets to guide the deployment and use of in-hospital Clinical Monitoring System Technology (CMST) and to develop a toolkit to promote optimal implementation, adoption, use, and spread of CMST. METHODS Six steps were carried out to (1) establish leadership support; (2) identify, educate, and sustain champions; (3) enlist clinical staff users to learn barriers and facilitators; (4) examine initial qualitative data from 11 clinician group interviews; (5) validate barriers/facilitators to CMST use and toolkit content; and (6) propose a toolkit to promote utilization. Clinical Monitoring System Technology output before and after implementation were compared. RESULTS The top 3 barriers to effective CMST use were as follows: (1) inadequate education/training/support, (2) clinical workflow challenges, and (3) lack of communication. Facilitators to CMST implementation and adoption included the following: (1) providing comprehensive and consistent CMST education, (2) presenting evidence early and often, (3) tailoring device and usage expectations to individual environments, and (4) providing regular feedback about progress. Empirical data drove the development of a CMST implementation toolkit covering 6 areas: (1) why, (2) readiness, (3) readiness and implementation, (4) patient/family introduction, (5) champions, (6) care team saves, and (7) troubleshooting. Clinical Monitoring System Technology positively impacted failure to rescue events. Monthly median cardiac alert responses decreased from 30 to 3.64 minutes (87.9%), and respiratory alert responses decreased from 26 to 4.85 minutes (81.4%). CONCLUSIONS Using implementation science tenets to concurrently guide deployment and study performance of 2 CMST devices and impact on workload was effective for both learning CMST efficacy at 2 hospital systems and developing a toolkit to promote optimal implementation, adoption, use, and spread.
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Affiliation(s)
| | - Graham Lowenthal
- From the Center for Patient Safety, Research, and Practice, Department of Medicine, Brigham and Women's Hospital
| | - Ann Faris
- Wake Forest Baptist Medical Center, Wake Forest Baptist Health, Winston Salem, North Carolina
| | - Michelle Waters Leonard
- Wake Forest Baptist Medical Center, Wake Forest Baptist Health, Winston Salem, North Carolina
| | - Robin Hack
- Wake Forest Baptist Medical Center, Wake Forest Baptist Health, Winston Salem, North Carolina
| | - Deborah Harding
- Wake Forest Baptist Medical Center, Wake Forest Baptist Health, Winston Salem, North Carolina
| | - Carolyn Huffman Whnp
- Wake Forest Baptist Medical Center, Wake Forest Baptist Health, Winston Salem, North Carolina
| | - Ann Hurley
- From the Center for Patient Safety, Research, and Practice, Department of Medicine, Brigham and Women's Hospital
| | - Perry An
- Newton-Wellesley Hospital, Newton, Massachusetts
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Polomano RC, Giordano NA, Miyamoto S, Trautman D, Kempf S, Nuzzo PM. Emerging roles for research intensive PhD prepared nurses: Beyond faculty positions. J Prof Nurs 2020; 37:235-240. [PMID: 33674101 DOI: 10.1016/j.profnurs.2020.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 12/18/2022]
Abstract
Research-intensive PhD programs need to prepare nurse scientists to bridge the chasms between research, and practice and policy in an increasingly complex healthcare system. In practice, nurse scientists are critical to building capacity for research, promoting excellence in patient-centered care, and achieving or exceeding national quality benchmarks. Moreover, they provide methodological expertise and insight to address pressing clinical questions. PhD-prepared nurses also leverage their research expertise and practice knowledge to transform health policy in roles as organizational executives and leaders, advocates, and communicators. Re-envisioning nursing PhD curricula is required to ensure that PhD students are capable of not only conducting rigorous and impactful science, but launching careers across sectors of healthcare. Here, we summarize viewpoints of a special session from the October 2019 PhD Summit "Re-Envisioning PhD Programs of the Future" sponsored by the University of Pennsylvania School of Nursing and literature to invigorate thinking about ways to promote career transitions into nontraditional vital positions for nurse scientists. Advancing the health of patients and communities depends on preparing the next generation of nurse scientist to pursue career trajectories outside of traditional academic institutions.
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Affiliation(s)
- Rosemary C Polomano
- Pain Practice, University of Pennsylvania School of Nursing, University of Pennsylvania Perelman School of Medicine, 418 Curie Boulevard, Philadelphia, PA 19104-4217, United States of America.
| | - Nicholas A Giordano
- Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, United States of America
| | - Suzanne Miyamoto
- American Academy of Nursing, 1000 Vermont Avenue NW, Suite 910, Washington, DC 20005-4903, United States of America
| | - Deborah Trautman
- American Association of Colleges of Nursing (AACN), 655 K Street, NW, Suite 750, Washington, DC 20001, United States of America
| | - Sheila Kempf
- Penn Medicine Princeton Health, 1 Plainsboro Road, Plainsboro, NJ 08536, United States of America
| | - Paula Milone Nuzzo
- Massachusetts General Hospital, Institute of Health Professionals, 36 1st Avenue, Boston, MA 02129-4557, United States of America
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