Worldviews on evidence-based nursing
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Worldviews Evid Based Nurs · Jan 2008
Multicenter Study Clinical TrialEffectiveness of a computer-based educational program on nurses' knowledge, attitude, and skill level related to evidence-based practice.
To conduct a baseline assessment of nurses' perceptions of knowledge, attitude, and skill level related to evidence-based practice (EBP) and research utilisation; determine the level of organisational readiness for implementing EBP and research; and examine the effectiveness of a computer-based educational program on nurses' perceptions of knowledge, attitude, and skill level related to EBP and research utilisation. ⋯ Nurses in clinical settings need to be able to use research findings and incorporate EBP into their nursing practice to promote positive patient outcomes. Appropriate organisational infrastructures are essential for promoting EBP and research utilisation in clinical settings. Diverse and effective methods are essential in educating and engaging nurses in EBP and research utilisation. Computer-based education is an effective approach that can be used by nursing leaders in health care organisations to educate and engage nurses in EBP initiatives and research utilisation.
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Worldviews Evid Based Nurs · Jan 2008
Multicenter StudyRegistered nurses' adherence to clinical guidelines regarding peripheral venous catheters: a structured observational study.
Peripheral catheterization is a common procedure, which affects numerous patients in health care today. Having peripheral venous catheters in situ might lead to complications such as thrombophlebitis and sepsis, and clinical guidelines have been developed to assist nurses in their decision-making. Several reasons are given for clinicians not always adhering to clinical guidelines, although such adherence might lead to fewer complications. ⋯ Nurses partly adhered to clinical guidelines. Differences in guideline adherence were observed for wards with local or national guidelines, as well as for wards with different specialities. In accordance with clinical guidelines, the nurses seemed to replace or remove peripheral venous catheters before any severe complications arose. IMPLICATIONS FOR PRACTICE, RESEARCH, AND MANAGEMENT: Adherence to clinical guidelines has an impact for preventing patient complications and thus it is essential that nurses are aware of their existence. Feedback and discussions of guideline adherence or of complication rates might influence nurses' clinical decision-making.
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Worldviews Evid Based Nurs · Jan 2008
ReviewVentilator-associated pneumonia bundled strategies: an evidence-based practice.
Ventilator-associated pneumonia (VAP) is an ongoing challenge for critical care nurses as they use current evidence-based strategies to decrease its incidence and prevalence. Mechanical intubation negates effective cough reflexes and impedes mucociliary clearance of secretions, causing leakage and microaspiration of virulent bacteria into the lungs. VAP is responsible for 90% of nosocomial infections and occurs within 48 hours of intubation. VAP is a major health care burden in terms of mortality, escalating health care costs, increased length of ventilator days and length of hospital stay. ⋯ Methodologically robust randomized controlled trials are required to examine the efficacy of VAPBs and determine causality between VAPBs and clinical outcomes. Organizational commitment is needed to adopt a conceptual framework that promotes effective knowledge translation, incorporating factors of evidence, context, and facilitation of VAPBs into clinical settings. Instituting nurse-led intervention champion leaders to facilitate reliable and consistent implementation of VAPBs into practice is warranted.