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.
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Worldviews Evid Based Nurs · Jan 2007
ReviewManagerial leadership for nurses' use of research evidence: an integrative review of the literature.
Integration of research evidence into clinical nursing practice is essential for the delivery of high-quality nursing care. Leadership behaviours of nurse managers and administrators have been identified as important to support research use and evidence-based practice. Yet minimal evidence exists indicating what constitutes effective nursing leadership for this purpose, or what kinds of interventions help leaders to successfully influence research-based care. ⋯ To date, important descriptive work highlights the strategic role managers have in research transfer. Both facilitative and regulatory activities appear to be necessary for managers to influence research use. These findings have important implications for evolving theoretical models describing factors that affect the process of research utilization. It is time to move the science forward and test a hypothesis linking leadership to outcomes. Qualitative methods are essential for understanding the process of leadership for research transfer.
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Worldviews Evid Based Nurs · Jan 2007
ReviewPostnatal debriefing interventions to prevent maternal mental health problems after birth: exploring the gap between the evidence and UK policy and practice.
Postnatal mental health problems range from transient psychological problems to depression, anxiety, psychosis, and post-traumatic stress disorder (PTSD). Debriefing is a structured psychological intervention to prevent postnatal psychological problems, particularly PTSD and depression. Many UK maternity service providers have established postnatal debriefing services, in some cases supported by policy, despite a lack of robust evidence. In this article, current evidence of the effectiveness of postnatal debriefing and the availability and current provision of debriefing offered in UK maternity services is described. ⋯ It might be appropriate to consider offering women an opportunity to discuss their childbirth experience and to differentiate this discussion from the offer of a formal debriefing, which is unsupported by evidence. IMPLICATIONS FOR PRACTICE/CONCLUSION: Midwives and other health care professionals who provide opportunities for women to talk about childbirth should be clear about terms used to describe the intervention, as well as the purpose and content of this. Differentiating between women who perceive their experience of childbirth as traumatic and those who develop symptoms of PTSD (for whom specific treatment may be required) is important. All health care professionals should be aware of the signs and symptoms of mental health problems after birth, which may include depression, anxiety, or psychosis in addition to PTSD.