25 Aug Do you think it is reasonable to expect nurses to stay current regarding new research/Evidence-Based Practice findings in their area of practice?
lease read the attached article and answer the question below:
Do you think it is reasonable to expect nurses to stay current regarding new research/Evidence-Based Practice findings in their area of practice? Or is this an agency/organization responsibility?
Requirements: one paragraph
IntroductionBackground:Thisstudyaimedtoidentifyclinicalnurses’evidence-basedpractice(EBP)knowledge,beliefs,organizationalreadiness,andEBPimplementationlevels,andtodeterminethefactorsthataffectEBPimplementationinordertosuccessfullyestablishEBP.Thisstudywasconductedatauniversity-affiliatedtertiaryhospitallocatedinaprovincialareainKorea.TheresearchdesignwasbasedonMelnykandFineout-Overholt’sAdvancingResearch&ClinicalPracticethroughCloseCollaborationmodelasthefirststep.Methods:Adescriptiveandcross-sectionaldesignwasconductedandaconveniencesampleof521full-timeregisterednursesfroman849-bedtertiaryhospitalwereincluded.StructuredquestionnaireswereusedtoassessEBPknowledge,EBPbeliefs,organizationalculture&readinessandEBPimplementation.DatawereanalyzedusingSPSSV25.0byusingdescriptiveandinferentialstatisticsandhierarchicalmultipleregressionwasperformedtodeterminethefactorsaffectingtheimplementationofEBP.Results:OurfindingsshowedthattheclinicalnurseshadapositivelevelofEBPbeliefs,butthelevelofEBPknowledge,organizationalreadinessandEBPimplementationwereinsufficient.EBPknowledge,beliefs,andorganizationalreadinessweresignificantlypositivelycorrelatedwithEBPimplementation.Inthefinalmodel,EBPknowledgeandorganizationalreadinessweresignificantpredictorsofEBPimplementation;themodelpredicted22.2%ofthevarianceinimplementation.Conclusions:Basedontheseresults,themainfocusofthestudywastheimportanceofindividualnurses’effortsincarryingoutEBP,butabovealleffortstocreateanorganizationalculturetoprepareandsupportEBPatthenursingorganizationlevel.IntheinitialprocessofintroducingandestablishingEBP,nurseadministratorswillneedtominimizeexpectedbarriers,enhancefacilitators,andstrivetobuildaninfrastructurebasedonvision,policy-making,budgeting,excellentpersonnelandfacilitieswithintheorganization.Evidence-basedpractice(EBP)isaproblem-solvingapproachtoclinicalcarethatincorporatestheconscioususeofthebestavailablescientificevidence,clinicians’expertise,andpatients’values[[1]].Thisleadstosafepatientcareandpositivepatientoutcomes,reducesnursingtimeandmedicalcoststhroughstandardizationofnursingpractice[[2]–[5]].Italsoimprovesprofessionalautonomyandjobsatisfactionforclinicalnurses,ultimatelybringingpotentialbenefitstopatients,nursesandthehealthcaresystem[[6]–[8]].Forthisreason,EBPhasemergedasacentralconceptintheplanningandimplementationofhealthcaresystemsworldwide.AsEBPrapidlyreplacesthetraditionalparadigmofauthorityinhealthcaredecision-making,healthprofessionalshaveanobligationtoaccessknowledge,applyitinpractice,andleadotherstouseitappropriately[[8]–[10]].Westerncountries,suchastheUnitedStates(US),UnitedKingdom(UK),andAustralia,haveemphasizednursingthroughEBPsincethe1990s,andthereareactivemovementssuchasdevelopingevidence-basedguidelinesprovidingvariousresourcesrelatedtoEBPfromorganizationsspecializedinEBP(Cochrane,JoannaBriggsInstitute,etc.)[[11]].Inaddition,theInstituteofMedicinepresentedEBPcompetencyasoneofthefivecorecompetenciesofhealthcareprofessionals[[13]],andtheAmericanAssociationofCollegesofNursingalsopresentedEBPasoneofthenineessentialelementsofprofessionalnursingpractice[[14]].Overthepast30years,therehasbeenmarkedtheoreticalandpracticalgrowthassociatedwithEBP,includingeducationandtrainingforEBPinnursingpractice,andresearchconductedincludingvariousfacilitationstrategies[[9],[15]].InKorea,however,EBPinnursingwasfirstintroducedintheearly2000s[[16]].AwarenessontheimportanceofEBPhasspreadaroundmajorlargetertiaryhospitalsinSeoul,buttheactualperformanceofEBPhasbeenreportedtobepooroutsideofthemetropolitanarea[[17]–[19]].Astudyinvolving437nursesattertiaryhospitalsconductedin2004,whichwastheveryfirsttimetheconceptofEBPwasintroducedinKorea,foundthat58%ofnursesdidnotperformnursingpracticeaccordingtothelatestguidelines[[20]].KoreannurseswerereportedtobeunderperformingEBPuntilrecently[[19]].In2013,only12ofthe30tertiaryhospitalssurveyed(40.0%)wereorganizedbyEBPcommitteesandwereconductingEBP-relatedclinicalnursingstudies[[18]].Althoughvariouseffortshavebeenmadeto
promoteEBPinKoreainrecentyears,itisapparentthatinstitutionalsupportforEBPisnotsystematicandinsufficientthroughoutthecountry.BarrierstoconductingEBPforKoreannursesinclude:thelackofknowledgeandskills,lackofbeliefandcapacity,lackofdatabaseaccessandutilization,andinsufficientcriticalthinkingandmotivation[[20]–[22]].ThebarrierstoconductingEBPinKoreaattheorganizationallevelareorganizationalculture,insufficienteducationprograms,lackofwell-trainedEBPexperts,lackoftime,andinadequatecommunication[[20],[23]].WhileEBPisavaluableconcept,itisdifficultforanursetoimplementitfirstbeforeanursingorganizationembracesthisnewconcept[[24]].Therefore,forasuccessfulimplementationofEBP,thereadinessofanindividualnurseandorganizationmustbeassessed.First,EBPimplementationisinfluencedbytheknowledge,skills,andbeliefsoftheindividualnurseonEBP[[22],[25]].Attheorganizationallevel,itisnecessarytocreateanorganizationalculturethatstrengthensandsupportsthenurse’svaluesandbeliefsonEBP,andtosharethecommonbeliefsorvaluesofitsmemberstoachievethecommongoalofsuccessfulimplementationofEBP[[12],[27]].ItisalsoimportanttoprovidetrainingprogramsfornursestostrengthentheirEBPcapabilitiesandtofosterleaderswhocaneffectivelyleadEBPimplementation[[7],[28]].TherearevariousstrategicmodelsforsuccessfulEBPimplementation[[15]].TheAdvancingResearchandClinicalPracticethroughCloseCollaboration(ARCC©)modelproposedbyMelnykandFineout-Overholt[[24]]isarepresentativestrategicmodelthatemphasizespersonalandorganizationalelements.TheARCC©,astrategicmodeldevelopedbytheEBPcenteroftheUniversityofArizonaintheUS,proposestheuseofmethodologicalstrategiestopromotetheimplementationofEBPbasedontheclosecooperationbetweenclinicalnursesandresearchers[[24]].ThefirststepintheARCC©modelistoassesstheorganizationalcultureandreadinessofthemedicalinstitutiontosuccessfullyestablishEBP.Thiswillhelpidentifythestrengthsandbarriersoftheorganizationandimprovethenurses’knowledgeon,beliefregarding,andcapacitytoadoptandimplementEBPthrougheducationandtraining,environmentalimprovement,andorganizationalsupportwhilefocusingonmentorswhoactasfacilitatorsintheperformanceofEBP[[24],[30]].SuccessfulimplementationofEBPcanincreasethejobsatisfactionofprofessionalnursesandultimatelyimprovenursing-sensitiveoutcomes[[6],[31]].TheconceptualframeworkinthisstudywasconstructedbasedontheARCC©model.Todate,onlyafewstudieshaveevaluatedthelevelofpreparation,correlation,andinfluencingfactorsofEBPimplementationamongindividualnursesandorganizationsinKorea.Thisstudywasconductedatauniversity-affiliatedtertiaryhospitallocatedinaprovincialareainKorea,asthefirststepinimplementingEBPinaccordancewiththeARCC©model.Thisstudyaimedtoidentifytheclinicalnurses’EBPknowledge,beliefs,organizationalreadiness,andEBPimplementationlevels,andtodeterminethefactorsthataffectEBPimplementationinordertosuccessfullyestablishEBP.Thespecificobjectivesofthisstudywereasfollows:●Toidentifytheclinicalnurses’EBPknowledge,beliefs,organizationalreadiness,andEBPimplementationlevels●Toexaminethedifferencesinclinicalnurses’EBPknowledge,beliefs,organizationalreadiness,andEBPimplementationlevelsbasedonthegeneralandresearch-relatedcharacteristicsofparticipantsandexploretherelationshipsamongthesevariables●ToidentifythefactorsthataffectEBPimplementationMethodsStudydesignandparticipantsThiswasacross-sectional,descriptivestudy.Theparticipantswererecruitedfroman849-bedacutecaretertiaryhospitalinSouthKorea.Conveniencesamplingwasusedtoselectfull-timeregisterednurses
employedatthishospital.ThesamplesizerequiredforthemultipleregressionanalysiswascalculatedusingG-Power3.1[[33]],withaneffectsizeof0.02,significancelevelof0.05,andtestpowerof0.80with14predictors.Itwasdeterminedthatatleast485participantswererequiredforanalysis.However,thisstudywasthefirststepinvolvedintheARCC©model,andallnursesweresurveyedtoidentifythecurrentstateofnursesbelongingtotheabovementionedhospital.Amongthe632registerednurses,82ofthefollowingnurseswereexcludedfromthesurvey:1)part-timenurses,2)nursesparticipatingintrainingfornewnurseswithoutfull-timeassignmentsinthehospital,and3)laboratoryandresearchnursesnotinvolvedwithdirectpatientcare.Atotalof550questionnairesweredistributed;521werereturned(94.7%responserate).Finally,521whofullyunderstoodthepurposeofthisstudyandvoluntarilyconsentedtoparticipatewereincluded.Participantsincludedclinicalnursesworkinginthewardsandspecialunits,clinicalnursespecialists,nursemanagers,andnurseadministrators.MeasurementsThisstudyusedstructuredquestionnaires,consistingofthefollowingitems:generalandresearch-relatedcharacteristics(13),EBPknowledge(14),EBPbeliefs(16),organizationalreadinessforEBP(25),andEBPimplementation(18).ThemeasurementsusedinthisstudywereapprovedbytheoriginalauthorsandtranslatedversionsintoKoreanhavealreadybeenusedinthepreviousstudies[[19],[22],[34]].However,researchershavemodifiedandsupplementedsomeoftheitemswithwordsorexpressionsthatarecommonlyusedbynursesinthishospitalwherethestudywasconducted.Priortothesurvey,apilottestoffiveclinicalnursesidentifiedandrevisedproblematicquestionnaireitems.Thedetailsofthemeasurementsforeachvariableareasfollows.EBPknowledgeParticipants’knowledgeinimplementingEBPwasmeasuredusingknowledge-relatedquestionsfromtheEvidence-basedPracticeQuestionnaire,developedbyUpton&Upton[[35]].Thistoolconsistsof14items,including”convertingyourinformationneedsintoaresearchquestion”and”abilitytoanalyzecritically,evidenceagainstsetstandards.”Responsescoresonthescalerangefrom1(verylacking)to7(excellent).Possibletotalscoresrangefrom14to98points,withhigherscoresindicatinghigherlevelsofknowledgeregardingEBP.Atthetimeofitsdevelopment,theCronbach’salphaofthetoolwas0.91[[35]]and0.93forKoreannurses[[19]].Inthisstudy,theCronbach’salphawasfoundtobe0.83.EBPbeliefsParticipants’beliefsinvaluingEBPweremeasuredusingtheEvidence-basedPracticeBeliefs(EBPB)tool,developedbyMelnykandcolleagues[[36]].Thistoolconsistsof16questions.ExamplesoftheitemsintheEBPBinclude”IamsurethatIcanimplementEBPinatimeefficientway”and”Iamsureabouthowtomeasuretheoutcomesofclinicalcare.”Eachquestionisratedonafive-pointLikertscale(1=stronglydisagree,5=stronglyagree),butscoringforitems11and13wasreversed.Possibletotalscoresrangefrom16to80points,withhigherscoresindicatingpositiveEBPbeliefs.Atthetimeofitsdevelopment,theCronbach’salphaofthetoolwas0.90[[36]]and0.88forKoreannurses[[34]].Inthisstudy,theCronbach’salphawasfoundtobe0.81.OrganizationalreadinessforEBPTheorganization’scultureanditsreadinessforsystem-wideEBPimplementationweremeasuredusingtheOrganizationalCultureandReadinessScaleforSystem-WideIntegrationofEvidence-BasedPractice(OCRSIEP)[[27]].TheOCRSIEPscalewasdevelopedtomeasurethelevelsofreadinessinperformingEBP,attheorganizationallevel,andconsistsof25questionsthatofferinsightsintothestrengthsofand
opportunitiesrelatedtofosteringEBP.Possibletotalscoresrangefrom25to125points,indicatingthatthehigherthescore,thebettertheorganizationalreadinessandculturalcultivationforimplementingEBP.Thefollowingquestionsareasked:”TowhatextentisEBPclearlydescribedascentraltothemissionandphilosophyofyourinstitution?”and”TowhatextentisthenursingstaffwithwhomyouworkcommittedtoEBP?”Atthetimeofitsdevelopment,theCronbach’salphaofthetoolwas0.94[[27]]and0.95forKoreannurses[[22]].Inthisstudy,theCronbach’salphawasfoundtobe0.87.EBPimplementationThefrequencyofperformingEBP-relatedactivitieswasmeasuredusingtheEvidence-BasedPracticeImplementationtool,developedbyMelnykandcolleagues[[36]].Thistoolconsistsof18questionspertainingtohowoften,inthelast8weeks,participantsperformedcertainEBPactivities,suchas”GeneratedaPICOT(P=patient,I=intervention,C=comparison,O=outcome,T=time)questionaboutmyclinicalpractice,””AccessedtheNationalGuidelinesClearinghouse,”and”Evaluatedacareinitiativebycollectingpatientoutcomedata.”Responsesonthescalerangefrom0(0times)to4(over8times).Thepossibletotalscoresrangefrom0to72points,withhigherscoresindicatinghigherlevelsofcommitmenttoimplementingEBP-relatedactivities.Atthetimeofitsdevelopment,theCronbach’salphaofthetoolwas0.96[[36]]and0.95forKoreannurses[[22]].Inthisstudy,theCronbach’salphawasfoundtobe0.81.DatacollectionandethicalconsiderationsTheInstitutionalReviewBoard(IRB)approvalwasobtainedpriortodatacollectionfromtheauthors’institution(no.2-1041055-AB-N-01-2018-10,ChosunUniversityInstitutionalReviewBoard).DatawerecollectedfromDecember2017toJanuary2018.Fordatacollection,wecontactedanurseadministratoratChosunUniversityHospitalandexplainedthepurposeofthisstudy.ChosunUniversityHospitalisaprivateuniversity-affiliated,tertiarycarehospitallocatedinGwangjucity,SouthKorea.ItislocatedinGwangjuMetropolitanCityinthesoutherndistrictofKoreaandisinchargeofmedicalservicesinJeollaprovince.Thehospitalconsistsof849beds,with25medicaldepartmentsinoperation,including15generalwards,4intensivecareunits,regionalemergencymedicalcenter,operatingrooms,outpatientdepartments,andlaboratories.Aresearchervisitedthehospitaltoexplainthepurposeofthisstudyaswellastheinclusioncriteriatothenurseunitmanagers,duringasupervisormeeting.Thequestionnaireswereenclosedindifferentenvelopesforeachwardanddistributedbythestaffandassistantsofthenursingeducationteamwhodidnotparticipateinthissurvey.Thecollectionboxesweremadeanddistributedtoeachward,andnurseswereallowedtosubmitquestionnairesvoluntarilyatanytime.Toensureanonymityoftheparticipants,theconsentformwasgiveninwritingwithamarkornumbersthatcouldonlybeknowntothemselves.Therefore,allnurses,whosequestionnaireswerecollected,wereconsideredtohaveparticipatedinthisstudyoftheirownwill.StatisticalanalysisDataanalysiswasperformedusingSPSSV25.0.Descriptivestatistics,includingthemeans,standarddeviations,frequencies,andpercentages,wereusedtodescribetheparticipants’generalandresearch-relatedcharacteristics,andEBP-relatedvariables.Differencesbetweenmajorvariables,byparticipants’characteristics,wereanalyzedthroughindependentt-tests,analysisofvariance,andScheffetest.TherelationshipsbetweenmajorvariableswereanalyzedusingPearson’scorrelationcoefficient.HierarchicalmultipleregressionwasperformedtodeterminethefactorsaffectingtheimplementationofEBP.
ResultsGeneralandresearch-relatedcharacteristicsoftheparticipantsTable1presentstheparticipants’characteristics.Themeanageofallparticipantswas31.9±9.2years,with58.9%aged21to30.Theiroverallclinicalexperiencewas9.0+4.2y
