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Development and implementation of a standardized care plan for carotid endarterectomy.

https://arctichealth.org/en/permalink/ahliterature124247
Source
J Vasc Nurs. 2012 Jun;30(2):44-53
Publication Type
Article
Date
Jun-2012
Author
Susanne Svensson
Karin Ohlsson
Christine Wann-Hansson
Author Affiliation
Faculty of Health and Society, Malmö University, and Vascular Centre, Malmö University Hospital, Malmö, Sweden.
Source
J Vasc Nurs. 2012 Jun;30(2):44-53
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Endarterectomy, Carotid - nursing
Evidence-Based Nursing - methods - organization & administration
Humans
Nurse's Role
Patient Care Planning - organization & administration - standards
Postoperative Care - nursing
Preoperative Care - nursing
Quality of Health Care
Sweden
Abstract
Carotid endarterectomy (CEA) is a standardized surgical procedure and is the third most common vascular surgical procedure in Sweden. To improve the quality of pre- and postoperative care for patients undergoing elective CEA, a standardized care plan (SCP) was developed and implemented during Spring of 2007 at a vascular clinic in Sweden. In order to spread light on obstacles and possibilities in the implementation-process of this procedure, the aim was to evaluate the development and implementation process of the standardized care plan for CEA. During the first ten months after the implementation of the SCP for CEA, a review of 83 SCPs was performed. Further, fifteen registered nurses and fourteen assistant nurses answered a questionnaire aimed at evaluating the use of standardized care plans. The review of the used SCP for CEA showed that three out of eighty-four patients had not been cared for in accordance to the SCP and that some of the documentation was redundant and unnecessary. All 29 nurses (100%) reported that they totally or partly agree with the Usability Items. Twenty-four of all nurses (82%) reported that their documentation was restricted by using the SCP; on the other hand, all nurses (100%) agreed that the documentation was easy, saved time, and decreased redundant information. The total sample reported high median scores in the areas of Quality of Care and Implementation (32.0, respectively 13.0), but sixteen nurses (59%) agreed that they mostly relied on their work experience and not the SCP. All nurses generally had a positive attitude towards SCP and felt that these procedures do facilitate their work and improve quality of care. The introduction of SCPs is one important way of implementing evidence-based knowledge and pursuing high quality work.
PubMed ID
22608175 View in PubMed
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Getting evidence-based pressure ulcer prevention into practice: a process evaluation of a multifaceted intervention in a hospital setting.

https://arctichealth.org/en/permalink/ahliterature288301
Source
J Clin Nurs. 2017 Oct;26(19-20):3200-3211
Publication Type
Article
Date
Oct-2017
Author
Eva Sving
Lennart Fredriksson
Lena Gunningberg
Anna-Greta Mamhidir
Source
J Clin Nurs. 2017 Oct;26(19-20):3200-3211
Date
Oct-2017
Language
English
Publication Type
Article
Keywords
Evidence-Based Nursing - methods
Focus Groups
Humans
Nursing Staff, Hospital - psychology
Pressure Ulcer - nursing - prevention & control
Qualitative Research
Quality Improvement
Skin Care - methods
Sweden
Abstract
To describe registered nurses', assistant nurses' and first-line managers' experiences and perceptions of a multifaceted hospital setting intervention focused on implementing evidence-based pressure ulcer prevention.
Pressure ulcer prevention is deficient. Different models exist to support implementation of evidence-based care. Little is known about implementation processes.
A descriptive qualitative approach.
Five focus-group nurse interviews and five individual first-line manager interviews were conducted at five Swedish hospital units. Qualitative content analysis was used.
The findings support that the intervention and the implementation process changed the understanding and way of working with pressure ulcer prevention: from treating to preventing. This became possible as 'Changed understanding enables changed actions - through one's own performance and reflection on pressure ulcer prevention'. Having a common outlook on pressure ulcer prevention, easy access to pressure-reducing equipment, and external and internal facilitator support were described as important factors for changed practices. Bedside support, feedback and discussions on current results increased the awareness of needed improvements.
The multifaceted intervention approach and the participants' positive attitudes seemed to be crucial for changing understanding and working more preventatively. The strategies used and the skills of the facilitators need to be tailored to the problems surrounding the context. Feedback discussions among the staff regarding the results of the care provided also appear to be vital.
It is crucial that dedicated facilitators are involved to promote the implementation process. A preventative mindset should be strived for. Creating an implementation plan with an outcome and a process evaluation should be emphasised. It is important to give the staff regular feedback on the quality of care and on those occasions allocate time for discussion and reflection.
PubMed ID
27875015 View in PubMed
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Nurses' Evidence-Based Practice Beliefs and the Role of Evidence-Based Practice Mentors at University Hospitals in Finland.

https://arctichealth.org/en/permalink/ahliterature280935
Source
Worldviews Evid Based Nurs. 2017 Feb;14(1):35-45
Publication Type
Article
Date
Feb-2017
Author
Hannele Saunders
Katri Vehviläinen-Julkunen
Source
Worldviews Evid Based Nurs. 2017 Feb;14(1):35-45
Date
Feb-2017
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Cross-Sectional Studies
Evidence-Based Nursing - methods
Female
Finland
Humans
Male
Mentoring - methods
Middle Aged
Nurses - psychology
Surveys and Questionnaires
Abstract
Although systematic implementation of evidence-based practice (EBP) is essential to effectively improve patient outcomes, quality, and value of care, nurses do not consistently use evidence in practice. Uptake is hampered by lack of nurses' readiness for EBP, including nurses' EBP beliefs and lack of EBP mentors. Favorable EBP beliefs are foundational to Registered Nurses' (RNs) use and integration of best evidence into clinical decision making, whereas EBP mentors are in a key role for strengthening RNs' beliefs in the value of EBP and confidence in their ability to implement EBP. Although nurses' EBP beliefs and role of BP mentors have been widely studied in countries leading the EBP movement, less is known about them in the non-English-speaking world.
To determine RNs EBP beliefs and the role of EBP mentors at Finnish university hospitals and to explore the associations between RNs' EBP beliefs and sociodemographic factors.
A cross-sectional descriptive survey was conducted in November-December 2014 at every university hospital in Finland with a convenience sample (n = 943) of practicing RNs. The data were collected via an electronic survey, and analyzed using descriptive and inferential statistics.
RNs reported low levels of EBP beliefs in the degree to which they believed that clinical nursing practice and their own practice were based on evidence. EBP mentors worked in many professional nursing roles. Several significant differences were found between RN's EBP beliefs and sociodemographic variables.
Although RNs were familiar with and believed in the value of EBP in improving care quality and patient outcomes, their ratings were low about the degree to which they believed that clinical nursing practice and their own practice were based on evidence, indicating a modest level of individual EBP readiness among Finnish RNs required for integrating best evidence into clinical care delivery.
PubMed ID
28002654 View in PubMed
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Self-efficacy-based training for research literature appraisal: a competency for evidence-based practice.

https://arctichealth.org/en/permalink/ahliterature141745
Source
J Nurses Staff Dev. 2010 Jul-Aug;26(4):170-7
Publication Type
Article
Author
Teri Lynn Kiss
Maureen O'Malley
Thomas J Hendrix
Author Affiliation
School of Nursing, University of Alaska Anchorage, Anchorage, AK 99701, USA. teri.kiss@bannerhealth.com
Source
J Nurses Staff Dev. 2010 Jul-Aug;26(4):170-7
Language
English
Publication Type
Article
Keywords
Alaska
Analysis of Variance
Clinical Competence
Evidence-Based Nursing - methods
Female
Health Knowledge, Attitudes, Practice
Humans
Information Dissemination
Male
Middle Aged
Models, Nursing
Patient-Centered Care
Pilot Projects
Program Evaluation
Self Efficacy
Staff Development - methods
Statistics, nonparametric
Abstract
Evidence-based practice requires nurses to integrate research findings into patient care. The lack of skill and confidence in effective literature appraisal remains a barrier for many nurses. The author describes a self-efficacy-based pilot project designed to enhance nurses' skill and confidence, thus increasing their ability and willingness to critically evaluate research findings. After the intervention, nurses were better prepared to critically appraise the literature and, through enhanced readiness, were more inclined to make evidence-based practice a clinical reality. This approach may be beneficial to staff development educators to develop and enhance an evidence-based practice culture.
PubMed ID
20683302 View in PubMed
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