ABSTRACT
Introduction: Evidence-based practice (EBP) has been recognized as the gold standard for safe and high quality care. Nurse leaders have a strategic position in terms of initiating changes in clinical settings for successfully implementing EBP. Therefore, the factors that influence implementing EBP must be measured. Aims: To examine nurse leaders’ attitudes, self-efficacy, and training needs for implementing evidence-based practice. Place and Duration of Study: Four teaching hospitals affiliated to Kerman University of Medical Sciences in the southeast of Iran from January to April 2014. Methods: A cross-sectional study was conducted on 70 nurse leaders from four teaching hospitals. After using a modified forward/backward translation procedure to create a Persian version of "perceptions of nurses of evidence-based practice questionnaire", data were collected from the participants and analyzed using SPSS (version 20), descriptive statistics, Student’s t-test, analysis of variance (ANOVA), and Pearson’s correlation. Results: Most (82.86%) of the participants had not attended any specific training course on the implementation of EBP and 80% had not been involved in any research activities. Nurse leaders’ attitudes toward EBP were unfavorable (mean=2.55±0.88), their levels of self-efficacy in EBP skills were weak (mean=2.64±1.31), and their demand for training in all of the EBP areas was moderate (3.89±.97). Conclusion: Current practice of nurse leaders is not evidence-based, which is worrisome and can result in serious deficiencies in the quality and safety of nursing care. Nurse leaders must attempt to equip themselves with the attitudes and skills required to change in practice using EBP.
ABSTRACT
Introduction: Clinical governance is a framework through which health organizations are accountable to improve the quality of their services continuously and safeguard high standards of care by creating an environment in which excellence in clinical care will be flourished. Since clinical governance approach has been introduced to Iranian hospitals for more than half a decade, and clinical staff have a very important role in implementing and organizing clinical governance, this study aimed to evaluate the clinical staff's attitude toward clinical governance, barriers, facilitating factors, and outcomes of implementing and organizing this approach
Method: The present study was a descriptive analysis conducted in a cross-sectional method at a hospital affiliated with Kerman University of Medical Sciences in 2014. Data were collected using a five-part researcher-made questionnaire [demographic characteristics, attitude, barriers, facilitating factors, and outcomes of clinical governance]. Sampling was conducted by the census method, and 147 people of clinical staff participated in the study. Descriptive statistic [percentage, mean, and standard deviation] and analytic statistic [t-test, analysis of variance, and Pearson's correlation coefficient] have been used. SPSS version 20 software was used for data analysis
Results: The results showed that 73.5% of staff had a background of participation in educational programs of clinical governance. Clinical staff's attitude toward clinical governance was moderate [3.18+/-1.21], and also barriers, facilitating factors, and outcomes were in moderate level. The staff claimed that the biggest barriers were the increasing bureaucracy, regulations, and paperwork [4.01 +/-1.91]. The most important facilitating factor was educational programs, such as seminars and workshops [3.77+/-1.20], and the most important outcome of clinical governance was to prevent errors and mistakes in the way of service and learning from them [3.48 +/- 1.95]
Conclusion: Since the implementation of clinical governance is complex and dynamic, successful implementation and organization of clinical governance require a strategic plan proportional to the structure, location, and facilities of Iranian hospitals based on its barriers, facilitating factors and its constructive outcomes