ABSTRACT
BACKGROUND: The Veterans Health Administration's Office of Nursing Services launched several initiatives to support evidence-based practice (EBP) initiatives throughout its system. From evaluation of these initiatives and reflection on discussions with nurse leaders and direct care nurses, our thinking about and approach to EBP has evolved from a project-focused to a practice-focused interpretation. PURPOSE: (a) Offer an expanded view that moves beyond interpreting EBP as process-driven projects to a "way of practicing" where nurses assume ownership for a practice that integrates best available evidence, clinical expertise, and patient preferences, and (b) describe and generate discussion on the educational, cultural, and role modeling implications of this expanded view. METHODS: We illustrate EBP integration using a point-of-care interaction scenario. CONCLUSION: Commitment to EBP is reflected at the point-of-care where each nurse demonstrates the ability to integrate evidence-based interventions, patient preferences, and clinical expertise to arrive at patient-centric health care decisions.
Subject(s)
Attitude of Health Personnel , Evidence-Based Nursing/organization & administration , Hospitals, Veterans/organization & administration , Nursing Staff, Hospital/psychology , Organizational Culture , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , United States , United States Department of Veterans AffairsABSTRACT
To study the influence of psychosocial resources on psychological recovery after heart transplantation, 28 patients were surveyed during their hospitalization after transplant surgery and 6 months posttransplantation. Scales from the Coping With Serious Illness Battery were used to measure psychosocial resources (social support and personal control) and psychological and functional outcomes. Psychosocial resources assessed during hospitalization were associated with recovery outcomes at 6 months posttransplantation. Personal control was positively correlated with optimism, well-being, and satisfaction with life (r = .41 to .49) and negatively correlated with anger (r = -.57) and depression (r = -.52). Social support network helpfulness and attachment with others were correlated with psychological outcomes (r = .41 to .59) and functional outcome (r = .42 to .47). Efforts directed toward enhancing perceptions of personal control, social support network helpfulness, and attachment may be useful for promoting psychosocial recovery.
