RESUMO
BACKGROUND@#By current estimates, it takes 17 years to adopt a new evidence-based practice (EBP) intervention. Nursing efforts to increase EBP adoption typically focus on education. But, there is a research gap in that there is a lack of evidence to support that education impacts the adoption of evidence-based practice. This study explored factors associated with adopting quantitative pupillometry (QP).@*METHODS@#This longitudinal, retrospective study used registry data to calculate QP usage rates between 2015 and 2021. Events and interventions hypothesized to increase EBP adoption were identified through stakeholder interviews and literature search. Events were categorized as: conference presentations, publications, education, new study sites, QP adoption on other nursing units, equipment purchase, and policy changes. Scatterplots and Spearman's Rho were used to examine the relationship between time and usage rate of QP. Odds ratio analyses were conducted to explore the relationship between the selected event types and changes in usage rate from month-to-month.@*RESULTS@#Using 74,428 QP observations from 3,976 patients, there was a significant positive relationship between usage rate of QP and time (r = .642, P < .0001). However, there was no statistically significant odds of any event-type (alone or in combination) impacting the rate of QP adoption.@*CONCLUSION@#Time was the only independent variable significantly associated with an increase in EBP adoption for this intervention. Common methods used to accelerate nursing adoption of EBP may have limited effect.
RESUMO
The purpose of this study was to explore the inter-device reliability of NPi-100 pupillometers (NeuroOptics, Inc.). The pupillary examination is a fundamental element of the neurological exam. Current evidence suggests that the traditional examination of the pupil with a hand held flashlight has limited inter-rater reliability. Automated pupillometers were developed to provide an objective scoring of pupil size and reactivity. However, there are no data examining inter-device reliability of automated pupil assessments. This study included 210 paired pupillometer measurements were obtained by 33 practitioners from 20 patients at risk for cerebral edema. There was no statistically significant difference between the mean maximum pupil size at rest, the minimum pupil size during light stimulation, and the mean pupil reactivity, for both the right and left eye, when assessed by two investigators, each with a different pupillometer. In addition, Cohen's Kappa assessments of pupil size and reactivity revealed an almost perfect agreement between the two pupillometers for the maximum pupil size, the minimum pupil size, and for pupil reactivity for both eyes. There is a high inter-device reliability of automated pupillary assessments by two practitioners examining the same patient using different NPi-100 pupillometers.
