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BACKGROUND: Evidence-based practice (EBP) is a cornerstone for safe, high-quality care. Implementation science recognizes that many factors influence the successful use of EBP, from attitudes and beliefs, self-efficacy, and knowledge and skills to contextual factors related to unit and organizational culture. This integrative review aimed to identify valid and reliable instruments measuring critical EBP domains with nursing professionals. METHODS: A systematic search of the literature was conducted. CINAHL, PubMed, EMBASE, Cochrane, and Joanna Briggs were searched to identify original research publications testing the reliability and validity of EBP nursing instruments. RESULTS: Of 347 records, 48 studies representing 50 instruments were identified as having undergone psychometric testing, thus meeting the inclusion criteria. Most instruments were validated in English-speaking countries. Content validity, construct validity, and internal consistency standards were met for 70%, 62%, and 94% of instruments, respectively. Limited testing was found for other types of validity, test-retest reliability, acceptability, feasibility, or responsivity and sensitivity, thus representing gaps in psychometric validation. Less than 20% of instruments have been translated to other languages limiting their use to advance EBP worldwide. LINKING EVIDENCE TO ACTION: Eighty-two percent of instruments met minimal psychometric standards and are sound for education, practice, and research. Expanding psychometric testing and utilizing validated EBP instruments will further the EBP movement to improve global population health.
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BACKGROUND: Few objective measures of evidence-based practice (EBP) knowledge/skill exist. The Fresno Test, one objective method, was validated first with medicine, followed by versions for physical therapists, occupational therapists, speech therapists, social workers, dietitians, pediatric nurses, and health care students. The Fresno Test was adapted and tested with cohorts of acute care nurses. Six of the 14 items required revision to achieve acceptable psychometrics. AIM: The aim of this second validation study was to revise and validate a new version of the test, The Modified Fresno Test-Acute Care Nursing (MFT-ACN), to determine if it could distinguish EBP knowledge/skills among acute care nurses. METHODS: A panel of eight EBP experts were engaged in multiple Delphi rounds to revise items. Individual-content validity indices (CVI) ranged from 0.83 to 1.0, with scale-CVI 0.92. Using a cohort design, a cross-sectional sample of 90 novice, master, and expert nurses were recruited via national listservs or snowball sampling to complete the revised test. Two doctorally prepared EBP experts independently scored tests using the standardized rubric. RESULTS: The MFT-ACN yielded strong psychometric properties (intra-class correlation coefficients > 0.80; item discrimination indices > 0.20; item-total correlations > 0.30). One poorly performing item was dropped per a priori cut-off values. The final test included 13 items, with a Cronbach's alpha = 0.77. Item difficulty was moderate to high. Most items discriminated well between cohorts. Mean total scores were positively correlated with age, years since graduation, years of acute care experience, and formal EBP or research workshops or conferences or courses or immersions. Perceived level of EBP expertise was not associated with mean scores. Further research is recommended with a larger sample to assess the tests' responsiveness to change in EBP knowledge/skills over time and enhance its acceptability and feasibility. Additional research should further evaluate construct and concurrent validity against other objective assessments of EBP knowledge/skills. LINKING EVIDENCE TO ACTION: The validated 13-item MFT-ACN can be used to evaluate EBP competencies of acute care nurses in academic and practice settings. It can also be used by nurse scientists to build a stronger evidence base on types of educational programs that excel in advancing the critical competency of EBP among our nursing workforce.
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Avaliação Educacional , Enfermeiros Pediátricos , Criança , Humanos , Psicometria/métodos , Avaliação Educacional/métodos , Estudos Transversais , Inquéritos e Questionários , Reprodutibilidade dos Testes , Prática Clínica Baseada em Evidências/educação , Competência ClínicaAssuntos
Antimaláricos/efeitos adversos , Cloroquina/efeitos adversos , Infecções por Coronavirus/tratamento farmacológico , Hidroxicloroquina/efeitos adversos , Pneumonia Viral/tratamento farmacológico , Antimaláricos/uso terapêutico , Betacoronavirus , COVID-19 , Cloroquina/uso terapêutico , Cardiopatias/induzido quimicamente , Mortalidade Hospitalar , Humanos , Hidroxicloroquina/uso terapêutico , Pandemias , SARS-CoV-2Assuntos
Hospitalização , Úlcera por Pressão/prevenção & controle , Bandagens , Fricção , Humanos , Dispositivos de Compressão Pneumática Intermitente , Intubação/instrumentação , Máscaras/efeitos adversos , Oxigenoterapia/instrumentação , Fatores de Risco , Higiene da Pele , Traqueostomia/instrumentaçãoAssuntos
Enfermagem de Cuidados Críticos/normas , Estado Terminal/enfermagem , Diários como Assunto , Unidades de Terapia Intensiva/normas , Guias de Prática Clínica como Assunto , Adulto , Idoso , Idoso de 80 Anos ou mais , Enfermagem de Cuidados Críticos/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-IdadeAssuntos
Estado Terminal/enfermagem , Família/psicologia , Narração , Recursos Humanos de Enfermagem Hospitalar/psicologia , Pacientes/psicologia , Fatores Etários , Transtornos Cognitivos/epidemiologia , Estado Terminal/psicologia , Humanos , Unidades de Terapia Intensiva , Saúde Mental , Fatores Sexuais , Fatores SocioeconômicosRESUMO
Sustaining a clinical excellence culture for Magnet® redesignation requires continued engagement of frontline nurses, nurse leaders, and executives. Appreciative Inquiry is a strength-based approach emanating from a positive core. From this core, teams discover, dream, design, and create their preferred destiny. This article describes how a Magnet-designated organization used Appreciative Inquiry to revitalize its redesignation preparation and beyond.
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Competência Clínica , Liderança , Recursos Humanos de Enfermagem Hospitalar/organização & administração , Garantia da Qualidade dos Cuidados de Saúde , Humanos , Satisfação no Emprego , Avaliação de Resultados em Cuidados de Saúde , Estados UnidosRESUMO
BACKGROUND: Proficiency in evidence-based practice (EBP) is essential for relevant research findings to be integrated into clinical care when congruent with patient preferences. Few valid and reliable tools are available to evaluate the effectiveness of educational programs in advancing EBP attitudes, knowledge, skills, or behaviors, and ongoing competency. The Fresno test is one objective method to evaluate EBP knowledge and skills; however, the original and modified versions were validated with family physicians, physical therapists, and speech and language therapists. AIMS: To adapt the Modified Fresno-Acute Care Nursing test and develop a psychometrically sound tool for use in academic and practice settings. METHODS: In Phase 1, modified Fresno (Tilson, 2010) items were adapted for acute care nursing. In Phase 2, content validity was established with an expert panel. Content validity indices (I-CVI) ranged from .75 to 1.0. Scale CVI was .95%. A cross-sectional convenience sample of acute care nurses (n = 90) in novice, master, and expert cohorts completed the Modified Fresno-Acute Care Nursing test administered electronically via SurveyMonkey. FINDINGS: Total scores were significantly different between training levels (p < .0001). Novice nurses scored significantly lower than master or expert nurses, but differences were not found between the latter cohorts. Total score reliability was acceptable: (interrater [ICC (2, 1)]) = .88. Cronbach's alpha was 0.70. Psychometric properties of most modified items were satisfactory; however, six require further revision and testing to meet acceptable standards. LINKING EVIDENCE TO ACTION: The Modified Fresno-Acute Care Nursing test is a 14-item test for objectively assessing EBP knowledge and skills of acute care nurses. While preliminary psychometric properties for this new EBP knowledge measure for acute care nursing are promising, further validation of some of the items and scoring rubric is needed.
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Educação em Enfermagem/normas , Avaliação Educacional/métodos , Psicometria/normas , Competência Clínica/normas , Estudos de Coortes , Estudos Transversais , Educação em Enfermagem/métodos , Prática Clínica Baseada em Evidências/métodos , Prática Clínica Baseada em Evidências/normas , Humanos , Psicometria/instrumentação , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
In our journey from Magnet designation to a Lean hospital, a team of advanced practice nurses, a nurse scientist, and Lean specialists developed a crosswalk of evidence-based practice (EBP) with Lean to explicitly embed the use of evidence in our organization's 4-step problem-solving method. Once finalized, the blended Lean-EBP model now guides improvement work as highlighted in the example of updating our practice for frequency of changing peripheral intravenous catheters.
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Eficiência Organizacional , Prática Clínica Baseada em Evidências , Avaliação de Processos em Cuidados de Saúde , Prática Avançada de Enfermagem/métodos , Atitude do Pessoal de Saúde , Humanos , Objetivos Organizacionais , Melhoria de QualidadeRESUMO
BACKGROUND: Caring for coronary artery bypass (CABG) surgery patients can be challenging. No studies have explored caregiver burden by age and gender. OBJECTIVE: To describe age and gender-specific concerns, needs and strategies during the first 3 months. METHODS: Themes for burden concerns, needs and strategies were derived from interviews of 32 CABG caregivers using constant comparative analysis. RESULTS: Age-specific themes related to motivating exercise (<70), applying support hose, and self-reliance (>70). Gender-specific themes related to incision worries and transportation (all females); regulating blood sugars, vital sign anxiety, hurrying back, reinforcing healthy behaviors, and being there (females <70); meal planning, coordinating appointments, and anger over self-care reminders (females >70); caregiver relief, inconsistent information, and doing it all (all males); upsetting scars (males <70), and lost sleep (male >70). CONCLUSIONS: Future research should validate concerns in diverse samples so interventions can be targeted to support male and female caregivers by age groups.