Factors influencing the continuity of evidence-based practice in perioperative airway management for elderly patients with fractures:A qualitative study

BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.AIM To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.METHODS This study was qualitative research.Nine nurses who implemented evidencebased practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects.Semi-structured interviews were conducted with them,and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.RESULTS Three main themes and ten subthemes were identified:Process aspects(benefits to patients,benefits to nurses,lack of follow-up,complex processes);staff aspects(insufficient human resources,inadequate training and education,lack of leadership support);and organizational environment aspects(inadequate infrastructure,poor patient compliance,poor doctor cooperation).CONCLUSION Human resources,training and education,leadership support,infrastructure,and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.

Evidence-Based Nursing Practice of Reducing Immune-Related Skin Toxicity of Tumor Patients Guided by Sensitive Indicators

Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy settings as the control group. August-October, 2023 60 cases the patients treated with immune therapy were the experimental group. The control group adopted regular nursing methods, while the experimental group sensitive Indicators, evidence-based give preventive care. The social situation, psychological state, physical function, quality of life score, incidence of skin toxicity caused by immune checkpoint inhibitors, moderate and above of the two groups of patients were compared. Incidence of skin toxicity. Result: experience group SAS score, SDS score higher than the control group, the difference was statistically significant (P < 0.05);The incidence of skin toxic reactions caused by immune checkpoint inhibitors and the incidence of moderate and above skin toxic reactions in the experimental group are lower than those in the control group, and the difference is statistically significant (P < 0.05). Conclusion: sensitive indicator guidance evidence-based preventive care can reduce the degree of immune-related skin toxicity, improve the psychological state and quality of life of tumor patients treated with immune therapy and reduce the incidence of adverse reactions, improve nursing quality and patient satisfaction.

Necessary prerequisites for evidence-based practice:results of investigating nurses'informatics competency and information literacy skills

This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.

Practice and Exploration of Ideological and Political Education for Postgraduate Students Under the Mentor Responsibility System

This study aims to address the problems existing in the ideological and political education of postgraduate students,and combines the implementation of the mentor responsibility system to explore the role orientation,work content,and practical effects of mentors in the ideological and political education of postgraduate students.Through questionnaire surveys,interviews,and other research methods,the current situation of ideological and political education of postgraduate students under the mentor responsibility system is analyzed,and corresponding optimization strategies are proposed.

Nurses’ and midwives’ participation and utilization of health-related research in Kenya: Implications for evidence-based practice

Objective To assess the level of participation of nurses and midwives in health-related research,determine the status of utilization of research to inform nursing and midwifery practice in Kenya,and explore perspectives of nurses and midwives about strategies to empower nurses/midwives to engage in health research in Kenya.Methods Data were extracted from online survey responses of 156 nurse and midwife educators,practitioners,and managers/administrators.SPSS version 26 was used to analyze quantitative data;qualitative data were analyzed using Excel to organize data into categories.Results Over one-third of participants reported ever publishing research(37.2%,58/156).Participants reported using knowledge gained in nursing school to guide practice most frequently(n=148).Utilization of research findings to guide practice was reported by 80.3%(110/137)of participants.Strategies to enhance participation in the research included research training,research forums,policy reforms,and emphasis on research in curricula.Conclusions There is need to intensify and prioritize proposed strategies to empower nurses/midwives to engage in health research.

Validation of short version of evidence-based practice instruments among nurses in clinical practice:Evidence-based practice beliefs,implementation,and organizational culture

Objective:The objective of the study is to validate the short version of evidence-based practice(EBP)instruments among nurses in clinical practice.Methods:An institutional-based cross-sectional research design was used and a stratified sampling technique to select 285 nurse clinicians.The study utilized a structured questionnaire comprising of demographic data from the participants and three validated scales:the shortened versions of the EBP Beliefs Scale,the EBP Implementation Scale,and the Organizational Culture and Readiness for System-Wide Integration of Evidence-Based Practice(OCRSIEP)survey.With the use of descriptive statistics,the data were analyzed and presented in frequencies and percentages,while inter-item correlation coefficient(ICC)and the Kaiser-Meyer-Olkin measure of sampling adequacy were used to confirm the validity of using factor analysis.Results:Findings revealed the mean scores of the EBP Beliefs Scale ranged from 1.50 to 1.61,EBP Implementation Scale ranged from 1.84 to 1.94,and the OCRSIEP Scale ranged from 1.93 to 2.19.All the three shortened scales accordingly had good internal reliability,29.30±9.93 out of 80 for the EBP Beliefs Scale,19.56±7.37 out of 72 for the EBP Implementation Scale,and 66.32±20.35 out of 125 for the OCRSIEP Scale.Conclusion:This study has generated a valid Short Version of EBP reliable instrument that is psychometrically robust that can be used by nurses and clinicians to evaluate EBP in clinical settings since the results presented as a whole confirmed the high reliability and factorial validity.

New evidence-based practice:Artificial intelligence as a barrier breaker

The concept of evidence-based practice has persisted over several years and remains a cornerstone in clinical practice,representing the gold standard for optimal patient care.However,despite widespread recognition of its significance,practical application faces various challenges and barriers,including a lack of skills in interpreting studies,limited resources,time constraints,linguistic competencies,and more.Recently,we have witnessed the emergence of a groundbreaking technological revolution known as artificial intelligence.Although artificial intelligence has become increasingly integrated into our daily lives,some reluctance persists among certain segments of the public.This article explores the potential of artificial intelligence as a solution to some of the main barriers encountered in the application of evidence-based practice.It highlights how artificial intelligence can assist in staying updated with the latest evidence,enhancing clinical decision-making,addressing patient misinformation,and mitigating time constraints in clinical practice.The integration of artificial intelligence into evidence-based practice has the potential to revolutionize healthcare,leading to more precise diagnoses,personalized treatment plans,and improved doctor-patient interactions.This proposed synergy between evidencebased practice and artificial intelligence may necessitate adjustments to its core concept,heralding a new era in healthcare.

Implementation strategies to improve evidence-based practice for post-stroke dysphagia identification and management:A before-andafter study

Objectives Even though guidelines are available to guide dysphagia identification and management practice,there is still a gap between evidence and practice,which requires improvement.The purpose of this study was to determine the effect of using tailored,multifaceted strategies to improve evidence-based post-stroke dysphagia identification and management practice in a community hospital.Methods Guided by the Knowledge to Action framework,the tailored,multifaceted strategies were developed and implemented for 5 months in a community hospital using a before-and-after study design.These strategies consisted of training intervention,policy intervention,and audit and feedback intervention.Nurses’level of knowledge and adherence,were collected in March 2019 and again in January 2020.Patients’quality of life and satisfaction were evaluated during the pre-intervention period(between February 2019 and April 2019)and the post-intervention period(between November 2019 and January 2020).Results A total of 55 patients with post-stroke dysphagia(28 in the pre-intervention period and 27 in the post-intervention period)and 17 registered nurses were recruited.Following implementation,there were statistically significant improvements in patients’outcomes(quality of life and satisfaction)and nurses’outcomes(level of knowledge and adherence).Conclusions This study assists in closing the research-practice gap by using tailored,multifaceted strategies to increase the use of evidence-based nursing care for dysphagia identification and management practices.

Needs assessment and expectations regarding evidence-based practice knowledge acquisition and training activities:A cross-sectional study of healthcare personnel in China

Objectives Evidence-based healthcare contributes to the improvement of healthcare quality and informs healthcare decision-making.The provision of timely high-quality evidence is always required to fulfil the ever-changing needs and expectations of healthcare personnel.This study aimed to assess the needs and expectations of healthcare personnel regarding evidence-based healthcare in China.Methods We conducted a cross-sectional online survey from December 8,2020 to January 15,2021 involving 901 participants across China.Healthcare providers,policy makers,researchers and educators,and full-time postgraduate medical and nursing students working/living in China were eligible to participate.A self-developed questionnaire was used.Results Participants generally agreed that health-related research evidence was beneficial.Evidence-based resources,such as Cochrane resources,were only known or used by about half of the respondents due to difficulties related to availability and accessibility.Various types of resources,topics of evidence,and themes of workshops were of particular interest to most of the participants.Conclusions The dissemination and translation of evidence,provision of more support in evidence availability,offering evidence-based training,and determining the most in-demand research areas have been identified as priority areas of work which could fulfil the needs and expectations of healthcare personnel in China.

The concept of narrative evidence-based medicine and shared decision-making in traditional Chinese medical practice

For the explosive development of emerging diagnostic and therapeutic technologies brought by the advancement of precision medicine strategy, shared decision-making could improve the quality of clinical decision-making and promote the transformation of clinical research evidence in TCM. Paying attention to patients＇ narrative needs and strengthening medical humanistic concerns could improve clinical outcome and patient satisfaction. We described the origins and development of evidence-based medicine, narrative medicine and shared decision-making, and analyzed the existing problems in TCM clinical decision-making. Further, we put forward the model of shared decision-making between clinicians and patients under the guidance of narrative evidence-based medicine concepts and methods.

Enhancing Evidence-Based Practice and Critical Thinking Skills of Nursing Students: Lessons from the Review of the Bachelor of Science in Nursing Curriculum of the University of Zambia

Background: Making changes in the existing curriculum aims, objectives, course contents learning outcomes and assessment strategies have become a fact of life for nurse educators. Purpose: To enhance the existing Bachelor of Science (BSc) in nursing curriculum through integration of evidence-based practice (EBP) and teaching of critical thinking skills. Materials and Methods: A needs analysis was conducted using a five-phased approach to review the BSc in nursing Curriculum. Kern’s six-step model was adapted and introduced through a series of workshop exercises that highlighted the application of each step: 1) Desk review of the BSc curriculum offered globally;2) Administration of the needs assessment questionnaire to key informants;3) Strengths, weakness, opportunities and threat analysis;4) Consultative meeting with major stakeholders;5) Curriculum review. Results: The five-phased approach established some gaps in existing curricula, and identified critical core competences and best practices in integrating EPB and critical thinking in the BSc undergraduate curriculum and some “A” level content that was not in tandem with the practice of nurses. New courses were developed to support students in academic writing and enhance professionalism and duration of training was reduced from 5 to 4 years. Conclusion: The process demonstrated that BSc curriculum review, in fact, should be thoroughly scrutinized to encourage positive changes to the curriculum, provide opportunities for team building and the development of leadership skills and a whole-of course perspective on the curriculum.

Knowledge,attitude and behaviour to evidence-based practice among psychiatric nurses:A cross-sectional survey

Objective To identify the status of knowledge,attitude,and behaviour toward evidence-based practice(EBP)among Chinese psychiatric nurses,and to examine the influencing factors of EBP behaviour.Methods We utilised a cross-sectional design.A total of 923 psychiatric nurses from 168 hospitals in 27 provinces in the mainland of China participated in our survey.The EBP questionnaire,the barriers to research utilisation scale and the facilitators to research utilisation scale were used for data collection via WeChat group from July 2018 to April 2019.Multiple regression analysis was used to analyse the influencing factors of psychiatric nurses’evidence-based practice behaviour.Results The score of Chinese psychiatric nurses’EBP attitude,behaviour and knowledge were 4.81±1.34,4.11±1.36 and 3.53±1.29,respectively.Multiple regression analysis showed that nurses’EBP behaviour was mainly determined by knowledge and attitude,which together explained 61.8%of the variance.The two top barriers were the dimensions of presentation and research.Facilitators include managerial support,employing nurses with research skills as models and providing advanced education on evidence-based nursing.Conclusion Psychiatric nurses have positive attitudes toward EBP,but their level of knowledge and behaviour is insufficient.Heavy workload,insufficient time,and a lack of knowledge and skills is the main barrier.Managerial support,employing nurses with research skills as models and providing advanced education are the main facilitators.

Obstacles in employing evidence-based practice by nurses in their clinical settings: a descriptive study

Objective: The challenge of employing evidence-based practice (EBP) is multifarious and varied. Nursing interventions supported by research evidence have been exposed to progress positive patient outcomes, while its implementation is faced with various obstacles. This study aimed to identify obstacles in employing EBP by nurses in their clinical settings. Methods: This descriptive design study was conducted at Benha University Hospital with a convenient sample of 154 nurses. Two tools were utilized: (Ⅰ) sociodemographic data sheet, which included sociodemographic characteristics of the participants, and (Ⅱ) interview scale, which contained two parts: (1) obstacles scale, which contained obstacles that impede nurses from the utilization of EBP, and (2) questions to rank the three greatest obstacles in employing EBP by nurses. Results: The greatest EBP obstacle ranked by nurses was the organizational limitations (90.9%), followed by research quality (86.9%) and research accessibility (51.0%), while individual characteristics (35.9%) were ranked as the least obstacle. There was a significant statistical correlation between organizational limitations, research quality as well accessibility-related obstacles and nurses' age, level of education, as well their years of work experience (P<0.05). Conclusions: Findings of this study showed series of obstacles in employing EBP by nurses in their clinical settings, stressing the call for expansion of nurses' capabilities related to EBP utilization in patients' care.

Evidence-based practice profiles of nurses: a transcultural study

Objective: To compare(i) the evidence-based practice(EBP) profiles and(ii) socio-demographic characteristics of nurses in 4 selected low-middle income countries(LMICs).Methods: A cross-sectional survey was conducted among 677 nurses from 4 hospitals in 4 countries(Afghanistan, Ghana, Iran, and Uganda).Results: The findings revealed that there are significant differences between the 3 EBP subscales(that is, practice/use, attitude, and knowledge/skill) across the 4 countries(P < 0.05). No significant EBP differences were identified across age groups and gender in the subscales of practice, knowledge, and attitude. Practice and knowledge subscales were significantly associated with working schedules(that is, par t-time and full-time)(P < 0.05). Analyses also revealed significant differences between attitude and knowledge subscales and working experience(P < 0.05).Conclusions: Nurses in the 4 countries have moderate practice, attitude, and knowledge/skil s of EBP. Nurses in LMICs require continuous professional development programs and suppor t to enhance their practice and knowledge regarding EBP in clinical settings.

Investigation on the Clinical Readiness of Nurses’Evidence-Based Practice in a 3A-Level General Hospital in Beijing

Objective:To understand the evidence-based practice readiness of developing evidence application projects in a 3A-level general hospital in Beijing,to identify barriers to evidence-based practice and to promote the successful application of evidence.Methods:All the clinical nurses who were going to participate in the application units of the evidence-based practice project were selected as the survey objects,and the self-made“Basic Information Questionnaire”and“Clinical Readiness to Evidence-based Nursing Assessment(CREBNA)”were used to conduct the survey.The total amounts and subscales were calculated.The factors that influence the score of the total scale were scored and analyzed.Results:The CREBNA total score was(119.87±19.18),the evidence subscale score was(47.94±8.54),the organizational environmental subscale score was(36.09±6.11),and the facilitator subscale score was(35.83±7.56).Univariate analysis showed that the total score of the scale was related to years of work,scientific research experience,knowledge of evidence-based care,and participation in evidence-based practice.Conclusion:The current evidence-based practice preparation situation is good.It is feasible to carry out evidence-based practice activities in the hospital.The follow-up development plan should be made based on the corresponding obstacle factors.

An Exploration of Perceived Barriers to Evidence-Based Practice among Physiotherapy Students during Clinical Placement—A Descriptive Cross-Sectional Study

Introduction: Teaching evidence-based practice (EBP) has become part of the standard curriculum for health care students and professionals. Teaching EBP skills should be emphasized in entry level physiotherapy education as physiotherapists are expected to practice in an evidence-based way. Identifying barriers to the application of EBP in clinical placement plays an important role in developing physiotherapy programs. The present study aimed to explore physiotherapy students’ perceived barriers toward the use of EBP during their clinical placements. Methods: A cross-sectional study was conducted among third-year physiotherapy students at the Faculty of Health Sciences University of Ljubljana, Slovenia. Participants were asked to complete a self-reported questionnaire that was developed by the researcher based on previously developed surveys. The analyses applied included descriptive statistics and calculation of frequencies, percentages, means and standard deviations of the participating students’ scores. Results: Fifty final-year undergraduate students with a mean age of 23.7 (±4.3, range 23 - 27) years participated in the study. Majority of participants reported lack of formal training, poor ability to critically appraise research evidence, insufficient time, their clinical supervisors, or other therapists not using EBP when treating patients as barriers towards practicing EBP. Conclusions: Physiotherapy students face many challenges in terms of training, organizational, and personal barriers toward the use of EBP during clinical placement. Lack of formal training, lack of research skills, insufficient time and their clinical supervisors or other therapists not using EBP when treating patients, emerged as top barriers. This fact underlines the importance of teaching students EBP skills, which would enable them to use EBP when working with patients.

Nurses’ Knowledge and Attitude Regarding Evidence-Based Practice: An Integrative Review

Background: As a result of its influence on nurses’ knowledge and practice, evidence-based practice (EBP) has gained prominence in the nursing profession. Therefore, evidence-based practice (EBP) is increasingly acknowledged as a critical component of improving the quality of healthcare and nursing care services, as well as achieving patient care excellence. Aim: One of the primary objectives of this review is to consolidate the existing research on nurses’ understanding of evidence-based practice, attitudes toward it, and practices related to it. Methods: The following databases from 2012 to 2021 have been searched such as: Cochrane Collaboration, MEDLINE, AVOID, CINAHL, EMBASE, Science Direct, ASSIA, Web of Science, Scopus, PubMed and JSTOR. Only cohort, case-control and randomized controlled trials studies with full text in English were eligible. Results: Only eight articles were found to meet the inclusion criteria out of 2155 total articles after the exclusion criteria were applied. The majority of these eight researches discovered a favourable attitude about EBP as well as a low level of expertise. Conclusion: The majority of nurses have a good attitude toward their job, but most are uninformed of the significance of EBP in their profession. In order to recognize and compare the components that may impact knowledge, attitude, and practices of EBP throughout the world in order to discover similarities that may assist global strategies for the transfer of research results to nursing, additional research on this topic is required to recognize and compare the components that may impact knowledge, attitude, and practices of EBP throughout the world in order to discover similarities that may assist global strategies for the transfer of research results to nursing.

Evidence-Based Practice and Job Satisfaction of Nurses in Long-Term Care

Purpose: The purpose of this study was to identify the relationship between evidence-based practice (EBP) and job satisfaction among nurses working in long-term care facilities. Methods: The study used a descriptive cross-sectional design. A total of 146 nurses working in 6 long-term care facilities in South Korea self-reported their perception of EBP implementation, barriers to research utilization, and job satisfaction. Results: The level of job satisfaction was higher in nurses who were single, older, more experienced, and had a higher income. Lower perceived barriers to research utilization were associated with greater job satisfaction. However, there was no significant relationship between a level of EBP implementation and job satisfaction. Factors influencing job satisfaction included lower barriers to the organization and communication domains of research utilization, being unmarried and older. Conclusion: Decreasing barriers to research utilization may improve the job satisfaction of nurses working in long-term care facilities.

Factor Analytical Examination of the Evidence-Based Practice Beliefs Scale: Indications of a Two-Factor Structure

Background: Promotion of Evidence-Based Practice (EBP) in nursing appears to be developing slowly. Research indicates that nurses’ beliefs in EBP may play an even more significant role than knowledge and resources in making implementation feasible. To address this issue, measurement of nurses’ beliefs regarding EBP is paramount. Aims and objectives: This study explores the internal consistency reliability and the construct factor structure of the Norwegian version of the original Evidence-Based Practice Beliefs Scale (EBP-BS). Methods: The study has a Non-experimental exploratory survey design. A Norwegian translation of the EBP-BS was tested in a convenience sample of 118 healthcare professionals (95% nurses) attending a continuing education program at a University College in Norway. The response rate was 95% (n = 112). The internal consistency of the scale was measured by Cronbach’s alpha, and an explorative Principal Component Analysis (PCA) was used to explore the construct structure. Results: The overall internal consistency of the EBP-BS was acceptable. The PCA indicated a four-factor structure. The psychometric properties of two of the factors were too weak for expanding to a four-factor model. Based on our investigation of the EBP-BS, we suggest a two-factor structure model. The factors were named 1) General knowledge and confidence concerning EBP and 2) Task specific beliefs in EBP. This finding differs from previous results that indicated a unidimensional structure. Conclusion: As a starting point, reliable and valid measurement of nurses’ beliefs about EBP is required in order to identify possible obstacles and to optimize implementation in the individual clinical setting. Our results indicate that the EBP-BS has a two-factor structure. Further exploration of the factor structure is needed. Further empirical research may contribute to the resolving of controversies concerning basic understandings of the concept of EBP.

Evidence-based practice with knowledge, attitude and practice of ophthalmic nursing staffs: a cross-sectional study in south China

Background:This study aims to investigate the current status and influencing factors of evidence-based practice(EBP)with knowledge,attitude and practice(KAP)of ophthalmic nursing staffs in south China.Methods:Using a convenient sampling method,we selected 429 ophthalmic nursing staffs from 28 ophthalmology specialist hospitals or general hospitals in south China,and investigated their general information and implemented the evidence-based practice questionnaire(EBPQ).Results:The scores of EBP and KAP of ophthalmic nursing staffs in south China from high to low were as follows:practical attitude(4.85±1.07 points),practical behavior(4.42±1.14 points),practical knowledge and skills(4.30±0.65 points).The single factor analysis results showed that the first graduation degree,technical title,scientific research achievements,whether or not participate in EBP training,the frequency of reading literature at ordinary time,and whether or not participate in EBP project were the influencing factors of EBP level;the multi-factor analysis results showed that EBP attitude,EBP knowledge and skills,whether or not participate in EBP training were independent influencing factors of EBP.Conclusions:The ophthalmic nursing staffs in south China have a positive attitude towards EBP,however,their EBP knowledge,skills and behavioral capabilities need to be focused and improved.The ophthalmic nursing administrators should fully master the factors affecting the implementation of EBP,and take effective intervention measurement to improve the EBP abilities of ophthalmic nursing staffs,and promote the development of EBP in ophthalmology specialty.