Barriers to Evidence-Based Care in Nursing: Historical Legacies and Conflicting Cultures

1998 ◽  
Vol 11 (3) ◽  
pp. 137-147 ◽  
Author(s):  
C. Hicks
Keyword(s):  
Health Care Professionals ◽  
Research Evidence ◽  
Professional Status ◽  
Evidence Based ◽  
Scientific Justification ◽  
Medical Professions ◽  
Evidence Based Care ◽  
The Impact ◽  
Evidence Based Nursing ◽  
Local Levels

The British National Health Service (NHS) has witnessed many fundamental changes over the last decade, one of the most significant of which is the imperative for health-care professionals to ensure that their clinical practice can be supported by research evidence. This move from intuition and historical ritual to scientific justification has not been fully successful in either the medical or non-medical professions, with the result that a great deal of research has been sponsored at both the national and local levels to investigate the reasons underlying the research/practice divide. Within nursing the problem has been particularly exacerbated by its ideological framework, the culture and tradition of the profession itself and the recent reforms that were intended to raise its professional status and autonomy. This paper considers the impact of nursing traditions and stereotypes and the bureaucratic structures of the NHS on the introduction of evidence-based nursing care. It is suggested that the essential nature of nursing, its legacy and philosophy, together with the health service's hidden agendas, have conspired to keep nursing in a subordinated, quasi-professional role as one means by which the workforce can be controlled. Because the nursing profession has colluded with this, albeit inadvertently, it now needs to re-establish its complementary functions, in order to salvage its position and truly establish nursing as a profession in its own right.

scholarly journals Building capacity for implementation—the KT Challenge

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

scholarly journals Longitudinal experiences and impact of the COVID-19 pandemic among people with past or current eating disorders in Sweden

2021 ◽  
Author(s):  
Andreas Birgegård ◽  
Afrouz Abbaspour ◽  
Stina Borg ◽  
David Clinton ◽  
Emma Forsén Mantilla ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Data Availability ◽  
Evidence Based ◽  
List Type ◽  
Convenience Sample ◽  
Eating Disorder Symptom ◽  
Disorder Symptom ◽  
Evidence Based Care ◽  
The Impact

AbstractObjectiveTo document the impact of the COVI-19 pandemic on the health and well-being of individuals with past and current eating disorders in Sweden.MethodWe re-contacted participants from two previous Swedish studies who had a known lifetime history of an eating disorder. Participants completed an online questionnaire about their health and functioning at baseline early in the pandemic (Wave 1; N=982) and six months later (Wave 2); N=646).ResultsThree important patterns emerged: 1) higher current eating disorder symptom levels were associated with greater anxiety, worry, and pandemic-related eating disorder symptom increase; 2) patterns were fairly stable across time, although a concerning number who reported being symptom-free at Wave 1 reported re-emergence of symptoms at Wave 2; and only a minority of participants with current eating disorders were in treatment, and of those who were in treatment, many reported fewer treatment sessions than pre-pandemic and decreased quality of care.ConclusionsThe COVID-19 pandemic is posing serious health challenges for individuals with eating disorders, whether currently symptomatic or in remission. We encourage health service providers and patient advocates to be alert to the needs of individuals with eating disorders and to take active measures to ensure access to appropriate evidence-based care both during and following the pandemic.Significant Outcomes and LimitationsIndividuals with eating disorders symptoms or current active disorder report higher adverse impact of COVID-19 on their mental healthEven individuals who were symptom-free early in the pandemic reported a resurgence of eating disorder symptomsA large proportion of symptomatic individuals were not in treatment for their eating disorder, services should be aware and access to evidence-based care should be ensured across SwedenLimitations included the use of a convenience sample with atypical diagnostic distribution, and a low initial response rate, possibly introducing bias and limiting generalisability.Data Availability StatementFully anonymized data are available from the corresponding author upon request.

scholarly journals Sustainability reporting challenges in developing countries: towards management perceptions research evidence-based practices

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Venancio Tauringana
Keyword(s):  
Developing Countries ◽  
Research Evidence ◽  
Sustainability Reporting ◽  
Policy Formulation ◽  
Global Reporting Initiative ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Content Type ◽  
Awareness Campaigns ◽  
The Impact

PurposeThe purpose of this paper is threefold. First, it aims to identify managerial perceptions-based research determinants of sustainability reporting. Second, it sets out to evaluate the impact of the Global Reporting Initiative (GRI) efforts in increasing SR in developing countries. Third, the researcher argues for the adoption of management perceptions research evidence-based practices (EBP) to address SR challenges in developing countries.Design/methodology/approachThe study was undertaken using a desk-based review of management perceptions-based research literature on the determinants of SR. The impact of GRI efforts in increasing adoption of SR was undertaken through both desk-based research and descriptive analysis of data obtained from the GRI database from 2014 to 2019 relating to 107 developing countries. The call for the adoption of management perceptions research EBP is based on a critical analysis of both the management perceptions of the determinants of SR research and evaluation the impact of GRI efforts to increase SR in developing countries.FindingsTraining, legislation, issuing of guidance, stakeholder pressure, awareness campaigns, market and public pressure were identified as some of the determinants of SR. The evaluation of the impact of GRI efforts shows they had limited impact on increasing SR in developing countries. Research needed to adopt management perceptions research EBP is identified.Research limitations/implicationsThis study is conceptual. Management perceptions-based research is needed in more developing countries to better understand the determinants of SR and identify the most effective policies or practices to address related challenges.Originality/valueThe findings contribute to the calls to make academic research more relevant to policy formulation. In particular, the proposal for research needed to inform EBP adoption to address SR challenges in developing countries is new.

scholarly journals Analysis of the impact of a national initiative to promote evidence-based nursing practice

2006 ◽  
Vol 12 (4) ◽  
pp. 232-240 ◽  
Author(s):  
Nicola Ring ◽  
Alison Coull ◽  
Catherine Howie ◽  
Tricia Murphy-Black ◽  
Andrew Watterson
Keyword(s):  
Nursing Practice ◽  
Evidence Based ◽  
National Initiative ◽  
The Impact ◽  
Evidence Based Nursing

scholarly journals Interdisciplinary Collaboration among Health Professionals: A Panacea for effective and Evidence-based Health Care delivery

2020 ◽  
Vol 34 (1) ◽  
pp. 12-23
Author(s):  
Joseph D Z ◽  
Aminu B ◽  
Halilu S ◽  
Mark A D ◽  
Kayode O ◽  
...  
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Patient Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Interdisciplinary Collaboration ◽  
Healthcare Delivery ◽  
Evidence Based ◽  
Search Term ◽  
The Impact

Introduction: Interdisciplinary collaboration (IDC) is important in health care settings as the complex nature and demands of the health care work environment requires the expertise and knowledge of different individuals or specialists working together to solve multifaceted and complex patient care problems. Objective: To assess the health professionals' attitude towards the development of an interdisciplinary collaborative approach to patient care in health institutions and to systematically review the impact of IDC as a panacea for effective health outcomes in Nigeria. Methodology: The research is a systematic review that provides various approaches for studying interdisciplinary teams. Fifty articles were selected from different search engines such as Google, google scholar, science direct and research gate with the search term Interdisciplinary collaboration among health care professionals. Articles were arranged based on most relevant, relevant and closely related articles. Result: The study revealed that IDC is pivotal in evidence-based care and contributes immensely to effective and efficient health outcomes. It puts the patient at the centre of the healthcare team's focus and allows all health professionals, with the patient, to collaboratively provide input, be part of the decision making, and improve outcomes. Although there are several obstacles to IDC, adopting this team-based culture of mutual respect and understanding is possible and, in fact, necessary. Conclusion: This study reveals that there are many benefits to IDC. It can improve safety and healthcare delivery, as well as reduce costs. The interprofessional team supports patient and personnel engagement, organizational efficiency and innovation.

scholarly journals Building Capacity for Implementation – The KT Challenge

2020 ◽  
Author(s):  
Agnes Black ◽  
Marla Steinberg ◽  
Amanda Chisholm ◽  
Kristi Coldwell ◽  
Alison Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity and practice change. MethodsThe evaluation used a mixed-methods, time-series design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, six months into implementation, and at the end of the two-year funded projects) to measure KT capacity ( knowledge, skills and confidence), and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analysed using non-parametric statistics. ResultsParticipants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. ConclusionsThe KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the KT Challenge program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

scholarly journals Building Capacity for Implementation – The KT Challenge

2021 ◽  
Author(s):  
Agnes Black ◽  
Marla Steinberg ◽  
Amanda Chisholm ◽  
Kristi Coldwell ◽  
Alison Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity and practice change. MethodsThe evaluation used a mixed-methods, time-series design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, six months into implementation, and at the end of the two-year funded projects) to measure KT capacity ( knowledge, skills and confidence), and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analysed using non-parametric statistics. ResultsParticipants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. ConclusionsThe KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

scholarly journals 2553. Addressing Knowledge and Practice Gaps in HIV Management with Engaging Continuing Education

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S887-S887
Author(s):  
Katie Robinson ◽  
Jennifer Frederick ◽  
Robert A. Esgro ◽  
Marlene Heeg ◽  
Michael B Kays ◽  
...  
Keyword(s):  
Continuing Education ◽  
Hiv Care ◽  
Evidence Based ◽  
Hiv Knowledge ◽  
Hiv Management ◽  
Practice Gaps ◽  
Knowledge And Practice ◽  
Evidence Based Care ◽  
The Impact ◽  
Case Based

Abstract Background Given the rapid evolution of HIV management guidelines and the emergence of new treatment paradigms, infectious disease specialists are challenged to stay current on the latest evidence-based care and how to tailor treatment to optimally meet an individual patient’s needs. To address identified knowledge and practice gaps regarding the care of patients with HIV, an engaging continuing education (CE) initiative was implemented, and the impact of the education on provider knowledge and practice was measured. Methods Vindico Medical Education partnered with Purdue University College of Pharmacy to deliver a highly engaging, 2.0-credit hour, CE initiative at ID week in October 2018. The symposium was comprised of multiple formats, including didactic presentations, case-based discussion, and the gamified segment, Wheel of HIV Knowledge. Coverage of the live program was posted to Healio.com, extending the reach of the education. Analysis of the impact of this education was achieved via pre- and post-test test assessment. Results 357 healthcare providers participated in the live session, and 236 have accessed the web activity as of April 2019. The gamified and case-based segments of the live activity engaged on average 70% of learners and revealed insights into current practice patterns and persisting gaps in knowledge regarding the latest, evidence-based HIV care. Across the curriculum, there was a 46% relative increase in knowledge and competence. A total of 223 providers who see on average 15 patients per month with HIV completed the education, resulting in approximately 2,500 patients with HIV per month who are more likely to receive the latest evidence-based care. Moreover, 3 months following the education, 55% of providers reported implementing practice improvements, including applying the latest clinical guidelines and recommendations. Of those providers who implemented changes, 47% observed patient improvements such as improved adherence, satisfaction, and reduced viral loads. Conclusion In recent years of rapid advances for HIV management, providers are challenged to administer the latest evidence-based care. This study highlights the power of engaging CE to address persisting knowledge and practice gaps toward the delivery of enhanced care for patients with HIV. Disclosures All authors: No reported disclosures.

Clinical Effectiveness: Systematic Reviews and Evidence-Based Practice in Occupational Therapy

1997 ◽  
Vol 60 (11) ◽  
pp. 479-483 ◽  
Author(s):  
Katrina Bannigan
Keyword(s):  
Health Care ◽  
Occupational Therapy ◽  
Systematic Reviews ◽  
Health Care Professionals ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Occupational Therapists ◽  
Evidence Based ◽  
Sources Of Information ◽  
High Quality

Evidence-based health care can be defined as an approach to health care that involves finding and using up-to-date research into the effectiveness of health care interventions to inform decision making (Entwistle et al, 1996). For many occupational therapists, the practicalities of keeping up to date with the best research evidence is difficult; however, through the National Health Service Centre for Reviews and Dissemination (NHS CRD), the NHS Research and Development (R&D) Programme is aiming to improve the availability of high quality research evidence to all health care professionals. The NHS CRD carries out and commissions systematic reviews. Systematic reviews are a means of pulling together large quantities of research information and are considered to be one of the most reliable sources of information about effectiveness (Chalmers and Altman, 1995). The NHS CRD also disseminates the findings of systematic reviews, one method of which is through the Database of Abstracts of Reviews of Effectiveness (DARE). The relevance of systematic reviews to the clinical practice of occupational therapists is explored in this paper using two examples: a poor quality and a high quality systematic review identified from the abstracting process for DARE. Both reviews are directly relevant to occupational therapy, being about sensory integration and falls in the elderly respectively. The implications of these reviews for evidence-based practice in occupational therapy are discussed.

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