scholarly journals Enabling and inhibitory factors that influenced implementation of evidence-based practice for urinary incontinence in a nursing home

2016 ◽  
Vol 37 (2) ◽  
pp. 109-116
Author(s):  
Doris Hägglund ◽  
Lena Olai

The aim of the present follow-up study was to describe staff perceptions of enabling and inhibitory factors that influenced implementation of evidence-based practice (EBP) for urinary incontinence in a nursing home. Focus-group interviews were carried out and the text was deductively analyzed using the PARIHS framework and qualitative content analysis. Factors believed to be most enabling for implementation were EBP being considered as relevant and as a social process, and visiting the lavatory being considered as a right for all. One determinant of successful implementation was having clear and involved leaders who had a continuous positive attitude toward EBP and demanded results. Staff members who were given the role of continence agents were important facilitators. The factor believed to inhibit implementation most was staff having to carry out pad-weight tests before prescribing individual incontinence aids. Evidence-based practice offers a successful concept for caring for older people with urinary incontinence in nursing homes. Evidence-based practice should be spread, both local and more widely.

2020 ◽  
Vol 16 (1) ◽  
pp. 17
Author(s):  
Gro Røkholt ◽  
Liv-Signe Davidsen ◽  
Heidi Ness Johnsen ◽  
Alfhild Dihle

Student experiences with supervision and learning through participation in a quality improvement evidence-baced practice project in a hospital, -a descriptive and explorative study A significant part of health care students’ education is provided through clinical placement supervised by practitioners with required education and experience. This study has been conducted to increase knowledge of students’ experiences with supervision and learning related to participation in a quality improvement project in a hospital using evidence-based practice tools. A descriptive and exploratory design with focus group interviews. Data was analysed using qualitative content analysis. Three main themes emerged: changed student role, understanding the importance of keeping professional knowledge updated and need for the facilitation of the clinical placement period. The study showed that supervision helped students become equals of their supervisors and part of the community of practice. The project contributed to students`' coping skills. Integrating evidence-based practice into practice taught students a method of professional knowledge updating and quality improvement.


2021 ◽  
Vol 26 (1-2) ◽  
pp. 149-165
Author(s):  
Ethan Schuler ◽  
Sandra Mott ◽  
Peter W Forbes ◽  
Alexis Schmid ◽  
Carole Atkinson ◽  
...  

Background Evidence-based practice (EBP) is essential for clinical decision-making, improving care, reducing costs and achieving optimal patient outcomes. The Evidence-based Practice Mentorship Program (EBPMP) is a flexible, self-directed programme whereby participants carry out EBP projects guided by expert mentors. Aims To evaluate EBPMP effectiveness and participant experience. Methods To evaluate effectiveness, as measured by changes in EBP value, knowledge and implementation, participants completed pre- and post-EBPMP Quick-EBP-Value, Implementation and Knowledge (VIK) surveys. To understand participants’ experiences individual and group interviews were conducted at the end of the programme and analysed using qualitative content analysis. Results Most participants were over 50 years old, Caucasian, inpatient staff nurses, baccalaureate prepared, with over 11 years’ experience. Statistically significant improvements were observed in the post Quick-EBP-VIK knowledge and implementation domains. Individual and group participant interviews revealed four categories of importance to the experience: 1. perceived benefits of EBP, 2. time as a barrier to EBP, 3. desire for more cohort interaction and 4. positive mentee–mentor experience. Conclusions EBPMP can improve participants’ knowledge and implementation of EBP in an environment that values EBP; however, opportunities exist to implement programme modifications that address barriers identified by participants including project time and increased participant interactions.


2015 ◽  
Vol 29 (6) ◽  
pp. 684-700 ◽  
Author(s):  
Kristin A. Schuller ◽  
Bita A. Kash ◽  
Larry D. Gamm

Purpose – The purpose of this paper is to analyze the implementation of an organizational change initiative – Studer Group®’s Evidence-Based Leadership (EBL) – in two large, US health systems by comparing and contrasting the factors associated with successful implementation and sustainability of the EBL initiative. Design/methodology/approach – This comparative case study assesses the responses to two pairs of open-ended questions during in-depth qualitative interviews of leaders and managers at both health systems. Qualitative content analysis was employed to identify major themes. Findings – Three themes associated with success and sustainability of EBL emerged at both health systems: leadership; culture; and organizational processes. The theme most frequently identified for both success and sustainability of EBL was culture. In contrast, there was a significant decline in salience of the leadership theme as attention shifts from success in implementation of EBL to sustaining EBL long term. Within the culture theme, accountability, and buy-in were most often cited by interviewees as success factors, while sense of accountability, buy-in, and communication were the most reported factors for sustainability. Originality/value – Cultural factors, such as accountability, staff support, and communication are driving forces of success and sustainability of EBL across both health systems. Leadership, a critical factor in several stages of implementation, appears to be less salient as among factors identified as important to longer term sustainability of EBL.


2013 ◽  
Vol 48 (3) ◽  
pp. 405-415 ◽  
Author(s):  
Cailee W. McCarty ◽  
Dorice A. Hankemeier ◽  
Jessica M. Walter ◽  
Eric J. Newton ◽  
Bonnie L. Van Lunen

Context: Successful implementation of evidence-based practice (EBP) within athletic training is contingent upon understanding the attitudes and beliefs and perceived barriers toward EBP as well as the accessibility to EBP resources of athletic training educators, clinicians, and students. Objective: To assess the attitudes, beliefs, and perceived barriers toward EBP and accessibility to EBP resources among athletic training educators, clinicians, and students. Design: Cross-sectional study. Setting: Online survey instrument. Patients or Other Participants: A total of 1209 athletic trainers participated: professional athletic training education program directors (n = 132), clinical preceptors (n = 266), clinicians (n = 716), postprofessional athletic training educators (n = 24) and postprofessional students (n = 71). Main Outcome Measure(s): Likert-scale items (1 = strongly disagree, 4 = strongly agree) assessed attitudes and beliefs and perceived barriers, whereas multipart questions assessed accessibility to resources. Kruskal-Wallis H tests (P ≤ .05) and Mann-Whitney U tests with a Bonferroni adjustment (P ≤ .01) were used to determine differences among groups. Results: Athletic trainers agreed (3.27 ± 0.39 out of 4.0) that EBP has various benefits to clinical practice and disagreed (2.23 ± 0.42 out of 4.0) that negative perceptions are associated with EBP. Benefits to practice scores (P = .002) and negative perception scores (P < .001) differed among groups. With respect to perceived barriers, athletic trainers disagreed that personal skills and attributes (2.29 ± 0.52 out of 4.0) as well as support and accessibility to resources (2.40 ± 0.40 out of 4.0) were barriers to EBP implementation. Differences were found among groups for personal skills and attributes scores (P < .001) and support and accessibility to resources scores (P < .001). Time (76.6%) and availability of EBP mentors (69.6%) were the 2 most prevalent barriers reported. Of the resources assessed, participants were most unfamiliar with clinical prediction rules (37.6%) and Cochrane databases (52.5%); direct access to these 2 resources varied among participants. Conclusions: Athletic trainers had positive attitudes toward the implementation of EBP within didactic education and clinical practice. However, accessibility and resource use remained low for some EBP-related resources. Although the perceived barriers to implementation are minimal, effective integration of EBP within athletic training will present challenges until these barriers dissolve.


Author(s):  
Chris Cimdi

Evidence-Based Practice (EBP) is considered to be an essential component of clinical service delivery in healthcare. Australian physiotherapists have access to a wide range of resources to support the implementation of EBP. However, research indicates variability in how physiotherapists apply EBP with a range of factors affecting the successful implementation of EBP into everyday clinical practice. Using survey methodology, this study examined whether participation in an EBP professional development workshop is an effective strategy to enhance knowledge, attitudes and behaviours associated with EBP of physiotherapists working in a rehabilitation setting. Results revealed that nearly one third of participants rated their EBP knowledge and skills at a higher level following attendance at the workshop. An increase in the frequency in EBP related activities by physiotherapists including conducting searches and reading or reviewing research literature to support clinical decision-making was observed following attendance at the EBP workshop. Participants’ opinions of the value of EBP in improving the quality of patient care were noted to be more positive following the workshop. This small-scale study provides some promising results regarding the positive effects that designated EBP professional development can have on knowledge, attitudes, and behaviours of physiotherapists in their application of EBP. The elements that are required to further support and sustain a strong EBP culture amongst physiotherapists working in rehabilitation are also discussed.


2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Seyed Abolfazl Tohidast ◽  
Leila Ghelichi ◽  
Mohammad Kamali ◽  
Abbas Ebadi ◽  
Narges Shafaroodi ◽  
...  

Background: Identifying and removing the barriers faced by speech and language pathologists (SLPs) for implementing evidence-based practice (EBP) can facilitate its administration among Iranian SLPs. Objectives: The present study was conducted to explore the barriers to implementing EBP among Iranian SLPs. Methods: A total of 14 SLPs were recruited using a purposive sampling technique. Semi-structured interviews were conducted for data collection. The interviews continued until data saturation was reached. Data were recorded and transcribed verbatim, and qualitative content analysis was used for data analysis. Results: Data analysis yielded three themes, including individual factors, organizational (workplace) factors, and extra organizational factors, and 13 subthemes. Conclusions: This study demonstrated that Iranian SLPs are faced with several barriers to using EBP in clinical practice, which may be related to both the SLPs themselves and their surroundings. These barriers should be considered by policymakers, administrators, teachers, and rehabilitation team members to facilitate the implementation of EBP by SLPs.


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