Exploring the usability of the COM-B model and Theoretical Domains Framework (TDF) to define the helpers of and hindrances to evidence-based practice in midwifery.

Abstract Background Despite the advancement of scientific research in the field of maternity care, midwives face challenges translating latest evidence into evidence-based practice (EBP) and express reticence towards leading practice change in clinical areas. This study aimed to explore midwifery leaders’ views on what factors help or hinder midwives’ efforts to translate latest evidence into everyday practice and consider them in relation to both the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF).Methods This qualitative study formed part of a larger Action Research (AR) project that was designed to improve midwives’ EBP implementation capability. Data were obtained from eight Western Australian midwifery leaders who were employed in either managerial or executive positions within their organisation. Five midwives attended a focus group workshop and three opted for face-to-face interviews. Thematic analysis was used to code the transcribed data and group alike findings into sub-categories, which were collapsed to four major categories and one overarching core finding. These were mapped to a matrix combining the COM-B and TDF to establish the usability of these tools in midwifery contexts. Results Four major categories were developed from the data collected in this study. Three reported the hindrances midwives’ experienced when trying to initiate new EBPs: “For midwives, medical opposition and workplace culture are the biggest challenges”, “Fear can stop change: it’s personal for midwives” and “Midwives are tired of fighting the battle for EBP; they need knowledge and the confidence to bring about practice change.” The other major category highlighted factors midwives’ considered helpers of EBP: “Having stakeholder buy-in and strong midwifery leadership is a huge advantage.” When mapped to the TDF and COM-B, these findings provided valuable insight into the helpers of and hindrances to evidence-based practice in midwifery. Conclusion Midwives are motivated to initiate evidence-based change yet have limited knowledge of implementation processes or the confidence to lead practice change. Factors such as inter-disciplinary buy-in, clear instruction for midwives and support from midwifery leaders were considered beneficial to implementing practice change in clinical areas. The TDF when used in combination with the COM-B was deemed useful to midwives wanting to lead practice change projects in clinical areas.

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Exploring the usability of the COM-B model and Theoretical Domains Framework (TDF) to define the helpers of and hindrances to evidence-based practice in midwifery.

10.21203/rs.3.rs-40581/v3 ◽

2020 ◽

Author(s):

Annemarie De Leo ◽

Sara BAYES ◽

Dianne BLOXSOME ◽

Janice BUTT

Keyword(s):

Evidence Based Practice ◽

Theoretical Domains Framework ◽

Practice Change ◽

Evidence Based ◽

Valuable Insight ◽

Implementation Processes ◽

Change Factors ◽

Change Projects ◽

Formed Part ◽

Ebp Implementation

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Exploring the usability of the COM-B model and Theoretical Domains Framework (TDF) to define the helpers of and hindrances to evidence-based practice in midwifery

Implementation Science Communications ◽

10.1186/s43058-020-00100-x ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Annemarie De Leo ◽

Sara Bayes ◽

Dianne Bloxsome ◽

Janice Butt

Keyword(s):

Evidence Based Practice ◽

Theoretical Domains Framework ◽

Practice Change ◽

Evidence Based ◽

Valuable Insight ◽

Implementation Processes ◽

Change Factors ◽

Change Projects ◽

Formed Part ◽

Ebp Implementation

Abstract Background Despite the advancement of scientific research in the field of maternity care, midwives face challenges translating latest evidence into evidence-based practice (EBP) and express reticence towards leading practice change in clinical areas. This study aimed to explore midwifery leaders’ views on what factors help or hinder midwives’ efforts to translate latest evidence into everyday practice and consider them in relation to both the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF). Methods This qualitative study formed part of a larger action research (AR) project that was designed to improve midwives’ EBP implementation capability. Data were obtained from eight Western Australian midwifery leaders who were employed in either managerial or executive positions within their organisation. Five midwives attended a focus group workshop and three opted for face-to-face interviews. Thematic analysis was used to code the transcribed data and group alike findings into sub-categories, which were collapsed to four major categories and one overarching core finding. These were mapped to a matrix combining the COM-B and TDF to establish the usability of these tools in midwifery contexts. Results Four major categories were developed from the data collected in this study. Three reported the hindrances midwives’ experienced when trying to initiate new EBPs: ‘For midwives, medical opposition and workplace culture are the biggest challenges’, ‘Fear can stop change: it’s personal for midwives’ and ‘Midwives are tired of fighting the battle for EBP; they need knowledge and the confidence to bring about practice change.’ The other major category highlighted factors midwives’ considered helpers of EBP: ‘Having stakeholder buy-in and strong midwifery leadership is a huge advantage.’ When mapped to the TDF and COM-B, these findings provided valuable insight into the helpers of and hindrances to evidence-based practice in midwifery. Conclusion Midwives are motivated to initiate evidence-based change yet have limited knowledge of implementation processes or the confidence to lead practice change. Factors such as inter-disciplinary buy-in, clear instruction for midwives and support from midwifery leaders were considered beneficial to implementing practice change in clinical areas. The TDF when used in combination with the COM-B was deemed useful to midwives wanting to lead practice change projects in clinical areas.

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Exploring the usability of the COM-B model and Transtheoretical Domains Framework (TDF) to define the underlying helpers and hindrances of evidence-based change in midwifery

10.21203/rs.3.rs-40581/v1 ◽

2020 ◽

Author(s):

Annemarie De Leo ◽

Sara BAYES ◽

Dianne BLOXSOME ◽

Janice BUTT

Keyword(s):

Evidence Based Practice ◽

Scientific Evidence ◽

Implementation Strategies ◽

Practice Change ◽

Assessment Tools ◽

Evidence Based ◽

Valuable Insight ◽

Leadership Roles ◽

Participatory Action ◽

Formed Part

Abstract Background Despite the ongoing production of new scientific evidence in the field of maternity care, midwives continue to face challenges when translating latest evidence into evidence-informed care, and report reticence towards implementing evidence-based change in clinical areas. This study aimed to explore midwifery leaders’ views on what factors help or hinder midwives’ efforts to implement evidence-based practice, and test the usability of the Capability, Opportunity, Motivation and Behaviour model and Transtheoretical Domains Framework to analyse the barriers and facilitators to evidence-based change. Methods This qualitative study formed part of a larger Participatory Action Research (PAR) project designed to improve the processes by which midwives implement evidence-based practice change in clinical areas. Data were obtained from a focus group workshop and individual face-to-face interviews between July – September 2019. Thematic analysis was used to interpret the transcribed data, which were then coded and categorised into meaningful themes. Results One overarching core finding emerged from four major categories: Fear can stop change and midwives are reticent towards evidence-based change; however, inter-disciplinary collaboration and midwives in leadership roles is a huge advantage. Conclusion This study confirms what is known about the helpers and hinderances of evidence-based change, and provides valuable insight into the usability of behavioural theories and context assessment tools to both diagnose and develop implementation strategies applicable to midwives in clinical areas.

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Experiences of nurses implementing evidence-based practice in an acute care setting in Nigeria: A qualitative study

Clinical Nursing Studies ◽

10.5430/cns.v7n4p54 ◽

2019 ◽

Vol 7 (4) ◽

pp. 54

Author(s):

Jude N. Ominyi ◽

David A. Agom ◽

Chukwuma N. Anyigor ◽

Aaron B. Nwedu ◽

Simon N. Onwe

Keyword(s):

Acute Care ◽

Care Setting ◽

Nurse Managers ◽

Evidence Based Practice ◽

Staff Nurses ◽

Evidence Based ◽

Acute Care Setting ◽

Face To Face ◽

Implementation Processes ◽

Ebp Implementation

Background: Evidence-based practice (EBP) is widely recognised as being relevant in improving nursing care. However, its implementation in nursing practice has been difficult for nurses, particularly in the developing countries. Existing evidence suggests that bureaucracy in organisational governance impacts implementation processes, however, the nature of this effect is not yet explored. Objective: The study examined experiences of nursing staff implementing EBP in a bureaucratic acute care setting in Nigeria.Methods: A qualitative exploratory design was adopted. A purposive sample of 11 ward managers and 12 staff nurses from a large acute care setting in Nigeria participated in the in-depth, face-to-face interviews. Data was analysed using the thematic analysis approach.Results: Four key themes emerged: (1) top down managerial approach; (2) nurse and nurse manager relations; (3) managerial prerogatives; (4) managerial autonomy.Conclusions and implications for practice: The Nigerian bureaucracy limits professional and managerial autonomy that nurses require in driving EBP implementation. Nurse Managers require greater leadership visibility and structural empowerment to create enabling environment for EBP implementation in nursing.

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Quality Improvement and Evidence-Based Practice Change Projects and the Institutional Review Board: Is Approval Necessary?

Worldviews on Evidence-Based Nursing ◽

10.1111/wvn.12049 ◽

2014 ◽

Vol 11 (4) ◽

pp. 217-218 ◽

Cited By ~ 3

Author(s):

Marilyn Hockenberry

Keyword(s):

Quality Improvement ◽

Evidence Based Practice ◽

Practice Change ◽

Institutional Review Board ◽

Evidence Based ◽

Institutional Review ◽

Change Projects

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Implementing Evidence Into Everyday Practice: Midwifery Leaders’ Views About What Helps and Hinders Clinical Innovation.

10.21203/rs.3.rs-37978/v1 ◽

2020 ◽

Author(s):

Annemarie De Leo ◽

Sara Bayes ◽

Dianne Bloxome ◽

Janice Butt ◽

Sadie Geraghty

Keyword(s):

Evidence Based Practice ◽

Scientific Evidence ◽

Practice Change ◽

Assessment Tools ◽

Everyday Practice ◽

Nominal Group ◽

Evidence Based ◽

Valuable Insight ◽

Evidence Based Practices ◽

High Level

Abstract BackgroundDespite the ongoing production of new scientific evidence in the field of maternity care, midwives continue to face challenges when translating latest evidence into evidence-informed care, and report uncertainty in both knowledge and confidence to implement sustained evidence-based change in clinical areas. This study aimed toexplore midwifery leaders’ views on what factors help or hinder midwives’ efforts to implement evidence-based practices, and test the usability of the Capability, Opportunity, Motivation and Behaviour model and Transtheoretical Domains Framework to analyse the barriers and facilitators of evidence-based change.MethodsThis qualitative study formed part of a larger Participatory Action Research (PAR) project designed to improve the processes by which midwives implement evidence-based practice change in clinical areas. Data were obtained by a nominal group workshop and individual face-to-face interviews between July – September 2019. Thematic analysis was used to interpret the transcribed data, which were then coded and categorised into meaningful themes.ResultsOne overarching core finding emerged from four major categories to fulfil the aim of this study: Fear can stop change and midwives lack the confidence and time to implement new evidence-based practices, however having high level midwives in leadership roles is a huge advantage.ConclusionThis study confirms what is known about the hinderances and helpers of translating latest evidence into everyday practice, and provides valuable insight into the usability of behavioural theories and context assessment tools to both diagnose and develop intervention strategies applicable to midwives initiating evidence-based practice change in clinical areas.

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What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-19-00171 ◽

2020 ◽

Vol 29 (2) ◽

pp. 688-704

Author(s):

Katrina Fulcher-Rood ◽

Anny Castilla-Earls ◽

Jeff Higginbotham

Keyword(s):

Clinical Practice ◽

Research Evidence ◽

Evidence Based Practice ◽

Evidence Based ◽

Clinical Expertise ◽

Speech Language Pathologists ◽

School Based ◽

Research Findings ◽

Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

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Implementation of a Metabolic Management Practice Change in a Community Behavioral Health Clinic: An Evidence Based Practice Project

10.22371/07.2017.037 ◽

2017 ◽

Author(s):

Brenda Boyle

Keyword(s):

Behavioral Health ◽

Evidence Based Practice ◽

Management Practice ◽

Practice Change ◽

Health Clinic ◽

Evidence Based ◽

Metabolic Management ◽

Community Behavioral Health

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Evidence-Based Practice Patterns Among Speech-Language Pathologists and Audiologists in Saudi Arabia

Communication Disorders Quarterly ◽

10.1177/1525740119843681 ◽

2019 ◽

Vol 41 (4) ◽

pp. 242-249 ◽

Cited By ~ 1

Author(s):

Abdulsalam Alhaidary

Keyword(s):

Saudi Arabia ◽

Clinical Decision Making ◽

Practice Patterns ◽

Evidence Based Practice ◽

Clinical Decision ◽

Limited Resources ◽

Evidence Based ◽

Speech Language Pathologists ◽

Insufficient Time ◽

Ebp Implementation

The goal of this study was to explore the evidence-based practice (EBP) pattern among speech-language pathologists (SLPs) and audiologists in Saudi Arabia. A total of 48 clinicians working in Saudi Arabia completed a questionnaire that investigated patterns, attitudes, skills, and time and resources at the workplace related to EBP. The results showed that SLPs and audiologists held favorable attitudes toward EBP, and the use of research studies to guide clinical decision making was increased among the participants with previous EBP training. Also, the study found that skills and knowledge related to EBP need to be enhanced, but they were not major barriers to EBP implementation. Limited resources appeared to impose some hindrances, whereas insufficient time at the workplace was found to be a major challenge for EBP implementation. Overall, the findings from this study highlight the importance of increasing the continuing education and professional time for EBP activities in the workplace.

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