The Use of Evidence-Based Management in Nursing Management

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Edris Hasanpoor ◽  
Yibeltal Siraneh Belete ◽  
Ali Janati ◽  
Sakineh Hajebrahimi ◽  
Elaheh Haghgoshayie
Keyword(s):  
Decision Making ◽  
Social Development ◽  
Research Evidence ◽  
Evidence Based ◽  
Nursing Management ◽  
Professional Expertise ◽  
Cross Sectional ◽  
North West ◽  
Nursing Managers ◽  
Development Plans

Evidence-based management (EBM) has been developed as a management framework for improving the quality of decisions. To use that, we need to identify the sources of evidence and to assess the utilisation of evidence in EBM. Therefore, the purpose of this study was to assess the utilisation of evidences and to identify predominantly used sources in EBM among nursing managers in Tabriz, north-west Iran. A facility-based descriptive cross-sectional study design was used in Tabriz hospitals. Out of 276 nursing managers eligible for the study from the Tabriz hospitals (n = 20), 205 nursing managers completed and returned the self-administered questionnaire, which indicated a response rate of 74.27 per cent. The questionnaire components included scientific and research evidence (four sources), facts and information from the hospitals (four sources), political-social development plans (three sources), the managers’ professional expertise (three sources), ethical-moral evidence (three sources), and values and expectations of all stakeholders (three sources). The results showed that the average use of scientific and research evidence (58.41 ± 13.23) was less than other sources of evidence. The average use of values and expectations of all stakeholders’ political-social development plans was (67.15 ± 14.78), managers’ professional expertise (70.47 ± 12.49), and ethical-moral evidence (68.91 ± 11.62). In addition, hospital ownership and the participants’ gender influence the use of facts and information of hospital and managers’ professional expertise. The findings showed that nursing managers were more customer- and expertise-oriented in the decision-making process. From the study findings we recommend utilisation of all the sources of evidence for decision-making in a full evidence-based nursing management process.

Evidence-Based Nursing Management: Basing Organizational Practices on the Best Available Evidence

2021 ◽  
Vol 27 (2) ◽  
pp. 94-97
Author(s):  
Elaheh Haghgoshayie ◽  
Edris Hasanpoor
Keyword(s):  
Research Evidence ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Nursing Management ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
Development Plans ◽  
Patient Values ◽  
Effective Use ◽  
Evidence Based Nursing

Evidence-based nursing management, developed as a framework for improving the quality of decisions to provide the most effective health-care outcomes, is a synthesis of clinical expertise, research evidence, and patient values, to create effective patient care strategies. Effective use of evidence-based nursing management requires identifying the sources of evidence and assessing their utilization. This article suggests a model for evidence-based nursing management in nursing practice. The literature shows six sources utilized for nursing management decisions: scientific and research evidence, information from hospitals, political-social development plans, managers' professional expertise, ethical-moral evidence, and values and expectations of all stakeholders.

Women's decision-making about mode of birth after a previous caesarean section

2020 ◽  
Vol 28 (2) ◽  
pp. 104-113
Author(s):  
Simona Fumagalli ◽  
Elisabetta Colciago ◽  
Laura Antolini ◽  
Sofia Perego ◽  
Micaela Fiorasi ◽  
...  
Keyword(s):  
Decision Making ◽  
Cross Sectional Study ◽  
Vaginal Birth ◽  
Evidence Based ◽  
Sectional Study ◽  
Cross Sectional ◽  
Midwifery Care ◽  
Previous Birth ◽  
Mode Of Birth ◽  
Vaginal Birth After Caesarean

Background Evidence on the safety and appropriateness of vaginal birth after caesarean (VBAC) appears clear, but knowledge about women's choice towards this mode of birth is limited. Aims To identify variables related to women's decision-making about whether to try for VBAC. Method and findings Cross-sectional study was conducted. Feelings of body failure towards the previous birth and the desire to have a vaginal birth were associated with maternal choice of VBAC. Women who perceived a repeated section as being dangerous for them opted for a VBAC (p=0.030). Opinion of women with the same experience and information found online were implicated into maternal decision-making. Conclusion This is the first Italian study to confirm that maternal choice is complex and involves many factors. Midwives and obstetricians should strive to provide an evidence-based midwifery care, in order to offer a VBAC as a safe birth option.

scholarly journals EVIDENCE-BASED MEDICINE IN THE TIMES OF COVID-19: A CROSS-SECTIONAL SURVEY TO UNDERSTAND THE INDIAN PERSPECTIVE

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Karan B. Bhanushali ◽  
Nikita Gupta ◽  
Vinayak Mishra ◽  
Heena Asnani
Keyword(s):  
Decision Making ◽  
Clinical Experience ◽  
Evidence Based Medicine ◽  
Online Survey ◽  
Medical Literature ◽  
Evidence Based ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference ◽  
Based Medicine

Introduction: During the COVID-19 pandemic, there is a tremendous amount of literature published regularly. In a country like India, historically, where there is a paternalistic approach to practicing medicine, there is a lot of hindrance to evidence-based medicine (EBM). Doctors have always weighed one's clinical experience superior over any other form of decision-making. This system of practice has made decision-making difficult for the physicians during this pandemic as COVID-19 is a reasonably new disease entity and the physicians lack enough 'prior experience' dealing with such a situation. Our survey tries to address the common barriers to evidence-based medical practices especially during the COVID-19 pandemic in India. We also try to explore the various source of information used by the doctors. Methods: It is a descriptive cross-sectional survey. The questions were provided in multiple-choice question format. An online survey comprising of 10 questions entitled “Hurdles faced by physicians to assimilate evidence-based guidelines on COVID-19” was made using Google Forms (Google Inc, California, US) and circulated through email to medical practitioners in the Ghatkopar (Mumbai, India) Medical Association's register from 17th June 2020 to 1st September 2020. Results: Our survey collected 213 responses, out of which 80.3% (n=171) of doctors were involved in care, counseling, or management of COVID-19 patients. The most opted primary sources for evidence-based information during this pandemic were teachings of/discussions with medical colleagues (71.4%, n=152), followed by online webinars (59.6%, n= 127) and social media (41.8%, n=89). When questioned about the main obstacles faced by them to obtain evidence-based information, the responses were as follows: Overload of medical literature (53.5%, n=114), limited access to quality resources (40.8%, n=87), unfamiliarity with the bio-statistics analysis (39%, n= 83), difficulty in locating relevant medical literature (38%, n=81), unfamiliarity with the research methodology (37.1%, n=79), lack of time (30%, n=64).  Our respondents' perspective concerning EBM attributes: 57.3% (n=122) think evidence-based practice takes their clinical experience into account. 93.4% (n=199) of them have shown an interest in broadening their skills. There was no significant difference between doctors' attitudes with less than 10 years and more than 10 years of experience (chi-square value = 0.857, p = 0.65). Conclusion: Our survey results highlight the balance maintained between evidence-based medicine and experience-based medicine by Indian physicians. They identify the importance of EBM while acknowledging its shortcomings. They realize the significance of developing their repertoire to understand, appraise, and practice EBM. Keywords: EBM, COVID-19

scholarly journals Commitment Levels of Health Care Providers in Using the District Health Information System and the Associated Factors for Decision Making in Resource-Limited Settings: Cross-sectional Survey Study

10.2196/23951 ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. e23951
Author(s):  
Shuma G Kanfe ◽  
Berhanu F Endehabtu ◽  
Mohammedjud H Ahmed ◽  
Nebyu D Mengestie ◽  
Binyam Tilahun
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Providers ◽  
Data Use ◽  
Health Information System ◽  
Evidence Based ◽  
Care Providers ◽  
District Health ◽  
Cross Sectional ◽  
Evidence Based Decision Making

Background Changing the culture of information use, which is one of the transformation agendas of the Ministry of Health of Ethiopia, cannot become real unless health care providers are committed to using locally collected data for evidence-based decision making. The commitment of health care providers has paramount influence on district health information system 2 (DHIS2) data utilization for decision making. Evidence is limited on health care providers’ level of commitment to using DHIS2 data in Ethiopia. Therefore, this study aims to fill this evidence gap. Objective This study aimed to assess the levels of commitment of health care providers and the factors influencing their commitment levels in using DHIS2 data for decision making at public health care facilities in the Ilu Aba Bora zone of the Oromia national regional state, Ethiopia in 2020. Methods The cross-sectional quantitative study supplemented by qualitative methods was conducted from February 26, 2020 to April 17, 2020. A total of 264 participants were approached. SPSS version 20 software was used for data entry and analysis. Descriptive and analytical statistics, including bivariable and multivariable analyses, were performed. Thematic analysis was conducted for the qualitative data. Results Of the 264 respondents, 121 (45.8%, 95% CI 40.0%-52.8%) respondents showed high commitment levels to use DHIS2 data. The variables associated with the level of commitment to use DHIS2 data were found to be provision of feedback for DHIS2 data use (adjusted odds ratio [AOR] 1.85, 95% CI 1.02-3.33), regular supervision and managerial support (AOR 2.84, 95% CI 1.50-5.37), information use culture (AOR 1.92, 95% CI 1.03-3.59), motivation to use DHIS2 data (AOR 1.80, 95% CI 1.00-3.25), health needs (AOR 3.96, 95% CI 2.11-7.41), and competency in DHIS2 tasks (AOR 2.41, 95% CI 1.27-4.55). Conclusions In general, less than half of the study participants showed high commitment levels to use DHIS2 data for decision making in health care. Providing regular supportive supervision and feedback and increasing the motivation and competency of the health care providers in performing DHIS2 data tasks will help in promoting their levels of commitment that can result in the cultural transformation of data use for evidence-based decision making in health care.

scholarly journals Strategies to Promote Evidence-Based Practice in Pediatric Physical Therapy: A Formative Evaluation Pilot Project

2009 ◽  
Vol 89 (9) ◽  
pp. 918-933 ◽  
Author(s):  
Joe Schreiber ◽  
Perri Stern ◽  
Gregory Marchetti ◽  
Ingrid Provident
Keyword(s):  
Decision Making ◽  
Formative Evaluation ◽  
Research Evidence ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Physical Therapists ◽  
Pilot Project ◽  
Clinical Decision ◽  
Evidence Based ◽  
Practice Behaviors

BackgroundThe physical therapy profession has been perceived as one that bases its practice largely on anecdotal evidence and that uses treatment techniques for which there is little scientific support. Physical therapists have been urged to increase evidence-based practice behaviors as a means to address this perception and to enhance the translation of knowledge from research evidence into clinical practice. However, little attention has been paid to the best ways in which to support clinicians’ efforts toward improving evidence-based practice.ObjectivesThe purpose of this study was to identify, implement, and evaluate the effectiveness of strategies aimed at enhancing the ability of 5 pediatric physical therapists to integrate scientific research evidence into clinical decision making.DesignThis study was a formative evaluation pilot project.MethodsThe participants in this study collaborated with the first author to identify and implement strategies and outcomes aimed at enhancing their ability to use research evidence during clinical decision making. Outcome data were analyzed with qualitative methods.ResultsThe participants were able to implement several, but not all, of the strategies and made modest self-reported improvements in evidence-based practice behaviors, such as reading journal articles and completing database searches. They identified several barriers, including a lack of time, other influences on clinical decision making, and a lack of incentives for evidence-based practice activities.ConclusionsThe pediatric physical therapists who took part in this project had positive attitudes toward evidence-based practice and made modest improvements in this area. It is critical for the profession to continue to investigate optimal strategies to aid practicing clinicians in applying research evidence to clinical decision making.

scholarly journals Evidence-based decision making and promotion of physical activity among directors of local health departments

2018 ◽  
Vol 52 ◽  
pp. 90
Author(s):  
Leonardo Augusto Becker ◽  
Cassiano Ricardo Rech ◽  
Adriano Akira Ferreira Hino ◽  
Rodrigo Siqueira Reis
Keyword(s):  
Physical Activity ◽  
Decision Making ◽  
The State ◽  
Evidence Based ◽  
Local Health ◽  
Cross Sectional ◽  
Promotion Of Physical Activity ◽  
Municipal Administrators ◽  
Decision Making Model ◽  
Evidence Based Decision Making

OBJECTIVE: To describe the steps involved in evidence-based decision making for the implementation of programs aimed at the promotion of physical activity. METHODS: It is a descriptive, cross-sectional study with quali-quantitative approach, held with municipal health secretaries chosen deliberately by regional health representatives of the state of Paraná. A total of 27 secretaries participated in a telephone interview consisting of 17 open questions. Content analysis was conducted according to the categories of an evidencebased decision-making model consisting of seven steps. RESULTS: None of the participants employed every step of the evidence-based decision-making model. The steps that were most often mentioned included: evaluation of the program (33.3%), use of evidence from the literature (22.2%) and identification of the problem (22.2%). The steps that were reported the least included: quantification of the problem (14.8%), development and prioritization of actions (14.8%), development of the plan of action (14.8%) and evaluation of the community (3.7%). CONCLUSIONS: The use of evidence-based decision making in the context of the promotion of physical activity was shown to be incipient among the health secretaries of the state of Paraná. We suggest widening dissemination and training on the use of evidence-based decision making among municipal administrators to increase the effectiveness of actions for promotion of physical activity.

Navigating the Evidence-Based Practice Maze

2012 ◽  
Vol 48 (3) ◽  
pp. 159-166 ◽  
Author(s):  
Valerie L. Mazzotti ◽  
Dawn R. Rowe ◽  
David W. Test
Keyword(s):  
Decision Making ◽  
Students With Disabilities ◽  
Secondary Students ◽  
Teaching Practices ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Statewide Testing ◽  
Education Movement

Factors such as the standards-based education movement, mandated participation in statewide testing, and inclusion have forced an increased focus on improving outcomes for students with disabilities. There are many determinants of postschool success for students with disabilities; however, teachers primarily have control over only one, teaching practices and programs. As a result, it is important that teachers choose and implement practices that have proven successful for secondary students with disabilities. This article guides teachers through the process of navigating the evidence-based practice maze to identify evidence-based practices and programs for secondary students with disabilities. Particularly, it addresses the need to (a) follow a research-based framework (i.e., Kohler’s Taxonomy), (b) use practices with the best available research evidence to support effectiveness, and (c) use data-based decision making to guide use of evidence-based practices.

scholarly journals Cross-Sectional Study to Examine Evidence-Based Practice Skills and Behaviors of Physical Therapy Graduates: Is There a Knowledge-to-Practice Gap?

2015 ◽  
Vol 95 (4) ◽  
pp. 568-578 ◽  
Author(s):  
Patricia J. Manns ◽  
Amy V. Norton ◽  
Johanna Darrah
Keyword(s):  
Decision Making ◽  
Clinical Experience ◽  
Evidence Based Practice ◽  
Cross Sectional Study ◽  
Evidence Based ◽  
Sectional Study ◽  
Cross Sectional ◽  
Academic Knowledge ◽  
Practice Gap ◽  
Practice Skills

Background Curricula changes in physical therapist education programs in Canada emphasize evidence-based practice skills, including literature retrieval and evaluation. Do graduates use these skills in practice? Objectives The aim of this study was to evaluate the use of research information in the clinical decision making of therapists with different years of experience and evidence-based practice preparation. Perceptions about evidence-based practice were explored qualitatively. Design A cross-sectional study with 4 graduating cohorts was conducted. Methods Eighty physical therapists representing 4 different graduating cohorts participated in interviews focused on 2 clinical scenarios. Participants had varying years of clinical experience (range=1–15 years) and academic knowledge of evidence-based practice skills. Therapists discussed the effectiveness of interventions related to the scenarios and identified the sources of information used to reach decisions. Participants also answered general questions related to evidence-based practice knowledge. Results Recent graduates demonstrated better knowledge of evidence-based practice skills compared with therapists with 6 to 15 years of clinical experience. However, all groups used clinical experience most frequently as their source of information for clinical decisions. Research evidence was infrequently included in decision making. Limitations This study used a convenience sample of therapists who agreed to volunteer for the study. Conclusions The results suggest a knowledge-to-practice gap; graduates are not using the new skills to inform their practice. Tailoring academic evidence-based activities more to the time constraints of clinical practice may help students to be more successful in applying evidence in practice. Academic programs need to do more to create and nurture environments in both academic and clinical settings to ensure students practice using evidence-based practice skills across settings.

scholarly journals Exploring the Use of Evidence From the Development and Evaluation of an Electronic Health (eHealth) Trial: Case Study

10.2196/17718 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e17718
Author(s):  
Monika Jurkeviciute ◽  
Henrik Eriksson
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Patient Preferences ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Professional Experience ◽  
Evidence Based ◽  
Policy Decisions ◽  
Professional Experiences

Background Evidence-based practice refers to building clinical decisions on credible research evidence, professional experience, and patient preferences. However, there is a growing concern that evidence in the context of electronic health (eHealth) is not sufficiently used when forming policies and practice of health care. In this context, using evaluation and research evidence in clinical or policy decisions dominates the discourse. However, the use of additional types of evidence, such as professional experience, is underexplored. Moreover, there might be other ways of using evidence than in clinical or policy decisions. Objective This study aimed to analyze how different types of evidence (such as evaluation outcomes [including patient preferences], professional experiences, and existing scientific evidence from other research) obtained within the development and evaluation of an eHealth trial are used by diverse stakeholders. An additional aim was to identify barriers to the use of evidence and ways to support its use. Methods This study was built on a case of an eHealth trial funded by the European Union. The project included 4 care centers, 2 research and development companies that provided the web-based physical exercise program and an activity monitoring device, and 2 science institutions. The qualitative data collection included 9 semistructured interviews conducted 8 months after the evaluation was concluded. The data analysis concerned (1) activities and decisions that were made based on evidence after the project ended, (2) evidence used for those activities and decisions, (3) in what way the evidence was used, and (4) barriers to the use of evidence. Results Evidence generated from eHealth trials can be used by various stakeholders for decisions regarding clinical integration of eHealth solutions, policy making, scientific publishing, research funding applications, eHealth technology, and teaching. Evaluation evidence has less value than professional experiences to local decision making regarding eHealth integration into clinical practice. Professional experiences constitute the evidence that is valuable to the highest variety of activities and decisions in relation to eHealth trials. When using existing scientific evidence related to eHealth trials, it is important to consider contextual relevance, such as location or disease. To support the use of evidence, it is suggested to create possibilities for health care professionals to gain experience, assess a few rather than a large number of variables, and design for shorter iterative cycles of evaluation. Conclusions Initiatives to support and standardize evidence-based practice in the context of eHealth should consider the complexities in how the evidence is used in order to achieve better uptake of evidence in practice. However, one should be aware that the assumption of fact-based decision making in organizations is misleading. In order to create better chances that the evidence produced would be used, this should be addressed through the design of eHealth trials.

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