Knowledge, attitudes and behaviours of evidence-informed practice in respiratory therapy: A cross-sectional survey

Given the increased complexity of healthcare needs, evidence-informed practices are needed, now more than ever. Combining the best available research evidence, the perspectives of patients and communities, and the voices of healthcare workers in guiding policy and practice is essential. All of us involved in providing and strengthening family medicine and primary care need to be good consumers (users) of research, and some will be good producers (doers) of research. In both using and doing research, a helpful starting point is evidence synthesis - a form of secondary research that collates primary research on the same research question. This short report outlines when and how to incorporate evidence synthesis into doctoral work, highlighting methodological considerations, ethical principles and reporting standards. Practical tips and decision points are provided to support relevance, rigour and impact. Thoughtful integration of evidence synthesis - whether by using existing reviews or conducting new ones - enables doctoral researchers to contribute meaningfully to evidence-informed primary care practice and policy.

Improving Quality of Asthma Care After Emergency Department Discharge: Evidence Before Action

Background: Data-based decision-making (DBDM) and research-informed teaching practice (RITP) are key to teacher and school improvement. Currently, however, DBDM and RITP represent two distinct approaches to developing evidence-informed practice (EIP) and do not correspond to the all-encompassing notion of EIP envisaged by many academics and commentators.Purpose: DBDM and RITP are usually employed independently of each other. Each is associated with its own theoretical perspectives and research base, and each has its own pitfalls and strengths. Yet the approaches employed appear to be complementary, suggesting that there might be value in combining DBDM and RITP into one overarching process for achieving EIP. This paper presents the conceptual analysis and arguments for this proposal.Sources of evidence: Drawing from literature and previous research in the fields of DBDM, RITP and EIP, we describe both DBDM and RITP, before comparing and contrasting the integral aspects of each.Main argument: Our analysis leads us to suggest that not only is there overlap between these two approaches, but the strengths of each appear to mirror and compensate for the weaknesses of the other. As such, we argue that it is important that decisions in education are based on a combination of personal judgement, research evidence and local school data. This is because such a combination is likely to lead to equitable, effective and efficient decisions that are informed by values and preferences, grounded in context and steeped in practices that have been shown to be effective elsewhere.Conclusions: We suggest that an effective strategy for EIP might be to achieve ‘the best of two worlds’ by integrating DBDM and RITP. In line with evidence-informed practices in medicine and management, this means EIP in education can finally be engaged in as a holistic approach to educational decision-making that critically appraises different forms of evidence before key improvement decisions are made. Our proposed approach, Evidence informed School and Teacher Improvement, is thus designed with the aim of enhancing the quality of educational provision by employing these evidence types as part of a systematic cycle of inquiry, focused on continuously improving the quality of learning in schools.

Digital health technology adoption has accelerated in respiratory care, particularly since the COVID-19 pandemic, supporting various applications from self-management to telerehabilitation. While these technologies have transformed health care delivery, their impact on the patient-provider relationship in specialist respiratory care remains poorly understood. This study aims to systematically review the literature on the impact of digital health technology on the patient-provider relationship in respiratory secondary care settings and to understand the factors that enhance or diminish this relationship. In December 2023, we conducted a systematic review following Cochrane methodology, searching MEDLINE, Embase, CINAHL, Cochrane databases, and PsycINFO. We included qualitative, quantitative, and mixed methods studies examining digital health interventions in respiratory secondary care. Trained volunteers from the European Respiratory Society CONNECT Clinical Research Collaboration performed screening and data extraction. We conducted a qualitative meta-synthesis of findings, followed by an abductive quantitative data analysis. A total of 3 stakeholder workshops were held to interpret findings collaboratively with patients and health care professionals. From 15,779 papers screened, 97 met the inclusion criteria (55 qualitative/mixed-methods studies, 42 quantitative studies). Studies covered various respiratory conditions, including COPD (32%), asthma (26%), and COVID-19 (13%). Four main themes emerged: trust (foundational to the relationship), adoption factors (including clinical context and implementation drivers), confidence in technology (based on functionality and the evidence base), and connection (encompassing communication and a caring presence). Digital health technology can either enhance or diminish trust between patients and clinicians, with patients' perceptions of the motivations behind its implementation being crucial. While technology facilitated access and communication, remote consultations risked depersonalisation, particularly when not balanced with in-person interactions. Self-monitoring and access to information empowered patients and promoted more equitable patient-provider relationships. Digital health technology can either strengthen or weaken patient-provider relationships in respiratory care, with effects impacted by adoption factors, confidence in technology, connection, and patient empowerment. Maintaining trust in the era of digital care requires transparent implementation of motivations, consideration of individual circumstances, and reliable technology that supports rather than replaces the therapeutic relationship. PROSPERO CRD42024493664; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024493664.

BACKGROUND Digital health technology adoption has accelerated in respiratory care, particularly since the COVID-19 pandemic, supporting various applications from self-management to telerehabilitation. While these technologies have transformed health care delivery, their impact on the patient-provider relationship in specialist respiratory care remains poorly understood. OBJECTIVE This study aims to systematically review the literature on the impact of digital health technology on the patient-provider relationship in respiratory secondary care settings and to understand the factors that enhance or diminish this relationship. METHODS In December 2023, we conducted a systematic review following Cochrane methodology, searching MEDLINE, Embase, CINAHL, Cochrane databases, and PsycINFO. We included qualitative, quantitative, and mixed methods studies examining digital health interventions in respiratory secondary care. Trained volunteers from the European Respiratory Society CONNECT Clinical Research Collaboration performed screening and data extraction. We conducted a qualitative meta-synthesis of findings, followed by an abductive quantitative data analysis. A total of 3 stakeholder workshops were held to interpret findings collaboratively with patients and health care professionals. RESULTS From 15,779 papers screened, 97 met the inclusion criteria (55 qualitative/mixed-methods studies, 42 quantitative studies). Studies covered various respiratory conditions, including COPD (32%), asthma (26%), and COVID-19 (13%). Four main themes emerged: trust (foundational to the relationship), adoption factors (including clinical context and implementation drivers), confidence in technology (based on functionality and the evidence base), and connection (encompassing communication and a caring presence). Digital health technology can either enhance or diminish trust between patients and clinicians, with patients' perceptions of the motivations behind its implementation being crucial. While technology facilitated access and communication, remote consultations risked depersonalisation, particularly when not balanced with in-person interactions. Self-monitoring and access to information empowered patients and promoted more equitable patient-provider relationships. CONCLUSIONS Digital health technology can either strengthen or weaken patient-provider relationships in respiratory care, with effects impacted by adoption factors, confidence in technology, connection, and patient empowerment. Maintaining trust in the era of digital care requires transparent implementation of motivations, consideration of individual circumstances, and reliable technology that supports rather than replaces the therapeutic relationship. CLINICALTRIAL PROSPERO CRD42024493664; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024493664

The concepts of reflection and reflective practice are increasingly popular themes in the nursing literature. Reflective practice has been advocated as a method for overcoming the divergence between nursing theory and practice, and as a means of articulating and developing knowledge embedded in practice. However, these claims are based more on theoretical debate than research evidence. In common with other regulatory bodies, the Irish regulatory nursing body advocates the need for reflective nurses, and curricula are being adapted to reflect this. These changes are taking place when there is still little guidance on the teaching or assessment of reflective practice. Given the lack of research on the topic and the need for evidence on which to base the teaching of reflective practice, a descriptive exploratory study was undertaken. The aim of this paper is to report how a group of nurse teachers perceived and interpreted reflective practice in preregistration nursing curricula in schools of nursing in The Republic of Ireland. Data were collected using a postal questionnaire distributed to all schools of nursing involved in the preregistration diploma in nursing (n = 40). The results indicate variation between institutions in the number of hours allocated to the subject and where reflective practice was included in the curriculum. Emphasis was placed on theoretical models of reflection as opposed to the process or the skills required to become a reflective practitioner. Lecture and group discussion were the dominant teaching methods. Additionally, a number of teachers expressed dissatisfaction with the preparation they had received to teach the subject, and identified some of the challenges they experience when teaching reflective practice. The results provide a focus for further debate amongst nurse educators involved in implementing reflective practice in the curriculum. The results are limited by a response rate of 50% and by the geographic setting. Further research is needed to substantiate the findings of the study. However, there results do suggest that there is a need to clarify curricular content in relation to reflective practice and prepare nurse tutors for their role in teaching this subject more effectively.

Journal clubs are employed by education and healthcare institutions to facilitate learning about study design, to teach critical reading of the literature, and to help trainees and practitioners keep abreast in their fields. Our respiratory care department initiated a journal club that was open to all respiratory therapists in the community. The articles were selected by the journal club coordinator and posted on the club's web site. However, attendance remained poor despite changes in venue, time, and day of the week. In Washington State, respiratory therapists are required to obtain continuing respiratory care education credits (CRCEs), so we hypothesized that offering American Association for Respiratory Care CRCEs for journal club attendance would increase participation. We measured journal club attendance during the 8 months preceding and the 8 months following introduction of CRCE credit for journal club attendance. The journal club meetings were held during same time frame, on the same day of the week, and in the same geographic region during the pre-CRCE and CRCE periods. Advertising for the journal club was the same during both periods as well. Pre-CRCE attendance ranged from 5 to 8 persons per meeting (mean ± SD 6 ± 1 persons), and CRCE-period attendance ranged from 7 to 10 persons (mean ± SD 8 ± 1) (P = .01). Providing CRCE credits for attendance was associated with increased participation in our departmental journal club.

Evidence-informed massage therapy – an Australian practitioner perspective

This article identifies dualisms in the continuing and sometimes acrimonious discourse concerning the relationship between social work practice and research. In so doing, it describes the epistemological assumptions of and differences between evidence-based practice, research-based practice, practice-based research, and reflective practice. In the spirit of the Hong Kong conference, the author extends McNeill's concept of “evidence-informed practice” to suggest a more inclusive and harmonious conception of practice–research integration. The article concludes by considering what such a model might look like.

From Prevention through to Therapy: Supporting Evidence‐Informed Practice across the Spectrum of Child Maltreatment

Attitudes of Respiratory Care Practitioners and Students Regarding Pulmonary Prevention

Our critical care medicine journal clubs meet in an area somewhat remote from the critical care units. Led by the critical care medicine faculty, the sessions take place at a specified date and time during the day, and are not repeated. High acuity and an intense pace contributed to the challenges for staff in arranging to leave the bedside for an hour block of time. The review articles are available in an administrative area usually not frequented by the nursing staff.Because the nature of the articles may be intimidating to some staff nurses, they may be reluctant to contribute to the discussion. Results of studies conducted by physicians are shared with nurses in an inconsistent manner, which means the nurses may not appreciate the relevance to their daily practice. On a few occasions, advanced practice nurses ( APNs) have led the journal clubs, but the participation of nurses in the review and discussion of current research literature has been sparse overall. To address some of these issues, our pediatric intensive care unit ( PICU) APN started nursing journal clubs for the critical care nurses. The goals were to bring nursing research to the staff, to enhance staff nurse participation in journal clubs, to make nursing research more palatable, to advance the concept of evidence-based practice and to ease staff into the research process. The APN collaborated with the PICU nursing leadership to select a consistent meeting day and time that would best accommodate the nurses schedules. Because the census usually is low, Sunday was chosen.To allow for the participation of nurses on the night shift, who are usually organized and under way with their care by early evening, leadership recommended meeting at 10:30 PM. This would sandwich the journal club between change of shifts and lunch hours, while fulfilling the APN's night staff requirement. The discussion format used is consistent with the American Journal of Critical Care Journal Club Article Discussion Points that can be found online at www.ajc-conline.org. The components included are description of the study, literature evaluation, methods and design, results and clinical significance.However, because of time constraints, not all these points are covered each time. Instead, the APN higlights 1 or 2 components that are most interesting, most relevant to practice or most unique in terms of other studies on the same topic.Flexibility is essential to the success of the arrangement. The APN must be willing to repeat journal clubs several times during the same night, and to stop and start while nurses leave to tend to their patients needs. . Because of the way the unit is configured, journal clubs usually meet at the central nursing stations with front- and backroom locations. An isolation hallway also poses coverage issues for staff to relieve one another.Occasionally, journal clubs are repeated for the intermediate and cardiac ICU staffs. There is no minimum attendance requirement. In fact, journal clubs have been repeated for a single nurse whose patient assignment load precluded attending at the time scheduled. These repeat offerings make the time commitment for the APN significant. Of course, staff nurses who lead journal clubs do not have the degree of flexibility, so their sessions are not as likely to be repeated.Some of the ways the journal club has been approached are unique. For example, an undergraduate nursing student doing her practicum at our organization asked if she could do a critical care project. The APN worked with the faculty member to arrange that a journal club be presented by the student for the PICU staff. She aligned her topic with an evidence-based project that was launching at our organization. The result was that the needs of both the student and the staff were met. Another approach that was used by 2 nurses was copresenting. They had similar interests and found that sharing the work of preparation was more fun than working alone. Staff nurse presenters have the freedom to choose a topic, as long as the topic is consistent with current debate in the literature.Journal club meetings are announced through several channels including electronic mail, consistently formatted flyers placed in high traffic areas and overhead announcements within the unit one half hour before and immediately prior to the journal club beginning. There are also postings on a research-devoted bulletin board outside the nursing lounge. Charge nurses are called and reminded at the start of the shift during which the journal club will occur.With increasing popularity, there is now a monthly sign-up schedule, and club sessions are announced in advance in our Critical Care Newsletter.In the future, we hope to expand journal club participation to the neonatal ICU and to involve Transport Team nurses and respiratory therapists. We also want to have staff nurses summarize their presentations in the Critical Care Newsletter, because writing fits professionally with presenting and research. In addition, the APN has collaborated with the nurse who coordinates continuing education in trauma for the organization. The credit is applied to journal club attendance, and nurses may use it toward their trauma requirement. Collaboration is beginning to take place between staff nurses and the critical care education specialists on article selection and new product information. If topics pertaining to quality are being considered, the APN and staff nurses will verify with the nurse manager that they are aligned with unit goals.Targeting staff when they are in their first or second year of employment may be a valuable retention measure. In this early stage of employment, nurses are often ready to forge ahead professionally, and expand their level of participation and commitment to the unit on which they work. Involvement in research via journal clubs may be one method to accomplish career satisfaction. In fact, nurses have even given their peers a quiet ovation when they complete an article review!“In Our Unit” highlights unique practices, innovations, research, or resourceful solutions to commonly encountered problems in critical care areas and settings where critically ill patients are cared for. If you have an idea for an upcoming “In Our Unit,” send it to CRITICAL CARE NURSE,101 Columbia, Aliso Viejo, CA 92656; fax, (949)362-2049; e-mail, ccn@aacn.org.

Evidence-informed practice (EIP) is a model that incorporates best available research evidence; client’s needs, values, and preferences; practitioner wisdom; and theory into the clinical decision-making process filtered through the lens of client, agency, and community culture. The purpose of this article is to define and describe the evidence-informed practice model within social work and to explore the evolution of evidence-informed practice over time. The article distinguishes evidence-informed practice from the more commonly known (and perhaps more popular) evidence-based practice. And, having outlined the essential components of evidence-informed practice, describes the barriers to its effective implementation. Critical contextual factors related to the implementation of evidence-informed practice at the individual level, as well as within social work organizations, are also addressed. Finally, implications both for social work practice and education are explored.

Evidence-Informed Practice (EIP) utilizes the three components of expert opinion, research evidence, and client values. It is a recommended training competency for integrative health practitioners in diverse fields, such as acupuncture and massage therapy. Research Literacy (RL) is a necessary pre-requisite to EIP. Many yoga therapists have limited training in these skills, which negatively impacts inter-professional communication and collaboration, as well as further advancement of yoga therapy research and practice. In this article, we propose inclusion of RL and EIP in the training of yoga therapists. Benefits for client care, collaborative care, and the field of yoga therapy are discussed.

In 2018, the General Dental Council introduced reflective practice as part of an Enhanced Continuing Professional Development (ECPD) system, mandatory for registrants in the United Kingdom. The aim of this pilot study was to investigate dental professionals' perceptions and practice of reflection and to explore the benefits of an evidence-informed reflective practice learning course. This study was conducted at two dental schools in the United Kingdom (UK). A short course on reflective practice which included pre- and post-course surveys, using closed- and open-ended questions, was afforded to dental professionals attending Continuing Professional Development (CPD) courses. Quantitative data were analysed using SPSS version 25.0 software, and responses to open-ended questions were explored by content analysis. Fifty-two dentists attending the short course provided responses; the majority were female (73%, n=38) and internationally qualified (60%, n=31). The pre-course questionnaire revealed that the majority of participants (94%; n=49) considered reflection as part of their professional practice, with 55% (n=29) reporting doing so daily. Most (88%; n=46) had received no formal training. The post-course questionnaire revealed that 88% (n=46) found the course useful as it gave a "systematic and schematic" approach enhancing the participants' understanding of reflective practice. The findings suggest that a theoretically informed short course on reflective practice was welcomed by participants who showed a strong interest in learning how to reflect supported by mentors. This pilot provides the basis for further research on reflective practice.