Implementation Of Evidence-based Practices Research Articles

Pilot study of implementing Managing and Adapting Practice in a German psychotherapy master’s program

Despite a significant accumulation of research, there has been little systemic implementation of evidence-based practices (EBP) in youth mental health care. The fragmentation of the evidence base complicates implementation efforts. In light of this challenge, we sought to pilot a system that consolidates and coordinates the entire evidence base in a single direct service model (i.e., Managing and Adapting Practice; MAP) in the context of a legal reform of psychotherapy training in Germany. This pilot study aimed to evaluate the feasibility of the implementation of MAP into the curriculum of the reformed German master's program. Eligible participants were students in the master’s program at Philipps-University Marburg during the winter-term 2022/2023. Students first learned about MAP through introductions and role plays (seminar 1), followed by actively planning and conducting interventions using MAP resources for patients in a case seminar under supervision (seminar 2). A repeated-measures survey was conducted to investigate students’ knowledge gains, perception of MAP and changes in their self-rated confidence to use EBP. Results indicated that students perceive MAP to be manageable to learn. Positive progress was achieved with regard to their knowledge and self-reported confidence to use EBP, although interpretation and generalization of the results are limited by small and homogeneous samples, lack of statistical power and missing comparison groups. The feasibility of the implementation and suitability of measures are discussed. Important implications could be drawn with regard to future investigations.

Navigating complexities: clinicians’ experiences and systemic challenges in the implementation of evidence-based practice for chronic low back pain – a qualitative study

Purpose Implementation of evidence-based practice (EBP) for chronic low back pain (CLBP) is poor. This study aimed to investigate the factors that influence exercise-based clinicians’ implementation of EBP for people with CLBP. Materials and Methods Semi-structured interviews were conducted with 40 clinicians (20 physiotherapists and 20 accredited exercise physiologists). Interviews explored clinicians’ definition of EBP, understanding of EBP in CLBP management, barriers and enablers to EBP, and the impact of these factors on EBP implementation. Interviews were analysed using reflexive thematic analysis. Results A complex interplay among clinician factors, systemic factors, and patient interactions was identified. Clinicians encountered challenges stemming from their misconceptions about EBP, which influenced their perspective(s) on its implementation. Clinicians expressed the challenges of implementing EBP when navigating patient expectations and beliefs, experiencing external pressures from funders and business models, and the subsequent impacts on their well-being. Continuing professional development, support from community, and workplaces that prioritised EBP enhanced clinicians’ ability to make decisions that accommodate for the complexities of CLBP and better align with EBP. Conclusion A variety of factors impact exercise-based clinicians’ implementation of EBP. The interaction between these factors greatly influences clinicians’ ability to engage in and implement EBP in clinical practice.

T111 - The ATTC Network: 30 Years of Supporting EBP Implementation in SUD Treatment and Recovery Services

T111 - The ATTC Network: 30 Years of Supporting EBP Implementation in SUD Treatment and Recovery Services

ABORDAGENS CONTEMPORÂNEAS NO MANEJO DA ECLAMPSIA: ESTRATÉGIAS PARA MELHORAR RESULTADOS MATERNOS E FETAIS

Introduction: Eclampsia represents one of the most severe and challenging obstetric complications, characterized by the development of seizures in women with preeclampsia, a condition marked by high blood pressure and proteinuria during pregnancy. Methodology: The research question was carefully formulated to capture the main advances and practices in the management of eclampsia. The central question defined was: "What are the effective contemporary strategies in managing eclampsia that contribute to the improvement of maternal and fetal outcomes?" Results: Technological advancements have played an increasing role in the management of eclampsia. Advanced imaging technologies, such as Doppler ultrasound, have been used to assess fetal health and placental perfusion, providing valuable information that can guide clinical decision-making. Conclusion: Collaboration among researchers, healthcare professionals, and patients is crucial to promote the advancement of knowledge and the implementation of evidence-based practices in the management of eclampsia, thus ensuring better outcomes for women and their children.

The Role of Implementation Climate in Moderating Educator Use of Evidence-Based Practices and Outcomes for Autistic Students.

Ensuring effective use of evidence-based practice (EBP) for autism in schools is imperative due to the significantly increasing number of autistic students receiving school services each year. High-quality EBP use has proven challenging in schools. Research indicates implementation climate, or how EBP are supported, rewarded, and valued, and EBP resources are related to successful implementation. However, limited understanding of system-level contextual factors that impact EBP implementation for school-based providers makes development of appropriate implementation supports challenging. Understanding these factors is crucial for selecting and tailoring implementation strategies to support EBP scale up. In this observational study, California school-based providers (n = 1084) completed surveys related to implementation climate, leadership, autism experience and EBP implementation (use, competence, knowledge). Student outcomes included state level academic and behavioral indicators. Using an implementation science framework (Aarons et al., in Administration and Policy in Mental Health and Mental Health Services Research 38:4-23, 2011) and multilevel modeling, we examined the relationship between EBP Implementation and student outcomes and the moderation effects of provider and district level factors. Higher implementation climate predicted better EBP implementation outcomes, and proved more impactful when provider hands-on autism experience was low. Greater EBP resources predicted a higher percentage of students who met math standards only when district poverty level was high. Our findings suggested moderating effects on EBP implementation from both provider and system level factors. Implementation climate and resources may be especially key in addressing equity issues related to high poverty schools in which teachers often have less autism experience.

Fostering citizen-engaged HIV implementation science.

Successful implementation of evidence-based practices depends on contextual factors like stakeholder engagement, the socio-political environment, resource availability, and stakeholders' felt needs and preferences. Nevertheless, inequities in implementation exist and undermine efforts to address HIV in marginalized key populations. Implementation science shows promise in addressing such inequities in the HIV response, but can be limited without meaningful engagement from citizens or communities. We define the concept of a citizen-engaged HIV implementation science as one that involves citizens and communities deeply in HIV implementation science activities. In this commentary, we discuss how citizen science approaches can be leveraged to spur equity in HIV implementation science. Drawing on three areas previously defined by Geng and colleagues that serve to drive impactful implementation science in the HIV response, we discuss how citizens can be engaged when considering "whose perspectives?", "what questions are being asked?" and "how are questions asked?". With respect to "whose perspectives?" a citizen-engaged HIV implementation science would leverage participatory methods and tools, such as co-creation, co-production and crowdsourcing approaches, to engage the public in identifying challenges, solve health problems and implement solutions. In terms of "what questions are being asked?", we discuss how efforts are being made to synthesize citizen or community-led approaches with existing implementation science frameworks and approaches. This also means that we ensure communities have a say in interrogating and deconstructing such frameworks and adapting them to local contexts through participatory approaches. Finally, when considering "how are questions asked?", we argue for the development and adoption of broad, guiding principles and frameworks that account for dynamic contexts to promote citizen-engaged research in HIV implementation science. This also means avoiding narrow definitions that limit the creativity, innovation and ground-up wisdom of local citizens. By involving communities and citizens in the development and growth of HIV implementation science, we can ensure that our implementation approaches remain equitable and committed to bridging divides and ending AIDS as a public health threat. Ultimately, efforts should be made to foster a citizen- and community-engaged HIV implementation science to spur equity in our global HIV response.

Clinical Implementation of DIGEST as an Evidence-Based Practice Tool for Videofluoroscopy in Oncology: A Six-Year Single Institution Implementation Evaluation.

Clinical implementation of evidence-based practice (EBP) tools is a healthcare priority. The Dynamic Grade of Swallowing Toxicity (DIGEST) is an EBP tool developed in 2016 for videofluoroscopy in head and neck (H&N) oncology with clinical implementation as a goal. We sought to examine: (1) feasibility of clinical implementation of DIGEST in a national comprehensive cancer center, and (2) fidelity of DIGEST adoption in real-world practice. A retrospective implementation evaluation was conducted in accordance with the STARI framework. Electronic health record (EHR) databases were queried for all consecutive modified barium swallow (MBS) studies conducted at MD Anderson Cancer Center from 2016 to 2021. Implementation outcomes included: feasibility as measured by DIGEST reporting in EHR (as a marker of clinical use) and fidelity as measured by accuracy of DIGEST reporting relative to the decision-tree logic (penetration-aspiration scale [PAS], residue, and Safety [S] and Efficiency [E] grades). Contextual factors examined included year, setting, cancer type, MBS indication, and provider. 13,055 MBS were conducted by 29 providers in 7,842 unique patients across the lifespan in diverse oncology populations (69% M; age 1-96 years; 58% H&N cancer; 10% inpatient, 90% outpatient). DIGEST was reported in 12,137/13,088 exams over the 6-year implementation period representing 93% (95% CI: 93-94%) adoption in all exams and 99% (95% CI: 98-99%) of exams excluding the total laryngectomy population (n = 730). DIGEST reporting varied modestly by year, cancer type, and setting/provider (> 91% in all subgroups, p < 0.001). Accuracy of DIGEST reporting was high for overall DIGEST (incorrect SE profile 1.6%, 200/12,137), DIGEST-safety (incorrect PAS 0.4% 51/12,137) and DIGEST-efficiency (incorrect residue 1.2%, 148/12,137). Clinical implementation of DIGEST was feasible with high fidelity in a busy oncology practice across a large number of providers. Adoption of the tool across the lifespan in diverse cancer diagnoses may motivate validation beyond H&N oncology.

Barriers and facilitators of nurse-led self-management support for adolescents with epilepsy: A mixed-methods study in transition preparation

AimsTo gain insight into the readiness for evidence-based practice of self-management support during transition for adolescents with epilepsy among pediatric nurses, and to explore the promoting and hindering factors. DesignA mixed-methods design with an explanatory sequential approach was employed. SettingThree specialty children's hospitals in southwest regions of China. MethodsIn phase 1, a total of 126 participants were included in the Survey of Clinical Readiness of Evidence-Based Nursing Assessment (CREBNA) from Dec 2022 to Feb 2023. Total scale and subscale scores were calculated. In phase 2, we developed the interview outline based on the analysis of the quantitative results. In-depth interviews (n = 15) were conducted from Feb 2023 to Apr 2023 to explain and supplement the quantitative phase results. ResultsThe total score of CREBNA indicated that teams have good readiness and capacity for implementation of evidence-based nursing practice Compared with the norm. The scores of the three subscales of evidence factors, organizational environment, and promoting factors were normal. In subsequent interviews and integration, we extracted four themes based on the Knowledge-To-Action (KTA) framework: 1. organization barriers (incentive mechanism, interdisciplinary cooperation process, information aids); 2. operational barriers (Exemplary evidence-based practice, time pressure, gaps in patient and family understanding of evidence); 3. individual-level barriers (evidence-based and professional knowledge reserve, professional autonomy, shared decision-making roles, dependence on habitual clinical behaviors); and 4. facilitating factors (leadership commitment, self-management identity, transition service needs, patient- and family-centered care culture). A conceptual model was constructed based on the KTA. ConclusionIt is feasible to carry out evidence-based practice of nurse-led self-management support in transition preparation. Nursing researchers and managers should carry out knowledge selection and tailoring based on barriers at the organizational, operational, and individual levels to promote favorable factors and improve the smooth transition of adolescents with chronic diseases.

What Really Matters in the Implementation of Evidence-based Practices in Community Mental Health? Insight and Recommendations from Experts, Providers, and Clients.

Perceptions of evidence-based practices (EBPs) and implementation are inherent drivers of implementation outcomes. Most studies on implementation perceptions have focused on direct service providers, but clients and EBP experts may offer additional meaningful information about implementing EBPs in community settings. EBP providers (n = 21), EBP experts (n = 12), and clients who received EBPs (n = 6) participated in focus groups to ascertain their perceptions of and experiences with EBP implementation, as part of a program evaluation. Thematic analysis indicated that provider and expert perceptions of EBP implementation in community settings converged around themes of implementation supports and training and client outcomes, along with several subthemes. Client perceptions centered on themes regarding the importance of their personal experiences, their impressions of EBPs, as well as their recommendation for increasing public awareness and use of EBPs. Findings suggest that the perspectives of EBP providers and experts are closely aligned, focusing on system-level, individual-level, and training issues that impact EBP implementation within a public mental health system. The themes that were important to clients were primarily related to their experiences as recipients of an EBP which produced insightful recommendations for promoting EBPs in the community.

Enhancing Language Skills in Golden Age Children through English Phonology

This study explores the significance of English phonology in enhancing language skills during the golden age of childhood. Phonological awareness, encompassing sound discrimination and manipulation, plays a crucial role in vocabulary acquisition, reading proficiency, and overall linguistic development. Early intervention through phonological activities in educational settings, supported by parental involvement and technological integration, fosters a strong foundation for language acquisition. Continuous professional development for educators ensures the implementation of evidence-based practices in phonological instruction. Investing in phonological awareness during childhood is essential for promoting academic success, cognitive development, and lifelong literacy.

Improving quality and patient safety in surgical care through standardisation and harmonisation of perioperative care (SAFEST project): A research protocol for a mixed methods study.

Adverse events in health care affect 8% to 12% of patients admitted to hospitals in the European Union (EU), with surgical adverse events being the most common types reported. SAFEST project aims to enhance perioperative care quality and patient safety by establishing and implementing widely supported evidence-based perioperative patient safety practices to reduce surgical adverse events. We will conduct a mixed-methods hybrid type III implementation study supporting the development and adoption of evidence-based practices through a Quality Improvement Learning Collaborative (QILC) in co-creation with stakeholders. The project will be conducted in 10 hospitals and related healthcare facilities of 5 European countries. We will assess the level of adherence to the standardised practices, as well as surgical complications incidence, patient-reported outcomes, contextual factors influencing the implementation of the patient safety practices, and sustainability. The project will consist of six components: 1) Development of patient safety standardised practices in perioperative care; 2) Guided self-evaluation of the standardised practices; 3) Identification of priorities and actions plans; 4) Implementation of a QILC strategy; 5) Evaluation of the strategy effectiveness; 6) Patient empowerment for patient safety. Sustainability of the project will be ensured by systematic assessment of sustainability factors and business plans. Towards the end of the project, a call for participation will be launched to allow other hospitals to conduct the self-evaluation of the standardized practices. The SAFEST project will promote patient safety standardized practices in the continuum of care for adult patients undergoing surgery. This project will result in a broad implementation of evidence-based practices for perioperative care, spanning from the care provided before hospital admission to post-operative recovery at home or outpatient facilities. Different implementation challenges will be faced in the application of the evidence-based practices, which will be mitigated by developing context-specific implementation strategies. Results will be disseminated in peer-reviewed publications and will be available in an online platform.

Knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries: A scoping review.

Over the past three decades, research studies on nurses' engagement in evidence-based practice (EBP) have been widely reported, particularly in high-income countries, with studies from these countries dominating literature reviews. As low- and middle-income countries (LMICs) continue to join the EBP movement, primary research has emerged over the past decade about nurses' engagement with EBP. The aim of this scoping review was to identify the types and extent of published research regarding nurses' knowledge, skills, attitudes, beliefs, and implementation of EBP in LMICs. The JBI scoping review methodology was used. Eight databases were searched up to November 2023. The review included primary studies (quantitative, qualitative, and mixed methods) that reported the knowledge, skills, attitudes, beliefs, or implementation of EBP among nurses in LMICs. Included studies focused on registered nurses in all healthcare settings within LMICs. Studies published in English were included with no limit on publication date. Two independent reviewers screened titles, abstracts, and full-text articles of published studies. Data were analyzed quantitatively using frequencies and counts. Textual data from qualitative studies were analyzed using descriptive content analysis. Fifty-three publications were included, involving 20 LMICs. Studies were published between 2007 and 2023, with over 60% published in the past 7 years. Studies that evaluated familiarity/awareness of EBP showed that in general, nurses had low familiarity with or awareness of EBP. Most studies (60%) described nurses' attitudes toward EBP as positive, favorable, or high, and 31% as moderate. However, over 60% of studies described nurses' EBP knowledge/skills as moderate, low, or insufficient. Approximately 84% of studies described EBP implementation in healthcare settings as moderate, low, poor, or suboptimal. Studies on nursing EBP have been increasing in LMICs for the past two decades, with findings highlighting opportunities for advancing EBP in nursing within LMICs. Health systems and healthcare organization leaders in LMICs should equip nurses with EBP knowledge and skills while providing the needed resources and support to ensure consistent implementation of EBP to improve health outcomes.

Utility of the Leadership and Organizational Change for Implementation-Systems Level (LOCI-SL) strategy for a statewide substance use treatment implementation effort

IntroductionMulti-level and cross-context implementation strategies are needed to support health systems, healthcare delivery organizations, and providers to adopt evidence-based practice (EBP) for substance use disorder (SUD) treatment. However, misalignment between state oversight agencies and healthcare organizations about which services to prioritize and which outcomes are reasonable to expect can hinder implementation success and widespread access to high-quality care. This study investigated the utility of the Leadership and Organizational Change for Implementation-System Level (LOCI-SL) strategy for supporting statewide EBP implementation for SUD treatment. MethodsNine community mental health centers (CMHCs) contracted by a state agency participated in a combined motivational-enhancement therapy and cognitive behavioral therapy (MET/CBT) implementation effort. Five of the CMHCs also received the LOCI-SL strategy to obtain ongoing implementation support. We conducted 21 individual interviews and three small group interviews with 30 participants across CMHCs and state health agencies to investigate the utility of LOCI-SL in supporting their EBP implementation efforts. Deductive thematic analysis was guided by the Exploration, Preparation, Implementation, Sustainment Framework. ResultsFive themes described CMHCs' LOCI-SL and broader contextual experiences implementing EBPs: (1) LOCI-SL supported executives in Preparation phase activities that holistically considered organizational needs and capacity to implement and sustain EBPs; (2) LOCI-SL facilitated trust and communication processes across Preparation, Implementation, and Sustainment phases to improve EBP uptake; (3) LOCI-SL increased CMHCs' use of implementation climate strengthening activities throughout the Implementation phase; (4) state contracts did not emphasize quality and thus were not sufficient bridging factors to enforce EBP fidelity during Implementation; and, (5) limited funding and low Medicaid reimbursement rates hindered EBP use throughout the Implementation and Sustainment phases. ConclusionsLOCI-SL was viewed as a favorable and useful implementation strategy for supporting statewide adoption of EBPs. However, outer context barriers, including limited financial investments in the treatment system, impeded implementation and sustainment efforts. While previous research suggests that contracts are viable alignment-promoting bridging factors, this study demonstrates the importance of articulating implementation outcome expectations to aid state-contracted organizations in achieving EBP implementation success. This study also highlights the need for multi-level implementation strategies to effectively align implementation expectations between outer- and inner-context entities.

Implementation Science's Role in Community Engagement for Substance Use Prevention.

Until recently, the field of implementation science has provided limited insight and guidance on the use of community engagement and partnership to support implementation of evidence-based practices. Listing community engagement as a barrier to optimal implementation is often the extent of the discussion. An article recently published by Perry et al. (PS 24:61-76, 2023) details what community engagement can entail and documents how this engagement can shape opioid use prevention research. The article also describes benefits of engaging community partners in prevention interventions, particularly for opioid use disorder, and the feasibility of employing multiple levels of engagement to do so. The article concludes by emphasizing areas for future research including examining the role community engagement has on the success of prevention interventions and the impact on long-term intervention outcomes. To respond to the Perry et al. (PS 24:61-76, 2023) article, our team conducted a literature scan of recently published implementation science and community engagement manuscripts, which demonstrated a growing body of research on the subject. We summarize these findings by offering suggested approaches for integrating implementation science and community engagement for substance use prevention programs and suggestions for advancing this intersection.

Designing studies and reviews to produce informative, trustworthy evidence about complex interventions in rehabilitation: a narrative review and commentary.

According to Cochrane Rehabilitation's recently published definition for research purposes, rehabilitation is inherently complex. Rehabilitation teams frequently implement multiple strategies concurrently, draw on input from a range of different health professionals, target multiple outcomes, and personalize therapeutic plans. The success of rehabilitation lies not only in the specific therapies employed, but also in how they are delivered, when they are delivered, and the capability and willingness of patients to engage in them. In 2021, the UK Medical Research Council (MRC) and the National Institute of Health Research (NIHR) released the second major update of its framework for developing and evaluating complex interventions. This framework has direct relevance to the development and implementation of evidence-based practice in the field of rehabilitation. While previous iterations of this framework positioned complex interventions as anything that involved multiple components, multiple people, multiple settings, multiple targets of effect, and behavior change, this latest framework expanded on this concept of complexity to also include the characteristics and influence of the context in which interventions occur. The revised MRC-NIHR framework presents complex intervention research as comprising the following four inter-related and overlapping phases: 1) development or identification of the intervention; 2) feasibility; 3) evaluation; and 4) implementation, with different methods and tools required to address each of these phases. This paper provides an overview of the MRC-NIHR framework and its application to rehabilitation, with examples from past research. Rehabilitation researchers are encouraged to learn about the MRC-NIHR framework and its application. Funders of rehabilitation research are also encouraged to place greater emphasis on supporting studies that involve the right design to address key uncertainties in rehabilitation clinical practice. This will require investment into a broader range of types of research than simply individual-level randomized controlled trials. Rehabilitation research can both learn from and contribute to future iterations of the MRC-NIHR framework as it is an excellent environment for exploring complexity in clinical practice.

Nurses’ Perception on Evidence Based Practice in Tertiary Hospital of Nepal: A Quantitative Cross-sectional Study

Background: The evidence-based practice movement has spread globally, prompting calls for evidence-based policymaking and public health. Health care being the dynamic discipline with research, is, intended to improve practice through evidence-based novel approaches. As evidence based practice (EBP) among nurses is essential for improving the quality of care, fewer pieces of evidence are available in Nepal. This study aimed to assess the perception of evidence-based practice among nurses of a tertiary hospital in Nepal. Methods: We conducted a quantitative cross-sectional study among the 100 nurses of Bir Hospital in Kathmandu. The self-administered questionnaires were applied using the survey instrument by Upton and Upton. A purposive sampling technique was employed. We calculated the mean score to assess the nurses’ perceptions in the three sub-scales of knowledge, attitude, and use of evidence-based practice. Bivariate analysis was performed to examine the relationship between subscales. Results: The majority (89.0%) of nurses did not receive training on evidence-based practices. The mean score of knowledge on EBP was 4.47±1.11, the mean score of attitude on EBP was 4.45±1.06, and the mean score of EBP use was 4.18±1.42. EBP knowledge, attitude, and use were not significantly associated with the selected demographic variables (age, work experience, EBP training and marital status). Conclusion: Nurses’ perceptions of evidence-based practice were moderate. The implementation of EBP use needs to be strengthened among the nurses. Nurses need to be more involved in the implementation of EBP. To incorporate evidence in practice, nurses require training and support from high authorities.

Empowering nursing council implementation science: An appeal to action

In most hospitals, nursing councils are responsible for EBP implementation and evaluation. To enhance the perceived value of council participation by frontline nurses, administrators must promote the impact of council projects on healthcare outcomes. The purposes of this appeal to action are to describe the role of nursing councils in promoting IS and EBP, and to provide recommendations that enhance the value of IS and/or EBP councils to frontline nurses, thereby incentivizing participation on these councils. Nurse researchers from three metropolitan hospitals partnered with a medical librarian to recommend six strategies aimed at enhancing the perceived value of council participation. An argumentative review was conducted to support these strategies. Recommendations are inclusion of methods experts on councils; support from nursing administrators in the development, implementation, and evaluation of projects; formation of partnerships with nursing academic departments; expansion of publication opportunities and availability; and connection of projects to measurable quality indicators. Enhancing the perceived value of nursing councils by providing tools that optimize time and resource management can result in greater council participation and broader dissemination of IS evidence.

Development of a training program prototype to enhance implementation leadership competencies and behaviours of Chinese unit nurse managers: a qualitative descriptive study

BackgroundUnit nurse managers hold essential positions that can facilitate implementation of evidence-based practice. Studies showed that nurse managers in China lacked competencies and behaviours necessary to lead evidence-based practice implementation. The aim of the current study was to develop a context-fit training program prototype to enhance leadership competencies and behaviours regarding evidence-based practice implementation of Chinese unit nurse managers.MethodWe used a descriptive qualitative study design and followed the integrated knowledge translation approach to co-develop the prototype in a tertiary hospital in Changsha, China. Seven nurse managers from the participated hospital and a researcher co-developed the prototype based on the Ottawa Model of Implementation Leadership (O-MILe). The development process encompassed four phases from November 2021 to March 2022 that involved group discussions (n = 4) and individual interviews (n = 21). All data were analysed by two independent researchers using the thematic analysis method.ResultsManagers agreed that all O-MILe behaviours were important to evidence-based practice implementation, and only minor modifications were needed for clarification and adaptation. The actions managers identified that could operationalize the leadership behaviours were related to current clinical practices, evidence-based practice, nurses, patients, interprofessional staff members, incentives and resources, organization and external entities. Three types of general competencies related to evidence-based practice, professional nursing, and implementation leadership were identified. Multimodal activities such as lectures, experience sharing, group discussions, plan development and coaching were suggested to deliver the training program.ConclusionsAll O-MILe leadership behaviours were perceived as essential for unit nurse managers to lead EBP implementation in the hospital context in China. We identified the leadership actions and the competencies required for nursing managers to implement EBP in China. Further studies are required to evaluate the acceptability and impact of this prototype. Further studies with large sample sizes across various clinical settings are needed to facilitate the generalization of the findings and gain an in-depth understanding of the program.

A Narrative Review of NICU Implementation of Evidence-Based Early Relational Health Interventions.

Early relational health (ERH) interventions in the neonatal intensive care unit (NICU) buffer infants from toxic stress effects. Implementation science (IS) can guide successful uptake of evidence-based practice (EBP) ERH interventions. It is unknown if implementors of ERH interventions currently use the resources of IS to improve implementation. A narrative review of recent literature on implementation of ERH EBPs was completed to understand (a) which ERH interventions are currently being implemented in NICUs globally, (b) whether clinical implementors of ERH interventions have adopted the resources of IS, (c) existence of implementation gaps, and (d) implementation outcomes of ERH interventions in contemporary literature. Scopus, PubMed, and CINHAL were searched for original research regarding implementation of dyadic ERH interventions using key words related to IS and ERH. For inclusion, ERH EBPs had to have been implemented exclusively in NICU settings, contained data addressing an IS domain, printed in English within the last 5 years. Twenty-four studies met inclusion criteria. Studies were distilled for intervention, IS domains addressed, location, aims, design, sample, and outcomes. Eleven ERH interventions were described in the literature. Few studies utilized the resources of IS, indicating variable degrees of success in implementation. Discussions of implementation cost were notably missing. Implementors of ERH interventions appear to be largely unfamiliar with IS resources. More work is needed to reach clinicians with the tools and resources of IS to improve implementation outcomes.

Collaborative Partnerships During Fieldwork Experiences to Promote Evidence-Based Practices

AbstractIn early childhood education, implementing evidence-based practices (EBPs) is crucial for enhancing children's developmental outcomes. While educator preparation program coursework often covers the content knowledge of EBPs, the application of this knowledge in fieldwork settings is limited. This results in infrequent implementation of EBPs in early childhood settings, highlighting the need for better strategies. One effective way to promote educators' implementation of EBPs is integrating the behavioral skills training (BST) model during fieldwork experiences. Incorporating BST into early childhood educator preparation programs can foster strong collaborative partnerships among team members, facilitating the identification and intentional use of EBPs to support individual children's learning and development. We describe this new collaborative partnership model in fieldwork experiences to demonstrate how preservice educators, in-service educators, and teacher educators play pivotal roles in influencing each other's performance. This collaborative effort aims to promote the implementation of EBPs that lead to the children's improved developmental outcomes.