Evidence-based Practice In Relation Research Articles

Evidence-based practice in relation to post-adoption support in educational settings

This article presents a critical review of research into post-adoption support in educational settings using a rigorous systematic methodology. This is an important topic as effective support services at every stage can be transformative to adopted children’s school experiences and achievements. Relevant studies were found to be limited in number and methodological quality. Aspects of effective support identified across 11 studies were classified under four themes: strategies for support; shared understanding; communication; and monitoring. These themes can inform collaborative planning to meet adoptive children’s needs and could be introduced to school staff and adoptive parents through joint training. We propose that co-ordinated interdisciplinary research that focuses on the views of children and young people is required to meet the requirements of the Children and Social Work Act 2017 and make effective use of funding provided at both organisational and school levels.

Promoting evidence-based practice and raising concerns: considerations for the newly-qualified midwife

Although newly-qualified midwives have achieved the professional standards required to become autonomous practitioners, many doubt their capabilities and decision-making skills, often comparing their limited clinical experience to that of senior midwives. As a result, it may prove challenging to ensure that evidence-based practice and the professional standards are upheld when confronted with resistance to change in practice. This article will discuss these challenges for the newly-qualified midwife, exploring the promotion of evidence-based practice in relation to providing breastfeeding support and advice; dealing with poor professional practice in relation to supporting mothers to breastfeed; and the stigmatised issue of whistle-blowing.

Knowledge, Behaviors, and Attitudes of Polish Nurses As Compared With Evidence-Based Practice in Relation to the Guidelines of the European Resuscitation Council.

BackgroundThe emphasis on Evidence-Based Practice (EBP) is taking on new importance as the profession of nursing strives to meet the challenge of defining the direction of health care, promoting optimal outcomes, and ensuring patient safety. Therefore, Evidence-Based Practice has never been more important to nursing than in the current health-care environment.ObjectiveThe study was designed to assess the knowledge, behaviors, and attitudes of nurses as compared with Evidence-Based Practice in relation to the Guidelines of the European Resuscitation Council.MethodsThe study covered involved a total of 236 nurses who participated in a cardiopulmonary resuscitation course over a period of 12 months. The nurses who qualified for the study followed a complete study registration procedure.ResultsThe current findings show that the lowest score was achieved in the domain of attitude toward selected Evidence-Based Practice aspects in professional work. Detailed domain questions concerned nurses’ Evidence-Based Practice and its limitations related to procedures, the lack of equipment and personnel issues, as well as the lack of scientific evidence. Furthermore, nurses saw clinical experience as being more valuable than research findings for practical decision-making than research findings, and, according to the respondents, they presented opinions that the best way to assess the effectiveness of an action was through clinical experience. In addition, the nurses gave low scores and tended to underestimate the critical literature review aspect within the domain, along with its significance for the general professional practice, believing that search for scientific evidence alone does not apply into their professional work.ConclusionsThe validated Polish version of the Evidence-Based Practice profile questionnaire is a reliable instrument. The study demonstrates that nurses are facing a multitude of limitations due to procedures, the lack of equipment, and personnel issues. Currently perceived as very poor, the ability to make critical assessments and synthesize evidence should be improved. According to the nurses, clinical experience cannot be the only and the best way to assess the effectiveness of a given measure.

Mental healthcare providers’ attitudes towards the adoption of evidence-based practice in the treatment of post-traumatic stress disorder in South Africa

South African society is characterised by a high prevalence of exposure to traumatic events that can lead to post-traumatic stress disorder. In treating post-traumatic stress disorder, mental healthcare providers are tasked with ensuring that their practice is evidence based. However, existing evidence indicates that the rates of adoption of evidence-based practice are generally poor. The promotion and implementation of evidence-based practice into routine clinical settings requires an understanding of the attitudes of mental healthcare providers towards these practices. This study investigated attitudes towards evidence-based practice in the treatment of post-traumatic stress disorder. Participants were 60 mental healthcare providers (clinical/counselling psychologists, social workers, and registered counsellors) in the Western Cape Province working predominantly with trauma survivors. Participants completed a demographic survey and the Attitude Towards Evidence-Based Practice Scale, adapted to assess for attitudes towards the adoption of evidence-based practice in relation to the treatment of post-traumatic stress disorder. Overall, participants reported favourable attitudes towards evidence-based practice in the treatment of post-traumatic stress disorder. Statistical analysis revealed that occupation, age, and gender significantly correlated with attitudes. Social workers and registered counsellors were more likely to report adopting evidence-based practice for post-traumatic stress disorder compared to clinical and counselling psychologists. Older participants and women also reported more favourable attitudes towards evidence-based practice. The implications of these findings are discussed.

Tensions of difference: reconciling organisational imperatives for risk management with consumer-focused care from the perspectives of clinicians and managers.

To understand the impact of risk management and assessment on the delivery of mental health care from the perspectives of managers and clinicians. The concept of risk is now embedded in contemporary mental health services. A focus on risk has been identified as a barrier to the provision of consumer-focused care; however, there is a paucity of research in this area, particularly being drawn from key stakeholders in the field. Qualitative exploratory methods. In-depth interviews were conducted with managers and clinicians from a large metropolitan aged-care mental health service in Australia. The participants represented a range of disciplines and expertise across practice settings (community, inpatient and residential). The theme tensions of difference emerged from this research. This theme referred to the tensions between accountability and attending to risk issues and consumer-centred care, with concerns being raised that procedural and bureaucratic accountability influence (often negatively) the provision of care. Differences in the perspectives of clinicians and managers were also evident in the perceived contribution of evidence-based practice in relation to risk. Prioritising risk management may be interfering with the capacity of clinicians and managers to provide quality and consumer-focused mental health care. A deeper examination and reconceptualisation of the role and importance of risk in mental health care are needed to ensure the focus of service delivery remains consumer-focused.

Assessing fidelity of delivery of smoking cessation behavioural support in practice.

BackgroundEffectiveness of evidence-based behaviour change interventions is likely to be undermined by failure to deliver interventions as planned. Behavioural support for smoking cessation can be a highly cost-effective, life-saving intervention. However, in practice, outcomes are highly variable. Part of this may be due to variability in fidelity of intervention implementation. To date, there have been no published studies on this. The present study aimed to: evaluate a method for assessing fidelity of behavioural support; assess fidelity of delivery in two English Stop-Smoking Services; and compare the extent of fidelity according to session types, duration, individual practitioners, and component behaviour change techniques (BCTs).MethodsTreatment manuals and transcripts of 34 audio-recorded behavioural support sessions were obtained from two Stop-Smoking Services and coded into component BCTs using a taxonomy of 43 BCTs. Inter-rater reliability was assessed using percentage agreement. Fidelity was assessed by examining the proportion of BCTs specified in the manuals that were delivered in individual sessions. This was assessed by session type (i.e., pre-quit, quit, post-quit), duration, individual practitioner, and BCT.ResultsInter-coder reliability was high (87.1%). On average, 66% of manual-specified BCTs were delivered per session (SD 15.3, range: 35% to 90%). In Service 1, average fidelity was highest for post-quit sessions (69%) and lowest for pre-quit (58%). In Service 2, fidelity was highest for quit-day (81%) and lowest for post-quit sessions (56%). Session duration was not significantly correlated with fidelity. Individual practitioner fidelity ranged from 55% to 78%. Individual manual-specified BCTs were delivered on average 63% of the time (SD 28.5, range: 0 to 100%).ConclusionsThe extent to which smoking cessation behavioural support is delivered as specified in treatment manuals can be reliably assessed using transcripts of audiotaped sessions. This allows the investigation of the implementation of evidence-based practice in relation to smoking cessation, a first step in designing interventions to improve it. There are grounds for believing that fidelity in the English Stop-Smoking Services may be low and that routine monitoring is warranted.

Research strategies and evidence-based practice in relation to communication disorders

EnAbstract Introduction To be effective, all professional practices, including speech and language pathology, should be built on a foundation of basic and applied research. Clinicians working in these fields, similar to clinicians in other fields, need to be aware of the validity and reliability of the methods they select while dealing with their patients. Moreover, the current emphasis on evidence-based practice in medicine across all scientific fields emphasizes the importance of understanding the philosophy of science, research strategies, and evidence-based practice. This would aid in bridging the gap between the research and clinical work, thereby, maximizing the therapeutic benefit that the patients gain. Objectives The aim of this article is to review some of the facts related to research methodology, research evaluation, and evidence-based practice as well as to highlight the importance of integrating individual clinical expertise with the best available external evidence obtained from systematic research. Recommendations (a) Research should be considered as an integral part of clinical practice. (b) Keeping the concept of validity, reliability, and evidence-based practice in mind at all times while designing scientific studies. (c) Discussing the project design with an advisor or a group of colleagues to help ensure that validity is maintained at every stage of the process. (d) Correctly forming a research problem, sticking to research ethics while carrying out research work, and closely reviewing the selected literature before as well as during the study. (e) Randomly selecting a representative sample population of adequate size to represent the target population. (f) Identifying variables before starting research, choosing appropriate study designs, and appropriately dealing with missing data and confounding (extraneous) variables.

Álcool e drogas na atenção primária: avaliando estratégias de capacitação

O presente estudo teve por objetivo analisar práticas de prevenção ao uso de risco de álcool e outras drogas adotadas por enfermeiros da Atenção Primária à Saúde (APS) capacitados nas modalidades presencial e à distância e por enfermeiros não capacitados. Os dados foram coletados através de roteiro de entrevista semiestruturada com sete enfermeiras que atuam na APS, e o procedimento analítico adotado foi a análise de conteúdo. Procedeu-se à análise de seis temas, a saber: capacitação; práticas; atitudes; crenças sobre álcool e outras drogas; conhecimentos específicos sobre tratamentos para álcool e outras drogas; sentimentos envolvidos ao lidar com o tema álcool e outras drogas. Os resultados sugerem que ainda prevalece a subutilização de práticas baseadas em evidências no tocante a álcool e outras drogas, e que um espaço de discussão permanente subsequente às capacitações serviria de reforço, em médio prazo, para a capacitação, aumentando o senso de autoeficácia para lidar com esta demanda.

Bed bathing among adult patients in a private oncology ward within an acute care hospital

Bed bathing cleanses the skin, removes odor, and enhances personal hygiene, leading to higher self-esteem. Therefore, it is essential to perform bed bathing based on the best available evidence, so that hospitalized patients are receiving high quality care. The aims of this project were to ensure bed bathing is performed according to the best available evidence, provide a pleasant bed bathing experience for patients, and promote evidence-based practice within clinical culture. The project was implemented in three phases using a system of audit and feedback. JBI PACES (Practical Application of Clinical Evidence System) was utilized to set up a team, data collection, data analysis, GRIP process (Getting Research into Practice) and report writing. GRIP was used for barriers identification, formulation of strategies, and resource identification. There was 100% and 90% improvement of criteria 1 and 2 respectively. There were 21 sub criteria in criteria 1. The 21 sub criteria were detailed steps to follow when performing a bed bath. Criterion 2 referred to evidence of bed bathing and documentation in the patient's file. This project has successfully introduced evidence-based practice in relation to bed bathing among the assistant nurses. They have increased levels of confidence in performing high quality care, and are better prepared to be ambassadors for evidence-based practice among their colleagues.

Evidence-based practice in speech-language pathology curricula: A scoping study

This scoping study investigated how evidence-based practice (EBP) principles are taught in Australian speech-language pathology (SLP) teaching and learning contexts. It explored how Australian SLP university programs: (1) facilitate student learning about the principles of EBP in academic and clinical settings, and (2) self-evaluate their curricula in relation to EBP. The research involved two surveys. Survey 1 respondents were 131 academic staff, program coordinators, and on-campus and off-campus clinical educators. This survey gathered information about EBP teaching and learning in SLP programs as well as future EBP curriculum plans. Survey 2 investigated how clinical educators incorporated EBP into the way they taught clinical decision-making to students. Surveys responses from 85 clinical educators were analysed using descriptive and non-parametric statistics and thematic grouping of open-ended qualitative responses. Both surveys revealed strengths and gaps in integrating EBP into Australian SLP curricula. Perceived strengths were that respondents were positive about EBP, most had EBP training and access to EBP resources. The perceived gaps included the academic staff's perceptions of students' understanding and application of EBP, respondents' understanding of research methodologies, communication and collaboration between academic staff and clinical educators, and a lack of explicit discussion by clinical educators and students of EBP in relation to clients.

Registered nurses' application of evidence‐based practice: a national survey

Evidence-based practice (EBP) is a worldwide approach to improving health care. There is, however, a shortage of studies examining whether or not newly graduated health care professionals are actually applying EBP in their daily work. To examine the application of EBP in clinical practice by registered nurses (RNs) 2 years post graduation and to explore whether the application of EBP differed with regard to the clinical settings where RNs were working. A cross-sectional design using a national sample. Data were collected in 2007 from 987 RNs (response rate 76%). Six items measuring respondents' self-reported extent of applying EBP were used. Results Of the 987 RNs, 19% formulated questions and performed searches in data bases, 56% used other information sources, 31% appraised the literature, 30% participated in practice development and 34% participated in evaluating clinical practice. A greater proportion of the RNs working in elder care applied EBP compared with the RNs working in hospitals, psychiatric care and primary care. The RNs applied the components of EBP to a rather low extent 2 years post graduation despite EBP being an important objective in Swedish health care and educational programmes since the 1990s. These findings support other studies reporting the implementation of EBP in organizations as a complex and often slow process. The differences in the RNs extent of applying EBP in relation to their workplace indicate that contextual factors and the role of the RN in the organization are of importance for getting EBP into practice.

Barriers to reducing the use of restraints in residential elder care facilities

This paper is a report of a study to compare perspectives of staff in residential elder care facilities with those of residents and family members from the same facilities about barriers to reducing the use of physical, chemical and environmental restraints. There is growing research evidence of the potential risk of physical and emotional harm of restraining residents in residential elder care facilities. Despite the potential harms, restraints continue to be a common practice in facilities across Australia. Little research has been undertaken to explore the barriers to reducing the use of restraints. Eighteen individual interviews were conducted with staff, general practitioners and a pharmacist and three focus groups were conducted with a total of 12 residents and 17 family members associated with three residential elder care facilities in Melbourne, Australia in 2004. The three participating facilities were committed to reducing the use of restraints, although physical, chemical and environmental restraints were used in all three facilities. Barriers to reducing restraint use included fear of resident injury, staff and resource limitations, lack of education and information about alternatives to restraints, environmental constraints, policy and management issues, beliefs and expectations (of staff, family and residents), inadequate review practices and communication barriers. Further education and support for staff and family members in evidence-based practice in relation to resident care and restraint use is needed in at least some residential elder care facilities.