Front-line Clinical Nurses Research Articles

Barriers and facilitators of the nurse providing evidence-based preoperative visit-care for transcatheter aortic valve replacement: a mixed-methods study based on an evidence application setting

BackgroundPreoperative visit-care for transcatheter aortic valve replacement (TAVR) plays a crucial role in improving the quality of care and patient safety. However, preoperative care for TAVR patients is still in its early stages in China, with the care often being experience-based. The application of relevant evidence in nursing practice is necessary. Little is known regarding the facilitators and barriers to apply and compliance to the evidences about preoperative visit-care for TAVR in nursing.MethodsThe Nurse’s Compliance Checklist was used to investigate the evidence-based compliance of nurses (n = 21) who worked in the TAVR team in the evidence-based implementation setting. Meanwhile, an Evidence-Based Practice Beliefs Scale, and Influencing Factors Checklist were used to investigate all nurses (n = 66) who work in the same setting. Stakeholders (Middle and senior-level nursing administrators, frontline clinical nurses, and patients) interview was carried out to further disclose the barriers and facilitators in the process of evidence-based practice.ResultsThe results of this study showed that only 1 evidence implemented fully (100%) by nurses, 3 evidences with 0% implementation rate, and implementation rate of the other evidences were 9.5∼71.4%. The overall score of nurses’ evidence-based nursing belief level was (3.52 ± 0.82). Three domains of barriers were identified: the Context Domain included lack of nursing procedures, inadequate health education materials, insufficient training; the Practitioner Domain included insufficient attention, lack of relevant knowledge, high work pressure and uncertainty of expected results, and Patient Domain included lack of relational knowledge. Facilitating factors included leadership support, nurse’ high evidence-based nursing belief, high executive ability and enthusiasm for learning.ConclusionThe study indicated that the nurses’ compliance of evidence-based practice in preoperative visit-care for TAVR was in lower level. There were some factors influencing the application of the evidences. The study revealed potential modifiable barriers to the successful implementation of evidence-based preoperative visit-care, including a lack of preoperative visit- care routine, related knowledge and training. Leadership support and nurse training should be considered to improve nurses’ compliance with evidence-based practice.

Effects of Psychological Intervention Based on the Self-Transcendence Theory on the Sleep Quality of Chinese Nurses.

COVID-19 infection is transmitted easily and quickly, exposing medical care workers, especially nursing workers, to tremendous stress. Therefore, identifying the factors influencing the sleep quality of nurses and implementing corresponding interventions are conducive to improving the sleep quality of nurses and enhancing their nursing quality. Form September to December 2022, a survey-based evaluation was conducted on 1074 front-line clinical nurses randomly selected from three hospitals in Zhejiang Province, China. Based on the survey results, 152 nurses were selected and randomly divided into the experimental group and the control group, with 76 nurses in each group. A 2-month psychological intervention based on the self-transcendence theory was conducted, and the two groups were compared before and after the intervention. The average PSQI score of nurses was 7.19±3.65, with 471 of them suffering from poor sleep (PSQI>7), accounting for 45.46%. In addition, 57.10% of the nurses were under excessive stress, whereas 62% of them had a Self-Rating Anxiety Scale score of ≥50. After the intervention, the PSQI score of the experimental group was significantly lower than that of the control group, with the difference being statistically significant (P<0.05). Clinical nurses in tertiary hospitals have poor sleep quality and more severe stress and anxiety problems during COVID-19 than during non-epidemic periods. Clinical interventions based on the self-transcendence theory can effectively improve the sleep quality of nurses. Results of this study provide reference for enhancing the sleep quality of nurses and ensuring their physical and mental health during epidemic.

Research, Evidence-Based Practice, and Quality Improvement Simplified

Is the research process different than evidence-based practice and quality improvement, or is it the same? Scattered evidence and misperceptions regarding research, evidence-based practice, and quality improvement make the answer unclear among nurses. This article clarifies and simplifies the three processes for frontline clinical nurses and nurse leaders. The three processes are described and discussed to give the reader standards for differentiating one from the other. The similarities and differences are highlighted, and examples are provided for contextualization of the methods. [J Contin Educ Nurs. 2023;54(1):40-48.].

The experiences of clinical nurses coping with patient death in the context of rising hospital deaths in China: a qualitative study

BackgroundChinese clinical nurses are increasingly confronting patient death, as the proportion of hospital deaths is growing. Witnessing patient suffering and death is stressful, and failure to cope with this challenge may result in decreased well-being of nurses and impediment of the provision of “good death” care for patients and their families. To our knowledge, few studies have specifically explored clinical nurses’ experiences coping with patient death in mainland China. ObjectiveWe aimed to explore nurses’ experiences coping with patient death in China in order to support frontline clinical nurses effectively and guide the government in improving hospice care policy.MethodsClinical nurses were recruited using purposive and snowball sampling between June 2020 and August 2020. We gathered experiences of clinical nurses who have coped with patient death using face-to-face, semi-structured, in-depth interviews. Audio recordings were transcribed verbatim and analyzed using thematic analysis.ResultsThree thematic categories were generated from data analysis. The first was “negative emotions from contextual challenges.” This category involved grief over deaths of younger persons, pity for deaths without family, and dread related to coping with patient death on night duty. The second category was “awareness of mortality on its own.” Subthemes included the ideas that death means that everything stops being and good living is important because we all die and disappear. The third category was “coping style.” This category included focusing on treating dying patients, recording the signs and symptoms, and responding to changes in the patient’s condition. It also involved subthemes such as avoiding talk about death due to the grief associated with dying and death, and seeking help from colleagues.ConclusionsClinical nurses’ emotional experiences are shaped by intense Chinese filial love, charity, and cultural attitudes towards death. Reasonable nurse scheduling to ensure patient and staff safety is a major priority. “Good death” decisions based on Chinese ethical and moral beliefs must be embedded throughout hospital care.

Mental health status of frontline clinical nurses fighting the Omicron variant of COVID-19 – a cross-sectional survey in China

1. World Health Organization. Tracking SARS-CoV-2 variants, 2022. https://www.who.int/en/ activities/tracking-SARS-CoV-2-variants/ (accessed: 16 May 2022 27). Google Scholar

PB2277: ANALYSIS ON POLLUTION STATUS AND INFLUENCING FACTORS OF NURSES’ UNIFORMS IN HEMATOLOGY GENERAL WARD

Background: In clinical work, nurses are the direct caregivers of patients, and they need to cooperate with doctors to observe patients’ conditions and carry out a number of clinical operations. Therefore, the contamination of nurses’ uniforms should be taken into account by hospital infection control workers. Contaminated nurses’ uniforms will reduce the quality of nursing and affect the treatment and rehabilitation of diseases, especially the hematological tumors patients who with low immunity. According to the study, nurses should change cleaning. Aims: Investigate and analyze the contamination of nurses’ uniforms after different working hours in hematology general ward, in order to providing some references to improve the quality of hospital infection management. Methods: From July to November 2021, front-line clinical nurses in the hematology general ward of a tertiary hospital in Chongqing were selected as the research objects by convenience sampling method. Samples were taken from different parts of the nurse at 8 different times, which including when changing clean uniform, and 1h, 3h, 6h, 2d, 3d, 4d and 5d after changing clean uniforms. Results: In this study, a total of 264 qualified specimens were collected from 33 nurses’ uniforms. Descriptive analysis showed that the bacterial colony counts of cuff, abdomen and front chest at the 6th hour after changing clean uniforms were (11.30±3.56) CFU/cm2, (8.79±2.33) CFU/cm2, and (11.06±2.71)CFU/cm2 and the qualified rates of cleanliness were 0, 9.1% and 3.0% respectively. Multiple linear regression analysis showed that, at the 6th hour after changing clean uniforms, the main influence factors of the bacterial colony count on the cuffs were work times, environmental humidity and the height of nurse, the fore chests were work times and the height of nurse, and the abdomens were work times, the total number of patients and the number of first-grade patients (all P<0.05). After 5 days, the main influence factors of the bacterial colony count on the cuffs were work times and the total number of patients, the fore chests were work times and the height of nurse, and the abdomens were work times and the total number of patients (all P<0.05). Summary/Conclusion: It is necessary for nurses in general hematology department to increase the frequency of changing nurses’ uniforms and improve the cleanliness to ensure the nursing quality and patient safety. For nursing managers, it is essential to optimize the allocation of human resources further and provide necessary infection protection equipment to reduce the risk of hospital-acquired infection caused by the serious pollution of nurses’ work clothes.

The path of depression among frontline nurses during COVID-19 pandemic: A fuzzy-set qualitative comparative analysis.

This study aimed to explore the combination of different conditional variables that led to depressive symptoms among frontline nurses who were fought against COVID‐19 during the outbreak in Wuhan City, Hubei Province of China. The study was conducted in August 2020, which included 331 frontline clinical nurses who supported Wuhan's fight against COVID‐19. The age range was 21–57 years and included 315 female nurses and 16 male nurses. This study used the fuzzy‐set qualitative comparative analysis research method to explore the path of depression among frontline nurses. This study generated nine different configurations for the path of depression among frontline nurses, and had a detailed demonstration for each configuration. Each configuration distinguishes the different effects of influencing factors. For example, in the first configuration, gender, sleep disorder and PTSD exist as core conditions, while social support exists as a core condition lack. This study was presented results which was different what linear regression model reports. It takes into consideration the combined effect of each conditional variable on the development of depression. Nurse managers should pay attention to the combination of multiple influencing factors, instead of focus on single factors.

Italian nurses' COVID-19 experiences from mass media interviews: a qualitative study

SummaryIntroductionThe COVID-19 pandemic is heavily hitting healthcare systems around the world, and nurses are battling in the front line. Previous studies have reported nurses’ responses to catastrophic situations, but also interviews released by Italian nurses to the main mass media channels could bear important messages for policy makers and stakeholders. This study describes Italian front-line nurses’ experiences during the COVID-19 pandemic through television interviews.MethodsThis is a descriptive qualitative study. Data were collected through purposive sampling from Italian front-line nurses’ interviews during the COVID-19 pandemic. Publicly available interviews between 7th and 29th March 2020 were collected from the websites of national and regional television stations. Thematic content analysis was used to describe, summarize, and classify data into macro themes. The study is compliant with Standards for Reporting Qualitative Research.ResultsA total of 21 television interviews were collected from front-line clinical nurses, nursing managers, nursing trade union representatives and representatives of the Nursing Regulator. Thematic analysis yielded four macro-themes: psycho-social effects of the COVID-19 pandemic on health professionals; altered patient relationships; personal safety; recognition and promotion of the profession.ConclusionsThe COVID-19 pandemic has exacerbated some problems already present, such as the shortage of nurses, but has also turned the spotlight on the nursing profession. Highly involved and affected by the pandemic, nurses have become better known by the public and often also protagonists of public discussions. It is important that nurses’ value as allies of the public emerges stronger from this dramatic situation.

Late-onset PTSD and coping strategies for frontline nurses during the COVID-19 epidemic in China.

AimTo evaluate the late‐onset post‐traumatic stress disorder (PTSD) situation, coping strategies and social supports for frontline clinical nurses 6 months after involvement in fighting against coronavirus disease 2019 (COVID–19) outbreak in China.DesignA cross‐sectional design.MethodsWe recently randomly distributed a questionnaire online to Chinese nurses who had taken care of COVID‐19 patients since the end of January 2020. The questionnaire was made up of three professional scales, the impact of event scale‐revised, simplified coping style questionnaire and social support rating scale included.ResultsThe general prevalence of late‐onset PTSD among frontline nurses was 88.19%. Nurses who worked in Hubei Province (the kindle place of the COVID‐19 outbreak) showed lower risk of late‐onset PTSD symptoms than those who did not. We also found that positive coping strategies were correlated with less late‐onset PTSD symptoms. Meanwhile, getting more social supports could help these nurses to obtain positive coping strategies.

Perceived COVID-19-associated discrimination, mental health and professional-turnover intention among frontline clinical nurses: The mediating role of resilience.

COVID‐19‐associated discrimination (CAD) is an important issue that may adversely affect frontline nurses’ work effectiveness and well‐being. This study examined the relationships between frontline nurses’ perceptions of COVID‐19‐associated discrimination and their resilience, mental health, and professional‐turnover intention. This cross‐sectional descriptive study involved 259 frontline nurses in the Central Philippines and used four online self‐report measures. The results revealed that frontline nurses perceived a moderate level of COVID‐19‐associated discrimination. Frontline nurses who perceived a higher level of discrimination during the coronavirus pandemic reported poorer mental health and higher professional‐turnover intention. Resilience acted as a mediator and reduced the effects of COVID‐19‐associated discrimination on nurses’ mental health and their professional‐turnover intention. Proactive measures to reduce the negative consequences of discrimination during the pandemic, and efforts to foster resilience in nurses who are in the forefront of the fight against the highly transmissible virus, should be given high priority by hospital and nursing administrators to better support nurses’ mental health and foster retention.

Pandemic fatigue and clinical nurses' mental health, sleep quality and job contentment during the covid-19 pandemic: The mediating role of resilience.

AimThis study examined the influence of pandemic fatigue on clinical nurses’ mental health, sleep quality and job contentment, with resilience as a mediator.BackgroundPandemic fatigue is an emerging health concern among frontline clinical nurses as a consequence of the ongoing coronavirus pandemic and the various measures implemented to slow the spread of infection. As yet, no studies have investigated the link between pandemic fatigue and resilience, mental health, sleep quality and job contentment in frontline clinical nurses.MethodsThis was a descriptive, cross‐sectional study involving 255 frontline clinical nurses in the Philippines. The Pandemic Fatigue Questionnaire, Brief Resilience Scale, Job Contentment Scale and the Sleep Quality Scale were used to collect data through an online survey.ResultsThe mean pandemic fatigue score was 3.086 (out of 5). Being vaccinated (β = 0.231, p < .001) and increased staffing levels (β = −0.488, p < .01) were associated with decreased pandemic fatigue in clinical nurses. Resilience partially mediated the relationships between (a) pandemic fatigue and mental health (β = −0.488, p < .001), (b) pandemic fatigue and sleep quality (β = −0.326, p < .001) and (c) pandemic fatigue and job contentment (β = −0.395, p < .001).ConclusionClinical nurses who received a COVID‐19 vaccine and those who perceived sufficient staffing in their units reported lower levels of pandemic fatigue. Resilience reduces the effects of pandemic fatigue on clinical nurses’ mental health, sleep quality and job contentment.Implications for Nursing ManagementBy providing frontline nurses with access to COVID‐19 vaccines and ensuring sufficient staffing levels, nurse managers could effectively reduce or prevent pandemic fatigue and improve their mental health. Implementing resilience‐promoting measures are essential to support nurses’ mental health, promote their sleep quality and foster job satisfaction.

Attitudes of Front-Line Nurses Toward Hospice Care During the COVID-19 Pandemic.

The aim of this study was to understand the attitudes of front-line clinical nurses toward hospice care in the fight against the COVID-19 pandemic, to provide a source of reference for hospice care education and training in hospitals treating patients with COVID-19. Front-line nurses from a designated COVID-19 hospital in Wuhan, China, participated. Participants completed the Chinese versions of the General Information Questionnaire, the Frommelt Attitudes Toward Care of the Dying Scale, the Jefferson Scale of Empathy, and the General Self-Efficacy Scale. A total of 149 questionnaires were included in the analysis. The median total hospice care attitudes score was median 102.00(interquartile range, 95.5-120.50). The nurses' attitudes toward hospice care were significantly associated with their age, knowledge of hospice care, level of empathy, and self-efficacy. The attitudes of front-line nurses toward hospice care need to be improved. Hospital departments should establish an effective public health emergency strategy, provide training to increase front-line nurses' knowledge and practical experience of hospice care, cultivate nurses' empathy, and enhance their sense of self-efficacy, in order to improve the quality of hospice care for patients and their families.

Anxiety and Depression of Nurses in a North West Province in China During the Period of Novel Coronavirus Pneumonia Outbreak.

PurposeTo investigate the anxiety and depression levels of frontline clinical nurses working in 14 hospitals in Gansu Province, China, during this period.DesignA cross‐sectional survey was conducted online between February 7 and 10, 2020, with a convenience sample of 22,034 nurses working in 14 prefecture and city hospitals in Gansu Province, located in northwest China.MethodsA self‐reported questionnaire with four parts (demographic characteristics, general questions related to novel coronavirus‐infected pneumonia, self‐rating anxiety scale, and self‐rating depression scale) was administered. Descriptive statistics including frequencies, means, and SDs were computed. The associations between anxiety and depression with sociodemographic characteristics, work‐related concerns, and impacts were analyzed, followed by multiple stepwise linear regression to identify factors that best predicted the nurses’ anxiety and depression levels.FindingsA total of 21,199 questionnaires were checked to be valid, with an effective recovery rate of 96.21%. The mean ± SD age of the respondents was 31.89 ± 7.084 years, and the mean ± SD length of service was 9.40 ± 7.638 years. The majority of the respondents were female (98.6%) and married (73.1%). Some demographic characteristics, related concerns, and impacts of COVID‐19 were found to be significantly associated with both anxiety (p < .001) and depression (p < .001). Nurses who needed to take care of children or elderly relatives, took leave from work because they were worried about COVID‐19, avoided contact with family and friends, and wanted to obtain more COVID‐19‐related knowledge had higher levels of both anxiety and depression.ConclusionsResults show that nurses faced with the COVID‐19 outbreak are at risk for experiencing anxiety and depression. Demographic background, psychosocial factors, and work‐related factors predicted the psychological responses. The family responsibilities and burdens of women may explain the higher levels of anxiety and depression among nurses with these obligations as compared to those without. On the other hand, nurses who chose not to take leave from work or who did not avoid going to work during this period were less anxious and depressed.Clinical RelevanceProfessional commitment might be a protective factor for adverse psychological responses. It is pertinent to provide emotional support for nurses and recognize their professional commitment in providing service to people in need.

Anxiety and related factors in frontline clinical nurses fighting COVID-19 in Wuhan.

The aim of this study was to examine the anxiety status of the frontline clinical nurses in the designated hospitals for the treatment of coronavirus disease 2019 (COVID-19) in Wuhan and to analyze the influencing factors, to provide data for psychologic nursing.This study used a cross-sectional survey design and convenience sampling. The questionnaires were completed by 176 frontline clinical nurses. Anxiety was determined using the Hamilton anxiety scale. General data were collected using a survey. Correlation analyses were used.Among the 176 frontline nurses, 77.3% (136/176) had anxiety. The anxiety scores of the frontline clinical nurse fighting COVID-19 were 17.1 ± 8.1. Anxiety symptoms, mild to moderate anxiety symptoms, and severe anxiety symptoms were found in 27.3%, 25%, and 25% of the nurses, respectively. Sex, age, marital status, length of service, and clinical working time against COVID-19 were associated with anxiety (P < .05).The frontline nurses working in the designated hospitals for the treatment of COVID-19 in Wuhan had serious anxiety. Sex, age, length of service, and clinical working time against COVID-19 were associated with anxiety in those nurses. Psychologic care guidance, counseling, and social support should be provided to the nurses to reduce their physical and mental burden. Nursing human resources in each province should be adjusted according to each province's reality.

Grit: The Essential Trait of Nurses During a Disaster.

Natural and man-made disasters have increased dramatically over time, requiring healthcare systems to develop and sustain emergency preparedness plans. Nurse leaders and frontline clinical nurses are often the first and long-term responders during these traumatic events. Emergency preparedness requires nurses exceed expectations beyond the daily level of performance in caring for patients in the presence of obstacles. A disaster creates additional burdens on nurses psychosocially due to work and home demands. Despite this adversity, nurses are able to work under harsh conditions and make critical clinical decisions. This commitment is often described as being resilient. A deeper reason why nurses perform during disasters is that they possess the personality trait known as grit. Grit motivates them to endure challenges and be successful over time. The critical attributes of grit are passion and perseverance. Cultivating grit among nurse leaders and clinical nurses is essential to sustaining interest in emergency preparedness and ensuring the needs of patients and caregivers are met when a disaster occurs.

Engaging and developing front-line clinical nurses to drive care excellence: Evaluating the Chief Nurse Excellence in Care Junior Fellowship initiative.

Global challenges in the development of a highly skilled and motivated nursing workforce jeopardise the delivery of high-quality care. Flexible and innovative workforce solutions are required to overcome these challenges. To describe the implementation and present the preliminary evaluation of the 'Chief Nurse Excellence in Care Junior' bespoke Fellowship initiative designed to develop the foundational clinical and academic skills of front-line junior clinical staff. This initiative was developed and piloted at a large, inner-city, acute NHS trust. The initiative involved two main components: a bespoke development programme and an improvement project that was supported by clinical and academic mentors. The initiative was evaluated using structured feedback, case studies and data on dissemination activities. Six front-line nurses completed the first cohort of the initiative that commenced in spring 2016. Results showed a positive impact on professional development relating to the acquisition of new knowledge and skills. Case studies of projects had a demonstrable impact on patient experiences, outcomes and cost savings. Wider organisational and NHS impact was demonstrated through multiple dissemination activities. This preliminary evaluation provides evidence that this initiative is a sustainable, clinically driven career development opportunity at a foundational level that has a demonstrable positive impact on care and staff development. Further work is underway to carry out a longitudinal structure, process and outcome evaluation with particular focus on impact.

Review: Engaging and developing front-line clinical nurses to drive care excellence: Evaluating the Chief Nurse Excellence in Care Junior Fellowship initiative.

Review: Engaging and developing front-line clinical nurses to drive care excellence: Evaluating the Chief Nurse Excellence in Care Junior Fellowship initiative.

Quality Improvement Initiative to Improve Postoperative Pain with a Clinical Pathway and Nursing Education Program

Background and AimsWe created a multicomponent intervention to improve pain management in the immediate postoperative period with the goal of improving the quality of patient recovery. DesignA multicomponent intervention to improve pain management in the immediate postoperative period with the goal of improving the quality of patient recovery. SettingsPain management education of postanesthesia recovery room nurses through a practical intervention has the potential to improve patient pain experience, especially in those with a history of opioid tolerance. Participants/SubjectsPostanesthesia recovery nurses/postanesthesia patients. MethodsThe intervention included two components: a clinical pain pathway on multimodal analgesia for both opioid-naïve and opioid-tolerant patients undergoing surgery and an educational program on pain management for frontline clinical nurses in the postanesthesia care unit (PACU). We measured the intervention's impact on time to pain relief, PACU length of stay, and patient satisfaction with pain management, as measured by self-report. ResultsPatient PACU surveys indicated a decrease in the percent of patients with opioid tolerance who required more than 60 minutes to achieve adequate pain relief (from 32.7% preintervention to 21.3% postintervention). Additionally, after the intervention, the average time from a patient's PACU arrival to his or her discharge criteria being met decreased by 53 minutes and PACU stay prolongation as a result of uncontrolled pain for opioid-tolerant patients decreased from 45.2% to 25.7%. The sample size was underpowered to perform statistical analysis of this improvement. ConclusionsAfter the combined intervention of a clinical pain pathway and interactive teaching workshop, we noted shortened PACU length of stay, reduced time to reach pain control, and improved overall patient satisfaction. Although we could not determine statistical significance, our findings suggest improved management of acute postoperative pain, especially for patients who are opioid tolerant. Because of the paucity of data, we were not able to conduct the analysis needed to evaluate quality improvement projects, as per SQUIRE 2.0. could be adopted by any institution.

Leadership Through Scholarly Dissemination: The NYP Nursing Experience

Nurse leaders are consistently called upon to demonstrate their communication skills. In fact, excellence in communication is requisite for the leadership role. Yet the translation of day-to-day communication skills to the dissemination of nursing scholarship has not been a consistent part of the culture of nursing within our health care institutions. Although there are a number of reports of workshops to develop nurses' writing skills, the practice is not widespread, most especially workshops offered for frontline clinical nurses. The systematic review conducted by Derouin and colleagues1 indicated that between 2003 and 2014, there were reports of 17 programs, with only 9 of these offered for practicing nurses. The format of the program almost always included a writing for publication workshop followed by one-to-one or small-group mentoring for enhancing writing skills of participants. The yield, that is, the number of manuscripts submitted and/or published varied from program to program but ranged from 25% to 82% success.2,3 Main reasons for the higher yield may have been the small group size (N = 17) that participated and the use of 4 workshops over the project period. Both with the limited experiences with publication workshops for practicing nurses, and the similar workshops for nurse faculty and students, a number of strategies have been identified that promote success. These include the need to supplement workshops with one-to-one mentoring and/or coaching, provision of incentives for nurse participation, recognition of nurses' successes once they have published, and the requirement of manuscript submission from each workshop attendee.1 The current writing for publication project was launched in 2013 at NewYork Presbyterian (NYP) Hospital, which has 6 campuses, namely: Allen, Columbia University Medical Center, Lower Manhattan, Morgan Stanley Children's, Westchester, and Weill Cornell Medical Center.

Evidence-based practice in a hospital setting in Finland – the organization and activities

Background: Evidence-based practice (EBP) is a major paradigm of health care and policy worldwide. In nursing, the transformation has not been very fast due to the challenges in closing the gap between clinical practice and research; this is the case in Finland, too. There is evidence gained from many research studies in nursing that major factors affecting EBP include lack of knowledge and skills, as well as lack of organization or understanding how to support nurses in EBP. Objective: The aim of this presentation is to describe the development of EBP in nursing; how it has been organized and what the activities are organized and followed as suggested in Magnet Hospitals. Methods: Discussion paper based on an example from one of the five university hospital with 800 beds in Finland. Results: EBP in nursing was organized following Magnet Hospital system in an university hospital with 800 beds. A council for EBP was initiated and formed in 2010. The council consists of frontline clinical nurses, nurse directors, teachers, researchers and representative of the nursing leadership. The purpose of the council is to advance EBP in patient care and management, support the use of research and other evidence by organizing systematic education to nurses and leaders, JBI guidelines, information retrieval, journal clubs and learning from the best practices. EBP tutors and mentors started their work in 2013 in the units. Several activities are on the way, e.g. preventing patients’ falls, pain management, hygiene and continuing education of EBP to nurse leaders and frontline nurses. The council is a part of the hospital's Nursing Development, Teaching and Research Unit (NDTRU) lead by chief nursing officer. Discussion: Organizing EBP in clinical practice should be sysematic and well organized. Conclusion: Since 2010, EBP has evolved and the interest among practicing nurses has increased. Results of the activity should be measured in a reliable way.