Implementation Of Evidence-based Nursing Research Articles

Foot Reflexology and 4-7-8 Breathing Exercise as Supporting Therapy to Reduce Anxiety and Maintain Vital Signs of ICU Patients

The noise of the Intensive Care Unit (ICU) equipment, the high mortality rate, the instability of other patients' conditions, and limited information increase ICU patient anxiety. Anxiety has an impact on declining health. Anxiety makes it difficult for patients to sleep, increases blood pressure values, and slows down the healing process. Management of patient anxiety is to avoid anxiety factors, use non-pharmacological and pharmacological therapies. In addition, combined pharmacological and non-pharmacological therapy is more effective in increasing patient recovery. For this reason, this study aims to evaluate the additional non-pharmacological implementation therapy of foot reflexology and 4-7-8 breathing training in patients in the ICU. The method used is a nursing practice based on evidence-based nursing implementation. The evidence-based references used are 3 international journals indexed by Scopus. The patient selection technique used purposive sampling with inclusion and exclusion criteria. Furthermore, a combination of foot reflexology intervention and 4-7-8 breathing training was given for 2 days to 3 patients. The results of the evaluation showed that there was a decrease in anxiety rates and an improvement in physiological values after being given non-pharmacological and pharmacological interventions. Improved physiological values are, blood pressure and respiratory rate. Additional non-pharmacological interventions foot reflexology and 4-7-8 breathing training reduce anxiety levels and improve the patient's physiological values.

Use of "The Knowledge-to-Action Framework" for the implementation of evidence-based nursing in child and family care: Study protocol.

Nurses are increasingly focused on a practice based on scientific knowledge. However, it is important to distinguish high-quality evidence that can be applied in practice from studies of low or dubious scientific quality. Therefore, nurses must base their practice on structural support that allows for the definition of personalized and context-specific interventions. The objectives of this study are to identify the main barriers and facilitators to the evidence-based nursing approach and to implement an Evidence-Based Practice model (EBP) in clinical practice settings. We seek to contribute to evidence-based nursing by promoting professional skills in nurses, using "The Knowledge-to-Action Framework" (KTA). The research focuses on a participatory action research methodology based on the cyclical process of the KTA framework, contemplating the creation of knowledge and the implementation of existing solutions or new solutions through an action cycle. The participants will be nurses and parents/caregivers) from a pediatric service in Northern Portugal. The study will be conducted in 3 phases: phase 1 will identify the priority issues by exploring the barriers and facilitators of EBP from the nurses' perspective and assessing the parents'/caregivers' satisfaction with nursing care. Phase 2 will be divided into (a) the planning and (b) the implementation of the KTA model, where we aim to build and validate (a) a training plan and (b) the implementation of the KTA model. Phase 3 is for the evaluation of the model implementation and sustaining knowledge. It is recognized that there is a large gap between knowledge production and the subsequent implementation of interventions based on the best available evidence. However, this reality is complex and involves several levels of decision and intervention that oscillate from the individual responsibility of each nurse to the organizational dimension.

Observation of the clinical effectiveness of evidence-based nursing for patients with a vertebral osteoporotic fracture.

An osteoporotic fracture (OPF) can significantly affect patients' activities of daily living (ADLs). This study observed the effects of evidence-based nursing (EBN) on the occurrence of postoperative complications and ADLs in patients with a vertebral OPF. A total of 90 patients with vertebral OPF were divided into two groups. The conventional orthopedic nursing method was conducted for the control group, and the EBN model was delivered for the observation group. Differences in the Barthel index (BI) score on the first day of admission were not statistically significant between the two groups. The BI scores on the day before discharge, compared with the day of admission, had improved in both groups. The BI score on the day before discharge was 83.67 ± 6.94 in the observation group, and the difference was statistically significant (P< 0.05) compared with the control group (76.56 ± 6.89). The rate of satisfaction with nursing in the observation group (100.0%) was significantly higher than in the control group (82.2%) (P< 0.05). The incidence of postoperative complications in the observation group (2.2%) was significantly lower than in the control group (24.4%) (P< 0.05). The implementation of EBN in patients with vertebral OPF improved the postoperative ADLs, reduced the incidence of postoperative complications, and improved the patients' satisfaction with nursing.

Using mixed-methods in evidence-based nursing: a scoping review guided by a socio-ecological perspective.

Increased pressure for evidence-based practice in nursing necessitates that researchers use effective approaches. Mixed-methods research (MMR) has potential to improve the knowledge and implementation of evidence-based nursing (EBN) by generating outcome-based and contextually-focused evidence. To identify methodological trends in how MMR is used in EBN research. Searches were completed in PubMed, CINAHL, and Google Scholar using the terms "nursing", "mixed-methods", and "evidence-based". Seventy-two articles using MMR to address EBN and published 2000-2021 were reviewed across content themes and methodological domains of the Socio-Ecological Framework for MMR. Mixed-methods research has been used to study how EBN strategies are perceived, developed and assessed, and implemented or evaluated. A few studies provided an MMR definition reflecting the methods perspective, and the dominant MMR rationale was gaining a comprehensive understanding of the issue. The leading design was concurrent, and half of studies intersected MMR with evaluation, action/participatory, and/or case-study approaches. Research quality was primarily assessed using criteria specific to quantitative and qualitative approaches. Mixed-methods research has great potential to enhance EBN research by generating more clinically useful findings and helping nurses understand how to identify and implement the best available research evidence in practice.

Achievements and challenges in baccalaureate student nurses' preparation for evidence-based nursing practice: A mixed methods study.

Evidence-based nursing (EBN) implementation is still limited. The effect of the incorporation of this competence into the whole nursing curricula as a cross-cutting topic has not yet been assessed. This study aimed to explore the perceptions of final year student nurses of their preparation for EBN practice and its current implementation in the local healthcare system. This study followed a mixed-methods approach. The data collection methods were a self-administered online questionnaire followed by individual in-depth interviews. The majority of participants (93.4%) chose asking a colleague as the main source of information for decision making during their last year of clinical training. However, scientific evidence was considered the most accurate and credible source instead of colleagues. The main barriers impeding EBN practice were revealed to be: not being able to find the required information, lack of time to search, and not feeling able to interpret information found. In the qualitative analysis of the interviews, three categories were identified: 'Towards EBN at a snail's pace'; 'A huge gap between theory and practice'; and 'Where is nursing?' Although participants in this study consistently attributed more credibility to clinical guidelines, protocols, and scientific publications over colleagues, asking a colleague continues to be the main resource to address clinical doubts. Lack of institutional support, the unresolved theory-practice gap in nursing, and the status of nurses in relation to other healthcare providers were identified as barriers for further EBN implementation.

Application of Evidence-based Nursing Intervention Combined with PBL Teaching Model in Nursing of Acute Myocardial Infarction and Its Effects on Quality of Life and Satisfaction of Patients

Objective. To explore the application of evidence-based nursing (EBN) intervention combined with PBL teaching mode in acute myocardial infarction (AMI) nursing and the effects on quality of life (QOL) and satisfaction of patients. Methods. Ninety AMI patients enrolled in our hospital (January 2019-January 2021) were chosen as the study subjects and equally randomized into group M and group N. Group N received conventional nursing, and group M received EBN combined with PBL teaching mode. The cardiac function indexes, self-care ability, disease awareness and nursing satisfaction were compared between the two groups. The self-care ability was scored by the Exercise of Self-Care Agency Scale (ESCA). The QOL of both groups before and after intervention was scored by the Generic Quality of Life lnventory-74 (GQOLI-74). The emotional state before and after intervention was evaluated by the Hospital Anxiety and Depression Scale (HAD). Results. After nursing, cardiac function indexes were markedly higher in group M than group N (P&lt;0.001). Compared with group N, group M achieved notably higher ESCA scores (P&lt;0.001), higher awareness of disease knowledge (P&lt;0.001) and higher nursing satisfaction (P&lt;0.05). After intervention, the GQOLI-74 score in group M was obviously higher while the HAD score was lower compared with group N (P&lt;0.001). Conclusion. The implementation of EBN combined with PBL teaching model in AMI patients can effectively improve nursing satisfaction and QOL as well as alleviate the negative emotions, so as to create a harmonious nurse-patient relationship. Therefore, it is worth applying and promoting.

A Case Study: Murotal Distraction to Reduce Pain Level among Post-Mastectomy Patients

Carcinoma mammae or breast cancer is a malignant disease that originates from the parenchyma. Women who suffer from this disease will choose treatment using mastectomy. Mastectomy treatment is a process of removing all breast tissue that can inhibit the development of cancer cells. Post-operative mastectomy pain can be relieved by non-pharmacological therapy, one of which is murotal therapy. This case study aims to present the results of applying evidence-based murotal treatment to reduce pain scales in post-mastectomy surgery patients. Physical examination was performed using the head-to-toe method in post-operative patients. The North American Nursing Diagnosis Association is used to determine nursing diagnoses. Meanwhile, nursing intervention refers to the Nursing Intervention Classification and Nursing Outcome Classification. The intervention was carried out in five stages of evidence-based nursing implementation in nursing practice, with complementary therapy in murotal therapy and progressive application for 6 days for post-mastectomy surgery patients. As a result, giving murotal therapy intervention for 6 days showed a reduction in the pain scale from a scale of 4 (1-10) to 1 (1-10). The implementation of EBN murotal therapy proved to be effective in reducing the intensity of the pain scale in post-mastectomy surgery patients

Complementary of Nursing Care for an Elderly Family: Management of Hypertension and Smoking Behaviour

Background: An elderly was closed to some medical problem, especially hypertension. Problems that occur in elderly patients with hypertension not only involve the patient itself but also involve the family as the closest person to the patient. One important aspect of family nursing is the family itself. To achieve good treatment outcomes, implementation of evidence-based nursing is needed. The purpose of this study is to present the implementation of evidence-based nursing to an eldelry in a family bu using coconut water to reduce high blood pressure and progressive muscle relaxation therapy to reduce pain intensity in hypertensive patients, as well as acupressure therapy in stopping smoking that is applied 1 week each other. Method: In the implementation, complementary therapy is applied to hypertensive patients by given young coconut water and progressive muscle relaxation therapy, and acupressure therapy in an effort to stop smoking. Results: showed significant results in the reduction of high blood pressure before being given an intervention was TD: 200/100 mmHg and after being given the intervention obtained TD: 140/80 mmHg and decreased pain intensity in hypertensive patients using relaxation therapy, as well as a decrease in the number of cigarettes smoked with acupressure therapy for 1 week. Conclusion: The application of complementary therapy carried out showed improvement in elderly patients suffering from hypertension and smoking behaviour, therefore, the application of evidence based nursing in providing nursing care is recommended. Suggestion: Complementary Nursing Case Study this is expended to be a reference material to improve health services and provide an overview in carrying out complementary nursing care to families, especially an elderly with comprehensive cases of hypertension (bio, psycho, social and spiritual).

Implementasi Evidence Based Nursing Pada Pasien Hipertensi dan Rehumathoid Arthritis : Studi Kasus

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;Problems that occur in elderly patients not only involve the patient itself but also involve the family as the closest person to the patient. One important aspect of family nursing is the family, because the family is the smallest unit in society which is the client or the recipient of nursing care. To achieve good treatment outcomes, implementation of evidence-based nursing is needed. The purpose of this study is to present the implementation of eviden-based nursing with mernimun juice to reduce high blood pressure and warm lemongrass therapy to reduce pain intensity in the joints, each applied for 1 week.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;strong&gt;&lt;em&gt;Method&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: &lt;/em&gt;&lt;em&gt;In implementation, complementary therapy is applied to hypertension patients,&lt;/em&gt;&lt;em&gt; given cucumber juice&lt;/em&gt;&lt;em&gt;.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;strong&gt;&lt;em&gt;Results&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: &lt;/em&gt;&lt;em&gt;can show significant results in the reduction of high blood pressure that is before given the intervention TD: 180 / 100mmhg after given the intervention obtained TD: 130/90 mmhg and decreased pain intensity in hypertension patients using warm lemongrass compresses for 1 week&lt;/em&gt;&lt;em&gt;.&lt;/em&gt;&lt;em&gt; &lt;strong&gt;Conclusion&lt;/strong&gt;: &lt;/em&gt;&lt;em&gt;: &lt;/em&gt;&lt;em&gt;The application of complementary therapies showed improvement in patients suffering from rheumatism, therefore, the application of evidence-based nursing in providing nursing care is recommended.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;

Implementasi Evidence Based Nursing Pada Pasien Rematik : Studi Kasus

&lt;strong&gt;&lt;em&gt;Background:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; Rheumatoid is a disease that has long been known and is widespread throughout the world that symmetrically experiences inflammation so that swelling, pain and eventually cause damage to the inside of the joints and will disrupt the activities / work of patients. The main symptom of rheumatism is pain in the affected joint, especially when moving. Generally arise slowly. At first it feels stiff, then arises pain that decreases with rest. Family support plays an important role in nursing care provided. To achieve good treatment outcomes, implementation of evidence-based nursing is needed. &lt;strong&gt;Method&lt;/strong&gt;: this case study aims to present the implementation of evidence-based nursing with complementary therapy, warm and progressive ginger compresses applied for 1 week.. &lt;strong&gt;Results&lt;/strong&gt;: After each intervention given in combination the pre and post results show that before the intervention is given, the pain scale at the joint 5 after the intervention is given the pain scale 2. &lt;strong&gt;Conclusion&lt;/strong&gt;: : Complementary therapy of warm ginger compresses performed 1 time in the day as long as 7 days for 20 minutes, showing pain results the patient's joints and bones are reduced&lt;/em&gt;

Context as a Facilitator of the Implementation of Evidence-based Nursing: A Meta-synthesis.

Nurses have numerous difficulties in implementing science due to obstacles related to the work context. The aim is to explore the work-context-related facilitators of the application of evidence in clinical practice by nursing professionals. Qualitative meta-synthesis of primary studies on nurses' experiences of work-context-related facilitators, as defined by the Promoting Action on Research Implementation in Health Services model. Using the Qualitative Appraisal and Review Instrument of the Joanna Briggs Institute. Of the total 57 primary research articles included, an explanatory model of the facilitating factors related to the work context was generated on the basis of four general categories: institutional support (leadership), multidisciplinary support (teamwork and communication), culture of improving quality of care (nursing professionals' attitudes towards change) and use of research (valuing research). Action can be taken on the facilitating factors of the evidence-based practice application in nursing clinical environments, providing resources and motivation from the organization.

Application Value of Evidence-based Nursing in Patients with Multiple Myeloma and Evaluation of Nursing Quality

<i>Objective</i> to explore the application value and quality of evidence-based nursing in patients with multiple myeloma. <i>Methods</i> A total of 92 patients with multiple myeloma from December 2016 to December 2019 were selected as observation objects, and they were divided into control group 46 and observation group 46 according to the order of admission. The control group was given routine nursing care, and the observation group was given evidence-based nursing care. The bone pain relief rate, Pittsburgh Sleep Quality Score (PSQI), anxiety self-rating scale (SAS) score, depression self-rating scale (SDS) score and nursing quality were compared between the two groups. <i>Results</i>: The relief rate of bone pain in the observation group was higher than that in the control group (P <0.05). The quality of sleep, sleep time, sleep time, sleep efficiency, sleep disorders, daytime dysfunction scores and PSQI total scores in the observation group were lower than those in the control group after nursing (P <0.05). P <0.05); SAS and SDS scores in the observation group were lower than those in the control group after nursing (P <0.05). After the implementation of evidence-based nursing, the quality of basic nursing, specialist nursing, critical care, ward management, and health education nursing care of nursing staff was higher than that before implementation (P <0.05). <i>Conclusion</i> Applying evidence-based nursing to patients with multiple myeloma can improve bone pain relief, improve sleep quality, reduce anxiety and depression, and improve the quality of care.

Looking into the nurses’ views regarding implementation of Evidence-Based Nursing in clinical practice

Introduction: Although there are plenty of guidelines and protocols for clinical practice, the implementation, by healthcare professionals, of evidence-based practice (EBP) is not quite widespread in clinical practice. Evidence-based practice is related with improved patient outcomes and cost-effective care. The purpose of this study was to investigate the nurses’s views regarding the implementation of EBP in clinical practice. Methods: This is a systematic review. The literature review was conducted in Pubmed database with specific key-words and it consisted of last five years publications in English or Greek language. Initially 417 articles were found, of which ten, full text, clinical and multicentered studies, meta-analysis and comparison studies were finally selected. Results: Almost half of the nurses knew about EBP, had a positive attitude, and were keen to increasing their knowledge to follow the new trends in clinical practice. Nurses are less familiar with EBP, but argued that it is useful in clinical practice eventhough they lack the knowledge to implement it. Although most nurses knew what EBP was, they were less confident about their own knowledge and skills required. EBP needing advanced scientific knowledge and skills have been less frequently implemented. Lack of time, lack of skills required to search for information, processing and implementation of information, lack of administrative support and the lack of recognition of nursing profession were found to be the main obstacles in applying EBP in clinical practice. Younger nurses, those with a higher level of education, who held an administrative position and a full-time job had stronger views regarding the extent to which clinical nursing practice can be based on EBP. Conclusions: All nurses need to be properly educated and trained in order to be able to evaluate research and apply evidence-based changes in clinical practice. The introduction of evidence-based practice into nursing curricula, as well as its systematic integration into everyday clinical practice, will greatly enhance nurses' conviction.

An Integrative Review of Interventions for Enhancing Leadership in the Implementation of Evidence-Based Nursing.

The most common barriers to evidence-based nursing (EBN) are related to nurse leadership and to organizational characteristics. Scientific evidence is needed regarding interventions that support nurse leadership. The aim was to gather, assess, and synthesize the current empirical evidence regarding interventions for enhancing nursing leadership in EBN implementation. We conducted an integrative review of interventions that enhance the roles of nurse leaders in EBN implementation using reporting guidance according to the PRISMA statement. The search identified five studies, which described two intervention types: interventions improving nurse leaders' capabilities for EBN implementation and supporting the activities for EBN implementing. The interventions focused on strategic, teamwork, and individual levels. All interventions produced positive outcomes on primary outcomes, however all not statistically significant. The studies mainly had descriptive designs and short follow-up times, so it was not possible to propose evidence-based recommendations for effective interventions. The certainty of evidence was very low due to the study designs and the risk of bias. Structured clinical education might promote new innovations in evidence-based leadership in nursing. Conclusions about the impact of the interventions must be drawn with caution. They might be useful for promoting the abilities of nurse leaders to implement EBN, but further studies are needed to provide more reliable recommendations.

Leadership practices of nurse managers for implementing evidence-based nursing in China.

To explore leadership of Chinese nurse managers in evidence-based nursing implementation. Despite much in the literature that highlights the significance of involving nurse managers, the qualitative nature of how their leadership practices influence the evidence implementation has not yet been fully explored. A qualitative secondary data analysis was conducted on 15 transcripts of interviews of nurse managers from a parent grounded theory study. The method for analysis employed the directed content analysis approach, using the framework of Kouzes & Posner's Five Practices of Exemplary Leadership® model. All the leadership practice categories of Five Practices of Exemplary Leadership® were observed in the data. Two additional categories "getting oneself prepared" and "keep it going" were also identified as important leadership practices of nurse managers to exhibit during evidence-based practice implementation. This study advances the leadership model by providing validation of existing exemplars and suggests two new practices with exemplars for a better understanding of the nurse managers' role during evidence implementation. Strategies are proposed to recognise, value and prepare nurse managers' leadership practices during evidence implementation. Emphasis should also be put on cultivating and developing individual nurses' professional practice to sustain evidence-based practice.

Perception of Belgian nurses about evidence-based clinical practice implementation: a focus group study

Background/objectives: Despite recommendations to integrate evidence-based practice into nursing care, evidence-based nursing (EBN) implementation is generally lacking. Strategies for developing an EBN implementation plan require an evaluation of nurses’ needs and expectations. The aim of this study was to evaluate how Belgian nurses perceive EBN.Methods: Descriptive qualitative data were obtained via focus groups. Fifty-six nurses took part in the study and were assigned to one of seven focus groups based on their work setting and the local language.Results: The main results revealed little familiarity with the EBN concept. There were a number of reported barriers to integrating EBN into practice: lack of time; lack of skills needed to find, process, and apply information; lack of support from management; and lack of recognition of the nursing profession.Conclusion: Participants identified four strategies for facilitating EBN development: specific staff dedicated to supporting EBN implementation; an interactive web-based platform to help nurses find, select, and interpret relevant scientific sources; an electronic tool to help nurses in clinical decision-making based on patients’ clinical data; and a change in clinical culture to include EBN in decision-making processes.

Taking Root: a grounded theory on evidence-based nursing implementation in China.

Evidence-based nursing is widely recognized as the critical foundation for quality care. To develop a middle-range theory on the process of evidence-based nursing implementation in Chinese context. A grounded theory study using unstructured in-depth individual interviews was conducted with 56 participants who were involved in 24 evidence-based nursing implementation projects in Mainland China from September 2015 to September 2016. A middle-range grounded theory of 'Taking Root' was developed. The theory describes the evidence implementation process consisting of four components (driving forces, process, outcome, sustainment/regression), three approaches (top-down, bottom-up and outside-in), four implementation strategies (patient-centred, nurses at the heart of change, reaching agreement, collaboration) and two patterns (transformational and adaptive implementation). Certain perspectives may have not been captured, as the retrospective nature of the interviewing technique did not allow for 'real-time' assessment of the actual implementation process. The transferability of the findings requires further exploration as few participants with negative experiences were recruited. This is the first study that explored evidence-based implementation process, strategies, approaches and patterns in the Chinese nursing practice context to inform international nursing and health policymaking. The theory of Taking Root described various approaches to evidence implementation and how the implementation can be transformational for the nurses and the setting in which they work. Nursing educators, managers and researchers should work together to improve nurses' readiness for evidence implementation. Healthcare systems need to optimize internal mechanisms and external collaborations to promote nursing practice in line with evidence and achieve clinical outcomes and sustainability.

Implementation of Evidence-Based Nursing: Challenges and Barriers

Implementation of Evidence-Based Nursing: Challenges and Barriers

A Systematic Review of Journal Clubs for Nurses.

Two previous systematic reviews describe studies on journal clubs from 1995 to 2007. To gather, assess, and synthesize the current empirical evidence on implementation of journal clubs, influencing factors, and outcomes of journal clubs in promoting evidence-based nursing. A systematic review based on the procedure of the Centre for Reviews and Dissemination. Cochrane, CINAHL, and PubMed Medline databases were sought from 2008 to 2015. The final data consisted of 10 studies. Articles' references were searched manually. The quality appraisal was made according to study design. Data were analyzed by qualitative content analysis and narrative synthesis. The analyses produced four main categories with 14 subcategories that described the journal clubs: organization, conduct of meetings, influencing factors, and intervention outcomes. Journal clubs had been carried out in a fairly uniform manner in different nursing communities. There remains a lack of evidence on journal clubs' impact on evidence-based nursing (EBN) implementation, which challenges the development of journal clubs' content and methods. Because journal clubs have achieved a uniform and easy-to-follow manner that is suitable for different nursing contexts and provide multiple positive outcomes, they are recommended for EBN. In work communities, journal clubs should be combined with other well-known factors that promote EBN implementation. The assessment of the outcomes of journal clubs should cover all learning categories of EBN with a focus on medium- to long-term effectiveness. The evaluation of the effectiveness of journal clubs on patient care is of great importance for future studies.

Acupressure and Evidence-Based Nursing

Acupressure is a traditional Chinese medicine approach to disease prevention and treatment that may be operated by nurses independently. Therefore, acupressure is being increasingly applied in clinical nursing practice and research. Recently, the implementation of evidence-based nursing (EBN) in clinical practice has been encouraged to promote nursing quality. Evidence-based nursing is a method-ology and process of implementation that applies the best-available evidence to clinical practice, which is acquired through the use of empirical nursing research. Therefore, in this paper, we address the topic of acupressure within the context of empirical nursing practice. We first introduce the current status of acupressure research and provide the locations of common acupoints in order to guide future empirical nursing research and to help nurses use these acupoints in clinical practice. Finally, we describe the steps that are necessary to apply the current empirical information on acupressure as well as provide suggestions to promote safety and efficacy in order to guide nurses in the accurate application of acupressure in nursing practice.