Use Of Evidence In Practice Research Articles

Tools of the trade: Improving nurses' ability to access and evaluate research.

To evaluate the effect of a manager-required RN competency on staff nurses' perceived knowledge, ability and frequency of information-seeking activities. Basing clinical practice on research and standards of care is essential to delivering appropriate care with optimal outcomes. Nurses' information-seeking abilities are critical for acquiring evidence-based answers to aid clinical decision-making, yet nurses under-utilize library resources and report barriers. A unit manager sought to test the effect of an innovative competency for acquiring and appraising evidence for practice. This longitudinal descriptive study evaluated 28 nurses before and after a 1-hr class, as well as 5months later. The class covered library information services and the basics of critiquing research articles. Nurses had statistically significant improvements in four of five items measuring knowledge/ability and four of five items measuring frequency of information-seeking activities. At 5months, most knowledge/ability items increased. There was no effect of nurse characteristics on outcomes. A required competency improved nurses' knowledge, ability and frequency of acquiring and appraising evidence with a single 1-hr class and a hands-on practice activity. Unit managers can have great impact on nurses' use of evidence for practice.

Improving Nurse Competencies for Using Evidence in Practice: A Pilot Study of the Language of Data Program.

Nursing professional development practitioners are in a key position to use tools that foster nurses' interpretation of research findings for increased use of evidence in practice. An online course was developed to teach statistics as language. The feasibility and efficacy of this "Language of Data" program were examined in a pilot study with a convenience sample from inpatient settings. Recognition and interpretation of statistical symbols significantly improved after the intervention. Knowledge, confidence, and accuracy also improved. The Language of Data program may be used by nursing professional development practitioners to improve nurses' adoption of evidence-based practice by furthering their ability to translate science.

Evidence-Based Practice Education for Better Knowledge, Attitudes, and Practices in Nurses and Midwives

Background: Evidence-based practice (EBP) education is important to overcome barriers to evidence use in practice. Method: The authors conducted a cross-sectional study to evaluate the EBP knowledge, attitudes, and practices (KAP) of RNs and midwives who had participated in an EBP workshop and compared their results with those of nonparticipants. Results: A total of 198 nurses and midwives responded to the survey, 91 who had received EBP education and 107 who had not. There was a significant difference in terms of mean total KAP score which was significantly higher in the education group, indicating greater KAP in those respondents than those who had not received education ( p = .004). Conclusion: This study has shown that participation in a single day of EBP education covering the basic steps of EBP results in nurses who have more positive attitudes, and greater knowledge and practice abilities in EBP than those who had not participated. J Contin Educ Nurs . 2017;48(6):256–262.

What can evidence-use in practice learn from evidence-use in policy?

Background: This paper approaches evidence-informed practice from the perspective of evidence-informed policy-making. Using the findings of a recent study of evidence-use by educational policy-makers to raise questions about evidence-use by educational practitioners, it seeks to explore what such a study might tell us about how to understand and improve evidence-use by educational practitioners.Purpose: The paper aims, therefore, to identify potential connections, shared insights and common issues between evidence-use in policy and evidence-use in practice. It does this by focusing on two specific areas: the nature of the evidence (i.e. what evidence is used) and the nature of the use (i.e. how evidence is used). The paper outlines what was found about each of these aspects of evidence-use in policy, and then considers what questions and issues these findings might raise for evidence-use in educational practice.Sample: The empirical study on which this paper is based was an in-depth study of the use of evidence within educational policy development in Australia. It focused on the development of three specific education policies within one Australian state education department and involved interviews with 25 policy-makers who were actively involved in the development of these policies.Design and methods: The policy-based study involved the following data collection processes: (i) in-depth semi-structured interviews with 25 policy-makers who were involved in the development of the selected policies; (ii) documentary analysis of policy documents, background research reports and other relevant papers relating to the selected policies; (iii) unstructured observation (where possible) of meetings and events connected with the development of the selected policies; and (iv) feedback from 40 wider policy staff who took part in a verification workshop to discuss the project’s emerging findings.Findings: Drawing on the findings from the original policy study, two areas of potential connection to evidence-use in practice are explored. First, in relation to ‘varieties of evidence and uses’, the negotiation of diverse evidence types and the potential for using evidence in multiple and varied ways appear to be features of evidence-use that are common to educational policy-makers as well as educational practitioners. Secondly, in relation to ‘narrowness of evidence sources’, there is potential for both policy-makers and practitioners to use a narrow (rather than broad) selection of evidence, due to a tendency to work with certain evidence types as a starting point (e.g. performance data) and a tendency to draw on certain evidence sources more frequently (e.g. well-known, familiar research sources).Conclusions: This paper emphasises: (i) the need for more integrated (or joined-up) understandings of evidence-use across contexts of practice and contexts of policy; (ii) the importance of continued efforts to understand and represent evidence-use more effectively within educational practices; and (iii) the value of paying careful attention to the quality and qualities of evidence-use within and across the different settings of educational practice and policy.

Barriers and facilitators to the implementation of evidence-based practice by pediatric surgeons

Background/PurposeEvidence-based practice (EBP) has been identified as a foundation of mainstream medical practice, yet pediatric surgery has been slow in the acceptance and implementation of EBP. MethodsSemi-structured interviews of 14 pediatric surgeons were conducted to determine barriers and facilitators to EBP. Resulting data were analyzed using a systematic 3-step approached of coding, generation of specific beliefs, and identification of domains relevant to practice change. ResultsSix domains were identified as relevant to changing pediatric surgeons' use of evidence in practice: environmental context and resources, goals, knowledge, skills, social influence, and social/professional role and identity. Important barriers to EBP implementation included time constrains and resource limitations, the general poor quality of evidence in pediatric surgery, a lack of required skills, and a culture that continues to rely on an apprenticeship style of teaching. Facilitators include working in a research hospital, and having a local champion/ peers that support EBP implementation. There were conflicting thoughts as to whether working as a group facilitated or impeded EBP. ConclusionsPediatric surgeons' use of research evidence in practice is influenced by a number of domains. These results may be used to inform the design of behavior change interventions intended to encourage EBP implementation. Levels of evidenceLevel V.

Evidence-based medicine and life-long learning competency requirements in new residency teaching standards

The objective of this study is to compare accreditation standards across medical and surgical specialties in the USA to determine the requirements for evidence-based medicine (EBM) and information management (life-long...

Psychometric Properties of the Slovak and Czech Versions of the Evidence‐Based Practice Beliefs and Implementation Scales

The Evidence-Based Practice Beliefs (EBP-B) and Evidence-Based Practice Implementation (EBP-I) scales are psychometrically sound instruments that were used, within an educational setting, to systematically study students' beliefs about and their implementation of evidence-based practice (EBP).Czech and Slovak versions of these instruments were developed and evaluated using a sample population of nursing students. The purpose of the study was to test the psychometric properties of the Czech and Slovak versions of the EBP-B and EBP-I scales. Psychometric properties were evaluated using a sample of undergraduate and graduate (nearly graduated) nursing students (n = 223) completing EBP courses. To test psychometric properties of the questionnaire, its reliability and validity were explored. Cronbach´s alpha was computed to evaluate internal structure and internal consistency. The Slovak versions of both the EBP-B and the EBP-I scale have good internal consistency (Cronbach's alpha: .82 and .94, respectively). Similarly, the Czech versions of the EBP-B and the EBP-I scales both have good internal consistency (Cronbach's alpha: .85 and .89, respectively). The results of psychometric analysis of the Czech and Slovak versions of the EBP-B and the EBP-I scales are consistent with the results of the original study and indicate that the Czech and Slovak versions have the potential to be valid, reliable, and sensitive instruments for measuring an individual's beliefs about the value of EBP and their ability to implement it. Both instruments can be used to assess changes in nurses´ beliefs about EBP over time as well as the effectiveness of strategies aimed at promoting the use of evidence in practice.

Organisational support for evidence-based practice: occupational therapists perceptions.

Barriers to the use of evidence-based practice extend beyond the individual clinician and often include organisational barriers. Adoption of systematic organisational support for evidence-based practice in health care is integral to its use. This study aimed to explore the perceptions of occupational therapy staff regarding the influence of organisational initiatives to support evidence-based practice on workplace culture and clinical practice. This study used semi-structured interviews with 30 occupational therapists working in a major metropolitan hospital in Brisbane, Australia regarding their perceptions of organisational initiatives designed to support evidence-based practice. Four themes emerged from the data: (i) firmly embedding a culture valuing research and EBP, (ii) aligning professional identity with the Research and Evidence in Practice model, (iii) experiences of change: pride, confidence and pressure and (iv) making evidence-based changes to clinical practices. Organisational initiatives for evidence-based practice were perceived as influencing the culture of the workplace, therapists' sense of identity as clinicians, and as contributing to changes in clinical practice. It is therefore important to consider organisational factors when attempting to increase the use of evidence in practice.

A guiding framework to understand relationships within the profession of massage therapy

An element of professionalization is the development of a body of knowledge and the integration of that knowledge into practice, also known as evidence-informed practice (EIP). EIP was officially adopted in Ontario, Canada, by the massage therapy profession in 2002 when the professional competency document was updated to include competencies related to research literacy (College of Massage Therapists of Ontario, 2002). Despite efforts to increase EIP, there continues to be a research-practice gap in massage therapy. However, there also seems to be interest in finding ways to support the increase massage therapists' capacity to apply research. To support change, it is useful to describe the relationships in the profession that may have an effect on the use of evidence in practice and the development of a broader culture of inquiry. In order to better understand how these relationships may impact on EIP, an ecological model is proposed.

Safety of rush subcutaneous immunotherapy administered in real life using an infusion pump

Rush subcutaneous immunotherapy (SCIT) schedules offer rapid clinical response, improved adherence, and increased cost-effectiveness because of a lower number of visits and doses. However, this therapy is associated with an increased incidence of adverse reactions (ARs). 1 Pfaar O. Leitzbach S. Hörmann K. Klimek L. Cluster protocols in SCIT: enough evidence for practical use?. Curr Opin Allergy Clin Immunol. 2010; 10: 188-193 Crossref PubMed Scopus (17) Google Scholar , 2 Justicia J.L. Barasona M.J. Serrano P. Moreno C. Guerra F. Predicting patients at high-risk of systemic reactions to cluster allergen immunotherapy: a pilot prospective observational study. J Investig Allergol Clin Immunol. 2007; 17: 386-392 PubMed Google Scholar , 3 Tabar A.I. Fernández-Távora L. Alonso R. et al. Tolerance of a cluster schedule with a house dust mite extract quantified in mass units: multicentre study. J Investig Allergol Clin Immunol. 2004; 14: 193-197 PubMed Google Scholar , 4 Goldberg A. Yogev A. Confino-Cohen R. Three days rush venom immunotherapy in bee allergy: safe, inexpensive and instantaneously effective. Int Arch Allergy Immunol. 2011; 156: 90-98 Crossref PubMed Scopus (27) Google Scholar , 5 Calabria C.W. Accelerated immunotherapy schedules. Curr Allergy Asthma Rep. 2013; 13: 389-398 Crossref PubMed Scopus (28) Google Scholar , 6 Cox L. Advantages and disadvantages accelerated immunotherapy schedules. J Allergy Clin Immunol. 2008; 122: 432-434 Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar A few years ago, our group described the use of an infusion pump (IP) to administer SCIT according to a rush schedule. [7] Sastre J. Vallejo L. Fernandez-Nieto M. Hernandez E. Rico P. Rush allergen subcutaneous immunotherapy administered with infusion pump. Ann Allergy Asthma Immunol. 2011; 107: 459-460 Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar The purpose of this study is to update our data on the safety of this therapy approach and to assess risk factors for ARs in real life using a similar rush schedule with an IP.

Validity and usability of a professional association’s web-based knowledge translation portal: American Physical Therapy Association’s PTNow.org

BackgroundPTNow.org is an evidence-based, on-line portal created by a professional membership association to promote use of evidence in practice and to help decrease unwarranted variation in practice. The site contains synthesis documents designed to promote efficient clinical reasoning. These documents were written and peer-reviewed by teams of content experts and master clinicians. The purpose of this paper is to report on the content and construct validity as well as usability of the site.MethodsPhysical therapist participants used clinical summaries (available in 3 formats--as a full summary with hyperlinks, “quick takes” with hyperlinks, and a portable two-page version) on the PTNow.org site to answer knowledge acquisition and clinical reasoning questions related to four patient scenarios. They also responded to questions about ease of use related to website navigation and about format and completeness of information using a 1–5 Likert scale. Responses were coded to reflect how participants used the site and then were summarized descriptively. Preferences for clinical summary format were analyzed using an analysis of variance (ANOVA) and a Dunnett T3 post hoc analysis.ResultsSeventeen participants completed the study. Clinical relevance and completeness ratings by experienced clinicians, which were used as the measure of content validity, ranged from 3.1 to 4.6 on a 5 point scale. Construct validity based on the information on the PTNow.org site was supported for knowledge acquisition questions 66 % of the time and for clinical reasoning questions 40 % of the time. Usability ratings for the full clinical summary were 4.6 (1.2); for the quick takes, 3.5 (.98); and for the portable clinical summary, 4.0 (.45). Participants preferred the full clinical summary over the other two formats (F = 5.908, P = 0.007). One hundred percent of the participants stated that they would recommend the PTNow site to their colleagues.ConclusionPrelimary evidence supported both content validity and construct validity of knowledge acquisition, and partially supported construct validity of clinical reasoning for the clinical summaries on the PTNow.org site. Usability was supported, with users preferring the full clinical summary over the other two formats. Iterative design is ongoing.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-015-0178-y) contains supplementary material, which is available to authorized users.

Impact of a Curricular Change on Perceived Knowledge, Skills, and Use of Evidence in Occupational Therapy Practice: A Cohort Study.

We evaluated the impact of a curriculum revision that emphasized experiential use of evidence in clinical environments on occupational therapy graduates' attitudes, perceived knowledge and skill, and use of evidence in practice. We used a retrospective cohort design to compare two curriculum cohorts of recent graduates exposed to different evidence-based practice (EBP) educational approaches. Responses on a validated survey of attitudes, knowledge/skill, and use of evidence in practice were compared using t tests and Mann-Whitney U tests for Cohort 1 (n = 63) and Cohort 2 (n = 62) graduates. Findings suggest similar attitudes and use of evidence between cohorts; Cohort 2 reported statistically greater perceived knowledge of and skill in EBP. Emphasis on experiential learning in school with reinforcement of skills in clinical learning environments is not sufficient to change graduates' use of evidence. Although the curriculum revision improved perceived knowledge/skill, our study suggests systems or other factors may influence use after graduation.

Opportunities for capacity building and integration in community based health promotion

Introduction: Health promotion is a complex interdisciplinary field and health promotion workforce capacity is influenced by the skills, knowledge and work practices of those doing health promotion work. Place based and settings based approaches to health promotion offer a framework for grounding the complexity of health promotion practice in context. This presentation reports on the baseline capacity of community based health promotion practitioners by exploring the nature and extent of their health promotion practice. This study is one part of an Australian Research Council linkage project, the overall aim of the project was to improve health promotion workforce capacity. Methods: Five focus groups were conducted with participants in roles including: Hospital based nurse practitioner; school based health nurse; community health home care; multidisciplinary community health; and dedicated health promotion practitioners. Results: Thematic analysis of the data illustrated tensions between health promotion roles, resources and capacity. Additionally there were contrasting disciplinary approaches to similar problems and contrasting understandings and use of evidence in practice. Practitioners from different sectors and roles approach health promotion in different ways, even in the context of existing collaborations. Health promotion practitioners have insight into opportunities for service improvement and integration. Conclusion: This research highlights that although contrasting philosophies underpin health promotion practice in the community there is an opportunity and a need to work with practitioners to find innovative ways to collaborate across sectors, and thus improve the translation of health promotion evidence into practice.

Bringing the clinic to the class.

The transformation of nurse education from diploma to degree has been coupled with greater emphasis on the use of evidence in practice. As a result, teaching staff have been trying to improve the integration of theory and practice learning.

The Athletic Profile of Fast Bowling in Cricket

Cricket is a global sport played in over 100 countries with elite performers attracting multimillion dollar contracts. Therefore, performers maintaining optimum physical fitness and remaining injury free is important. Fast bowlers have a vital position in a cricket team, and there is an increasing body of scientific literature that has reviewed this role over the past decade. Previous research on fast bowlers has tended to focus on biomechanical analysis and injury prevention in performers. However, this review aims to critically analyze the emerging contribution of physiological-based literature linked to fast bowling in cricket, highlight the current evidence related to simulated and competitive in-match performance, and relate this practically to the conditioning coach. Furthermore, the review considers limitations with past research and possible avenues for future investigation. It is clear with the advent of new applied mobile monitoring technology that there is scope for more ecologically valid and longitudinal exploration capturing in-match data, providing quantification of physiological workloads, and analysis of the physical demands across the differing formats of the game. Currently, strength and conditioning specialists do not have a critical academic resource with which to shape professional practice, and this review aims to provide a starting point for evidence in the specific area.

Methodological pluralism in the age of evidence-informed practice and policy

The use of evidence in practice and policy in public health and social services is a tricky endeavour. While virtually every practitioner, manager, or policy maker would agree that evidence should be used, there is disagreement about the nature of evidence and which evidence should be used, how, when, in what circumstances, and for whom. Within these disagreements, however, can be found some essential truths: (1) scientific knowledge evolves over time; (2) different types of evidence are needed for different purposes; (3) evidence has a range of quality; (4) synthesising multiple forms of evidence is difficult and inevitably includes some level of subjectivity; and (5) effective implementation of evidence is as important as the decision to use evidence in the first place. This paper will discuss the use of evidence in practice in what is arguably the most complex helping environment - social services - detailing the emergence and evolution of evidence-informed practice, dispelling some myths about its structure and application, and linking it to the broader origins and structure of the social and governmental systems in which it operates. Using this expanded view, the paper will then describe some useful approaches for incorporating these larger considerations into the use of evidence in practice.

The impact of IT infrastructures on Iranian nurses' and students' health information-seeking strategies

Purpose – Health departments of Iran have attempted to encourage nursing staff to incorporate research findings into practice since 2005. Consequently, significant changes have occurred in nursing area including holding computer skills courses, digital library workshops, establishing web sites in hospitals, and developing information technology (IT) training in nursing students' curriculum to increase accessibility to best practice information and opportunity for nurses and students to use research-based information in their clinical decision. So a question has raised, what information resources are used by nursing staff and students in hospitals? The paper aims to discuss these issues. Design/methodology/approach – A total of 412 nurses and students working in hospitals connected to web and digital libraries participated. They are evaluated with a questionnaire. Findings – The results indicated that the students and the nurses preferred experiential knowledge to research-based information in their clinical decisions and they had little tendency to high-level evidence. Results showed that lack of skill in using library was the most important deterrent in using research-based information. Originality/value – It could be concluded that provision of the infrastructures for using research-based information in clinical decisions was not sufficient. In addition to infrastructures, the paper must invest on organizational, system-wide approaches such as organizational culture, information literacy culture, acceptance of innovation, role of clinical librarians and advanced nursing informatics, and social marketing in evidence-based practice to facilitate the use of higher-level evidence in practice.

Diagnosis, treatment and progression: Using research in the classroom

Evidence is everywhere – but what are teachers to think? Ben Durbin says teaching can be enhanced by the use of evidence in practice and, inspired by medical practice, gives three steps for its effective use

Three steps to using evidence in practice – diagnosis, treatment & progress

Ben Durbin explains how teaching can be enhanced by the use of evidence in practice and – inspired by the approach taken by medical professionals – he gives three steps for its effective use.

Research Utilization and Evidence-Based Practice in Occupational Therapy: A Scoping Study

Many articles have been written on the barriers to and facilitators of the use of evidence in practice in nursing and medicine, but to date no extensive review has been published of the literature on evidence-based practice (EBP) supports in occupational therapy. This article presents the results of a scoping review that examined factors that support the integration of research into practice. A review of 69 articles revealed four themes: (1) attitudes toward, perceptions of, confidence in, and use of research and EBP; (2) factors that support the use of research in practice; (3) effects of interventions targeting changes in knowledge, attitudes, skills, behaviors, and evidence-based practices; and (4) identification of the processes involved in the acquisition of EBP skills and their application in clinical practice. A process that integrates client-centered practice, structured reflection, case application, and peer consultations within a scholarship of practice model facilitates occupational therapists' evaluation and integration of research evidence.