Creating Infrastructure Supportive of Evidence‐Based Nursing Practice: Leadership Strategies

Newhouse, Robin

doi:10.1111/j.1741-6787.2007.00075.x

Cited by 87 publications

(82 citation statements)

References 39 publications

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“…6,7 The use of EBP in nursing is a long-term dynamic process which requires devoted human and material resources, and leadership support. 8 When implemented effectively, this process includes systematic, easy-to-use methods to promote and foster scholarship, resources to enhance evaluation of evidence and implement projects, and continued follow-up to assist nurses to integrating expertise into daily practice. [8][9][10][11] Yet to build sustain EBP, individually held beliefs and systemic organizational barriers are common across many healthcare organizations must be overcome.…”

Section: The Institute Of Medicine's (Iom) Report To Err Is Human: Bmentioning

confidence: 99%

“…8 When implemented effectively, this process includes systematic, easy-to-use methods to promote and foster scholarship, resources to enhance evaluation of evidence and implement projects, and continued follow-up to assist nurses to integrating expertise into daily practice. [8][9][10][11] Yet to build sustain EBP, individually held beliefs and systemic organizational barriers are common across many healthcare organizations must be overcome. 12,13 In a complex and often chaotic healthcare system, nurses serve as the final safety net keeping patients from harm; yet nursing remains a traditions-based profession, rather than an evidence-based one.…”

Section: The Institute Of Medicine's (Iom) Report To Err Is Human: Bmentioning

confidence: 99%

“…9,11,24,25 Lack of supporting infrastructure, including leadership, is noted as a system-wide barrier to sustainment. 8,26 Organizations may not have infrastructure or processes in place to support a long-term, systematic approach for developing and evaluating nursing interventions, protocols, projects, and policies that are derived from scientific evidence. 10 Although these and other barriers to EBP exist, there are also factors that may enable nurses to overcome EBP barriers.…”

mentioning

confidence: 99%

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Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice

Breckenridge‐Sproat¹,

Patrician²,

Raju³

et al. 2015

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Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. REPORT DATE (DD-MM-YYYY) SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR'S ACRONYM(S)TriService Nursing Research TSNRP Program, 4301 Jones Bridge RD Bethesda, MD 20814 SPONSOR/MONITOR'S REPORT NUMBER(S)N10-P02 DISTRIBUTION / AVAILABILITY STATEMENTApproved for public release; distribution unlimited SUPPLEMENTARY NOTESN/A ABSTRACT Purpose:This study tested the effectiveness of a dynamic educational and mentoring program, facilitated by unit-level mentors, to introduce, promote, and sustain an EBP culture among nurses in a military healthcare setting. Background: The need to identify gaps in practice, apply principles of evidence-based practice (EBP), and advance scientific applications in the pursuit of quality nursing care is as important to military healthcare as it is in the civilian sector. Description: The Advancing Research through Close Collaboration Model guided the intervention and study. Three instruments were used: The Organizational Readiness for System-wide Integration of Evidence-based Practice (ORSIEP); EBP Beliefs (EBPB); and EBP Implementation (EBPI) scales. The study took place in three military hospitals simultaneously undergoing facility and staff integration. Data were collected from staff nurses in the inpatient nursing units before and after a facilitated education and mentoring intervention. Outcome: 360 (38%) nurses completed baseline; and 325 (31%) completed follow-up surveys. Scores improved on all three measures following implementation of the program; however, the differences were statistically significant only for the ORSIEP scale (70.96 vs. 77.63, t = -3.95, p <.01). In the paired individual pre/post-test sub-sample (N=56), scores improved significantly on all three instruments. Conclusions: Despite typically high turnover rates of military personnel and restructuring of three facilities during the study period, the readiness for, beliefs about, and implementation of EBP improved. This study suggests that a commitment to an EBP culture may diffuse among individuals in an organization, even while experiencing significant change. It also demonstrates that a uni...

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Section: The Institute Of Medicine's (Iom) Report To Err Is Human: Bmentioning

confidence: 99%

Section: The Institute Of Medicine's (Iom) Report To Err Is Human: Bmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice

Breckenridge‐Sproat¹,

Patrician²,

Raju³

et al. 2015

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“…Leaders and staff will benefit from an assessment that provides insight into specific areas where education or training can be directed (Newhouse, 2007). Assessment is foundational to nursing practice and EBP implementation is no exception.…”

Section: Assessing Organizational Culturementioning

confidence: 99%

Evidence-Based Practice in Nursing

Linde

2015

Preprint

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<p>Evidenced-based practice (EBP) as defined by the Institute of Medicine(IOM) is the integration of "best research with clinical expertise and patient values for optimum care"(IOM, 2003, p.45-46). Evidence-based practice (EBP) is considered a standard for safe and quality care (Carlson & Plonczynski, 2008). Healthcare leaders recognize EBP as an integral part of achieving quality outcomes and attaining high reliability. The Institute of Medicine (IOM) has established a goal that 90% of healthcare decisions in the United States be evidenced based by the year 2020 (IOM, 2009). Despite the fact that EBP has been promoted for many years, inconsistencies in implementation and adoption have been noted. Barriers to the implementation of EBP need to be understood. Assessing organizational culture has been identified as a necessary first step in to overcoming common barriers (Carlson & Plonczynski, 2008; Frasure, 2008). The purpose of this study was to assess the practice, attitudes and knowledge of EBP in registered nurses using the Evidence-Based Practice Questionnaire (EBPQ). The study used a descriptive design with convenience sampling. All staff registered nurses (RNs), Clinical Managers (CMs) and Assistant Clinical Managers (ACMs) on inpatient units within a large medical center in the Northeast were invited to participate in this survey. Study results are similar to those found in literature previously cited: a positive attitude towards EBP with a lower perception of knowledge or practice (Melnyk et al., 2004) and belief that more knowledge is needed (Alspach, 2006; Melnyk et al., 2004; Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012). This assessment indicates a degree of environmental readiness and provides relative estimation of educational needs.</p>

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“…The role of strong leadership in creating a context which supports research implementation in healthcare has been described in the literature (e.g., Crow, 2006;Halm, 2010;Kitson et al, 1998;Marchionni & Ritchie, 2008;McCormack et al, 2002;Newhouse, 2007). In speech pathology, the role of leadership in creating evidence-based services is beginning to gain recognition and support.…”

Section: Leadership To Support Evidence-based Practice In the Speech mentioning

confidence: 99%

“Communication is taking a back seat”: An exploration of aphasia management in acute hospital settings

Foster¹

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While in the past the focus of speech pathologists working in the acute hospital setting has been service provision to people with communication disorders and their families, their primary role is now in dysphagia. In the limited literature regarding aphasia management in acute hospital settings, there is a lack of consistency regarding the type and amount of intervention being provided to people with aphasia; however, there is consensus that current practice is inconsistent with bestpractice recommendations. Given that aphasia intervention has been identified as being central to improved communicative outcomes, an increased capacity to effectively communicate healthcare needs, a decrease in hospital negative events, and an increased sense of satisfaction for people with aphasia, this is of concern. Little is known about the reasons underlying this evidence-practice gap.The overall aim of this thesis was to provide an understanding of current acute aphasia management practice and the factors that influence it. Specifically, the research aimed to: (a) provide an in-depth understanding of the current aphasia management pathway in the acute hospital setting; (b) explore acute speech-language pathologists' conceptualisation, experiences, and perceptions of post-stroke aphasia management, and provide a greater understanding of the factors that influence their practice; and, (c) understand the factors that influence acute aphasia management from the perspectives of speech pathologists, people with aphasia, and their close others, through a cultural lens.In order to address the research aims, the empirical aspects of this research were conducted in two Phases. Phase One, an interpretative phenomenological investigation, aimed to provide a deep understanding of aphasia management from the perspective of acute speech pathologists. Semistructured, in-depth interviews were undertaken with 15 Australian speech pathologists working with people with aphasia (one of which was later excluded resulting in a total n=14). Interviews were transcribed verbatim, and data were analysed using a thematic analysis. Key themes identified included: role perception; competing priorities; the de-prioritisation of aphasia; and, the sense of disempowerment experienced by speech pathologists as a result of their relationship with evidencebased practice for acute aphasia management. In addition, a qualitative content analysis was undertaken to describe the current aphasia management pathway. Grounded within the guiding construct, First contact with the profession, the findings represented the significant diversity in the ii pathways of care for people with aphasia and their families in the acute hospital setting. Overall, analysis revealed the complex, diverse, and multi-faceted nature of the phenomenon.Phase Two was designed based on the findings of Phase One. It examined the culture of acute aphasia management by speech pathologists in depth, through the use of focused ethnography in a single acute stroke unit. Three participant triads...

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Creating Infrastructure Supportive of Evidence‐Based Nursing Practice: Leadership Strategies

Abstract: Organizations that can enable the culture and build infrastructure to help nurses develop EBP competencies will produce a professional environment that will result in both personal growth for their staff and improvements in quality that would not otherwise be possible.

Cited by 87 publications

References 39 publications

Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice

Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice

Evidence-Based Practice in Nursing

“Communication is taking a back seat”: An exploration of aphasia management in acute hospital settings

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