Engaging advanced practice nurses in evidence‐based practice: An e‐mentoring program

Abstract

Background Mentoring is highly valued in the nursing profession and essential to building an evidence‐based practice (EBP) culture. However, many organizations have a limited number of EBP mentors, who have limited non‐clinical time to engage in mentoring. Aims This project aimed to test whether an e‐mentoring approach to nursing inquiry could enhance EBP beliefs (EBPB), increase EBP Implementation (EBPI), and improve Organizational Culture and Readiness for System‐Wide Implementation of EBP (OCRSIEP). Methods A pre‐experimental pilot intervention project was implemented utilizing a pretest‐posttest design with Advanced Practice Registered Nurses’ (APRNs) in clinical practice. The OCRSIEP, EBPB, and EBPI scales were used to measure organizational readiness for EBP implementation, individual beliefs regarding the value of EBP, and the extent to which nurses integrate scientific evidence into their clinical practice, respectively. The Wilcoxon‐Signed Rank test was used to analyze the difference between pretest and posttest scores of an EBP E‐mentoring program. A post‐hoc analysis was performed to calculate effect sizes. [Correction added on 13 May 2022, after first online publication: The Methods section was revised to add additional details.] Results Eleven APRNs completed the pretest and posttest surveys. When comparing the pre‐and post‐intervention scores, the median EBPB scores increased from 61 (IQR: 56–69) to 70 (IQR: 64–73), median EBPI scores increased from 13 (IQR: 7–33) to 20 (IQR: 13–31), and median OCRSIEP scores increased from 88 (IQR: 73–97) to 99 (IQR: 90–113). Linking Evidence to Action A 12‐week Nurse Inquiry E‐mentoring Program can leverage the small number of EBP mentors in an organization to improve EBPB. A program lasting longer in duration may also significantly improve EBPI and OCRSIEP scores. By utilizing technology and leveraging economies of scale, exponentially more nurses can be mentored to create and enhance an EBP culture.

Strategies to implement evidence-informed decision making at the organizational level: a rapid systematic review

“…High-quality evidence syntheses 6. Ongoing surveys and opportunities for feedback Quantitative: -Perceptions of leadership, governance, resource allocation, collaboration and engagement (Partnership survey) Qualitative: -Implementation and impact of projects (project evaluations) -Experiences and perceptions (semi-structured interviews) Partners reported: -Translation of research into policy was built into processes -Many projects involved partners from different sectors -Communication across sectors and teams was adequate -Capacity building activities were valuable -Synergies were identified across projects Moderate (Case report) Hitch, 2019 [ 54 ] Case report, no comparator Public mental health service, major city in Australia, 2014–2016 Occupational therapy Occupational therapists within the organization Leadership role in KT established to support EIDM, complete research projects, build research capacity and culture, and create a database of research activity Quantitative: -Attitudes towards EIDM (Evidence Based Practice Attitude Scale) -EIDM use (Evidence Based Practice Implementation Scale) -Staff perceptions of the Lead Research Occupational therapist role (survey) After implementation of the KT role, -number of quality assurance and research activities increased (Cliffs Delta = 0.44; 95% CI = 0.22, 0.62) -no significant change in attitudes towards EIDM -staff viewed KT role positively -staff engaged in KT activities -greater diffusion of evidence across programs Moderate (Case report) Hooge, 2022 [ 55 ] Single group pre-post study Large academic health system, southeast region, USA, 12-week program; dates not specified Primary care 11 Advanced practice registered nurses Virtual mentoring program delivered via Microsoft Teams platform included synchronous training sessions, podcasts, blog and video tutorials, and additional research articles and educational material Quantitative: -Knowledge and skill for EIDM (Evidence-based Practice Beliefs scale, Evidence-based Practice Implementation scale) -Organizational readiness for EIDM (Organizational Culture and Readiness for System-wide Integration of Evidence-based Practice scale) Qualitative -EIDM facilitators and barriers (open-ended survey) Compared to baseline, evidence-based practice beliefs scores increased (effect size = 0.71, p = 0.018). No significant change in evidence-based practice implementation and organizational culture and readiness for system-wide implementation of evid...…”

“…Knowledge Broker strategies were mostly implemented in parallel with other EIDM implementation strategies, such as capacity building for staff, integrating EIDM into decision-making processes and development of leadership to support EIDM. When these strategies were evaluated quantitatively for organizational capacity, culture and implementation of EIDM, most studies found positive results, such as increased scores for organizational climates supporting EIDM, improved attitudes toward EIDM, or the integration of EIDM into processes [ 44 , 52 , 54 , 62 , 66 , 67 , 71 , 72 ], although some studies found no change [ 55 , 60 ] following implementation of Knowledge Broker roles. Qualitatively, most studies described facilitators and barriers to EIDM, either through formal qualitative analysis or case report [ 14 , 20 , 39 – 43 , 45 , 47 , 48 , 52 , 55 , 57 , 59 – 61 , 64 , 65 , 68 ].…”

“…When these strategies were evaluated quantitatively for organizational capacity, culture and implementation of EIDM, most studies found positive results, such as increased scores for organizational climates supporting EIDM, improved attitudes toward EIDM, or the integration of EIDM into processes [ 44 , 52 , 54 , 62 , 66 , 67 , 71 , 72 ], although some studies found no change [ 55 , 60 ] following implementation of Knowledge Broker roles. Qualitatively, most studies described facilitators and barriers to EIDM, either through formal qualitative analysis or case report [ 14 , 20 , 39 – 43 , 45 , 47 , 48 , 52 , 55 , 57 , 59 – 61 , 64 , 65 , 68 ]. Facilitators included organizational culture with supportive leadership and staff buy-in, expectations to use evidence to inform decisions, accessible knowledge, and integration of EIDM into processes and templates.…”

Psychometric properties of the Organizational Culture and Readiness Scale for System‐Wide Integration of Evidence‐Based Practice

“…The OCRSIEP identifies organizational characteristics, including strengths and opportunities, for enhancing consistent implementation of EBP by clinicians within a healthcare system. The scale has been used in a variety of populations, has established face and content validity, and consistent internal consistency reliabilities (Cleary‐Holdforth et al, 2021; Hooge et al, 2022; Melnyk et al, 2016, 2020), but has yet to have construct validity thoroughly assessed. Thus, this study aimed to describe the OCRSIEP's construct validity through an in‐depth psychometric analysis that included exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and fit indices.…”

Strategies to implement evidence-informed practice at organizations: A rapid systematic review

“…When these strategies were evaluated quantitatively for organizational capacity, culture and implementation of EIDM, most studies found positive results, such as increased scores for organizational climates supporting EIDM, improved attitudes toward EIDM, or the integration of EIDM into processes(51, 54, 56, 59-61, 64, 65), although some studies found no change(53, 58) following implementation of Knowledge Broker roles. Qualitatively, most studies described facilitators and barriers to EIDM, either through formal qualitative analysis or case report(5, 46,49,50,52,53,57, 58, 62, 64,(66)(67)(68)(69)(70)(71)(72)(73)(74) Facilitators included organizational culture with supportive leadership and staff buy-in, expectations to use evidence to inform decisions, accessible knowledge, and integration of EIDM into processes and templates. Barriers included limited time and competing priorities, staff turnover, and lack of understanding and support from management.Ten included studies focused primarily on building EIDM capacity of existing staff at the organization, often at multiple levels (e.g., front-line service providers, managers, and leadership)(4, 5, 68,70,71,(73)(74)(75)(76)(77)(78).…”