Exploring nurse beliefs and perceived readiness for system wide integration of evidence based practice in a large pediatric health care system

Patton, Lindsey; Garcia, Mayra G.; Young, Virginia; Bradfield, Casey; Gosdin, Ann; Chen, Peng; Webb, Tammy; Tidwell, Jerithea

doi:10.1016/j.pedn.2021.12.018

Cited by 7 publications

(2 citation statements)

References 20 publications

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“…Although readiness to adopt evidence-based interventions and integrated health care delivery models has been explored in depth [12,[26][27][28][29][30][31][32][33][34][35][36], few studies have explored clinic readiness to adopt integrated delivery of cancer screening and chronic disease management activities in the USA. Our study examined the CRCCP, a public health program implemented in primary care clinics, to identify the factors that support readiness for integrated implementation of CRC EBIs and supporting activities with other screening and chronic disease management activities.…”

Section: Discussionmentioning

confidence: 99%

Factors that support readiness to implement integrated evidence-based practice to increase cancer screening

Soloe

Arena

Schlueter

et al. 2022

Implement Sci Commun

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Background In 2015, the Centers for Disease Control and Prevention (CDC) funded the Colorectal Cancer Control Program (CRCCP), which partners with health care systems and primary care clinics to increase colorectal cancer (CRC) screening uptake. We interviewed CRCCP stakeholders to explore the factors that support readiness for integrated implementation of evidence-based interventions (EBIs) and supporting activities to promote CRC screening with other screening and chronic disease management activities in primary care clinics. Methods Using the Consolidated Framework for Implementation Research (CFIR), we conducted a literature review and identified constructs to guide data collection and analysis. We purposively selected four CRCCP awardees that demonstrated ongoing engagement with clinic partner sites, willingness to collaborate with CDC and other stakeholders, and availability of high-quality data. We gathered background information on the selected program sites and conducted primary data collection interviews with program site staff and partners. We used NVivo QSR 11.0 to systematically pilot-code interview data, achieving a kappa coefficient of 0.8 or higher, then implemented a step-wise process to identify site-specific and cross-cutting emergent themes. We also included screening outcome data in our analysis to examine the impact of integrated cancer screening efforts on screening uptake. Results We identified four overarching factors that contribute to clinic readiness to implement integrated EBIs and supporting activities: the funding environment, clinic governance structure, information sharing within clinics, and clinic leadership support. Sites reported supporting clinic partners’ readiness for integrated implementation by providing coordinated funding application processes and braided funding streams and by funding partner organizations to provide technical assistance to support efficient incorporation of EBIs and supporting activities into existing clinic workflows. These actions, in turn, support clinic readiness to integrate the implementation of EBIs and supporting activities that promote CRC screening along with other screening and chronic disease management activities. Discussion The selected CRCCP program sites supported clinics’ readiness to integrate CRC EBIs and supporting activities with other screening and chronic disease management activities increasing uptake of CRC screening and improving coordination of patient care. Conclusions We identified the factors that support clinic readiness to implement integrated EBIs and supporting activities including flexible funding mechanisms, effective data sharing systems, coordination across clinical staff, and supportive leadership. The findings provide insights into how public health programs and their clinic partners can collectively support integrated implementation to promote efficient, coordinated patient-centered care.

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Section: Discussionmentioning

confidence: 99%

Factors that support readiness to implement integrated evidence-based practice to increase cancer screening

Soloe

Arena

Schlueter

et al. 2022

Implement Sci Commun

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“…This ongoing evaluation helps us to identify obstacles and challenges that enable appropriate actions to be taken. Moreover, determining HCPs' readiness and willingness to implement EBP is crucial for sustaining a culture of EBP [14]. Given the lack of evidence concerning the competence of HCPs in the EMR regarding EBP and the perceived barriers to its adoption in clinical decision making, it is essential to conduct a large survey among HCPs in the EMR.…”

Section: Introductionmentioning

confidence: 99%

The Internal Reliability and Construct Validity of the Evidence-Based Practice Questionnaire (EBPQ): Evidence from Healthcare Professionals in the Eastern Mediterranean Region

Youssef,

Saleeb,

Gebreal

et al. 2023

Healthcare

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Background: Fostering a culture of clinical effectiveness among healthcare professionals (HCPs) is crucial to achieving optimal patient health outcomes. To our knowledge, there is a lack of robust evidence-based practice (EBP) tools to assess the competence of HCPs in EBP in the Eastern Mediterranean Region (EMR). Aim: This study aims to comprehensively investigate the construct validity and internal reliability of the evidence-based practice questionnaire (EBPQ) among HCPs in the EMR. Methods: This multinational and multi-disciplinary cross-sectional study was conducted between 27 April and 11 May 2023. Convenience and snowball sampling methods were used to recruit a sample of HCPs (physicians, nurses, physiotherapists, dentists, and pharmacists) using an electronic survey questionnaire for data capture. To assess the reliability of the instrument, Cronbach’s alpha, inter-item reliability, and split-half reliability analyses were conducted. Furthermore, the convergent and discriminant validity of the questionnaire was ensured by calculating the average variance extracted (AVE) and the correlation coefficient between the different constructs, respectively. Factor loadings and cross-loadings of different indicators within each construct were calculated by performing both exploratory and confirmatory factor analyses. Results: A total of 1536 HCPs from 18 countries in the EMR (response rate = 96.786%) with a median age of 28 years participated; 47% were female, and 55% had Arabic as their first language. English was the most common language for a bachelor’s degree in science (54%). The construct validity of the EBPQ was investigated using exploratory factor analysis (EFA), which yielded four loaded factors. The confirmatory factor analysis (CFA) confirmed the four loaded factors. The CFA model showed that the root mean square error of approximation = 0.066, comparative fit index = 0.95, Tucker–Lewis’s index = 0.94, standardized root mean square residual = 0.033, normal fit index = 0.94, goodness of fit = 0.91, and χ2 test statistic= 22,553, with p < 0.001. The AVE values of the four factors were close to 1 (knowledge = 0.6, practice = 0.6, attitude = 0.5, and sharing = 0.7), thus supporting the convergent validity of the EBPQ. The four domains had Cronbach’s alpha coefficients and Omega ≥ 0.7 (knowledge = 0.9, practice = 0.9, attitude = 0.7, and sharing = 0.8), suggesting that the items within each domain had good internal consistency. These results support the discriminant validity of the EBPQ. Conclusions: The EBPQ is a robust questionnaire that can be completed in less than 10 min by EMR HCPs and can be used as a gold-standard questionnaire to collect valid data on the attitudes, knowledge, and proficiency of HCPs in making clinical decisions based on evidence. Future studies are recommended to investigate the retest reliability.

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Nursing Leaders’ Influence on Clinical Nurses’ Evidence-Based Practice Implementation: Impact of an Evidence-Based Practice Leadership Behavior Program

Patton,

Sajwani-Merchant,

Moore

et al. 2024

Nurse Leader

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Exploring nurse beliefs and perceived readiness for system wide integration of evidence based practice in a large pediatric health care system

Cited by 7 publications

References 20 publications

Factors that support readiness to implement integrated evidence-based practice to increase cancer screening

Factors that support readiness to implement integrated evidence-based practice to increase cancer screening

The Internal Reliability and Construct Validity of the Evidence-Based Practice Questionnaire (EBPQ): Evidence from Healthcare Professionals in the Eastern Mediterranean Region

Nursing Leaders’ Influence on Clinical Nurses’ Evidence-Based Practice Implementation: Impact of an Evidence-Based Practice Leadership Behavior Program

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