Moving to Evidence-Based Practice in Long-Term Care: The Role of a Best Practise Resource Centre in Two Long-Term Care Settings

Brazil, Kevin; Royle, Joan; Montemuro, Maureen; Blythe, Jennifer; Church, Anne

doi:10.3928/0098-9134-20040301-08

Cited by 8 publications

(10 citation statements)

References 19 publications

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“…In the study facility, the nursing staff were only able to access five computers; therefore, it was difficult for the nursing staff to search for research‐related and professional information and to check their emails frequently to receive the reminders for implementing the music protocol. Providing more computers, access to computers and information search are important in assisting improvement of nursing staff's perceptions and use of EBP in long‐term care (Brazil et al. 2004).…”

Section: Discussionmentioning

confidence: 99%

“…The other barriers include lack of time, resources and organizational support (Parahoo 2000, Hutchinson & Johnston 2004). In long‐term care settings, the barriers to EBP are even greater due to shortage of staff, increased workload with increased admissions of residents with cognitive impairment as well as limited resources in terms of computers and support for research and EBP (Brazil et al. 2004).…”

Section: Introductionmentioning

confidence: 99%

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An implementation programme to improve nursing home staff's knowledge of and adherence to an individualized music protocol

Sung

Chang

Abbey

2008

Journal of Clinical Nursing

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Aim. This paper reports the results of a study evaluating an implementation programme in improving nursing home staff's knowledge of and adherence to an individualized music protocol for older people with dementia. Background. The major barriers to evidence-based practice identified by nurses are the lack of knowledge and skills on implementing evidence-based practice. Some evidence supports the effectiveness of implementation strategies in facilitating practice change among healthcare professionals but need further testing. Little is known about what is the best way to facilitate nursing home staff's adoption of evidence-based care. Methods. A one-group pre-post test design was used with a convenience sample of 17 nursing staff from a long-term care facility. The implementation programme consisted of interactive education, reminders, a local opinion leader and audit. Data on nursing staff's knowledge of music protocol were collected by the music knowledge questionnaire and their adherence to the protocol was assessed by an audit checklist at baseline and week four after the implementation programme.Results. There was a significant improvement in nursing staff's knowledge (p < 0AE001) of the music protocol. The improvement was greater among nurse aides; however, the improvement between the nurse group and the nurse aide group was not significantly different (p > 0AE05). The mean level of their adherence to the protocol improved from nil at baseline to 72AE35% on the post-test.Conclusions. An innovative implementation programme consisting of interactive education, reminders, use of a local opinion leader and audit led to an improvement in nursing home staff's knowledge of and adherence to an individualized music protocol in dementia care. Relevance to clinical practice. Multifaceted implementation strategies with careful consideration of local circumstances may be essential in promoting uptake of evidence-based practice among nursing staff in long-term care settings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An implementation programme to improve nursing home staff's knowledge of and adherence to an individualized music protocol

Sung

Chang

Abbey

2008

Journal of Clinical Nursing

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“…Limited resources are among the top challenges to introducing EBP in LTC (Brazil, Royle, Montemuro, Blythe, & Church, 2004). Brazil and colleagues tested an innovative intervention to provide information services to a LTC and community setting.…”

Section: Factors That Influence the Use Of Ebp In Nhsmentioning

confidence: 99%

Evidence Based Practice in Long Term Care Settings

Specht

2013

J Korean Acad Nurs

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Purpose: The purpose of this manuscript is to discuss the need for use of evidence based practice (EBP) in LTC, the current use of evidence in long term care facilities and what we know about adoption of the use of EBP in LTC. Methods: Literature review and reporting of findings from the M-TRAIN study that was a quasi-experimental design to test the effectiveness of an intervention to increase the use of EBPs for urinary incontinence and pain in 48 LTC facilities. Results: Barriers to adopting EBPs include lack of available time, lack of access to current research literature, limited critical appraisal skills, excessive literature to review, non-receptive organizational culture, limited resources, and limited decision-making authority of staff to implement change. Strategies to promote adoption of EBP include the commitment of management; the culture of the home; leadership; staff knowledge, time, and reward; and facility size, complexity, the extent that members are involved outside the facility, NH chain membership, and high level of private pay residents. Findings from the M-TRAIN add, stability of nurse leader and congruency between the leaders perception of their leadership and the staff's perception of the leadership. Conclusion: There is clear evidence of the need and the benefits to residents of LTC and to the health care system yet adoption of EBP continues to be slow and sporadic. There is also evidence for the process of establishing best evidence and many resources to find the available EBPs. The urgent need now is finding ways to best get the EBPs implemented in LTC. There is growing evidence about best methods to do this but continued research is needed. Clearly, residents in LTC deserve the best care possible and EBPs represent an important vehicle by which to do this.

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“…During the past 10 years, nursing homes in various countries have made a start with the systematic implementation and evaluation of care planning [1][2][3][4], practice guidelines [5][6][7][8][9], quality indicators [10,11], client councils and quality management systems [12][13][14][15] to improve the quality of care provided [16,17] and adapt to the changing needs of nursing home residents [18]. In several countries, the government has also imposed legal requirements to improve the quality of nursing home care.…”

Section: Introductionmentioning

confidence: 99%

Quality management systems and clinical outcomes in Dutch nursing homes

et al. 2006

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The objective of the article is to explore the impact quality management systems and quality assurance activities in nursing homes have on clinical outcomes. The results are based on a cross-sectional study in 65 Dutch nursing homes. The management of the nursing homes as well as the residents (N = 12,377) participated in the study. Primary survey-data about the implementation of quality management systems and quality assurance activities were collected in 1994/1995 and in 1998, and were combined with information on resident characteristics and the prevalence of undesirable clinical outcomes. The results demonstrate that there are differences between nursing homes in the prevalence of undesirable clinical outcomes. In the nursing homes with the lowest scores, undesirable outcomes occur approximately 10 times less often than in nursing homes with the highest scores. The multi-level analysis has demonstrated that the differences in outcomes are mainly caused by differences between residents and, to some extent, also by differences between nursing homes. Resident characteristics explain 48% of the differences between residents and 72% of the differences between nursing homes. The size of the nursing home, the involvement of a client council and the implementation of a quality management system could explain a small part of the remaining variation in the number of undesirable outcomes. It seems that the implementation of a quality management system and the involvement of a client council had significant influence on the number of undesirable outcomes. Approximately 50% of the undesirable outcomes cannot be explained by the selected resident characteristics, the size of the nursing home and the implementation of quality management systems or quality assurance activities.

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Moving to Evidence-Based Practice in Long-Term Care: The Role of a Best Practise Resource Centre in Two Long-Term Care Settings

Cited by 8 publications

References 19 publications

An implementation programme to improve nursing home staff's knowledge of and adherence to an individualized music protocol

An implementation programme to improve nursing home staff's knowledge of and adherence to an individualized music protocol

Evidence Based Practice in Long Term Care Settings

Quality management systems and clinical outcomes in Dutch nursing homes

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