The Relationship Among Evidence‐Based Practice and Client Dyspnea, Pain, Falls, and Pressure Ulcer Outcomes in the Community Setting

Abstract

BackgroundThere are gaps in knowledge about the extent to which home care nurses’ practice is based on best evidence and whether evidence-based practice impacts patient outcomes.AimThe purpose of this study was to investigate the relationship between evidence-based practice and client pain, dyspnea, falls, and pressure ulcer outcomes in the home care setting. Evidence-based practice was defined as nursing interventions based on best practice guidelines.MethodsThe Nursing Role Effectiveness model was used to guide the selection of variables for investigation. Data were collected from administrative records on percent of visits made by Registered Nurses (RN), total number of nursing visits, and consistency of visits by principal nurse. Charts audits were used to collect data on nursing interventions and client outcomes. The sample consisted of 338 nurses from 13 home care offices and 939 de-identified client charts. Hierarchical generalized linear regression approaches were constructed to explore which variables explain variation in client outcomes.ResultsThe study found documentation of nursing interventions based on best practice guidelines was positively associated with improvement in dyspnea, pain, falls, and pressure ulcer outcomes. Percent of visits made by an RN and consistency of visits by a principal nurse were not found to be associated with improved client outcomes, but the total number of nursing visits was.Linking Evidence to ActionImplementation of best practice is associated with improved client outcomes in the home care setting. Future research needs to explore ways to more effectively foster the documentation of evidence-based practice interventions.

Longitudinal Outcomes of Home Care in Korea to Manage Pressure Ulcers

“…Separately, home care had limited capacity for environmental changes, such as use of pressure‐reduction devices, despite the high proportion of bedridden patients. Therefore, in a number of respects, adherence to guidelines for PrU management in home care was more difficult to perform than in the hospital, which is consistent with the results of other studies (Chaves et al, ; Doran et al, ; Ferrell, Josephson, Norvid, & Alcorn, ; Meaume & Marty, ). Nonetheless, home care is an essential and cost‐effective component of PrU management for economically vulnerable patients.…”

Exploring the utility of the Nursing Role Effectiveness Model in evaluating nursing contributions in primary health care: A scoping review

“… 1 Doran et al (); 2 Doran et al (); 3 Doran et al (); 4 Endacott et al (); 5 Gazarian, Moineddin, and Agha (); 6 Kossman and Scheidenhelm (); 7 Manojlovich (); 8 Manojlovich et al (); 9 Salgueiro et al (); 10 Saunders (); 11 White et al (); 12 Doran et al (); 13 Landesman et al (); 14 Rondinelli et al, ; 15 Tarlier (); 16 Seabra et al (). …”

“…Doran et al () found that nursing interventions (process) consistent with Registered Nurses Association of Ontario (RNAO) Best Practice Guidelines were associated with patient outcomes (Doran et al, ). There were associations between structural variables, such as patient age and medical diagnosis and outcome variables, such as pain and dyspnea (Doran et al, ). For example, the nursing intervention implemented to observe the pain (outcome) in patients was to screen patients at least once a visit for pain (process) ( p < 0.0001).…”

“…There was only one study conducted in home care. Doran et al (2014) found that nursing interventions (process) consistent with…”

Developing a Web-Based Nursing Practice and Research Information Management System

“…Extracting and analyzing clinical nursing data are essential to improving nursing care and patient outcomes, and the unique design and build of the NPRIMS successfully support capturing clinical nursing data and measurement of the relationship between nursing care provided and patient outcomes Nursing-sensitive outcomes, such as medication errors, nosocomial infections, patient falls, and pressure ulcers, are often used to evaluate the performance of nurses, because they are directly linked to nursing practice and patient safety. 17,[26][27][28][29] The outcomes of this study will be useful for measuring performance of nursing care in hospitals. Although visualization of analyzed data was attempted without any formal usability testing, it will facilitate stakeholders' understanding of relationships between care provided and patient outcomes.…”