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Implementing Evidence (implementing + evidence)
Selected AbstractsImplementing Evidence-Based Substance Use Prevention Curricula in North Carolina Public School DistrictsJOURNAL OF SCHOOL HEALTH, Issue 9 2004Melinda M. Pankratz ABSTRACT: The Safe and Drug-Free Schools and Communities Act (SDFSCA) provides funding for prevention education to nearly every school district in the nation. Recent federal policy requires SDFSCA recipients to implement evidence-based prevention programs. This paper reports the extent to which North Carolina public school districts implement evidence-based substance use prevention curricula. Results showed that while the majority of school districts use evidence-based prevention curricula, they are rarely the most commonly used curricula. Evidence-based curricula are much more likely to be used at the middle school level than at the elementary or high school levels. Urbanicity, coordinator time, and coordinator experience correlated with extensive use of evidence-based curricula in the bivariate analysis, but only time spent on prevention by the Safe and Drug-Free Schools (SDFS) coordinator significantly predicted extensive use in the multivariate analysis. Increasing district SDFSCA coordinator time is a necessary step for diffusing evidence-based curricula. (J Sch Health. 2004;74(9):353,358) [source] Implementing evidence-based nursing practice: a tale of two intrapartum nursing unitsNURSING INQUIRY, Issue 4 2003Jan Angus ANGUS J, HODNETT E and O'BRIEN-PALLAS L. Nursing Inquiry 2003; 10: 218,228 Implementing evidence-based nursing practice: a tale of two intrapartum nursing units Despite concerns that the rise of evidence-based practice threatens to transform nursing practice into a performative exercise disciplined by scientific knowledge, others have found that scientific knowledge is by no means the preeminent source of knowledge within the dynamic settings of health-care. We argue that the contexts within which evidence-based innovations are implemented are as influential in the outcomes as the individual practitioners who attempt these changes. A focused ethnography was done in follow-up to an earlier trial that evaluated the effectiveness of a marketing strategy to encourage the adoption of evidence-based intrapartum nursing practice. Bourdieu's (1990, 1991) concepts of habitus, capital and social field were used in our refinement of the analysis of the ethnographic findings. Nursing leadership, interprofessional struggle with physicians, the characteristics of the community and the physical environment were prominent issues at all of the sites. Detailed descriptions of the sociohistorical context and of the experiences at two sites are presented to illustrate the complexities encountered when implementing innovations. [source] Implementing evidence-based practicePRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 8 2003Dr George A Thomson Consultant Physician No abstract is available for this article. [source] Integrating evidence-based practice into the diabetes nurse curriculum in BergenEUROPEAN DIABETES NURSING, Issue 1 2010Perceived barriers to finding, reading, using research in practice Abstract Background: There is rising international interest in developing healthcare systems that are built on the basis of best evidence. However, it is a challenge to integrate evidence-based practice skills into existing educational courses, in a manner that enables students to interpret and use such skills effectively. Aims: To study students' abilities to find, read and critique research literature and to explore students' perceptions of barriers to implementing evidence-based knowledge and skills into their practice. Methods: An evidence-based approach was integrated into the curriculum of a postgraduate diabetes education programme. At the start of the course and after its completion, questionnaire data were collected to assess students' ability to find, read and critique research literature, and students' perceptions of barriers to implementing new knowledge and skills into practice. Qualitative data on barriers to transferring evidence into practice were also collected. Results: Thirty-three experienced nurses (all female), mean age 40 years (SD 7.7; range 28,52 years), mean work experience 12.8 years (SD 7.9; range 3,30 years) attended the course and completed the initial questionnaire. By the end of the course, three students (9%) had left because of maternity leave or health issues, and six students (18%) did not return the final questionnaires. The remaining students reported greater ability to find and critique research literature (increasing respectively from 6.7% to 40.0% and from 27.3% to 41.7% during the course). Perceived barriers of using research in practice were: lack of time (69.7%); workplace environment (30.4%); structural and organisational problems (25.0%). The qualitative findings indicated that hierarchy, fear of negative judgements, competing demands, and fear of change were perceived barriers. Conclusion: Students commented that the course had provided them with enhanced evidence-based practice skills for finding and interpreting research. However, postgraduate training should be linked very closely to the student's workplace, in order to support the transfer of best evidence into practice. Copyright © 2010 FEND [source] Promoting evidence-based practice: the roles and activities of professional nurses' associationsJOURNAL OF ADVANCED NURSING, Issue 5 2006Theo Van Achterberg PhD RN Aim., This paper reports a study exploring the role perceptions and current activities in evidence-based practice promotion of professional nurses' associations in the Netherlands. Background., The promotion of evidence-based practice contributes to professional standards in nursing and good quality care for patients. As professional nurses' associations can be key players in this process, the nature of their roles and current activities deserves to be explored. Methods., Roles and activities were explored for 43 professional nurses' associations (83% of all national associations). Data were collected using interviews with the associations' board members. Findings from the interviews were validated with those from an analysis of the associations' policy reports and other publications in the previous 2 years. Results., Board members primarily thought that they had roles in the selection and distribution of evidence. The roles of participant (n = 13) and performer (n = 13) in selecting evidence, and those of facilitator (n = 12), initiator (n = 15) and performer (n = 41) in the distribution of evidence were often addressed. A few respondents reflected on roles in generating evidence and implementing evidence-based practice in patient care. A majority of the associations was contemplating activities in the promotion of evidence-based practice. Specific activities for each of six relevant aspects in the promotion of evidence-based practice were found in fewer than five associations. Conclusion., Professional nurses' association roles in the promotion of evidence-based practice need to be viewed in relation to the tasks to be accomplished, especially those of selecting and distributing evidence. Although many organizations expressed motivation, professional nurses' associations have a long way to go in the promotion of evidence-based practice among their members. [source] Multi-institutional study of barriers to research utilisation and evidence-based practice among hospital nursesJOURNAL OF CLINICAL NURSING, Issue 13-14 2010Caroline E Brown Aims., The study aims were to explore the relationships between perceived barriers to research use and the implementation of evidence-based practice among hospital nurses and to investigate the barriers as predictors of implementation of evidence-based practice. Background., Evidence-based practice is critical in improving healthcare quality. Although barriers to research use have been extensively studied, little is known about the relationships between the barriers and the implementation of evidence-based practice in nursing. Design., Cross-sectional study. Method., Data were collected between December 2006,January 2007 for this cross-sectional study using computerised Evidence-Based Practice Questionnaire and BARRIERS surveys. A convenience sample (n = 1301) of nurses from four hospitals in southern California, USA, participated. Hierarchical multiple regression analyses were performed for each of the three dependent variables: practice, attitude and knowledge/skills associated with evidence-based practice. BARRIERS subscales were used as predictor variables. Results., The perceived barriers to research use predicted only 2·7, 2·4 and 4·5% of practice, attitude and knowledge/skills associated with evidence-based practice. Conclusions., It was unexpected that the barriers to research use predicted such small fractions of practice, attitude and knowledge/skills associated with evidence-based practice. The barriers appear to have minimal influence over the implementation of evidence-based practice for most hospital nurses. Relevance to clinical practice., In implementing evidence-based practice, the focus on barriers to research use among general nursing staff may be misplaced. Further studies are needed to identify the predictors of evidence-based practice and to identify the subset of nurses who are most amenable to adopting evidence-based practice. [source] An exploration of the factors that influence the implementation of evidence into practiceJOURNAL OF CLINICAL NURSING, Issue 8 2004Jo Rycroft-Malone PhD Background., The challenges of implementing evidence-based practice are complex and varied. Against this background a framework has been developed to represent the multiple factors that may influence the implementation of evidence into practice. It is proposed that successful implementation is dependent upon the nature of the evidence being used, the quality of context, and, the type of facilitation required to enable the change process. This study sets out to scrutinize the elements of the framework through empirical enquiry. Aims and objectives., The aim of the study was to address the following questions: , What factors do practitioners identify as the most important in enabling implementation of evidence into practice? , What are the factors practitioners identify that mediate the implementation of evidence into practice? , Do the concepts of evidence, context and facilitation constitute the key elements of a framework for getting evidence into practice? Design and methods., The study was conducted in two phases. Phase 1: Exploratory focus groups (n = 2) were conducted to inform the development of an interview guide. This was used with individual key informants in case study sites. Phase 2: Two sites with on-going or recent implementation projects were studied. Within sites semi-structured interviews were conducted (n = 17). Results., A number of key issues in relation to the implementation of evidence into practice emerged including: the nature and role of evidence, relevance and fit with organizational and practice issues, multi-professional relationships and collaboration, role of the project lead and resources. Conclusions., The results are discussed with reference to the wider literature and in relation to the on-going development of the framework. Crucially the growing body of evidence reveals that a focus on individual approaches to implementing evidence-based practice, such as skilling-up practitioners to appraise research evidence, will be ineffective by themselves. Relevance to clinical practice., Key elements that require attention in implementing evidence into practice are presented and may provide a useful checklist for future implementation and evaluation projects. [source] The relative effectiveness of practice change interventions in overcoming common barriers to change: a survey of 14 hospitals with experience implementing evidence-based guidelinesJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2007Fiona Simpson MND Abstract Aims and objectives, Changing practice to reflect current best evidence can be costly and time-consuming. The purpose of this survey was to determine the optimal combination of practice change interventions needed to overcome barriers to practice change commonly encountered in the intensive care unit (ICU). Design, A survey instrument delivered by mail with email follow-up reminders. Setting, Fourteen hospitals throughout Australia and New Zealand. Subjects, Individuals responsible for implementing an evidence-based guideline for nutritional support in the ICU. Survey, Practice change interventions were ranked in order of effectiveness and barriers to change were ranked in order of how frequently they were encountered. Results, A response rate of 100% was achieved. Interventions traditionally regarded as strong (academic detailing, active reminders) were ranked higher than those traditionally regarded as moderate (audit and feedback), or weak (posters, mouse mats). The high ranks of the site initiation visit (educational outreach, modest) and in-servicing (didactic lectures, weak) were unexpected, as was the relatively low rank of educationally influential, peer-nominated opinion leaders. Four hospitals reported the same doctor-related barrier as ,most common' and the remaining 10 hospitals reported three different doctor-related barriers, two nursing-related barriers and three organizational barriers as most common. Conclusions, When designing a multifaceted, multi-centre change strategy, the selection of individual practice change interventions should be based on: (1) an assessment of available resources; (2) recognition of the importance of different types of barriers to different sites; (3) the potential for combinations of interventions to have a synergistic effect on practice change, and (4) the potential for combinations of interventions to actually reduce workload. [source] Strengthening Prevention Performance Using Technology: A Formative Evaluation of Interactive Getting To Outcomes®AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 4 2009Matthew Chinman PhD Communities face challenges implementing evidence-based prevention programs. To help, policymakers are exploring how to build community-level capacity for prevention for thousands of organizations or communities across the United States. This article reports on a formative evaluation within 2 states' prevention systems of an Internet system designed to build capacity on a large scale, interactive Getting To Outcomes® (iGTO). In Tennessee, 30 coalitions were randomly assigned to receive either the iGTO system or nothing. In Missouri, 18 coalitions receiving iGTO were compared with 8 like coalitions who did not receive iGTO. The primary outcome was iGTO's impact on the performance of the coalitions' programs, assessed through interviews at baseline and after a year of iGTO implementation. Analyses suggest that iGTO-programs improved their performance of prevention practices over non-iGTO programs. Semi-structured interviews of iGTO users and state-level stakeholders showed that iGTO was adopted by most iGTO-assigned coalitions, albeit in mostly an elementary fashion. Perceptions of the iGTO system were mixed. The findings suggest that more comprehensive integration requires that state leadership also use iGTO and provide more support for its use at the local level. [source] | ||||||||||||||||||||||