This study aimed to identify clinical nurses' evidence-based practice (EBP) knowledge, beliefs, organizational readiness, and EBP implementation levels, and to determine the factors that affect EBP ...implementation in order to successfully establish EBP. This study was conducted at a university-affiliated tertiary hospital located in a provincial area in Korea. The research design was based on Melnyk and Fineout-Overholt's Advancing Research & Clinical Practice through Close Collaboration model as the first step.
A descriptive and cross-sectional design was conducted and a convenience sample of 521 full-time registered nurses from an 849-bed tertiary hospital were included. Structured questionnaires were used to assess EBP knowledge, EBP beliefs, organizational culture & readiness and EBP implementation. Data were analyzed using SPSS V 25.0 by using descriptive and inferential statistics and hierarchical multiple regression was performed to determine the factors affecting the implementation of EBP.
Our findings showed that the clinical nurses had a positive level of EBP beliefs, but the level of EBP knowledge, organizational readiness and EBP implementation were insufficient. EBP knowledge, beliefs, and organizational readiness were significantly positively correlated with EBP implementation. In the final model, EBP knowledge and organizational readiness were significant predictors of EBP implementation; the model predicted 22.2% of the variance in implementation.
Based on these results, the main focus of the study was the importance of individual nurses' efforts in carrying out EBP, but above all efforts to create an organizational culture to prepare and support EBP at the nursing organization level. In the initial process of introducing and establishing EBP, nurse administrators will need to minimize expected barriers, enhance facilitators, and strive to build an infrastructure based on vision, policy-making, budgeting, excellent personnel and facilities within the organization.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This paper describes the application of the principles of evidence based medicine to public health. It recounts the experience of the National Institute for Health and Clinical Excellence in England ...(NICE) which acquired a remit to develop public health guidance in 2005. Some of the history of the origins of the evidence based approach is described in the writings of Cochrane and others, and the way that this came to be a critical part of the NICE approach to developing clinical cost effectiveness is outlined. The challenge of applying these methods to an evidence base which is social and psychological as well as biomedical is considered. Key problems are identified: the breadth of the evidence base, different analytic levels of explanation, and the length of the causal chain between interventions and outcomes in public health.
The patient history Henderson, Mark C; Smetana, Gerald W; Tierney, Lawrence M
c2012.
eBook
For medical students and other health professions students, an accurate differential diagnosis starts with The Patient History. The ideal companion to major textbooks on the physical examination, ...this trusted guide is widely acclaimed for its skill-building, and evidence based approach to the medical history. Now in full color, The Patient History defines best practices for the patient interview, explaining how to effectively elicit information from the patient in order to generate an accurate differential diagnosis. The second edition features all-new chapters, case scenarios, and a wealth of diagnostic algorithms. Introductory chapters articulate the fundamental principles of medical interviewing. The book employs a rigorous evidenced-based approach, reviewing and highlighting relevant citations from the literature throughout each chapter.
To provide guidance on how systematic review authors, guideline developers, and health technology assessment practitioners should approach the use of the risk of bias in nonrandomized studies of ...interventions (ROBINS-I) tool as a part of GRADE's certainty rating process.
The study design and setting comprised iterative discussions, testing in systematic reviews, and presentation at GRADE working group meetings with feedback from the GRADE working group.
We describe where to start the initial assessment of a body of evidence with the use of ROBINS-I and where one would anticipate the final rating would end up. The GRADE accounted for issues that mitigate concerns about confounding and selection bias by introducing the upgrading domains: large effects, dose-effect relations, and when plausible residual confounders or other biases increase certainty. They will need to be considered in an assessment of a body of evidence when using ROBINS-I.
The use of ROBINS-I in GRADE assessments may allow for a better comparison of evidence from randomized controlled trials (RCTs) and nonrandomized studies (NRSs) because they are placed on a common metric for risk of bias. Challenges remain, including appropriate presentation of evidence from RCTs and NRSs for decision-making and how to optimally integrate RCTs and NRSs in an evidence assessment.
This article explores ways in which a dialogue between researchers and practitioners can be bidirectional, effective, and beneficial for the two professional communities. We suggest concrete ...directions for second language (L2) research: (a) a collaborative mindset, (b) the nature of research, (c) venues for dialogue, and (d) institutional support. First, we argue that we, researchers and teachers alike, can develop a collaborative mindset and understand that the dialogue is established by equal contributions and benefits. Second, we discuss that if a researcher's intention is to impact practice, they need to consider the practice relevance of their studies. We propose practice‐based research, in which practitioners and researchers work together for development and implementation of research. Third, we explore venues where reciprocal contributions may be explored, including teacher‐training programs, professional development workshops, and university–school collaborations. Finally, we share our hopes that institutions (universities and schools) will provide support for researchers and practitioners that would help create and facilitate reciprocal relationships, such as time release and promotive incentives. Overall, we argue that researchers shoulder the lion's share of responsibility in paving a path for a productive research–practice dialogue in the future.
In The Alchemy of Disease, John Whysner offers an accessible and compelling history of toxicology and its key findings. He details the experiments and discoveries that revealed the causal connections ...between chemical exposures and diseases.
The long-standing divide between research and practice in clinical psychology has received increased attention in view of the development of evidence-based interventions and practice and public ...interest, oversight, and management of psychological services. The gap has been reflected in concerns from those in practice about the applicability of findings from psychotherapy research as a guide to clinical work and concerns from those in research about how clinical work is conducted. Research and practice are united in their commitment to providing the best of psychological knowledge and methods to improve the quality of patient care. This article highlights issues in the research-practice debate as a backdrop for rapprochement. Suggestions are made for changes and shifts in emphases in psychotherapy research and clinical practice. The changes are designed to ensure that both research and practice contribute to our knowledge base and provide information that can be used more readily to improve patient care and, in the process, reduce the perceived and real hiatus between research and practice.
In Neuropsychological Aspects of Substance Use Disorders, internationally recognized experts provide clinicians with a translational overview of basic research and treatment findings regarding ...addictions, neuropsychological and neurological sequalae of the most common substances of abuse, and consideration of special issues that might confound interpretation of neuropsychological test results.
This is a book about using the best evidence to inform treatment decisions for people with skin disease. It is written by dermatologists for dermatologists, using dermatological examples throughout ...to illustrate key points. The book starts off with a "toolbox" section, written in a way which will help those relatively new to the principles of evidence-based dermatology to understand the key issues, and equip them with the basics of how to tell a good study from a bad one. The majority of the book then deals with an evidence-based summary of the common and important skin diseases in a structured and easy to read format around common patient scenarios.; Whilst most of the evidence is based on randomised controlled trials, other studies are cited where appropriate eg when discussing adverse events. The book has been challenging to write because of the extra work involved in conducting searches and literature appraisals, but it is a refreshing departure from the usual collection of chapters from experts. The book is by no means complete in coverage, and the unique accompanying book website will contain updates of new chapters and studies as they come in preparation for the next edition. This is a book to be used. We hope that you and your patients will benefit.
Summary In response to limitations in the understanding and use of published evidence, evidence-based medicine (EBM) began as a movement in the early 1990s. EBM's initial focus was on educating ...clinicians in the understanding and use of published literature to optimise clinical care, including the science of systematic reviews. EBM progressed to recognise limitations of evidence alone, and has increasingly stressed the need to combine critical appraisal of the evidence with patient's values and preferences through shared decision making. In another progress, EBM incorporated and further developed the science of producing trustworthy clinical practice guidelines pioneered by investigators in the 1980s. EBM's enduring contributions to clinical medicine include placing the practice of medicine on a solid scientific basis, the development of more sophisticated hierarchies of evidence, the recognition of the crucial role of patient values and preferences in clinical decision making, and the development of the methodology for generating trustworthy recommendations.
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