Aim
To explore the differences in beliefs on and implementation of evidence‐based practice in nurses working in different types of health care institutions.
Background
Optimal organizational context ...and knowledge are essential to support evidence‐based practice and sustain the use of evidence in professional nursing practice.
Method
A cross‐sectional study was conducted. A total of 1,014 nurses from 20 Slovenian hospitals and 29 primary health care centres participated. Variables included the following: Evidence‐Based Practice Beliefs and Implementation Scale, educational and training activities, job satisfaction, job training, perceived research and evidence‐based practice knowledge, and access to databases.
Results
Beliefs on evidence‐based practice were explained by evidence‐based practice (β = 0.249) and research (β = 0.162) knowledge, length of employment (β = 0.124), job satisfaction (β = 0.117), training in evidence‐based practice (β = −0.092) and holding a master's degree (β = 0.077). Implementation of evidence‐based practice depended on beliefs (β = 0.306) and the type of health care institution (β = 0.132). The highest implementation result was seen in primary health care centres (<0.001).
Conclusion
Training in evidence‐based practice and perceived knowledge of evidence‐based practice significantly influence the beliefs on and implementation of evidence‐based practice. Nurses employed at primary health care centres who had completed a task‐shifting training programme achieved significantly better results for implementation of evidence‐based practice.
Implications for Nursing Management
The indirect effects of development training programmes for the implementation of EBP have not yet been studied. Development activities and change implementation processes in nursing foster education and training opportunities, which have significantly influenced the implementation of EBP.
The vast majority of European countries are struggling to embrace nursing as a profession and as a science. There are still not enough nurses with bachelor’s degrees and advanced practical skills, ...and clinical specialisations for nurses are being developed at the master’s level. Attention should be paid to recognising nurses as an equal healthcare workforce who need to be empowered to advance their profession and be provided with professional development opportunities. Changes needed include improving pay and working conditions, providing opportunities to improve skills and professional recognition, empowering nurses to deliver care, and harnessing the power of technology to better support nurses. The declining interest in nursing education and the often stereotypical and condescending view of the role and work of nurses on the healthcare team should be a warning signal to all who are working on healthcare reform.
Aim
To establish the connection between values, competencies, selected job characteristics and evidence‐based practice use.
Background
Nurses rarely apply evidence‐based practice in everyday work. A ...recent body of research has looked at various variables explaining the use of evidence‐based practice, but not values and competencies.
Design
A cross‐sectional, non‐experimental quantitative explorative research design.
Methods
Standardized instruments were used (Nurse Professional Values Scale‐R, Nurse Competence Scale, Evidence‐Based Practice Beliefs and Implementation Scale). The sample included 780 nurses from 20 Slovenian hospitals. The data were collected in 2015.
Results
The study identifies two new variables contributing to a better understanding of beliefs on and implementation of evidence‐based practice, thus broadening the existing research evidence. These are the values of activism and professionalism and competencies aimed at the development and professionalization of nursing. Values of caring, trust and justice and competencies expected in everyday practice do not influence the beliefs and implementation of evidence‐based practice. Respondents ascribed less importance to values connected with activism and professionalism and competencies connected with the development of professionalism. Nurses agree that evidence‐based practice is useful in their clinical work, but they lack the knowledge to implement it in practice. Evidence‐based practice implementation in nursing practice is low.
Conclusions
Study results stress the importance of increasing the knowledge and skills on professional values of activism and professionalism and competencies connected to nursing development. The study expands the current understanding of evidence‐based practice use and provides invaluable insight for nursing managers, higher education managers and the national nursing association.
Abstract
Background
The benefits of cardiopulmonary resuscitation training for schoolchildren are well known, but the appropriate age for introducing training is still being discussed. This is a very ...important issue, since out-of-hospital cardiac arrest is a major public health concern. The objective of this study was to investigate the effects of implemented cardiopulmonary resuscitation training on the knowledge of schoolchildren in the last three grades of Slovenian elementary schools and theirs willingness, attitudes, and intentions toward helping others and performing cardiopulmonary resuscitation. The experience of training instructors was also explored.
Methods
A mixed methods research design was employed, using a Separate Pre-Post Samples Design and focus groups. Research was conducted in 15 Slovenian public elementary schools offering cardiopulmonary resuscitation training. Focus groups included training instructors and developers. Data was collected with a structured questionnaire from April to June 2018 and analyzed using univariate and bivariate analyses. The three focus groups were convened in September and October 2018. Content analysis of the discussion transcriptions was conducted. The sample included 764 schoolchildren aged 12.5–14.5 years before cardiopulmonary resuscitation training and 566 schoolchildren after training. Three non-homogeneous focus groups included eight cardiopulmonary resuscitation instructors.
Results
Significant progress in cardiopulmonary resuscitation knowledge was noted after training implementation, with the greatest progress seen in the youngest age group (mean age 12.5). The greatest increase after training was seen for the variables Attitude toward helping others (
p
= 0.001) and Self-confidence (
p
= 0.001). Analysis of the focus groups yielded two themes: (a) the effects of cardiopulmonary resuscitation training on schoolchildren, and (b) the systemic responsibility of the school system and professional bodies.
Conclusions
Significant progress in schoolchildren’s cardiopulmonary resuscitation knowledge after training was established. Early introduction of training is recommended. Cardiopulmonary resuscitation knowledge raises awareness of the responsibility to help others and increases self-confidence to provide bystander cardiopulmonary resuscitation. It can be concluded that early cardiopulmonary resuscitation training for children is crucial. It should be a mandatory part of school curricula in those countries where cardiopulmonary resuscitation is not yet mandatory.
To determine the level of job satisfaction of nursing professionals in Slovenian hospitals and factors influencing job satisfaction in nursing.
The study included 4 hospitals selected from the ...hospital list comprising 26 hospitals in Slovenia. The employees of these hospitals represent 29.8% and 509 employees included in the study represent 6% of all employees in nursing in Slovenian hospitals. One structured survey questionnaire was administered to the leaders and the other to employees, both consisting 154 items evaluated on a 5 point Likert-type scale. We examined the correlation between independent variables (age, number of years of employment, behavior of leaders, personal characteristics of leaders, and managerial competencies of leaders) and the dependent variable (job satisfaction - satisfaction with the work, coworkers, management, pay, etc) by applying correlation analysis and multivariate regression analysis. In addition, factor analysis was used to establish characteristic components of the variables measured.
We found a medium level of job satisfaction in both leaders (3.49±0.5) and employees (3.19±0.6), however, there was a significant difference between their estimates (t=3.237; P=lt;0.001). Job satisfaction was explained by age (Plt;0.05; β=0.091), years of employment (Plt;0.05; β=0.193), personal characteristics of leaders (Plt;0.001; β=0.158), and managerial competencies of leaders (Plt;0.000; β=0.634) in 46% of cases. The factor analysis yielded four factors explaining 64% of the total job satisfaction variance.
Satisfied employees play a crucial role in an organization's success, so health care organizations must be aware of the importance of employees' job satisfaction. It is recommended to monitor employees' job satisfaction levels on an annual basis.
Aim
The aim of the study was to explore the characteristics of nursing work and the correlation with the conditions in nurses’ work environment.
Background
Although the correlation between nurses’ ...work characteristics and the safety of health care provision has been confirmed, nurses continue to work in discouraging environments.
Method
A cross‐sectional study was conducted. A total of 1,744 nurses from 16 Slovenian hospitals participated. Variables included the following: work characteristics, ergonomic conditions at work, the prevalence of low back pain and self‐assessment of conditions in the work environment.
Results
One nurse was responsible for 17.90 patients per shift (SD = 13.615), shifts were understaffed in 42.9% of cases, and technical assistive devices were available in 30% of cases. Job demands were explained with number of patients/shift (p < .001), job satisfaction (p < .001), availability of assistive devices (p = .001) and the female gender (p = .001). Decision authority was low and explained with a non‐leadership position (p < .001), educational achievement (p < .001), dissatisfaction with the job (p < .001) and the male gender (p = .008).
Conclusion
A safe patient‐to‐nurse ratio, job satisfaction, availability of assistive devices and fostering decision authority turned out to be important in our study.
Implications for Nursing Management
Europe is facing an increasing shortage of nurses, so actions for reducing nurse overload and encouraging decision authority are extremely important both for nurses and for patients. Participative leadership and ensuring gender equality in nursing are vital.
Background
Consensus on evidence‐based practice (EBP) competencies and associated learning outcomes for registered nurses has not yet been achieved in the European context.
Aims
To establish a set of ...core EBP competencies for nurses and the most important EBP learning outcomes encompassing attitudes, knowledge, and skills dimensions for implementation into nursing education in European countries.
Methods
A multi‐phase modified Delphi survey was conducted: Phase 1, a literature review; Phase 2, a two‐round consensus of experts; and Phase 3, a Delphi survey. Experts from six European countries participated.
Results
In Phase 1, 88 records were selected and 835 statements extracted, which were grouped according to the seven steps of EBP. After removing 157 duplicates, the remaining competencies (n = 678) were evaluated in Phase 2. Then, a two‐round expert consensus was reached, with 24 competencies and 120 learning outcomes identified and divided into affective, cognitive, and skills domains. In Phase 3, based on a Delphi survey expert consensus, all evaluated statements were included in a final set of competencies and learning outcomes. Only two learning outcomes were recommended for allocation to a different domain, and four were reformulated as suggested, with no further changes to the others.
Linking Evidence to Action
The set of EBP competencies and learning outcomes can guide nurse educators, managers, and EBP stakeholders in the development of content that incorporates EBP knowledge, skills, and attitudes into educational programs. Prioritizing the EBP competencies and learning outcomes that are most necessary and adapting them to every context will provide healthcare organizations with guidelines for enhancing the continuing education of nurses. These results could facilitate the development of effective tools for assessing nursing students’ and nurses’ perception of competencies required for EBP processes.
To determine teachers' understanding of and attitudes towards nursing education reform at four medical colleges in Kyrgyzstan.
The quality of nursing education at undergraduate and postgraduate ...levels has a major impact on patient outcomes and the development of nursing as a profession and a science.
Lower middle-income countries have sought to advance their nursing education by adopting the experiences of high-income countries.
A mixed-method cross-sectional study design was used. The STROBE combined checklist was followed. A cohort of all faculty members at four colleges were included (N = 150). The questionnaire consisted of 10 groups of questions and statements. Both quantitative and qualitative data were collected.
A total of 56.4% of respondents were familiar with the European approach to nurse education; 73.3% of respondents with a nursing education reported being familiar with the European approach, compared to 40.7% of respondents with a medical education. Qualitative written comments yielded 57 superscripts of codes, 14 subcategories, 5 categories and 2 themes as drivers and barriers of reform.
The survey revealed weak support for the nursing education reform. Respondents do not envisage nurse education being offered at all three levels of higher education (bachelor's, master's, and PhD), and even fewer recognise nurses as leaders of healthcare institutions.
Teachers in nursing programmes should mostly be nurses with academic careers.
Nursing is still not recognised as an extremely important health profession that needs to be developed. This misunderstanding and negative attitude towards the role of nurses in the health care system are evident in both the quantitative and qualitative parts of the study.
Purpose
To determine the impact of advanced hybrid closed - loop (AHCL) insulin delivery on quality of life, metabolic control and time in range (TIR) in youth with type 1 diabetes mellitus (T1DM).
...Methods
Twenty-four children and adolescents with T1DM (14 female) aged of 10 to 18 years participated in the study. Mixed methods study design was implemented. Quantitative part of the study was conducted as a longitudinal crossover study with data collection before and at the end of AHCL use. Qualitative data were obtained with modeled interviews of four focus groups before and the end of the period. Clinical data were collected from the electronic medical records.
Results
The use of AHCL significantly improved the quality of life in terms of decreased fear of hypoglycemia (p<0.001), decrease in diabetes-related emotional distress (p<0.001), and increased wellbeing (p=0.003). The mean A1C decreased from 8.55 ± 1.34% (69.9 ± 12.3 mmol/mol) to 7.73 ± 0.42 (61.1 ± 2.2 mmol/mol) (p=0.002) at the end of the study. Mean TIR was 68.22% (± 13.89) before and 78.26 (± 6.29) % (p<0.001) at the end of the study.
Conclusion
The use of advanced hybrid closed loop significantly improved the quality of life and metabolic control in children and adolescents with T1DM.
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