Barriers to implementing evidence-based nursing practice from the hospitals' point of view in China: A regional cross-sectional study

Lai, Jie; Brettle, Alison; Zhang, Yingjie; Zhou, Chunlan; Li, Chaixiu; Fu, Jiaqi; Wu, Yanni

doi:10.1016/j.nedt.2022.105436

Cited by 15 publications

(10 citation statements)

References 51 publications

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“…In the domain of ‘emotion’, nurses reported that the large workloads and doubts in nurses' professional values among patients made them irritable and upset. Consistent with the findings of a previous study (Lai et al, 2022), barriers related to the environment, resources, knowledge and skills were identified as important factors in both qualitative and quantitative sections. According to the interviews, the big influence of domain ‘belief about consequence’ was also due to the lack of environment and resources support and increased workload, making nurses feel pessimistic about the sustainability of DSA.…”

Section: Discussionsupporting

confidence: 88%

Nursing adherence, barriers and facilitators to conduct post‐stroke dysphagia screening and assessment: A study based on theoretical domain framework

Guo

Dong

et al. 2023

Journal of Clinical Nursing

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Background: There are an increasing number of evidence-based recommendations for managing dysphagia in post-stroke patients. However, it is unclear whether nurses adopt these recommendations in their daily nursing practices.Aims: This study aimed to explore nurses' adherence, barriers, facilitators and views on dysphagia screening and assessment of post-stroke dysphagia.Methods: In this study, multiple methods were adopted. In Phase 1, a general information questionnaire and a knowledge-attitude-practice and barriers/facilitators questionnaire for dysphagia screening and assessment were distributed in 55 hospitals online. In Phase 2, semi-structured interviews were conducted to explore nurses' views on barriers. Descriptive and one-way variance analyses were used to analyse the quantitative data, while content analysis was used to analyse the qualitative data.This study adheres to STROBE and COREQ guidelines.Results: Nine hundred and forty-two completed questionnaires were collected. Only 36.52% of the nurses screened for swallow function in patients as a guideline. The biggest barrier was 'memory, attention and decision process', with an average score of 3.22 (.74). The different stages of implementation had various types and degrees of barriers (p < .001). Five themes were extracted after interviews, namely 'Inadequate environment and resource support', 'Increased workload', 'Professional value perception', 'Organisational culture', and 'Poor knowledge and skill'. Conclusions:Nurses' practice of dysphagia screening and assessment of patients with dysphagia after stroke were inadequate, and the barriers originated from patients, leadership and the nurses themselves.Relevance to clinical practice: This research extracted five barriers of guidance adherence for post-stroke dysphagia screening and assessment and identified the different kinds and degrees of barriers in five implementation stages, providing a basis for nursing managers to break through the bottleneck of guideline implementation.

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Section: Discussionsupporting

confidence: 88%

Nursing adherence, barriers and facilitators to conduct post‐stroke dysphagia screening and assessment: A study based on theoretical domain framework

Guo

Dong

et al. 2023

Journal of Clinical Nursing

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“…This is the basis of clinical judgement and innovation in nursing and distinguishes professional nursing practice from other academic disciplines (Kennedy et al, 2015 ). However, some studies have shown that implementing evidence‐based nursing care can be a complicated and slow process (Horntvedt et al, 2018 ; Lai et al, 2022 ). One of the existing challenges in this field is the excessive focus of students on knowledge acquisition, which makes them often neglect the critical evaluation of evidence to answer clinical questions.…”

Section: Discussionmentioning

confidence: 99%

Competencies expected of undergraduate nursing students: A scoping review

Purabdollah,

Zamanzadeh,

Ghahramanian

et al. 2023

Nursing Open

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AimNursing competencies are crucial indicators for providing quality and safe care. The lack of international agreement in this field has caused problems in the generalization and application of findings. The purpose of this review is to identify the core competencies necessary for undergraduate nursing students to enter nursing work.Data SourcesWe conducted a structured search using Scopus, MEDLINE (PubMed), Science Direct, CINAHL, Web of Science, and Google Scholar.Review MethodsWe conducted a scoping review using the methodology recommended by the Joanna Briggs Institute, supported by the PAGER framework, and guided by the PRISMA‐ScR Checklist. Inclusion criteria included full‐text articles in English, quantitative and qualitative research related to competencies for undergraduate students or newly graduated nurses, competency assessment, and tool development from 1970 to 2022. We excluded articles related to specific nursing roles, specific contexts, Master's and Ph.D. curricula, hospital work environment competencies, and editorial.ResultsOut of 15,875 articles, we selected 43 studies, and data analysis with summative content analysis identified five themes named individualized care, professional nursing process, nursing administration, readiness, and professional development.ConclusionConsidering the dynamics of competencies and their change with time, experience, and setting, it is necessary to update, localize, and levelling of the proposed competencies based on the culture of each country.ImpactThese competencies provide a guide for undergraduate nursing curriculum development and offer a framework for both clinical instruction and the evaluation of nursing students.

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“…As China is located in East Asia, one of the largest developing countries in the world, its clinical leadership hierarchy is different from that of many developed Western countries. The dominant culture of nursing leadership in Chinese clinics is centralised with the role of the Head Nurse, and most clinical nurses in China have less theoretical knowledge and experience in EBP [ 19 ]. A scoping review published in China showed that as of 17 January 2020, there were 152 articles published in Chinese on evidence implementation projects in nursing.…”

Section: Introductionmentioning

confidence: 99%

Translation and cross-cultural adaptation of the National Health Service Sustainability Model to the Chinese healthcare context

Lai

Maher

et al. 2023

BMC Nurs

Self Cite

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Background International attention is being paid to the issue of making evidence sustainable after implementation. Developing an identification model is essential to promote and monitor the sustainability of evidence implementation. However, this model is not available in Chinese. This study aims to translate the National Health Service Sustainability Model into Chinese and to verify whether the model is adapted to the Chinese healthcare environment. Methods This study follows the translation and validation guidelines developed by Sousa and Rojjanasrirat. The translations include forward and backward translations and their comparison. Expert reviews were used to validate the content validity of the Chinese version of the National Health Service sustainability model. Cognitive interviews were used to assess the validity of the language in the Chinese setting. Results The translation was conducted by a bilingual research team and took 12 months. Expert reviews were undertaken with eight experts, and cognitive interviews with six participants. The content validity of the model is excellent, but at least 20% of the experts still felt that items one, three, five and nine needed refinements. In the cognitive interviews, most items, instructions and response options were well understood by the participants responsible for the evidence-based practice project. However, some language issues were still identified in items one, three, four, five, seven, nine, and ten. Participants reported that the sustainability results of the model assessment were consistent with their previous judgments of the items. Based on the expert review and interview results, items one, three, four, five, seven, nine and ten require further refinement. In summary, seven of the ten items have been amended. Conclusions This study provides insight into how the National Health Service sustainability model can be used in the Chinese healthcare setting and paves the way for future large-scale psychometric testing.

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Barriers to implementing evidence-based nursing practice from the hospitals' point of view in China: A regional cross-sectional study

Cited by 15 publications

References 51 publications

Nursing adherence, barriers and facilitators to conduct post‐stroke dysphagia screening and assessment: A study based on theoretical domain framework

Nursing adherence, barriers and facilitators to conduct post‐stroke dysphagia screening and assessment: A study based on theoretical domain framework

Competencies expected of undergraduate nursing students: A scoping review

Translation and cross-cultural adaptation of the National Health Service Sustainability Model to the Chinese healthcare context

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