Does unit culture matter? The association between unit culture and the use of evidence-based practice among hospital nurses

Jun, Jin; Kovner, Christine; Dickson, Victoria Vaughan; Stimpfel, Amy Witkoski; Rosenfeld, Peri

doi:10.1016/j.apnr.2020.151251

Cited by 12 publications

(24 citation statements)

References 41 publications

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“…Staff culture emerged as a significant positive predictor of nurse manager implementation of all five EBMPs. Our finding is consistent with existing literature on clinically focused EBPs implemented by managers in health care (Birken et al, 2018; Jun, Kovner, Dickson, Stimpfel, & Rosenfeld, 2020). Based on a systematic review of 105 studies, Birken et al (2018) identified that one of the central influences that managers had in facilitating EBP was building an open, confirming, evidence‐based culture for both administrative and clinical EBP.…”

Section: Discussionsupporting

confidence: 92%

“…Based on a systematic review of 105 studies, Birken et al (2018) identified that one of the central influences that managers had in facilitating EBP was building an open, confirming, evidence‐based culture for both administrative and clinical EBP. Further, a study of hospital nurses and their use of EBP showed that a certain type of nursing unit culture was associated with the practice and knowledge of EBP (Jun et al, 2020). Also, culture emerged as a predictor of EBP competency in the Melnyk et al (2018) study.…”

Section: Discussionmentioning

confidence: 99%

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An Examination of the Factors Associated With Implementation of Evidence‐Based Management Practices for Improving Nurse Work Environments

Djukic

Jun

Fletcher

2021

Worldviews Ev Based Nurs

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Background Evidence‐based management practices (EBMPs) that improve nurses’ work environments have been linked to improvements in patient outcomes such as patient satisfaction and mortality. Yet, the extent to which nurse managers implement these EBMP or the factors associated with their implementation is not known. Aims Guided by the Promoting Action on Research Implementation in Health Services (PARIHS) Framework, we examined individual, evidence, and organizational characteristics associated with nurse managers’ implementation of the five EBMPs. Methods A cross‐sectional, correlational, survey design was used. Nurse managers from 10 public hospitals in New York City were recruited. Evidence and contextual variables were measured with the Organizational Readiness for Change Assessment instrument. EBMPs were measured with a modified version of the Practice Environment Scale of the Nursing Work Index. All multi‐item scales were validated with confirmatory factors analysis in the studied sample. Additionally, the scales had Cronbach’s alpha reliability greater than .8. A multivariate linear regression analysis with robust standard error correction was used to analyze the data and to adjust for clustering of managers in hospitals. Results A total of 331 nurse managers responded for a 47.4% response rate. Bachelor’s degree, number of staff supervised, managers’ personal experience with evidence for EBMPs, staff culture, and organizational resources were significant predictors of nurse managers’ implementation of EBMPs for NWE improvement (p < .05). Linking Evidence to Action Staff culture was positively associated with implementation of all five EBMPs for improving nurses’ work environments. Managers should prioritize nursing unit culture that encourages staff to innovate and change in order to improve care.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

An Examination of the Factors Associated With Implementation of Evidence‐Based Management Practices for Improving Nurse Work Environments

Djukic

Jun

Fletcher

2021

Worldviews Ev Based Nurs

Self Cite

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“…While it is similar to other academic medical centers in size and characteristics, organizational-specific policies and culture may be different. 22 Also, our convenience sample of frontline clinical staff may hold varying perspectives than their clinical colleagues. However, we made efforts to recruit a representative interdisciplinary sample and employed theoretically-driven data analysis to allow for emergent themes.…”

Section: Discussionmentioning

confidence: 99%

The powder keg: Lessons learned about clinical staff preparedness during the early phase of the COVID-19 pandemic

Aliyu

Norful

Schroeder

et al. 2021

American Journal of Infection Control

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Highlights Three themes emerged from the data: Risk assessment and planning, innovative evolution of roles and responsibilities, and pandemic response and capacity. In a rapidly changing landscape of practice protocols and discipline-specific responsibilities, it is key to secure capacity-building resources early on. Hierarchies seemed to compress during the pandemic, with a leveling of the traditional roles played by different professions. Clear, concise and consistent information must be accessible to all staff.

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“…34 The patient safety culture within our study seems to fit into the Hierarchy model of the four types of culture in Cameron and Quinn's competing values framework, 35 in which power, uniformity, policy, and formal rules drive individuals. 36 The monitoring requirement for sedation within the hospital mandated the use of capnography. Nurses perceived capnography as a supportive monitor for clinical assessment despite their positive opinions about it--their use of capnography was policy-rather than value-driven.…”

Section: Discussionmentioning

confidence: 99%

A focused ethnography of how endoscopy practitioners utilize capnography in sedated patients

Aldossary¹,

Milton

2020

Qual Res Med Healthc

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The literature shows that respiratory complications are common with sedation. Given the inherent risk, capnography monitoring is recommended whenever sedation is administered. We aimed to explore sedation practitioners’ behavior patterns and perceptions regarding capnography monitoring during endoscopy sedation and examine how capnography influenced clinical decision making when assessing respiration. We conducted a focused ethnography with triangulated observations and semi-structured interviews, and we purposively sampled and recruited five sedation practitioners as participants at a hospital in Saudi Arabia. Through data analysis, we identified representative themes and found cultural differences between anesthesia practitioners and nurses when using capnography during sedation. Anesthesia practitioners linked safety and the use of capnography to maintain adequate respiration, while nurses believed capnography was a secondary supportive monitor to patient observation and assessment. Findings also captured the unique cultures and values of each professional group to be associated with the varying perceptions. We also identified several factors facilitating and barring adequate utilization of capnography. In conclusion, professional culture, hospital policy, knowledge and previous experience with capnography guided the monitoring practice of endoscopy practitioners when assessing respiration during sedation.

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Does unit culture matter? The association between unit culture and the use of evidence-based practice among hospital nurses

Cited by 12 publications

References 41 publications

An Examination of the Factors Associated With Implementation of Evidence‐Based Management Practices for Improving Nurse Work Environments

An Examination of the Factors Associated With Implementation of Evidence‐Based Management Practices for Improving Nurse Work Environments

The powder keg: Lessons learned about clinical staff preparedness during the early phase of the COVID-19 pandemic

A focused ethnography of how endoscopy practitioners utilize capnography in sedated patients

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