Nursing best practice statements: an exploration of their implementation in clinical practice

Ring, Nicola; Malcolm, Cari; Coull, Alison; Murphy-Black, Tricia; Watterson, Andrew

doi:10.1111/j.1365-2702.2005.01225.x

Cited by 48 publications

(46 citation statements)

References 26 publications

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“…Operationalization deficiencies (influences change); meso level (unit) and organizational level (Hagedorn and Heideman, 2010) Intermediate reporting quality Leadership as an organizational capability to implement change (aspect of organizational culture; facilitation practices; leadership implementation roles) Leadership culture, leadership (staffing policies, communication, clear definition of roles/responsibilities); leadership facilitation (practices); leadership implementation roles (engagement, commitment, support); data analysed at unit level (Ring et al, 2005) Few deficiencies Leadership support, not specified Interview guide probes into barriers of implementation; from data analysis: personal authority to make changes within organization and ability to motivate others; opinion vs clinical leadership: change both professional attitudes and the clinical context for implementation (Sandstrom et al, 2011) High risk of bias Task-and relations-oriented leadership; behaviours "...the role of the person in charge, that is, the leader, and how he or she can promote the process of implementing EBP in nursing" (Schultz and Kitson, 2010) Intermediate reporting quality Not elaborated in the article Providing general support, leader seeking feedback, acknowledges, "leader handles stressful situation calmly"; data analysed at organizational level (Sharp et al, 2004) Some deficiencies (intermediate study quality)…”

Section: Authormentioning

confidence: 99%

Leadership in evidence-based practice: a systematic review

Reichenpfader

Carlfjord

Nilsen

2015

Leadership in Health Services

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1 Structured Abstract:Purpose: We aimed to systematically review published empirical research on leadership as a determinant for the implementation of evidence-based practice (EBP) and to investigate leadership conceptualization and operationalization in this field. Design/methodology/approach: A systematic review with narrative synthesis was conducted. Relevant bibliographic databases and reference lists of pertinent review articles were searched. To be included, a study had to involve empirical research and refer to both leadership and EBP in health care. Study quality was assessed with a structured instrument based on study design. Findings: A total of 17 studies were included. Leadership was mostly viewed as a modifier for implementation success, acting through leadership support. Yet, there was definitional imprecision as well as conceptual inconsistency and studies seemed to inadequately address situational and contextual factors. Although referring to an organizational factor, the concept was mostly analysed at the individual or group level. Research limitations/implications:The concept of leadership in implementation science seems to be not fully developed. It is unclear whether attempts to tap the concept of leadership in available instruments truly capture and measure the full range of the diverse leadership elements at various levels. Research in implementation science would benefit from a better integration of research findings from other disciplinary fields. Once a more mature concept has been established, researchers in implementation science could proceed to further elaborate operationalization and measurement. Originality/value Although the relevance of leadership in implementation science has been acknowledged, the conceptual base of leadership in this field has received only limited attention. KeywordsLeadership, Conceptualization, Measurement, Evidence-based practice, Systematic review 2 BackgroundDespite widespread acceptance of the importance of implementing evidence-based practice (EBP) and the use of findings from scientific research in clinical practice, many patients still do not receive treatments with proven effectiveness or may receive care that is of little benefit or harmful (Dopson et al., 2002, Greenhalgh et al., 2004, Oxman et al., 1995. Implementation science has emerged as a vital interdisciplinary research field to address the challenges associated with the gap identified between the production and use of evidence in various settings. Explanations for this gap have largely focused on the characteristics of the individual provider, such as limited access to research, poor confidence in identifying and critically appraising evidence and perceived time restrictions to integrate research into clinical practice (Rycroft-Malone, 2008, Estabrooks et al., 2003, Squires et al., 2011.However, within the field of implementation science, there has been increasing recognition of the role of the organizational context in the implementation of EBP (Durlak and DuPre, 2008, Greenhalgh et al.,...

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Section: Authormentioning

confidence: 99%

Leadership in evidence-based practice: a systematic review

Reichenpfader

Carlfjord

Nilsen

2015

Leadership in Health Services

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“…4,5 Many practicing nurses did not grow up using technology and have only learned how to use it later in their career (digital immigrants). Newer nurses, on the other hand, may have grown up with technology and may be more familiar with its use (digital natives).…”

Section: Digital Natives and Digital Immigrantsmentioning

confidence: 99%

Informatics Competence in the EHR Era

Byrne¹

2012

Journal of PeriAnesthesia Nursing

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“…agreement with the content of the guidelines, 9 motivation, 40 education and training, 16,40,41 patientassociated reasons, 9,40 access, 40 and lack of time and resources. 9,16,41 We were able to recognize that attitudes are a critical determinant of how guidelines are used by nurses. Further study will be valuable in determining how to best measure guideline users' attitudes and how to incorporate the findings into strategies for implementing guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…A VAP prevention enhancer represents environmental or hospital-wide influence on VAP prevention as guided by the literature. 16,40,41 The score for VAP prevention enhancer was a mean of the responses for 7 items. Each item had a 4-point response scale: factors (7 items).…”

Section: Check Onementioning

confidence: 99%

Adherence to Institution-Specific Ventilator-Associated Pneumonia Prevention Guidelines

Kiyoshi‐Teo¹,

Cabana²,

Froelicher³

et al. 2014

American Journal of Critical Care

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A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Describe the relationship between the increased availability of guidelines for prevention of ventilator-associated pneumonia (VAP) and current adherence to those recommendations. 2. Identify potential barriers to and facilitators of adherence to guidelines for prevention of VAP. 3. Discuss ideas for incorporating study results into strategies for implementation of guidelines for prevention of VAP. Background Various institution-specific guidelines have been developed to prevent ventilator-associated pneumonia. However, the availability of guidelines does not ensure adherence to recommended strategies. Objective To identify factors that influence adherence to guidelines for prevention of ventilator-associated pneumonia, with a focus on oral hygiene, head-of-bed elevation, and spontaneous breathing trials. Methods A cross-sectional descriptive study of critical care nurses at 8 hospitals in Northern California was conducted. A survey was created to gather information on possible facilitators of and barriers to adherence to institution-specific guidelines for preventing ventilator-associated pneumonia. User factors, guideline qualities, and contextual factors were explored and tested for possible relationships. Results A total of 576 critical care nurses participated in the survey. Each hospital had unique guidelines for preventing ventilator-associated pneumonia. In general, nurses had positive attitudes and reported adhering to the guidelines always or most of the time. Factors associated with adherence differed according to the intervention implemented. The score on the user attitude scale was the strongest and most consistent predictor of adherence across interventions (odds ratio, 3.49-4.75). Time availability (odds ratio, 1.54) and the level of prioritization (odds ratio, 1.86) were also significant predictors. ConclusionThe most consistent facilitator of adherence to guidelines for prevention of ventilator-associated pneumonia was nurses' positive attitude toward the guidelines.

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Nursing best practice statements: an exploration of their implementation in clinical practice

Cited by 48 publications

References 26 publications

Leadership in evidence-based practice: a systematic review

Leadership in evidence-based practice: a systematic review

Informatics Competence in the EHR Era

Adherence to Institution-Specific Ventilator-Associated Pneumonia Prevention Guidelines

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