Dissertations / Theses: 'Evidence-based nursing'

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Chang, hui chen. "Evidence-based practice in nursing homes." University of Sydney, 2008. http://hdl.handle.net/2123/3572.

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Doctor of Philosophy
Aim and significance: The aim of this research was to investigate how evidence-based practice (EBP) in nursing homes is understood in the context of Taiwan, a non-Western country. There is a growing movement towards using research evidence to inform practice in the nursing profession with variable success. To date, factors that promote or inhibit implementation of EBP in health care have been investigated through research conducted in hospital settings in Western countries. Remarkably little is known about nurses’ experience and perceptions of EBP in residential aged care facilities (RACFs), especially in non-Western countries. Method: The study adopted a mixed method approach. Subjects were recruited from six nursing homes in the Hsinchu district of Taiwan. In Stage 1, 89 registered nurses completed a comprehensive questionnaire specifically developed for this project. It was designed to elicit information about (1) their experience of and attitudes towards research and EBP; (2) the barriers they perceive to its implementation; and (3) what strategies they believe would enhance its implementation in the nursing home setting. In Stage 2, six nursing managers participated in semi-structured in-depth interviews that explored the same topic areas as those in the questionnaire but used an open-ended format which allowed for new themes to emerge. Findings: The majority of nurses and nursing managers expressed positive attitudes towards research and EBP but reported relatively little experience in its implementation. Nurses relied most heavily on knowledge derived from past experience and on interactions with nursing colleagues, medical staff and patients to inform their clinical practice. They identified the main barriers to EBP as: insufficient authority to change practice, their own lack of research knowledge and insufficient time to implement new ideas in the workplace. They believed EBP would be facilitated by: improved access to computers and internet facilities in the workplace; more effective research training; collaboration with academics; and dedicated time to search for and read research articles. As anticipated, nurses viewed the issues from a practical stance in relation to their own time, resources and lack of authority to effect change. Nursing managers expressed similar views to the nurses in relation to attitudes towards EBP implementation. However, they identified barriers which related to aspects of the organizational framework. In particular, they expressed concerns about issues such as budgetary constraints, staff quality (notably the reliance on minimally trained assistants in nursing (AINs) for direct resident care), as well as factors that reflected the wider political and economic context of health care in Taiwan. Conclusion: The findings of this study have implications for research, policy and practice in both Western and non-Western countries. Further research on EBP would be beneficial if conducted in settings other than hospitals, such as RACFs. There remains also the need to examine the potential for EBP in different social-cultural contexts, such as those in non-Western countries. Nursing managers have generally been excluded in previous research but, because of their particular role, there is a need to examine their perspectives of EBP and then compare these with those of the nurses. In Taiwan specifically, policy change is needed at both government and institutional levels to encourage and support the development of protocols and procedures for the implementation of EBP. If EBP was a government requirement for accreditation and a standard for protocols in hospitals and RACFs, it would lead to improved standards of care and cost effectiveness. This study supports the findings of a number of investigations conducted in Western countries which indicate that further education and training in research for nurses may lead to higher standards of patient care, greater job satisfaction and higher staff retention rates.

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Chang, Hui-Chen. "Evidence-based practice in nursing homes." Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/3572.

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Abstract:

Aim and significance: The aim of this research was to investigate how evidence-based practice (EBP) in nursing homes is understood in the context of Taiwan, a non-Western country. There is a growing movement towards using research evidence to inform practice in the nursing profession with variable success. To date, factors that promote or inhibit implementation of EBP in health care have been investigated through research conducted in hospital settings in Western countries. Remarkably little is known about nurses’ experience and perceptions of EBP in residential aged care facilities (RACFs), especially in non-Western countries. Method: The study adopted a mixed method approach. Subjects were recruited from six nursing homes in the Hsinchu district of Taiwan. In Stage 1, 89 registered nurses completed a comprehensive questionnaire specifically developed for this project. It was designed to elicit information about (1) their experience of and attitudes towards research and EBP; (2) the barriers they perceive to its implementation; and (3) what strategies they believe would enhance its implementation in the nursing home setting. In Stage 2, six nursing managers participated in semi-structured in-depth interviews that explored the same topic areas as those in the questionnaire but used an open-ended format which allowed for new themes to emerge. Findings: The majority of nurses and nursing managers expressed positive attitudes towards research and EBP but reported relatively little experience in its implementation. Nurses relied most heavily on knowledge derived from past experience and on interactions with nursing colleagues, medical staff and patients to inform their clinical practice. They identified the main barriers to EBP as: insufficient authority to change practice, their own lack of research knowledge and insufficient time to implement new ideas in the workplace. They believed EBP would be facilitated by: improved access to computers and internet facilities in the workplace; more effective research training; collaboration with academics; and dedicated time to search for and read research articles. As anticipated, nurses viewed the issues from a practical stance in relation to their own time, resources and lack of authority to effect change. Nursing managers expressed similar views to the nurses in relation to attitudes towards EBP implementation. However, they identified barriers which related to aspects of the organizational framework. In particular, they expressed concerns about issues such as budgetary constraints, staff quality (notably the reliance on minimally trained assistants in nursing (AINs) for direct resident care), as well as factors that reflected the wider political and economic context of health care in Taiwan. Conclusion: The findings of this study have implications for research, policy and practice in both Western and non-Western countries. Further research on EBP would be beneficial if conducted in settings other than hospitals, such as RACFs. There remains also the need to examine the potential for EBP in different social-cultural contexts, such as those in non-Western countries. Nursing managers have generally been excluded in previous research but, because of their particular role, there is a need to examine their perspectives of EBP and then compare these with those of the nurses. In Taiwan specifically, policy change is needed at both government and institutional levels to encourage and support the development of protocols and procedures for the implementation of EBP. If EBP was a government requirement for accreditation and a standard for protocols in hospitals and RACFs, it would lead to improved standards of care and cost effectiveness. This study supports the findings of a number of investigations conducted in Western countries which indicate that further education and training in research for nurses may lead to higher standards of patient care, greater job satisfaction and higher staff retention rates.

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Waters, Donna. "Evidence : the knowledge of most worth." University of Sydney, 2006. http://hdl.handle.net/2123/1903.

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Doctor of Philosophy
Similar to their colleagues throughout the world, nurses and midwives in New South Wales (NSW), Australia, welcome evidencebased practice (EBP) as a means to improve patient or client outcomes. This thesis explores the way nurses and midwives understand evidence for EBP and aims to determine whether members of these professions currently have the knowledge and skills necessary to implement evidence‐based care. Three separate studies were conducted to explore NSW nurses’ readiness for EBP. Attitudes, knowledge and skill were investigated using an EBP questionnaire returned by 383 nurses. The views of 23 nursing opinion leaders were elicited during qualitative in‐depth interviews, and their ideas on maximising the potential for future nurses to confidently engage in EBP were explored. Current approaches to teaching EBP in undergraduate nursing programs were investigated by examining documents issued by NSW nursing education providers. The results demonstrate many differences between the ways NSW nurses currently understand evidence for EBP, and a range of approaches to teaching EBP in undergraduate nursing programs. Under current conditions, nurses graduating from universities in NSW commence practice with varying levels of preparation for EBP and enter into a professional arena that is itself struggling to cope with the concepts and language of this approach to improving healthcare. v Evidence for the effectiveness of EBP is slowly accumulating and despite some small positive signs, the collective results of this thesis suggest that current educational approaches are not capable of producing the kind of results that are both necessary and desirable for the promotion of evidence‐based nursing practice in NSW. Articulating a commitment to EBP, using a common language and a consistent approach are among the recommendations made for the future promotion of EBP in nursing education.

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Ousley, Lisa, and Retha D. Gentry. "Evidence-Based Physical Examination." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etsu-works/7142.

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This chapter helps the reader to review the anatomy and describe the life-span variances of the skin, hair, and nails and to develop a systematic approach to performing a comprehensive history and physical examination of the integumentary system. It discusses the key history and physical exam findings of common skin disorders. Understanding the structure and the function of the skin complements evidence-based physical assessment of the integumentary system. A competent clinician must have fundamental knowledge of the functions, topography, and major components of the skin. Taking a comprehensive history is one of the most important tools in determining an accurate diagnosis. The patient’s current health status, past medical history, family history, and personal and psychosocial history as well as the patient’s home, occupational, and travel history may all affect the condition of his or her skin, hair, and nails. The clinician must also consider the patient’s age, gender, race, culture, and environment.

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Williams, Katherine Sarah. "Evidence based nursing practice and continence care." Thesis, Oxford Brookes University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.325499.

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Leufer, Therese. "Tackling evidence-based practice in nursing education." Thesis, University of Bristol, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.702872.

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This study addresses the challenge of preparing undergraduate student nurses to be able to engage profitably in Evidence -based Practice. It focuses on the tension between learning about Evidence-based Practice within the Academy and the competencies and skills required to utilise it in clinical settings. Evidence-based Practice is a dynamic process which has core components and defined steps. Nurse education programmes are required by regulatory bodies to prepare nurses to utilise the best evidence to underpin their practice. However, they provide no specific guidance on how this should be organised and delivered or how it can be measured within nurse education programmes. This study evaluated a teaching module in nurse education which was re-designed to embed Evidence-based Practice into its teaching, learning and assessment strategies. The new module aimed to foster capability for Evidence-based Practice at undergraduate level through specifically modified teaching, learning and assessment strategies; and to evaluate the impact of the intervention on the attitudes, beliefs, knowledge and utilisation of Evidence-based Practice. The study was a pre-test/post-test quasi-experimental design employing two questionnaires administered to the same cohort on two separate occasions. The pre-test was administered immediately before the module commenced; the post-test was administered after the module, following a year-long placement in clinical nursing practice. Participants were also asked two free text response qualitative questions regarding their views on aspects relating to Evidence-based Practice in practice. Results indicated static levels of knowledge, attitudes and beliefs about Evidence-based Practice between pre-test and post-test phases. Declined levels of utilisation were demonstrated on post-test measurement. The findings suggest that programme-wide curricular reform coupled with a focused, structured collaboration with clinical partners is required if Evidence-based Practice is to become embedded in nurse education and practice. A number of theoretical perspectives offer real promise of greater insight and understanding of how nurses learn, know and practice and the factors that can and do affect these characteristics. Such insight could facilitate more sensitive, appropriate and targeted integration of Evidence-based Practice knowledge into practice ensuring its success and sustainability

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Wilkinson, Joyce E. "Managing to implement evidence-based practice? : an exploration and explanation of the roles of nurse managers in evidence-based practice implementation." Thesis, St Andrews, 2008. http://hdl.handle.net/10023/560.

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Villanueva, Elizabeth. "Evidence-based mentorship program| Overview, review of evidence, and approach." Thesis, Walden University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3727336.

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Nurses comprise the largest segment of the healthcare workforce. Adequate numbers of nurses help to ensure sufficient and safe nursing care in all settings. The current nursing shortage poses a barrier to optimum nursing care, and the nature of recruitment and retention of nurses has generated research interest because of its association with the labor shortage. The purpose of the project was to develop a nurse mentorship program for possible adoption by a northern state correctional facility. Goals are to aid recruitment and improve retention of nurses in the facility. This quality improvement project was informed by Jean Watson’s theory of transpersonal caring. Program development was guided by a team of interdisciplinary stakeholders in the institution, including a nurse educator, institutional directors of both education and nursing departments, and senior staff nurses who agreed agreeing to function as project coordinators. The peer-reviewed literature and institutional contexts informed program conceptualization and planning for implementation and planning. A series of meetings were held in which the project team explored and discussed available evidence relative to institutional context and needs. The primary product of the project was a mentoring program, and secondary products include plans for implementation and evaluation of that program by the institution in the future as part of a broader institutional initiative. The developed program was shared with 5 nurse scholars with relevant expertise as a content validation process, with revisions made in accordance with feedback. The implementation and evaluation plans include all details necessary for operationalizing as well as evaluating merit and worth of the program over time.

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Wallace, Rick, and Patricia M. Vanhook. "The Importance of Evidence-Based Practice." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7417.

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MacLaren, Jill E. "Training nursing students in evidence-based nonpharmacological pain management techniques." Morgantown, W. Va. : [West Virginia University Libraries], 2006. https://eidr.wvu.edu/etd/documentdata.eTD?documentid=4680.

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Thesis (Ph. D.)--West Virginia University, 2006.
Title from document title page. Document formatted into pages; contains vi, 79 p. : ill. Includes abstract. Includes bibliographical references (p. 36-40).

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Wagner, Kelly. "Evidence-Based Care in Urgent Care Centers." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7261.

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Concussions are brain injuries--also called mild traumatic brain injuries--that affect the function of the brain temporarily or permanently. The purpose of this doctoral project was to develop an education module for staff at an urgent care center to address the lack of knowledge and low level of comfort regarding the care for patients with a head trauma. This project introduced and educated the clinical staff on an evidence-based protocol for the treatment and management of a patient with a concussion. The Rosswurm and Larrabee model for evidence-based change was used as a foundation for refining the practice question, gathering evidence, and translation of the protocol into the clinical setting. The Dreyfus model of the 5 stages of skill acquisition was used to measure the learners' level of achievement. A pretest and posttest were conducted to determine whether there was a gain in knowledge and confidence as a result of the project. There were 6 participants: 3 nonclinical staff and 3 nurses. Overall, there was a statistically significant improvement in confidence based on the Wilcoxon sign ranks test (z = -2.201; p = .028); however, a statistically significant increase in knowledge was not apparent, even though the scores did improve. All staff members were able to apply the practice guideline and make sound judgments using case studies. This project resulted in the translation of evidenced-based care into the urgent care setting, enhanced the confidence of the nursing staff, and has the potential to bring about positive social change by improving the quality of care that will be provided to patients with head injuries.

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Smith-Keys, Sherri L. "Education and Mentoring of Staff Nurses in Evidence Based Practice." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3123.

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Current gaps in nursing practice can decrease by the translation, implementation, and dissemination of evidence-based practice (EBP). The purpose of this project was to provide staff nurses with EBP education and mentoring in identifying and addressing nursing practice issues using EBP to manage patient care. The Advancing Research & Clinical Practice through Close Collaboration (ARCC) and the social cognitive theory were used as a framework to guide this project development, which addressed if medical surgical nurses receiving education in EBP practice led to improved use, implementation, and improved best practice outcomes. Seven randomly selected medical surgical nurses from a local community 200-bed hospital were recruited to participate in this project. The participants were placed in a quiet room and asked to complete a pre ARCC EBP Beliefs Scale survey, review newly developed EBP education tool, and complete a post ARCC EBP Beliefs Scale survey. The EBP Beliefs Scale (EBPB) survey was used pre and post EBP educational tool review and consisted of 16 statements addressing nurses' beliefs about EBP knowledge. This survey also addressed the implementation of EBP into nursing practice. Descriptive statistical analysis was used to analyze the surveys. The results of the survey show a positive correlation between receiving education and mentoring with utilizing EBP in nursing practice. The results of this quality improvement project's social impact will improve collaboration in healthcare organizations and nursing staff to improve the use, translation, and dissemination of EBP projects for patient care improvements and overall improved patient care outcomes.

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Nied, Alice M. "New Nurse Residency - An Evidence Based Approach." UNF Digital Commons, 2009. http://digitalcommons.unf.edu/etd/197.

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Nurse educators believe that their graduates are well-prepared for entry level positions in nursing. In the acute healthcare setting, new graduates are placed on virtually every type of nursing unit, including critical care. Employers have developed formal orientations to familiarize new graduate nurses new with the institution and its policies and procedures and to teach the things employers believe new RNs need to know but do not, either because they were never taught the material or they have not retained it. The purposes of this project were to (a) examine the evidence relative to a disconnect between nursing education and nursing practice, (b) design a formal residency program for new graduates based on the evidence, and (c) implement and evaluate the residency program. Based on the evidence, a 16-week new nurse residency was developed in which Residents were each assigned both a Preceptor and Mentor to assist their progress. Weekly educational offerings were targeted at specific competency deficits identified by Residents, Preceptors and Mentors at the beginning of the residency program. Seven out of the original 10 Residents completed the Residency. Pre-residency, the Residents were very confident of their clinical skills and abilities and this was unchanged post-residency. The Preceptors and Mentors were much less confident of the clinical skills and abilities of the Residents pre-residency. Post-residency, the confidence level of the Preceptors and Mentors was improved, but significantly so only for the Mentors. It is imperative that nursing administrators be aware of the discrepancy between the confidence new nurses have in their own skills and the perceptions of the nurses who work side by side with them on a daily basis. Residencies for new graduate nurses are costly. Nursing administrators must make the determination if the benefits outweigh the costs. They may find the results of not having a residency are far more costly.

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Chang, Hui-Chen. "Evidence-based practice in nursing homes a study of Taiwanese nurses' and nursing managers' perceptions /." Connect to full text, 2008. http://hdl.handle.net/2123/3572.

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Thesis (Ph. D.)--University of Sydney, 2008.
Title from title screen (viewed 11 February 2009). Includes tables and questionnaires. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Behavioural and Community Health Sciences, Faculty of Health Sciences. Includes bibliographical references. Also available in print form.

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Chan, Chun-ha, and 陳春霞. "Evidence-based practice guideline for patients undergoing intermittentcatheterization procedure." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46581297.

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Costolo, Megan. "Evidence-Based Intervention for Families of Children with Epilepsy." Diss., The University of Arizona, 2011. http://hdl.handle.net/10150/203001.

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The purpose of this paper is to propose an evidence-based intervention guideline to increase effective coping and positive adaptation in families with a preschool age child who has epilepsy. This population was chosen because there is a lack of research regarding interventions for families of preschool age children with epilepsy. Relevant literature was reviewed to summarize the effects of childhood epilepsy on families, and to assess the effectiveness of interventions to improve coping and adaptation in these families. The main stressors caused by epilepsy are knowledge deficits about epilepsy, knowledge deficits about treatments for epilepsy, increased seizure frequency, and emotional disturbances caused by epilepsy. Prior interventions for families of children with epilepsy included psychoeducational programs, support groups, education programs, family counseling groups, and therapeutic alliance. All interventions in the studies reviewed had positive outcomes for families of children with epilepsy. However, psychoeducational programs tended to address all of the common stressors, whereas other interventions did not. This paper provides an evidence-based intervention guideline for families affected by epilepsy. The significance and limitations of the program are discussed, and recommendations for future research in this area are presented.

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Lenhart, Natalie Kay. "Nursing Leadership Influence on Evidence-Based Practice Culture and Integration." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3497.

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Translating research to practice takes 10-20 years or more and evidence-based practice (EBP) integration remains at 10%-20%, despite recommendations requiring EBP-guided decisions. EBP integration has been associated with up to 30% decreases in healthcare system spending, improved quality outcomes, and increased staff satisfaction. Nurse leaders are accountable for EBP enculturation, yet rate quality and safety as the highest priority and EBP as the lowest. This knowledge gap perpetuates low EBP integration rates and hinders EBP enculturation. Asking whether EBP facilitative interventions for nurse leaders increase scores on organizational culture and readiness, beliefs, and EBP use scales addressed the knowledge gap via this quality improvement, pre/posttest pilot project. Multiple frameworks guided the project: the nursing process, Lewin's change management model, the Johns Hopkins Nursing EBP model, and the Five Practices of Exemplary Leadership-® model. A comprehensive literature search validated the design using EBP facilitators: educational interventions, transformational leadership, strategic planning, and a systems perspective. Pre/posttest data garnered from 14 non-direct care nurse leaders on the Organizational Culture and Readiness for System-Wide Integration of EBP Scale, the EBP Beliefs Scale, and the EBP Implementation Scale was analyzed using 2-sample t tests. Individual questions on the scales revealed statistically significant differences correlating to the facilitative interventions, yet overall aggregate scores did not change significantly. The limited findings contribute to the existing body of knowledge, while positive social implications include resolving public health and safety issues, reversing fiscal irresponsibility, and overcoming resistance to change.

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Lam, Kwun-yu, and 林冠羽. "Evidence-based exercise guidelines for adult cancer patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46581984.

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Wong, Siu-ling, and 黃少玲. "Evidence-based clinical guidelines for pressure ulcer prevention in elderly patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48339337.

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Older adults are particularly vulnerable to the development of pressure ulcers (PUs) as a result of skin changes and reduced mobility (Knox, Anderson & Anderson, 1994; Russell et al., 2003). This is associated with diminished quality of life, longer hospitalisations and increased morbidity and mortality (Margolis et al., 2002).In view of the high incidence of PUs (grade 1-4) occurring in elderly patients in acute care, a systematic review of related studies was conducted in August 2011. The optimal frequency and methods of repositioning are described in the literature. With well-designed implementation and evaluation plans, the proposed repositioning guidelines are likely to reduce the incidence of PUs (grade 1-4), while in turn lessening the healthcare burden and preserving patients’ quality of life. Pilot testing, a trial run to test the feasibility of the innovation, will be carried out in the proposed medical ward, and training provided to all staff before the intervention. To proceed with the change, the intervention must be cost-effective and beneficial to all stakeholders. Outcome evaluation determines the number of goals achieved by the innovation and to what degree, and is very important (Melnyk & Fineout-Overholt, 2005).The PU incidence (grade 1-4) is expected to be different after the implementation of the innovation.
published_or_final_version
Nursing Studies
Master
Master of Nursing

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Vavra, Curtiss John. "Policy Knowledge Communication in Nursing." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7440.

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Evidence-based practices in nursing improve patient outcomes, decrease healthcare costs, and can be implemented with policies and procedures. However, there is limited literature describing how nurses acquire policy knowledge, the dissemination of which may require a significant investment of resources by a hospital. The purpose of this study was to learn more about how nurses obtain policy knowledge. Rogers's diffusion of innovations theory guided the examination of communication channels and how they relate to the formation of policy knowledge. The research questions were designed to gather information on the relationship of policy communication channels, demographic factors, and the frequency of document access in policy knowledge formation. This correlational study, using select subscales of the Policy Communication Index, was conducted to examine how nurses create and communicate policy knowledge. The sample included 22 nurses who practice at the bedside in a small hospital. Data sources included an anonymous online survey and frequency of policy access data. Data analyses included multiple regression, Pearson's r correlation, and Spearman's correlation of the data. The results showed that nurses report meeting discussions are the primary source of policy knowledge rather than written documents. A subset of participants who supplied an employee identification number showed a strong correlation with electronically distributed. Based on these results, nursing leaders can concentrate policy knowledge dissemination through meetings and safety huddles. The positive social change implication of this study includes better practices to convey evidence-based policy knowledge to nurses practicing at the bedside.

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Treat, Sarah E. "An Evidence-Based Sexual Health Intervention." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/8487.

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Reid, Marlene. "Development of an Evidence-Based Influenza Vaccination Program for Nurses." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1449.

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The purpose of this educational influenza vaccination project was to increase nurses' influenza vaccination rates. Nationally, 41% of nurses were vaccinated, which is far below the Healthy People 2020 goal of an influenza vaccination rate of 90%. Literature suggests that the low nurses' vaccination rate is responsible for inpatient healthcare associated influenza, mortality, and influenza-like illness. Healthcare facilities will not be reimbursed for treatment of healthcare associated infection. Despite recommendations from the Centers for Disease Control and Prevention for nurses to become vaccinated, only 20% of the 800 nurses at a healthcare facility in Baltimore were vaccinated for the past 2 years. A literature search for evidence-based articles was done electronically. Databases such as CINAHL, PubMed, and Medline identified 450 scholarly articles on attitudes, perceptions, and benefits of vaccination. Twenty-one scholarly articles written from 2006 onward that referenced increasing nurse vaccination rate were selected. Pender's health promotion model provided a conceptual view on beliefs and attitudes while explaining the delay in nurses to becoming vaccinated. Based on these scholarly sources a Power-Point presentation was developed that included 10 educational sessions. Five advisory committee members of experts were contacted via e-mail and telephone to review the educational project for feasibility and content validity. The advisory committee members commented that the educational project was feasible and relevant to the content of influenza vaccination for nurses. Social change will focus on nurses adapting a change in practice, and increasing their vaccination rate as a result of this evidence-based educational project.

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Mahoney, Glenna. "Competency Assessment in Sexual Assault Nursing Practice| An Evidence-Based Approach." Thesis, Carlow University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3595809.

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The purpose of this project was to develop and test a pilot competency assessment tool for sexual assault nurses. The content for the competency assessment was based on available evidence, primarily targeting current standards of sexual assault nurse examiner (SANE) practice. Descriptive statistics from a regional crime lab allowed the researcher to identify areas for improvement in the evidence-collection technique. This information was then used to develop the content of the competency assessment. A team of experts helped inform the development of an online competency assessment using a web-based platform. The competency assessment was tested on a small sample of sexual-assault nurse examiners. The instrument demonstrated a reasonable level of consistency and reliability (KR20 was 0.66) for an initial assessment. The aim of developing and testing an online instrument to serve as a baseline for establishing a valid and reliable competency assessment for sexual assault nurse examiners was achieved.

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Dorwart, Shawna Drugge. "An evidence based policy recommendation addressing body art among nursing personnel." Thesis, Montana State University, 2009. http://etd.lib.montana.edu/etd/2009/dorwart/DorwartS0809.pdf.

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Body art in the form of tattoos and piercings is becoming more prevalent as a form of self-expression. Body art is found among members of all socio-economic groups and across a variety of professions. With this increased prevalence many organizations are developing policies to address body art among employees. The intent of this project is to look specifically at policy development in regard to body art among nursing personnel. A thorough review of literature was carried out, exploring body art from multiple perspectives. In addition to examining body art, careful consideration was made for the aspects of nursing potentially impacted by body art. Beyond the review of literature this investigation was expanded to include communication with an expert in body art research. Contact was also made with organizations of varying sizes to establish what policy statements currently exist regarding body art among nursing personnel. During these contacts rationale and references serving as a basis for these policies were also investigated. The desired outcome of the analysis was to identify evidence to support a body art policy among nursing personnel that provided for the well-being and safety of the patients while allowing the nursing staff as much personal freedom as possible. The results of the investigation revealed a lack of evidence identifying the prevalence of body art among nurses, or the impact of body art among nursing personnel on patient outcomes.

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Baxley, Michelle. "School nurse's implementation of evidence-based practice| A mixed method study." Thesis, University of Phoenix, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10257368.

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Evidence-based practice (EBP) ensures excellent nursing care; however, limited literature exists for implementing EBP within schools. This mixed method study, using the Promoting Action on Research Implementation in Health Services (PARIHS) framework, explained EBP implementation within three school districts. Quantitative results identified the level of implementation and nursing characteristics predictive of EBP implementation. The mean EBP Implementation score (n = 64) was 8.36 (SD 9.75), indicating a low level of EBP implementation. EBP Belief scores was the only nursing characteristic that explained 34% of the variance. Qualitative results explained survey results, using a multiple case study design with interviews with six school nurses with high or low EBP Implementation scores. Analysis included pattern matching to propositional statements derived from PARIHS evidence, context, and facilitation concepts. Individual case stories varied and demonstrated both positive and negative patterns. Data synthesis examining propositions and themes indicated all cases supported four evidence propositions. No cases supported the evidence proposition about collecting and using routine student data. Three cases (n =3) with high EBP Implementation scores supported six evidence and context propositions. Three cases (n = 3) with low EBP Implementation scores supported thirteen propositions for the evidence, contest, and facilitation concepts. Common themes across cases were using evidence, cultural influences, structural supports, and impeding implementation. When integrating findings only three EBP Implementation scale items indicated routine implementation of evidence, which matched with evidence propositions supported across cases and the theme using evidence. Context and facilitation propositions and themes primarily explained low EBP Implementation items.

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Brown, Susan J. "The Concept of Facilitation in the Implementation of Evidence-Based Practice: Development of an Instrument to Measure Facilitation." Diss., The University of Arizona, 2011. http://hdl.handle.net/10150/217069.

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In 2001 the Institute of Medicine identified a significant gap between what is known about how we care for patients and the care that they receive. This identified gap renewed interest in the development and implementation of evidence-based practice (EBP). A number of research studies have evaluated barriers to EBP yet questions still arise as to why evidence is not routinely incorporated into practice. This led to a new field of inquiry called implementation science focused on methods for translating evidence into practice. The Promoting Action on Research Implementation in Health Services (PARiHS) framework purports that successful implementation of EBP is a function of the strength of the evidence to be implemented, the quality of the context into which it will be implemented and appropriate facilitation. There currently are levels of evidence and measures of context that can be utilized but no measures of appropriate facilitation. The purpose of this research was to develop an instrument (the Facilitation Assessment Index) to measure facilitation. This methodological study was conducted to determine the psychometric properties of an investigator-developed instrument to define and measure the concept of facilitation. The instrument was distributed to1025 Registered Nurses in an Academic Medical Center. The response rate was 28%. The majority of respondents were in a staff nurse role, over age 35 and had at least a Bachelor's degree. The Facilitation Assessment Index (FAI) demonstrated adequate psychometrics. Factor analysis delineated four subscales entitled Support, Leadership, Respect and Autonomy. The overall reliability of the scale was r = .93 and the range of reliability of the subscales was r = .85-.93. The test-retest correlation for the total scale was r = .85 (p<.001). Correlations for the subscales ranged from r = .61-.85 (p<.01).Relationships between demographic variables and facilitation were evaluated. Both unit and job title variables demonstrated relationships with scale scores but group sizes were not equal. Future research is needed to strengthen the psychometric properties of the FAI. Subsequent research could focus on use in strengthening the PARiHS framework and quantifying the amount of facilitation needed to implement EBP.

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Christeleit, Deborah. "Use of Simulation to Reinforce Evidence-based Collection Processes." UNF Digital Commons, 2011. http://digitalcommons.unf.edu/etd/209.

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Proper collection of blood cultures is needed to identify pathogens causing serious infections and direct appropriate antibiotic therapy. Blood culture contamination can lead to longer hospital stays, incorrect antibiotic treatment, additional testing, and overall increased costs for the patient and hospital. Blood culture collection technique is the most important factor affecting contamination rates. The purpose of this project was to determine the effect of simulation reinforcement of blood culture collection processes on the rate of contamination of blood cultures drawn by nurses in a community medical center emergency department. This one-group before-and-after cohort study utilized a convenience sample of 50 nurses who collect blood cultures on adult clients. Each participant completed a pretest, attended a simulation in-service class, and completed a posttest immediately after the simulation and again one-month later. There was significant knowledge gained from pretest to immediate posttest, with no significant decrease in knowledge at I-month post-intervention. The 3-month blood culture contamination rate was 3.26% prior to the intervention, 4% during the intervention period, 3.7% after the intervention, and 2% in months 4 aI1d 5 postintervention. The use of simulation in the professional development of practicing nurses has the potential to improve clinical practice performance and patient outcomes.

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Watson, Sherry. "Implementation of Evidence-based COPD Education." Mount St. Joseph University Dept. of Nursing / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=msjdn1588248198588369.

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Jetha, Farah Shirazdin. "Teaching needs and evidence-based strategies to support novice nursing clinical teachers: a rapid evidence assessment." Thesis, University of British Columbia, 2013. http://hdl.handle.net/2429/44317.

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Clinical education is the cornerstone of nursing curricula and comprises almost half of many current nursing curricula. It is through this practice that students learn to apply their theoretical knowledge to practice and socialize into the nursing profession. The clinical teacher is pivotal in this process. The current nursing profession is challenged with a decreasing supply of competent clinical teachers due to an aging nursing workforce, and economic barriers which impacts the quality of nursing education. To meet this increasing demand for competent clinical teachers, members of academic institutions are resorting to hiring expert nurses who are mostly novice teachers. These novice clinical teachers are in need of support during their transition from practice to teaching. An assessment of the evidence-based scholarly literature was conducted to identify the teaching needs and strategies to support this unique group of expert nurses transitioning as novices into teaching practice. By means of a rapid evidence assessment (REA) method and a reflective framework, 29 research studies were reviewed. A comprehensive view of what is described in the evidence-based literature as the needs for novice clinical teachers’ teaching practice as well as current recommendations of best practices to support and prepare novice clinical teachers are presented. Teaching needs for novice clinical teachers identified in the REA are socialization into the culture of teaching, professional development, and the need to self-reflect and be self-confident. Supportive strategies that are highlighted include working in familiar environments, having prior exposure to students, participating in a comprehensive orientation process using principles of adult learning theory, building relationships and creating a new identity. The main recommendations to support novice clinical teachers’ needs include strategies to enhance socialization into the teaching role, the development of a comprehensive orientation process, ongoing professional development sessions, mentorship programs, and self-reflective strategies.

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Fung, Wai-kei Vicky, and 馮惠祺. "Evidence-based clinical practice guideline on nursing support for parents of preterm babies upon hospital discharge." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46581741.

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Ng, Yuk-ling, and 伍玉玲. "An evidence-based education program to promote health outcomes in asthmatic children." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48335988.

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Asthma is a common chronic disease for children and is a leading cause for their hospitalization. Despite its negative health impact, a local survey has shown that children with asthma as well as their parents have a lack of understanding for asthma management (Wong, Wong, Chung & Lau, 2001). However, to help asthmatic children to better cope with their condition, it is important for health care professional such as nurses to enhance their knowledge in asthma management. Recent empirical research has shown that education promoting knowledge of asthma management can improve health outcomes in asthmatic children. Therefore, it is important to develop an evidence-based asthma education guideline for them. This dissertation aims to evaluate the empirical evidence of the education program for asthmatic children, with the age ranging from 5 to 18, and their parents. The goal of the proposed program is to reduce their re-hospitalization rate by enhancing their knowledge of asthma care. A translational nursing research was conducted and 10 studies focusing on asthma education program for children and their parents were identified from electronic databases. Critical appraisal was performed using the recognized assessment tool, named the Scottish Intercollegiate Guidelines Network (SIGN) (2008). Recommendations were developed based on the data extracted from the review. Based on the literatures reviewed, it was found that a 45-to-60 minute one-to-one educational intervention conducted by nurses using self-management plan is the most effective method for improving the health outcomes for asthmatic children. A plan of translating the empirical information extracted from the review into practice was developed and the potential of implementation was assessed. Based on the assessment, it was found that there is high transferability of the findings from the review and the proposed innovation is feasible in the selected clinical setting. In addition, the benefits generated from the proposed innovation also outweigh its cost. An evidence-based guideline was then developed based on the high and medium level of evidence. The grades of the recommendation were stated as well. A comprehensive communication plan targeting on various stakeholders was prepared. A pilot study was designed to examine the feasibility of the proposed innovation before the full-scale implementation. The outcomes of the proposed innovation include the re-hospitalization rate of asthmatic children, the patients’ and nurses’ level of knowledge in asthma care, the satisfactory level of patients and nurses towards the innovation, the competency of nurses in conducting the innovation, and the utilization rate and the cost of the innovation. They would be evaluated using appropriate methodologies. The proposed innovation would be considered as effective if the primary outcome, the re-hospitalization rate of asthmatic children is reduced.
published_or_final_version
Nursing Studies
Master
Master of Nursing

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Morris, Arlene H. Witte James E. "Factors influencing Bachelor of Science in Nursing students' perceptions of eldercare cultural self-efficacy." Auburn, Ala., 2007. http://hdl.handle.net/10415/1339.

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Richards, Heather. "Development of a Quality Improvement Program to Support Evidence-Based Nursing Practice." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5408.

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Nurses are expected to perform evidence-based practice (EBP) at the point of care (POC) to promote positive outcomes through the quality and safety of patient care. The struggle for nurses on the surgical digestive unit in a hospital to adopt EBP is the lack of access and knowledge to evidence-based research at the POC. The utilization of information technology is an innovated approach to providing access and knowledge for EBP at the POC to improve patient outcomes. The project was to develop a quality improvement program to improve nursing access and knowledge of EBP resources. The program was to identify the type of e-nursing resources and necessary education to provide nurses access to evidence-based resources and the knowledge to utilize these resources in nursing practice. The purpose of the doctoral project was set to identify necessary resources to develop an evidence-based program for staff nurses to access evidence-based resources and improve nursing knowledge on EBP at the POC. The use of the Stevens's star model of knowledge transformation was the framework for the project, and use of the logic model guided the structure for program evaluation. The quantitative project used a 1 group pre- and post-survey design using a convenience sample (n =10). A final statistical analysis to determine effectiveness of the educational intervention was inconclusive. Quantitative descriptive data from pre- and post-survey results were used to summarize recommendations for the future development of an EBP quality improvement project with the use of information technology tools. The further dissemination of the findings could promote new methods to implement quality improvement programs to improve the quality and safety of patient care to promote positive health outcomes.

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Kochanowicz, Kathleen Marie. "Evaluation of Evidence-Based Practice Guideline for Pediatric Obesity." Diss., The University of Arizona, 2014. http://hdl.handle.net/10150/316778.

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Introduction: Pediatric obesity prevention and management is a high priority for pediatric providers. Pediatric providers use evidence-based clinical guidelines to integrate the best current recommendations into practice. The contention of this inquiry is that while practice guidelines and obesity programs address the "who, what, when, where, and why" of pediatric obesity interventions, the guidelines fail to address the "how" of the process that bolsters adherence and attacks the high attrition rates of obesity management. Objective: The objective of this practice inquiry is to evaluate Prevention and Treatment for Pediatric Obesity: An Endocrine Society Clinical Practice Guideline Based on Expert Opinion using the Appraisal for Guidelines and Research and Evaluation (AGREE II) instrument and to investigate techniques to improve adherence to the lifestyle changes recommended in the guideline, by synthesizing the current research for using motivational interviewing with obese pediatric patients, and propose a plan for translating the intervention to measurable outcomes. Methods: Prevention and Treatment of Pediatric Obesity: An Endocrine Society Clinical Practice Guideline Based on Expert Opinion was evaluated using the AGREE II instrument. The current recommendations are detailed based on the findings of a review of the literature. Using the RE-AIM framework, recommendations are made to determine the translation potential for the use of motivational interviewing to improve adherence to lifestyle recommendations, thus improving the current clinical practice guideline. Results: Review of the Endocrine Society's CPG using the AGREE II instrument yielded an overall guideline quality rating of 6/7. The guideline is recommended for use with modifications to improve applicability. Integration of MI to the practice guideline and the use of the RE-AIM framework to improve uptake of the intervention is proposed to address the weaknesses in applicability revealed in the guideline evaluation. Conclusion: The CPG reviewed in this PI provides quality recommendations for the treatment and prevention of pediatric obesity. By integrating MI techniques and using the RE-AIM framework, pediatric providers may be able to bolster adherence to the guideline recommendations and ultimately improve clinical outcomes and impede the rising pediatric obesity rates. Future research should include evaluation of MI interventions in the pediatric clinical setting.

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Van, Roper Stephen. "Evidence Based Practice Among Primary Care Nurse Practitioners." Diss., The University of Arizona, 2011. http://hdl.handle.net/10150/217049.

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This study describes primary care nurse practitioner (PCNP) beliefs in, knowledge, implementation and utilization of evidence based practice (EBP). Research questions answered are: 1. What are the levels of belief, implementation, knowledge and utilization of EBP among PCNPs? 2. Is there a relationship with PCNP demographics (personal, professional, and practice), belief, knowledge, implementation and utilization of EBP? 3. Do PCNP demographics (personal, professional, and practice) and scores on belief, knowledge and implementation influence EBP utilization? EBP is considered a standard of care and essential to nurse practitioner practice. The primary advantages of EBP include improved quality of care through the utilization of patient resources, provider resources and experiences, current research and scientific information. However, few studies describe nurse practitioner beliefs, knowledge in EBP and the extent to which this may affect primary care nurse practitioners' (PCNP) utilization of EBP in their practice. Four questionnaires incorporated into one survey were used to examine PCNP beliefs, knowledge, implementation and utilization of EBP. JNC7 guideline knowledge and self-reported use was used to measure EBP utilization. A convenience sample of 202 FNPs, ANPs and GNPs were obtained during the American Academy of Nurse Practitioners National Conference 2011 in Las Vegas, Nevada. PCNPs surveyed were found to have a high level of belief in EBP but did not report implementing EBP more than 3 times in the past 8 weeks. Belief was statistically higher in doctorally prepared PCNPs. Ninety-five percent of the participants were familiar with the JNC7 guideline but the group scored a mean of 69% on knowledge of JNC7 guideline specifics. Only 25% of respondents indicated they utilized guidelines in hypertension management. Future studies should include quantitative and qualitative evaluation of EBP implementation facilitators and obstacles. Findings in this study have provided initial information to better understand PCNPs and EBP.

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Morrison, April H. "Breastfeeding: Evidence-Based Clinical Guidelines Every Health Care Provider Should Know." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7123.

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Annesi, Sandra M. "An Evidence Based Multi-Activity Handwashing Education Program in Children." UNF Digital Commons, 2010. http://digitalcommons.unf.edu/etd/286.

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Proper handwashing is one of the simplest, most affordable and effective means of stopping the spread of infection. Due to the close proximity of children in schools and child care settings, there is a high risk for the spread of infectious disease. The purpose of this project was to improve handwashing behaviors of three to six year old children in a community school setting by implementing an evidence based multi-activity handwashing education program. The objective was to increase understanding of the relationship between germs and handwashing, as well as increase the frequency and correct technique procedure of handwashing behavior in children in the community. The evidence based handwashing education program was implemented over several weeks and included multiple activities that were found in the literature to be effective. These activities included a lecture and presentation, a return demonstration, a Glo Germ™ training device, and a video and story on handwashing. The results of the statistical analysis found that the program was effective in increasing both the frequency and correct technique procedure of the children. Most parents (80%) reported that they noticed an increase in how often their child washes his/her hands. A majority of parents (83%) noticed an increase in the duration of how long their child washes his/her hands; a larger majority (90%) noticed a decrease in how often they needed to prompt their child to wash his/her hands. Nurses working collaboratively with other disciplines in the community can implement evidence based practice handwashing education programs in a variety of public child care settings. The effects of the handwashing programs may significantly decrease child healthcare costs associated with prescriptions, visits to the provider, hospital admissions and emergency room visits and influence positive health promotion behaviors in children. Implementing affordable and effective handwashing education programs can lead to a reduction in infectious diseases, absenteeism, antibiotic resistance and health care costs. By fostering positive health promotion practices, such as proper handwashing behaviors in children, habits may be instilled that carry into adulthood. These habits can increase the health of a child and the community.

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Ubani, Tochi Onyenwe. "Nurse-Physician Communication Tools to Enhance use of Nursing Evidence-Based Protocols." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/334.

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Nurse-Physician Communication Tools to Enhance use of Nursing Evidence-Based Protocols by Tochi Onyenwe Ubani MSN, Walden University, 2011 BSN, Chamberlain College of Nursing, 2009 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University February 2015 In the current health care environment, consumers are demanding collaboration among clinicians even when traditional attitudes minimize nurses' input on the direction of clinical care. Compounding this problem is that nursing practices have not always been derived from randomized clinical trials, but instead from personal experiences. The purpose of this study was to explore the perceptions of nurses, physicians, and administrators on clinical protocols, including the use of nurse evidence-based practice (EBP) in practice settings. The study aimed at fostering clinical decisions anchored on shared knowledge, collegiate interactions, and emotions. A survey designed using nurse-physician communication tools was disseminated among a convenience sample of 50 nurses, 12 physicians, and 3 administrators. Content analysis was applied to survey responses. The findings revealed that effective communication between nurses, physicians, and administrators enhanced the use of nursing EBPs; these findings were used to generate the Nurse-Physician Communication Tools (NPCT) as a mechanism to enhance the translation of nursing EBP in clinical setting. The use of NPCT provided a mechanism for practice changes needed to improve clinical collaboration and enhance use of nursing EBPs in patient care.

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Stagner, Tonya Sue. "Introduction of Evidence-Based Practice to Acute Stroke Center Nursing in Jakarta, Indonesia." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3725.

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Evidence-based practice (EBP) is a relatively new concept for nurses in Indonesia; it has not been integrated into nursing care. This project sought to introduce EBP to nurses at an acute stroke center (ASC). The knowledge transfer team approach guided the project. The goal was to identify and analyze current data and to develop an EBP guideline for clinical nursing practice in the ASC. Sources of evidence that was used to address the practice-focused question included project team members, organizational documents, and a database search to identify EBP guidelines for the nursing care of acute stroke patients. A database search was conducted using the key terms: stroke, nursing care, nurse, guideline, implementation, and evidence-based practice. The search databases included the National Guideline Clearinghouse, CINAHL Plus, ProQuest, and MEDLINE. From 185 articles, 6 guidelines were identified with applicability and relevance to Indonesian nursing practice. The excluded data consisted of guidelines specific to rehabilitation, medication management, and stroke prevention. Guidelines chosen for further analysis were published by international professional organizations. The AGREE II-GRS instrument guided the analysis of the published international guidelines. Four of the 6 analyzed guidelines scored 7 on all AGREE II-GRS criteria, indicating the highest quality. The conclusion of this doctoral project was the positive reception of EBP via a guideline developed for poststroke patients. The process of EBP introduction to nurses not previously exposed will provide data to further nursing's global body of knowledge. Successful strategies to introduce and incorporate EBP in developing countries will provide positive social change for international nursing practice.

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Cuddy, Janet Brooke. "Development of an Evidence-Based Nursing Orientation Program for a Community Health System." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/748.

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Through discussion with the community health system's administration, it was identified that their current nursing orientation program was not well structured or comprehensive. The nursing staff also reported dissatisfaction with the current program. Therefore, a Doctor of Nursing Practice project commenced to develop an evidence-based nursing orientation program for Registered Nurses (RN) and Licensed Practical Nurses (LPN) at a community health system in Virginia. The Competency Outcomes Performance Assessment model guided development of the project through a comprehensive literature review to identify evidence-based data for competencies, learning strategies, and performance evaluations. This review highlighted the importance and benefits of nursing orientation programs as well as the use of evidence-based strategies. As a result of this review, an evidence-based nursing orientation program was developed to meet the needs of the nursing staff as well as the organization. The evidence-based nursing orientation program was translated into an electronic format with an accompanying manual to be used when nurses are hired by the community health system. An advisory board from the organization reviewed the program and their feedback was incorporated. Social change is expected to occur, as nurses will be better prepared for their new position with increased job satisfaction and also to provide optimal care to patients from the community. This project addressed a gap in the literature for generalized nursing orientation programs. Publication in a peer-reviewed journal or oral presentation at the Virginia Community Healthcare Association annual conference was selected for project dissemination.

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Camacho-Walsh, Mercedes. "Evidence-Based Practice| Reducing Unnecessary Antibiotic Prescriptions for Pediatric Pharyngitis." Thesis, Saint Peter's University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10742646.

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The purpose of this project was to decrease of the rate of unnecessary antibiotic prescribing for pharyngitis by implementing an evidence-based training session for physicians in an outpatient pediatric setting. The PICOT question explored was, "For health providers treating children aged 4–15 presenting with sore throat, will the use of a power point training session presenting the rapid antigen detection test (RADT) with reflexive culture, combined with the ICE (ideas, concern and expectations) method, improve knowledge and reduce antibiotic prescribing compared to RADT alone in a 20 day period?"

The provider study group consisted of four pediatricians and one family practice physician ranging from 32–72 years old. Their pre-test (34.63%) and post-test (53.75%) knowledge scores were significantly different ( t = –2.3822, df = 6, p < 0.05). A total of 125 cases were sampled, 64 pre-intervention and 61 post-intervention. Pearson’s Chi Square analysis revealed homogeneity between both the groups in age (X² = 0.94, df = 1, p = 0.33), gender (X2 = 0.64, df = 1, p = 0.42), and ethnicity (X2 = 1.29, df = 2, p = 0.53) and a decrease in overall antibiotic prescribing rates from 40.6% (n = 26) to 27.9% (n = 17). Although this was not a significant statistical reduction (p = .13), further analysis using a binomial test revealed statistically different rates of success in the accuracy of diagnosis and associated antibiotic prescribing pre-intervention (79.7%) compared to 96.7% post-intervention (p = .00; 95% CI [88.7, 99.6]). Unnecessary antibiotic exposure was reduced by 17.2%.

The most common ICE elements were thought of possible strep infection (39), viral or other infection (26), concern for pain (24), infecting other family members (14), fever (14), expectation to get better (32), test for strep (18), and pain relief (9). Only 2 of the 5 cases in the post-intervention group (n = 61) who expressed desire for antibiotics received them.

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Vanhook, Patricia M. "Overcoming the Barriers to EBP." Digital Commons @ East Tennessee State University, 2009. https://dc.etsu.edu/etsu-works/7451.

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Versteeg, Cynthia Elaine. "Fostering collaborative evidence-based decision-making: The public health nurse's role." Thesis, University of Ottawa (Canada), 2002. http://hdl.handle.net/10393/6360.

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The Canadian Nursing Association promotes the use of evidence-based decision-making (EBDM) as a component of quality nursing care. A shift to a population health approach encourages public participation in health-related decision-making. Public health nurses (PHNs) participate in joint health-related decision-making with community partners. The purpose of this exploratory and descriptive study was to gain an in-depth understanding of EBDM from the perspective of the PHN. The meaning of EBDM, the perceived barriers and facilitators of using evidence, and the role of the PHN in bringing evidence to the joint decision-making process that they share with community partners was explored. A qualitative methodology known as ethnography was used and data were collected from two sources: observations at team meetings and semi-structured interviews with PHNs. Analysis of the data led to the identification of three sub-themes: holistically knowing the community, bridging 'evidence' to context, and actively managing information. All three sub-themes contribute to the main theme: the PHNs' role in fostering collaborative 'evidence-based' decision-making in the community. The PHNs' holistic view of evidence, which includes hard and soft data, contextual data and professional experience, is discussed. Basic steps in a shared EBDM process are described and dimensions of the context in which PHNs practice are explored. Implications for education, practice, research, and policy are discussed.

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Stidham, April, and Christine M. Mullins. "Evidence-Based Recommendations for the Prevention of Herpes Zoster in Older Adults." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7135.

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Chung, Lisa. "AN EXPLORATION OF SELECTED CHARACTERISTICS OF REGISTERED NURSES AND THEIR USE OF EVIDENCE-BASED PRACTICE IN ACUTE CARE SETTINGS." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1430143066.

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Pelton, Derrick Kyle. "Evidence-Based Plan for Promoting Physical Activity Among Deaf Adults in Primary Care." Diss., The University of Arizona, 2013. http://hdl.handle.net/10150/311571.

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Objectives. The purpose of this practice inquiry (PI) was to develop an evidence based plan for promoting physical activity among Deaf adults in a primary care setting. The aims of this PI were to 1) review research about the relationship between physical activity and health 2) review research about use of pedometers to motivate increased walking and 3) describe baseline physical activity among Deaf adults using pedometer step counts based on a secondary analysis of an existing data set. Design. The secondary analysis of an existing data set analyzed demographic data and pedometer data (steps/day). Participants received standardized instructions about using the pedometer in-person, in American Sign Language (ASL) and also received a DVD with the instructions in ASL for review at home. The review of literature and secondary analysis were used to propose an evidenced-based plan to increase physical activity in Deaf adults in the primary care setting. Sample: Eighty-seven participants met inclusion criteria for this secondary analysis: 1) at least 45 years of age, 2) self-identified as a member of the Deaf community, 3) fluent in ASL, 4) no existing diagnosis of coronary artery disease, and 5) at least one risk factor for cardiovascular disease: overweight/obese, sedentary, diabetes, hypertension, hyperlipidemia. Results: Results support the value of physical activity for health promotion and risk reduction, and supported use of pedometers to encourage increased walking. The secondary analysis of data from 87 Deaf adults showed that their average steps/day were 5,667, which fall short of the 2008 Physical Activity Guidelines for Americans. Men tended to walk more than women, though the difference did not reach statistical significance. There was an inverse correlation between age and steps/day (r=.280, p=.007) consistent with a low active lifestyle. Conclusion. There is considerable support for providing pedometers to at-risk Deaf adults in primary care, with both group and individual instructions in ASL and follow-up to monitor increases in average steps/day as an effective strategy for increasing physical activity. This would not be a stand-alone intervention, but part of an overall risk assessment and evidenced based plan to increase physical activity in Deaf adults.

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Leung, Tai-tei Betty, and 梁帶娣. "Evidence-based guideline on nanocrystalline silver (ACTICOAT) therapy for outpatient burn management." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B4658268X.

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Breit, Susan Annette. "Development of Mentors to Facilitate Evidence-Based Practice in a Nurse Residency." ScholarWorks, 2015. http://scholarworks.waldenu.edu/dissertations/1673.

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Evidence-based practice has resulted in better patient outcomes, higher patient satisfaction, and effective patient-centered care. Leadership of a large teaching hospital determined that new nurses lacked the education and experience to design and implement an evidence-based project at the bedside, which was an expected outcome for completion of the established nurse residency program. The purpose of this project was to develop a design-only project in which Masters of Science in Nursing-prepared mentors were added to the residency program to establish the required evidence-based project. A mentor workshop was developed to guide the mentors in this role using Benner's novice to expert theoretical model. A team of stakeholders, including an expert in the field of nursing education, provided ongoing process evaluation in the development of the outcome products including the Mentor Facilitation Guide, Mentor Workshop Curriculum, Mentoring Toolkit, Pre-and Post-Mentor Workshop Survey Assessment, and Mentor Implementation Plan. Stakeholders completed a summative evaluation on the processes, outcomes, and student leadership of the project. Findings showed that the project met 100% of the stated goals and objectives, as evidenced by the stakeholders' responses to the summative evaluation regarding the degree of effectiveness for the project, process, and leadership skills. Implementation and evaluation of the project, which was developed for use in the hospitals' existing nurse residency program, will occur post-graduation. Social change will occur if new nurses learn to use evidence-based practice to support their nursing actions, resulting in improved patient care outcomes and population health.

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Cameron, Nancy G. "An Evidence-Based Orientation Course for an Online MSN Program." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7047.

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Students are able to focus more on the course subject matter in the first few weeks of class when they have a clearer understanding of the LMS, graduate school and online learning expectations, and resource/support availability before classes start. A positive early start adds strength for managing future barriers and frustrations of graduate education. These concepts may be applied to meet the specific requirements of other academic programs. Further research is needed to compare the retention rates of those participating in the orientation program and those who did not. The finding in this project support the importance of an orientation program to graduate nursing studies which includes setting realistic expectations, developing a sense of community and support, and practicing for proficiency in the program LMS.

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Breytenbach, Cecile. "A best practice guideline for evidence based teaching strategies for nurse educators." Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/4831.

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Abstract:

Evidence based practice (EBP) is a worldwide phenomena defined as the “conscientious explicit and judicious use of current best evidence in making decisions about the patient’s care”. The evidence based practice concept’s aim is to effectively guide health care professionals to build knowledge that will be supported by evidence. Evidence based practice must be supported by evidence based teaching. Nurse educators must be up to date with evidence based teaching as well as the latest evidence based teaching strategies, in order to teach the new millennial nursing students and for the new qualifications structure. Teaching the concept of evidence based practice by implementing evidence based teaching to nursing students will enable them to transform the future of healthcare by delivering high quality care practice. A paucity of evidence is available on evidence based teaching and teaching strategies in the South African context. Therefore the researcher used a systematic review methodology to explore and describe the best available evidence based teaching strategies and to develop a guideline on evidence based teaching strategies for nurse educators. The data bases searched included: MEDLINE, CINAHL, PubMed and Google Scholar. Manual searches were done and completed with the assistance of librarians. A total number of n=50 studies were identified as potentially relevant to the study. The number or articles included for critical appraisal were 20. On completion of the critical appraisal n=17 articles were identified for the review. The included studies for the review were n=7 Level 1, systematic reviews and n=10 Level 2, quasi-experimental studies. Three studies were excluded after critical appraisal from two reviewers, appraisal was done independently, and consensuses were reached between the two reviewers. The Joanna Briggs Institutes critical appraisal and data extraction instruments were used for the study. The descriptive data synthesis was done of the included studies as well as a comparison of teaching strategies to determine which one to better than the other one. Although n = 4 of the teaching strategies (concept mapping, internet-based learning, evidence based interactive strategy and cultural competence) significantly increased knowledge, the overall results found that a variety of teaching strategies to be implemented to increase the knowledge outcomes of the nursing students. The different teaching strategies found were: e-learning, concept mapping, internet-based learning, web-based learning, gaming, problem-based learning, and case studies, evidence based learning and cultural competence. However, more research is needed to investigate the best use of the different teaching strategies and compare the impact of a variety of teaching strategies on increasing knowledge of the nursing student.

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Dissertations / Theses on the topic 'Evidence-based nursing'

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