The Development of a Coaching Model: Challenges and Implications for Intervention Research

To develop a clinical scenario-based educational program incorporating five evidence-based practice (EBP) steps and evaluate its effects on EBP knowledge and skills and EBP implementation among hospital nurses. This study employed a randomized controlled trial design. Eighty-seven registered nurses were recruited from 22 hospitals across Japan and randomly assigned to either the Intervention group (n = 44) or the Control group (n = 43). The Intervention group received a clinical scenario-based education program incorporating the five EBP steps, utilizing the Prevention of Delirium in Elderly Hospitalized Patients scenario. EBP knowledge and skills and EBP implementation were measured at baseline (T1), immediately post-intervention (T2), and 2 months later (T3). Linear mixed models were used to assess the between-group differences in EBP knowledge and skills, as well as EBP implementation. No significant differences were found between groups at T1 in EBP knowledge and skills (25.4 [22.6-28.1] vs. 27.9 [25.0-30.7], p = .219) and implementation scores (14.8 [12.7-16.9] vs. 15.0 [12.8-17.3], p = .882). At T2 and T3, the Intervention group had significantly higher knowledge and skills (T2: 33.8 [31.4-36.3] vs. 27.6 [25.1-30.2], p = .001; T3: 36.8 [34.3-39.3] vs. 27.2 [24.7-29.7], p < .001) and higher implementation scores at T3 (21.5 [19.5-23.5] vs. 14.5 [12.5-16.5], p < .001). A clinical scenario-based educational program incorporating the five steps of EBP effectively enhanced EBP knowledge and skills as well as promoted EBP implementation among hospital nurses. Trial registration number UMIN000053457 (1/27/2024).

Background: Evidence-based practice has been considered as a key for healthcare quality measure. As a result of its influence on nurses’ knowledge and practice, evidence-based practice has gained prominence in the nursing profession. Therefore, evidence-based practice is increasingly acknowledged as a critical component of improving the quality of healthcare and nursing care services, as well as achieving patient care excellence. The study aimed to explore nurses’ knowledge and attitudes toward implementing evidence-based practice. Research design: A cross-sectional research design was used to answer the study question. Sample: A convenient sampling of 100 nurses from staff nurses. Setting: The study was applied at Minia University Hospitals. Tools of data collection: Two tools were used, 1st tool was personal and professional data the second part was nurses’ knowledge related to implementation of evidence-based nursing practice, and 2nd tool: was the evidence-based practice attitude scale. Results: The study revealed that (34.5%) of nurses had satisfactory knowledge, while (37.9%) of nurses had a negative attitude toward evidence-based nursing practice implementation.Conclusion: There a positive correlation between nurses’ knowledge and attitude toward evidence-based nursing practice implementation. This study provides a foundation for the adoption of measures to encourage the use of EBP by nurses in different healthcare settings in Egypt, as well as a baseline assessment for upcoming reviews. Recommendations: Carefully crafted evidence-based programs, properly equipped facilities with state-of-the-art informatics tools.

The implementation of evidence-based practices (EBPs) in community mental health settings for youths has consistently yielded weakened effects compared with controlled trials. There is a need to feasibly measure the quality of large-scale implementation efforts to inform improvement targets. This study used therapist-reported caregiver attendance in treatment sessions as a quality indicator in the community implementation of EBPs. Data were collected from therapists practicing in agencies contracted to provide publicly funded children's mental health services following a system-driven implementation of multiple EBPs. Community therapists (N=101) provided information about youth clients (N=267) and psychotherapy sessions (N=685). Multivariable binomial logistic regressions were conducted to examine associations between caregiver attendance and therapist factors (e.g., licensure status, education), youth factors (e.g., gender, age), and the type of EBP delivered. Caregiver attendance occurred in 42% of sessions. The following factors were associated with increased odds of caregiver attendance: younger client age, male sex of client, externalizing presenting problem, and delivery of an EBP that prescribes caregiver attendance at all sessions. Caregiver attendance at sessions targeting trauma or externalizing disorders appeared to explain the differences between boys and girls in levels of caregiver engagement. Overall, the patterns of actual caregiver attendance appeared consistent with empirically informed practice parameters for involvement of caregivers in treatment. Still, the rates of caregiver attendance in externalizing-focused sessions were suboptimal, and the gender difference in these rates-which clearly disfavored girls-suggests targeted areas for quality improvement. Potential reasons for these quality gaps are discussed.

BackgroundThe implementation of evidence-based practice (EBP) in daily health care practice is strongly encouraged; it is widely recognized as a means to improve the quality and safety of health care for patients and reduce avoidable costs. Primary care nurses and physiotherapists face numerous challenges in trying to ensure that they deliver effective daily care. Broadly promoted educational interventions aim to increase the integration and implementation of EBP in their daily practice.ObjectiveThis systematic review will retrieve and evaluate publications examining the effectiveness of educational interventions to increase the integration and implementation of EBP among nurses, nurse practitioners, and physiotherapists active in primary care.MethodsWe will conduct a systematic review of published articles in relevant professional, scientific journals (from their start dates) and in the following electronic databases, from inception until October 31, 2020: Medline Ovid SP (from 1946), PubMed (NOT Medline[sb]; from 1996), Embase.com (from 1947), CINAHL Ebesco (from 1937), the Cochrane Central Register of Controlled Trials Wiley (from 1992), PsycINFO Ovid SP (from 1806), Web of Science Core collection (from 1900), PEDro (from 1999), the JBI Database of Systematic Reviews and Implementation Reports (from 1998), and the Trip Database (from 1997). We will use the predefined search terms of “evidence-based practice,” “nurses,” or “physiotherapists” and combinations with other terms, such as “educational interventions.” We will also conduct a hand search of the bibliographies of all the relevant articles and a search for unpublished studies using Google Scholar, the ProQuest Dissertations and Theses dissemination, Mednar, WorldCat, OpenGrey, and Grey Literature Report. We will consider publications in English, French, German, and Portuguese.ResultsThe electronic database searches were completed in October 2020. Retrieved articles are currently being screened, and the entire study is expected to be completed by March 2021.ConclusionsThis systematic review will provide specific knowledge about the effectiveness of educational interventions to increase the implementation and integration of EBP in the daily practice of nurses and physiotherapists providing primary care services. Its findings will inform us about the types and frequencies of the most successful educational interventions.Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42017077309; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=77309International Registered Report Identifier (IRRID)DERR1-10.2196/17621

BackgroundThis study aimed to identify clinical nurses’ evidence-based practice (EBP) knowledge, beliefs, organizational readiness, and EBP implementation levels, and to determine the factors that affect EBP implementation in order to successfully establish EBP. This study was conducted at a university-affiliated tertiary hospital located in a provincial area in Korea. The research design was based on Melnyk and Fineout-Overholt’s Advancing Research & Clinical Practice through Close Collaboration model as the first step.MethodsA descriptive and cross-sectional design was conducted and a convenience sample of 521 full-time registered nurses from an 849-bed tertiary hospital were included. Structured questionnaires were used to assess EBP knowledge, EBP beliefs, organizational culture & readiness and EBP implementation. Data were analyzed using SPSS V 25.0 by using descriptive and inferential statistics and hierarchical multiple regression was performed to determine the factors affecting the implementation of EBP.ResultsOur findings showed that the clinical nurses had a positive level of EBP beliefs, but the level of EBP knowledge, organizational readiness and EBP implementation were insufficient. EBP knowledge, beliefs, and organizational readiness were significantly positively correlated with EBP implementation. In the final model, EBP knowledge and organizational readiness were significant predictors of EBP implementation; the model predicted 22.2% of the variance in implementation.ConclusionsBased on these results, the main focus of the study was the importance of individual nurses' efforts in carrying out EBP, but above all efforts to create an organizational culture to prepare and support EBP at the nursing organization level. In the initial process of introducing and establishing EBP, nurse administrators will need to minimize expected barriers, enhance facilitators, and strive to build an infrastructure based on vision, policy-making, budgeting, excellent personnel and facilities within the organization.

The Advancing Research and Clinical practice through close Collaboration (ARCC© ) Model is a system-wide framework for implementing and sustaining evidence-based practice (EBP) in hospitals and healthcare systems. The model involves assessing organizational culture and readiness for EBP in addition to the development of a critical mass of EBP mentors who work with point-of-care clinicians to facilitate the implementation of evidence-based care. Determining how the various components of the ARCC© Model relate to one another is important for understanding how EBP culture and mentorship impact EBP implementation, nurses' job satisfaction, and intent to stay. The current study aimed to test a model that could explain the relationships and direct pathways among eight key variables in the ARCC© Model: (1) EBP culture, (2) mentorship, (3) knowledge, (4) beliefs, (5) competency, (6) implementation, (7) nurses' job satisfaction, and (8) intent to stay. Structural equation modeling was used to test relationships among the variables in the ARCC© Model with data obtained from an earlier cross-sectional descriptive study with 2,344 nurses from 19 hospitals and healthcare systems across the United States. The final structural equation model found that EBP culture and mentorship were key variables that positively impacted EBP knowledge, beliefs, competency, implementation, job satisfaction, and intent to stay among nurses. As described in the ARCC© Model, establishing a strong sustainable EBP culture along with a critical mass of EBP mentors is crucial for the development of EBP competency and consistent implementation of evidence-based care by nurses. A strong EBP culture along with EBP mentorship also can result in higher job satisfaction and intent to stay. Implementation of the ARCC© Model is a key strategy in assisting systems to reach health care's Quadruple Aim.

BackgroundHaving a positive attitude towards evidence-based practice and being able to see the value of evidence-based practice for patients have been reported as important for the implementation of evidence-based practice among nurses.The aim of this study was to map self-reported beliefs towards EBP and EBP implementation among nurses, and to investigate whether there was a positive correlation between EBP beliefs and EBP implementation.MethodWe carried out a cross-sectional study among 356 nurses at a specialist hospital for the treatment of cancer in Norway. The Norwegian translations of the Evidence-based Practice Belief Scale and the Evidence-based Practice Implementation Scale were used.ResultsIn total, 185 nurses participated in the study (response rate 52%). The results showed that nurses were positive towards evidence-based practice, but only practised it to a small extent. There was a positive correlation (r) between beliefs towards evidence-based practice and implementation of evidence-based practice (r = 0.59, p = 0.001).There was a statistical significant positive, but moderate correlation between all the four subscales of the EBP Beliefs Scale (beliefs related to: 1) knowledge, 2) resources, 3) the value of EBP and 4) difficulty and time) and the EBP Implementation Scale, with the highest correlation observed for beliefs related to knowledge (r = 0.38, p < .0001). Participants who had learned about evidence-based practice had significantly higher scores on the Evidence-based Practice Belief Scale than participants who were unfamiliar with evidence-based practice. Those involved in evidence-based practice working groups also reported significantly higher scores on the Evidence-based Practice Belief Scale than participants not involved in these groups.ConclusionThis study shows that nurses have a positive attitude towards evidence-based practice, but practise it to a lesser extent. There was a positive correlation between beliefs about evidence-based practice and implementation of evidence-based practice. Beliefs related to knowledge appear to have the greatest effect on implementation of evidence-based practice. Having knowledge and taking part in evidence-based practice working groups seem important.

BackgroundUsing evidence-based practice (EBP) is one of the core skills that students should have acquired by the end of their Bachelor of Science in Nursing (BSN). However, little is known about how their beliefs about EBP and their frequency of implementation relate to multi-component educational programmes on this topic. This study aims to investigate the impact of a multi-component educational programme on nursing students’ beliefs about EBP and their frequency of implementation at the School of Health Sciences, HES-SO Valais.MethodsThis quantitative, pre–post-design study compared undergraduate nursing students’ beliefs about EBP and their frequency of implementation before and after completing a multi-component educational programme on EBP. The programme included integrative workshops based on the steps of EBP held during their clinical internships throughout their three-year curriculum. The study occurred between September 2017 and June 2020: the start and end of their studies. The programme’s impact was measured using Melnyk et al.’s self-reported EBP Beliefs and Implementation Scales. Descriptive, comparative, correlational and regression statistics were computed to evaluate nurses’ responses and scores.ResultsNinety-five eligible first-year undergraduate nursing students were invited to participate in this EBP study and 81 completed the pre- and post-test questionnaires. Mean EBP scores improved significantly versus baseline on both the Beliefs (49.1 vs. 53.3; p < 0.001) and Implementation (1.7 vs. 9.0; p < 0.001) scales. Cronbach alphas for the EBP Beliefs scale were 0.799 pre-test (95% CI: 0.729, 0.858) and 0.869 post-test (95% CI: 0.823, 0.907). Cronbach’s alphas for the EBP Implementation scale were 0.804 pre-test (95% CI: 0.736, 0.861) and 0.939 post-test (95% CI: 0.918, 0.957). There were significant correlations between EBP Beliefs and Implementation scores (p < 0.001). Linear regression analysis showed that the programme’s theory-based component contributed significantly more than clinical internships to raising EBP Beliefs and Implementation scores.ConclusionsThe multi-component educational programme on EBP improved undergraduate nursing students’ EBP Beliefs and Implementation scores. Future research should investigate means of optimally integrating EBP into undergraduate nursing curricula and explore nursing students’ intentions to implement EBP in clinical practice.

To describe beliefs about evidence-based practice and record levels of implementation among community health nurses working independently and in community healthcare centres in the canton of Valais, Switzerland. In many settings, evidence-based practice is considered a key means of delivering better and secure health care. However, there is a paucity of published studies on the implementation of evidence-based practice in community health care. Cross-sectional descriptive study (n=100). Beliefs about evidence-based practice and levels of implementation were measured using validated scales developed by Melnyk etal. (Worldviews on Evidence-Based Nursing, 5, 2008, 208). Information on respondents' sociodemographic and professional characteristics was collected. Data were analysed using descriptive and inferential statistics. The final response rate was 32.3% (n=100). More than half of respondents had previously heard about evidence-based practice; most believed in the value of using evidence to guide their practice and were prepared to improve their skills to be able to do so. However, the rate of implementation of evidence-based practice in daily practice in the 8weeks before the survey was poor. Statistically significant positive associations were found between beliefs about evidence-based practice and how respondents had heard about it and between implementation rates and whether they had heard about evidence-based practice and how they had done so. Evidence-based practices requiring scientific knowledge and skills were implemented less frequently. Greater professional community healthcare experience and management roles did not increase implementation of evidence-based practice. The systematic implementation of evidence-based practice by community health nurses working independently and in healthcare centres in Valais was rare, despite their positive beliefs about it. These results revealed the level of implementation of evidence-based practice by nurses in community healthcare settings in Valais. Further research is required to better understand their needs and expectations and to develop suitable strategies that will allow the integration of evidence-based practice into nurses' daily practice.

The research-to-practice gap often occurs when evidence-based practice (EBP) is inadequately implemented into clinical practice. Nurses are critical to bridging the gap in EBP implementation (EBPI) and identifying effective strategies to promote its use in practice; however, they need a supportive work environment to develop the necessary research capacity/culture (RCC). The purpose of this study was to examine relationships between nurses' perceptions of individual RCC and EBPI, team RCC and EBPI, and health care organization RCC and EBPI, adjusting for educational background, health care organization setting, and health care organization type. Survey data were collected from 175 nurses across the United States using a prospective cross-sectional study design. The Research Capacity in Context (RCC) tool and EBPI scale were used to measure nurses' perception of RCC and nurses' EBPI, respectively. Simple linear regression was used to assess the relationship between organizational, team, and individual RCC and EBPI. Multiple linear regression was used to adjust for pertinent participant demographics. The results of this study indicated that organization (R2 = 0.033, p = 0.016), team (R2 = 0.064, p < 0.001), and individual (R2 = 0.155, p < 0.001) RCC were significantly associated with nurse EBPI. Moreover, findings remained significant after adjusting for educational background, health care organization setting, and type. The regression model suggested that education significantly predicted EBPI (R2 = 0.142, p < 0.001). These results emphasize the importance of building RCC in health care organizations, as it can be an effective strategy to increase nurses' EBPI, which has been shown to impact patient outcomes directly. Future research should identify strategies to assist organizations and leadership in building RCC among nurses.

Background: The evidence-based practice movement has spread globally, prompting calls for evidence-based policymaking and public health. Health care being the dynamic discipline with research, is, intended to improve practice through evidence-based novel approaches. As evidence based practice (EBP) among nurses is essential for improving the quality of care, fewer pieces of evidence are available in Nepal. This study aimed to assess the perception of evidence-based practice among nurses of a tertiary hospital in Nepal. Methods: We conducted a quantitative cross-sectional study among the 100 nurses of Bir Hospital in Kathmandu. The self-administered questionnaires were applied using the survey instrument by Upton and Upton. A purposive sampling technique was employed. We calculated the mean score to assess the nurses’ perceptions in the three sub-scales of knowledge, attitude, and use of evidence-based practice. Bivariate analysis was performed to examine the relationship between subscales. Results: The majority (89.0%) of nurses did not receive training on evidence-based practices. The mean score of knowledge on EBP was 4.47±1.11, the mean score of attitude on EBP was 4.45±1.06, and the mean score of EBP use was 4.18±1.42. EBP knowledge, attitude, and use were not significantly associated with the selected demographic variables (age, work experience, EBP training and marital status). Conclusion: Nurses’ perceptions of evidence-based practice were moderate. The implementation of EBP use needs to be strengthened among the nurses. Nurses need to be more involved in the implementation of EBP. To incorporate evidence in practice, nurses require training and support from high authorities.

When it comes to evidence-based practices (EBPs) such as interactive engagement, collaborative problem solving, and project-based learning, the proof is in the name. These pedagogies are called "evidence-based" because there is little conflicting evidence about their efficacy. Yet, discipline-based education research still tends to focus on students' outcomes from EBPs, rather than on how to successfully sustain the use of those EBPs. Because of students' transient engagement with STEM higher education (i.e., a four-to five-year window), STEM education reformers should not rely on them as the primary change agents for sustained transformation of the culture in STEM fields, especially when instructors can spend decades in the STEM higher education context and touch the lives of thousands of students. That is, rather than asking about students' outcomes from EBPs, the truly transformative questions are a) given all of the evidence that EBPs are effective, why are so many instructors still unwilling to abandon straight didactic lecture, and b) why are EBP-supportive instructors still referred to as the "choir," rather than the norm? This work-in-progress begins with the hypothesis that instructors' own mental processes around teaching and learning may be the most important and least explored aspects of the slow progress in transforming the culture in STEM fields. Through the development of a brief (less than 15 question) survey, this work seeks to answer three important questions related to why instructors choose to implement EBPs (or not) in their teaching: 1. What psychological attributes correlate with sustained implementation of EBPs? 2. Are there "counterexample" instructors who successfully implement EBPs when their psychological attributes predict that they would not? 3. What factors contribute to counterexample instructors' success in implementing EBPs? By drawing out themes from the answers to these questions, this work proposes to operationalize instructors' experiences into actionable methods of helping reluctant instructors with higher psychological tolls for implementing EBPs overcome those tolls.

Uvod: Na dokazih temelječa praksa velja za zlati standard obravnave pacientov. Namen raziskave je bil preučiti odnos, znanje in ovire pri implementaciji na dokazih temelječe prakse v zdravstveni negi.Metode: Uporabljen je bil sistematični pregled znanstvene in strokovne literature. V pregled so bile vključene naslednje baze: CINAHL Plus, ProQuest Dissertations &amp; Theses Global, SpringerLink, WILEY in PubMed. Omejitvena kriterija iskanja sta bila objava članka med letoma 2008 in 2017 ter dostopnost celotnega besedila člankov v angleščini. Ključne besede iskanja: nurse, evidence based practice, implementation barriers. V končni pregled je bilo vključenih 37 člankov. Ocena kakovosti dokazov je prikazana v hierarhiji dokazov. Podatki so bili obdelani s tematsko kvalitativno analizo.Rezultati: Identificiranih je 73 kod, ki so združene v 7 vsebinskih kategorij: (1) dejavniki, ki vplivajo na negativen odnos medicinskih sester do na dokazih temelječe prakse, (2) dejavniki, ki vplivajo na pozitiven odnos medicinskih sester do na dokazih temelječe prakse, (3) znanje raziskovanja medicinskih sester za uporabo znanstvenih dokazov v kliničnem okolju, (4) znanje uporabe informacijske tehnologije za iskanje dokazov, (5) vpliv mentorstva in kompetenc za implementacijo na dokazih temelječe prakse v klinično okolje, (6) ovire organizacije za implementacijo na dokazih temelječe prakse v klinično okolje in (7) ovire medicinskih sester za implementacijo na dokazih temelječe prakse v klinično okolje.Diskusija in zaključek: Raziskava pokaže pozitiven kot tudi negativen odnos medicinskih sester do na dokazih temelječe prakse. Osredotoča se na pomanjkanja znanja in ovire, s katerimi se srečujejo medicinske sestre pri implementaciji na dokazih temelječe prakse v klinično okolje.

The aim of this paper is to discuss the effect of nurses' beliefs, knowledge, and skills on the implementation of evidence-based practice (EBP) in hospital and community settings. EBP refers to the implementation of the most up-to-date robust research into clinical practice. Barriers have been well documented and traditionally include the negative beliefs of nurses as well as a lack of time, knowledge, and skills. However, with degree entry nursing and a focus on community health care provision, what has changed? A comprehensive search of contemporary literature (2010-2015) was completed. The findings of this review show that the traditionally acknowledged barriers of a lack of time, knowledge, and skills remained; however, nurses' beliefs toward EBP were more positive, but positive beliefs did not affect the intentions to implement EBP or the knowledge and skills of EBP. Nurses in hospital and community settings reported similar barriers and facilitators.

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