Assessment of an intervention for the diffusion of evidence-based nursing in a teaching hospital

Camargo, Fernanda Carolina; Iwamoto, Helena Hemiko; Monteiro, Damiana Aparecida Trindade; Lorena, Lourraine Tavares; Pereira, Gilberto de Araújo

doi:10.1590/1983-1447.2016.esp.68962

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Original Papers • Rev. Gaúcha Enferm. (Online) 37 (spe) • 2016 • https://doi.org/10.1590/1983-1447.2016.esp.68962 linkcopy

Assessment of an intervention for the diffusion of evidence-based nursing in a teaching hospital

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective To evaluate an intervention for the diffusion of evidence-based practice among the nurse leaders of a public teaching hospital.

Methods This is a descriptive-quantitative study based on the evaluation of workshops at a teaching hospital in the Triângulo Mineiro region of the state of Minas Gerais, Brazil, in 2016, conducted from the conceptual perspective of “Diffusion of Innovation and Skills for the Use of Evidence-Based Nursing in Care Settings”. We applied an Evidence-Based Practice Questionnaire and analysed the individual evaluations of each participant according to the frequency of cores of meaning and the calculation of content validity index.

Results Ninety percent of the nurse leaders agreed to participate in the evaluation. The leaders had a positive attitude toward incorporating evidence into practice (average = 5.4; SD = ±1.3). Their main difficulty was the ability to understand research (average = 3.5; SD = ±1.3). Motivational aspects related to intervention had the highest content validity index (CVI = 0.9).

Conclusion The workshops encouraged the diffusion of information regarding the need to incorporate scientific evidences to better qualify the care provided by nurse leaders in the public teaching hospital.

Evidence-based nursing; Evidence-based practice; Hospitals, teaching

Stages	Model of Rogers	Proposal of Melnyk, Gallagher-Ford and Fineout-Overholt
I	Knowledge stage: relates to the understanding of the social system variables regarding the need to change and incorporate innovations	Identify problems in the nursing practice. Formulate questions using the PICOT strategy and conduct a systematic search of evidence, anchored in quality research results
II	Persuasion stage: corresponds to the relative advantages caused by change and the adoption of innovation	Involve interested parties (nursing co-workers, and other professionals; institution leaders; people, families and other groups that may benefit from the changes in care) that can contribute to criticism and the implementation of the intervention in the healthcare setting
III	Decision stage: corresponds to the adoption or rejection of the proposed change and incorporation of innovations	Integrate evidence with the nurses` expertise and preferences of the users for the adoption of the best clinical decision
IV	Confirmation stage: refers to the diffusion of results and the reorganisation of the system for change and the incorporation of innovations	Assess the impact of the intervention; diffuse the results among the users, co-workers and policymakers. Incorporate the evidence to internal protocols in order to generate the best practices in the healthcare environment. Support other working groups in the conduct of EBN

Aspects^a	Average	SD
Performs professional practice according to EBN
Formulated a question	5.1	1.2
Sought relevant evidence once the question was formulated	4.7	1.3
Critically evaluated all the literature found	4.7	1.3
Combined the evidence with his/her knowledge and experience	4.6	1.1
Evaluated the results of his/her practice	4.6	1.5
Shared this knowledge with co-workers	4.2	1.2
Total	4.7	1.3
Attitudes related to EBN
Set time for new evidence in my work schedule	3.6	1.8
I am open to questions about my practice	5.9	1.3
EBNs are fundamental for professional practice	6.6	0.7
I change the practice according to the evidence I have found	5.4	1.2
Total	5.4	1.3
Knowledge and skills for EBN
Research skills	3.5	1.3
Computer skills	4.3	1.3
Monitoring and practice review skills	4	1
Ability to transform needs into research questions	3.9	1.1
Knowledge of the main types and sources of information	4.1	0.9
Ability to identify gaps in professional practice	4.7	1.1
Knowledge on how to collect evidence	3.6	1.1
Ability to critically analyse the evidence	4.3	0.9
Ability to determine validity of the material	4.4	0.6
Ability to determine clinical applicability	4.4	1.2
Ability to apply the knowledge to individual cases	4.4	1
Shares ideas and knowledge with co-workers	4.1	0.8
Diffusion of new ideas about care among co-workers	4.3	0.9
Ability to review his/her own practice	4.9	0.9
Total	4.2	1

Thematic Dimension	n(%)^a
Conceptual apprehension of EBN
Incorporation of research results into practice	15 (23.4)
Knowledge, attitudes and practices that facilitate EBN	7 (10.9)
Responsibility for the authorisation of research projects in the hospital	7 (10.9)
EBN as a resource to systematise nursing care	6 (9.4)
Concept of EBN	6 (9.4)
Research design	6 (9.4)
Steps for implementing EBN	5 (7.8)
Classification of levels of evidence	4 (6.3)
Healthcare quality and patient safety through EBN	4 (6.3)
Barriers to the implementation of EBN	3 (4.7)
History of EBN	1 (1.6)
Motivational aspects for the diffusion of EBN
Opportunity to expose the practice reality	23 (18.9)
Group interaction	14 (11.4)
Feeling of potential for change of the hospital reality	14 (11.4)
Identification of local structures that support EBN	12 (9.5)
Expansion of autonomy and critical judgment of the nurse	11 (8.9)
Encourage partnerships between faculty, researchers and nurses	10 (8.2)
Stimulate personal initiatives for the adoption of EBN	8 (6.5)
Awakening to the production and consumption of research findings	7 (5.7)
Capacity to deal with the feelings generated due to the barriers of EBN	7 (5.7)
Possibility to review the professional performance	6 (4.9)
Learning by a non-traditional method	6 (4.9)
Exchange of experiences	5 (4.1)

Thematic Dimension	CVI

	Average	Median	SD
Conceptual apprehension of EBN	0.7	0.6	0.1
Motivational aspects for the diffusion of EBN	0.9	0.9	0.1

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Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
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[TFN1001] Source: Prepared by the authors, 2016.