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  • 1. Boström, Anne-Marie
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Gustavsson, Petter
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska Institutet.
    Registered nurses' application of evidence based practice: a national survey2009Inngår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 15, nr 6, s. 1159-1163Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background. Evidence-based practice (EBP) is a worldwide approach to improving health care. There is, however, a shortage of studies examining whether or not newly graduated health care professionals are actually applying EBP in their daily work.

    Objectives. To examine the application of EBP in clinical practice by registered nurses (RNs) 2 years post graduation and to explore whether the application of EBP differed with regard to the clinical settings where RNs were working.

    Method. A cross-sectional design using a national sample. Data were collected in 2007 from 987 RNs (response rate 76%). Six items measuring respondents' self-reported extent of applying EBP were used.

    Results. Of the 987 RNs, 19% formulated questions and performed searches in data bases, 56% used other information sources, 31% appraised the literature, 30% participated in practice development and 34% participated in evaluating clinical practice. A greater proportion of the RNs working in elder care applied EBP compared with the RNs working in hospitals, psychiatric care and primary care.

    Conclusions. The RNs applied the components of EBP to a rather low extent 2 years post graduation despite EBP being an important objective in Swedish health care and educational programmes since the 1990s. These findings support other studies reporting the implementation of EBP in organizations as a complex and often slow process. The differences in the RNs extent of applying EBP in relation to their workplace indicate that contextual factors and the role of the RN in the organization are of importance for getting EBP into practice.

  • 2. Boström, Anne-Marie
    et al.
    Wallin, Lars
    Karolinska Institutet.
    Nordström, Gun
    Evidence-based practice and determinants of research use in elderly care in Sweden2007Inngår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 13, nr 4, s. 665-73Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    RATIONALE AND OBJECTIVE: Evidence-based practice is a strategic ingredient in today's health care. Despite extensive efforts to produce and disseminate clinical guidelines, research uptake is still a difficult task. In Sweden, elderly care (EC) has shifted from hospital care to community-based care, and the major nursing-staff group in EC has no university education. These and other factors make implementation of evidence-based care particularly challenging in EC settings. The purpose of this study was to identify determinants of research utilization in EC.

    METHOD: Two questionnaires that cover research utilization and organizational climate were mailed to all staff (n = 132) working in seven EC units. The response rate was 67%.

    RESULTS: Of all respondents, 28% reported that they used research findings in daily practice (the RU group). Remaining respondents constituted the non-RU group. Significant differences existed between the RU group and the non-RU group as per six individual and six organizational factors. Using logistic regression models, four factors were significantly related to research utilization, namely: attitudes toward research (OR = 5.52, P = 0.004); seeking research that is related to clinical practice (OR = 5.56, P = 0.019); support from unit manager (OR = 4.03, P = 0.044) and access to research findings at work place (OR = 6.65, P = 0.005).

    CONCLUSIONS: Individual and organizational factors were associated with the use of research in EC. Despite distinguishing conditions in EC settings, identified factors reflect well-known determinants of research use that, as in many other health care contexts, should be considered in the endeavours of evidence-based practice.

  • 3. Hälleberg Nyman, Maria
    et al.
    Forsman, Henrietta
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ostaszkiewicz, Joanne
    Hommel, Ami
    Eldh, Ann Catrine
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Promoting evidence-based urinary incontinence management in acute nursing and rehabilitation care: A process evaluation of an implementation intervention in the orthopaedic context2019Inngår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 25, nr 2, s. 282-289Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    RATIONALE, AIMS, AND OBJECTIVES:

    The risk of developing urinary incontinence (UI) is associated with older age and hip surgery. There has been limited focus on factors that promote evidence-based UI practice in the orthopaedic context. The aim of this study was to evaluate an implementation intervention to support evidence-based practice for UI in patients aged 65 or older undergoing hip surgery.

    METHODS:

    A 3-month intervention was delivered in 2014 to facilitate the implementation of UI knowledge in orthopaedic units in 2 hospitals in Sweden. Each unit appointed a multidisciplinary team of nurses and physiotherapists or occupational therapists to facilitate the implementation. The teams were supported by external facilitators who shared knowledge about UI and implementation science. Interviews, nonparticipant observations, and audits of patient records were performed.

    RESULTS:

    Prior to the intervention, there was no use of guidelines regarding UI. The intervention raised the internal facilitators' awareness of UI risks associated with hip surgery. As internal facilitators shared this information with their peers, staff awareness of UI increased. The teams of internal facilitators described needing additional time and support from managers to implement evidence-based UI care. A management initiative triggered by the intervention increased the documentation of UI and urinary problems in 1 unit.

    CONCLUSION:

    To promote evidence-based practice related to safe procedures for older people in hospital care, there is a need to better understand strategies that successfully facilitate knowledge implementation. This study suggests that a multiprofessional team approach is promising for instigating a process towards evidence-based management of UI.

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