Odnos in znanje medicinskih sester ter ovire pri implementaciji na dokazih temelječe prakse

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 & 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

Odnos medicinskih sester do pacienta, odvisnega od prepovedanih drog

Uvod: Odnos medicinskih sester do pacientov, odvisnih od prepovedanih drog, je dejavnik, ki vpliva tako na izid zdravljenja kot na rehabilitacijo pacientov, odvisnih od prepovedanih drog. Namen raziskave je bil raziskati odnos medicinskih sester do zdravstvene obravnave pacientov, odvisnih od prepovedanih drog. Metode: Uporabili smo analizo in sintezo pregleda dokazov iz zbirk podatkov CINAHL, ProQuest Dissertations & Theses Global, SpringerLink, WILEY in PubMed. Omejitvena kriterija iskanja sta bila: objava članka med letoma 2008 in 2018 ter dostopnost celotnega besedila članka v angleščini. Oblikovan je bil konceptualni model PICOT s ključnimi besedami: »nurses«, »substance use disorders«, »attitudes«. Ocena kakovosti dokazov je prikazana v hierarhiji dokazov. Podatki so bili obdelani s tematsko analizo. Rezultati: V končni pregled je bilo vključenih 18 izbranih ustreznih člankov, identificiranih je bilo 68 kod, ki so združene v pet vsebinskih kategorij: (1) dejavniki vpliva na negativen medosebni odnos; (2) dejavniki vpliva na pozitivnejši medosebni odnos; (3) psihopatološki, vedenjski in drugi dejavniki tveganja na strani pacienta, ki imajo pomen za kakovost medosebnega odnosa; (4) posledice neustreznega odnosa medicinskih sester za zdravstveno obravnavo pacientov; (5) ukrepi za preprečevanje predsodkov in stigmatizacije pacientov, odvisnih od prepovedanih drog. Diskusija in zaključek: Raziskava potrjuje negativni odnos medicinskih sester do pacientov, odvisnih od prepovedanih drog. Določeni dejavniki so povezani tako z negativnim kot s pozitivnim odnosom medicinskih sester do teh pacientov. Njihovo proučevanje in posledice za zdravstveno oskrbo pacientov, odvisnih od prepovedanih drog, pa zahtevajo dodatne raziskave

Teaching evidence-based practice (EBP) in nursing curricula in six European countries—A descriptive study

©2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Accepted version of a Published Work that appeared in final form in Nurse Education Today. To access the final edited and published work see https://doi.org/10.1016/j.nedt.2020.104561Background: Teaching evidence-based practice (EBP) in nursing education varies among nurse educators and universities. Lack of nurses' knowledge and skills are among the barriers commonly associated with the limited use of EBP in practice. Objectives: To describe the presence, characteristics and content of courses of EBP in nursing bachelor's, master's, and PhD programs in six European countries. Design: A descriptive study design was employed. Settings: The study was implemented as part of the EBP e-Toolkit Project as a strategic partnership of six European higher education institutions from six countries in the framework of the Erasmus+ Programme. Participants: Census sampling (N = 225) was used. A total of 162 (72%) faculties responded from the following countries: Spain (79), Italy (44), the Czech Republic (15), Poland (12), Greece (7), and Slovenia (5). Methods: Three structured instruments were developed by using the consensus development panel. The research was conducted from December 2018 to March 2019. For names of subjects, a manual narrative Template Analysis was used with open descriptive coding. Results: Subjects in “EBP in Nursing or Health Care” are included in 45 (29.2%) bachelor's programs, mostly worth 180 European Credit Transfer System (ECTS) credits, 30 (28%) master's, and 6 (40%) PhD programs. In bachelor's programs, an average of 134 h are spent teaching EBP steps, followed by 127 h in master's programs and 52 h in PhD programs. EBP subjects have different focuses: clear topics in EBP, development of research knowledge, awareness of the need for evidence-based clinical work, and understanding the needs of the profession. Conclusions: Teaching EBP is not yet sufficiently integrated into nursing curricula. For more efficient integration, guidelines on the standardization of teaching approaches and content have to be developed in all three cycles of higher education. Further research is needed on the implementation of teaching at master's and PhD levels of nursing curricul

Anxiety levels in employees and students in psychiatric nursing

Introduction: Several research finding indicate that nursing care professionals are often faced with situations which may lead to anxiety. The aim of the present research was to determine the prevalence and typical signs of anxiety among nursing employees and nursing students in psychiatric settings. Methods: The Burns Anxiety Inventory was used as an assessment tool to measure anxiety. The research sample consisted of 242 participants. The data collected were processed by the descriptive statistics, Leveneʹs test, the ANOVA statistical test, the Welchʹs t-test, and the post hoc analysis. Pearsonʹs correlation coefficient was used to measure the strength of the association between the variables. Results: The results of the current study show that nearly half of the participants experience anxiety, but the differences were noted as regards their anxiety thoughts (p = 0.039). Anxiety feelings are more prevalent in female students (p = 0.046). Habitual smokers (p = 0.030) and casual smokers (p = 0.020) are more likely to develop anxious feelings and physical signs of anxiety. The anxiety signs are also more pronounced in the respondents with self-assessed lower economic status (p = 0.001) and poor self-rated health (p = 0.0001). Discussion and conclusion: The professionals and students in psychiatric nursing often encounter situations conducive to the development of anxiety. Further studies on the current topic are therefore recommended to design adequate educational programmes to timely recognise anxiety symptoms and to implement mutual and self-help measure

Pogostost in značilnosti nasilja nad zdravstvenimi delavci na področju nujne medicinske pomoči in psihiatrije

Uvod: Nasilje pacientov nad zdravstvenimi delavci je ena izmed najbolj perečih težav, s katerimi se soočajo zdravstveni delavci. Namen raziskave je bil proučiti pojavnost ter oblike nasilnih vedenj, ki so jim izpostavljeni zdravstveni delavci na področju psihiatrije in nujne medicinske pomoči. Metode: Raziskava je temeljila na neeksperimentalni kvantitativni metodi z nenaključnim priročnim vzorcem. Uporabljen je bil strukturirani vprašalnik Perception of Prevalence of Aggression Scale. Sodelovalo je 197 anketirancev. Raziskava je potekala od junija do oktobra 2015. Podatki so bili obdelani z deskriptivno statistiko, s faktorsko analizo – z metodo poševne rotacije OBLIMIN, z Mann-Whitneyevim testom in s Kruskal-Wallisovim testom. Rezultati: Zaposleni v psihiatriji so pogosteje kot ostali anketiranci soočeni z manj ogrožajočim vedenjem (U = 2092,00, p = 0,008) in ogrožajočim vedenjem (U = 1685,50, p = 0,000). Anketirani z nižjo izobrazbo in zaposleni v izmenah so tisti, ki so nasilju bolj izpostavljeni. Ženske so v primerjavi z moškimi pogosteje soočene s spolnim nasilnim vedenjem (U = 3962,00, p = 0,033). Za obvladovanje nasilnega vedenja so anketirani nezadostno usposobljeni (x = 2,8, s = 1,186). Diskusija in zaključek: Zaposleni v psihiatričnih bolnišnicah in enotah nujne medicinske pomoči se v raziskavi pogosto srečujejo z nasiljem. Potrebne bi bile raziskave, ki bi proučile povezanost usposabljanja s področja obvladovanja nasilnega vedenja pacientov na pojavnost nasilja nad zdravstvenimi delavci

Evidence-based practice beliefs and implementation among nurses with a higher education degree in Slovenia (1. Part)

Uvod: Za načrtovanje strategije uvajanja na dokazih podprte prakse v slovenski zdravstveni negi je pomembna ocena znanj, prepričanj in različnih vidikov uporabe na dokazih podprte prakse pri izvajalcih zdravstvene nege. Ocena mora biti zanesljiva, veljavna in reprezentativna, da lahko koristi načrtovanju nacionalnih strategij na tem področju. Namen raziskave je prikaz psihometrične analize uporabljenega in mednarodno uveljavljenega instrumenta.Metode: Sodelovalo je 1014 visokošolsko izobraženih medicinskih sester in zdravstvenikov z vseh treh nivojev zdravstvenega varstva. V raziskavi sta bili uporabljeni dve lestvici, in sicer »Evidence-Based Practice Beliefs Scale« in »Evidence-Based PracticeImplementation Scale«. Lestvici sta bili psihometrično analizirani s testi zanesljivosti in veljavnosti.Rezultati: Povprečna vrednost prepričanj na dokazih podprte prakse je 3,47 (s = 0,54). Zanesljivost lestvice je znašala 0,909, varianca je bila pojasnjena v 63,71 % s tremi faktorji (prepričanja v znanje, prepričanja v uporabnost, težavnost uporabe in časovna potratnost). Povprečna vrednost implementacije je 2,23 (s = 0, 89). Zanesljivost lestvice je znašala 0,969, varianca je bila pojasnjena v 68,52 % z dvema faktorjema (uporaba znanj, uporaba korakov).Diskusija in zaključek: Testirana instrumenta se pokažeta kot zanesljiva in veljavna. Raziskava zelo poudari primanjkljaj znanj za razvoj na dokazih podprte prakse in znanj, ki so del vsakodnevnih razvojnih aktivnosti v delokrogu visokošolsko izobražene medicinske sestre. Zahtevajo se aktivnosti za izboljšanje stanja na ravni visokošolskih in zdravstvenih zavodov, kot na ravni nacionalnih združenj v zdravstveni negi.Introduction: Planning the strategy of evidence-based care implementation in Slovenian nursing calls for an assessment of knowledge, beliefs, and various aspects of evidence-based care implementation among nursing care providers. The assessment should be reliable, valid and representative in order to be used for the planning of national strategies in this field. The aim of the article is to present the psychometric analysis results of the internationally-renowned instrument used.Methods: A total of 1,014 nurses with a higher education degree from all three levels of health care participated in the research. Two established scales were used in the research: Evidence-Based Practice Beliefs Scale and Evidence-Based Practice Implementation Scale. A psychometric analysis of the data was conducted using reliable, valid tests.Results: The mean value for evidence-based practice beliefs was 3.47 (s = 0.54). Reliability of the scale was 0.909, the variance was explained in 63.71% with three factors (beliefs in knowledgebeliefs in usefulnessdifficulty of implementation and time efficiency). The mean value for implementation was 2.23 (s = 0.89). Reliability of the scale was 0.969, the variance was explained in 68.52% with two factors (application of knowledgeapplication of implementation steps).Discussion and conclusion: The tested instruments have proven to be reliable and valid.Research results clearly demonstrate insufficient knowledge for the development of evidence-based practice and knowledge that is required for daily development activities implemented by nurses with a higher education degree. Steps should be taken to improve the situation in higher education institutions, healthcare institutions, and at the level of national nursing associations

Beliefs and implementation of evidence-based practice among nurses with a higher education degree (2. Part)

Uvod: Zaposleni v zdravstveni negi še vedno niso dovolj opolnomočeni s kompetencami o dokazih podprti praksi. Namen raziskave je bil prepoznati dejavnike, ki oblikujejo prepričanja in tudi implementacijo na dokazih podprte prakse medicinskih sester na vseh ravneh zdravstvenega varstva v Sloveniji. Metode: Izvedena je bila presečna raziskava. Uporabljeni sta bili dve lestvici, in sicer »Evidenced based practice Beliefs Scale and the Implementation Scale«. Sodelovalo je 1014 visokošolsko izobraženih medicinskih sester in zdravstvenikov z vseh treh nivojev zdravstvenega varstva. Podatke smo obdelali z opisnimi, eksplorativnimi in eksplikativnimi statističnimi metodami. Rezultati: O raziskovanju na področju zdravstva se je izobraževalo n = 325 (38,8 %) anketirancev, o dokazih podprti praksi n = 280 (34 %) anketirancev. Pozitivna prepričanja o dokazih podprte prakse pojasnijo samoocena znanja o dokazih podprti praksi (β = 0,249) in raziskovanju (β = 0,162), leta zaposlitve (β = –0,124), zadovoljstvo z delom (β = 0,117), izobraževanje o dokazih podprti praksi (β = 0,092) in izobrazba strokovni magisterij (β = 0,077). Pogostejšo implementacijo pojasnijo pozitivna prepričanja o dokazih podprte prakse (β = 0,306) in zaposlitev v zdravstvenem domu (β = 0,132). Diskusija in zaključek: Pomanjkanje znanja o raziskovanju in dokazih podprte prakse se pokažeta kot najtrdnejša napovedna dejavnika za razvoj prepričanj, medtem ko so pozitivna prepričanja trden napovednik za pogostejšo implementacijo na dokazih podprte prakse. Karierni razvoj medicinskih sester in zdravstvenikov na primarni ravni, ki je osredinjen na prevzem novih nalog, se pokaže kot pomemben dejavnik implementacije na dokazih podprte prakse med vključenimi v raziskavo.Introduction: Nursing professionals are still not sufficiently empowered to use evidence-based practice competences. The aim of the study was to identify the factors shaping the beliefs on and implementation of evidence-based practice among nurses working in the Slovenian health care system. Methods: This study used a cross-sectional research design. A total of 1,014 nurses with a higher education degree from all three levels of the health care system participated in the study. Two scales were used: EBP Beliefs Scale and EBP Implementation Scale. Data were processed using descriptive, exploratory, and explanatory methods. Results: Overall, a total of 325 participants (38.8%) had received education and training in research, compared to 280 of those (34%) who had received education and training in evidence-based practice. Self-assessed knowledge about research and evidence-based practice was highest among respondents with a master’s degree. Beliefs about evidence-based practice were explained by self-assessed knowledge of evidence-based practice (β = 0,249) and research (β = 0,162), total years of employment (β = ‒0,124), job satisfaction (β = 0,117), training in evidence-based practice (β = 0,092), and master\u27s degree (β = 0,077). Implementation of evidencebased practice is explained by beliefs regarding evidence-based practice (β = 0,306) and employment at a community health centre (β = 0,132). Discussion and conclusion: Lack of knowledge in research and evidence-based practice and the importance of knowledge obtained through master\u27s programmes are central to developing beliefs regarding evidencebased practice and improving its implementation. Career development at the primary level focused on taking on new roles and linked to both postgraduate education and independent work in nursing proved to be an important factor in the implementation of evidence-based practice