Integration of Evidence-Based Practice in Nursing Education

Evidence based practice (EBP) has gained momentum globally, to provide effective and efficient health care. Although EBP has evolved to a great extent over the last two decades and is accepted as an important concept by all health care professionals, its integration in practice is still challenging. Integration of EBP in nursing profession both in nursing practice and nursing education is an important issue. This article describes the experience of the authors in integrating evidence based practice in nursing education in Manipal University. It focuses on the training of nurse educators in EBP, alignment of EBP in curriculum and EBP practicum in curriculum so as to enable a nurse to identify evidences, make appropriate clinical decisions and utilize EBP in rendering scientific and quality patient care

Rubrics in Nursing Education

Evaluating assignments or course work is a challenging job for faculty of nursing. In order to avoid the dilemmas of evaluation, nurse educators use rubrics as an evaluation tool. In educational technology, rubric refers to „performance standard‟ for a student population. A rubric is defined as an assessment tool that lays out the set standards and criteria to assess a performance, assignment or behavior. The four essential components of a rubric are task description, scale of achievement, dimensions & description of dimensions. Various types of scoring rubrics are available. The type of rubric chosen for assessment depends on the task being evaluated and the needs of the assessor. Holistic rubrics, analytic rubrics, generic rubrics, specific rubrics are the different types of rubrics. In nursing education, rubrics has got wide range of applications such as to; assess clinical skills, grade assignments, evaluate clinical competency and analyze presentations. Rubrics helps to define "quality performance” and promote awareness on critical components in a performance. Rubrics not only act as an evaluation tool for instructors, but also act as a feedback proforma for students. Rubrics are vital tools that can be utilized to solve the problem of subjectivity in evaluation. Rubrics provide consistency in evaluation, reduces subjectivity and enhances objectivity

Coupled catastrophes: sudden shifts cascade and hop among interdependent systems

An important challenge in several disciplines is to understand how sudden changes can propagate among coupled systems. Examples include the synchronization of business cycles, population collapse in patchy ecosystems, markets shifting to a new technology platform, collapses in prices and in confidence in financial markets, and protests erupting in multiple countries. A number of mathematical models of these phenomena have multiple equilibria separated by saddle-node bifurcations. We study this behavior in its normal form as fast--slow ordinary differential equations. In our model, a system consists of multiple subsystems, such as countries in the global economy or patches of an ecosystem. Each subsystem is described by a scalar quantity, such as economic output or population, that undergoes sudden changes via saddle-node bifurcations. The subsystems are coupled via their scalar quantity (e.g., trade couples economic output; diffusion couples populations); that coupling moves the locations of their bifurcations. The model demonstrates two ways in which sudden changes can propagate: they can cascade (one causing the next), or they can hop over subsystems. The latter is absent from classic models of cascades. For an application, we study the Arab Spring protests. After connecting the model to sociological theories that have bistability, we use socioeconomic data to estimate relative proximities to tipping points and Facebook data to estimate couplings among countries. We find that although protests tend to spread locally, they also seem to "hop" over countries, like in the stylized model; this result highlights a new class of temporal motifs in longitudinal network datasets.Comment: 20 pages, 4 figures, plus a 6-page supplementary material that contains 5 figures. Accepted at Journal of the Royal Society Interfac

A business model design framework for viability:a business ecosystem approach

Purpose: To facilitate the design of viable business models by proposing a novel business model design framework for viability. Design: A design science research method is adopted to develop a business model design framework for viability. The business model design framework for viability is demonstrated by using it to design a business model for an energy enterprise. The aforementioned framework is validated in theory by using expert opinion. Findings: It is difficult to design viable business models because of the changing market conditions, and competing interests of stakeholders in a business ecosystem setting. Although the literature on business models provides guidance on designing viable business models, the languages (business model ontologies) used to design business models largely ignore such guidelines. Therefore, we propose a business model design framework for viability to overcome the identified shortcomings. The theoretical validation of the business model design framework for viability indicates that it is able to successfully bridge the identified shortcomings, and it is able to facilitate the design of viable business models. Moreover, the validation of the framework in practice is currently underway. Originality / value: Several business model ontologies are used to conceptualise and evaluate business models. However, their rote application will not lead to viable business models, because they largely ignore vital design elements, such as design principles, configuration techniques, business rules, design choices, and assumptions. Therefore, we propose and validate a novel business model design framework for viability that overcomes the aforementioned shortcomings

Effectiveness of an Evidence-Based Practice Training Program for Nurse Educators: A Cluster-Randomized Controlled Trial

BACKGROUND: Evidence-based practice (EBP) endeavors to integrate the best available evidence with clinical expertise and patient preference to enhance clinical outcomes. For nurses to effectively demonstrate EBP, the concepts of EBP should be systematically incorporated into the nursing curriculum, with nurse educators playing a pivotal role in execution. However, the effect of EBP training programs on nurse educators remains largely unexplored. AIM: To evaluate the effectiveness of an EBP training program on the knowledge, attitude, practice, and competency of nurse educators. METHODS: A pragmatic randomized controlled trial was conducted at a nursing education institution. Fifty-one nurse educators were cluster randomized into intervention and control groups. A 30-hour EBP training intervention was provided for nurse educators in the intervention group. The outcome variables were knowledge, attitude, practice, and competency regarding EBP. These outcomes were evaluated using the EBP knowledge and practice questionnaire, EBP attitude scale, and Fresno test. Data were collected at baseline, the end of 5 months, and the end of 10 months. RESULTS: Fifty-one eligible participants were enrolled in the study. The intervention and control group had three clusters each with 27 and 24 participants, respectively. Participants in both groups were comparable for variables such as age, years of experience, and educational background (p > .05). Between groups, outcome variables were compared using mixed linear multi-level modeling. Nurse educators who received the EBP training program demonstrated significant differences in knowledge (p < .05), attitude (p < .05), practice (p < .05), and competency scores (p < .05), than that of the control group, indicating the intervention effectiveness. LINKING EVIDENCE TO ACTION: EBP training programs are effective in improving the knowledge, attitude, practice, and competency of nurse educators

An assessment framework of business modelling ontologies to ensure the viability of business models

Organisations operate in an increasingly dynamic environment. Consequently, the business models span several organisations, dealing with multiple stakeholders and their competing interests. As a result, the enterprise information systems supporting this new market setting are highly distributed, and their components are owned and managed by different stakeholders. For successful businesses to exist it is crucial that their enterprise architectures are derived from and aligned with viable business models. Business model ontologies (BMOs) are effective tools for designing and evaluating business models. However, the viability perspective has been largely neglected. In this paper, current BMOs have been assessed on their capabilities to support the design and evaluation of viable business models. As such, a list of criteria is derived from literature to evaluate BMOs from a viability perspective. These criteria are subsequently applied to six well-established BMOs, to identify a BMO best suited for design and evaluation of viable business models. The analysis reveals that, although none of the BMOs satisfy all the criteria, e3-value is the most appropriate BMO for designing and evaluating business models from a viability perspective. Furthermore, the identified deficits provide clear areas for enhancing the assessed BMOs from a viability perspective

Towards the drivers of value creation in the biogas industry:enablers and inhibiters in the Netherlands

The Dutch biogas industry is developing slowly and in many instances still unviable. Insights in the drivers of value creation may help to create viable biogas business networks. This research explores these related drivers and accordingly, proposes a new and comprehensive definition of a driver of value creation. This definition focuses on the enabling and inhibiting factors of value creation in a business network and forms the backbone of three case studies. The results suggest the presence of four specific drivers as necessary for a viable biogas business network: stability and certainty, partner alignment, local opportunities and economies of scale

Undertaking Systematic Reviews in Nursing

Health care knowledge is rapidly evolving with inexorable volumes of research based information geing published every day. Systematic reviews provide comprehensive and unbiased summaries of a research on a single topic. Systematic reviews are considered as the gold standard for summarizing evidence found in research literature. The objective of this article is to sensitize nurses regarding systematic reviews by summarizing major steps and process involved in doing a systematic review. Doing a systematic review requires significant planning and execution. This article is an introductory description on how to undertake a systematic review. A thorough understanding of systematic review is necessary to make a quality review. Following the systematic rigorous methodology helps to reduce bias and improve the reliability and accuracy of conclusions

Resources for Evidence-Based Health Care: Accessibility and Availability

Evidence – Based Practice (EBP) is a problem solving approach to clinical care that incorporates the conscientious use of current best evidence from well-designed studies, clinician’s expertise, and patient values and preferences (Melnyk & Fineout-Overholt, 2005; Sackett, Straus, Richardson, Rosenberg, &Haynes, 2000). It is important to see clinical expertise as the ability to integrate research evidence and patients' circumstances and preferences to help patients arrive at optimal decisions (Guyatt, Cook,& Haynes, 2004). Research has shown that patient outcomes are 28% better when clinical care is based upon evidence, versus clinical practice steeped in tradition (Heater, Becker, & Olsen, 1998). The process of EBP minimizes the translation time needed for incorporating research findings into practice and clarifies the differences between ritualistic practice, habitual approaches, personal preferences, anecdotal experiences, empirical data, and statistical significance to support nursing practice (Alspach, 2006). The availability of evidence based practice tools and methods helps in faster identification of the best available evidence to provide care at the point it matters most. Implementing EBP in health care is complex and challenging. One of the main components of EBP is retrieving evidence from different sources. Information explosion with thousands of health literature and research papers published every year has created a need to expand the knowledge base for providing evidence based health care worldwide. Retrieval of evidence from various sources may be difficult due to several reasons. It may be difficult for health professionals to find the best available evidence due to time constraints (Ervin, 2002) or lack of knowledge among health professionals to effectively search for evidence (Sitzia, 2002). It is even difficult to find authentic sources of evidence