Advancing long term care: central European perspectives.

Item does not contain fulltext1 september 201

Teaching evidence-based practice (EBP) in nursing curricula in six European countries\u2014A descriptive study

Background: 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 \u201cEBP in Nursing or Health Care\u201d 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 curricula

Providing a teaching and learning open and innovative toolkit for evidence-based practice to nursing European curriculum (EBP e-Toolkit): Project rationale and design

Evidence-based practice (EBP) is an instrument of great utility in making clinical decisions in nursing care, improving the quality of nursing care and patients\u2019 health outcomes. There is no European framework for EBP competency, and no guidelines for EBP teaching. The general concept of the project \u2018Providing a Teaching and Learning Open and Innovative Toolkit for Evidence-based Practice to Nursing European Curriculum: (EBP e-Toolkit)\u2019 is to fill this gap in Nursing education across Europe and to foster and harmonize the teaching and learning of EBP in the European nursing curricula and to produce the acquisition of EBP competence earlier in professional life. The project is organized along four major outputs, and a dissemination and sustainability plan has been set up. A mixed method research constitutes the main methodological approach applied in the project. This methodology requires the active participation of all research groups, partners, steering committee, nursing students, and educators, in the project. The use of the EBP e-Toolkit will increase nurses\u2019 and nursing students\u2019 level of EBP competence by formulating specific guidelines to be implemented in EBP teaching

Core Evidence-Based Practice Competencies and Learning Outcomes for European Nurses: Consensus Statements

Background: Consensus on evidence-based practice (EBP) competencies and associated learning outcomes for registered nurses has not yet been achieved in the European context. Aims: To establish a set of core EBP competencies for nurses and the most important EBP learning outcomes encompassing attitudes, knowledge, and skills dimensions for implementation into nursing education in European countries. Methods: A multi-phase modified Delphi survey was conducted: Phase 1, a literature review; Phase 2, a two-round consensus of experts; and Phase 3, a Delphi survey. Experts from six European countries participated. Results: In Phase 1, 88 records were selected and 835 statements extracted, which were grouped according to the seven steps of EBP. After removing 157 duplicates, the remaining competencies (n = 678) were evaluated in Phase 2. Then, a two-round expert consensus was reached, with 24 competencies and 120 learning outcomes identified and divided into affective, cognitive, and skills domains. In Phase 3, based on a Delphi survey expert consensus, all evaluated statements were included in a final set of competencies and learning outcomes. Only two learning outcomes were recommended for allocation to a different domain, and four were reformulated as suggested, with no further changes to the others. Linking Evidence to Action: The set of EBP competencies and learning outcomes can guide nurse educators, managers, and EBP stakeholders in the development of content that incorporates EBP knowledge, skills, and attitudes into educational programs. Prioritizing the EBP competencies and learning outcomes that are most necessary and adapting them to every context will provide healthcare organizations with guidelines for enhancing the continuing education of nurses. These results could facilitate the development of effective tools for assessing nursing students’ and nurses’ perception of competencies required for EBP processes

Educational interventions for teaching evidence-based practice to undergraduate nursing students: A scoping review

Background: Evidence-based practice (EBP) is the appropriate approach to guide healthcare personnel in their clinical practice. Despite the importance of EBP, undergraduate nursing students are not very much engaged and have a lack of knowledge and skills. Aim: The aim of this study was to gather, assess and synthesize evidence on educational interventions promoting evidence-based practice competencies in traditional undergraduate nursing students. Methods: This is a scoping review on sixteen English and non-English databases. A data extraction form was established including authors, year of publication, country, types of participant, specific objectives, study design, educational intervention, comparison if existed, and outcomes of significance. Results: The search strategy retrieved 8901 records in total. After screening for duplicates and eligibility, 20 articles were included in the qualitative synthesis. Improvement in EBP domains such as knowledge, skills, attitudes/behaviours, EBP beliefs, use, practice, level of evidence, critical thinking and future use of EBP were mentioned and assessed in different studies. Conclusions: EBP training can improve nursing students’ capacity in healthcare provision. Teaching EBP competencies along undergraduate nursing curricula should be a high priority at nursing programmes. The use of innovative approaches seems to be more effective than traditional ways. Education of EBP increases its future use and critical thinking and EBP programs improve self-efficacy and the level of evidence utilization

Significados das hierarquias no trabalho em hospitais públicos brasileiros a partir de estudos empíricos

OBJETIVO: Compreender como as estruturas hierárquicas presentes na cultura organizacional de hospitais públicos brasileiros significam no trabalho hospitalar. MÉTODOS: O corpus da pesquisa originou-se em quatro teses e seis dissertações e foi organizado, analisado e interpretado sob a perspectiva da antropologia simbólica-interpretativa. RESULTADOS: Hospitais estão calcados na burocracia profissional e mecanicista, e as hierarquias, decorrentes dessas estruturas, produzem significados que interpretados indicam fragmentação das relações, disputas profissionais e distanciamentos, bem como conflitos e comportamentos subversivos no trabalho, respectivamente. CONCLUSÃO: As hierarquias em cada uma das burocracias encaminham diferentes enfrentamentos que desestabilizam os trabalhadores e seus processos de trabalho. Estratégias de reorientação e conscientização dos limites hierárquicos devem ser equacionadas, para que o trabalho seja otimizado.Objective: Understand the meaning, in hospital work, of hierarchical structures present in the organizational culture of Brazilian public hospitals. Methods: The corpus of research was originated in four theses and six dissertations, and was organized, analyzed and interpreted from the perspective of symbolic anthropology interpretation. Results: Hospitals copied the professional mechanistic bureaucracy and hierarchies, from these structures, produce meanings that indicate a fragmentation of relationships, professional disputes and separations, as well as conflicts and subversive behavior at work. Conclusion: The hierarchies in each of the bureaucracies created several clashes that disrupt the workers and their work processes. Reorientation strategies and awareness of the hierarchical boundaries should be studied so that the work is optimized.Objetivo: Comprender que significan, en el trabajo hospitalario, las estructuras jerárquicas presentes en la cultura organizacional de hospitales públicos brasileños. Métodos: El corpus de la investigación se originó en cuatro tesis y seis disertaciones y fue organizado, analizado y interpretado bajo la perspectiva de la antropología simbólica interpretativa. Resultados: Los Hospitales copian la burocracia profesional y mecanicista, y las jerarquías, provenientes de esas estructuras, producen significados que indican una fragmentación de las relaciones, disputas profesionales y distanciamientos, así como conflictos y comportamientos subversivos en el trabajo. Conclusión: Las jerarquías en cada una de las burocracias crean diferentes enfrentamientos que desestabilizan a los trabajadores y a sus procesos de trabajo. Estrategias de reorientación y concientización de los límites jerárquicos deben ser estudiadas, para que el trabajo sea optimizado