| 1. |
- Hellström, Amanda, et al.
(författare)
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Promoting sleep by nursing interventions in health care settings : A systematic review
- 2011
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Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley. - 1545-102X .- 1741-6787. ; 8:3, s. 128-142
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sleep disturbances are a common problem among individuals in hospitals and institutions. Although several studies have explored this phenomenon, there is still a lack of knowledge about the effectiveness of sleep-promoting nursing interventions. This systematic review aims to describe and evaluate the effectiveness of sleep-promoting nursing interventions in health care settings. Design: A systematic review was performed. Method: In June 2009, a literature search was carried out in the following databases: Academic Search Elite, CINAHL, the Cochrane Library and MedLine/PubMed. Fifty-two references were identified and after critical appraisal nine studies were selected. A compilation of the results and the outcomes of the interventions were carried out. Further, the evidence strength of the interventions was assessed. Findings: Evidence for the nursing interventions sleep hygiene, music, natural sound and vision, stimulation of acupoints, relaxation, massage and aromatherapy, is found to be low or very low. Still large effects of interventions where found when using massage, acupuncture and music, natural sounds or music videos. The use of sleep hygiene and relaxation on the other hand showed only small effects. Conclusion: The paucity of studies implies that the confidence in the effects shown, and the lack of high evidence strength for many nursing interventions, most certain will change if further studies are carried out. The uncertainty about the effects calls for more research before implementing the interventions into clinical practice.
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| 2. |
- Sandströma, Boel, et al.
(författare)
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Promoting the Implementation of Evidence-Based Practice: A Literature Review Focusing on the Role of Nursing Leadership.
- 2011
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Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley. - 1741-6787 .- 1545-102X. ; 8:4, s. 212-223
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Despite a growing interest in evidence-based practice (EBP), the implementation into clinical practice of knowledge derived from research has proved to be a cumbersome process. Additionally, the literature seems to present a fragmented picture with research mainly focusing on a few factors of possible importance, among which leadership appears to be one of the more important. Thus, this study aimed to systematically review the literature regarding leadership and its possible influence on the process of implementing EBP. Approach: A literature review was conducted. Electronic database searches were conducted to identify studies on leadership, administrators, managers, implementation, evidence-based and nursing. The search identified 43 potentially relevant papers, of which 36 were excluded after an appraisal was performed by two independent reviewers. Results were extracted and synthesised into a narrative text. Findings: Seven papers were included in the literature review. The findings can be divided into three major areas: (1) characteristics of the leader, (2) characteristics of the organisation and (3) characteristics of the culture. Our findings indicate that leadership is vital for the process of implementing EBP in nursing and also highlights the possible importance of the organisation and the culture in which the leader operates. These factors together with their characteristics were interpreted to be intrinsic in the creation of a nursing milieu that is open and responsive to the implementation of EBP. Conclusions: Although there seems to be scholarly agreement that leadership is a vital part of the process of implementing EBP, more rigorous research is needed concerning the possible role of the leader. Our findings also indicate that leadership cannot be studied in isolation or without being clearly defined.
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| 3. |
- Wallin, Lars, et al.
(författare)
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Newborn individual development care and assessment program (NIDCAP) : a systematic review of the literature
- 2009
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Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley. - 1545-102X .- 1741-6787. ; 6:2, s. 54-69
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Forskningsöversikt (refereegranskat)abstract
- Background: Important advancements have been made in the care of preterm infants. Health services have introduced various methods aimed at promoting attachment, breastfeeding, and neurological development. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP), developed to stimulate preterm infants at levels adapted to the child's degree of neurological maturity, is increasingly being used.Objectives: The aim was to investigate the impact of NIDCAP on the psychomotor development, neurological status, medical/nursing care outcomes, and parental perceptions. A further aim was to evaluate the cost-related effects of NIDCAP.Data Extraction and Analysis: A literature search up to September 2007 was performed. The reviewed papers were assessed for methodological quality and only statistically significant findings were extracted.Findings: The evidence compiled on the effects of NIDCAP is based on 12 articles from six randomized controlled trials that included approximately 250 children. Each of the studies was assessed as having medium quality. Most of the studies were small and many investigated a huge number of outcome variables, which decreased their scientific strength. On outcome variables in which a significant difference was found between the intervention (NIDCAP) and control groups, most studies showed better results for the NIDCAP group. This was particularly valid for cognitive and psychomotor development. Four studies also showed a reduced need for respiratory support for the NIDCAP group. No studies were identified that weighed the total cost of NIDCAP against its effects.Conclusions: Despite promising findings, primarily on cognitive and motor development, the scientific evidence on the effects of NIDCAP is limited. Shortcomings in design and methods in the reviewed studies hamper far-reaching claims on the effectiveness of the method. Scientific grounds for assessing the effects of NIDCAP would be substantially enhanced by a sufficiently comprehensive study with extended follow-up and a clear focus on a few important outcome variables.
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| 4. |
- Annersten, Magdalena, et al.
(författare)
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is : a literature review
- 2005
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Ingår i: Worldviews on Evidence-Based Nursing. - : Alpha Beta Sigma. - 1545-102X .- 1741-6787. ; 2:3, s. 122-130
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Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- Background: Persons using daily subcutaneous injections to administer medicine perform them in different ways and thereby increase the risk of skin complications related to the injection. It is often part of nurses’ role to administer medicine and educate the patient in injection technique. Course literature in nursing education, commercial patient education pamphlets, and instructional leaflets do not give consistent advice regarding subcutaneous injection technique. Aim: The aim of this review was to identify the scientific foundation for the technical performance of subcutaneous injections. The question to be answered was: How should a subcutaneous injection be administered to achieve the right dose in the right place with minimum complications? Method: The review included a search in three databases, a screening process at abstract level, followed by a quality assessment of included articles. The quality assessment was done independently by two people and followed specific protocols. Result: A total of 38 articles were assessed for quality and covered information on dose, location, and complications of subcutaneous injection. The assessed studies are heterogeneous in design and describe different aspects of the subcutaneous injection technique. Therefore, the scientific foundation for technical performance is weak. However, several studies indicate that the amount of subcutaneous fat and appropriate needle length are of high importance for the drug to reach the target tissue. Conclusion: More research regarding effective subcutaneous injection technique needs to be done.
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| 5. |
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| 6. |
- Jakobsson, Jenny, et al.
(författare)
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Searching for Evidence Regarding Using Preoperative Disinfection Showers to Prevent Surgical Site Infections : A Systematic Review
- 2011
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Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley. - 1545-102X .- 1741-6787. ; 8:3, s. 143-152
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Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- Background: Postoperative surgical site infections (SSI) are the third most common health care associated infection. Even though several studies have pointed out the benefits of disinfection showers prior to surgery in order to reduce SSI, it remains unclear how to optimize this disinfection procedure. Aim: To find evidence for how many times preoperative disinfection showers should be performed in order to reduce bacterial colonies and minimize the risk of SSI. Method: A comprehensive literature search of multiple databases published during 1986-2008, supplemented by a manual search of the references in all relevant articles. Protocols were used in quality assessment and the data synthesis is descriptive in a narrative form. Results: The 10 studies included had different designs, interventions, and samples, which makes it difficult to compare them. Moreover, the quality of the reviewed studies varied and only four had a high level of evidence. Therefore, the results failed to give an unambiguous answer about the optimal number of preoperative showers, so only assumptions can be made. It is quite obvious, however, that preoperative disinfection showers with chlorhexidine gluconate (CHG) are effective from a microbiological point of view since eight of the reviewed studies showed a sharply reduced skin flora after using CHG. Conclusions: Currently, clear evidence for how many times preoperative disinfection showers should be performed to minimize the risk of SSI is missing. This highlights the need for further research that focuses on the number of preoperative disinfection showers in relation to SSI, in order to obtain optimal effect. Until then, it would be wise to follow previously made recommendation of three to five preoperative showers. Moreover, in order to have the intended effect of preoperative disinfection, it is important that health care professionals have the knowledge to guide patients with information and clear instructions about disinfection shower procedures.
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| 7. |
- Jansson, Inger, et al.
(författare)
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Factors and Conditions That Have an Impact in Relation to the Successful Implementation and Maintenance of Individual Care Plans
- 2011
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Ingår i: Worldviews on Evidence-Based Nursing. - Oxford : Blackwell Publishing. - 1545-102X .- 1741-6787. ; 8:2, s. 66-75
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Tidskriftsartikel (refereegranskat)abstract
- Background: The gap between what is stated in legislation about written individualized nursing care plans (ICP) and how they are used in practice is still too wide. Aim: To explore attitudes and experiences among nurses and managers in order to capture which factors and conditions impact on the successful implementation of individual care plans within hospital care, as well as the strategies that were adopted to ensure continued use. Method: The study was carried out through directed content analysis guided by the Promoting Action on Research Implementation in Health Services framework. Interviews were conducted with 15 informants on different operational and decision levels at a hospital that is well known in Sweden for its work in the ICP area. Findings: Important factors for implementation on the wards were clear instructions from the hospital management at the start of implementation as well as clear roles and mandates for those involved. The work of internal facilitators was crucial for the continuation of the process. Clinical experience was important as the long-term driving force. Implications: On the basis of the findings of this study, we argue that it is important for hospital managers to recruit leaders that focus on individual nursing care and can highlight needs and instigate change. It seems also important that the organization takes advantage of the potential of skilled facilitators.
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| 8. |
- Johansson, Maria Eiman, et al.
(författare)
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Registered Nurses´Adherence to Clinical Guidelines Regarding Peripheral Venous Catheters : A Structured Observational Study
- 2008
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Ingår i: Worldviews on Evidence-Based Nursing. - : Blackwell. - 1545-102X .- 1741-6787. ; 5:3, s. 148-159
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Tidskriftsartikel (refereegranskat)abstract
- peripheral catheterization is a common procedure, which affects numerous patients in health care today. having peripheral venous catheters in situ might lead to complications such as thrombophlebitis and sepsis, and clinical guidelines have been developed to assist nurses in their decisionmaking. Several reasons are given for clinicians not always adhering to clinical guidelines, although such adherence might lead to fewer complications. This papaer aims to describe registered nurses´adherence to national and local guidelines on peripheral venous catheters by focusing on time in situ, site, size, and documentation at the dressing. An additional aim is to describe the thrombophlebitis frequency associated with peripheral venous catheters in situ. Structured observational study of patients with peripheral venous catheters in situ, conducted from December 2004 to June 2005. data of 343 peripheral venous catheters were analyzed. Nurses partly adhered to national and local guidelines concerning size and site. Guideline adherence concerning documentation at the dressing was low. The results showed that non-adherence pertaining to time in situ varied between 5% and 26.3%. Differences between adherence to national or local guidelines were shown for size, site, and documentation at the dressing. Mild thrombophlebitis (Grades 1 and 2) was observed in 7.0%. Nurses partly adhered to clinical guidelines. Differences in guideline adherence were observed for wards with local or national guigelines, as well as for wards with different specialities. In accordance with clinical guidelines, the nurses seemed to replace or remove peripheral venous catheters before any severe complications arose. Adherence to clinical guidelines has an impact for preventing patient complications and thus it is essential that nurses are aware of their existence. Feedback and discussions of guideline adherence or of complication rates might influence nurses´clinical decision-making.
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| 9. |
- Nilsson Kajermo, Kerstin, et al.
(författare)
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Swedish Translation, Adaptation and Psychometric Evaluation of the Context Assessment Index (CAI)
- 2013
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Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley-Blackwell. - 1545-102X .- 1741-6787. ; 10:1, s. 41-50
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The strength of and relationship between the fundamental elements context, evidence and facilitation of the PARIHS framework are proposed to be key for successful implementation of evidence into healthcare practice. A better understanding of the presence and strength of contextual factors is assumed to enhance the opportunities of adequately developing an implementation strategy for a specific setting. A tool for assessing context-The Context Assessment Index (CAI)-was developed and published 2009. A Swedish version of the instrument was developed and evaluated among registered nurses. This work forms the focus of this paper. PURPOSE: The purpose of this study was to translate the CAI into Swedish, adapt the instrument for use in Swedish healthcare practice and assess its psychometric properties. METHODS: The instrument was translated and back-translated to English. The feasibility of items and response scales were evaluated through think aloud interviews with clinically active nurses. Psychometric properties were evaluated in a sample of registered nurses (n = 373) working in a variety of healthcare organisations in the Stockholm area. Item and factor analyses and Cronbach's alpha were computed to evaluate internal structure and internal consistency. RESULT: Sixteen items were modified based on the think aloud interviews and to adapt the instrument for use in acute care. A ceiling effect was observed for many items and the originally identified 37 item five-factor model was not confirmed. Item analyses showed an overlap between factors and indicated a one-dimensional scale. DISCUSSION: The Swedish version of the CAI has a wider application than the original instrument. This might have contributed to the differences in factor structure. Different opportunities for further development of the scale are discussed. CONCLUSIONS: Further evaluation of the psychometric properties of the CAI is required.
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| 10. |
- Scott, Shannon D, et al.
(författare)
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Mapping the knowledge utilization field in nursing from 1945 to 2004 : a bibliometric analysis
- 2010
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Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley. - 1545-102X .- 1741-6787. ; 7:4, s. 226-37
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The field of knowledge utilization has been hampered by several issues including: the synonymous use of multiple terms with little attempt at definition precision; an overexamination of knowledge utilization as product, rather than a process; and a lack of progress to cross disciplinary boundaries to advance knowledge development. In order to address the challenges and current knowledge gaps in the knowledge utilization field in nursing, a comprehensive picture of the current state of the field is required.METHODS: Bibliometric analyses were used to map knowledge utilization literature in nursing as an international field of study, and to identify the structure of its scientific community.FINDINGS: Analyses of bibliographic data for 433 articles from the period 1945-2004 demonstrated three trends: (1) there has been significant recent growth and interest in this field, (2) the structure of the scientific knowledge utilization community is evolving, and (3) the Web of Science does not index the majority of journals where this literature is published.CONCLUSIONS: In order to enhance the accessibility and profile of this literature, and nursing's scientific literature at large, we encourage the International Academy of Nursing Editors to work collaboratively to increase the number of journals indexed in the Web of Science.
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