Melnyk Bernadette Mazurek, Bullock Tracey, McGrath Jacqueline, Jacobson Diana, Kelly Stephanie, Baba Lisa
Arizona State University College of Nursing & Healthcare Innovation, Phoenix Children's Hospital, Phoenix, Arizona 85004, USA.
J Perinat Neonatal Nurs. 2010 Jan-Mar;24(1):74-80. doi: 10.1097/JPN.0b013e3181ce314b.
Many interventions that have been supported as efficacious through research never make it to clinical practice to improve care and patient outcomes. Therefore, the purposes of this dissemination-implementation study were to determine (a) the impact of translating the evidence-based Creating Opportunities for Personal Empowerment (COPE) program for parents of premature infants into clinical practice on nurses' EBP (evidence-based practice) beliefs and implementation; (b) the best strategy for disseminating COPE into the neonatal intensive care unit (NICU), including evaluating the use of a COPE EBP mentor; and (c) barriers and facilitators to successful implementation of the COPE program.
The subjects for this study were 81 (45%) out of 180 nurses from a 55-bed NICU of a large children's hospital located in the Southwest region of the United States. The nurses completed the EBP beliefs and EBP implementation scales at baseline and 6 months after a full-day workshop on COPE and EBP and introduction of the COPE program into the unit. Evaluations from the nurses assisted in the identification of barriers and facilitators that fostered implementation of COPE in the NICU.
Nurses in the 2 pods in which COPE was being implemented reported higher EBP beliefs and greater EBP implementation than did nurses in the non-COPE pods. The EBP mentor was instrumental in routine delivery of COPE to the parents. Strategies to accelerate the translation of efficacious interventions into clinical practice and to create cultures to support evidence-based care in healthcare systems are urgently needed.
许多经研究证实有效的干预措施从未进入临床实践以改善护理及患者结局。因此,这项传播与实施研究的目的在于确定:(a) 将基于证据的“为早产儿父母创造个人赋权机会”(COPE) 项目转化为临床实践对护士循证实践 (EBP) 信念及实施的影响;(b) 将COPE传播至新生儿重症监护病房 (NICU) 的最佳策略,包括评估使用COPE循证实践导师的情况;以及 (c) COPE项目成功实施的障碍与促进因素。
本研究的对象是美国西南部一家大型儿童医院55张床位的NICU的180名护士中的81名(45%)。护士们在基线时以及在参加关于COPE和循证实践的全天研讨会并将COPE项目引入该科室6个月后,完成了循证实践信念和循证实践实施量表。护士们的评估有助于确定在NICU中促进COPE实施的障碍与促进因素。
正在实施COPE的两个病区的护士报告的循证实践信念更高,循证实践实施情况也比未实施COPE的病区的护士更好。循证实践导师在向家长常规提供COPE方面发挥了作用。迫切需要加快将有效干预措施转化为临床实践的策略,并在医疗保健系统中营造支持循证护理的文化。