Hospital Son Llàtzer, 07198 Palma, Balearic Islands, Spain.
Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma, Balearic Islands, Spain.
Int J Environ Res Public Health. 2020 May 16;17(10):3473. doi: 10.3390/ijerph17103473.
Evidence-based practice (EBP) combined with quality of care improves patient outcomes. However, there are still difficulties for its implementation in daily clinical practice. This project aims to evaluate the impact of the incorporation of the Advanced Practice Nurse (APN) role on the implementation of EBP at three levels: context, nurses' perceptions, and clinical outcomes. Mixed-methods study in two phases is proposed. Phase 1: a quasi-experimental design where five APNs are included in five hospitalization wards that are compared with another five similar wards without APNs. Variables from Practice-Environment-Scale-Nursing-Work-Index, Health-Science-Evidence-Based-Practice-Questionnaire, and Advanced-Practice-Nursing-Competency-Assessment-Instrument are used. Clinical outcomes are followed-up with monthly. A descriptive and exploratory analysis is performed. Phase 2: an exploratory qualitative design through focus groups at the intervention wards after one year of APNs implementation. Explicative data are gathered to explain the progression of change and how actors perceive and attribute triggers, barriers, and facilitators for change. An inductive thematic analysis is performed. The inclusion of APN in hospitalization context is insufficiently studied. It is hoped that these figures provide solutions to the multiple barriers in the development of EBP in these sceneries and contribute to resolve the gap between research results and healthcare practice.
循证实践（EBP）与医疗质量的结合可以改善患者的预后。然而，在日常临床实践中，EBP 的实施仍然存在困难。本项目旨在评估将高级实践护士（APN）角色纳入三个层面（背景、护士认知和临床结果）对 EBP 实施的影响。提出了一个两阶段的混合方法研究。第一阶段：准实验设计，将五名 APN 纳入五个住院病房，与另外五个没有 APN 的类似病房进行比较。使用实践环境量表-护理工作指数、健康科学循证实践问卷和高级实践护理能力评估工具中的变量。每月对临床结果进行随访。进行描述性和探索性分析。第二阶段：在 APN 实施一年后，在干预病房进行焦点小组的探索性定性设计。收集解释性数据，以解释变革的进展情况，以及参与者如何感知和归因于变革的触发因素、障碍和促进因素。进行归纳主题分析。在住院背景中纳入 APN 的研究不足。希望这些数据能够为这些场景中 EBP 发展的多种障碍提供解决方案，并有助于缩小研究结果与医疗保健实践之间的差距。
