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EBP 教育和领导者技能培养:一项 RCT 研究,旨在促进综合癌症中心的 EBP 基础设施、流程和实施。

EBP education and skills building for leaders: An RCT to promote EBP infrastructure, process and implementation in a comprehensive cancer center.

机构信息

Helene Fuld Health Trust National Institute for EBP, Columbus, Ohio, USA.

Implementation/Translation Science Core, Helene Fuld Health Trust National Institute for EBP, Columbus, Ohio, USA.

出版信息

Worldviews Evid Based Nurs. 2022 Oct;19(5):359-371. doi: 10.1111/wvn.12600. Epub 2022 Aug 3.

Abstract

BACKGROUND

Implementation of evidence-based practice (EBP) in healthcare remains challenging. The influence of leadership has been recognized. However, few randomized trials have tested effects of an educational and skills building intervention for leaders in clinical settings.

AIMS

Test effects of an EBP leadership immersion intervention on EBP attributes over time among two cohorts of leaders at a national comprehensive cancer center.

METHODS

A stratified, randomized, wait-list group, controlled design was conducted. Participants received the evidence-based intervention one year apart (2020, n = 36; 2021, n = 30) with EBP knowledge, beliefs, competencies, implementation self-efficacy, implementation behaviors, and organizational readiness measured at pre- and post-intervention, and one- and two-year follow-ups. Participants applied learnings to a specific clinical or organization priority topic.

RESULTS

Baseline outcomes variables and demographics did not differ between cohorts except for age and years of experience. Both cohorts demonstrated significant changes in EBP attributes (except organizational readiness) post-intervention. Mixed linear modeling revealed group by time effects at 3-months for all EBP attributes except implementation behaviors and organizational readiness after the first intervention, favoring cohort 2020, with retained effects for EBP beliefs and competencies at one year. Following Cohort 2021 intervention, at 12-weeks post-intervention, implementation behaviors were significantly higher for cohort 2021.

LINKING EVIDENCE TO ACTION

An intensive EBP intervention can increase healthcare leaders' EBP knowledge and competencies. Aligning EBP projects with organizational priorities is strategic. Follow-up with participants to retain motivation, knowledge and competencies is essential. Future research must demonstrate effects on clinical outcomes.

摘要

背景

将循证实践(EBP)应用于医疗保健仍然具有挑战性。领导力的影响已经得到认可。然而,很少有随机试验测试过针对临床环境中领导者的教育和技能培养干预措施的效果。

目的

在一家国家综合癌症中心的两个领导群体中,随着时间的推移,测试 EBP 领导力沉浸干预对 EBP 属性的影响。

方法

采用分层、随机、等待名单组、对照设计进行。参与者在一年的时间间隔内接受基于证据的干预(2020 年,n=36;2021 年,n=30),在干预前、干预后以及一年和两年随访时测量 EBP 知识、信念、能力、实施自我效能、实施行为和组织准备情况。参与者将所学知识应用于特定的临床或组织优先事项。

结果

除了年龄和工作经验外,两个队列的基线结果变量和人口统计学特征没有差异。两个队列在干预后 EBP 属性(除组织准备外)均发生显著变化。混合线性模型显示,在第一次干预后,除实施行为和组织准备外,所有 EBP 属性在 3 个月时均具有群组和时间的影响,偏向于 2020 年队列,并且在一年时保留了 EBP 信念和能力的效果。在 2021 年队列接受干预后 12 周,实施行为显著更高。

将证据付诸行动

强化 EBP 干预可以提高医疗保健领导者的 EBP 知识和能力。使 EBP 项目与组织优先事项保持一致具有战略性。跟进参与者以保持动力、知识和能力至关重要。未来的研究必须证明对临床结果的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3872/9804542/539bdb81c513/WVN-19-359-g007.jpg

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