School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Departments of Family Medicine and Community Health and Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Worldviews Evid Based Nurs. 2024 Apr;21(2):128-136. doi: 10.1111/wvn.12708. Epub 2024 Mar 15.
Nurses play a critical role in providing evidence-based, high-quality care to optimize patient outcomes. Models from implementation science suggest social networks may influence the adoption of evidence-based practices (EBPs). However, few studies have examined this relationship among hospital nurses. Social network analysis (SNA) mathematically evaluates patterns of communication, a critical step in implementation. Exploring hospital nurses' communication networks may provide insight into influences on the adoption of EBPs.
This study aimed to describe complete communication networks of hospital nurses for practice changes on inpatient units, including upper level nursing administrators.
This descriptive, exploratory, cross-sectional study used SNA on two inpatient units from one hospital. A sociometric survey was completed by nurses (unit to executive level) regarding communication frequency about practice changes. Network-level density, diameter, average path length, centralization, and arc reciprocity were measured. Attribute data were used to explore subnetworks.
Surveys from 148 nurses on two inpatient adult intensive care units (response rates 90% and 98%) revealed high communication frequency. Network measures were similar across the two units and among subnetworks. Analysis identified central (charge nurses and nurse leaders) and peripheral members of the network (new-to-practice nurses). Subnetworks aligned with the weekend and shift worked.
Established communication channels, including subnetworks and opinion leaders, should be used to maximize and optimize implementation strategies and facilitate the uptake of EBPs. Future work should employ SNA to measure the impact of communication networks on promoting the uptake of EBP and to improve patient outcomes.
护士在提供基于证据的高质量护理方面发挥着关键作用，以优化患者的治疗效果。实施科学的模型表明，社会网络可能会影响基于证据的实践（EBP）的采用。然而，很少有研究探讨过医院护士之间的这种关系。社会网络分析（SNA）从数学角度评估了沟通模式，这是实施的关键步骤。探索医院护士的沟通网络可以深入了解对 EBP 采用的影响。
本研究旨在描述住院部护士的完整沟通网络，包括高级护理管理人员，以进行病房的实践改变。
这是一项描述性、探索性、横断面研究，在一家医院的两个住院病房中使用 SNA。对护士（从病房到行政级别）进行了关于实践改变的沟通频率的社会计量调查。测量了网络级别的密度、直径、平均路径长度、集中化和弧互惠性。属性数据用于探索子网。
对两个成人重症监护病房的 148 名护士进行的调查（回应率为 90%和 98%）显示出了很高的沟通频率。两个病房之间以及子网之间的网络测量结果相似。分析确定了网络的中心成员（护士长和护士领导者）和边缘成员（新实践护士）。子网与周末和轮班工作相对应。
应利用既定的沟通渠道，包括子网和意见领袖，以最大限度地提高和优化实施策略，并促进 EBP 的采用。未来的工作应该使用 SNA 来衡量沟通网络对促进 EBP 采用的影响，并改善患者的治疗效果。
