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群组学习、个体和群组对循证实践的内化以及护士对实践的维持之间的关系:一项横断面研究。

Relationship among group learning, individuals' and groups' internalization of evidence-based practice, and nurses' sustainment of the practice: a cross-sectional study.

机构信息

Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Nursing Department, The University of Tokyo Hospital, Tokyo, Japan.

出版信息

J Health Organ Manag. 2024 Jul 16;38(5):705-723. doi: 10.1108/JHOM-04-2023-0096.

DOI:10.1108/JHOM-04-2023-0096
PMID:39008091
Abstract

PURPOSE

This study, by applying the feedback process of the organizational learning model, examined the relationships among group learning, individuals' and groups' internalization of institutionalized evidence-based practice (I-EBP), and nurses' sustainment of I-EBP.

DESIGN/METHODOLOGY/APPROACH: Twelve hospitals were included in this cross-sectional study, with 1,741 nurses from 59 wards. Anonymous questionnaires were administered from October to December 2021. Participants self-reported their wards' group learning, internalization of I-EBP, sustainment of I-EBP, EBP beliefs, intra-hospital transfers, and nursing research experiences. The number of nurses and I-EBP introduction length and type of I-EBP were assessed. Internalization of I-EBP of nurses and groups was considered the mediating variable, while group learning and nurses' sustainment of I-EBP were the independent and dependent variables, respectively. Significant variables in bivariate analyses were used as control variables. Multi-level Mediation Analysis and a significance test of indirect effect using the bootstrap method were conducted.

FINDINGS

Responses from 360 nurses in 48 wards from 12 hospitals were analyzed. Groups' internalization of I-EBP significantly mediated the relationship between group learning and nurses' sustainment of I-EBP. In contrast, no significant mediating effect of nurses' internalization of I-EBP was observed.

ORIGINALITY/VALUE: In the feedback process of organizational learning, group learning and its subsequent effects on individuals and groups have not been previously examined. Regardless of the nurses' degree of internalization of I-EBP, those who belong to the ward with a high degree of internalization of I-EBP are more likely to sustain it. Conducting group learning may prevent superficial practice, resulting in its sustainability.

摘要

目的

本研究应用组织学习模型的反馈过程,考察了群体学习、个体和群体对制度化循证实践(I-EBP)的内化以及护士对 I-EBP 的持续应用之间的关系。

设计/方法/方法:本横断面研究纳入了 12 家医院,共有 59 个病房的 1741 名护士。2021 年 10 月至 12 月期间,采用匿名问卷进行调查。参与者自我报告其所在病房的群体学习、I-EBP 的内化、I-EBP 的持续应用、EBP 信念、院内转科和护理研究经验。评估了护士人数和 I-EBP 的引入时间以及 I-EBP 的类型。护士和群体对 I-EBP 的内化被视为中介变量,而群体学习和护士对 I-EBP 的持续应用分别为自变量和因变量。将二变量分析中的显著变量作为控制变量。进行了多层次中介分析和使用 bootstrap 方法的间接效应显著性检验。

结果

对来自 12 家医院 48 个病房的 360 名护士的回复进行了分析。群体对 I-EBP 的内化显著中介了群体学习与护士对 I-EBP 的持续应用之间的关系。相比之下,护士对 I-EBP 的内化没有表现出显著的中介效应。

原创性/价值:在组织学习的反馈过程中,群体学习及其对个体和群体的后续影响尚未得到先前的研究。无论护士对 I-EBP 的内化程度如何,那些属于高度内化 I-EBP 的病房的护士更有可能持续应用它。开展群体学习可能会防止表面化的实践,从而使其具有可持续性。

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