Ishii Keiko, Takemura Yukie, Kitamura Aya
Department of Home Health and Palliative Care Nursing, Graduate School of Health Care Sciences, Institute of Science Tokyo, Tokyo, Japan.
Nursing Department, The University of Tokyo Hospital, Tokyo, Japan.
J Nurs Manag. 2025 Mar 3;2025:6080964. doi: 10.1155/jonm/6080964. eCollection 2025.
This study is a secondary analysis aimed at verifying the relationship between organizational learning activities for evidence-based practices (EBPs) in hospital wards and nurses' internalization of those EBPs and analyzing the contextual effects. This study used data from a previous study which was conducted to develop the group organizational learning activity inventory and used the same sampling method. The participants were asked about the extent of their internalization of EBPs, the organizational learning activities in their ward, and individual and ward characteristics. This study employed two-level hierarchical linear modeling with nurses' internalization of EBPs as the objective variable, eight factors of the Group Organizational Learning Activity (GOLA) Inventory as the explanatory variable, and individual and ward characteristics as control variables. Nurses' individual scores for the eight factors of the GOLA Inventory were analyzed by centering within clusters, and the wards' mean GOLA Inventory scores were also examined. To show the effectiveness of concrete activities for the internalization of EBPs, we calculated the contextual effects of the wards' organizational learning activities on the internalization of EBPs. As in the primary analysis, a total of 422 nurses from 56 wards in 12 hospitals responded to the survey and 360 nurses from 48 departments were included in this secondary analysis. Although the mean scores of all eight factors of the GOLA Inventory (ward level) were significantly positively associated with the internalization of EBPs, the contextual effect of each factor differed. Rather than creating an EBP team, specific ward-level activities, such as those designed to ensure that the staff can understand why EBPs are implemented and encourage them to take ownership of EBPs, are necessary for nurses' internalization of EBPs. Based on the results of this research, hospital or ward managers, as well as staff involved in introducing new practices, can implement efforts to promote nurses' internalization of EBPs.
本研究是一项二次分析，旨在验证医院病房基于循证实践（EBP）的组织学习活动与护士对这些循证实践的内化之间的关系，并分析情境效应。本研究使用了之前一项研究的数据，该研究旨在开发团体组织学习活动量表，且采用了相同的抽样方法。研究询问了参与者对循证实践的内化程度、其所在病房的组织学习活动以及个人和病房特征。本研究采用二级分层线性模型，将护士对循证实践的内化作为目标变量，团体组织学习活动（GOLA）量表的八个因素作为解释变量，个人和病房特征作为控制变量。通过聚类内中心化分析了护士在GOLA量表八个因素上的个人得分，并考察了病房GOLA量表得分的均值。为了展示促进循证实践内化的具体活动的有效性，我们计算了病房组织学习活动对循证实践内化的情境效应。与初次分析一样，来自12家医院56个病房的422名护士参与了调查，本二次分析纳入了来自48个科室的360名护士。尽管GOLA量表所有八个因素（病房层面）的平均得分与循证实践的内化均呈显著正相关，但各因素的情境效应有所不同。对于护士对循证实践的内化而言，开展特定的病房层面活动，如旨在确保工作人员理解为何实施循证实践并鼓励他们对循证实践负责的活动，比组建循证实践团队更为必要。基于本研究结果，医院或病房管理人员以及参与引入新实践的工作人员可努力促进护士对循证实践的内化。
