护理人员循证护理实践基本素质构成及现况调查

目的：探讨护理人员循证护理实践基本素质构成及现状调查。方法选择24名护理专家对护理人员开展循证护理实践应具备的基本素质进行访谈,对结果进行分析,明确循证护理实践基本素质的构成。随后对重庆市4所三级甲等医院936名护理人员进行循证护理实践基本素质现况的问卷调查,了解护理人员在循证态度、循证知识、循证技能等方面的状况。结果专家访谈结果的协调系数为0．601～0．783（均P＜0．01）,变异系数均小于0．2,说明专家的意见比较集中,一致性较好。50．5％的护理人员初步具备循证护理素质,循证实践态度积极,但循证知识和循证技能两方面较弱,且不同职称、学历、年龄的护理人员之间循证护理实践基本素质的差异均具有统计学意义（P＜0．01）。结论循证护理实践基本素质包括循证态度、循证知识、循证技能;护理人员均具备积极的循证护理态度,但在循证知识和循证技能两方面较弱。护师及以上职称、本科及以上学历及30～39岁的护理人员循证护理实践基本素质较好。     

Lecturers’ and students’ perceptions of portfolios in an English School of Nursing

Aims. This study was aimed at comparing perceptions of portfolios between student nurses at the early and latter stages of their training and how they compare with their lecturers’ perceptions. Background. Portfolios are used widely in nurse education. There has been research into how portfolios are perceived and understood, but there is little evidence into how student nurses and lecturers compare quantitatively in perceptions of portfolio use. Design. Survey. Method. Forty‐eight nursing lecturers and 413 nursing students, from a multi‐centred School of Nursing in the UK, completed a questionnaire. Data were analysed with exploratory factor analysis, varimax rotation of the factor solution, internal consistency analysis, and analysis of variance. Results. Five factors were extracted, which were labelled: (1) portfolios as a means of skills acquisition, (2) other means of teaching and learning beyond using portfolios, (3) processes of showing the portfolio to others, (4) having favourable attitudes towards portfolios and (5) lecturers’ ability to share knowledge about portfolios. Scales developed from these five factors had high levels of internal consistency. Lecturers were the most positive of the three respondent groups in their views of portfolios, whereas third‐ and fourth‐year students were the least positive. There were significant differences between student nurses and their lecturers, concerning how information on portfolios is communicated by the lecturer. Conclusion. There were significant discrepancies between lecturers and student nurses in their views on how portfolios are used. The value of portfolios becomes less salient to student nurses towards the end of their training. Relevance to clinical practice. Lecturers and clinical mentors need to look at students’ perceptions and why some nursing students’ views on portfolios deteriorate. There could be regular discussions with students to see how and why the students begin to see portfolios as less useful for their education and continual professional development.     

Evidence‐based nursing: clarifying the concepts for nurses in practice

Aim. To provide a critical analysis of key concepts associated with evidence‐based nursing (EBN) to substantiate an operational definition for nurses to use in practice. Background. Despite the plethora of literature surrounding what evidence‐based nursing is and is not and how it differs from its cousins, evidence‐based medicine and evidence‐based practice, nurses still struggle to get evidence into practice. Several reasons for this have been reported, for example, a lack of understanding about what evidence‐based nursing means or time to engage with and apply the evidence into practice. Design. An in‐depth critical review and synthesis of literature was undertaken. Method. Using the key words; evidence‐based nursing, evidence‐based medicine and evidence‐based practice 496 articles were yielded. These articles were limited to 83. Using Burns and Grove’s (2001) phased approach to reviewing the literature the articles were critically reviewed and categorised into key concepts and themes. Results. The in‐depth critical review and synthesis of the literature demonstrated that evidence‐based nursing could be defined as a distinct concept. The review clearly shows that for evidence‐based nursing to occur, nurses need to be aware of what evidence‐based nursing means, what constitutes evidence, how evidence‐based nursing differs from evidence‐based medicine and evidence‐based practice and what the process is to engage with and apply the evidence. Conclusion. The in‐depth critical review and synthesis of the evidence‐based nursing literature reinforces the need to consolidate a position for nursing in the evidence‐based field. The review confirms that evidence‐based nursing can be defined and conceptualised; however, for nurses to engage and apply with the evidence‐based processes they need to be informed of what these are and how to engage with them in practice. Relevance to clinical practice. This paper examines the concept of evidence‐based nursing and its application to clinical practice.     

Research utilization and attitudes towards research among psychiatric nurses in Northern Ireland

Evidence-based practice depends on a number of factors including practitioners' attitudes towards, and knowledge of, research, the availability and access to relevant research, adequate resources and managers' support. Yet little is known about these issues with regard to psychiatric nurses. The aim of this study was to survey psychiatric nurses on their attitudes to research, their perceptions of their use of research and other research-related activities. This paper reports data collected from a convenience sample of 236 nurses from the six main psychiatric hospitals and from the psychiatric wards of six general hospitals. The results show that, while they report positive attitudes towards research, their perception of their use of research in practice indicates that evidence-based practice is far from being realized. There is also some evidence to suggest that psychiatric nurses' reported extent of research utilization and frequency of reading research literature in this study are lower than those of general nurses. The implications of these and other findings are discussed.     

Bridging the research–practice gap: exploring the research cultures of practitioners and managers

To ensure effective utilization of research in nursing more evidence is needed which illuminates the way nurses think about research, the value which they put on it, and how they envisage that it may help or hinder them in their everyday work. This English study aimed to meet these objectives by describing the research culture of practising nurses, health visitors and midwives, and their managers. It rests on two assumptions. Firstly that the reasons why practitioners do, or do not, base their practice on research are complex, and secondly, that interventions to increase research utilization must be grounded in an appreciation of this complex 'whole'. Thus the study took a qualitative approach to exploring: what participants thought and felt about research; the current status of research based practice; and the opportunities and constraints to increasing research based practice. The results confirm the hypothesis that many factors, both individual and organizational affect research utilization. Furthermore, practitioners and managers hold differing perceptions regarding the nature of research, its role, and the opportunities and constraints which effect its dissemination and utilization. The implications of the results for education, policy and practice are discussed.     

浙江省临床护士循证素质及影响因素的现状分析

目的了解浙江省临床护士的循证素质及其影响因素,为临床实施循证护理干预提供可靠的理论依据。方法采用临床护士循证基本素质调查表及中文版循证护理实践障碍量表,以分层整群抽样法选择浙江全省11个行政区22所医院的831名临床护士进行横断面调查。结果62．2％的临床护士循证素质得分处于稍差等级,5．2％处于很差等级;45．5％的临床护士循证护理实践障碍得分等级为中度影响,24．3％的为重度影响,在循证护理实践中存在障碍。临床护士循证素质的独立影响因素是护士的职称、职务和循证实践障碍得分（P〈0．05）,职称和职务越高、循证实践障碍得分越低的护士,循证素质越好。结论浙江省临床护士整体的循证素质有待提高,医院应提供组织保障,采取精英式培训和分层培训相结合的方法加强循证护理教育,完善硬件设施,促进循证护理的发展．     

上海地区循证护理教育培训内容和形式的调查

目的 探讨上海地区开展循证护理教育的培训内容和形式.方法 2008年4-6月我们采用自行设计的问卷对上海市已开展研究生教育的护理院校60名护理专业课教师进行调查,其内容包括:开设循证护理教育的教学条件、内容、重点难点、方法、学时及考核方式.结果 90%以上的护理专业课教师认为,开设循证护理课程的学院应拥有良好的图书馆资...     

大型医院临床护士实施循证护理的认知状况

目的 了解护士对实施循证护理的认知状况. 主要包括护士对实施循证护理的看法;护士对实施循证护理存在的主要障碍和困难的认知;护士对循证护理基本术语的理解程度以及她们获取临床知识的主要渠道的认知. 方法 在2014年3~5月期间,采用自制的调查表对北京一大型医院的临床护士进行调查,399名应答者完成了问卷调查. 结果 有73. 4%的护士知道循证护理,然而,熟悉和比较熟悉循证护理的仅有9. 1%;73. 6%的护士认为在护理工作中有必要开展循证护理;67. 2%的护士在护理工作中有过尝试循证护理的想法,但在临床实践中尝试过循证护理的仅有7. 6%. 为一半护士所认知的实施循证护理的障碍是工作太忙,没有时间、缺乏检索和理解研究资料和报告方面的知识以及学习和培训的机会太少. 只有少数人能够理解循证护理术语并且可以解释给他人. 护士获取临床知识主要渠道是教科书、网络和学术会议. 结论 尽管临床护士对实施循证护理持积极态度,然而,循证护理认知和实施循证护理实践的水平较低,阻止循证护理实施的主要认知障碍是缺乏时间,缺乏检索和理解研究资料和报告方面的知识以及学习和培训机会少. 此外,临床护士循证护理基础知识十分欠缺. 结果提示医院管理者需要构建和采取综合性的策略措施,通过合理安排时间以及适当的教育培训来增强临床护士循证护理的认知和知识技能.     

Nurses' perceptions of health beliefs and impact on teaching and practice: a Q‐sort study

Aim

To understand Chinese nurses’ perceptions of health beliefs, their content, origin and the influence of sociocultural factors, as a basis of their evidence‐based practice. This study contributes to a larger study to establish the health beliefs of Japanese, Australian, Chinese, South Korean and Thai nurses.

Background

Registered nurses teach patients and students about maintaining or attaining health are subject to the same range of influences and their health beliefs may be antithetical to current health evidence.

Methods

Q‐method design using q‐sort and interview was used to explore the perspectives on a range of health beliefs of 60 nurses in four cities in China.

Findings

Three factors arose from the perceptions of the participants about health and accounted for 50.2% of the total variance: (1) social impact, (2) ‘the importance of evidence’, and (3) beliefs rooted in culture.

Discussion

Influence on nurses’ health beliefs was explored in terms of the internalized and frequently unconscious beliefs, values and norms tying them to their communities, reflecting the need for nurses to be aware of their health beliefs and behaviours.

Conclusions

Education for nurses in practice needs to acknowledge that individual practitioners’ beliefs strongly influence health teaching for patients and families. In order to implement evidenced‐based practice and teach in line with current evidence nurses need to critically examine and reflect on the impact of culture, society and the media on their own health beliefs.

Implications for nursing policy and health policy

Education policy needs to consider that culture and societal pressures affect nurses’ health beliefs and practice. Critical thinking, reflective and evidence‐based practice need to be emphasized in clinical training and nurse education. China also needs to develop policies to allow nurses to be able to assess the reliability of health information on the Internet and to make quality health research more available.     

The attitudes of casualty nurses in Taiwan to patients who have attempted suicide

Aims and objectives. The aims of this study were to investigate a sample group of casualty nurses’ attitudes towards patients who have attempted suicide in the middle of Taiwan and to identify factors contributing to their attitudes towards attempted suicide. Design. A quantitative study using a questionnaire containing 22 statements with a five‐point Likert‐type scale was developed from the Domino's Suicide Opinion Questionnaire, and from a comprehensive analysis of research literature on the area of attitudes towards suicide. Methods. The questionnaire was distributed to casualty nurses (n = 155) to investigate their attitudes toward patients who have attempted suicide. Seven large hospitals in the middle of Taiwan were targeted. Results. This sample group of casualty nurses from the middle of Taiwan held positive attitudes toward patients who have attempted suicide. In addition, three statistically significant differences were identified: (i) The higher the level of nursing education the more positive the nurses’ attitudes towards patients who had attempted suicide. (ii) The casualty nurses who did not have a religion held more positive attitudes towards suicidal behaviour than those who followed a religion. (3) Casualty nurses who had suicide care experience with 1–10 patients had more positive attitudes towards suicidal patients than nurses who had nursed above 10 patients who had attempted suicide. Conclusions. The results indicated that casualty nurses in Taiwan require further education on and training in all aspects of suicide to foster more positive attitudes towards patients who attempt suicide. Relevance to clinical practice. The role of casualty nurses is pivotal to the front‐line care of people who are suicidal and their attitudes play a major part in the provision of effective care.     

Association between nurses' education about research and their research use

Knowledge about research methods, skills for critical appraisal of research reports, and a positive attitude towards research have been identified as means to potentially overcome barriers to individual nurses’ research utilization, and ultimately improve nursing practice. The objective of this study was to examine independent relationships between nurses’ education about research and research use and their attitudes towards research, knowledge about research and research utilization. Research utilization and attitude towards research were measured using the Edmonton Research Orientation Scale. One hundred and seventy-five nurses working in a pediatric hospital responded to the survey. Higher levels of education were associated with both (1) positive attitudes towards research and (2) higher levels of self-reported research utilization. Whether or not nurses had university education, completing a course about research design or a course about how to read and use research was associated with positive attitudes towards research. Having completed a course about how to read and use research was not associated with self-reported research utilization. The association between having completed a course about research design and self-reported research utilization was not independent of the association between level of education and research utilization. The findings indicate that education about research may be one way to overcome negative attitudes towards research as a barrier to research utilization.     

Nurses' leaving intentions: antecedents and mediating factors

Title. Nurses’ leaving intentions: antecedents and mediating factors. Aim. This paper is a report of a study to investigate how nurses’ work values, perceptions of environmental characteristics, and organizational commitment are related to their leaving intentions. Background. Nurse leaving is a serious international problem as it contributes to the nursing shortage that threatens the welfare of society. The characteristics of nurses, the work environment and nurses’ feelings towards their jobs (or organizations) have an impact on their leaving intentions. Method. A convenience sample of 849 Registered Nurses was recruited from three public hospitals in the central‐west region of Japan during 2006 and 319 completed questionnaires were returned (response rate 39%). Data were analysed using regression analysis. Findings. Nurses’ work values and their perceptions of their workplace environment interacted to influence leaving intentions. When there was a match between the importance nurses placed on being able to challenge current clinical practices and the number of the actual opportunities to do so, leaving intentions were low. When there was a mismatch, intention to quit the job became stronger. In addition, organizational commitment intervened between nurses’ perceptions of the match in clinical challenges and leaving intention. Conclusion. Nurses’ leaving intentions, deserve extensive exploration of their causes. Such exploration should include attending to both nurses’ needs and organizational characteristics, investigating how the match between them could affect nurses’ leaving intention, and exploring factors that intervene between nurses’ perceptions of the match and leaving intention.     

Portuguese nurses' knowledge of and attitudes toward hospitalized older adults

Portugal is impacted by the rapid growth of the aging population, which has significant implications for its health care system. However, nurses have received little education focusing on the unique and complex care needs of older adults. This gap in the nurses′ education has an enormous impact in their knowledge and attitudes and affects the quality of nursing care provided to older adults. A cross‐sectional study was conducted among 1068 Portuguese nurses in five hospitals (northern and central region) with the following purposes: (i) explore the knowledge and attitudes of nurses about four common geriatric syndromes (pressure ulcer, incontinence, restraint use and sleep disturbance) in Portuguese hospitals; and (ii) evaluate the influence of demographic, professional and nurses' perception about hospital educational support, geriatric knowledge, and burden of caring for older adults upon geriatric nursing knowledge and attitudes. The mean knowledge and attitudes scores were 0.41 ± 0.15 and 0.40 ± 0.21, respectively (the maximum score was 1). Knowledge of nurses in Portuguese hospitals about the four geriatric syndromes (pressure ulcers, sleep disturbance, urinary incontinence and restraint use) was found inadequate. The nurses' attitudes towards caring for hospitalized older adults were generally negative. Nurses who work in academic hospitals demonstrated significantly more knowledge than nurses in hospital centers. The attitudes of nurses were significantly associated with the hospital and unit type, region, hospital educational support, staff knowledge, and perceived burden of caring for older adults. The study findings support the need for improving nurses' knowledge and attitudes towards hospitalized older adults and implementing evidence‐based guidelines in their practice.     

A situational analysis: the potential to produce evidence‐based nursing practice guidelines within a regional neonatal intensive care unit

Aims This paper describes a study which was undertaken to determine the factors which may influence the production of nursing practice guideline (NPG) documents. The aim was to examine the factors which impact on the ability to successfully produce evidence based nursing practice guidelines within a regional neonatal intensive care unit (NICU), in order to develop strategies to assist in the success of such a project. Background Recent government recommendations have highlighted the increasing importance of quality in practice. Supporting infrastructures may not be in place within Trusts and specialist areas to allow for nurses in clinical practice to produce evidence‐based guideline documents, in response to these recommendations. Method A situational analysis was utilized, via the application of documentary evidence and semi‐structured interviews, to support and give meaning to the construction of a clearer understanding of the project, with the primary focus being from the perspective of the nurses completing the documents. Findings Provision of appropriate resources in terms of time, staffing levels and facilities impact heavily on the ability of nurses to produce evidence‐based guidelines documents and their motivations towards doing so. The emphasis given to academic, rather than practice‐based, continuing education programmes may not always be relevant when considering ongoing development of quality of care. Conclusion Lack of appropriate resource allocation has meant that a gap exists between the ideals set out by the recent introduction of NHS quality initiatives and the reality facing nursing staff attempting to put those strategies into practice.     

Introduction of assistive devices: home nurses' practices and beliefs

AIMS: This paper reports a study describing home nurses' intention and current practices regarding introducing assistive devices, and investigating whether their practice is related to social cognitive factors (attitudes, subjective norms and self-efficacy). BACKGROUND: Home nurses not only care for patients in particular medical domains, but also educate and guide them towards more independence. Patients with age-related disabilities in mobility and self-care might benefit from the use of assistive devices. A home nurse might be the first and only person to discuss the disability and use of an assistive device. Therefore, home nurses' beliefs about the introduction of assistive devices could affect their daily practices. METHODS: A cross-sectional study was conducted with a convenience sample of 64 home nurses chosen from a random sample of home nursing departments. The home nurses completed a self-administered questionnaire. The Theory of Planned Behaviour framework was used to develop the social cognitive measures regarding each of the six steps distinguished in the introduction of assistive devices. RESULTS: Home nurses had positive attitudes and high levels of intention, subjective norm and self-efficacy towards most steps of the decision process to introduce assistive devices. In a multiple linear regression analysis, attitude and self-efficacy predicted intention to introduce assistive devices to older clients with disabilities. Intention was correlated to home nurses' current practices. CONCLUSIONS: The findings suggest that conditions are present to involve home nurses more explicitly in the introduction of assistive devices to their patients. Social cognitive factors should be taken into account when developing interventions that aim to support home nurses to do this.     

Attitudes of nursing students towards caring for people with HIV/AIDS: thematic literature review

Title.  Attitudes of nursing students towards caring for people with HIV/AIDS: thematic literature review.
Aim. This paper is a report of a literature review conducted to examine current research studies into attitudes of nursing students towards caring for people with HIV/AIDS and to identify factors that influenced those attitudes to inform current nursing practice and to develop nursing education regarding care provided to people with HIV/AIDS.
Background. Attitudes of nurses towards people living with HIV/AIDS have long been scrutinized. Studies show that some nurses have negative attitudes and are reluctant to provide care to people with HIV/AIDS, resulting in poorer quality nursing support being provided. Attitudes of nursing students towards caring for people with HIV/AIDS is thus of vital importance since they become the future practising nurses.
Data sources.  Eight electronic data bases were searched from 1996–2008.
Review methods.  Criteria used for study selection were: attitudes of nursing students towards caring for people with HIV/AIDS, primary research studies, published in English language in peer reviewed journals from 1996 to June 2008. Sixteen studies were identified for inclusion in this thematic review.
Results.  The following themes were identified: education and knowledge of HIV/AIDS; fear of contracting HIV/AIDS; reluctance to care for people with HIV/AIDS; homophobia; and stigma associated with HIV/AIDS.
Conclusion. There is reluctance on the part of some nursing students in specific regions of the world to provide care for people with HIV/AIDS. Educational programmes based on research evidence must play a leading role in developing strategies to help nursing students understand and overcome such attitudes.