German hospital nurses` attitudes concerning evidence

Transcription

Sektion für Forschung und Lehre in der Pflege
German hospital nurses‘ attitudes
concerning evidence-based
nursing practice
Anja Behncke, Katrin Balzer, Sascha Köpke
Evidence-based practice (EBP)
• Claim for EBP
•
•
•
•
best research evidence
patient values
clinical expertise
resources
• Basis for implementation of EBP
• use of effective nursing interventions in practice („research
utilization“ RU)
• Identification and elimination of potential barriers
• e.g. nurses‘ attitudes and skills
Anja Behncke
22.03.2013
Attitudes concerning EBP and RU
• Squires et al. (2011)
• Systematic Review: 108 publications concerning 60 instruments
• High level of evidence-based practice
• Nurses‘ attitudes concerning research important requirement for
RU
• Germany / Austria: Schnittger et al. (2012) / Breimaier et
al. (2011)
• Small regional surveys
• Indicating negative attitudes concerning EBP and RU
Anja Behncke
22.03.2013
Nursing training in Germany
• Currently mostly 3-year vocational training
• Research council (2012) and science council (2012)
• Need for scientific education for nurses
• Academic nursing training necessary to maintain suitable care (i.e.
EBP)
• Own motivation
• Obvious need for adequately trained nurses in direct patient care at
our University hospital (UKSH)
• Currently planning of a Bachelor-programme for „Advanced Nurse
Practitioners“
Anja Behncke
22.03.2013
Aim of the study
To assess
• nurses‘ attitudes concerning EBP and RU
• nurses’ evaluation of different prerequisites for EBP
• current status of implementation of EBP
• nurses‘ attitudes concerning academic training
• prerequisites to start academic nursing training
Anja Behncke
22.03.2013
Methods
Multi-centre survey in Northern Germany
• Literature review
• Questionnaire development
• Items or subscales of validated instruments (EROS instrument,
Parahoo instrument, Estabrooks instrument)
• Own items
• Pretest
• 4 experts (cognitive interviews)
• 2 wards with 21 participants (feasibility)
Anja Behncke
22.03.2013
Methods
• Aim: 20 hospitals with approx. 80 wards
• Hospitals were randomly selected from hospital
directories, stratified according to number of hospital beds
and federal state
• Wards were selected by hospitals managers
• Participants: Nurses and trainees who were on duty during
a predefined week
Anja Behncke
22.03.2013
Results: Response
• 21 participating hospitals (of 37 invited)
• 92 wards
• 1,384 nurses
 response 1,023 questionnaires (74%)
Anja Behncke
22.03.2013
Demographic data (n=1.023)
Age (mean years±SD)
39.3±11.5
Registered since (mean years±SD)
16.4±11.3
Advanced training (n)
335 (33.5%)
Education level
9 years education
31 (3.1%)
10 years education
649 (64.7%)
12 years education
119 (11.6%)
13 years education
204 (20.3%)
Anja Behncke
22.03.2013
Sources of knowledge (Estabrook instrument)
The knowledge that I use in my practice is based on …
91,4
personal experience
7,9
0,7
84
information about each patient/client
13,2
2,8
the information my fellow nurses share
77,8
20,5
1,7
16,8
30,5
articles published in nursing research journals
52,8
13,3
33,2
information I get from the media
53,5
13,1
30
articles published in medical journals
frequently/always
sometimes
56,9
0
10
rarely/never
Anja Behncke
20
30
40
50
60
22.03.2013
70
80
90
100 %
Research utilization (Parahoo instrument)
Have you used current research in your practice during the last two years?
100
n=1.023
90
Breimaier et al. 2011
80
70
100
60
90
50
45.7
80
70
40
29.4
30
24.9
20
60
50
40
10
30
0
%
n=974
86.8
yes
no
I don't know
20
13.2
10
0
%
Anja Behncke
n/a
yes
no
22.03.2013
I don't know
Attitudes concerning EBP
(EROS instrument: subscale ‘being on the leading edge’)
94.5
New ideas about clinical practice are exciting.
2.1
3.4
85.8
Keeping up with new information is an important part of my job.
8.1
6.2
85.6
I like to incorporate new ways of doing things into my clinical practice.
7.3
7.1
69.5
I am capable of developing new or revised treatments which will help clients.
13.6
17
69.2
I am looking for new information to help with my work
23.4
7.4
34.9
I am willing to use own money to attend a conference that interests me
0
rather valid/definitely valid
rather not valid/definitely not valid
Anja Behncke
52.6
12.5
20
40
I don't know
22.03.2013
60
80
100 %
Requirements for EBP (own items): What do you need to establish EBP?
nurses superior support
4.7
Nursing examination
4.6
advanced training to research
4.5
support by colleaques
4.4
support by medical colleaques
4.3
accesss to literature database
4.2
access to online-plattform with current scientific findings in nursing science
4.2
proportionate exemption for implementation of research findings
4.1
offer on EbN-courses
4
proportionate exemption to search for current research findings
3.9
regular meetings in journal clubs
3.8
long-time professional experiences
3.5
good command of English
1=irrelevant to 5=relevant (Mean±SD)
3.4
1
Anja Behncke
1.5
2
2.5
22.03.2013
3
3.5
4
4.5
5
Value and implementation of research (Parahoo instrument)
Research often leads to real practical advances in nursing care.
3,7
Nursing should become a research-based profession
3,5
Research is no relevant to the real day-to-day work in nursing.
3,5
Nursing superiors support the implementation and use of research results into
practice.
3,4
Nurses rarely use research findings in practice.
3,2
Nurses are too busy delivering care to spend time reading professional journals.
3,2
Nurses are too busy delivering care to incorporate research findings.
3,2
Most nurses are informed about research results.
2,3
Research is no relevant to the real day-to-day work in nursing.
2,3
Nursing is only relevant to nursing education, not to nursing practice.
1=is definitely not valid to 5=is definitely valid
2
1
1=definitely not valid to 5=definitely valid (mean±SD)
Anja Behncke
1,5
2
2,5
22.03.2013
3
3,5
4
4,5
5
Academic nursing training (own item)
I consider it important that it is now possible in Germany to achieve a bachelor of
nursing degree together with a nursing certificate.
100
90
80
70
58.3%
60
50
40
30,9
30
23,4
20
10
27,4
13,2
5
0
%
definitely not rather not valid
valid
Anja Behncke
I don't know
rather valid
22.03.2013
definitely valid
Are you planning to start an academic nursing course during the next two years?
(own item)
100
90
80
70
60
60
50
45
37
40
31
29
30
10
21
19
20
5
6
27
15
5
0
%
no (study completed/ongoing)
no, is out of question
≤ 39 years (n=494)
Anja Behncke
I don't know
> 39 years (n=484)
yes
total
22.03.2013
Conclusion
• Representative survey of nurses‘ attitudes in Northern
Germany
• Research is considered important for nursing practice
• Discrepancy between readiness and implementation
• Skills and knowledge limited
• Academic programmes are rated important
• 20% are planning to start academic courses (27% in
younger participants)
• Nursing education and training should focus on EBP by
combining research and practical expertise
Anja Behncke
22.03.2013
Thank you very much for your attention!
Anja Behncke
22.03.2013

German hospital nurses` attitudes concerning evidence

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